Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proo...Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.展开更多
Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a dis...Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.展开更多
Objective IgA nephropathy(IgAN)is the most prevalent form of primary glomerular disease.However,its diagnosis is contingent on kidney biopsy.Therefore,noninvasive biomarkers are urgently needed for diagnosis.This stud...Objective IgA nephropathy(IgAN)is the most prevalent form of primary glomerular disease.However,its diagnosis is contingent on kidney biopsy.Therefore,noninvasive biomarkers are urgently needed for diagnosis.This study aims to identify novel urinary biomarkers that differentiate IgAN from other common primary glomerular diseases,specifically membranous nephropathy(MN)and minimal change disease(MCD).Methods The peripheral blood mononuclear cell(PBMC)transcriptome dataset GSE73953 was obtained from the GEO database.Differential gene expression,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment,Gene Ontology(GO)enrichment,and immune infiltration analyses were performed.Protein–protein interaction(PPI)analysis and lysosome-related genes were used to identify hub genes.The expression of the hub gene ATP6V1D in urine and kidney tissues from individuals with IgAN,healthy controls,MCD and MN patients was assessed using enzyme-linked immunosorbent assay(ELISA),Western blotting,and immunostaining techniques.Spearman’s correlation analysis was employed to investigate the relationships between the concentration of ATP6V1D in urine,the concentration of galactose-deficient IgA1(GD-IgA1),and the clinical data of patients.The receiver operating characteristic(ROC)curve was used to assess the role of urine ATP6V1D levels in distinguishing IgAN from MN and MCD.Results ATPase was identified as the principal intracellular structure associated with differentially expressed genes(DEGs)between IgAN patients and healthy controls in PBMCs.ATP6V1D was identified as a hub gene at the intersection of lysosome-related and differential genes.ATP6V1D levels were lower in PBMCs,urine,and kidney samples from IgAN patients than in those from healthy individuals,MCD and MN patients.The decreased urinary ATP6V1D levels and increased GD-IgA1 levels in IgAN patients were further validated.These changes were positively correlated with 24-h urine protein levels.Notably,a negative correlation was observed between ATP6V1D and GD-IgA1 levels.ROC curve analysis demonstrated that urinary ATP6V1D(AUC=0.972)and GD-IgA1(AUC=0.952)had significant discriminative power in distinguishing IgAN patients from MCD and MN patients,with no significant difference in predictive performance between the two biomarkers(P>0.05).Conclusions The findings underscore the potential utility of the urine ATP6V1D concentration as a biomarker to distinguish IgAN from MN and MCD.展开更多
Objective Safranal is a natural product from saffron(Crocus sativus L.)with anti-inflammatory and nephroprotective potential.This study aimed to explore the role of safranal in a cationic bovine serum albumin(C-BSA)-i...Objective Safranal is a natural product from saffron(Crocus sativus L.)with anti-inflammatory and nephroprotective potential.This study aimed to explore the role of safranal in a cationic bovine serum albumin(C-BSA)-induced rat model of membranous glomerulonephritis(MGN).Methods After model establishment,Sprague–Dawley rats were administered 100 or 200 mg/kg safranal by gavage.A biochemical analyser was used to measure the urine protein levels and serum levels of renal function parameters.Hematoxylin–eosin and immunofluorescence staining of kidney tissues were performed to examine histopathological changes and assess the expression of IgG,C3,and Sirt1.Western blotting was performed to measure the protein levels of podocin,nephrin,Sirt1,and factors involved in the NF-κB/p65 pathway.Inflammatory cytokine levels in renal homogenates were determined by ELISA.Results Safranal at 100 or 200 mg/kg reduced kidney weight(2.07±0.15 g and 2.05±0.15 g)and the kidney somatic index(0.83±0.08%and 0.81±0.08%)in MGN rats compared with those in the model group without drug administration(2.62±0.17 g and 1.05±0.1%).C-BSA increased the urine protein level to 117.68±10.52 mg/day(compared with the sham group,5.03±0.45 mg/day),caused dysregulation of renal function indicators,and induced glomerular expansion and inflammatory cell infiltration in the rat kidney samples.All the biochemical and histological changes were improved by safranal administration.Safranal at two doses also increased the fluorescence intensities of IgG(0.1±0.009 and 0.088±0.008)and C3(0.065±0.006 and 0.048±0.004)compared with those in the MGN group(0.15±0.013 and 0.086±0.008).Additionally,safranal reversed the downregulation of podocin,nephrin,and Wilms tumor protein-1(WT1)levels and reversed the high inflammatory cytokine levels in MGN rats.Mechanistically,safranal activated Sirt1 signalling to interfere with NF-κB signalling in the kidney tissues of MGN rats.Conclusions Safranal ameliorates renal damage,inflammation,and podocyte injury in MGN by upregulating SIRT1 and inhibiting NF-κB signalling.展开更多
Objective Inflammation and fibrosis are key features of diabetic nephropathy(DN).Triptolide(TP)exhibits anti-inflammatory and anti-fibrotic properties,though its mechanisms of action in DN remain unclear.CREKA(Cys-Arg...Objective Inflammation and fibrosis are key features of diabetic nephropathy(DN).Triptolide(TP)exhibits anti-inflammatory and anti-fibrotic properties,though its mechanisms of action in DN remain unclear.CREKA(Cys-Arg-Glu-Lys-Ala)is a pentapeptide that specifically binds to fibronectin(FN),and the CREKA-modified liposome(CREKA-Lip)represents a novel FN-targeted drug delivery system.This study aimed to investigate the role of TP in diabetic db/db mice and determine whether encapsulation within CREKA-Lip enhances therapeutic efficacy while reducing the multi-organ toxicity of TP.Methods Eight-week-old diabetic db/db mice received tail vein injections twice weekly with vehicle,free TP,or CREKA-Lip/TP for 10 weeks.Urine and serum parameters were measured,and kidney,heart,liver,and testis tissues were collected for pathological evaluation.Protein-protein interaction networks were constructed using Cytoscape and its plug-ins to identify core targets and elucidate the therapeutic mechanism of TP against DN.Inflammatory,fibrotic,apoptotic,and lipid metabolism markers were evaluated in the kidneys of diabetic mice with DN and in high glucose-treated mouse mesangial cells and podocytes using qPCR,Western blot,immunohistochemistry,and immunofluorescence assays.Results TP administration reduced fasting blood glucose levels and glomerular mesangial expansion in diabetic mice.TP significantly suppressed renal inflammation,fibrosis,and apoptosis while enhancing lipid metabolism.Integration of network pharmacology,molecular docking,and transcriptomics revealed that TP ameliorated DN by inhibiting the JAK2-STAT1 signaling pathway.In vitro,TP inhibited high glucose-induced phosphorylation of JAK2 and STAT1,reduced collagen production in mesangial cells,decreased apoptosis,and improved lipid metabolism in podocytes.Moreover,CREKA-Lip/TP exhibited superior efficacy compared with free TP,with a more sustained reduction in urine albumin-to-creatinine ratio and greater inhibition of mesangial expansion.Notably,CREKA-Lip/TP treatment did not induce systemic toxicity.Conclusion TP improves renal inflammation,fibrosis,apoptosis,and lipid homeostasis,thereby ameliorating DN by inhibiting JAK2-STAT1 activation.Targeted delivery of TP via FN-binding CREKA-Lip enhances therapeutic efficacy while minimizing multi-organ toxicity.展开更多
This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the in...This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the interstitium,tubular cells,and glomeruli.Renal tubules are highly susceptible to proteinuria,metabolic disorders,and toxins.Since diabetic nephropathy persistently activates inflammatory and fibrotic pathways,epithelial-to-mesenchymal transition mechanisms present promising targets for risk assessment.Periostin,a cellular matrix protein,plays a key role in modulating extracellular interactions.Increased periostin expression in tissue,serum,and urine correlates with type 2 diabetes,making it a valuable biomarker alongside neutrophil gelatinase-associated lipocalin and kidney injury molecule-1.While periostin and neutrophil gelatinase-associated lipocalin reflect distal tubular damage,kidney injury molecule-1 serves as a marker for proximal tubular injury.Combining these biomarkers enhances diagnostic precision.展开更多
