To systemically evaluate the efficacy and safety of salvianolate intravenous drip in combination with hydration against contrast-induced nephropathy( CIN),and guide clinical medication. Chinese and English databases( PubMed,EMbase,the Cochrane Library,CBM,VIP,Wan Fang database,CNKI) were retrieved to collect the randomized controlled trials( RCTs) about the efficacy of salvianolate intravenous drip in combination with hydration( trial group) vs routine hydration( control group) in the prevention of contrastinduced nephropathy. The methodological quality of the RCTs was evaluated by using the Cochrane 5. 1. 0 Bias Risks Assessment Tool.The data were extracted and Meta-analysis was conducted by Reviewer Manager 5. 3. Egger's test and non-parametric clipping method were used to evaluate publication bias. A total of 9 RCTs with 2 186 participants were included. RESULTS:: of Meta-analysis showed that the incidence of contrast-induced nephropathy of trial group was significantly higher than that of control group( RR = 0. 46,95% CI[0. 35,0. 59],P<0. 001). Subgroup analysis showed that the incidences of CIN in patients with acute coronary syndrome( ACS) undergoing PCI,in patients with the average age≥65 years,in patients who received mean contrast volume ≥200 m L,in patients with serum creatinine( Scr) ≥ 80 μmol,or in patients who received intraoperative administration of salvianolate or PCI were higher than those in control group,with statistically significant differences( P<0. 05). The experimental group was superior to the control group in improving the indexes of renal function after operation,and the difference was statistically significant( P<0. 05). No study reported the incidence of adverse reactions( ADRs). The funnel plots of the incidence of CIN showed potential publication bias. The results of Egger's linear regression showed that there was certain publication bias. Sensitivity analysis,funnel plot,and " trim and fill" showed that the results of this study were stable and reliable. Salvianolate combined with routine hydration showed definite clinical efficacy in the prevention of contrast-induced nephropathy. However,exact conclusion should be further verified by additional high-quality,multi-centre,and large-scale RCT studies.
Contrast Media ; adverse effects ; Humans ; Kidney Diseases ; chemically induced ; prevention & control ; Percutaneous Coronary Intervention ; Plant Extracts ; therapeutic use ; Randomized Controlled Trials as Topic

To discover the nephroprotective substances from Huangkui capsule.The components of Huangkui capsule were isolated by preparative liquid chromatography, and the active components were screened by LC/MS and identified. The adriamycine-injured HK-2 cells were treated with various active components with different concentrations, and the malonaldehyde (MDA) content, adenosine triphosphate (ATP) level and mitochondrial oxygen consumption rate were measured to verify the protective activity of the compounds.Four active components in Huangkui capsule were identified to exert nephroprotective effects. Fifteen flavanoids from these four components were tentatively identified by LC/MS, and hyperin, myricetin, quercetin, rutin and isoquercetin were confirmed. Hyperin, myricetin quercetin and rutin showed dose-dependent protective effects on injured HK-2 cells. Espacially, hyperin significantly reduced MDA content, quercetin and rutin significantly increased ATP level, and myricetin significantly increased mitochondrial oxygen consumption rate.Hyperin, myricetin, querctein and rutin might be the potential nephroprotective compounds in Huangkui capsule, their effects may be related to the inhibition of lipid peroxidation and the alleviation of mitochondrial damage.
Abelmoschus ; chemistry ; drug effects ; Adenosine Triphosphate ; metabolism ; Cell Line, Transformed ; Chromatography, Liquid ; Doxorubicin ; Drugs, Chinese Herbal ; Epithelial Cells ; drug effects ; Flavonoids ; pharmacology ; Kidney Diseases ; chemically induced ; drug therapy ; prevention & control ; Kidney Tubules, Proximal ; drug effects ; Lipid Peroxidation ; drug effects ; Malondialdehyde ; metabolism ; Mass Spectrometry ; Mitochondria ; drug effects ; Oxygen Consumption ; drug effects ; Protective Agents ; chemistry ; pharmacology ; Quercetin ; analogs & derivatives ; pharmacology ; Rutin ; pharmacology

