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  Most popular articles (Since June 29, 2021)

 
 
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EDITORIAL
The yin and yang role of transforming growth factor-β in kidney disease
Hui-yao Lan
2021, 8:1 (8 September 2021)
DOI:10.4103/imna.imna_17_21  
  1,861 160 1
REVIEW ARTICLES
New insights into the immunity and podocyte in glomerular health and disease: From pathogenesis to therapy in proteinuric kidney disease
Paulina X Medina Rangel, Anupama Priyadarshini, Xuefei Tian
2021, 8:5 (8 September 2021)
DOI:10.4103/imna.imna_26_21  
Evidence has been furnished that immune cells, and immune-podocytes interactions have increasingly become the focus of proteinuric kidney diseases, which affect millions of patients worldwide. Podocytes are highly specialized, terminally differentiated epithelial cells that wrap around the glomerulus to maintain the integrity of the glomerular filtration barrier. More recent studies demonstrate that podocytes express many elements of the innate and adaptive immune system including the complement components and receptors, through which podocytes can be involved in immune-mediated glomerular injuries and as a therapeutic target to alleviate the podocyte injury and progression to chronic kidney disease. The present review will shed light on recent findings, which have furthered our understanding of the immune mechanisms involved in podocyte injury, as well as the therapeutic implications in the treatment of immune-mediated glomerular injury.
  1,805 141 -
ORIGINAL ARTICLES
Tangshen formula attenuates renal fibrosis by downregulating transforming growth factor β1/Smad3 and LncRNA-MEG3 in rats with diabetic kidney disease
Xue-Feng Zhou, Ying Wang, Min-Jing Luo, Ting-Ting Zhao, Ping Li
2021, 8:2 (8 September 2021)
DOI:10.4103/imna.imna_22_21  
Background and Objective: The traditional Chinese Tangshen formula (TSF) has been reported to ameliorate diabetic kidney disease (DKD) in humans and animals. However, the effect of TSF on renal fibrosis remains unclear. Transforming growth factor-β1 (TGF-β1)/Smad3 signaling and lncRNA MEG3 are important in renal fibrosis. In this study, we examined the therapeutic effect of TSF on renal fibrosis and explored whether it was related to the modulation of TGFβ1/Smad3 signaling and lncRNA MEG3 expression. Materials and Methods: Experiments were performed in rats in vivo and in the HK2 cells in vitro. DKD was induced in rats by uninephrectomy combined with a single streptozotocin injection. The HK2 cells were stimulated by high glucose (HG) to explore the mechanism of TSF effects in vitro. Results: TSF significantly attenuated renal injury by lowering proteinuria and renal histological damage in DKD rats. TSF reduced collagen deposition by decreasing the expression of the fibrotic indicators collagen I, collagen IV, and fibronectin at the protein and mRNA levels, which suggested that TSF ameliorated DKD by decreasing renal fibrosis. Furthermore, TSF decreased TGF-β1 expression and suppressed the levels of phosphorylated Smad3 and Smad2/3 in vivo. Moreover, TSF downregulated the lncRNA MEG3 level in DKD rats. TSF reversed the upregulation of collagen I and fibronectin expression and downregulated Smad2/3 phosphorylation in the HK2 cells stimulated with HG. Conclusions: TSF ameliorates renal fibrosis in rats with DKD by suppressing TGF-β1/Smad3 signaling and lncRNA MEG3 expression.
  1,578 140 -
REVIEW ARTICLES
Traditional chinese medicine in ameliorating diabetic kidney disease via modulating gut microbiota
Yanan Yang, Chongming Wu
2021, 8:8 (9 September 2021)
DOI:10.4103/imna.imna_28_21  
Diabetic kidney disease (DKD), a major microvascular complication of diabetes mellitus, has become the second cause of end-stage renal disease enhancing the mortality rate of diabetes. However, there are still few treatment approaches to combat it. Traditional Chinese medicine (TCM) has been applied for a long time to treat DKD. However, there is a lack of research on how does TCM plays the role in treating DKD due to the complex of composition of TCM. In recent decade, gut microbiota is increasingly recognized for its contributions to host health, and the occurrence of gut–kidney axis also attracts many interests about microbiota in kidney injury. Some of the studies have already revealed that TCM can alleviate the symptoms of DKD through regulating gut microbiota and ameliorate a vicious circle caused by imbalance of gut–kidney axis. However, the problems of which specific species mediates the efficacy of TCM and how gut microbiota influences the process of DKD are urgent to solve. Therefore, this review systematically summarized the application of TCM and the importance of gut microbiota in DKD. More importantly, the review provided a new insight to find biomarkers for diagnosis and treatment of DKD. In future study, targeted manipulation of the gut microbiota will be progressively recognized as a way to enhance human health.