BACKGROUND Bile cast nephropathy(BCN)is suspected in the setting of liver disease and hyperbilirubinemia and is characterized by the formation of tubular bile casts and acute tubular injury.While postmortem studies re...BACKGROUND Bile cast nephropathy(BCN)is suspected in the setting of liver disease and hyperbilirubinemia and is characterized by the formation of tubular bile casts and acute tubular injury.While postmortem studies reveal a high prevalence of BCN,little is known about this orphan acute kidney injury syndrome.AIM To address this knowledge gap,we performed a systematic review of case reports and case series of BCN,focusing on risk factors,diagnostic criteria,clinical presentation,kidney biopsy findings,severity,treatment approaches,and outcomes.METHODS Electronic databases were searched to identify eligible studies of patients with possible,probable,or definite BCN,using pre-established criteria.Relevant variables were extracted and analyzed.We explored the impact of serum total bilirubin levels and alcoholic liver disease on BCN severity and outcomes by stratifying cases into total bilirubin tertiles and alcoholic vs non-alcoholic liver disease.Univariate and multivariable logistic regression analyses were used to examine factors associated with the composite outcome of dialysis requirement or death.RESULTS Sixty-seven case reports and six case series(involving 2 patients each)met the inclusion criteria,totaling 79 cases of BCN.The mean age was 48.3 years,and 83.5%were men.The most common cause of liver disease was drug-induced injury(30.4%),followed by infection(18.9%)and alcoholism(12.7%).BCN diagnosis was deemed definite,probable,and possible in 65.8%,32.9%,and 1.3%of cases,respectively.Levels of serum creatinine,dialysis requirement,and renal recovery did not differ among the total bilirubin tertile groups.However,both initial and peak serum creatinine were significantly higher in the alcoholic liver disease group compared to the non-alcoholic group(P=0.011 and P=0.012,respectively).There was also a non-significant trend toward a higher incidence of dialysis requirement or death in the alcoholic liver disease group(80%vs 52%,P=0.098).Finally,higher initial serum creatinine(per 1 mg/dL increase)was independently associated with dialysis requirement or death(adjusted odds ratio 1.291,95%confidence interval:1.032-1.615,P=0.025).CONCLUSION BCN is a common and potentially serious cause of acute kidney injury in patients with liver disease.The degree of hyperbilirubinemia does not appear to correlate with BCN severity or outcomes.However,in alcoholic liver disease,BCN is associated with a greater rise in serum creatinine and a trend toward worse outcomes compared to non-alcoholic liver disease.Serum creatinine may be a valuable predictor of BCN prognosis.Further studies are needed to develop non-invasive diagnostic tools and establish effective treatments for BCN.展开更多
BACKGROUND Diabetic nephropathy(DN)is one of the most serious microvascular complications of type 2 diabetes mellitus(T2DM),and its incidence increases with the global rise in diabetes prevalence.It is the leading cau...BACKGROUND Diabetic nephropathy(DN)is one of the most serious microvascular complications of type 2 diabetes mellitus(T2DM),and its incidence increases with the global rise in diabetes prevalence.It is the leading cause of chronic kidney disease and end-stage kidney disease.Patients with DN often experience complex metabolic disorders and chronic inflammatory states,which not only accelerate the decline of renal function but are also closely related to complications such as cardiovascular events and osteoporosis(OP),seriously compromising quality of life.With the in-depth research on the gut microbiota and the emergence of concepts such as the"gut-kidney axis"and the"enteric-bone axis",the key roles of the gut microbiota and its metabolites in metabolic disorders,inflammatory responses,and target organ damage have been increasingly recognized.However,the specific role of gut microbiota in the pathogenesis of DN remains to be further explored.The results obtained may provide evidence to better understand the pathogenesis of DN and to identify high-risk populations at an early stage.This research direction is of strategic significance.AIM To assess the correlation of the gut microbiota metabolite trimethylamine N-oxide(TMAO)with inflammatory marker levels and OP in patients with DN.METHODS A total of 115 patients diagnosed with type 2 DN and treated at the Department of Endocrinology,Second Affiliated Hospital of Shandong First Medical University from August 2022 to December 2024 were enrolled in the DN group,and 115 patients with T2DM without nephropathy were included in the T2DM group.The two groups were compared in terms of gastrointestinal microbiota abundance and relative abundance at the genus level;levels of TMAO,inflammatory markers[including C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)],and bone metabolism markers[including procollagen type I N-terminal propeptide(PINP),β-CrossLaps(β-CTX),and alkaline phosphatase(ALP)];and lumbar spine and hip bone mineral density(BMD).The correlation of TMAO level with inflammatory factor and bone metabolism indicator levels was further analyzed.RESULTS The DN group had higher Chao1 and Simpson indices of gastrointestinal microbiota diversity than the T2DM group,whereas the ACE and Shannon indices were lower(P<0.05).The relative abundance of Firmicutes was higher,and the relative abundances of Bacteroidetes,Proteobacteria,and Actinobacteria were lower in the DN group than in the T2DM group(P<0.05).CRP,IL-6,IL-8,TNF-α,and TMAO levels were considerably elevated in the DN group compared to the T2DM group(P<0.05).Moreover,the DN group had higher levels of bone turnover markers-including PINP,β-CTX,and ALP-but lower lumbar spine and hip BMDs than the T2DM group(P<0.05).TMAO level positively correlated with the Chao1 and Simpson indices and negatively correlated with the ACE and Shannon indices of gut microbiota diversity.TMAO level also negatively correlated with the relative abundances of Bacteroidetes,Proteobacteria,and Actinobacteria and positively correlated with the abundance of Firmicutes.Additionally,TMAO level positively correlated with the inflammatory markers CRP,IL-6,IL-8,and TNF-α,as well as with the bone turnover markers PINP,β-CTX,and ALP.It negatively correlated with lumbar spine and hip BMDs(P<0.05).CONCLUSION Inflammatory and bone metabolic levels in patients with DN were found to be associated with the gut microbiota–derived metabolite TMAO.Elevated TMAO levels may mediate inflammatory responses and bone metabolism disorders in patients with DN,thereby contributing to the progression of systemic inflammation and OP.展开更多
BACKGROUND Background diabetic nephropathy(DN),a major complication of diabetes,is linked to gut microbiota dysbiosis.Elevated trimethylamine N-oxide(TMAO),a microbiota-derived metabolite,plays a central role in induc...BACKGROUND Background diabetic nephropathy(DN),a major complication of diabetes,is linked to gut microbiota dysbiosis.Elevated trimethylamine N-oxide(TMAO),a microbiota-derived metabolite,plays a central role in inducing renal injury during DN pathogenesis.AIM To investigate the role of TMAO in renal dysfunction and intestinal microbiota alterations associated with DN,hypothesizing that TMAO exacerbates renal injury and fibrosis through gut microbiota-dependent mechanisms.METHODS A DN model was successfully established using Zucker diabetic fatty(ZDF)rats.Blood samples were analyzed for renal function parameters,and serum TMAO levels were quantified via high-performance liquid chromatography-tandem mass spectrometry.Renal tissue morphology and fibrosis were assessed using hematoxylin and eosin and Masson staining,respectively.Additionally,16S rRNA sequencing was employed to profile fecal bacterial communities in rats with diabetes and DN.Fecal microbiota transplantation was conducted to verify alterations in TMAO production capacity in the gut microbiota of DN rats.RESULTS After 8 weeks of modeling,the ZDF rat model group exhibited blood glucose levels surpassing 16.7 mmol/L,and compared to the control group,renal function indicators,includingβ2-microglobulin,cystatin C,uric acid,and creatinine,were significantly elevated(P<0.05).Renal fibrosis was more pronounced in the ZDF model group,accompanied by heightened P-smad3 expression,in contrast to the TMAO inhibition group.Although Masson staining results did not reach statistical significance(P>0.05),notable alterations in intestinal flora structure were observed in DN rats,and fecal microbiota transplantation led to increased TMAO production within the intestinal flora of DN rats compared to controls(P>0.05).CONCLUSION DN is associated with gut microbiota alterations that potentiate TMAO generation,contributing to renal injury and fibrotic progression.While TMAO’s role in fibrosis warrants further validation,these findings implicate the gutkidney axis in DN pathogenesis.展开更多
BACKGROUND Diabetic nephropathy(DN)is a major complication of diabetes,marked by progressive renal damage and an inflammatory response.Although research has investigated the pathological mechanisms underlying DN,effec...BACKGROUND Diabetic nephropathy(DN)is a major complication of diabetes,marked by progressive renal damage and an inflammatory response.Although research has investigated the pathological mechanisms underlying DN,effective treatment options remain limited.AIM To evaluate the therapeutic impact of Shenzhuo formulation(SZF)on a DN mouse model and to examine its potential molecular mechanisms using transcriptomic and metabolomic approaches.METHODS We established a DN mouse model through a high-fat diet combined with streptozotocin(STZ)injection,followed by SZF treatment.We analyzed SZF’s effects on gene expression and metabolite profiles in renal tissues of DN mice using transcriptomics and metabolomics techniques.Additionally,based on transcriptomic and non-targeted metabolomic findings,we further assessed SZF’s influence on the expression of factors related to the cytochrome P450(CYP450)-mediated arachidonic acid(AA)metabolism pathway,as well as its effects on inflammation and oxidative stress.RESULTS SZF intervention significantly decreased hyperglycemia and mitigated renal function impairment in DN mice.Pathological analysis revealed that SZF treatment improved renal tissue damage,reduced fibrosis,and diminished glycogen deposition.Transcriptomic analysis indicated that SZF influenced mRNA expression of CYP450-related genes,including Cyp2j13,Cyp2b9,Pla2 g2e/Cyp4a12a,Cyp4a32,Cyp2e1,and Cyp4a14.Non-targeted metabolomic results demonstrated that SZF altered the levels of metabolites associated with the AA metabolic pathway,including 5,6-EET,14,15-EET,phosphatidylcholine,and 20-HETE.Further experiments showed that SZF upregulated the expression of CYP4A and CYP2E proteins in renal tissue,as well as CYP2J and CYP2B proteins.Additionally,SZF significantly reduced the expression of inflammatory factors in renal tissue,enhanced antioxidant enzyme activity,and alleviated oxidative stress.CONCLUSION SZF exerts anti-inflammatory and antioxidant effects by regulating CYP450-mediated AA metabolism,leading to improved renal function and improved pathological state in DN mice.展开更多
