Baby surprise: Woman mistakes 37-week pregnancy for bad Chinese food
A woman who thought she had bad Chinese food had the surprise of her life when she discovered she was actually pregnant.
Saturday, March 31, 2018
FOX NEWS: Baby surprise: Woman mistakes 37-week pregnancy for bad Chinese food
Baby surprise: Woman mistakes 37-week pregnancy for bad Chinese food
A woman who thought she had bad Chinese food had the surprise of her life when she discovered she was actually pregnant.
FOX NEWS: Teen battling cancer crowned honorary prom queen by South Carolina high school
Teen battling cancer crowned honorary prom queen by South Carolina high school
A 14-year-old girl from Barnwell, South Carolina, who's battling cancer was crowned honorary prom queen on Thursday.
Is This Tissue a New Organ? Maybe. A Conduit for Cancer? It Seems Likely.
By JACEY FORTIN from NYT Health https://ift.tt/2pUkjlA
Friday, March 30, 2018
FOX NEWS: Synthetic pot cases spike in Illinois, officials warn users may experience 'bleeding from eyes and ears'
Synthetic pot cases spike in Illinois, officials warn users may experience 'bleeding from eyes and ears'
Emergency rooms in Illinois are noticing a recent spike in synthetic pot users who are suffering from "severe bleeding" and state health officials are warning the public to remain vigilant.
This Months Highlights
from Journal of the American Society of Nephrology current issue https://ift.tt/2GGFVvS
Unique Gene Expression in Developing Ascending Vasa Recta: A Tale of Tie
from Journal of the American Society of Nephrology current issue https://ift.tt/2E85aSz
Maintenance and Breakdown of Glomerular Tuft Architecture
from Journal of the American Society of Nephrology current issue https://ift.tt/2GXusWH
We AIM2 Inflame
from Journal of the American Society of Nephrology current issue https://ift.tt/2pRsXkP
Evaluation of Potential Living Kidney Donors in the APOL1 Era
from Journal of the American Society of Nephrology current issue https://ift.tt/2H0vCRq
Gender Disparities and Financial Barriers to Living Kidney Donation
from Journal of the American Society of Nephrology current issue https://ift.tt/2E6rP1R
Targeting Zero Infections in Dialysis: New Devices, Yes, but also Guidelines, Checklists, and a Culture of Safety
from Journal of the American Society of Nephrology current issue https://ift.tt/2GZBoCO
Bariatric Surgery and Kidney Health
from Journal of the American Society of Nephrology current issue https://ift.tt/2E6Jarp
Filtering the Evidence: Is There a Cognitive Cost of Hemodialysis?
from Journal of the American Society of Nephrology current issue https://ift.tt/2GYyA8V
HIV-Positive Kidney Donor Selection for HIV-Positive Transplant Recipients
The risks associated with transplanting HIV-positive kidneys into HIV-positive recipients have not been well studied. Since 2008, 43 kidneys from 25 HIV-positive deceased donors have been transplanted into patients who are HIV positive in Cape Town, South Africa. Among the donors, 19 (76%) died secondary to trauma. The average age for donors was 34 (interquartile range, 19–52) years old. In some donors, only one kidney was used because of a limited number of suitable recipients on the waiting list. Only two donors had been previously exposed to antiretroviral triple therapy. In 23 of the deceased organ donors, the HIV status was not known before the time of death. Initial concerns about transplanting HIV-positive allografts into HIV-positive recipients in this clinic revolved around the possibility of HIV superinfection. However, all recipients remained virally suppressed several years after the transplant. Only one recipient experienced an increased viral load after the transplant, which was related to a period of noncompliance on her medication. After counseling and improved compliance, the viral load decreased and became suppressed again. Herein, we discuss the findings of this study and review the literature available on this crucial topic.
from Journal of the American Society of Nephrology current issue https://ift.tt/2E88A7T
Ascending Vasa Recta Are Angiopoietin/Tie2-Dependent Lymphatic-Like Vessels
Urinary concentrating ability is central to mammalian water balance and depends on a medullary osmotic gradient generated by a countercurrent multiplication mechanism. Medullary hyperosmolarity is protected from washout by countercurrent exchange and efficient removal of interstitial fluid resorbed from the loop of Henle and collecting ducts. In most tissues, lymphatic vessels drain excess interstitial fluid back to the venous circulation. However, the renal medulla is devoid of classic lymphatics. Studies have suggested that the fenestrated ascending vasa recta (AVRs) drain the interstitial fluid in this location, but this function has not been conclusively shown. We report that late gestational deletion of the angiopoietin receptor endothelial tyrosine kinase 2 (Tie2) or both angiopoietin-1 and angiopoietin-2 prevents AVR formation in mice. The absence of AVR associated with rapid accumulation of fluid and cysts in the medullary interstitium, loss of medullary vascular bundles, and decreased urine concentrating ability. In transgenic reporter mice with normal angiopoietin-Tie2 signaling, medullary AVR exhibited an unusual hybrid endothelial phenotype, expressing lymphatic markers (prospero homeobox protein 1 and vascular endothelial growth factor receptor 3) as well as blood endothelial markers (CD34, endomucin, platelet endothelial cell adhesion molecule 1, and plasmalemmal vesicle–associated protein). Taken together, our data redefine the AVRs as Tie2 signaling–dependent specialized hybrid vessels and provide genetic evidence of the critical role of AVR in the countercurrent exchange mechanism and the structural integrity of the renal medulla.
