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- Kocyigit, I, et al.
(author)
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Early arterial stiffness and inflammatory bio-markers in normotensive polycystic kidney disease patients
- 2012
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In: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 36:1, s. 11-18
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Journal article (peer-reviewed)abstract
- <b><i>Background/Aims:</i></b> Cardiovascular disease is the main cause of morbidity and mortality in autosomal-dominant polycystic kidney disease (ADPKD) patients. To clarify temporal relationship between ADPKD, hypertension and the loss of renal function, we examined these factors in patients with early-stage ADPKD who did not yet have hypertension. <b><i>Methods:</i></b> Fifty patients with ADPKD (42% males, 36.6 ± 9.9 years, no blood pressure medication) and 50 healthy controls (44% males, 35.4 ± 6.4 years) were studied cross-sectionally. Pulse wave velocity (PWV), cardiac morphology and function, aortic elastic indexes, estimated glomerular filtration rate (eGFR), 24-hour ambulatory blood pressure, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and highly sensitive C-reactive protein (hs-CRP) were measured in all participants, using conventional methods. <b><i>Results:</i></b> Despite a normal blood pressure, aortic stiffness index and pulse wave velocity values were increased in patients compared to controls (6.8 ± 4.7 vs. 5.1 ± 3.3, p = 0.043 and 9.6 ± 1.3 vs. 5.8 ± 1.1 m/s, p < 0.001). In univariate analysis, IL-6, TNF-α, hs-CRP and eGFR were all significantly correlated with PWV. The independence of these correlations were analyzed in a regression model, and showed PWV to be significantly predicted by IL-6, TNF-α and hs-CRP. <b><i>Conclusion:</i></b> Increased arterial stiffness and pulse wave velocity are early manifestations of ADPKD appearing before hypertension or reduced eGFR. However, these vascular abnormalities are related to signs of systemic low grade inflammation, suggesting a common pathophysiological mechanism apparently present also in other vascular diseases but yet to be elucidated.
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- Kocyigit, I, et al.
(author)
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Serum uric acid levels and endothelial dysfunction in patients with autosomal dominant polycystic kidney disease
- 2013
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In: Nephron. Clinical practice. - : S. Karger AG. - 1660-2110. ; 123:3-4, s. 157-164
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Journal article (peer-reviewed)abstract
- <b><i>Background/Aims:</i></b> Patients with autosomal dominant polycystic kidney disease (ADPKD) exhibit endothelial dysfunction (ED) despite normal levels of renal function. Hyperuricemia occurs in these patients and has been postulated to affect ED through the generation of oxidative stress. We therefore investigated the prevalence of ED and its association with serum uric acid levels in early-stage ADPKD. <b><i>Methods:</i></b> A cross-sectional design was used for the assessment of prevalent patients with early-stage (normal renal function) ADPKD (n = 91) from two academic medical centers. ED was assessed using ischemia-induced forearm flow-mediated vasodilation (FMD). Serum uric acid levels were evaluated using an Olympus AU2700 autoanalyzer. <b><i>Results:</i></b> ADPKD<b> </b>patients with higher serum uric acid levels had a higher asymmetric dimethylarginine (ADMA) level (1.19 ± 0.2 vs. 1.47 ± 0.3, p < 0.001) and lower FMD rates (8.1 ± 1.3 vs. 6.8 ± 0.7, p < 0.001). In multiple regression analysis for predictors of cohort FMD, uric acid (β = -0.32, p < 0.001), ADMA (β = -0.36, p < 0.001), high-sensitivity C reactive protein (CRP; β = -0.32, p < 0.001) and estimated glomerular filtration rate (eGFR; β = 0.33, p < 0.001) all predicted FMD. <b><i>Conclusions:</i></b> In early-stage ADPKD patients, uric acid levels, serum ADMA and eGFR all independently predict ED in a similar manner. Future studies are needed to investigate the causes of elevated serum uric acid, ADMA and CRP in these patients.
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- Kocyigit, I, et al.
