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[PMID]:27642786
[Au] Autor:Strutz F
[Ti] Título:[Autosomal polycystic kidney disease].
[Ti] Título:Polyzystische Nierenerkrankungen..
[So] Source:Dtsch Med Wochenschr;141(20):1463-1466, 2016 Sep.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenetic kidney disease. The clinical course is highly variable, association to certain genetic mutations only weak. Great progress has been made in recent years in determining the pathophysiology of the disease. Diagnosis of ADPKD is almost always possible by ultrasound, genetic examination is confined to selected cases. In addition, imaging is important for prognosis where MRI and computer tomography are superior for determination of total kidney volume. Until recently, supportive therapy has been the only available therapeutic option. This includes optimal antihypertensive therapy with a goal blood pressure below 110/75 mm mercury, at least with normal renal function and without any other contraindication. In addition, fluid intake should be increased to 2.5-4 l per day. Finally, tolvaptan is available as a specific therapy in selected countries. This therapy should be restricted to cases with rapid progressive and early renal failure due to costs and side effects. The value of this agent in later stages of chronic renal failure is currently being evaluated in clinical studies. Additional specific therapies are in early clinical evaluations.
[Mh] Termos MeSH primário: Anti-Hipertensivos/uso terapêutico
Diagnóstico por Imagem/métodos
Testes de Função Renal/métodos
Doenças Renais Policísticas/diagnóstico
Doenças Renais Policísticas/terapia
Fármacos Renais/uso terapêutico
[Mh] Termos MeSH secundário: Benzazepinas/uso terapêutico
Medicina Baseada em Evidências
Testes Genéticos/métodos
Seres Humanos
Doenças Renais Policísticas/genética
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Benzazepines); 0 (Renal Agents); 21G72T1950 (tolvaptan)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160920
[St] Status:MEDLINE


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[PMID]:27447457
[Au] Autor:Lenssen R; Liekweg A
[Ad] Endereço:Krankenhausapotheke, Uniklinik Köln, Gleueler Str. 88, 50937, Köln, Deutschland. rebekka.lenssen@uk-koeln.de.
[Ti] Título:[Strategies of age-adapted pharmacotherapy in renal failure].
[Ti] Título:Strategien der altersadäquaten Pharmakotherapie bei Niereninsuffizienz..
[So] Source:Z Gerontol Geriatr;49(6):494-9, 2016 Aug.
[Is] ISSN:1435-1269
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Many geriatric patients with multimorbidities have an increased risk for impaired renal function due to age and often the presence of comorbidities, such as diabetes mellitus, hypertension and heart failure. This impairment in kidney function in turn necessitates adjustments in drug therapy. A successful strategy for treating these patients includes treatment of the underlying diseases, a comprehensive review of the indications, selection of appropriate pharmacotherapeutic alternatives and for some drugs dose adjustment to the renal function. To achieve therapeutic success many patient individual factors, such as potentially complex medication regimens, polypharmacy, cognitive function and functional disabilities need to be considered when prescribing medications. This article describes the problems associated with drug therapy that is not adjusted to renal function and provides guidelines for assessment of the benefits and risks in patients with kidney failure. The characteristic features of geriatric patients in particular are considered and discussed.
[Mh] Termos MeSH primário: Nefropatias/diagnóstico
Nefropatias/tratamento farmacológico
Fármacos Renais/administração & dosagem
Fármacos Renais/efeitos adversos
Insuficiência Renal/diagnóstico
Insuficiência Renal/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença Crônica/tratamento farmacológico
Relação Dose-Resposta a Droga
Esquema de Medicação
Monitoramento de Medicamentos/métodos
Medicina Baseada em Evidências
Feminino
Avaliação Geriátrica/métodos
Alemanha
Seres Humanos
Nefropatias/complicações
Masculino
Polimedicação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Renal Agents)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160723
[St] Status:MEDLINE
[do] DOI:10.1007/s00391-016-1111-4


  3 / 804 MEDLINE  
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[PMID]:27344604
[Au] Autor:Ellsworth PI
[Ad] Endereço:UMassMemorial Medical Center, Department of Urology, Chief, Division of Pediatric Urology, 55 Lake Avenue North, Worcester, MA 01655, United States. Electronic address: pamelaellsworth@aol.com.
