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Niculae A, Gherghina ME, Peride I, Tiglis M, Nechita AM, Checherita IA. Pathway from Acute Kidney Injury to Chronic Kidney Disease: Molecules Involved in Renal Fibrosis. Int J Mol Sci 2023; 24:14019. [PMID: 37762322 PMCID: PMC10531003 DOI: 10.3390/ijms241814019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Acute kidney injury (AKI) is one of the main conditions responsible for chronic kidney disease (CKD), including end-stage renal disease (ESRD) as a long-term complication. Besides short-term complications, such as electrolyte and acid-base disorders, fluid overload, bleeding complications or immune dysfunctions, AKI can develop chronic injuries and subsequent CKD through renal fibrosis pathways. Kidney fibrosis is a pathological process defined by excessive extracellular matrix (ECM) deposition, evidenced in chronic kidney injuries with maladaptive architecture restoration. So far, cited maladaptive kidney processes responsible for AKI to CKD transition were epithelial, endothelial, pericyte, macrophage and fibroblast transition to myofibroblasts. These are responsible for smooth muscle actin (SMA) synthesis and abnormal renal architecture. Recently, AKI progress to CKD or ESRD gained a lot of interest, with impressive progression in discovering the mechanisms involved in renal fibrosis, including cellular and molecular pathways. Risk factors mentioned in AKI progression to CKD are frequency and severity of kidney injury, chronic diseases such as uncontrolled hypertension, diabetes mellitus, obesity and unmodifiable risk factors (i.e., genetics, older age or gender). To provide a better understanding of AKI transition to CKD, we have selected relevant and updated information regarding the risk factors responsible for AKIs unfavorable long-term evolution and mechanisms incriminated in the progression to a chronic state, along with possible therapeutic approaches in preventing or delaying CKD from AKI.
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Affiliation(s)
- Andrei Niculae
- Department of Nephrology, Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Mihai-Emil Gherghina
- Department of Nephrology, Ilfov County Emergency Clinical Hospital, 022104 Bucharest, Romania
| | - Ileana Peride
- Department of Nephrology, Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Mirela Tiglis
- Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania
| | - Ana-Maria Nechita
- Department of Nephrology, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania
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Niculae A, Peride I, Nechita AM, Petcu LC, Tiglis M, Checherita IA. Epidemiological Characteristics and Mortality Risk Factors Comparison in Dialysis and Non-Dialysis CKD Patients with COVID-19-A Single Center Experience. J Pers Med 2022; 12:jpm12060966. [PMID: 35743751 PMCID: PMC9224649 DOI: 10.3390/jpm12060966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/05/2022] [Accepted: 06/11/2022] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Despite some controversies between studies, chronic kidney disease (CKD) has a negative impact on COVID-19 outcomes, with patients presenting a higher mortality risk than in the general population. Studies have shown an association between COVID-19 severe cases and different inflammatory biomarkers. The aim of this study was to emphasize the epidemiological characteristics of CKD patients diagnosed with COVID-19 and to determine if the risk of mortality, and the severity of this infection might be influenced by different parameters. (2) Methods: Our retrospective study included CKD patients with COVID-19—362 in the non-dialysis group and 132 in the dialysis group. (3) Results: There were significant statistical differences between our groups regarding age (p < 0.001), hemoglobin (p < 0.001), interleukin-6 (p < 0.001), serum albumin (p = 0.016), procalcitonin (p = 0.002), ferritin (p < 0.001), and of course serum creatinine (p < 0.001). Even if the risk of death was higher in the dialysis group (Exp(b) = 1.839), the survival proportions were similar in both groups. (4) Conclusions: High values of hemoglobin, serum creatinine, and LDH at admission, age, length of hospital stay ≤ 10 days, and a pulmonary impairment > 25% are responsible for an adverse outcome in non-dialysis and dialysis patients diagnosed with COVID-19.
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Affiliation(s)
- Andrei Niculae
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (I.A.C.)
- Department of Nephrology and Dialysis, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania;
| | - Ileana Peride
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (I.A.C.)
- Department of Nephrology and Dialysis, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania;
- Correspondence: (I.P.); (M.T.)
| | - Ana-Maria Nechita
- Department of Nephrology and Dialysis, “St. John” Emergency Clinical Hospital, 042122 Bucharest, Romania;
| | - Lucian Cristian Petcu
- Department of Biophysics and Biostatistics, Faculty of Dentistry, “Ovidius” University, 900684 Constanta, Romania;
| | - Mirela Tiglis
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (I.P.); (M.T.)
| | - Ionel Alexandru Checherita
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (I.A.C.)
