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BMC Nephrology Feb 2023Contrast-induced acute kidney injury (CI-AKI) is the third most common cause of hospital-acquired renal failure. However, there is no effective treatment of CI-AKI, and...
BACKGROUND
Contrast-induced acute kidney injury (CI-AKI) is the third most common cause of hospital-acquired renal failure. However, there is no effective treatment of CI-AKI, and its mechanism is unknown. Interestingly, atorvastatin has been reported to be effective in renal injury. Therefore, the aim of this study was to explore the effect and possible molecular mechanism of atorvastatin in CI-AKI.
METHODS
On the CI-AKI in vitro model, rat tubular epithelial cells (NRK-52E) were treated with 18 mg I/ml meglumine diatrizoate (MEG) and then pretreated with atorvastatin. pcDNA3.1-TLR4 treatment was performed to overexpress toll-like receptor 4 (TLR4) in NRK-52E cells. Cell Counting Kit-8 (CCK-8) and lactate dehydrogenase (LDH) kits were used to detect NRK-52E cell viability as well as LDH release in each group, respectively; qRT-PCR to determine mRNA expression of TLR4 in cells; western blot to detect protein expression levels of pyroptosis-related proteins (NLRP3, caspase-1, ASC, and GSDMD) and TLR4/MyD88/NF-κB signaling pathway-related proteins (TLR4, MyD88, NF-κBp65, and p-NF-κB p65) in cells.
RESULTS
MEG treatment significantly inhibited the viability of NRK-52E cells, increased pro-inflammatory factor levels and promoted pyroptosis, representing successful establishment of a rat tubular epithelial cell (NRK-52E) CI-AKI in vitro model. Notably, atorvastatin increased the activity of MEG-treated NRK-52E cells and alleviated cell injury in a concentration-dependent manner. In addition, atorvastatin significantly down-regulated the expression of TLR4 in MEG-treated NRK-52E cells. However, overexpression of TLR4 inhibited the effects of atorvastatin on increasing cell viability, alleviating cell injury, reducing pro-inflammatory factors (IL-1β, IL-6, and TNF-α) levels, and inhibiting apoptosis (by down-regulating the expression of NLRP3, caspase-1, ASC, and GSDMD). Furthermore, atorvastatin also inhibited the expression of TLR4/MyD88/NF-κB pathway-related proteins (TLR4, MyD88, and p-NF-κB p65).
CONCLUSION
Atorvastatin can attenuate CI-AKI through increasing the activity of MEG-treated renal tubular epithelial cells, relieving cell injury, as well as inhibiting pyroptosis and inflammation. More importantly, the mechanism was achieved by inhibiting the TLR4//MyD88/NF-κB signaling pathway.
Topics: Rats; Animals; NF-kappa B; Atorvastatin; Myeloid Differentiation Factor 88; Contrast Media; NLR Family, Pyrin Domain-Containing 3 Protein; Pyroptosis; Toll-Like Receptor 4; Signal Transduction; Acute Kidney Injury; Epithelial Cells; Caspases
PubMed: 36732683
DOI: 10.1186/s12882-023-03066-9 -
The Journal of Surgical Research May 2015Contrast-induced nephropathy (CIN) is an important complication of vascular interventions. Ozone therapy can induce tolerance to ischemic insults, a phenomenon known as...
BACKGROUND
Contrast-induced nephropathy (CIN) is an important complication of vascular interventions. Ozone therapy can induce tolerance to ischemic insults, a phenomenon known as ozone oxidative preconditioning (OOP). The aim of this study was to investigate the effects of OOP on CIN.
MATERIALS AND METHODS
Thirty-two Wistar rats were randomized into four groups (n = 8). The control group had intravenous saline injection. The contrast media (CM) group had intravenous meglumine/sodium diatrizoate injection to form CIN. The ozone (O3) group received intraperitoneal ozone for 5 d before the induction of CIN. The oxygen (O2) group was given an equal amount of oxygen for 5 d before the induction of CIN. The animals were sacrificed 48 h after the administration of contrast agent or saline. Kidneys were harvested, and blood samples were obtained. Renal function tests, serum and renal tissue malondialdehyde (MDA), and nitric oxide (NO) levels and renal oxidant system parameters were determined. Histologic examination was performed for renal injury.