from Journal of the American Society of Nephrology current issue https://ift.tt/2GZ7379
The Adiponectin Receptor Agonist AdipoRon Ameliorates Diabetic Nephropathy in a Model of Type 2 Diabetes
Adiponectin exerts renoprotective effects against diabetic nephropathy (DN) by activating the AMP-activated protein kinase (AMPK)/peroxisome proliferative-activated receptor–α (PPARα) pathway through adiponectin receptors (AdipoRs). AdipoRon is an orally active synthetic adiponectin receptor agonist. We investigated the expression of AdipoRs and the associated intracellular pathways in 27 patients with type 2 diabetes and examined the effects of AdipoRon on DN development in male C57BLKS/J db/db mice, glomerular endothelial cells (GECs), and podocytes. The extent of glomerulosclerosis and tubulointerstitial fibrosis correlated with renal function deterioration in human kidneys. Expression of AdipoR1, AdipoR2, and Ca2+/calmodulin-dependent protein kinase kinase–β (CaMKKβ) and numbers of phosphorylated liver kinase B1 (LKB1)– and AMPK-positive cells significantly decreased in the glomeruli of early stage human DN. AdipoRon treatment restored diabetes-induced renal alterations in db/db mice. AdipoRon exerted renoprotective effects by directly activating intrarenal AdipoR1 and AdipoR2, which increased CaMKKβ, phosphorylated Ser431LKB1, phosphorylated Thr172AMPK, and PPARα expression independently of the systemic effects of adiponectin. AdipoRon-induced improvement in diabetes-induced oxidative stress and inhibition of apoptosis in the kidneys ameliorated relevant intracellular pathways associated with lipid accumulation and endothelial dysfunction. In high-glucose–treated human GECs and murine podocytes, AdipoRon increased intracellular Ca2+ levels that activated a CaMKKβ/phosphorylated Ser431LKB1/phosphorylated Thr172AMPK/PPARα pathway and downstream signaling, thus decreasing high-glucose–induced oxidative stress and apoptosis and improving endothelial dysfunction. AdipoRon further produced cardioprotective effects through the same pathway demonstrated in the kidney. Our results show that AdipoRon ameliorates GEC and podocyte injury by activating the intracellular Ca2+/LKB1-AMPK/PPARα pathway, suggesting its efficacy for treating type 2 diabetes–associated DN.
from Journal of the American Society of Nephrology current issue https://ift.tt/2GqhLmb
Nephronectin Regulates Mesangial Cell Adhesion and Behavior in Glomeruli
A critical aspect of kidney function occurs at the glomerulus, the capillary network that filters the blood. The glomerular basement membrane (GBM) is a key component of filtration, yet our understanding of GBM interactions with mesangial cells, specialized pericytes that provide structural stability to glomeruli, is limited. We investigated the role of nephronectin (Npnt), a GBM component and known ligand of α8β1 integrin. Immunolocalization and in situ hybridization studies in kidneys of adult mice revealed that nephronectin is produced by podocytes and deposited into the GBM. Conditional deletion of Npnt from nephron progenitors caused a pronounced increase in mesangial cell number and mesangial sclerosis. Nephronectin colocalized with α8β1 integrin to novel, specialized adhesion structures that occurred at sites of mesangial cell protrusion at the base of the capillary loops. Absence of nephronectin disrupted these adhesion structures, leading to mislocalization of α8β1. Podocyte-specific deletion of Npnt also led to mesangial sclerosis in mice. These results demonstrate a novel role for nephronectin and α8β1 integrin in a newly described adhesion complex and begin to uncover the molecular interactions between the GBM and mesangial cells, which govern mesangial cell behavior and may have a role in pathologic states.
from Journal of the American Society of Nephrology current issue https://ift.tt/2GE4utt
The MFHR1 Fusion Protein Is a Novel Synthetic Multitarget Complement Inhibitor with Therapeutic Potential
The complement system is essential for host defense, but uncontrolled complement system activation leads to severe, mostly renal pathologies, such as atypical hemolytic uremic syndrome or C3 glomerulopathy. Here, we investigated a novel combinational approach to modulate complement activation by targeting C3 and the terminal pathway simultaneously. The synthetic fusion protein MFHR1 links the regulatory domains of complement factor H (FH) with the C5 convertase/C5b-9 inhibitory fragment of the FH-related protein 1. In vitro, MFHR1 showed cofactor and decay acceleration activity and inhibited C5 convertase activation and C5b-9 assembly, which prevented C3b deposition and reduced C3a/C5a and C5b-9 generation. Furthermore, this fusion protein showed the ability to escape deregulation by FH-related proteins and form multimeric complexes with increased inhibitory activity. In addition to substantially inhibiting alternative and classic pathway activation, MFHR1 blocked hemolysis mediated by serum from a patient with aHUS expressing truncated FH. In FH–/– mice, MFHR1 administration augmented serum C3 levels, reduced abnormal glomerular C3 deposition, and ameliorated C3 glomerulopathy. Taking the unique design of MFHR1 into account, we suggest that the combination of proximal and terminal cascade inhibition together with the ability to form multimeric complexes explain the strong inhibitory capacity of MFHR1, which offers a novel basis for complement therapeutics.
from Journal of the American Society of Nephrology current issue https://ift.tt/2Gnae7A
Exogenous Gene Transmission of Isocitrate Dehydrogenase 2 Mimics Ischemic Preconditioning Protection
Ischemic preconditioning confers organ-wide protection against subsequent ischemic stress. A substantial body of evidence underscores the importance of mitochondria adaptation as a critical component of cell protection from ischemia. To identify changes in mitochondria protein expression in response to ischemic preconditioning, we isolated mitochondria from ischemic preconditioned kidneys and sham-treated kidneys as a basis for comparison. The proteomic screen identified highly upregulated proteins, including NADP+-dependent isocitrate dehydrogenase 2 (IDH2), and we confirmed the ability of this protein to confer cellular protection from injury in murine S3 proximal tubule cells subjected to hypoxia. To further evaluate the role of IDH2 in cell protection, we performed detailed analysis of the effects of Idh2 gene delivery on kidney susceptibility to ischemia-reperfusion injury. Gene delivery of IDH2 before injury attenuated the injury-induced rise in serum creatinine (P<0.05) observed in controls and increased the mitochondria membrane potential (P<0.05), maximal respiratory capacity (P<0.05), and intracellular ATP levels (P<0.05) above those in controls. This communication shows that gene delivery of Idh2 can confer organ-wide protection against subsequent ischemia-reperfusion injury and mimics ischemic preconditioning.
from Journal of the American Society of Nephrology current issue https://ift.tt/2pU1tLn
FOX NEWS: Twin brothers in Michigan welcome newborns on the same day: 'It was destined to be'
Twin brothers in Michigan welcome newborns on the same day: 'It was destined to be'
Twin brothers in Michigan had an unexpected surprise on Tuesday when both of their wives gave birth on the same day.