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Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Magnesium—A More Important Role in CKD–MBD than We Thought. Diagnostics (Basel) 2022; 12:diagnostics12040880. [PMID: 35453928 PMCID: PMC9031465 DOI: 10.3390/diagnostics12040880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/13/2022] [Accepted: 03/30/2022] [Indexed: 12/17/2022] Open
Abstract
Chronic kidney disease (CKD) is associated with different complications, including chronic kidney disease–mineral and bone disorder (CKD–MBD), which represents a systemic disorder that involves the presence of different mineral or bone structure abnormalities (i.e., modification of bone turnover, strength, volume, etc.), including even vascular calcification development. Even if, over the years, different pathophysiological theories have been developed to explain the onset and progression of CKD–MBD, the influence and importance of serum magnesium level on the evolution of CKD have only recently been highlighted. So far, data are inconclusive and conflicting; therefore, further studies are necessary to validate these findings, which could be useful in developing a better, more adequate, and personalized management of CKD patients.
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Affiliation(s)
- Ileana Peride
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Correspondence: (I.P.); (A.N.)
| | - Mirela Tiglis
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Tiberiu Paul Neagu
- Clinical Department No. 11, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Andrei Niculae
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Correspondence: (I.P.); (A.N.)
| | - Ionel Alexandru Checherita
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
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Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Uric Acid and Oxidative Stress-Relationship with Cardiovascular, Metabolic, and Renal Impairment. Int J Mol Sci 2022; 23:ijms23063188. [PMID: 35328614 PMCID: PMC8949471 DOI: 10.3390/ijms23063188] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The connection between uric acid (UA) and renal impairment is well known due to the urate capacity to precipitate within the tubules or extra-renal system. Emerging studies allege a new hypothesis concerning UA and renal impairment involving a pro-inflammatory status, endothelial dysfunction, and excessive activation of renin–angiotensin–aldosterone system (RAAS). Additionally, hyperuricemia associated with oxidative stress is incriminated in DNA damage, oxidations, inflammatory cytokine production, and even cell apoptosis. There is also increasing evidence regarding the association of hyperuricemia with chronic kidney disease (CKD), cardiovascular disease, and metabolic syndrome or diabetes mellitus. Conclusions: Important aspects need to be clarified regarding hyperuricemia predisposition to oxidative stress and its effects in order to initiate the proper treatment to determine the optimal maintenance of UA level, improving patients’ long-term prognosis and their quality of life.
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Affiliation(s)
- Mihai-Emil Gherghina
- Department of Nephrology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (M.-E.G.); (I.A.C.)
| | - Ileana Peride
- Department of Nephrology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (M.-E.G.); (I.A.C.)
- Correspondence: (I.P.); (A.N.)
| | - Mirela Tiglis
- Department of Anesthesiology and Intensive Care, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania;
| | - Tiberiu Paul Neagu
- Department of Plastic Surgery and Reconstructive Microsurgery, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania;
| | - Andrei Niculae
- Department of Nephrology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (M.-E.G.); (I.A.C.)
- Correspondence: (I.P.); (A.N.)
| | - Ionel Alexandru Checherita
- Department of Nephrology, “Carol Davila” University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (M.-E.G.); (I.A.C.)