BACKGROUND The coexistence of rheumatological and immunological diseases with nephropathy presents considerable clinical challenges.These challenges often result in heightened anxiety and depression,which detrimentall...BACKGROUND The coexistence of rheumatological and immunological diseases with nephropathy presents considerable clinical challenges.These challenges often result in heightened anxiety and depression,which detrimentally affect patient outcomes.Motivational psychological nursing,which incorporates motivational interview and cognitive-behavioral therapy,may offer a promising approach to address these psychological concerns.AIM To evaluate the effectiveness of motivational psychological nursing in the reduction of anxiety and depression and improvement of the quality of life of patients with rheumatological and immunological diseases complicated by nephropathy.METHODS We conducted a retrospective cohort study involving 206 patients with rheumatological and immunological diseases complicated by nephropathy and who were treated between January 2021 and January 2025.The inclusion criteria were as follows:Aged 18-75 years,met the diagnostic criteria for rheumatological and immunological diseases with a renal biopsy classification above type II,hospitalized in our facility,received consistent basic nursing care,and had complete clinical data available.Participants allotted to the observation group(n=102)receiving motivational psychological nursing,and those in the control group(n=104)received standard care.Psychological status was assessed using Self-Rating Anxiety Scale(SAS),Beck Anxiety Inventory,Hamilton Anxiety Rating Scale,Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9,and other standardized measures.Intervention lasted throughout hospitalization,with follow-up assessments conducted before discharge.RESULTS Pre-intervention,anxiety,and depression scores were similar across groups.Postintervention,the observation group showed significant reductions in anxiety(SAS:44.53±6.72 vs 46.79±6.94;P=0.018)and depression(SDS:45.20±5.07 vs 46.97±5.25;P=0.014)compared with the control group.General self-efficacy(P=0.044),healthrelated quality of life(P=0.044),and World Health Organization Quality of Life(P=0.040)scores also revealed significant improvement.CONCLUSION Motivational psychological nursing considerably reduces anxiety and depression in patients with rheumatological and immunological diseases complicated by nephropathy,which enhances the overall quality of life.展开更多
BACKGROUND The specific mechanism of diabetic nephropathy(DN)has not been fully elucidated,and more and more evidence shows that the development of DN is related to intestinal flora imbalance and micro-inflammatory st...BACKGROUND The specific mechanism of diabetic nephropathy(DN)has not been fully elucidated,and more and more evidence shows that the development of DN is related to intestinal flora imbalance and micro-inflammatory state process,and this mechanism urgently needs to be further clarified by relevant research.AIM To investigate the correlation between intestinal microbiota dysbiosis,low-grade inflammatory status,renal function impairment,and disease severity in older patients with DN,in order to provide a basis for the prevention and therapeutic intervention of DN.METHODS We enrolled 167 older patients with DN,diagnosed in the Department of Nephrology between June 2020 and June 2023.Eighty-five patients with type 2 diabetes mellitus(without DN)were enrolled to serve as the control group.A one-year follow-up observation was conducted.We compared the differences in gut microbiota composition,levels of inflammatory markers,and renal function indicators between the two groups,and the characteristics of gut microbiota and the changing patterns of inflammatory markers across different stages of disease progression.RESULTS In the DN group,the Chao,Ace,and Shannon indices were significantly lower,while the Simpson index was significantly higher than the control group.The relative abundances of Bacteroides and Bifidobacterium were significantly lower,whereas the relative abundances of Clostridium,Butyricimonas,Klebsiella,Enterococcus,Veillonella,and Megamonas were significantly higher than those in the control group(P<0.05).Estimated glomerular filtration rate was positively correlated with the Chao,Ace,and Shannon diversity indices of the gut microbiota,as well as with the relative abundances of Bacteroides,Bifidobacterium,and Akkermansia,and was negatively correlated with the relative abundances of Clostridium,Klebsiella,and Enterococcus(P<0.05).Logistic regression analysis indicated that lower Chao,Ace,and Shannon indices and higher Simpson index were associated with an increased risk of developing DN.After one year of follow-up,patients in the progression group exhibited a significantly greater decrease in Chao,Ace,and Shannon indices and a greater increase in Simpson index than the stable group.The reduction in the relative abundances of Bacteroides,Clostridium,Bifidobacterium,and Butyricimonas,as well as the increase in Klebsiella,Enterococcus,Veillonella,and Megamonas,were significantly more pronounced in the progression group than in the stable group(P<0.05).Regression analysis indicated that greater declines in Chao,Ace,and Shannon indices and Bacteroides relative abundance,along with greater increases in Simpson index and Enterococcus relative abundance,were associated with a more rapid decline in renal function.CONCLUSION The onset and progression of DN in older patients with diabetes are closely associated with gut microbiota composition.The more severe the dysbiosis,the lower the abundance of beneficial bacteria and the higher the abundance of harmful bacteria,leading to an increased risk of both DN occurrence and disease progression.展开更多
Diabetic nephropathy(DN)is one of the most serious complications of diabetes and a major cause of end-stage renal disease.However,due to the complexity of its pathogenesis,no new therapeutic drugs have been developed ...Diabetic nephropathy(DN)is one of the most serious complications of diabetes and a major cause of end-stage renal disease.However,due to the complexity of its pathogenesis,no new therapeutic drugs have been developed in the past 20 years,except for angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin receptor blockers(ARBs).Breviscapine is a flavonoid active component isolated from Erigeron breviscapus,a member of the Asteraceae family.Pharmacological studies have confi rmed that this compound has antioxidant stress,anti-inflammatory regulation,anti-fibrosis and neuroprotective eff ects.Currently,it is mainly used in clinical practice as an adjuvant treatment for ischemic stroke and non-alcoholic fatty liver disease.Notably,although its antioxidant and anti-fibrotic properties have been verified in organs such as the liver and lungs,the mechanism of action in the field of DN has not been fully elucidated,especially the regulatory eff ect on the interstitial transformation of renal tubular epithelial cells remains to be revealed.Our research group has for the fi rst time systematically explored the molecular mechanism by which breviscapine improves high glucose-induced renal tubular fibrosis,providing a new theoretical basis for expanding its clinical application.展开更多
BACKGROUND Diabetic nephropathy(DN)is a leading cause of chronic kidney disease and endstage renal disease,and is a significant global healthcare burden.Although proximal tubular epithelial cells(PTECs)and podocytes a...BACKGROUND Diabetic nephropathy(DN)is a leading cause of chronic kidney disease and endstage renal disease,and is a significant global healthcare burden.Although proximal tubular epithelial cells(PTECs)and podocytes are involved in DN progression,the specific molecular interactions between these cells are not well understood.AIM To elucidate the role of interleukin-6(IL-6)/Rab5 signaling in mediating crosstalk between PTECs and podocytes,and to evaluate the protective effects of nicotinamide mononucleotide(NMN)against DN progression.METHODS We utilized in vitro and in vivo models to investigate the pathogenesis of DN.In vitro,human PTECs and murine podocytes were cultured under high-glucose conditions,and IL-6 neutralizing antibodies or NMN treatments were applied.Podocyte injury was assessed by measurements of nephrin endocytosis,Rab5 activity,cytoskeletal organization,cell adhesion,and cell-spreading assays.In vivo,DN was induced in mice using streptozotocin,and mice then received NMN,insulin,or both treatments over an 8-week period.Renal tissues were analyzed histologically,ultrastructurally,and immunochemically,and urinary albumin excretion was measured to assess renal function.Statistical analyses were conducted using one-way ANOVA and Tukey's test.RESULTS High-glucose conditions induced the epithelial-mesenchymal transition(EMT)in PTECs,increased IL-6 secretion,and activated Rab5 signaling in podocytes,leading to increased nephrin endocytosis and podocyte injury.Blocking IL-6 significantly attenuated these effects.NMN treatment of diabetic mice markedly reduced podocyte injury,glomerular hypertrophy,foot-process effacement,and urinary albumin excretion.Mechanistically,NMN suppressed the EMT and IL-6 secretion by PTECs,inhibited Rab5 activation in podocytes,and prevented nephrin endocytosis,thereby preserving the cytoskeletal integrity and function of podocytes.CONCLUSION Our findings reveal a novel pathogenic mechanism of DN in which IL-6 released from glucose-stressed PTECs activates Rab5 signaling in podocytes,followed by nephrin endocytosis and structural injury of podocytes.Importantly,NMN treatment effectively disrupted this pathological pathway of intercellular communication,and provided significant protection against DN progression.These results suggest that NMN supplementation and targeting the IL-6/Rab5 signaling axis has promise as a therapeutic strategy for managing DN.展开更多
Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated...Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated morbidity and mortality.Recent studies highlight increased mortality related to diabetic kidney disease,with disparities across demographic and geographic groups.Novel pharmacological treatments,including sodium-glucose cotransporter 2 inhibitors,non-steroidal mineralocorticoid receptor antagonists,and glucagon-like peptide-1 agonists,offer promise in slowing disease progression and reducing renal mortality.However,the growing epidemics of obesity and diabetes necessitate prioritizing public health policies focused on primary and secondary prevention,along with comprehensive multidisciplinary care.展开更多
Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data o...Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data of an 8-year-old boy with MN in the recurrent phase complicated with cerebral venous sinus thrombosis(CVST)was retroactively analyzed.Systematic nursing was implemented based on evidence-based practices,including strict neurological monitoring,anticoagulation and thrombolysis medication nursing,fluid and electrolyte management,hypoalbuminemia and edema nursing,complication prevention,and mental health education.Results:After 16 days of continuous infusion of low molecular weight heparin and supportive treatment,the child’s symptoms,such as headache and vomiting,disappeared.The reexamination of MRV showed significant absorption of thrombosis,and there was no residual neurological deficit.During the 3-month follow-up,the anticoagulation compliance was good,and there was no recurrence.Conclusion:Early identification of hypercoagulability risk,strengthening dynamic evaluation of neurological signs and coagulation indicators,standardizing anticoagulation and thrombolysis nursing,and cooperating with continuous health management can significantly improve the prognosis of children with MN combined with CVST.展开更多
Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomeruloneph...Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomerulonephritis may occur in rare instances.Deposition of IgA in the mesangium seems to be the underlying disease mechanism.Despite current treatment,IgA nephropathy may progress into end-stage renal disease,indicating the necessity for the development of new therapeutic agents.Lifestyle modifications and anti-proteinuric treatment are recommended,and steroids have shown to be beneficial to high risk groups.Nevertheless,other conventional immunosuppressive agents,such as cyclophosphamide and mycophenolate mofetil,may be considered,despite the lack of sufficient evidence to support their efficacy.A considerable proportion of cases remain unresponsive to these treatments,underscoring the need for novel therapeutic approaches.There are several promising immunosuppressive drugs,such as B-cell lineage depleting agents or complement system inhibitors,that are currently undergoing clinical trials.These therapies may be considered for use in selected cases.展开更多
Objective Traditional Chinese medicine exhibits positive therapeutic effects as a primary or adjunctive treatment for diabetic nephropathy(DN).This study aimed to evaluate the impact and mechanism of action of Xiaoke ...Objective Traditional Chinese medicine exhibits positive therapeutic effects as a primary or adjunctive treatment for diabetic nephropathy(DN).This study aimed to evaluate the impact and mechanism of action of Xiaoke decoction(XKD),a traditional Chinese medicine,on renal function in DN rats.Methods A rat model of DN was established,and the rats were divided into five groups(n=7 per group):normal control group(NC),DN model group(DN),low-dose XKD treatment group(DN+XKD-L,1.5 g/kg/d),high-dose XKD treatment group(DN+XKD-H,6 g/kg/d),and cyclooxygenase-2(COX-2)inhibitor(NS398)treatment group(DN+NS398,8 mg/kg/d).Medications were administered via gavage for 12 consecutive weeks,while equal volumes of normal saline were given to the NC and DN groups.A glucometer was used to detect changes in blood glucose(BG).Enzyme-linked immunosorbent assay(ELISA)and an automatic biochemical analyzer were employed to measure levels of insulin,serum creatinine(Scr),blood urea nitrogen(BUN),triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and 24-h urine protein quantity(UP/24 h)in rats.Renal tissue sections from different treatment groups were prepared,with tissue lesions examined via periodic acid-Schiff(PAS)and hematoxylin–eosin(HE)staining.Tissue inflammation and lipid deposition were evaluated using ELISA and Oil Red O staining.Immunohistochemistry and Western blotting were used to detect changes in the expression levels of COX-2 and low-density lipoprotein receptor(LDLr)in tissues,and to clarify the regulatory mechanism of XKD on renal function in DN rats.Results XKD,particularly at the high dose(XKD-H,6 g/kg/d),significantly reduced BG,insulin levels,renal weight ratio,Scr,BUN,and UP/24 h in DN rats.DN rats showed significant renal lesions,and XKD gavage(especially XKD-H)markedly improved these pathological changes.In DN rats,XKD significantly decreased the protein expression levels of COX-2 and LDLr,downregulated the levels of inflammatory factors and lipid factors,reduced lipid deposition in renal tissues,and ameliorated structural abnormalities in glomeruli,basement membranes,and renal tubules.Conclusions XKD alleviates renal tissue damage by regulating the COX-2-mediated LDLr pathway,thereby reducing the release of inflammatory factors and lipid accumulation in DN rats and protecting renal function.Graphical Abstract XKD improves renal function in streptozotocin(STZ)-induced DN rats by regulating the COX-2-mediated LDLr pathway,reducing inflammatory factors and lipid deposition,and alleviating renal tissue damage.展开更多
BACKGROUND The exact mechanisms underlying diabetic nephropathy(DN)remain incompletely elucidated,prompting researchers to explore new perspectives and identify novel intervention targets in this field.AIM To explore ...BACKGROUND The exact mechanisms underlying diabetic nephropathy(DN)remain incompletely elucidated,prompting researchers to explore new perspectives and identify novel intervention targets in this field.AIM To explore the role and underlying mechanisms of farnesoid X receptor(FXR)in the development of DN by regulating endoplasmic reticulum stress(ERS)molecular chaperone binding immunoglobulin protein(BiP)expression.METHODS Bioinformatics analyses identified potential FXR-binding elements in the BiP promoter.Dual-luciferase and chromatin immunoprecipitation(ChIP)assays confirmed FXR-BiP binding sites.In vitro studies used SV40 MES 13 cells under varying glucose conditions and treatments with FXR modulators[obeticholic acid(INT-747)and guggulsterones]or BiP small interfering RNA.The expression of BiP and ERS-related proteins[protein kinase R-like endoplasmic reticulum kinase(PERK),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6)]was assessed alongside cell proliferation and extracellular matrix(ECM)synthesis.In vivo studies in DN mice(db/db)examined the effects of FXR activation on renal function and morphology.RESULTS FXR bound to the target sequence in the BiP promoter region,enhancing transcriptional activity,as confirmed by ChIP experiments.FXR expression decreased in SV40 MES 13 cells stimulated with high glucose and in renal tissues of DN mice compared with control.Treatment of SV40 MES 13 cells with the FXR agonist INT-747 significantly increased intracellular BiP expression,whereas silencing the FXR gene led to the downregulation of BiP levels.In vivo administration of INT-747 significantly elevated BiP levels in renal tissues,improved renal function and fibrosis in DN mice,while inhibiting the expression of ERS-related signaling proteins PERK,IRE1,and ATF6.CONCLUSION FXR promotes BiP expression by binding to its promoter,suppressing ERS pathways,and reducing mesangial cell proliferation and ECM synthesis.These findings highlight FXR as a potential therapeutic target for diabetic glomerulosclerosis.展开更多
Diabetic nephropathy(DN)is a well-known microvascular complication in patients with diabetes mellitus,which is characterized by the accumulation of extracellular matrix in the glomerular and tubulointerstitial compart...Diabetic nephropathy(DN)is a well-known microvascular complication in patients with diabetes mellitus,which is characterized by the accumulation of extracellular matrix in the glomerular and tubulointerstitial compartments,along with the hyalinization of intrarenal vasculature.DN has recently emerged as a leading cause of chronic and end-stage renal disease.While the pathobiology of other diabetic microvascular complications,such as retinopathy,is largely understood and has reasonable therapeutic options,the mechanisms and management strategies for DN remain incompletely elucidated.In this editorial,we comment on the article by Liu et al,focusing on the mechanisms underlying the detrimental impact ofβ-arrestin-2 on the kidneys in the context of DN.The authors suggest that inhibitingβ-arrestin-2 could alleviate renal damage through suppressing apoptosis of glomerular endothelial cells(GENCs),highlightingβ-arrestin-2 as a promising therapeutic target for DN.The study proposed thatβ-arrestin-2 triggers endoplasmic reticulum(ER)stress via the ATF6 signaling pathway,thereby promoting GENC apoptosis and exacerbating DN progression.Given the novel and crucial role ofβ-arrestin-2 in ER stress-related DN,it is imperative to further exploreβ-arrestin-2,its roles in ER stress and the potential therapeutic implications in DN.展开更多
文摘Medical Data Mining published an article entitled Mapping the global research trends and hotspots on hypertensive nephropathy:A novel bibliometrics overview on 10 October 2025.The author confirmed this article’s proof on 28 September 2025 without any questions.However,on 13 November 2025,the Editorial Office of Medical Data Mining noticed an inconsistency between the data presented in the main text and Figure 1.Specifically,erroneous Figure 1 states“a total of 56,691 literatures were obtained through database search”,while the main text in the Search results section states“According to the search term,a total of 59,220 publications were retrieved from the database.”The authors acknowledge that the original version of Figure 1 was incorrect and have provided the revised,correct version in this corrigendum.The authors would like to assert that there is no change in the body text of the article.