[Ti] Título:Response to Commentary re 'Evaluating use of higher dose oxybutynin in combination with desmopressin for refractory nocturnal enuresis'.
[So] Source:J Pediatr Urol;12(4):222, 2016 Aug.
[Is] ISSN:1873-4898
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Desamino Arginina Vasopressina
Enurese Noturna
[Mh] Termos MeSH secundário: Antidiuréticos
Enurese
Seres Humanos
Ácidos Mandélicos
Fármacos Renais
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Antidiuretic Agents); 0 (Mandelic Acids); 0 (Renal Agents); ENR1LLB0FP (Deamino Arginine Vasopressin); K9P6MC7092 (oxybutynin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160627
[St] Status:MEDLINE


  4 / 804 MEDLINE  
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[PMID]:27230798
[Au] Autor:Breyer MD; Susztak K
[Ad] Endereço:Biotechnology Discovery Research, Eli Lilly and Company, Indianapolis, Indiana 46285, USA.
[Ti] Título:The next generation of therapeutics for chronic kidney disease.
[So] Source:Nat Rev Drug Discov;15(8):568-88, 2016 08.
[Is] ISSN:1474-1784
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Chronic kidney disease (CKD) represents a leading cause of death in the United States. There is no cure for this disease, with current treatment strategies relying on blood pressure control through blockade of the renin-angiotensin system. Such approaches only delay the development of end-stage kidney disease and can be associated with serious side effects. Recent identification of several novel mechanisms contributing to CKD development - including vascular changes, loss of podocytes and renal epithelial cells, matrix deposition, inflammation and metabolic dysregulation - has revealed new potential therapeutic approaches for CKD. This Review assesses emerging strategies and agents for CKD treatment, highlighting the associated challenges in their clinical development.
[Mh] Termos MeSH primário: Fármacos Renais/farmacologia
Fármacos Renais/uso terapêutico
Insuficiência Renal Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Fibrose
Seres Humanos
Camundongos
Circulação Renal/efeitos dos fármacos
Insuficiência Renal Crônica/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Renal Agents)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160528
[St] Status:MEDLINE
[do] DOI:10.1038/nrd.2016.67


  5 / 804 MEDLINE  
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[PMID]:27200371
[Au] Autor:Du M; Hu X; Kou L; Zhang B; Zhang C
[Ad] Endereço:Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China.
[Ti] Título:Lycium barbarum Polysaccharide Mediated the Antidiabetic and Antinephritic Effects in Diet-Streptozotocin-Induced Diabetic Sprague Dawley Rats via Regulation of NF-κB.
[So] Source:Biomed Res Int;2016:3140290, 2016.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Lycium barbarum, extensively utilized as a medicinal plant in China for years, exhibits antitumor, immunoregulative, hepatoprotective, and neuroprotective properties. The present study aims to investigate the hyperglycemic and antidiabetic nephritic effects of polysaccharide which is separated from Lycium barbarum (LBPS) in high-fat diet-streptozotocin- (STZ-) induced rat models. The reduced bodyweight and enhanced blood glucose concentration in serum were observed in diabetic rats, and they were significantly normalized to the healthy level by 100 mg/kg of metformin (Met) and LBPS at doses of 100, 250, and 500 mg/kg. LBPS inhibited albuminuria and blood urea nitrogen concentration and serum levels of inflammatory factors including IL-2, IL-6, TNF-α, IFN-α, MCP-1, and ICAM-1 compared with diabetic rats, and it indicates the protection on renal damage. Furthermore, the activities of SOD and GSH-Px in serum were enhanced strikingly by LBPS which suggests its antioxidation effects. LBPS, compared with nontreated diabetic rats, inhibited the expression of phosphor-nuclear factors kappa B (NF-κB) and inhibitor kappa B alpha in kidney tissues. Collectively, LBPS possesses antidiabetic and antinephritic effects related to NF-κB-mediated antioxidant and antiinflammatory activities.