  1,579 122 2
COVID-19 and kidney involvement – A systematic review
Guang Yang, Yang Liu, Jiebin Hou, Qingli Cheng
2021, 8:4 (8 September 2021)
DOI:10.4103/imna.imna_14_21  
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has resulted in an ongoing worldwide pandemic since it was first recognized in December 2019. The kidney is one of the organs most easily affected by COVID-19. The injury of the kidney by COVID-19 manifested as hematuria, proteinuria, serum creatinine fluctuations, and even acute kidney injury (AKI). Critically ill patients with COVID-19 are much more prone to suffer from AKI. Moreover, AKI is related to poor outcomes in the patients infected with SARS-CoV-2. Therefore, early detection and active prevention of kidney injury are very important. In this article, we reviewed the epidemiology, clinical characteristics, pathogenesis, pathological manifestations, treatment, and prognosis of kidney injury in patients with COVID-19. It is expected to provide valuable insights for disease prevention and control from the perspective of nephrologists.
  1,457 129 -
CASE REPORTS
Treatment of membranoproliferative glomerulonephritis with traditional chinese medicine and rituximab: A case report
Yao-wei Wang, Qin Zeng, Ren-huan Yu
2021, 8:3 (8 September 2021)
DOI:10.4103/imna.imna_10_21  
Membranoproliferative glomerulonephritis (MPGN) is usually characterized by refractory nephrotic syndrome and is associated with a poor prognosis. An older patient diagnosed with MPGN had a 20-year history of proteinuria and had clinical manifestations of nephrotic syndrome in the past 2 years. MPGN. Before the patients received an 11-month traditional Chinese medicine (TCM) treatment, the patient was treated with prednisone, tacrolimus, mycophenolate mofetil, and rituximab for 11 months. After 22 months, the urine protein level decreased to <1 g/d, with normal plasma albumin level, and remarkably increased glomerular filtration rate. Combination of TCM with Western medicine for 22 months was effective for the treatment of MPGN.
  1,454 122 -
PERSPECTIVE
COVID-19 acute kidney injury: Current knowledge and barriers of research
Yifei Zhong, John Cijiang He
2021, 8:6 (9 September 2021)
DOI:10.4103/imna.imna_11_21  
  1,354 100 -
EDITORIAL ANNOUNCEMENT
Integrative Medicine in Nephrology and Andrology is welcoming a fresh start
Yangang Ren, Renhuan Yu, Hui-yao Lan, Ping Li
2021, 8:7 (9 September 2021)
DOI:10.4103/imna.imna_31_21  
  1,221 97 -
ORIGINAL ARTICLES
Patients with chronic kidney disease have higher acute kidney injury morbidity than those without after SARS-CoV-2 infection
Yuting Song, Dongdong Mao, Rong Zou, Yanglin Hu, Dan Luo, Hong Liu, Can Tu, Fei Xiong
2021, 8:12 (29 November 2021)
DOI:10.4103/imna.imna_24_21  
Background and Objectives: Chronic kidney disease (CKD) and acute kidney injury (AKI) increase the risk of serious disease and mortality in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected patients. This study evaluated the occurrence and outcome of AKI in CKD and non-CKD patients infected with SARS-CoV-2. Subjects and Methods: We retrospectively analyzed the medical records of 845 patients with SARS-CoV-2 infection regarding the occurrence and outcome of AKI in a coronavirus disease-2019 (COVID-19)-designated hospital in Wuhan, China, from December 31, 2019, to March 20, 2020. Results: Of the 845 COVID-19 patients, 91 had CKD and 754 had no CKD (non-CKD), of whom 22 and 14 developed AKI, respectively. Finally, 36 patients were included in the analysis. Older patients and those with cardiovascular or cerebrovascular diseases were more likely to develop AKI. More CKD patients progressed to critical illness (72.73%) than non-CKD patients (57.14%), but the degree of AKI in CKD patients was lesser than that in non-CKD patients. Higher urea nitrogen, creatinine, and proteinuria levels were observed in CKD patients. More non-CKD patients were treated with human albumin than CKD patients. The survival probability of CKD patients was lower than that of non-CKD patients, but it was not statistically significant. Conclusion: There were significant differences in the incidence rate of AKI after SARS-CoV-2 infection between CKD and non-CKD patients, and the clinical manifestations and treatments of AKI also differed. These results highlight the necessity of variable treatment methods for optimal clinical management.