文摘Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.
基金supported by the Science and Technology Innovation Project of Hunan Province(No.2020SK51601)the Health Commission of Hunan Province Scientific Research Projects(No.202203054127)the Science and Technology Plan of Loudi City(No.202202).
文摘Objective IgA nephropathy(IgAN)is the most prevalent form of primary glomerular disease.However,its diagnosis is contingent on kidney biopsy.Therefore,noninvasive biomarkers are urgently needed for diagnosis.This study aims to identify novel urinary biomarkers that differentiate IgAN from other common primary glomerular diseases,specifically membranous nephropathy(MN)and minimal change disease(MCD).Methods The peripheral blood mononuclear cell(PBMC)transcriptome dataset GSE73953 was obtained from the GEO database.Differential gene expression,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment,Gene Ontology(GO)enrichment,and immune infiltration analyses were performed.Protein–protein interaction(PPI)analysis and lysosome-related genes were used to identify hub genes.The expression of the hub gene ATP6V1D in urine and kidney tissues from individuals with IgAN,healthy controls,MCD and MN patients was assessed using enzyme-linked immunosorbent assay(ELISA),Western blotting,and immunostaining techniques.Spearman’s correlation analysis was employed to investigate the relationships between the concentration of ATP6V1D in urine,the concentration of galactose-deficient IgA1(GD-IgA1),and the clinical data of patients.The receiver operating characteristic(ROC)curve was used to assess the role of urine ATP6V1D levels in distinguishing IgAN from MN and MCD.Results ATPase was identified as the principal intracellular structure associated with differentially expressed genes(DEGs)between IgAN patients and healthy controls in PBMCs.ATP6V1D was identified as a hub gene at the intersection of lysosome-related and differential genes.ATP6V1D levels were lower in PBMCs,urine,and kidney samples from IgAN patients than in those from healthy individuals,MCD and MN patients.The decreased urinary ATP6V1D levels and increased GD-IgA1 levels in IgAN patients were further validated.These changes were positively correlated with 24-h urine protein levels.Notably,a negative correlation was observed between ATP6V1D and GD-IgA1 levels.ROC curve analysis demonstrated that urinary ATP6V1D(AUC=0.972)and GD-IgA1(AUC=0.952)had significant discriminative power in distinguishing IgAN patients from MCD and MN patients,with no significant difference in predictive performance between the two biomarkers(P>0.05).Conclusions The findings underscore the potential utility of the urine ATP6V1D concentration as a biomarker to distinguish IgAN from MN and MCD.
基金supported by the National Natural Science Foundation of China(Nos.82474412 and 82074364)the Innovation Program of Wuhan-Basic Research in 2022(No.2022020801020506)the Natural Science Foundation of Hubei Province(No.2022CFC024).
文摘Objective Safranal is a natural product from saffron(Crocus sativus L.)with anti-inflammatory and nephroprotective potential.This study aimed to explore the role of safranal in a cationic bovine serum albumin(C-BSA)-induced rat model of membranous glomerulonephritis(MGN).Methods After model establishment,Sprague–Dawley rats were administered 100 or 200 mg/kg safranal by gavage.A biochemical analyser was used to measure the urine protein levels and serum levels of renal function parameters.Hematoxylin–eosin and immunofluorescence staining of kidney tissues were performed to examine histopathological changes and assess the expression of IgG,C3,and Sirt1.Western blotting was performed to measure the protein levels of podocin,nephrin,Sirt1,and factors involved in the NF-κB/p65 pathway.Inflammatory cytokine levels in renal homogenates were determined by ELISA.Results Safranal at 100 or 200 mg/kg reduced kidney weight(2.07±0.15 g and 2.05±0.15 g)and the kidney somatic index(0.83±0.08%and 0.81±0.08%)in MGN rats compared with those in the model group without drug administration(2.62±0.17 g and 1.05±0.1%).C-BSA increased the urine protein level to 117.68±10.52 mg/day(compared with the sham group,5.03±0.45 mg/day),caused dysregulation of renal function indicators,and induced glomerular expansion and inflammatory cell infiltration in the rat kidney samples.All the biochemical and histological changes were improved by safranal administration.Safranal at two doses also increased the fluorescence intensities of IgG(0.1±0.009 and 0.088±0.008)and C3(0.065±0.006 and 0.048±0.004)compared with those in the MGN group(0.15±0.013 and 0.086±0.008).Additionally,safranal reversed the downregulation of podocin,nephrin,and Wilms tumor protein-1(WT1)levels and reversed the high inflammatory cytokine levels in MGN rats.Mechanistically,safranal activated Sirt1 signalling to interfere with NF-κB signalling in the kidney tissues of MGN rats.Conclusions Safranal ameliorates renal damage,inflammation,and podocyte injury in MGN by upregulating SIRT1 and inhibiting NF-κB signalling.
文摘Objective Inflammation and fibrosis are key features of diabetic nephropathy(DN).Triptolide(TP)exhibits anti-inflammatory and anti-fibrotic properties,though its mechanisms of action in DN remain unclear.CREKA(Cys-Arg-Glu-Lys-Ala)is a pentapeptide that specifically binds to fibronectin(FN),and the CREKA-modified liposome(CREKA-Lip)represents a novel FN-targeted drug delivery system.This study aimed to investigate the role of TP in diabetic db/db mice and determine whether encapsulation within CREKA-Lip enhances therapeutic efficacy while reducing the multi-organ toxicity of TP.Methods Eight-week-old diabetic db/db mice received tail vein injections twice weekly with vehicle,free TP,or CREKA-Lip/TP for 10 weeks.Urine and serum parameters were measured,and kidney,heart,liver,and testis tissues were collected for pathological evaluation.Protein-protein interaction networks were constructed using Cytoscape and its plug-ins to identify core targets and elucidate the therapeutic mechanism of TP against DN.Inflammatory,fibrotic,apoptotic,and lipid metabolism markers were evaluated in the kidneys of diabetic mice with DN and in high glucose-treated mouse mesangial cells and podocytes using qPCR,Western blot,immunohistochemistry,and immunofluorescence assays.Results TP administration reduced fasting blood glucose levels and glomerular mesangial expansion in diabetic mice.TP significantly suppressed renal inflammation,fibrosis,and apoptosis while enhancing lipid metabolism.Integration of network pharmacology,molecular docking,and transcriptomics revealed that TP ameliorated DN by inhibiting the JAK2-STAT1 signaling pathway.In vitro,TP inhibited high glucose-induced phosphorylation of JAK2 and STAT1,reduced collagen production in mesangial cells,decreased apoptosis,and improved lipid metabolism in podocytes.Moreover,CREKA-Lip/TP exhibited superior efficacy compared with free TP,with a more sustained reduction in urine albumin-to-creatinine ratio and greater inhibition of mesangial expansion.Notably,CREKA-Lip/TP treatment did not induce systemic toxicity.Conclusion TP improves renal inflammation,fibrosis,apoptosis,and lipid homeostasis,thereby ameliorating DN by inhibiting JAK2-STAT1 activation.Targeted delivery of TP via FN-binding CREKA-Lip enhances therapeutic efficacy while minimizing multi-organ toxicity.
文摘This article comments on Varatharajan et al recent article,highlighting the role of tubulointerstitial damage mechanisms in diabetic nephropathy progression.Evidence suggests a bidirectional interaction between the interstitium,tubular cells,and glomeruli.Renal tubules are highly susceptible to proteinuria,metabolic disorders,and toxins.Since diabetic nephropathy persistently activates inflammatory and fibrotic pathways,epithelial-to-mesenchymal transition mechanisms present promising targets for risk assessment.Periostin,a cellular matrix protein,plays a key role in modulating extracellular interactions.Increased periostin expression in tissue,serum,and urine correlates with type 2 diabetes,making it a valuable biomarker alongside neutrophil gelatinase-associated lipocalin and kidney injury molecule-1.While periostin and neutrophil gelatinase-associated lipocalin reflect distal tubular damage,kidney injury molecule-1 serves as a marker for proximal tubular injury.Combining these biomarkers enhances diagnostic precision.