[Mh] Termos MeSH primário: Diabetes Mellitus Experimental/tratamento farmacológico
Diabetes Mellitus Experimental/imunologia
Nefropatias Diabéticas/tratamento farmacológico
Nefropatias Diabéticas/imunologia
Medicamentos de Ervas Chinesas/administração & dosagem
NF-kappa B/imunologia
[Mh] Termos MeSH secundário: Animais
Anti-Inflamatórios/administração & dosagem
Glicemia/imunologia
Citocinas/sangue
Diabetes Mellitus Experimental/diagnóstico
Nefropatias Diabéticas/diagnóstico
Gorduras na Dieta
Relação Dose-Resposta a Droga
Sinergismo Farmacológico
Masculino
Metformina/administração & dosagem
Ratos
Ratos Sprague-Dawley
Fármacos Renais/administração & dosagem
Estreptozocina
Resultado do Tratamento
Ureia/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Blood Glucose); 0 (Cytokines); 0 (Dietary Fats); 0 (Drugs, Chinese Herbal); 0 (NF-kappa B); 0 (Renal Agents); 0 (lycium barbarum polysaccharide); 5W494URQ81 (Streptozocin); 8W8T17847W (Urea); 9100L32L2N (Metformin)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160521
[St] Status:MEDLINE
[do] DOI:10.1155/2016/3140290


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[PMID]:26913679
[Au] Autor:Rababa'h AM; Deo SV; Altarabsheh SE; De Caro J; Tarboush NA; Alzoubi KH; Ababneh M; McConnell BK; Markowitz AH; Park SJ
[Ad] Endereço:Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
[Ti] Título:N-Acetyl Cysteine Therapy Does Not Prevent Renal Failure in High-Risk Patients Undergoing Open-Heart Surgery.
[So] Source:Heart Surg Forum;19(1):E16-22, 2016 Feb 22.
[Is] ISSN:1522-6662
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Renal dysfunction is a common complication after cardiovascular surgery. Controversial issues have been discussed regarding the role of N-acetyl cysteine in the prevention of postoperative renal dysfunction. The purpose of this meta-analysis is to assess whether N-acetyl cysteine offers any protection against the development of acute renal dysfunction after cardiac surgery. METHODS: Multiple databases were searched for randomized trials comparing the role of N-acetyl cysteine and placebo in human patients undergoing cardiac surgery. End-points studied were: the incidence of acute renal failure, hemodialysis, early mortality, duration of hospital stay, and maximal change in creatinine values. Dichotomous variables were compared using the risk difference (RD) calculated with inverse weighting; continuous data was pooled as (standardized) mean difference. Results are presented with 95% confidence interval (P < .05 is significant); results are presented within 95% confidence interval. RESULTS: Thirteen randomized trials (713 and 707 patients in the N-acetyl cysteine and control groups, respectively) were included in the present analysis; nine dealing with patients at high-risk for acute renal failure. The incidence of postoperative acute renal dysfunction was 23% and 36% in the N-acetyl cysteine and control cohorts, respectively. N-acetyl cysteine therapy did not reduce acute renal dysfunction in the high-risk cohort [RD -0.03 (-0.09 to 0.02); P = .22; I2 = 24%]. Maximal change in creatinine levels after surgery was also comparable [standardized mean difference 0.07 (-0.23, 0.09); P = .39]. Early mortality was 2.9% and 3.7% in the N-acetyl cysteine and control cohorts respectively; [RD 0 (-0.03 to 0.02); P = .63; I2 = 20%]. Hospital stay (mean length of stay 10.4 and 10.1 days in the N-acetyl cysteine and control cohorts, respectively) was also similar in both cohorts [WMD 0.17 (-0.02 to 0.37) days; P = .81]. CONCLUSION: Prophylactic N-acetyl cysteine therapy does not reduce the incidence of renal dysfunction in high-risk patients undergoing cardiac surgery.