PURPOSE: Endothelial dysfunction (ED) is a pivotal phenomenon in the development of cardiovascular disease (CVD) in patients receiving hemodialysis (HD). Indoxyl sulfate (IS) is a known uremic toxin that induces ED in patients with chronic kidney disease. The aim of this study was to investigate whether AST-120, an absorbent of IS, improves microvascular or macrovascular ED in HD patients. MATERIALS AND METHODS: We conducted a prospective, case-controlled trial. Fourteen patients each were enrolled in respective AST-120 and control groups. The subjects in the AST-120 group were treated with AST-120 (6 g/day) for 6 months. Microvascular function was assessed by laser Doppler flowmetry using iontophoresis of acetylcholine (Ach) and sodium nitroprusside (SNP) at baseline and again at 3 and 6 months. Carotid arterial intima-media thickness (cIMT) and flow-mediated vasodilation were measured at baseline and 6 months. The Wilcoxon rank test was used to compare values before and after AST-120 treatment. RESULTS: Ach-induced iontophoresis (endothelium-dependent response) was dramatically ameliorated at 3 months and 6 months in the AST-120 group. SNP-induced response showed delayed improvement only at 6 months in the AST-120 group. The IS level was decreased at 3 months in the AST-120 group, but remained stable thereafter. cIMT was significantly reduced after AST-120 treatment. No significant complications in patients taking AST-120 were reported. CONCLUSION: AST-120 ameliorated microvascular ED and cIMT in HD patients. A randomized study including a larger population will be required to establish a definitive role of AST-120 as a preventive medication for CVD in HD patients.
Acetylcholine ; Adult ; Carbon/*therapeutic use ; Cardiovascular Diseases/etiology/*prevention & control ; Carotid Intima-Media Thickness ; Endothelium, Vascular/*physiopathology ; Female ; Humans ; Iontophoresis ; Kidney Failure, Chronic/complications/*physiopathology/*therapy ; Laser-Doppler Flowmetry ; Male ; Microcirculation/physiology ; Middle Aged ; Nitroprusside ; Oxides/*therapeutic use ; Prospective Studies ; *Renal Dialysis ; Young Adult

From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery (ONSS) without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.
Arterial Occlusive Diseases ; etiology ; prevention & control ; Carcinoma, Renal Cell ; surgery ; Female ; Humans ; Kidney Neoplasms ; surgery ; Male ; Nephrons ; surgery ; Postoperative Complications ; Renal Artery ; pathology ; surgery ; Surgery, Computer-Assisted ; adverse effects ; methods ; Ultrasonography

OBJECTIVEIn this study, the ameliorative effects of gold nanoparticles (gold NP) on the renal tissue damage in Schistosoma mansoni (S. mansoni)-infected mice was investigated.

METHODSHigh-resolution transmission electron microscopy was used for the characterization of NP. The gold NP at concentrations of 250, 500, and 1000 μg/kg body weight were inoculated into S. mansoni-infected mice.

RESULTSThe parasite caused alterations in the histological architecture. Furthermore, it induced a significant reduction in the renal glutathione levels; however, the levels of nitric oxide and malondialdehyde were significantly elevated. The parasite also managed to downregulate KIM-1, NGAL, MCP-1, and TGF-β mRNA expression in infected animals. Notably, gold NP treatment in mice reduced the extent of histological impairment and renal oxidative damage. Gold NP were able to regulate gene expression impaired by S. Mansoni infection.

CONCLUSIONThe curative effect of gold NP against renal toxicity in S. mansoni-infected mice is associated with their role as free radical scavengers.

Animals ; Drug Evaluation, Preclinical ; Gold ; therapeutic use ; Kidney Diseases ; parasitology ; prevention & control ; Male ; Metal Nanoparticles ; therapeutic use ; Mice ; Schistosomiasis mansoni ; complications ; drug therapy

OBJECTIVETo study the prevention effect of salidroside on contrast-induced-nephropathy (CIN) and its underlying mechanism.

METHODSA total of 24 Wistar rats were randomly divided into 4 groups with 6 in each group. Rats were firstly administrated with normal saline (control and model groups), N-acetylcysteine (NAC, NAC group) and salidroside (salidroside group) for 7 days before model establishment in each group, respectively. Histopathological analysis was performed by periodic acid-Schiff (PAS) staining. Oxidative stress related parameters including superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA), nitric oxide (NO), angiotensin II (Ang II), 8-hydroxy-2'-deoxyguanosine (8-OHdG), mRNA and protein levels of endothelial nitric oxide synthase (eNOS), and nitric oxide synthase (NOS) activity were measured.