RESULTS
Serum blood urea nitrogen (BUN), creatinine, and serum and renal MDA were increased after contrast exposure. Renal NO was decreased, and there was prominent tubular necrosis in the CM group. Serum BUN, creatinine, serum and renal MDA, and grade of tubular necrosis were decreased in the O3 group as compared with those in the CM group. The levels of serum and renal NO and renal total antioxidant system in O3 group were higher than the levels in the CM group.
CONCLUSIONS
OOP attenuates experimental CIN. This effect is suggested to be mediated by reinforcement of renal antioxidant defenses and maintenance of renal NO levels.
Topics: Animals; Blood Urea Nitrogen; Contrast Media; Creatinine; Kidney Diseases; Male; Malondialdehyde; Nitric Oxide; Ozone; Rats; Rats, Wistar
PubMed: 25770741
DOI: 10.1016/j.jss.2015.01.041 -
Canadian Journal of Physiology and... Sep 2022Contrast medium (CM) is a chemical substance that is used for imaging anatomical boundaries and to explore normal and abnormal physiological findings; the use of CM was...
Contrast medium (CM) is a chemical substance that is used for imaging anatomical boundaries and to explore normal and abnormal physiological findings; the use of CM was associated with kidney injury and acute renal failure. Melatonin (M) possesses antioxidant, anti-inflammatory, and antiapoptotic effects in addition to autophagy modulation. This study aimed to investigate the protective effect of M against contrast-induced nephropathy (CIN) and its impact on the crosstalk between inflammasome, apoptosis, and autophagy in CIN. Male albino rats received M (10, 20, and 40 mg/kg/day, intraperitoneally) for 3 days. One hour after the last administration, rats were subjected to CIN induction (10 mg/kg indomethacin, double doses of l-NAME 10 mg/kg, i.v., and meglumine diatrizoate 60% 6 mL/kg, i.v.). CIN-induced kidney damage was evidenced through elevated kidney function biomarkers and induced renal histopathological changes. Pretreatment with M caused a significant decrease in nephrotoxicity biomarkers and histopathological alterations. Moreover, CIN-induced oxidative stress, NLRP3 inflammasome, and apoptosis were attenuated by M. Furthermore, M modulates autophagy in CIN rats. M inhibits CIN-induced NLRP3-inflammasome activation and apoptosis as well as enhances autophagy.
Topics: Acute Kidney Injury; Animals; Apoptosis; Autophagy; Biomarkers; Contrast Media; Inflammasomes; Inflammation; Male; Melatonin; NLR Family, Pyrin Domain-Containing 3 Protein; Rats
PubMed: 36017872
DOI: 10.1139/cjpp-2022-0111 -
The National Medical Journal of India 2019Retrograde pyelography (RGP) is done to evaluate the collecting system when intravenous contrast studies are contraindicated due to renal insufficiency or prior adverse...
Retrograde pyelography (RGP) is done to evaluate the collecting system when intravenous contrast studies are contraindicated due to renal insufficiency or prior adverse reactions. We report a patient who developed acute renal shutdown following bilateral RGP in the same sitting done for evaluation of positive malignant cytology of urine. A 65-year-old man on treatment for left stroke and hypertension, with a baseline serum creatinine of 1.9 mg/dl presented with painless haematuria for 2 months. Plain computed tomogram revealed a small papillary growth on the posterior wall of the urinary bladder. Transurethral resection revealed inflammatory atypia. As the patient continued to have haematuria, he was taken up for bilateral ureteric washings for cytology and bilateral RGP. A 5-Fr universal ureteral catheter was used to cannulate the ureters, urine was aspirated for cytology and 6 ml of 76% meglumine diatrizoate (1:2) was injected, and sufficient opacification with no abnormality or pyelosinus/venous or lymphatic reflux was noted. In the immediate postoperative period, he developed anuria and the serum creatinine rose to 3.6 mg/dl on postoperative day 1 and to 7.5 mg/dl on day 5. He needed three sessions of haemodialysis. Ultrasonography showed no hydroureteronephrosis. Urine output improved and his serum creatinine stabilized at the preoperative level of 1.8 mg/dl. The patient is doing well with stable renal function at 12 months. Although RGP is useful, it needs to be done with caution if a bilateral procedure is contemplated. This entity is seldom reported, and routine double-J stenting following unilateral/bilateral RGP also needs evaluation.