  1,197 106 -
REVIEW ARTICLES
Clinical analysis of kidney injury in elderly patients with COVID-19
Yang Liu, Chao- Chen Wang, Qiang- Guo Ao, Jie- Bin Hou, Lei Wei, Feng- Yu Qi, Wei He, Jia- Hui Zhao, Qiang Ma, Xiao- Hua Wang, Qing- Li Cheng, Guang Yang
2021, 8:11 (24 November 2021)
DOI:10.4103/imna.imna_13_21  
Objective: The aim of the study was to analyze the clinical features of elderly patients with coronavirus disease 2019 (COVID-19) and to explore the relationship between COVID-19 patients and kidney injury. Methods: A total of 188 elderly patients with confirmed COVID-19 enrolled in this study were hospitalized for at least 1 week in the Central Theater Command General Hospital of Chinese People's Liberation Army from January 3, 2020 to March 14, 2020. The recorded information included clinical data and results of kidney-related laboratory tests. Retrospective analysis was performed. Results: The median age of the patients was 69 years (interquartile range 65–78, range: 60–97 years); 31.4% were 60–74 years old, and 68.6% were over 75 years old. A total of 12.8% and 18.6% of the patients were in critical and severe stages of COVID-19, respectively. The proportions of patients using mechanical ventilators and deaths were 9.5% and 8.5%, respectively. A total of 26.1% and 8.5% of the patients showed mild elevation of blood urea nitrogen (BUN) and serum creatinine (SCr) levels at admission. A total of 18.6% and 5.9% of the patients had elevated BUN and SCr 1 week after admission, respectively. A total of 3.1% of the patients were diagnosed with acute kidney injury, and 75% of those patients had chronic kidney disease before admission. Compared with the patients aged 60–74 years, those over 75 years exhibited significantly increased proportions of elevated BUN levels, critical illness, use of mechanical ventilated, and death. Multivariate logistic regression analysis revealed that an elevated BUN level at admission and 1 week after admission were independent risk factors for death in the elderly patients with COVID-19. Conclusion: There were more critical cases and a high mortality in elderly patients with COVID-19. An increased BUN level was an independent risk factor for death in elderly patients with COVID-19.
  1,204 98 -
JUN amino terminal kinase in cell death and inflammation in acute and chronic kidney disease
David J Nikolic-Paterson, Keren Grynberg, Frank Y Ma
2021, 8:10 (24 November 2021)
DOI:10.4103/imna.imna_35_21  
Cell death and inflammation are important mechanisms in the induction of acute kidney injury (AKI) and the progression of chronic kidney disease. This focused review examines how the JUN amino terminal kinase (JNK) enzyme contributes to these pathologies. The JNK enzyme is activated in response to cellular stress, being most sensitive to oxidative stress. Biopsy studies have shown that JNK signaling is activated in human AKI and chronic kidney injury. Genetic and pharmacologic strategies have demonstrated a key role for JNK signaling in tubular cell death, inflammation, and loss of renal function in various animal models of AKI. This has been directly attributed to JNK1 signaling in the proximal tubular epithelial cells. JNK inhibition also reduces cell death, inflammation, and fibrosis in several models of progressive kidney disease; however, not all models show benefit with JNK blockade. JNK inhibitors are currently in clinical trials which opens the way for testing JNK-based therapy in selected types of renal injury. Some of the outstanding questions in this field include identifying the JNK1 target(s) in the induction of tubular cell necroptosis, and determining whether the pro-inflammatory actions of JNK signalling depend solely upon activation of JUN/Activator Protein-1.