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Peride I, Niculae A, Balas CA, Nechita AM, Checherita IA. MO385THE IMPACT OF SARS-COV-2 INFECTION ON MORTALITY IN CKD PATIENTS – A SINGLE-CENTER PILOT STUDY. Nephrol Dial Transplant 2021. [PMCID: PMC8194952 DOI: 10.1093/ndt/gfab082.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background and Aims Since the beginning of 2019, once COVID-19 pandemic was declared, there is a keen interest in understanding the impact of SARS-CoV-2 infection on chronic kidney disease (CKD) patients, regarding the influence on CKD progression and the suitable therapy options, as most of the indicated medications are contraindicated for a glomerular filtration rate (GFR) below 30 ml/min, and, in addition, there is a little experience in dialyzed patients. The aim of our single-center pilot study is to determine the influence of SARS-CoV-2 infection on CKD patients’ (dialyzed or not) outcome and hospitalization rate. Method We evaluated the patients diagnosed with COVID-19, admitted in our Department between October and December 2020. The inclusion criteria were: age > 18 years old, diagnosis of CKD – predialysis and hemodialyzed patients. The exclusion criteria were: patients without pre-existing CKD. All included subjects signed the patients’ consent. To all included patients we performed the following tests: total blood count, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, ferritin, serum free iron, serum creatinine, urea, uric acid, calcemia, total proteins, electrolytes and acid-base balance, urinary exams (including urine culture), coagulation and lipid profile, quantitative D-dimer, IL-6, procalcitonin, and imaging tests (CT, pulmonary Rx, abdominal ultrasonography). The patients were monitored by the infectious disease medical team that adjusted the therapy according to the patients’ lab and imagistic results. The specific treatment for SARS-CoV-2 infection included primary anti-interleukin receptor monoclonal antibody drugs (such as Anakinra, Tocilizumab), corticotherapy (dexamethasone), anti-retroviral therapy (remdesivir, favipiravir) only in hemodialyzed patients or in those presenting an eGFR > 30 mL/min, antibiotics, antifungal drugs, and oxygen-therapy. Usually, anti-interleukin receptor monoclonal antibody consisted in 7 doses, administrated every 48 hours. The dose of all other recommended drugs was adapted according to the patients’ eGFR. Results A total of 63 patients were admitted in our Department and were under our care, presenting medium or severe forms of SARS-CoV-2 infection. After applying the inclusion and exclusion criteria, only 38 patients were considered eligible: 21 male patients (mean age 63.52 ± 13.82 years), and 17 female patients (mean age 67.24 ± 12.83 years). 31.57% represented the percentage of death during the hospitalization (due to the severity of the disease, 4 patients died within 24 hours) in patients presenting heterogenous comorbidities, such as diabetes mellitus, hypertension, pre-existing glomerulonephritis and/or oncological pathologies; we also noticed that female gender represented 58.33% of the deceased patients. The mean hospitalization period in the deceased patients was 6.42 ± 5.38 days – 4 ± 3.21 days in female gender, and 9.8 ± 6.30 days in male gender. Conclusion Most of our patients, although diagnosed with medium and severe forms of SARS-CoV-2 infection, presented a favorable evolution, and an adequate response to the specific medication. We observed that most of the deceased cases were female patients, and compared to the male deceased subject, female deceased patients presented a lower period of hospitalization. Therefore, probably female CKD patients with comorbidities and diagnosed with COVID-19 are more predisposed to an unfavorable prognosis. Further and larger clinical trials are necessary to validate the impact of SARS-CoV-2 infection on mortality in CKD patients.
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Affiliation(s)
- Ileana Peride
- Carol Davila University of Medicine and Pharmacy, Nephrology, București, Romania
- Sf. Ioan Clinical Emergency Hospital, Nephrology, București, Romania
| | - Andrei Niculae
- Carol Davila University of Medicine and Pharmacy, Nephrology, București, Romania
- Sf. Ioan Clinical Emergency Hospital, București, Romania
| | | | - Ana-Maria Nechita
- Sf. Ioan Clinical Emergency Hospital, Nephrology, București, Romania
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Vinereanu IV, Peride I, Niculae A, Tiron AT, Caragheorgheopol A, Manda D, Checherita IA. The Relationship between Advanced Oxidation Protein Products, Vascular Calcifications and Arterial Stiffness in Predialysis Chronic Kidney Disease Patients. Medicina (Kaunas) 2021; 57:452. [PMID: 34066447 PMCID: PMC8148138 DOI: 10.3390/medicina57050452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 01/04/2023]
Abstract
Background and Objectives: Cardiovascular morbidity and mortality are increased in patients with chronic kidney disease (CKD). It is likely that the accumulation of uremic toxins resulting in increased oxidative stress (OS) is a major contributing factor, but no clear link has been identified. The purpose of this research is to establish if advanced oxidation protein product (AOPP) levels in the serum of predialysis patients are a contributing factor to vascular calcification and increased arterial stiffness. Materials and Methods: After obtaining the informed consent, 46 predialysis patients (CKD stages G3-G5) were included in the study. In order to identify vascular calcifications, hand and pelvic radiographs were performed. Valvular calcifications were identified using cardiac ultrasound. AOPP were measured using a commercially available ELISA kit. The relationships between serum AOPP values and biochemical parameters relevant in the evaluation of CKD patients were analyzed. In addition to identifying the differences in AOPP levels between patients with/without vascular or valvular calcifications, the research focused on describing the relationship between OS and arterial stiffness assessed by oscillometric pulse-wave velocity (PWV) measurement. Results: No significant relationship between serum AOPP and vascular or valvular calcifications was highlighted, but significant correlations of AOPP with C-reactive protein (p = 0.025), HDL-cholesterol levels (p = 0.04), HbA1c (p = 0.05) and PWV values (p = 0.02) were identified. Conclusions: The usefulness of (OS) measurement in clinical practice remains debatable; however, the relationship between AOPP and arterial stiffness could be valuable in improving cardiovascular risk assessment of patients with CKD.
