Nephrology articles list

Globally, approximately 12% of the population is inflicted by various types of urolithiasis. Standard treatments are available to avert and treat urolithiasis, but with significant adverse side effects. Pentacyclic triterpenes represent a group of naturally occurring compounds with immense potential as treatments for kidney stones. This review aims to provide an integrative description of how pentacyclic triterpenes can effectively treat calcium oxalate urolithiasis through various antioxidant, anti-inflammatory, diuretic, and angiotensin-converting enzyme inhibition mechanisms. Some pentacylic triterpenes showing promising activities include lupeol, oleanolic acid, betulin, and taraxasterol. Moreover, future perspectives on developing pentacyclic triterpenes in formulations/drugs for urinary stone prevention are highlighted. It is anticipated that compiled information would serve as a scientific baseline to advocate further investigations on the potential of pentacyclic triterpenes in urolithiasis remediation.

Dr. Salman Ahmed

Background: Acute and chronic heart or kidney failure affect each other in cardiorenal syndromes (CRS). In CRS, hemodynamic and non-hemodynamic changes occur, causing acute or progressive renal and cardiac failures. CRS is classified into five types based on the first organ failure and causes failure of the other organ. We believe that the current CRS classification is not the correct one that effectively describes the underlying cause of CRS. Hence, we consider it better to be classified into three categories (cardiorenal, renocardiac, and cardio-reno-cardiac syndrome) and then subdivided into acute and chronic types or types 1 and 2 (respectively, according to the onset of the underlying type of failure (i.e., acute or chronic). Other subtypes that occur inthe heart and dysfunction occur simultaneously are acute cardio-reno-cardiac syndrome (type 5) and Chronic cardio-reno-cardiac syndrome (type 6). Aim: In Part 1 of the review series, the pathophysiological mechanisms and clinical and therapeutic applications of all types of CRS will be narratively discussed and updated. Furthermore, we provide a comprehensive review of diagnostic biomarkers and their clinical significance in the identification, outcome prediction, and treatment of all CRS types. Method: An extensive search of PubMed, Google, EMBASE, Scopus, and Google Scholar was conducted for review articles, original articles, and commentaries published between Jan 2010 and Aug 2024 using different phrases, texts, and keywords, such as CRS, renocardiac syndrome, and CRS. The topics included secondary CRS, CRS pathogenesis, CRS therapy, SLGT inhibitor use in CRS, novel therapy in CRS types, and prevention of CRSs. Conclusion: Renal and cardiac failure in patients with CRS seem to have different pathophysiological mechanisms. Early detection and treatment can improve the outcomes of CRS. Clinical manifestations and therapy protocols vary according to pathophysiology. Hence, new guidelines and research on universal diagnostic and treatment techniques are urgently required. Moreover, the current nomenclature for CRS is confusing; therefore, we believe that a new nomenclature system should be introduced, reducing confusion and making differentiation between CRS types easier and less confusing.

Karishma

Accurate diagnosis of the cause of acute or chronic kidney dysfunction may require a percutaneous kidney biopsy (PKB). Unfortunately, the invasive nature of the procedure can lead to potential complications that may discourage the KBs. Lack of appropriate communication skills, experienced personnel and equipment, and high procedure costs can negatively impact complication rates and the frequency of conducted KBs. This nonsystematic review assesses KB procedures, indications, contraindications, complications, post-KB monitoring time, and cost. We looked for reviews and original articles published between January 2010 and Jan 2025 on Google, Google Scholar, and PubMed. Different keywords, phrases, and sentences include PKB, renal biopsy, native PKB, ultrasound guide, CT-guided, PKB, allograft PKB, and PKB procedures. KB makes histopathological and immunohistological diagnosis possible, which are necessary for diagnosis and treatment. It is often used despite the known complications. KB and other biochemical assays have tracked transplant rejection and antirejection drugs. Automatic gun spiral needles sizes 14 and 16 capture enough samples with fewer complications than gauge sizes 18 and 20. KB cost is another issue, especially in low-income areas, and deserves additional study.

Karishma

Hemolytic uremic syndrome (HUS) is a microangiopathic thrombotic disease, which is classified into atypical, typical, and secondary types. Thrombocytopenia, acute kidney failure, and hemolysis are the main features of HUS regardless of its type. Infection with Shiga toxin-producing Escherichia coli causes typical HUS, and gene mutations trigger atypical HUS, while secondary HUS is associated with bone marrow transplantation, autoimmunity, cancer, and other diseases. New insights into the pathogenesis of HUS have emerged over the past decades, suggesting an important role of the complement system in disease pathogenesis, which has been reinforced by the efficacy of plasma exchange and monoclonal antibodies in its treatment. In this review, we performed an updated review of HUS with a focus on understanding its pathogenesis.

Karishma

Patients who are on regular hemodialysis and who have advanced renal failure but have not yet started on renal replacement therapy have a high risk of tendon rupture, although this is a rare situation. We reported a case of 55-year-old male patient who had been on regular hemodialysis for the past 10 years. He presented with a sudden onset of pain and swelling in the left posterior ankle while climbing stairs. Ultrasonography revealed a complete disruption of the Achilles tendon, which was surgically repaired. His medical history was remarkable for the right Achilles tendon rupture a year ago. Investigations revealed tertiary hyperparathyroidism with chronic metabolic acidosis and high β-2 macroglobulin. With surgical repair, physiotherapy, and parathyroidectomy, the patient regained full active mobility. This case emphasized the importance of high parathyroid hormone level, metabolic acidosis, and high β-2 macroglobulin in the pathogenesis of tendons ruptures.

Karishma

We reported a case of cyclophosphamide (CYP)-induced posterior reversible encephalopathy syndrome (PRES) in a 26-year-old previously healthy male patient who was presented to the emergency department with a history of fever, shortness of breath, and hemoptysis. After extensive investigations, including bronchoscopy and autoimmune screening, he was diagnosed with renalpulmonary syndrome. The diagnosis of CYP-related PRES was based on the development of neurological clinical picture supported by magnetic resonance imaging findings. The dose of CYP was decreased to 75 mg/day, and the patient’s symptoms improved after 3 days.

Karishma