Macrophage Uptake of Necrotic Cell DNA Activates the AIM2 Inflammasome to Regulate a Proinflammatory Phenotype in CKD
Nonmicrobial inflammation contributes to CKD progression and fibrosis. Absent in melanoma 2 (AIM2) is an inflammasome-forming receptor for double-stranded DNA. AIM2 is expressed in the kidney and activated mainly by macrophages. We investigated the potential pathogenic role of the AIM2 inflammasome in kidney disease. In kidneys from patients with diabetic or nondiabetic CKD, immunofluorescence showed AIM2 expression in glomeruli, tubules, and infiltrating leukocytes. In a mouse model of unilateral ureteral obstruction (UUO), Aim2 deficiency attenuated the renal injury, fibrosis, and inflammation observed in wild-type (WT) littermates. In bone marrow chimera studies, UUO induced substantially more tubular injury and IL-1β cleavage in Aim2–/– or WT mice that received WT bone marrow than in WT mice that received Aim2–/– bone marrow. Intravital microscopy of the kidney in LysM(gfp/gfp) mice 5–6 days after UUO demonstrated the significant recruitment of GFP+ proinflammatory macrophages that crawled along injured tubules, engulfed DNA from necrotic cells, and expressed active caspase-1. DNA uptake occurred in large vacuolar structures within recruited macrophages but not resident CX3CR1+ renal phagocytes. In vitro, macrophages that engulfed necrotic debris showed AIM2-dependent activation of caspase-1 and IL-1β, as well as the formation of AIM2+ ASC specks. ASC specks are a hallmark of inflammasome activation. Cotreatment with DNaseI attenuated the increase in IL-1β levels, confirming that DNA was the principal damage-associated molecular pattern in this process. Therefore, the activation of the AIM2 inflammasome by DNA from necrotic cells drives a proinflammatory phenotype that contributes to chronic injury in the kidney.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J4SRKw
NBCe1-A Regulates Proximal Tubule Ammonia Metabolism under Basal Conditions and in Response to Metabolic Acidosis
Renal ammonia metabolism is the primary mechanism through which the kidneys maintain acid-base homeostasis, but the molecular mechanisms regulating renal ammonia generation are unclear. In these studies, we evaluated the role of the proximal tubule basolateral plasma membrane electrogenic sodium bicarbonate cotransporter 1 variant A (NBCe1-A) in this process. Deletion of the NBCe1-A gene caused severe spontaneous metabolic acidosis in mice. Despite this metabolic acidosis, which normally causes a dramatic increase in ammonia excretion, absolute urinary ammonia concentration was unaltered. Additionally, NBCe1-A deletion almost completely blocked the ability to increase ammonia excretion after exogenous acid loading. Under basal conditions and during acid loading, urine pH was more acidic in mice with NBCe1-A deletion than in wild-type controls, indicating that the abnormal ammonia excretion was not caused by a primary failure of urine acidification. Instead, NBCe1-A deletion altered the expression levels of multiple enzymes involved in proximal tubule ammonia generation, including phosphate-dependent glutaminase, phosphoenolpyruvate carboxykinase, and glutamine synthetase, under basal conditions and after exogenous acid loading. Deletion of NBCe1-A did not impair expression of key proteins involved in collecting duct ammonia secretion. These studies demonstrate that the integral membrane protein NBCe1-A has a critical role in basal and acidosis-stimulated ammonia metabolism through the regulation of proximal tubule ammonia-metabolizing enzymes.
from Journal of the American Society of Nephrology current issue https://ift.tt/2E7WJGW
Protein Kinase 2{beta} Is Expressed in Neural Crest-Derived Urinary Pacemaker Cells and Required for Pyeloureteric Contraction
Nonobstructive hydronephrosis, defined as dilatation of the renal pelvis with or without dilatation of the ureter, is the most common antenatal abnormality detected by fetal ultrasound. Yet, the etiology of nonobstructive hydronephrosis is poorly defined. We previously demonstrated that defective development of urinary tract pacemaker cells (utPMCs) expressing hyperpolarization-activated cyclic nucleotide-gated channel 3 (HCN3) and the stem cell marker cKIT causes abnormal ureteric peristalsis and nonobstructive hydronephrosis. However, further investigation of utPMC development and function is limited by lack of knowledge regarding the embryonic derivation, development, and molecular apparatus of these cells. Here, we used lineage tracing in mice to identify cells that give rise to utPMCs. Neural crest cells (NCCs) indelibly labeled with tdTomato expressed HCN3 and cKIT. Furthermore, purified HCN3+ and cKIT+ utPMCs were enriched in Sox10 and Tfap-2α, markers of NCCs. Sequencing of purified RNA from HCN3+ cells revealed enrichment of a small subset of RNAs, including RNA encoding protein kinase 2β (PTK2β), a Ca2+-dependent tyrosine kinase that regulates ion channel activity in neurons. Immunofluorescence analysis in situ revealed PTK2β expression in NCCs as early as embryonic day 12.5 and in HCN3+ and cKIT+ utPMCs as early as embryonic day 15.5, with sustained expression in HCN3+ utPMCs until postnatal week 8. Pharmacologic inhibition of PTK2β in murine pyeloureteral tissue explants inhibited contraction frequency. Together, these results demonstrate that utPMCs are derived from NCCs, identify new markers of utPMCs, and demonstrate a functional contribution of PTK2β to utPMC function.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J5JgDm
IL-17C/IL-17 Receptor E Signaling in CD4+ T Cells Promotes TH17 Cell-Driven Glomerular Inflammation
The IL-17 cytokine family and the cognate receptors thereof have a unique role in organ-specific autoimmunity. Most studies have focused on the founding member of the IL-17 family, IL-17A, as the central mediator of diseases. Indeed, although pathogenic functions have been ascribed to IL-17A and IL-17F in the context of immune-mediated glomerular diseases, the specific functions of the other IL-17 family members in immunity and inflammatory kidney diseases is largely unknown. Here, we report that compared with healthy controls, patients with acute Anti-neutrophil cytoplasmatic antibody (ANCA)-associated crescentic glomerulonephritis (GN) had significantly elevated serum levels of IL-17C (but not IL-17A, F, or E). In mouse models of crescentic GN (nephrotoxic nephritis) and pristane-induced lupus nephritis, deficiency in IL-17C significantly ameliorated the course of GN in terms of renal tissue injury and kidney function. Deficiency of the unique IL-17C receptor IL-17 receptor E (IL-17RE) provided similar protection against crescentic GN. These protective effects associated with a reduced TH17 response. Bone marrow transplantation experiments revealed that IL-17C is produced by tissue-resident cells, but not by lymphocytes. Finally, IL-17RE was highly expressed by CD4+ TH17 cells, and loss of this expression prevented the TH17 responses and subsequent tissue injury in crescentic GN. Our findings indicate that IL-17C promotes TH17 cell responses and immune-mediated kidney disease via IL-17RE expressed on CD4+ TH17 cells. Targeting the IL-17C/IL-17RE pathway may present an intriguing therapeutic strategy for TH17-induced autoimmune disorders.