[Mh] Termos MeSH primário: Acetilcisteína/uso terapêutico
Lesão Renal Aguda/mortalidade
Lesão Renal Aguda/prevenção & controle
Procedimentos Cirúrgicos Cardíacos/mortalidade
Complicações Pós-Operatórias/mortalidade
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Procedimentos Cirúrgicos Cardíacos/utilização
Feminino
Depuradores de Radicais Livres/administração & dosagem
Depuradores de Radicais Livres/uso terapêutico
Mortalidade Hospitalar
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Prevalência
Ensaios Clínicos Controlados Aleatórios como Assunto
Fármacos Renais
Fatores de Risco
Taxa de Sobrevida
Falha de Tratamento
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Free Radical Scavengers); 0 (Renal Agents); WYQ7N0BPYC (Acetylcysteine)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170117
[Lr] Data última revisão:
170117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160226
[St] Status:MEDLINE
[do] DOI:10.1532/hsf.1424


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[PMID]:26813471
[Au] Autor:Jin H; Zhang HN; Hou XL; Zhang B; Wu J; Zhang HB
[Ad] Endereço:Department of Nephrology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China. ejka827@163.com.
[Ti] Título:Clinical study of double dose of valsartan combined with tacrolimus in treatment of diabetic nephropathy.
[So] Source:Eur Rev Med Pharmacol Sci;20(1):174-9, 2016.
[Is] ISSN:2284-0729
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the clinical effect of double dose of valsartan combined with tacrolimus in the treatment of diabetic nephropathy (DN). PATIENTS AND METHODS: HA total of 86 cases diagnosed with DN were selected from October 2013 to October 2014 in Zaozhuang Municipal Hospital, China. The study was approved by our hospital Ethics Committee and written consent was obtained from patients and their family members. Patients were randomly divided into three groups according to the sequence of admission, group A (conventional dose of valsartan group, n = 28 cases), group B (double dose of valsartan group, n = 29 cases) and group C (double dose of valsartan combined with tacrolimus group, n = 29). Clinical effects were compared by analyzing the renal function tests after 8 weeks. RESULTS: 24h urine protein, serum creatinine level of patients in group B and group C were significantly lower than that of group A. Those in group C was much lower. The glomerular filtration rates were significantly higher for group B and C than that of group A, and those in group C were much higher. The difference is statistically significant (p < 0.05). High-sensitivity C-reactive protein (hs CRP) and adiponectin levels of patients in group B and C of were significantly lower than that of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). The high mobility group protein 1 (HMGB1) and renal tubular and interstitial damage index (TDI) of patients in B and C groups were significantly lower than those in the A group, and those in C group were significantly lower. The difference was statistically significant p < 0.05). The clinical effective rates of patients in group B and C were significantly higher than that in group A, and those of group C were much higher. The difference is statistically significant (p < 0.05). The recurrence rates of patients in group B and group C were significantly lower than those of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). Patients in three groups showed no obvious drug complications. CONCLUSIONS: Double dose of valsartan combined with tacrolimus treatment of DN patients can improve clinical symptoms, reducing inflammation, inhibiting or even reversing the interstitial fibrosis, which will improve the curative effect and reduce the recurrence, as to provide a new theoretical basis for the clinical treatment of the disease.
[Mh] Termos MeSH primário: Nefropatias Diabéticas/tratamento farmacológico
Fármacos Renais/administração & dosagem
Tacrolimo/administração & dosagem
Valsartana/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Nefropatias Diabéticas/fisiopatologia
Relação Dose-Resposta a Droga
Quimioterapia Combinada
Feminino
Taxa de Filtração Glomerular/efeitos dos fármacos
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Renal Agents); 80M03YXJ7I (Valsartan); WM0HAQ4WNM (Tacrolimus)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:160127
[Lr] Data última revisão:
160127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160128
[St] Status:MEDLINE


  8 / 804 MEDLINE  
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[PMID]:26687365
[Au] Autor:Schmiemann G; Herget-Rosenthal S; Hoffmann F
[Ad] Endereço:Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung (IPP), Universität Bremen, Grazer Str. 4, 28359, Bremen, Deutschland. schmiema@uni-bremen.de.
[Ti] Título:[Medical services for nursing home residents : Results of the study on inappropriate medication in patients with renal insufficiency in nursing homes].