文摘BACKGROUND Bile cast nephropathy(BCN)is suspected in the setting of liver disease and hyperbilirubinemia and is characterized by the formation of tubular bile casts and acute tubular injury.While postmortem studies reveal a high prevalence of BCN,little is known about this orphan acute kidney injury syndrome.AIM To address this knowledge gap,we performed a systematic review of case reports and case series of BCN,focusing on risk factors,diagnostic criteria,clinical presentation,kidney biopsy findings,severity,treatment approaches,and outcomes.METHODS Electronic databases were searched to identify eligible studies of patients with possible,probable,or definite BCN,using pre-established criteria.Relevant variables were extracted and analyzed.We explored the impact of serum total bilirubin levels and alcoholic liver disease on BCN severity and outcomes by stratifying cases into total bilirubin tertiles and alcoholic vs non-alcoholic liver disease.Univariate and multivariable logistic regression analyses were used to examine factors associated with the composite outcome of dialysis requirement or death.RESULTS Sixty-seven case reports and six case series(involving 2 patients each)met the inclusion criteria,totaling 79 cases of BCN.The mean age was 48.3 years,and 83.5%were men.The most common cause of liver disease was drug-induced injury(30.4%),followed by infection(18.9%)and alcoholism(12.7%).BCN diagnosis was deemed definite,probable,and possible in 65.8%,32.9%,and 1.3%of cases,respectively.Levels of serum creatinine,dialysis requirement,and renal recovery did not differ among the total bilirubin tertile groups.However,both initial and peak serum creatinine were significantly higher in the alcoholic liver disease group compared to the non-alcoholic group(P=0.011 and P=0.012,respectively).There was also a non-significant trend toward a higher incidence of dialysis requirement or death in the alcoholic liver disease group(80%vs 52%,P=0.098).Finally,higher initial serum creatinine(per 1 mg/dL increase)was independently associated with dialysis requirement or death(adjusted odds ratio 1.291,95%confidence interval:1.032-1.615,P=0.025).CONCLUSION BCN is a common and potentially serious cause of acute kidney injury in patients with liver disease.The degree of hyperbilirubinemia does not appear to correlate with BCN severity or outcomes.However,in alcoholic liver disease,BCN is associated with a greater rise in serum creatinine and a trend toward worse outcomes compared to non-alcoholic liver disease.Serum creatinine may be a valuable predictor of BCN prognosis.Further studies are needed to develop non-invasive diagnostic tools and establish effective treatments for BCN.
文摘BACKGROUND Diabetic nephropathy(DN)is one of the most serious microvascular complications of type 2 diabetes mellitus(T2DM),and its incidence increases with the global rise in diabetes prevalence.It is the leading cause of chronic kidney disease and end-stage kidney disease.Patients with DN often experience complex metabolic disorders and chronic inflammatory states,which not only accelerate the decline of renal function but are also closely related to complications such as cardiovascular events and osteoporosis(OP),seriously compromising quality of life.With the in-depth research on the gut microbiota and the emergence of concepts such as the"gut-kidney axis"and the"enteric-bone axis",the key roles of the gut microbiota and its metabolites in metabolic disorders,inflammatory responses,and target organ damage have been increasingly recognized.However,the specific role of gut microbiota in the pathogenesis of DN remains to be further explored.The results obtained may provide evidence to better understand the pathogenesis of DN and to identify high-risk populations at an early stage.This research direction is of strategic significance.AIM To assess the correlation of the gut microbiota metabolite trimethylamine N-oxide(TMAO)with inflammatory marker levels and OP in patients with DN.METHODS A total of 115 patients diagnosed with type 2 DN and treated at the Department of Endocrinology,Second Affiliated Hospital of Shandong First Medical University from August 2022 to December 2024 were enrolled in the DN group,and 115 patients with T2DM without nephropathy were included in the T2DM group.The two groups were compared in terms of gastrointestinal microbiota abundance and relative abundance at the genus level;levels of TMAO,inflammatory markers[including C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)],and bone metabolism markers[including procollagen type I N-terminal propeptide(PINP),β-CrossLaps(β-CTX),and alkaline phosphatase(ALP)];and lumbar spine and hip bone mineral density(BMD).The correlation of TMAO level with inflammatory factor and bone metabolism indicator levels was further analyzed.RESULTS The DN group had higher Chao1 and Simpson indices of gastrointestinal microbiota diversity than the T2DM group,whereas the ACE and Shannon indices were lower(P<0.05).The relative abundance of Firmicutes was higher,and the relative abundances of Bacteroidetes,Proteobacteria,and Actinobacteria were lower in the DN group than in the T2DM group(P<0.05).CRP,IL-6,IL-8,TNF-α,and TMAO levels were considerably elevated in the DN group compared to the T2DM group(P<0.05).Moreover,the DN group had higher levels of bone turnover markers-including PINP,β-CTX,and ALP-but lower lumbar spine and hip BMDs than the T2DM group(P<0.05).TMAO level positively correlated with the Chao1 and Simpson indices and negatively correlated with the ACE and Shannon indices of gut microbiota diversity.TMAO level also negatively correlated with the relative abundances of Bacteroidetes,Proteobacteria,and Actinobacteria and positively correlated with the abundance of Firmicutes.Additionally,TMAO level positively correlated with the inflammatory markers CRP,IL-6,IL-8,and TNF-α,as well as with the bone turnover markers PINP,β-CTX,and ALP.It negatively correlated with lumbar spine and hip BMDs(P<0.05).CONCLUSION Inflammatory and bone metabolic levels in patients with DN were found to be associated with the gut microbiota–derived metabolite TMAO.Elevated TMAO levels may mediate inflammatory responses and bone metabolism disorders in patients with DN,thereby contributing to the progression of systemic inflammation and OP.
基金Supported by the Chinese People’s Liberation Army,No.2021yxky056.
文摘BACKGROUND Background diabetic nephropathy(DN),a major complication of diabetes,is linked to gut microbiota dysbiosis.Elevated trimethylamine N-oxide(TMAO),a microbiota-derived metabolite,plays a central role in inducing renal injury during DN pathogenesis.AIM To investigate the role of TMAO in renal dysfunction and intestinal microbiota alterations associated with DN,hypothesizing that TMAO exacerbates renal injury and fibrosis through gut microbiota-dependent mechanisms.METHODS A DN model was successfully established using Zucker diabetic fatty(ZDF)rats.Blood samples were analyzed for renal function parameters,and serum TMAO levels were quantified via high-performance liquid chromatography-tandem mass spectrometry.Renal tissue morphology and fibrosis were assessed using hematoxylin and eosin and Masson staining,respectively.Additionally,16S rRNA sequencing was employed to profile fecal bacterial communities in rats with diabetes and DN.Fecal microbiota transplantation was conducted to verify alterations in TMAO production capacity in the gut microbiota of DN rats.RESULTS After 8 weeks of modeling,the ZDF rat model group exhibited blood glucose levels surpassing 16.7 mmol/L,and compared to the control group,renal function indicators,includingβ2-microglobulin,cystatin C,uric acid,and creatinine,were significantly elevated(P<0.05).Renal fibrosis was more pronounced in the ZDF model group,accompanied by heightened P-smad3 expression,in contrast to the TMAO inhibition group.Although Masson staining results did not reach statistical significance(P>0.05),notable alterations in intestinal flora structure were observed in DN rats,and fecal microbiota transplantation led to increased TMAO production within the intestinal flora of DN rats compared to controls(P>0.05).CONCLUSION DN is associated with gut microbiota alterations that potentiate TMAO generation,contributing to renal injury and fibrotic progression.While TMAO’s role in fibrosis warrants further validation,these findings implicate the gutkidney axis in DN pathogenesis.
基金Supported by the Natural Science Foundation of Hebei Province Beijing-Tianjin-Hebei Basic Research Special Program,No.H2020110287Key Laboratory for Diabetic Kidney Disease Syndrome and Treatment of the Traditional Chinese Medicine Administration of Hebei Province,No.7[2024]+2 种基金Yuansong Wang National Famous Traditional Chinese Medicine Expert Heritage Studio,No.3[2024]Hebei Key Laboratory of Integrated Traditional Chinese and Western Medicine for Diabetes and Its Complications,No.SZX2020015Jiangsu Province Chinese Medicine Science and Technology Development Program Project,No.YB2020065.