from Journal of the American Society of Nephrology current issue https://ift.tt/2E7WE66
Impairment of PPAR{alpha} and the Fatty Acid Oxidation Pathway Aggravates Renal Fibrosis during Aging
Defects in the renal fatty acid oxidation (FAO) pathway have been implicated in the development of renal fibrosis. Although, compared with young kidneys, aged kidneys show significantly increased fibrosis with impaired kidney function, the mechanisms underlying the effects of aging on renal fibrosis have not been investigated. In this study, we investigated peroxisome proliferator–activated receptor α (PPARα) and the FAO pathway as regulators of age-associated renal fibrosis. The expression of PPARα and the FAO pathway–associated proteins significantly decreased with the accumulation of lipids in the renal tubular epithelial region during aging in rats. In particular, decreased PPARα protein expression associated with increased expression of PPARα-targeting microRNAs. Among the microRNAs with increased expression during aging, miR-21 efficiently decreased PPARα expression and impaired FAO when ectopically expressed in renal epithelial cells. In cells pretreated with oleic acid to induce lipid stress, miR-21 treatment further enhanced lipid accumulation. Furthermore, treatment with miR-21 significantly exacerbated the TGF-β–induced fibroblast phenotype of epithelial cells. We verified the physiologic importance of our findings in a calorie restriction model. Calorie restriction rescued the impaired FAO pathway during aging and slowed fibrosis development. Finally, compared with kidneys of aged littermate controls, kidneys of aged PPARα–/– mice showed exaggerated lipid accumulation, with decreased activity of the FAO pathway and a severe fibrosis phenotype. Our results suggest that impaired renal PPARα signaling during aging aggravates renal fibrosis development, and targeting PPARα is useful for preventing age-associated CKD.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J7OjDo
Wnt9a Promotes Renal Fibrosis by Accelerating Cellular Senescence in Tubular Epithelial Cells
Cellular senescence is associated with renal disease progression, and accelerated tubular cell senescence promotes the pathogenesis of renal fibrosis. However, the underlying mechanism is unknown. We assessed the potential role of Wnt9a in tubular cell senescence and renal fibrosis. Compared with tubular cells of normal subjects, tubular cells of humans with a variety of nephropathies and those of several mouse models of CKD expressed high levels of Wnt9a that colocalized with the senescence-related protein p16INK4A. Wnt9a expression level correlated with the extent of renal fibrosis, decline of eGFR, and expression of p16INK4A. Furthermore, ectopic expression of Wnt9a after ischemia-reperfusion injury (IRI) induced activation of β-catenin and exacerbated renal fibrosis. Overexpression of Wnt9a exacerbated tubular senescence, evidenced by increased detection of p16INK4A expression and senescence-associated β-galactosidase activity. Conversely, shRNA-mediated knockdown of Wnt9a repressed IRI-induced renal fibrosis in vivo and impeded the growth of senescent tubular epithelial cells in culture. Notably, Wnt9a-induced renal fibrosis was inhibited by shRNA-mediated silencing of p16INK4A in the IRI mouse model. In a human proximal tubular epithelial cell line and primary renal tubular cells, Wnt9a remarkably upregulated levels of senescence-related p16INK4A, p19ARF, p53, and p21 and decreased the phosphorylation of retinoblastoma protein. Wnt9a also induced senescent tubular cells to produce TGF-β1, which promoted proliferation and activation in normal rat kidney fibroblasts. Thus, Wnt9a drives tubular senescence and fibroblast activation. Furthermore, the Wnt9a–TGF-β pathway appears to create a reciprocal activation loop between senescent tubular cells and activated fibroblasts that promotes and accelerates the pathogenesis of renal fibrosis.