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Affiliation(s)
- Ion-Vlad Vinereanu
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.-V.V.); (I.A.C.)
| | - Ileana Peride
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.-V.V.); (I.A.C.)
| | - Andrei Niculae
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.-V.V.); (I.A.C.)
| | - Andreea Taisia Tiron
- Department of Cardiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Andra Caragheorgheopol
- Department of Endocrinology, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.C.); (D.M.)
| | - Dana Manda
- Department of Endocrinology, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.C.); (D.M.)
| | - Ionel Alexandru Checherita
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (I.-V.V.); (I.A.C.)
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David C, Peride I, Radulescu D, Vacaroiu IA, Niculae A, Checherita IA. SP707CORRELATIONS BETWEEN ANGER SCALE STAXI PSYCHOLOGICAL ASSESSMENT AND BIOCHEMICAL PARAMETERS IN CHRONIC DIALYSIS PATIENTS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Cristiana David
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | - Ileana Peride
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | - Daniela Radulescu
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | | | - Andrei Niculae
- Carol Davila University of Medicine and Pharmacy, București, Romania
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Radulescu D, Peride I, David C, Vacaroiu IA, Niculae A, Checherita IA. SP220CORRELATION BETWEEN INCREASED FGF23 AND OUTCOME IN ACUTE KIDNEY INJURY. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daniela Radulescu
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | - Ileana Peride
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | - Cristiana David
- Carol Davila University of Medicine and Pharmacy, București, Romania
| | | | - Andrei Niculae
- Carol Davila University of Medicine and Pharmacy, București, Romania
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Radulescu D, Peride I, Petcu LC, Niculae A, Checherita IA. Supersonic Shear Wave Ultrasonography for Assessing Tissue Stiffness in Native Kidney. Ultrasound Med Biol 2018; 44:2556-2568. [PMID: 30154036 DOI: 10.1016/j.ultrasmedbio.2018.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/26/2018] [Accepted: 07/05/2018] [Indexed: 05/28/2023]
Abstract
Recent years have brought shear wave elastography to the attention of nephrologists as a non-invasive method for detecting kidney fibrosis and, therefore, as a potential tool for reducing the need for kidney biopsy. Few studies are performed on native kidney. We aimed to compare cortical stiffness, assessed by measuring Young's modulus (YM, kPa) with SuperSonic Imaging technology, in patients with various degrees of chronic kidney disease (CKD) compared with healthy individuals. Cortical stiffness was measured by two operators, in different sessions, in 32 patients with CKD stages 3-5 and 20 healthy individuals. Comparison between mean YM values in CKD and those in controls and also between the different stages of CKD was our primary objective. The influence of other possible confounders on YM readings was also investigated and analyzed. Mean YM was significantly greater in CKD patients than in controls. Estimated YM was not able to differentiate the stages of CKD, except stage 5. Intra-subject variability was greater in CKD than in controls. Body mass index was the most important confounder in multiple analyses, in both the CKD and control groups. Our results highlight a positive correlation between increased cortical stiffness and presence of CKD. Further studies are needed to validate this method for implementation in daily clinical practice.
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Affiliation(s)
- Daniela Radulescu
- Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania
| | - Ileana Peride
- Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania.