RESULTSCompared with the control group, the levels of MDA, Ang II and 8-OHdG were all significantly increased and levels of SOD, NO, and eNOS mRNA and protein were decreased significantly in the model group (P<0.05). Meanwhile, the NOS activity was also significantly decreased in the model group (P<0.05). In addition, the levels of these parameters were all improved in the NAC (P<0.05) and salidroside groups and no significant different was found between these two groups (P>0.05).

CONCLUSIONSalidroside can be the potential substitute of NAC to prevent CIN. The underlying mechanism may be associated with oxidative stress damage caused by contrast agents.

Acetylcysteine ; pharmacology ; Animals ; Contrast Media ; adverse effects ; Cytoprotection ; drug effects ; Glucosides ; pharmacology ; Kidney ; drug effects ; pathology ; Kidney Diseases ; chemically induced ; prevention & control ; Oxidative Stress ; drug effects ; Phenols ; pharmacology ; Rats ; Rats, Wistar ; Signal Transduction ; drug effects

To explore the protective effect of Angelica sinensis polysaccharides(ASP) on subacute renal damages induced by D-galactose in mice and its mechanism. Male C57BL/6J mice were randomly divided into 3 groups, with 10 mice in each group. The D-galactose model group was subcutaneously injected with D-galactose (120 mg x kg(-1)), qd x 42; the ASP + D-galactose model group was intraperitoneally injected with ASP since the 8th day of the replication of the D-galactose model, qd x 35; and the normal control group was subcutaneously injected with saline at the same dose and time. On the 2nd day of after the injection, the peripheral blood was collected to measure the content of BUN, Crea, UA, Cys-C; paraffin sections were made to observe the renal histomorphology by HE staining; senescence-associated β-g-alactosidase (SA-β-Gal) stain was used to observe the relative optical density (ROD) in renal tissues; transmission electron microscopy was assayed to observe the renal ultrastructure; the renal tissue homogenate was prepared to measure the content of SOD, GSH-PX, MDA; the content of AGEs and 8-OH-dG were measured by ELISA. According to the result, compared with the D-galactose model group, the ASP + D-galactose model group showed obviously decreases in the content of BUN, Crea, UA, Cysc, AGES, 8-OH-dG, the number of hardening renal corpuscle, renal capsular space and renal tubular lumen, ROD of SA-β-Gal staining positive kidney cells, mesangial cells, basement membrane thickness, podocyte secondary processes fusion and MDA and increases in the number of normal renal corpuscle, ribosome and rough endoplasmic reticulum in podocytes, the activity of SOD and GSH-PX. In Conclusion, A. sinensis polysaccharides can antagonize kidney subacute damages induced by D-galactose in mice. Its protective mechanism may be correlated with the inhibition of the oxidative stress injury.
Angelica sinensis ; chemistry ; Animals ; Deoxyguanosine ; analogs & derivatives ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Galactose ; adverse effects ; Humans ; Kidney ; anatomy & histology ; drug effects ; injuries ; Kidney Diseases ; chemically induced ; drug therapy ; metabolism ; prevention & control ; Male ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; drug effects ; Polysaccharides ; administration & dosage ; Protective Agents ; administration & dosage

PURPOSE: To investigate the effect of pretreatment with intravenous nicorandil on the incidence of contrast-induced nephropathy (CIN) in patients with renal dysfunction undergoing coronary angiography. MATERIALS AND METHODS: This randomized controlled multicenter study enrolled a total of 166 patients (nicorandil n=81; control n=85) with an estimated glomerular filtration rate <60 mL/min. Nicorandil 12 mg dissolved in 100 mL of 0.9% saline was administered intravenously for 30 minutes just prior to coronary angiography in the nicorandil group. The same volume of only saline was given to the control group. The primary end-point was the incidence of CIN, defined as >0.5 mg/dL increase or >25% rise in serum creatinine (SCr) concentration within 48 hours of contrast exposure compared to baseline. RESULTS: The final analysis included 149 patients (nicorandil n=73; control n=76). The baseline characteristics and the total volume of the used contrast (Iodixanol, 125.6+/-69.1 mL vs. 126.9+/-74.6 mL, p=0.916) were similar between the two groups. The incidence of CIN also did not differ between the nicorandil and control groups (6.8% vs. 6.6%, p=0.794). There was no difference between the two groups in the relative change in SCr from baseline to peak level within 48 hours after coronary angiography (-1.58+/-24.07% vs. 0.96+/-17.49%, p=0.464), although the nicorandil group showed less absolute change in SCr than the control group (-0.01+/-0.43 mg/mL vs. 0.02+/-0.31 mg/mL, p=0.005). CONCLUSION: Prophylactic intravenous infusion of nicorandil did not decrease the incidence of CIN in patients with renal dysfunction undergoing coronary angiography.
Administration, Intravenous ; Aged ; Contrast Media/*adverse effects ; Coronary Angiography/*adverse effects/methods ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Diseases/*chemically induced/epidemiology/physiopathology/*prevention & control ; Male ; Middle Aged ; Nicorandil/*administration & dosage/therapeutic use