from Journal of the American Society of Nephrology current issue https://ift.tt/2E7WziO
Fibroblast-Specific {beta}-Catenin Signaling Dictates the Outcome of AKI
AKI is a devastating condition with high morbidity and mortality. The pathologic features of AKI are characterized by tubular injury, inflammation, and vascular impairment. Whether fibroblasts in the renal interstitium have a role in the pathogenesis of AKI is unknown. In this study, we investigated the role of fibroblast-specific β-catenin signaling in dictating the outcome of AKI, using conditional knockout mice in which β-catenin was specifically ablated in fibroblasts (Gli1-β-cat–/–). After ischemia-reperfusion injury (IRI), Gli1-β-cat–/– mice had lower serum creatinine levels and less morphologic injury than Gli1-β-cat+/+ littermate controls. Moreover, we detected fewer apoptotic cells, as well as decreased cytochrome C release; reduced expression of Bax, FasL, and p53; and increased phosphorylation of Akt, in the Gli1-β-cat–/– kidneys. Gli1-β-cat–/– kidneys also exhibited upregulated expression of proliferating cell nuclear antigen and Ki-67, which are markers of cell proliferation. Furthermore, Gli1-β-cat–/– kidneys displayed suppressed NF-B signaling and cytokine expression and reduced infiltration of inflammatory cells. Notably, loss of β-catenin in fibroblasts induced renal expression of hepatocyte growth factor (HGF) and augmented the tyrosine phosphorylation of c-met receptor after IRI. In vitro, treatment with Wnt ligands or ectopic expression of active β-catenin inhibited HGF mRNA and protein expression and repressed HGF promoter activity. Collectively, these results suggest that fibroblast-specific β-catenin signaling can control tubular injury and repair in AKI by modulating HGF expression. Our studies uncover a previously unrecognized role for interstitial fibroblasts in the pathogenesis of AKI.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J2DyCd
Endogenous IL-33 Contributes to Kidney Ischemia-Reperfusion Injury as an Alarmin
Inflammation is a prominent feature of ischemia-reperfusion injury (IRI), which is characterized by leukocyte infiltration and renal tubular injury. However, signals that initiate these events remain poorly understood. We examined the role of the nuclear alarmin IL-33 in tissue injury and innate immune response triggered by experimental kidney ischemia-reperfusion. In wild-type mice, we found that IL-33 was constitutively expressed throughout the kidney in peritubular and periglomerular spaces, mainly by microvascular endothelial cells, from which it was released immediately during IRI. Compared with wild-type mice, mice lacking IL-33 (IL-33Gt/Gt) exhibited reductions in early tubular cell injury and subsequent renal infiltration of IFN-/IL-17A–producing neutrophils, with preservation of renal functions. This protection associated with decreased renal recruitment of myeloid dendritic cells, natural killer (NK) cells, and invariant natural killer T (iNKT) cells, the latter of which were reported as deleterious in IRI. Increases in the level of circulating IL-12, a key IL-33 cofactor, and the expression of ST2, an IL-33–specific receptor, on the surface of iNKT cells preceded the IL-33– and iNKT cell–dependent phase of neutrophil infiltration. Furthermore, IL-33 directly targeted iNKT cells in vitro, inducing IFN- and IL-17A production. We propose that endogenous IL-33 is released as an alarmin and contributes to kidney IRI by promoting iNKT cell recruitment and cytokine production, resulting in neutrophil infiltration and activation at the injury site. Our findings show a novel molecular mediator contributing to innate immune cell recruitment induced by renal ischemia-reperfusion and may provide therapeutic insights into AKI associated with renal transplantation.
from Journal of the American Society of Nephrology current issue https://ift.tt/2E7WvzA
Effect of Bariatric Surgery on CKD Risk
Obesity is linked to the development and progression of CKD, but whether bariatric surgery protects against CKD is poorly understood. We, therefore, examined whether bariatric surgery influences CKD risk. The study included 2144 adults who underwent bariatric surgery from March of 2006 to April of 2009 and participated in the Longitudinal Assessment of Bariatric Surgery-2 Study cohort. The primary outcome was CKD risk categories as assessed by the Kidney Disease Improving Global Outcomes (KDIGO) consortium criteria using a combination of eGFR and albuminuria. Patients were 79% women and 87% white, with a median age of 46 years old. Improvements were observed in CKD risk at 1 and 7 years after surgery in patients with moderate baseline CKD risk (63% and 53%, respectively), high baseline risk (78% and 56%, respectively), and very high baseline risk (59% and 23%, respectively). The proportion of patients whose CKD risk worsened was ≤10%; five patients developed ESRD. Sensitivity analyses using year 1 as baseline to minimize the effect of weight loss on serum creatinine and differing eGFR equations offered qualitatively similar results. Treatment with bariatric surgery associated with an improvement in CKD risk categories in a large proportion of patients for up to 7 years, especially in those with moderate and high baseline risk. These findings support consideration of CKD risk in evaluation for bariatric surgery and further study of bariatric surgery as a treatment for high-risk obese patients with CKD.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J6fIW5
The Change in Living Kidney Donation in Women and Men in the United States (2005-2015): A Population-Based Analysis
The factors underlying the decline in living kidney donation in the United States since 2005 must be understood to inform strategies to ensure access to this option for future patients. Population-based estimates provide a better assessment of donation activity than do trends in the number of living donor transplants. Using data from the Scientific Registry of Transplant Recipients and the United States Census, we determined longitudinal changes in living kidney donation between 2005 and 2015, focusing on the effect of sex and income. We used multilevel Poisson models to adjust for differences in age, race, the incidence of ESRD, and geographic factors (including population density, urbanization, and daily commuting). During the study period, the unadjusted rate of donation was 30.1 and 19.3 per million population in women and men, respectively, and the adjusted incidence of donation was 44% higher in women (incidence rate ratio [IRR], 1.44; 95% confidence interval [95% CI], 1.39 to 1.49). The incidence of donation was stable in women (IRR, 0.95; 95% CI, 0.84 to 1.07) but declined in men (IRR, 0.75; 95% CI, 0.68 to 0.83). Income was associated with longitudinal changes in donation in both sexes, yet donation was stable in the highest two population income quartiles in women but only in the highest income quartile in men. In both sexes, living related donations declined, irrespective of income. In conclusion, living donation declined in men but remained stable in women between 2005 and 2015, and income appeared to have a greater effect on living donation in men.