Topics: Aged; Anuria; Humans; Kidney; Male; Renal Dialysis; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography; Ureter; Ureteral Obstruction; Urinary Bladder Neoplasms; Urography
PubMed: 31823934
DOI: 10.4103/0970-258X.272110 -
Cirugia Espanola Nov 2016Postoperative ileus is one of the main complications in the postoperative period. New measures appeared with the introduction of «fast-track surgery» to accelerate... (Review)
Review
Postoperative ileus is one of the main complications in the postoperative period. New measures appeared with the introduction of «fast-track surgery» to accelerate recovery: coffee, chewing gum and gastrograffin. We performed a summary of current evidence, reviewing articles from MEDLINE, Cochrane Database of Systematic Reviews, ISI Web of Science, and SCOPUS databases. Employed search terms were «postoperative ileus» AND («definition» OR «epidemiology» OR «risk factors» OR «Management»). We selected 44 articles: 9 systematic reviews 11 narrative reviews, 13 randomized clinical trials, 6 observational studies, and the remaining 5 scientific letters, assumptions, etc. There is little literature about this topic, studies are heterogeneous, with disparity in the results. In addition, they only focus on colorectal and gynecological surgery. New high-quality studies are needed, preferably randomized clinical trials, in order to clarify the usefulness of these measures.
Topics: Chewing Gum; Coffee; Contrast Media; Diatrizoate Meglumine; Humans; Ileus; Postoperative Complications
PubMed: 27456544
DOI: 10.1016/j.ciresp.2016.05.020 -
Journal of Pediatric Surgery Jul 2021therapeutic strategy for meconium-related ileus (MRI) in very-low-birth-weight infants (VLBWs) has not been established. This study aims to clarify the optimum...
BACKGROUND/PURPOSE
therapeutic strategy for meconium-related ileus (MRI) in very-low-birth-weight infants (VLBWs) has not been established. This study aims to clarify the optimum therapeutic strategy for MRI in VLBWs.
METHODS
MRI was defined as delayed meconium excretion and microcolon on contrast enema with Gastrografin (diatrizoate acid). Forty-two infants with MRI were treated at our institution between 2009 and 2019, and are reviewed here. They were classified into two groups: in group A (n=21), Gastrografin regurgitated into the dilated intestine during the first or second round of Gastrografin enema (GaE), while in group B (N = 21), Gastrografin did not regurgitate. Laparotomy was indicated if the intestine was perforated, or if abdominal distention was not relieved by two rounds of GaE.
RESULTS
in group A, meconium was excreted in all cases within 24 h after GaE, and no cases required laparotomy. In group B, twelve cases (57%) underwent laparotomy (P < 0.01), six cases in this group (29%), showed free air on X-ray images (P < 0.01). The median hospital stay in groups A and B were 89.0 and 136.5 days, respectively (P < 0.05). Overall mortality was 2.4%.
CONCLUSIONS
early therapeutic diagnosis by GaE followed by early surgery is suggested as the optimum strategy for MRI in VLBWs.
Topics: Diatrizoate Meglumine; Enema; Humans; Ileus; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Obstruction; Meconium; Meconium Ileus
PubMed: 33896618
DOI: 10.1016/j.jpedsurg.2021.03.029 -
ANZ Journal of Surgery Sep 2018
Topics: Administration, Intravenous; Administration, Oral; Anastomosis, Surgical; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Colectomy; Diatrizoate Meglumine; Enterocolitis, Pseudomembranous; Humans; Ileostomy; Intestinal Obstruction; Male; Metronidazole; Middle Aged; Tomography, X-Ray Computed; Treatment Outcome; Vancomycin
PubMed: 27457536
DOI: 10.1111/ans.13679 -
The Journal of Trauma and Acute Care... Oct 2015The initial goal of evaluating a patient with SBO is to immediately identify strangulation and need for urgent operative intervention, concurrent with rapid... (Review)
Review
The initial goal of evaluating a patient with SBO is to immediately identify strangulation and need for urgent operative intervention, concurrent with rapid resuscitation. This relies on a combination of traditional clinical signs and CT findings. In patients without signs of strangulation, a protocol for administration of Gastrografin immediately in the emergency department efficiently sorts patients into those who will resolve their obstructions and those who will fail nonoperative management.Furthermore, because of the unique ability of Gastrografin to draw water into the bowel lumen, it expedites resolution of partial obstructions, shortening time to removal of nasogastric tube liberalization of diet, and discharge from the hospital. Implementation of such a protocol is a complex, multidisciplinary, and time-consuming endeavor. As such, we cannot over emphasize the importance of clear, open communication with everyone involved.If surgical management is warranted, we encourage an initial laparoscopic approach with open access. Even if this results in immediate conversion to laparotomy after assessment of the intra-abdominal status, we encourage this approach with a goal of 30% conversion rate or higher. This will attest that patients will have been given the highest likelihood of a successful laparoscopic LOA.