| | - Lucian Cristian Petcu
- Department of Biostatistics and Biophysics, Faculty of Dental Medicine, "Ovidius" University Constanta, Constanta, Romania
| | - Andrei Niculae
- Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania
| | - Ionel Alexandru Checherita
- Department of Nephrology and Dialysis, "St. John" Emergency Clinical Hospital, Bucharest, Romania; Clinical Department No. 3, "Carol Davila" University of Medicine, Bucharest, Romania
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Radulescu D, Peride I, Turcu FL, Niculae A, Checherita IA. FP650INCREASED PRESEPSIN VALUES IN CHRONIC HEMODIALYSED PATIENTS IN THE ABSENCE OF INFECTION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Daniela Radulescu
- Nephrology, "Carol Davila" University of Medicine and Pharmacy Bucharest, Nephrology, Buchaerst, Romania
| | - Ileana Peride
- Nephrology, "Carol Davila" University of Medicine and Pharmacy Bucharest, Nephrology, Bucharest, Romania
| | - Flavia Liliana Turcu
- Nephrology, "Carol Davila" University of Medicine and Pharmacy Bucharest, Nephrology, Buchaerst, Romania
| | - Andrei Niculae
- Nephrology, "Carol Davila" University of Medicine and Pharmacy, Buchaerst, Romania
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David C, Peride I, Radulescu D, Turcu F, Niculae A, Checherita IA. MP319THE CKD PRE-DIALYSIS REGISTER: A USEFUL TOOL IN PREVENTIVE NEPHROLOGY - A PILOT MULTIDISCIPLINARY STUDY. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx168.mp319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Radulescu D, Peride I, David C, Bogeanu C, Niculae A, Checherita IA. MP305FACTORS AFFECTING PROGNOSIS OF ACUTE KIDNEY INJURY IN ELDERLY. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx167.mp305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Checherita IA, Radulescu D, Niculae A, David C, Peride I, Vacaroiu IA. MP452IMPORTANCE OF INCREASED NTproBNP VALUES IN PREDIALYSIS CKD PATIENTS BEYOND CARDIOVASCULAR SIGNIFICANCE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Niculae A, Peride I, David C, Radulescu D, Vacaroiu IA, Checherita IA. SP249NEW PROGNOSTIC MARKERS IN PATIENTS WITH GENTAMICIN-ASSOCIATED ACUTE KIDNEY INJURY. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx144.sp249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Niculae A, David C, Dragomirescu RFI, Peride I, Turcu FL, Petcu LC, Covic A, Checherita IA. Correlation Between Recombinant Human Erythropoietin Dose and Inflammatory Status in Dialysed Patients. Rev Chim 2017. [DOI: 10.37358/rc.17.2.5452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Once recombinant human erythropoietin (r-HuEPO) was introduced in daily practice, huge steps were made in combating the adverse effects induced by anemia in chronic kidney disease population. Still, r-HuEPO resistance and the doses ensuring the maximum therapeutic benefit remain matters of debate. The aim of our study was to assess the correlation between the presence and the degree of inflammation and the r-HuEPO requirements in chronic dialysis patients. We conducted a 2 years prospective study on 146 patients undergoing chronic dialysis treated with r-HuEPO. Based on their average CRP (C-reactive protein) levels, obtained from repeated samplings at 3 months interval, 3 groups were formed; we noted in each group the average values of r-HuEPO prescribed to achieve the optimum hemoglobin levels according to the dialysis best practice guidelines and all the adverse effects of the therapy. A direct correlation was observed between CRP levels and r-HuEPO requirements in the first 2 groups of patients (CRP under 6 mg/L and CRP values 6-20 mg/L), with significant increase in r-HuEPO doses between groups (p [ 0.001); the third group, CRP values over 20 mg/dL, showed a minor, insignificant increase in average r-HuEPO doses compared to mild inflammation group (p = 0.199) and more adverse effects of the therapy (p [ 0.05). Inflammation is an important determinant of anemia in chronic dialysis patients and can induce an increase in the doses of r-HuEPO. However, prescribing excessive r-HuEPO doses is not the answer in severe inflammatory status, due to lack of response and possible adverse effects.