文摘BACKGROUND Diabetic nephropathy(DN)is a major complication of diabetes,marked by progressive renal damage and an inflammatory response.Although research has investigated the pathological mechanisms underlying DN,effective treatment options remain limited.AIM To evaluate the therapeutic impact of Shenzhuo formulation(SZF)on a DN mouse model and to examine its potential molecular mechanisms using transcriptomic and metabolomic approaches.METHODS We established a DN mouse model through a high-fat diet combined with streptozotocin(STZ)injection,followed by SZF treatment.We analyzed SZF’s effects on gene expression and metabolite profiles in renal tissues of DN mice using transcriptomics and metabolomics techniques.Additionally,based on transcriptomic and non-targeted metabolomic findings,we further assessed SZF’s influence on the expression of factors related to the cytochrome P450(CYP450)-mediated arachidonic acid(AA)metabolism pathway,as well as its effects on inflammation and oxidative stress.RESULTS SZF intervention significantly decreased hyperglycemia and mitigated renal function impairment in DN mice.Pathological analysis revealed that SZF treatment improved renal tissue damage,reduced fibrosis,and diminished glycogen deposition.Transcriptomic analysis indicated that SZF influenced mRNA expression of CYP450-related genes,including Cyp2j13,Cyp2b9,Pla2 g2e/Cyp4a12a,Cyp4a32,Cyp2e1,and Cyp4a14.Non-targeted metabolomic results demonstrated that SZF altered the levels of metabolites associated with the AA metabolic pathway,including 5,6-EET,14,15-EET,phosphatidylcholine,and 20-HETE.Further experiments showed that SZF upregulated the expression of CYP4A and CYP2E proteins in renal tissue,as well as CYP2J and CYP2B proteins.Additionally,SZF significantly reduced the expression of inflammatory factors in renal tissue,enhanced antioxidant enzyme activity,and alleviated oxidative stress.CONCLUSION SZF exerts anti-inflammatory and antioxidant effects by regulating CYP450-mediated AA metabolism,leading to improved renal function and improved pathological state in DN mice.
文摘BACKGROUND The coexistence of rheumatological and immunological diseases with nephropathy presents considerable clinical challenges.These challenges often result in heightened anxiety and depression,which detrimentally affect patient outcomes.Motivational psychological nursing,which incorporates motivational interview and cognitive-behavioral therapy,may offer a promising approach to address these psychological concerns.AIM To evaluate the effectiveness of motivational psychological nursing in the reduction of anxiety and depression and improvement of the quality of life of patients with rheumatological and immunological diseases complicated by nephropathy.METHODS We conducted a retrospective cohort study involving 206 patients with rheumatological and immunological diseases complicated by nephropathy and who were treated between January 2021 and January 2025.The inclusion criteria were as follows:Aged 18-75 years,met the diagnostic criteria for rheumatological and immunological diseases with a renal biopsy classification above type II,hospitalized in our facility,received consistent basic nursing care,and had complete clinical data available.Participants allotted to the observation group(n=102)receiving motivational psychological nursing,and those in the control group(n=104)received standard care.Psychological status was assessed using Self-Rating Anxiety Scale(SAS),Beck Anxiety Inventory,Hamilton Anxiety Rating Scale,Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9,and other standardized measures.Intervention lasted throughout hospitalization,with follow-up assessments conducted before discharge.RESULTS Pre-intervention,anxiety,and depression scores were similar across groups.Postintervention,the observation group showed significant reductions in anxiety(SAS:44.53±6.72 vs 46.79±6.94;P=0.018)and depression(SDS:45.20±5.07 vs 46.97±5.25;P=0.014)compared with the control group.General self-efficacy(P=0.044),healthrelated quality of life(P=0.044),and World Health Organization Quality of Life(P=0.040)scores also revealed significant improvement.CONCLUSION Motivational psychological nursing considerably reduces anxiety and depression in patients with rheumatological and immunological diseases complicated by nephropathy,which enhances the overall quality of life.
文摘BACKGROUND The specific mechanism of diabetic nephropathy(DN)has not been fully elucidated,and more and more evidence shows that the development of DN is related to intestinal flora imbalance and micro-inflammatory state process,and this mechanism urgently needs to be further clarified by relevant research.AIM To investigate the correlation between intestinal microbiota dysbiosis,low-grade inflammatory status,renal function impairment,and disease severity in older patients with DN,in order to provide a basis for the prevention and therapeutic intervention of DN.METHODS We enrolled 167 older patients with DN,diagnosed in the Department of Nephrology between June 2020 and June 2023.Eighty-five patients with type 2 diabetes mellitus(without DN)were enrolled to serve as the control group.A one-year follow-up observation was conducted.We compared the differences in gut microbiota composition,levels of inflammatory markers,and renal function indicators between the two groups,and the characteristics of gut microbiota and the changing patterns of inflammatory markers across different stages of disease progression.RESULTS In the DN group,the Chao,Ace,and Shannon indices were significantly lower,while the Simpson index was significantly higher than the control group.The relative abundances of Bacteroides and Bifidobacterium were significantly lower,whereas the relative abundances of Clostridium,Butyricimonas,Klebsiella,Enterococcus,Veillonella,and Megamonas were significantly higher than those in the control group(P<0.05).Estimated glomerular filtration rate was positively correlated with the Chao,Ace,and Shannon diversity indices of the gut microbiota,as well as with the relative abundances of Bacteroides,Bifidobacterium,and Akkermansia,and was negatively correlated with the relative abundances of Clostridium,Klebsiella,and Enterococcus(P<0.05).Logistic regression analysis indicated that lower Chao,Ace,and Shannon indices and higher Simpson index were associated with an increased risk of developing DN.After one year of follow-up,patients in the progression group exhibited a significantly greater decrease in Chao,Ace,and Shannon indices and a greater increase in Simpson index than the stable group.The reduction in the relative abundances of Bacteroides,Clostridium,Bifidobacterium,and Butyricimonas,as well as the increase in Klebsiella,Enterococcus,Veillonella,and Megamonas,were significantly more pronounced in the progression group than in the stable group(P<0.05).Regression analysis indicated that greater declines in Chao,Ace,and Shannon indices and Bacteroides relative abundance,along with greater increases in Simpson index and Enterococcus relative abundance,were associated with a more rapid decline in renal function.CONCLUSION The onset and progression of DN in older patients with diabetes are closely associated with gut microbiota composition.The more severe the dysbiosis,the lower the abundance of beneficial bacteria and the higher the abundance of harmful bacteria,leading to an increased risk of both DN occurrence and disease progression.
文摘Diabetic nephropathy(DN)is one of the most serious complications of diabetes and a major cause of end-stage renal disease.However,due to the complexity of its pathogenesis,no new therapeutic drugs have been developed in the past 20 years,except for angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin receptor blockers(ARBs).Breviscapine is a flavonoid active component isolated from Erigeron breviscapus,a member of the Asteraceae family.Pharmacological studies have confi rmed that this compound has antioxidant stress,anti-inflammatory regulation,anti-fibrosis and neuroprotective eff ects.Currently,it is mainly used in clinical practice as an adjuvant treatment for ischemic stroke and non-alcoholic fatty liver disease.Notably,although its antioxidant and anti-fibrotic properties have been verified in organs such as the liver and lungs,the mechanism of action in the field of DN has not been fully elucidated,especially the regulatory eff ect on the interstitial transformation of renal tubular epithelial cells remains to be revealed.Our research group has for the fi rst time systematically explored the molecular mechanism by which breviscapine improves high glucose-induced renal tubular fibrosis,providing a new theoretical basis for expanding its clinical application.
基金Supported by Hubei Provincial Natural Science Foundation,No.2023AFB732and Scientific Research Project of Hubei Provincial Health Commission,No.WJ2023M053.
文摘BACKGROUND Diabetic nephropathy(DN)is a leading cause of chronic kidney disease and endstage renal disease,and is a significant global healthcare burden.Although proximal tubular epithelial cells(PTECs)and podocytes are involved in DN progression,the specific molecular interactions between these cells are not well understood.AIM To elucidate the role of interleukin-6(IL-6)/Rab5 signaling in mediating crosstalk between PTECs and podocytes,and to evaluate the protective effects of nicotinamide mononucleotide(NMN)against DN progression.METHODS We utilized in vitro and in vivo models to investigate the pathogenesis of DN.In vitro,human PTECs and murine podocytes were cultured under high-glucose conditions,and IL-6 neutralizing antibodies or NMN treatments were applied.Podocyte injury was assessed by measurements of nephrin endocytosis,Rab5 activity,cytoskeletal organization,cell adhesion,and cell-spreading assays.In vivo,DN was induced in mice using streptozotocin,and mice then received NMN,insulin,or both treatments over an 8-week period.Renal tissues were analyzed histologically,ultrastructurally,and immunochemically,and urinary albumin excretion was measured to assess renal function.Statistical analyses were conducted using one-way ANOVA and Tukey's test.RESULTS High-glucose conditions induced the epithelial-mesenchymal transition(EMT)in PTECs,increased IL-6 secretion,and activated Rab5 signaling in podocytes,leading to increased nephrin endocytosis and podocyte injury.Blocking IL-6 significantly attenuated these effects.NMN treatment of diabetic mice markedly reduced podocyte injury,glomerular hypertrophy,foot-process effacement,and urinary albumin excretion.Mechanistically,NMN suppressed the EMT and IL-6 secretion by PTECs,inhibited Rab5 activation in podocytes,and prevented nephrin endocytosis,thereby preserving the cytoskeletal integrity and function of podocytes.CONCLUSION Our findings reveal a novel pathogenic mechanism of DN in which IL-6 released from glucose-stressed PTECs activates Rab5 signaling in podocytes,followed by nephrin endocytosis and structural injury of podocytes.Importantly,NMN treatment effectively disrupted this pathological pathway of intercellular communication,and provided significant protection against DN progression.These results suggest that NMN supplementation and targeting the IL-6/Rab5 signaling axis has promise as a therapeutic strategy for managing DN.