[Ti] Título:Ärztliche Versorgung von Pflegeheimbewohnern : Ergebnisse der Studie "Inappropriate medication in patients with renal insufficiency in nursing homes"..
[So] Source:Z Gerontol Geriatr;49(8):727-733, 2016 Dec.
[Is] ISSN:1435-1269
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:BACKGROUND: In Germany approximately 800,000 people are living in nursing homes. Outpatient medical treatment is provided by general practitioners (GP) and a variety of medical specialists. While nearly all residents have regular contact with GPs, care by specialists differs between the various disciplines. AIM: In this study an assessment of medical treatment for nursing home residents by GPs and specialists was made and compared with the available diagnoses. MATERIAL AND METHODS: Between October 2014 and April 2015 a cross-sectional study was conducted in nursing homes in Bremen and the surrounding areas. Anonymized data based on residents' files were collated by nursing staff. Every contact with various specialists within the preceding 12 months was assessed and grouped into (a) no physician visit, (b) resident visited physician and (c) physician visited resident. Analyses were stratified for age, sex and level of care dependency as well as dementia and further comorbidities. RESULTS: A total of 852 residents in 21 nursing homes were included (mean age 83.5 years, 76.5 % female) in the study. Dementia was diagnosed in 57.7 %. Nearly all residents had had contact with their GP in the previous 12 months, mostly by home visits (96.9 %). The majority (54.5 %) had not seen a dentist in the preceding 12 months and 25.4 % had been visited by a dentist. Of the residents 47.4 % were visited by a neurologist or psychiatrist but only 4.5 % visited these specialists in their practice. Higher care dependency and younger age were associated with more frequent visits by neurologists and psychiatrists. Contact rates to ophthalmologists (29.3 %) and urologists (20.5 %) were less frequent. A diagnosis of diabetes mellitus had no influence on the contact rate with ophthalmologists. CONCLUSION: Medical care by specialists is characterized by huge variations. Besides a frequent contact rate with GPs there seems to be an undersupply regarding care by dentists and ophthalmologists.
[Mh] Termos MeSH primário: Demência/epidemiologia
Instituição de Longa Permanência para Idosos/estatística & dados numéricos
Prescrição Inadequada/estatística & dados numéricos
Casas de Saúde/estatística & dados numéricos
Fármacos Renais/uso terapêutico
Insuficiência Renal/tratamento farmacológico
[Mh] Termos MeSH secundário: Distribuição por Idade
Idoso
Idoso de 80 Anos ou mais
Demência/tratamento farmacológico
Prescrições de Medicamentos/estatística & dados numéricos
Feminino
Clínicos Gerais/utilização
Alemanha/epidemiologia
Seres Humanos
Masculino
Cuidados de Enfermagem/utilização
Visita a Consultório Médico/utilização
Insuficiência Renal/epidemiologia
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Renal Agents)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151222
[St] Status:MEDLINE


  9 / 804 MEDLINE  
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[PMID]:26178649
[Au] Autor:Seyberth HW
[Ad] Endereço:Department of Pediatrics and Adolescent Medicine, Philipps University, Marburg, Germany. seyberth@staff.uni-marburg.de.
[Ti] Título:Pathophysiology and clinical presentations of salt-losing tubulopathies.
[So] Source:Pediatr Nephrol;31(3):407-18, 2016 Mar.
[Is] ISSN:1432-198X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:At least three renal tubular segments are involved in the pathophysiology of salt-losing tubulopathies (SLTs). Whether the pathogenesis starts either in the thick ascending limb of the loop of Henle (TAL) or in the distal convoluted tubule (DCT), it is the function of the downstream-localized aldosterone sensitive distal tubule (ASDT) to contribute to the adaptation process. In isolated TAL defects (loop disorders) ASDT adaptation is supported by upregulation of DCT, whereas in DCT disorders the ASDT is complemented by upregulation of TAL function. This upregulation has a major impact on the clinical presentation of SLT patients. Taking into account both the symptoms and signs of primary tubular defect and of the secondary reactions of adaptation, a clinical diagnosis can be made that eventually leads to an appropriate therapy. In addition to salt wasting, as occurs in all SLTs, characteristic features of loop disorders are hypo- or isosthenuric polyuria and hypercalciuria, whereas characteristics of DCT disorders are hypokalemia and (symptomatic) hypomagnesemia. In both SLT categories, replacement of urinary losses is the primary goal of treatment. In loop disorders COX inhibitors are also recommended to mitigate polyuria, and in DCT disorders magnesium supplementation is essential for effective treatment. Of note, the combination of a salt- and potassium-rich diet together with an adequate fluid intake is always the basis of long-term treatment in all SLTs.