from Journal of the American Society of Nephrology current issue https://ift.tt/2pU0Ykt
APOL1 Genotype and Renal Function of Black Living Donors
Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1.73 m2; P=0.04). At a median of 12 years after donation, donors with the APOL1 high-risk genotype had lower eGFR (57±18 versus 67±15 ml/min per 1.73 m2; P=0.02) and faster decline in eGFR after adjusting for predonation eGFR (1.19; 95% confidence interval, 0 to 2.3 versus 0.4; 95% confidence interval, 0.1 to 0.7 ml/min per 1.73 m2 per year, P=0.02). Two donors developed ESRD; both carried the APOL1 high-risk genotype. In a subgroup of 115 donors matched to 115 nondonors by APOL1 genotype, we did not find a difference between groups in the rate of eGFR decline (P=0.39) or any statistical interaction by APOL1 status (P=0.92). In conclusion, APOL1 high-risk genotype in black living kidney donors associated with greater decline in postdonation kidney function. Trajectory of renal function was similar between donors and nondonors. The association between APOL1 high-risk genotype and poor renal outcomes in kidney donors requires validation in a larger study.
from Journal of the American Society of Nephrology current issue https://ift.tt/2J6JDgT
Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients
The initiation of hemodialysis is associated with an accelerated decline of cognitive function and an increased incidence of cerebrovascular accidents and white matter lesions. Investigators have hypothesized that the repetitive circulatory stress of hemodialysis induces ischemic cerebral injury, but the mechanism is unclear. We studied the acute effect of conventional hemodialysis on cerebral blood flow (CBF), measured by [15O]H2O positron emission tomography–computed tomography (PET-CT). During a single hemodialysis session, three [15O]H2O PET-CT scans were performed: before, early after the start of, and at the end of hemodialysis. We used linear mixed models to study global and regional CBF change during hemodialysis. Twelve patients aged ≥65 years (five women, seven men), with a median dialysis vintage of 46 months, completed the study. Mean (±SD) arterial BP declined from 101±11 mm Hg before hemodialysis to 93±17 mm Hg at the end of hemodialysis. From before the start to the end of hemodialysis, global CBF declined significantly by 10%±15%, from a mean of 34.5 to 30.5 ml/100g per minute (difference, –4.1 ml/100 g per minute; 95% confidence interval, –7.3 to –0.9 ml/100 g per minute; P=0.03). CBF decline (20%) was symptomatic in one patient. Regional CBF declined in all volumes of interest, including the frontal, parietal, temporal, and occipital lobes; cerebellum; and thalamus. Higher tympanic temperature, ultrafiltration volume, ultrafiltration rate, and pH significantly associated with lower CBF. Thus, conventional hemodialysis induces a significant reduction in global and regional CBF in elderly patients. Repetitive intradialytic decreases in CBF may be one mechanism by which hemodialysis induces cerebral ischemic injury.
from Journal of the American Society of Nephrology current issue https://ift.tt/2pREZuk
Blood HER2 and Uromodulin as Causal Mediators of CKD
Many biomarkers have been epidemiologically linked with CKD; however, the possibility that such associations are due to reverse causation or confounding limits the utility of these biomarkers. To overcome this limitation, we used a Mendelian randomization (MR) approach to identify causal mediators of CKD. We performed MR by first identifying genetic determinants of 227 serum protein biomarkers assayed in 4147 participants of the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial who had early or prediabetes, and assessing the effects of these biomarkers on CKD in the CKD genetics consortium (n=117,165; 12,385 cases) using the inverse-variance weighted (fixed-effects) method. We then estimated the relationship between the serum concentration of each biomarker identified and incident CKD in ORIGIN participants. MR identified uromodulin (UMOD) and human EGF receptor 2 (HER2) as novel, causal mediators of CKD (UMOD: odds ratio [OR], 1.30 per SD; 95% confidence interval [95% CI], 1.25 to 1.35; P<5x10–20; HER2: OR, 1.30 per SD; 95% CI, 1.14 to 1.48; P=8.0x10–5). Consistent with these findings, blood HER2 concentration associated with CKD events in ORIGIN participants (OR, 1.07 per SD; 95% CI, 1.01 to 1.13; P=0.01). Additional exploratory MR analyses identified angiotensin-converting enzyme (ACE) as a regulator of HER2 levels (β=0.13 per SD; 95% CI, 0.08 to 0.16; P=2.5x10–7). This finding was corroborated by an inverse relationship between ACE inhibitor use and HER2 levels. Thus, UMOD and HER2 are independent causal mediators of CKD in humans, and serum HER2 levels are regulated in part by ACE. These biomarkers are potential therapeutic targets for CKD prevention.
from Journal of the American Society of Nephrology current issue https://ift.tt/2Ja0ZcS
Cluster-Randomized Trial of Devices to Prevent Catheter-Related Bloodstream Infection
Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group). Forty DaVita dialysis facilities in the United States were pair-matched by BSI rate, number of patients using CVCs, and geographic location, and then cluster randomized 1:1. We enrolled all adult patients undergoing dialysis with CVCs at these facilities, except those allergic to heparin or chlorhexidine. Overall, 1671 patients participated in the study, accruing >183,000 CVC-days. The study outcome was positive blood culture (PBC) rate as an indicator of BSI rate. We calculated results at the cluster level and adjusted for the facility cluster effect. During a 3-month run-in period immediately before study interventions, the groups had similar BSI rates (P=0.8). During the 13-month intervention period that immediately followed, the ClearGuard group had a BSI rate significantly lower than that of the Tego+Curos group (0.28 versus 0.75 PBCs per 1000 CVC-days, respectively; P=0.001). No device-related adverse events were reported. In conclusion, compared with Tego connectors plus Curos caps, ClearGuard HD antimicrobial barrier caps significantly lowered the rate of catheter-related BSIs in patients undergoing hemodialysis using CVCs, representing an important advancement in hemodialysis patient care.
from Journal of the American Society of Nephrology current issue https://ift.tt/2pU54J8
FOX NEWS: 7-year-old boy with Tourette's makes powerful video to stop teasing from classmates
7-year-old boy with Tourette's makes powerful video to stop teasing from classmates
A 7-year old boy with Tourette's Syndrome made a powerful video explaining the condition in an effort to stop his classmates from teasing him.