OBJECTIVETo analyze the relationship between the prognosis and clinical factors of primary vesicoureteral reflux (VUR) patients under the condition of non-surgical treatment.

METHODThe medical records of the patients who were diagnosed as VUR by micturating cystourethrography (MCU) from January 2000 to December 2009 in Children's Hospital of Fudan University underwent non-surgical treatment, and followed up for more than one year then had repeated MCU, were retrospectively reviewed.

RESULTA total of 73 children (30 boys, 43 girls) were included in this study. The percentage of mild reflux (grade I-II) was 19.2% (14/73), that of moderate reflux (grade III) was 53.4% (39/73), and that of severe reflux (grade IV-V) was 27.4% (20/73). Among 73 patients, 27 (37.0%) patients were found to have renal damage. The average interval of repeated MCU was (1.29 ± 0.40) years (1 - 2 years). After follow-up, it was found that the reflux grade was relieved in 41 (56.2%) patients, of whom 27 (37.0%) patients achieved complete resolution, 32 (43.8%) patients did not have remission in reflux grade, of whom 13 (17.8%) patients had worsened reflux grade. Logistic regression analysis showed that VUR patients with renal damage at initial diagnosis was an important clinical factor to affect reflux remission (P = 0.000), complete resolving (P = 0.008) and result in worsening (P = 0.002).

CONCLUSIONA certain proportion of primary VUR patients could get reflux grade self-resolution, it was also quite common in severe VUR patients. VUR patients with renal damage at initial diagnosis was an important clinical factor affecting the reflux grade prognosis. Mild and moderate VUR patients with renal damage were at risk of worsening. VUR patients with high reflux grade had normal renal status could still get remission or even disappearance of VUR. But severe VUR patients with renal damage were still recommended to receive surgical therapy.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Cicatrix ; Female ; Humans ; Infant ; Kidney Diseases ; epidemiology ; etiology ; pathology ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate ; Urinary Tract Infections ; epidemiology ; etiology ; prevention & control ; Urography ; Vesico-Ureteral Reflux ; complications ; drug therapy ; pathology

OBJECTIVETo evaluate the efficacy of atorvastatin in preventing contrast agent-induced nephropathy (CIN) in patients undergoing coronary angiography and explore the mechanism.

METHODSA total of 180 patients undergoing coronary angiography or percutaneous coronary interventions (PCI) were randomized into regular dose and high dose atorvastatin groups (n=90). Serum creatinine (Scr), glomerular filtration rate (GFR), cystatin, peripheral blood levels of myeloperoxidase (MPO), malondialdehyde (MDA), and superoxide dismutase (SOD) before and after the procedure were compared between the two groups.

RESULTSThe incidence of CIN was significantly lower in high-dose atorvastatin group than in the regular dose group. At 48-72 h after the surgery, serum Scr and cystatin levels were significantly lower and eGFR was significantly higher in the high-dose group. At 24 h after the surgery, MPO and MDA levels were significantly lower, and SOD activity was significantly higher in high-dose group than in the regular dose group.

CONCLUSIONHigh-dose atorvastatin used before angiography is more effective than the regular dose in attenuating contrast agent-induced renal dysfunction, and its mechanism is related with the inhibition of oxidative stress.

Aged ; Atorvastatin Calcium ; Contrast Media ; adverse effects ; Coronary Angiography ; adverse effects ; Female ; Heptanoic Acids ; administration & dosage ; pharmacology ; therapeutic use ; Humans ; Kidney Diseases ; chemically induced ; prevention & control ; Male ; Middle Aged ; Oxidative Stress ; drug effects ; Pyrroles ; administration & dosage ; pharmacology ; therapeutic use