文摘Diabetes mellitus is a major contributor to kidney failure,with diabetic nephro-pathy being a common microvascular complication.The increasing prevalence of diabetes and its complications suggests a rise in associated morbidity and mortality.Recent studies highlight increased mortality related to diabetic kidney disease,with disparities across demographic and geographic groups.Novel pharmacological treatments,including sodium-glucose cotransporter 2 inhibitors,non-steroidal mineralocorticoid receptor antagonists,and glucagon-like peptide-1 agonists,offer promise in slowing disease progression and reducing renal mortality.However,the growing epidemics of obesity and diabetes necessitate prioritizing public health policies focused on primary and secondary prevention,along with comprehensive multidisciplinary care.
文摘Objective:To explore the key points of holistic nursing for children with membranous nephropathy(MN)combined with cerebral venous thrombosis,providing a reference for similar cases.Methods:The course of illness data of an 8-year-old boy with MN in the recurrent phase complicated with cerebral venous sinus thrombosis(CVST)was retroactively analyzed.Systematic nursing was implemented based on evidence-based practices,including strict neurological monitoring,anticoagulation and thrombolysis medication nursing,fluid and electrolyte management,hypoalbuminemia and edema nursing,complication prevention,and mental health education.Results:After 16 days of continuous infusion of low molecular weight heparin and supportive treatment,the child’s symptoms,such as headache and vomiting,disappeared.The reexamination of MRV showed significant absorption of thrombosis,and there was no residual neurological deficit.During the 3-month follow-up,the anticoagulation compliance was good,and there was no recurrence.Conclusion:Early identification of hypercoagulability risk,strengthening dynamic evaluation of neurological signs and coagulation indicators,standardizing anticoagulation and thrombolysis nursing,and cooperating with continuous health management can significantly improve the prognosis of children with MN combined with CVST.
文摘Immunoglobulin(Ig)A nephropathy is the most common type of primary glomerulonephritis globally.It typically manifests with microscopic hematuria and a spectrum of proteinuria,although rapidly progressive glomerulonephritis may occur in rare instances.Deposition of IgA in the mesangium seems to be the underlying disease mechanism.Despite current treatment,IgA nephropathy may progress into end-stage renal disease,indicating the necessity for the development of new therapeutic agents.Lifestyle modifications and anti-proteinuric treatment are recommended,and steroids have shown to be beneficial to high risk groups.Nevertheless,other conventional immunosuppressive agents,such as cyclophosphamide and mycophenolate mofetil,may be considered,despite the lack of sufficient evidence to support their efficacy.A considerable proportion of cases remain unresponsive to these treatments,underscoring the need for novel therapeutic approaches.There are several promising immunosuppressive drugs,such as B-cell lineage depleting agents or complement system inhibitors,that are currently undergoing clinical trials.These therapies may be considered for use in selected cases.
基金supported by the Budget Project of Shanghai University of Traditional Chinese Medicine(18LK058).
文摘Objective Traditional Chinese medicine exhibits positive therapeutic effects as a primary or adjunctive treatment for diabetic nephropathy(DN).This study aimed to evaluate the impact and mechanism of action of Xiaoke decoction(XKD),a traditional Chinese medicine,on renal function in DN rats.Methods A rat model of DN was established,and the rats were divided into five groups(n=7 per group):normal control group(NC),DN model group(DN),low-dose XKD treatment group(DN+XKD-L,1.5 g/kg/d),high-dose XKD treatment group(DN+XKD-H,6 g/kg/d),and cyclooxygenase-2(COX-2)inhibitor(NS398)treatment group(DN+NS398,8 mg/kg/d).Medications were administered via gavage for 12 consecutive weeks,while equal volumes of normal saline were given to the NC and DN groups.A glucometer was used to detect changes in blood glucose(BG).Enzyme-linked immunosorbent assay(ELISA)and an automatic biochemical analyzer were employed to measure levels of insulin,serum creatinine(Scr),blood urea nitrogen(BUN),triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and 24-h urine protein quantity(UP/24 h)in rats.Renal tissue sections from different treatment groups were prepared,with tissue lesions examined via periodic acid-Schiff(PAS)and hematoxylin–eosin(HE)staining.Tissue inflammation and lipid deposition were evaluated using ELISA and Oil Red O staining.Immunohistochemistry and Western blotting were used to detect changes in the expression levels of COX-2 and low-density lipoprotein receptor(LDLr)in tissues,and to clarify the regulatory mechanism of XKD on renal function in DN rats.Results XKD,particularly at the high dose(XKD-H,6 g/kg/d),significantly reduced BG,insulin levels,renal weight ratio,Scr,BUN,and UP/24 h in DN rats.DN rats showed significant renal lesions,and XKD gavage(especially XKD-H)markedly improved these pathological changes.In DN rats,XKD significantly decreased the protein expression levels of COX-2 and LDLr,downregulated the levels of inflammatory factors and lipid factors,reduced lipid deposition in renal tissues,and ameliorated structural abnormalities in glomeruli,basement membranes,and renal tubules.Conclusions XKD alleviates renal tissue damage by regulating the COX-2-mediated LDLr pathway,thereby reducing the release of inflammatory factors and lipid accumulation in DN rats and protecting renal function.Graphical Abstract XKD improves renal function in streptozotocin(STZ)-induced DN rats by regulating the COX-2-mediated LDLr pathway,reducing inflammatory factors and lipid deposition,and alleviating renal tissue damage.
基金Supported by the Talent Launch Fund of Chongqing Medical University Affiliated University City HospitalChongqing Medical University Affiliated University City Hospital Youth Program,No.2021ZD05.
文摘BACKGROUND The exact mechanisms underlying diabetic nephropathy(DN)remain incompletely elucidated,prompting researchers to explore new perspectives and identify novel intervention targets in this field.AIM To explore the role and underlying mechanisms of farnesoid X receptor(FXR)in the development of DN by regulating endoplasmic reticulum stress(ERS)molecular chaperone binding immunoglobulin protein(BiP)expression.METHODS Bioinformatics analyses identified potential FXR-binding elements in the BiP promoter.Dual-luciferase and chromatin immunoprecipitation(ChIP)assays confirmed FXR-BiP binding sites.In vitro studies used SV40 MES 13 cells under varying glucose conditions and treatments with FXR modulators[obeticholic acid(INT-747)and guggulsterones]or BiP small interfering RNA.The expression of BiP and ERS-related proteins[protein kinase R-like endoplasmic reticulum kinase(PERK),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6)]was assessed alongside cell proliferation and extracellular matrix(ECM)synthesis.In vivo studies in DN mice(db/db)examined the effects of FXR activation on renal function and morphology.RESULTS FXR bound to the target sequence in the BiP promoter region,enhancing transcriptional activity,as confirmed by ChIP experiments.FXR expression decreased in SV40 MES 13 cells stimulated with high glucose and in renal tissues of DN mice compared with control.Treatment of SV40 MES 13 cells with the FXR agonist INT-747 significantly increased intracellular BiP expression,whereas silencing the FXR gene led to the downregulation of BiP levels.In vivo administration of INT-747 significantly elevated BiP levels in renal tissues,improved renal function and fibrosis in DN mice,while inhibiting the expression of ERS-related signaling proteins PERK,IRE1,and ATF6.CONCLUSION FXR promotes BiP expression by binding to its promoter,suppressing ERS pathways,and reducing mesangial cell proliferation and ECM synthesis.These findings highlight FXR as a potential therapeutic target for diabetic glomerulosclerosis.
基金Supported by National Natural Science Foundation of China,No.82303047,No.82372507,No.82172196 and No.32401046Natural Science Foundation of Hunan Province,No.2022JJ40801。
文摘Diabetic nephropathy(DN)is a well-known microvascular complication in patients with diabetes mellitus,which is characterized by the accumulation of extracellular matrix in the glomerular and tubulointerstitial compartments,along with the hyalinization of intrarenal vasculature.DN has recently emerged as a leading cause of chronic and end-stage renal disease.While the pathobiology of other diabetic microvascular complications,such as retinopathy,is largely understood and has reasonable therapeutic options,the mechanisms and management strategies for DN remain incompletely elucidated.In this editorial,we comment on the article by Liu et al,focusing on the mechanisms underlying the detrimental impact ofβ-arrestin-2 on the kidneys in the context of DN.The authors suggest that inhibitingβ-arrestin-2 could alleviate renal damage through suppressing apoptosis of glomerular endothelial cells(GENCs),highlightingβ-arrestin-2 as a promising therapeutic target for DN.The study proposed thatβ-arrestin-2 triggers endoplasmic reticulum(ER)stress via the ATF6 signaling pathway,thereby promoting GENC apoptosis and exacerbating DN progression.Given the novel and crucial role ofβ-arrestin-2 in ER stress-related DN,it is imperative to further exploreβ-arrestin-2,its roles in ER stress and the potential therapeutic implications in DN.