Bologna Blamed in Worst Listeria Outbreak in History
By EMILY BAUMGAERTNER from NYT Health https://ift.tt/2GpOmIT
FOX NEWS: Cancer experts say coffee is safe, despite California's new warning label requirement
Cancer experts say coffee is safe, despite California's new warning label requirement
A California court judge’s ruling ordering coffee companies to put cancer warning labels on their products is not changing the minds of scientists and health professionals who say there is no credible evidence to warrant the dramatic move.
FOX NEWS: Boy's delight over new wheelchair swing at park will warm your heart
Boy's delight over new wheelchair swing at park will warm your heart
A boy in a wheelchair is filled with joy after having the chance to play on the swings at a neighborhood park.
FOX NEWS: Baby surprise: Woman mistakes 37-week pregnancy for bad Chinese food
Baby surprise: Woman mistakes 37-week pregnancy for bad Chinese food
A woman who thought she had bad Chinese food had the surprise of her life when she discovered she was actually pregnant.
FOX NEWS: CDC director pledges to bring opioid epidemic 'to its knees'
CDC director pledges to bring opioid epidemic 'to its knees'
Dr. Robert Redfield, Jr, the new CDC new director pledged Thursday to work to bring the nation's opioid epidemic "to its knees" and said he believes the AIDS epidemic could be ended in three to seven years.
Many Americans Try Retirement, Then Change Their Minds
By PAULA SPAN from NYT Health https://ift.tt/2GktbvN
Thursday, March 29, 2018
FOX NEWS: Bullied Oklahoma boy, 7, adopts rescue cat with same rare eye condition and cleft lip
Bullied Oklahoma boy, 7, adopts rescue cat with same rare eye condition and cleft lip
Madden Humphreys and his newly-adopted rescue cat, Moon, were destined to be friends.
FOX NEWS: Coffee needs cancer warning in California, judge rules
Coffee needs cancer warning in California, judge rules
A Los Angeles judge has ruled that coffee companies need to carry a cancer warning label in California.
FOX NEWS: Man may find a new kidney thanks to a shopping visit to Costco
Man may find a new kidney thanks to a shopping visit to Costco
An 18-year-old girl saw him and is helping him crowdsource an organ through social media.
FOX NEWS: Twin brothers in Michigan welcome newborns on the same day: 'It was destined to be'
Twin brothers in Michigan welcome newborns on the same day: 'It was destined to be'
Twin brothers in Michigan had an unexpected surprise on Tuesday when both of their wives gave birth on the same day.
FOX NEWS: Mother turns her placenta into a smoothie and feeds it to her family for health benefits
Mother turns her placenta into a smoothie and feeds it to her family for health benefits
A woman turned her placenta into a smoothie and fed it to her husband and their 3-year-old son for what she believes are the health benefits.
FOX NEWS: Former NFL star Jim Kelly recovering after 12 hours of cancer surgery
Former NFL star Jim Kelly recovering after 12 hours of cancer surgery
Former NFL quarterback Jim Kelly was recovering Wednesday night in a New York City hospital after undergoing nearly 12 hours of surgery for oral cancer.
Wednesday, March 28, 2018
FOX NEWS: Surgeons amazed after removing over 2,000 gallstones from woman
Surgeons amazed after removing over 2,000 gallstones from woman
Doctors are amazed after removing 2,350 stones from a woman's gallbladder.
FOX NEWS: Doctors remove 30-pound tumor from man's beer belly
Doctors remove 30-pound tumor from man's beer belly
A man who thought he had a big belly actually had a 30-pound cancerous tumor growing in his abdomen.
FOX NEWS: Poisoned Russian ex-spy, daughter have slim chance of surviving, niece says
Poisoned Russian ex-spy, daughter have slim chance of surviving, niece says
The former Russian spy and his daughter poisoned by a military-grade nerve agent in Britain earlier this month have a slim chance on surviving, his niece said.
FOX NEWS: Toddler hospitalized with severe blisters from toy makeup kit making recovery
Toddler hospitalized with severe blisters from toy makeup kit making recovery
Lydia’s reaction was first reported in a Facebook post by her parents 24 hours after using the makeup. It went viral.
FOX NEWS: Chemical spill at Chicago-area medical clinic sends at least 15 to hospital
Chemical spill at Chicago-area medical clinic sends at least 15 to hospital
A chemical spill Tuesday at a suburban Chicago medical clinic sent at least 15 people to hospitals, including employees and patrons, authorities said.
Tuesday, March 27, 2018
FOX NEWS: Missouri man's sudden death during Colorado family ski trip sparks social media movement
Missouri man's sudden death during Colorado family ski trip sparks social media movement
It was the "perfect storm," Jim Flath says of his 26-year-old son's sudden death during a family ski vacation in Colorado last week.
FOX NEWS: New organ called 'interstitium' may explain how cancer spreads, study says
New organ called 'interstitium' may explain how cancer spreads, study says
A group of scientists recently discovered an organ called the interstitium. It may help to explain how cancer spreads.
FOX NEWS: Colorado hospitals cut opioid use by 36 percent in 6 months
Colorado hospitals cut opioid use by 36 percent in 6 months
Researchers find pilot program drastically reduced opioid use in emergency rooms; Alicia Acuna reports from Denver.
FOX NEWS: Pregnant woman discovered she had a tumor ‘as big as her baby’
Pregnant woman discovered she had a tumor ‘as big as her baby’
40-year-old Susan O'Flanagan was 20-weeks pregnant when the 14cm cancerous tumor was detected on her right kidney during a routine ultrasound.
FOX NEWS: Huge scare for pregnant woman when scan revealed she had a tumor 'as big as her baby'
Huge scare for pregnant woman when scan revealed she had a tumor 'as big as her baby'
A pregnant woman had a huge scare when a scan revealed she had a tumor “as big as her baby.”