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David C, Bover J, Voiculet C, Peride I, Petcu LC, Niculae A, Covic A, Checherita IA. Coronary risk score for mineral bone disease in chronic non-diabetic hemodialysis patients: results from a prospective pilot study. Int Urol Nephrol 2016; 49:689-700. [DOI: 10.1007/s11255-016-1481-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/07/2016] [Indexed: 12/27/2022]
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Peride I, Radulescu D, Vacaroiu I, David C, Niculae A, Constantin A, Checherita IA. SP245ACOUSTIC RADIATION FORCE IMPULSE IMAGING FOR THE EVALUATION OF THE RENAL PARENCHYMAL STIFFNESS IN NATIVE KIDNEY - PRELIMINARY RESULTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw163.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Niculae A, Radulescu D, Turcu F, David C, Peride I, Checherita IA. MP663RELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND GAMMA-GLUTAMYLTRANSFERASE VALUES IN CHRONIC HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw199.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Niculae A, Radulescu D, David C, Peride I, Vacaroiu I, Checherita IA. MP550INTRADIALYTIC VARIATION OF NTPROBNP - EARLY MARKER FOR LEFT VENTRICULAR SYSTOLIC DYSFUNCTION. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw196.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Peride I, David C, Constantin A, Radulescu D, Niculae A, Vacaroiu I, Checherita IA. SP534PREOPERATIVE PWV VALUES ASSOCIATION WITH SUCCESS RATES AND MATURATION TIMES OF NATIVE ARTERIOVENOUS FISTULA IN ESRD PATIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw173.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Niculae A, Peride I, Vacaroiu I, David C, Dragomirescu R, Radulescu D, Checherita IA. MP232NTPROBNP - NEW PROGNOSTIC MARKER IN PATIENTS WITH AKI AND RHABDOMYOLYSIS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw187.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pricop C, Branisteanu DD, Orsolya M, Puia D, Matei A, Checherita IA. Sublingual desmopressin is efficient and safe in the therapy of lithiasic renal colic. Int Urol Nephrol 2015; 48:183-9. [PMID: 26676309 DOI: 10.1007/s11255-015-1173-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 11/24/2015] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the effects of newer sublingual desmopressin administration in lithiasic renal colic, alone or combined with a nonsteroidal anti-inflammatory drug (NSAID). METHODS Prospective single-blind study including an initial number of 249 patients with lithiasic renal colic was randomized as follows: group NSAID (71 patients) received ketorolac tromethamine (ketorolac) 30 mg im and sublingual placebo (vitamin C), groups D1 and D2 (57 and 62 patients) received sublingual desmopressin (Minirin Melt), 60 and 120 μg, respectively, whereas group C (59 patients) received a combination of 30 mg im ketorolac and 60 μg sublingual desmopressin. Pain intensity was assessed using the visual analogue scale before and thirty minutes after drug administration. Patients experiencing pain aggravation were rescued and excluded from the study. RESULTS Dropout incidence was higher in the NSAID group than in the groups treated with desmopressin in monotherapy or combined with ketorolac (p < 0.05). Pain intensity was diminished at least as potently by the monotherapy with desmopressin and ketorolac. The higher dose of desmopressin and the combination therapy decreased pain intensity with 56 and 59%, respectively, significantly more than the 47% decrease obtained with ketorolac alone (p < 0.05 and p < 0.001). Mean pain decrease was higher in the combination group (C) than in the NSAID or D1 groups (p < 0.001 and p < 0.05, respectively), suggesting drug additivity. Patients did not experience severe side effects. CONCLUSIONS Sublingual desmopressin is at least as potent as NSAID in the treatment of lithiasic renal colic. The combination of sublingual desmopressin and NSAID has additive analgesic effects.
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Affiliation(s)
- Catalin Pricop
- Department of Urology, "Gr. T. Popa" University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania
| | - Dumitru D Branisteanu
- Department of Endocrinology, "Gr. T. Popa" University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania
| | - Martha Orsolya
- Department of Urology, Tg. Mures University of Medicine and Pharmacy, 38th Gheorghe Marinescu St, 540139, Tg Mures, Romania.
| | - Dragos Puia
- Department of Urology, "C.I. Parhon" Clinical Hospital, 50th Carol Bd., 700503, Iasi, Romania
| | - Anca Matei
- Department of Endocrinology, "St. Spiridon" Emergency Hospital, 1st Independentei Bd., 700106, Iasi, Romania
| | - Ionel Alexandru Checherita
- Department of Nephrology and Dialysis, Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, 37th Dionisie Lupu St, Sector 1, 020022, Bucharest, Romania
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Radulescu D, Peride I, Checherita IA, Niculae A, David C, Vacaroiu I. SP318RENAL HARMFUL EFFECTS OF ANABOLIC STEROIDS ABUSE IN NON-PROFESSIONAL BODYBUILDERS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv191.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Radulescu D, Checherita IA, Peride I, Ginghina O, Niculae A, David C, VACAROIU I. FP438INCIDENCE AND RISK FACTORS FOR PROLONGED HUNGRY BONE DISEASE AFTER PARATHYROIDECTOMY IN DIALYZED PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv177.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Checherita IA, Peride I, Geavlete B, Niculae A, Radulescu D, Vacaroiu I. FP108RELATIONSHIP BETWEEN URIC ACID NEPHROLITHIASIS AND OBESITY. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv170.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hamdouk M, Abdelraheem M, Taha A, Cristina D, Checherita IA, Alexandru C. The Association between Prolonged Occupational Exposure to Paraphenylenediamine (Hair-dye) and Renal Impairment. ACTA ACUST UNITED AC 2011; 4:21-5. [PMID: 21469591 DOI: 10.4314/ajnt.v4i1.63151] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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