Topics: Contrast Media; Decision Making; Diatrizoate Meglumine; Evidence-Based Medicine; Humans; Intestinal Obstruction; Intestine, Small; Laparoscopy; Tomography, X-Ray Computed
PubMed: 26402543
DOI: 10.1097/TA.0000000000000824 -
Palliative Medicine Jan 2018Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these...
BACKGROUND
Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety.
AIM
This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms.
DESIGN
A retrospective chart review was undertaken. Descriptive statistics were utilised.
SETTING/PARTICIPANTS
All patients with known advanced neoplasms admitted to Mater Health Services and St Vincent's Private Hospital Brisbane between January 2013 and October 2015; who were administered Diatrizoate Meglumine were included.
RESULTS
Seventy-one patients received Diatrizoate Meglumine. The most common diagnoses were ovarian or primary peritoneal neoplasms (33.8%). Diatrizoate Meglumine was most commonly used for intestinal obstruction (59.2%). The median dose used per patient episode was 50 mL (range: 15-500 mL). Thirty-two patients (45%) had imaging 4-24 h post-dose with Diatrizoate Meglumine being present in the large intestine in 75% of these images. Intestinal obstruction or constipation resolved in 90% of patients post-dose.
CONCLUSION
Most clinicians used 50 mL of Diatrizoate Meglumine as a single dose and repeated imaging after 4-24 h. Diatrizoate Meglumine was well tolerated and may be effective in resolving intestinal obstruction and constipation in patients with advanced neoplasms. Quality controlled studies are needed to further guide the use of Diatrizoate Meglumine in intestinal obstruction and constipation in patients with advanced neoplasms.
Topics: Adult; Aged; Aged, 80 and over; Australia; Constipation; Contrast Media; Diatrizoate Meglumine; Female; Humans; Intestinal Obstruction; Male; Middle Aged; Neoplasms; Prospective Studies; Retrospective Studies
PubMed: 28805119
DOI: 10.1177/0269216317726430 -
International Surgery 2014Parastomal hernia is the most common late stomal complication. Its appearance is usually asymptomatic. We report a parastomal hernia containing stomach. A 69-year-old...
Parastomal hernia is the most common late stomal complication. Its appearance is usually asymptomatic. We report a parastomal hernia containing stomach. A 69-year-old patient with end colostomy arrived at the emergency room presenting with abdominal pain associated with vomiting and functioning stoma. She had a distended and painful abdomen without signs of peritoneal irritation and pericolostomic eventration in the left iliac fossa. X-ray visualized gastric fornix dilatation without dilated intestine bowels, and computed tomography showed parastomal incarcerated gastric herniation. Gastrografin (Bayer Australia Limited, New South Wales, Australia) was administered, showing no passage to duodenum. She underwent surgery, with stomal transposition and placement of onlay polypropylene mesh around the new stoma. Parastomal hernias are a frequent late complication of colostomy. Only four gastric parastomal hernia cases are reported in the literature. Three of these four cases required surgery. The placement of prosthetic mesh in the moment of stoma elaboration should be considered as a potential preventive measure.
Topics: Aged; Colostomy; Contrast Media; Diatrizoate Meglumine; Female; Hernia, Ventral; Humans; Postoperative Complications; Stomach; Surgical Mesh
PubMed: 25058773
DOI: 10.9738/INTSURG-D-13-00100