[Mh] Termos MeSH primário: Túbulos Renais Distais/fisiopatologia
Erros Inatos do Transporte Tubular Renal/fisiopatologia
Equilíbrio Hidroeletrolítico
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Animais
Cálcio/metabolismo
Seres Humanos
Hiperaldosteronismo/etiologia
Hiperaldosteronismo/fisiopatologia
Túbulos Renais Distais/efeitos dos fármacos
Túbulos Renais Distais/metabolismo
Magnésio/metabolismo
Fármacos Renais/uso terapêutico
Reabsorção Renal
Erros Inatos do Transporte Tubular Renal/complicações
Erros Inatos do Transporte Tubular Renal/tratamento farmacológico
Erros Inatos do Transporte Tubular Renal/metabolismo
Cloreto de Sódio/metabolismo
Água/metabolismo
Equilíbrio Hidroeletrolítico/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Renal Agents); 059QF0KO0R (Water); 451W47IQ8X (Sodium Chloride); I38ZP9992A (Magnesium); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150717
[St] Status:MEDLINE
[do] DOI:10.1007/s00467-015-3143-1


  10 / 804 MEDLINE  
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[PMID]:25939817
[Au] Autor:Müller-Deile J; Schiffer M
[Ad] Endereço:Department of Nephrology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
[Ti] Título:Podocyte directed therapy of nephrotic syndrome-can we bring the inside out?
[So] Source:Pediatr Nephrol;31(3):393-405, 2016 Mar.
[Is] ISSN:1432-198X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Several of the drugs currently used for the treatment of glomerular diseases are prescribed for their immunotherapeutic or anti-inflammatory properties, based on the current understanding that glomerular diseases are mediated by immune responses. In recent years our understanding of podocytic signalling pathways and the crucial role of genetic predispositions in the pathology of glomerular diseases has broadened. Delineation of those signalling pathways supports the hypothesis that several of the medications and immunosuppressive agents used to treat glomerular diseases directly target glomerular podocytes. Several central downstream signalling pathways merge into regulatory pathways of the podocytic actin cytoskeleton and its connection to the slit diaphragm. The slit diaphragm and the cytoskeleton of the foot process represent a functional unit. A breakdown of the cytoskeletal backbone of the foot processes leads to internalization of slit diaphragm molecules, and internalization of slit diaphragm components in turn negatively affects cytoskeletal signalling pathways. Podocytes display a remarkable ability to recover from complete effacement and to re-form interdigitating foot processes and intact slit diaphragms after pharmacological intervention. This ability indicates an active inside-out signalling machinery which stabilizes integrin complex formations and triggers the recycling of slit diaphragm molecules from intracellular compartments to the cell surface. In this review we summarize current evidence from patient studies and model organisms on the direct impact of immunosuppressive and supportive drugs on podocyte signalling pathways. We highlight new therapeutic targets that may open novel opportunities to enhance and stabilize inside-out pathways in podocytes.
[Mh] Termos MeSH primário: Citoesqueleto/efeitos dos fármacos
Descoberta de Drogas/métodos
Terapia de Alvo Molecular
Síndrome Nefrótica/tratamento farmacológico
Podócitos/efeitos dos fármacos
Fármacos Renais/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Citoesqueleto/metabolismo
Citoesqueleto/patologia
Seres Humanos
Síndrome Nefrótica/diagnóstico
Síndrome Nefrótica/metabolismo
Podócitos/metabolismo
Podócitos/patologia
Transdução de Sinais/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Renal Agents)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150506
[St] Status:MEDLINE
[do] DOI:10.1007/s00467-015-3116-4



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