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Treatment options for anemia in kidney transplant patients: a review
Full text linkAnemia is common after kidney transplantation. The etiology may be multifactorial
including both causes of anemia in the general population and more specific causes
unique to the kidney transplant setting. Post-transplant anemia, particularly when severe,
may be associated with adverse effects including graft failure, mortality, and a decline in
kidney function. After careful investigation, having excluded or treated reversible causes
of anemia, treatment of anemia in patients with a kidney transplant is based on iron
supplementation and/or erythropoiesis stimulating agents though there are no specific
guidelines on anemia management in this patient population. Iron therapy is often
needed, but optimal and safe iron deficiency management strategies remain to be defined.
Evidence suggests that erythropoiesis stimulating agents are safe and potentially
associated with favorable outcomes. Better graft function has been reported upon ESA
use targeting hemoglobin levels higher than those recommended in the general chronic
kidney disease population with no apparent increased risk of cardiovascular events. These
results require further investigation. Data on the use of hypoxia-inducible factor
inhibitors are limited. Prevention and treatment of anemia in kidney transplantation can
improve patients’ quality of life, life expectancy, allograft function, and survival
Proteomics and nephrology
No full textProteome analysis has emerged as a new field of protein science offering the possibility of achieving unbiased identification, quantification and functional assessment of all proteins and peptides present in biological samples. Proteomics technologies are being used with increased frequency in the renal community. In this article we aim to highlight investigations in basic renal research and in clinical nephrology making use of recent developments in proteomic methods. Several examples are presented of how proteomics may be helpful to nephrology and affect possible future directions in kidney research
Blood cell proteomics in chronic kidney disease
Full text linkBackground: The uremic syndrome mimes a systemic poisoning with the retention of numerous compounds which are normally removed by the kidney. The study of proteins and peptides, or proteomics, represents an important field of research for the investigation of blood and blood diseases. Methods and Materials: We focused our review on the results of proteomic investigations on blood cells of uremic patients with particular regard to the study of red blood cells, platelets, and monocytes. Results: In literature there are few, preliminary studies on platelets and monocytes while the knowledge on uremic erythrocytes is much wider. Proteomic investigations showed that erythrocyte membrane proteome of uremic patients, differs significantly from the proteome of healthy subjects, being characterized by an extensive remodeling which may influence visco-elastic properties of RBC such as deformability and involve diverse molecular pathways driving red blood cell signaling and removal. Conclusion: Proteomic technologies emerged as a useful tool in defining and characterizing both physiological and disease processes being able, among others, to give important insights into uremic anemia. © 2018 Bonomini et al
Platelet activation and platelet-erytrocyte aggregates in end-stage renal disease patients on hemodialisis
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Examining hemodialyzer membrane performance using proteomic technologies
No full textMario Bonomini,1 Luisa Pieroni,2 Lorenzo Di Liberato,1 Vittorio Sirolli,1 Andrea Urbani2,3 1Department of Medicine, G. d’Annunzio University, Chieti, 2Proteomic and Metabonomic Units, IRCCS S. Lucia Foundation, Rome, 3Faculty of Medicine, Biochemistry and Clinical Biochemistry Institute, Catholic University of the “Sacred Heart”, Rome, Italy Abstract: The success and the quality of hemodialysis therapy are mainly related to both clearance and biocompatibility properties of the artificial membrane packed in the hemodialyzer. Performance of a membrane is strongly influenced by its interaction with the plasma protein repertoire during the extracorporeal procedure. Recognition that a number of medium–high molecular weight solutes, including proteins and protein-bound molecules, are potentially toxic has prompted the development of more permeable membranes. Such membrane engineering, however, may cause loss of vital proteins, with membrane removal being nonspecific. In addition, plasma proteins can be adsorbed onto the membrane surface upon blood contact during dialysis. Adsorption can contribute to the removal of toxic compounds and governs the biocompatibility of a membrane, since surface-adsorbed proteins may trigger a variety of biologic blood pathways with pathophysiologic consequences. Over the last years, use of proteomic approaches has allowed polypeptide spectrum involved in the process of hemodialysis, a key issue previously hampered by lack of suitable technology, to be assessed in an unbiased manner and in its full complexity. Proteomics has been successfully applied to identify and quantify proteins in complex mixtures such as dialysis outflow fluid and fluid desorbed from dialysis membrane containing adsorbed proteins. The identified proteins can also be characterized by their involvement in metabolic and signaling pathways, molecular networks, and biologic processes through application of bioinformatics tools. Proteomics may thus provide an actual functional definition as to the effect of a membrane material on plasma proteins during hemodialysis. Here, we review the results of proteomic studies on the performance of hemodialysis membranes, as evaluated in terms of solute removal efficiency and blood–membrane interactions. The evidence collected indicates that the information provided by proteomic investigations yields improved molecular and functional knowledge and may lead to the development of more efficient membranes for the potential benefit of the patient. Keywords: mass spectrometry, hemodialysis, end-stage renal disease, protein adsorption, biocompatibility, uremic toxi
Urinary Peptidomic Biomarkers in Kidney Diseases
Full text linkIn order to effectively develop personalized medicine for kidney diseases we urgently need to develop highly accurate biomarkers for use in the clinic, since current biomarkers of kidney damage (changes in serum creatinine and/or urine albumin excretion) apply to a later stage of disease, lack accuracy, and are not connected with molecular pathophysiology. Analysis of urine peptide content (urinary peptidomics) has emerged as one of the most attractive areas in disease biomarker discovery. Urinary peptidome analysis allows the detection of short and long-term physiological or pathological changes occurring within the kidney. Urinary peptidomics has been applied extensively for several years now in renal patients, and may greatly improve kidney disease management by supporting earlier and more accurate detection, prognostic assessment, and prediction of response to treatment. It also promises better understanding of kidney disease pathophysiology, and has been proposed as a "liquid biopsy" to discriminate various types of renal disorders. Furthermore, proteins being the major drug targets, peptidome analysis may allow one to evaluate the effects of therapies at the protein signaling pathway level. We here review the most recent findings on urinary peptidomics in the setting of the most common kidney diseases
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