(author)
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Systemic Succinate, Hypoxia-Inducible Factor-1 Alpha, and IL-1β Gene Expression in Autosomal Dominant Polycystic Kidney Disease with and without Hypertension
- 2019
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In: Cardiorenal medicine. - : S. Karger AG. - 1664-5502 .- 1664-3828. ; 9:6, s. 370-381
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Journal article (peer-reviewed)abstract
- <b><i>Background and Objectives:</i></b> Cyst pressure induces renin-angiotensin-aldosterone system activation and kidney hypoxia in autosomal dominant polycystic kidney disease (ADPKD). Lipopolysaccharide-induced Toll-like receptor activation causes metabolic disturbances that are triggered by increased succinate levels and hypoxia inducible factors, which results in inflammation via <i>IL-1β</i> activation. Since we aimed to investigate the role of both inflammation and hypoxia in the clinical course of ADPKD, via succinate levels from sera samples, <i>HIF-1α</i> gene expression from whole blood and urine samples and <i>IL-1β</i>gene expression from whole blood were measured. <b><i>Methods:</i></b> One hundred ADPKD patients and 100 matched healthy controls were enrolled to this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood, serum, and urine samples were taken after 12-h fasting for the measurement of biochemical parameters and succinate levels. Whole blood and urine samples were used for <i>HIF-1α</i> and <i>IL-1β</i> gene<i></i>expression by using quantitative real-time PCR. <b><i>Results:</i></b> There were significant differences in whole blood <i>HIF-1α</i>,<i> IL-1β</i> gene<i></i>expression, and serum<i></i>succinate levels between the ADPKD patients and the control subjects. Whole blood <i>HIF-1α</i>gene expression,<i> IL-1β</i> gene<i></i>expression, and serum<i></i>succinate levels were also significantly different in ADPKD patients with hypertension in comparison with normotensive ones (<i>p</i> < 0.05). Serum succinate levels and blood<i> IL-1β</i> gene<i></i>expression were increased in ADPKD patients with high levels of <i>HIF-1α gene</i>expression (<i>p</i> = 0.018 and <i>p</i> = 0.029, respectively). <b><i>Conclusions:</i></b> Increased age,<i></i>low eGFR, and <i>HIF-1α</i> and <i>IL-1β</i> gene<i></i>expressions were also independently associated with hypertension in ADPKD patients. Inflammation and hypoxia are both relevant factors that might be associated with hypertension in ADPKD.
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- Rampal, S., et al.
(author)
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A review of the efficacy of intraarticular hip injection for patients with hip osteoarthritis: To inject or not to inject in hip osteoarthritis?
- 2022
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In: Joint Diseases and Related Surgery. - : Joint Diseases and Related Surgery. - 2687-4784 .- 2687-4792. ; 33:1, s. 255-262
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Journal article (peer-reviewed)abstract
- Hip injection (HI) for osteoarthritis (OA) are in vogue nowadays. Corticosteroids (CSs) and hyaluronic acid (HA) gel are the two most common agents injected into the hip. Off late, platelet-rich plasma (PRP), mesenchymal stem cell (MSC), bone marrow aspirate concentrate (BMAC), local anesthetic (LA) agents, non-steroidal anti-inflammatory drugs (NSAIDs) and their different combinations have also been injected in hips to provide desired pain relief. However, there is a group of clinicians who vary of these injections. A search of the literature was performed on PubMed, Cochrane Library, and DOAJ using the keywords "hip osteoarthritis injection". Data were analyzed and compiled. Intraarticular CSs are effective in providing the desired pain relief in OA hip, but repeated injections should be avoided and the interval between HI and hip arthroplasty must be kept for more than three months. Methylprednisolone or triamcinolone are combined with 1% lidocaine or 0.5% bupivacaine. Chondrotoxic effects of LA is a concern. Although national guidelines do not favor the use of HA for hip OA, numerous publications have favored its usage for a moderate grade of OA. The PRP, MSC, and BMAC are treatment options with great potential; however, currently, the evidence is conflicting on their role in hip OA. There is always a risk of septic arthritis, particularly when aseptic precautions are not followed, and clinicians must vary of this complication.
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