FOX NEWS: Yucky ducky? Study reveals bath-time toy's dirty secret
Yucky ducky? Study reveals bath-time toy's dirty secret
The Swiss Federal Institute of Aquatic Science and Technology says researchers turned up “dense growths of bacteria and fungi” on the insides of toys like rubber ducks and crocodiles.
FOX NEWS: A woman with vitiligo goes makeup-free after 30 years of 'wearing a mask'
A woman with vitiligo goes makeup-free after 30 years of 'wearing a mask'
A woman with a heart-shaped vitiligo patch on her face finds the courage to go makeup-free after 30 years of "wearing a mask."
FOX NEWS: ObamaCare premiums may impact the midterm elections
ObamaCare premiums may impact the midterm elections
Dr Nicole Saphier speaks out on 'Fox & Friends First.'
FOX NEWS: Facebook more addictive than opioids?
Facebook more addictive than opioids?
As Facebook denies secretly collecting phone and data history on its users, there are concerns that the social media platform can be more addictive than opioids. #Tucker
FOX NEWS: A woman with a blotchy skin disease finds the courage to go makeup-free after 30 years of 'wearing a mask'
A woman with a blotchy skin disease finds the courage to go makeup-free after 30 years of 'wearing a mask'
A woman with a heart-shaped vitiligo patch on her face has told how she finally found the courage to go makeup-free after 30 years of "wearing a mask".
Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.
By JAN HOFFMAN from NYT Health https://ift.tt/2pJ3FoX
FOX NEWS: Some e-cigarette users may struggle to quit smoking
Some e-cigarette users may struggle to quit smoking
Smokers who say they want to kick the habit might have an easier time if they don't use e-cigarettes, a U.S. study suggests.
Monday, March 26, 2018
Grindr, Popular Gay Sex App, to Offer H.I.V. Test Reminders
By DONALD G. McNEIL Jr. from NYT Health https://ift.tt/2IWYJFB
FOX NEWS: Short bursts of exercise may be as beneficial as regular workouts in extending life
Short bursts of exercise may be as beneficial as regular workouts in extending life
New research suggests that more than 20 minutes of daily exercise is necessary to reduce mortality and the risk of disease. But the good news is that the exercise can provide all these benefits even when broken down into short bursts of activity.
For Many Strokes, There’s an Effective Treatment. Why Aren’t Some Doctors Offering It?
By GINA KOLATA from NYT Health https://ift.tt/2Gewv7B
FOX NEWS: A 380-lb girl with a genetic disorder that causes constant hunger crowned a pageant queen
A 380-lb girl with a genetic disorder that causes constant hunger crowned a pageant queen
A 15-year-old girl who weighs 380lbs due to a rare condition, called Prader-Willi Syndrome, has been crowned a pageant queen.
FOX NEWS: Fertility clinic rules out inappropriate access to tank area
Fertility clinic rules out inappropriate access to tank area
An Ohio fertility clinic where thousands of frozen eggs and embryos may have been damaged in a storage tank failure says it's ruled out any inappropriate physical access to its storage tanks area.
FOX NEWS: Obesity tied to shorter life, overweight people more years with heart disease
Obesity tied to shorter life, overweight people more years with heart disease
Obese people have shorter lives and even those who are just overweight spend more years living with heart disease than individuals who are a healthy weight, a U.S. study suggests.
Friday, March 23, 2018
Why Can’t Dying Patients Get the Drugs They Want?
By KATIE THOMAS from NYT Health https://ift.tt/2DQDykN
FOX NEWS: Woman who couldn't open her mouth for 30 years is finally able to chew
Woman who couldn't open her mouth for 30 years is finally able to chew
A woman has eaten solid food for the first time in 30 years after her jaw was fused shut by a tumor.
American Adults Just Keep Getting Fatter
By MATT RICHTEL and ANDREW JACOBS from NYT Health http://ift.tt/2pyWdgH
FOX NEWS: Scientists develop brain scanner in a helmet
Scientists develop brain scanner in a helmet
British scientists have developed a lightweight and highly sensitive brain imaging device that can be worn as a helmet, allowing the patient to move about naturally.
FOX NEWS: Freezing the 'hunger nerve' could help with weight loss, new study finds
Freezing the 'hunger nerve' could help with weight loss, new study finds
Researchers were able to freeze a nerve in the back that carries hunger signals to the brain, lowering patients' appetite and promoting weight loss.
FOX NEWS: Wrestler and 'Dad bod destroyer' shows how you can use your kids as dumbbells
Wrestler and 'Dad bod destroyer' shows how you can use your kids as dumbbells
Professional wrestler Robbie E., father of 15-month-old twin boys, explains how he avoids the dad bod and combines play time with pump time.
Thursday, March 22, 2018
FOX NEWS: Harry Connick Jr. talks colon cancer screening options
Harry Connick Jr. talks colon cancer screening options
Now that the Broadway crooner has turned 50, he is raising awareness on a cancer whose timely screening is crucial, colon cancer.
FOX NEWS: ‘Childhood Alzheimer’s’ robs a teenager's ability to speak
‘Childhood Alzheimer’s’ robs a teenager's ability to speak
Levi Ormeroid, 19, can no longer talk or belt out the words to his favorite songs. The teenager was diagnosed with Sanfilippo syndrome, a rare genetic disorder which causes brain damage and is dubbed 'childhood Alzheimer’s' because of its similarity to the degenerative disease that typically affects the elderly.
FOX NEWS: Harry Connick Jr. and wife have ‘colonoscopy double date’?
Harry Connick Jr. and wife have ‘colonoscopy double date’?
Multi-talented musician, actor and TV host Harry Connick Jr. had a big cancer scare in 2012 when his wife Jill was diagnosed with breast cancer. Today, she is cancer free but credits routine screening with saving her life. Now that the Broadway crooner has turned 50, he’s raising awareness on another cancer where timely screening is crucial, colon cancer.