  1,195 102 -
ORIGINAL ARTICLES
Xiaochaihu decoction in diabetic kidney disease: A study based on network pharmacology and molecular docking technology
Ying Wang, Xuefeng Zhou, Minjing Luo, Tingting Zhao, Ping Li
2021, 8:13 (31 December 2021)
DOI:10.4103/imna.imna_21_21  
Objective: To explore the potential mechanism of Xiaochaihu decoction (XCHD) in the treatment of diabetic kidney disease (DKD) by network pharmacology and molecular docking technology. Materials and Methods: Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to screen out main active components of XCHD. Gene names of target proteins were obtained with UniProt database. DKD targets were collected by GeneCard database, and common targets were selected through jvenn platform. STRING database was used to construct a protein–protein interaction network. Enrichment analysis was carried out through the Metascape platform. The “drug–component–target” and “component–target–KEGG pathway” networks were constructed using Cytoscape software. Molecular docking analysis was carried out with AutoDockTool software. Results: A total of 195 active components were obtained for XCHD. There were 238 corresponding targets and 128 common targets associated with DKD, and the core targets involved IL6, AKT1, VEGFA, TNF, TP53, PTGS2, and JUN. Gene ontology enrichment analysis revealed 2242 entries for biological processes, 82 entries for cellular components, and 166 items of molecular functions. A total of 333 signal pathways were screened by KEGG pathway enrichment analysis. Molecular docking showed that quercetin, baicalin, luteolin, and wogonin were tightly bound to the key target proteins of PTGS2 and AKT1. Conclusions: 195 active components were screened from XCHD, among which 128 intersections with DKD were identified, and 333 signaling pathways were identified by KEGG pathway enrichment analysis.The key active components in XCHD, such as quercetin, baicalin, luteolin and wogonin, regulate multiple signaling pathways by acting on PTGS2, AKT1 and other targets, for anti-inflammatory, antioxidant, regulating cell factors, improving insulin resistance, and protecting renal function. This study provides a more in-depth scientific basis and research direction for the investigation on XCHD treatment of DKD.
  989 86 -
REVIEW ARTICLES
Coronavirus disease 2019-associated acute kidney injury garners more attention
Meihua Yan, Wenquan Niu, Ping Li
2021, 8:9 (24 November 2021)
DOI:10.4103/imna.imna_15_21  
  925 83 -
REVIEW ARTICLE
Ferroptosis in diabetic nephropathy: A narrative review
Yifan Wang, Haiyong Chen
2022, 9:1 (28 February 2022)
DOI:10.4103/imna.imna_2_22  
The prevalence of diabetes has been sharply increasing over the past few decades. Approximately 20%–30% of patients with diabetes progress to evident nephropathy. Kidney cell deaths, for example, ferroptosis, pyroptosis, and apoptosis, are associated with diabetic nephropathy (DN). Ferroptosis is a novel regulated cell death characterized by the increase of oxidative stress and iron-dependent lipid peroxidation. Laboratory or clinical findings indicate that ferroptosis plays an important role in the pathogenesis of DN. This review aimed to summarize the mechanisms of ferroptosis and relevant signaling pathways in DN and provide perspectives and clinical strategies for attenuating ferroptosis-associated DN.
  723 69 -
EDITORIAL
Applying the guidelines to standardize the behavior of clinicians in the treatment of chronic kidney disease with Chinese patent medicine
Qingli Cheng, Ping Li
2022, 9:3 (27 April 2022)
DOI:10.4103/2773-0387.344230  
  217 31 -
REVIEW ARTICLE
Management of maintenance hemodialysis patients under the coronavirus disease pandemic
Fei Xiong, Can Tu
2022, 9:2 (27 April 2022)
DOI:10.4103/imna.imna_3_22  
Coronavirus disease (COVID-19) has spread worldwide and has resulted in high mortality, increased pressure on medical systems, and severe global economic losses. Hemodialysis patients may be highly susceptible to infections due to old age, immunocompromised status, preexisting comorbidities, and frequent hospital visits. Moreover, the closed and crowded environment of dialysis rooms increases the risk of cross-infections. The Wuhan Hemodialysis Quality Control Center has accumulated valuable experience in the prevention and control of the COVID-19 epidemic and has normalized management of the epidemic since early 2020. In this review, we garnered experiences and knowledge from China and worldwide to summarize an approach to COVID-19 prevention, control, and management in hemodialysis patients under normalized epidemic conditions.
  218 23 -