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PKC isoforms are activated by hyperglycaemia. This editorial elegantly describes the specific PKC isoforms possibly involved in diabetes-induced organ damage. Using PKC-isoform-specific knock-out mice, the specific role of individual PKD isoforms such as PKC
and ß was identified. The mechanism of the development of albuminuria following high glucose activation of PKC isoforms is mediated via three different molecular mechanisms. PKC isoform specificity and cellular diversity seem to be responsible for the divergent outcome leading to albuminuria and/or fibrosis. See article by Meier et al., pages 2421–2425
Expression of C-reactive protein in myointimal hyperplasia in an animal model of arteriovenous graft. In a porcine arteriovenous graft model, using immunohistochemical analysis and in situ hybridization techniques, CRP was produced in venous and arterial smooth muscle cells (SMC) and its expression was enhanced in the hyperplastic lesions associated with arteriovenous PTFE grafts. Together with the ability of CRP to promote SMC proliferation, these data suggest that CRP might play a pathogenic role in the development of myointimal hyperplasia in PTFE grafts.
See article by Kuji et al., pages 2469–2475
Mycophenolic acid (MPA) and its glucuronide metabolites interact with transport systems responsible for the excretion of organic anions in the basolateral membrane of the human kidney. Using molecular biological techniques in Xenopus laevis oocytes, it was shown that mycophenolic acid and its metabolites potently interact with renal organic anion transporters hOAT1 and hOAT3, and may thus interfere with the renal secretion of antiviral drugs, cortisol and other organic anions. These studies may have implications for the clinical management of patients with this widely used immunosuppressive agent.
See article by Wolff et al., pages 2497–2503
The yearly cost of implementing UK guidelines for the management of chronic kidney disease has been calculated in this study from the UK, based on the NEOERICA database.
It is stated in this article that renal services currently consume 2% of the National Health Service budget in the UK; this figure is set to rise, with increasing numbers requiring RRT. Tarif-based hospital haemodialysis is expensive, costing 
34 000 per patient annually in this country.
Implementation of the UK clinical guidelines results in significant increases in nephrology referral and additional investigations. However, these costs could be recouped, by delaying dialysis requirement by 1 year in one individual per 10 000 patients managed according to guidelines.
See article by Klebe et al., pages 2504–2512
The efficacy of ACE inhibitors on the progression of chronic kidney disease in children with hypodysplastic nephropathy was investigated in this report from the ItalKid Project database. Hypoplastic nephropathy is the most common cause of end-stage renal disease in children and progression was analysed as the slope of Ccr in a total of 164 patients: 41 cases and 123 matched controls. Although the mean slope of Ccr was 40% lower in the ACEi-treated cases in comparison to controls, this difference was not statistically significant.See article by Ardissino et al., pages 2525–2530
The long-term outcome of patients with biopsy-proven proliferative lupus nephritis was found to be better than usually assumed. All patients in this single-centre study were treated with an induction treatment, consisting of high doses of corticosteroids plus immunosuppressive agents in the more severe cases. This treatment was repeated in the event of a renal flare. Corticosteroids and immunosuppressive agents then were reduced to the minimal effective dose for maintenance.
Favourable factors for good long-term outcome are the achievement of complete renal remission, the absence of nephritic flares and their complete reversibility after therapy.
See article by Moroni et al., pages 2531–2539
Accelerated increase of arteriovenous fistula use in haemodialysis centres in the Netherlands was observed after a multicentre guidelines implementation programme, CIMINO, was initiated aiming at increasing the use of AVFs.
The prevalent AVF use increased from 58.5% to 62.7% in the CIMINO group and from 65.5% to only 67.3% in a time control group. These data suggest that the choice of access placement depends predominantly on the centre-specific factors.
See article by Huijbregts et al., pages 2595–2600
Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis (PD) patients as found in this study from Korea.
Kaplan-Meier analysis in a cohort of 204 PD patients showed that time to first PD peritonitis episode was significantly longer in the non-diabetic patients and in patients with higher residual GFR. Multivariate analysis showed that RRF hazard ratio for peritonitis was 0.81 per 1 ml/min/1.73 m2 increase.
See article by Han et al., pages 2653–2658
Comparison between creatinine and cystatin C-based GFR equations in renal transplantation, using inulin clearance as the reference test, revealed that serum creatinine-based equations did not appear to be inferior to cystatin C-based equations as a means to estimate GFR in renal transplant patients. However, bias, precision and agreement were otherwise similar in all the GFR tests.
See article by Zahran et al., pages 2659–2668
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Related articles in NDT:
- Nailing down PKC isoform specificity in diabetic nephropathy—two's company, three's a crowd
- Matthias Meier, Jan Menne, Joon-Keun Park, and Hermann Haller
NDT 2007 22: 2421-2425.[Extract] [FREE Full Text] - Expression of C-reactive protein in myointimal hyperplasia in a porcine arteriovenous graft model
- Tadashi Kuji, Takahisa Masaki, Li Li, and Alfred K. Cheung
NDT 2007 22: 2469-2475.[Abstract] [FREE Full Text] - Mycophenolic acid (MPA) and its glucuronide metabolites interact with transport systems responsible for excretion of organic anions in the basolateral membrane of the human kidney
- Natascha A. Wolff, Birgitta C. Burckhardt, Gerhard Burckhardt, Michael Oellerich, and Victor W. Armstrong
NDT 2007 22: 2497-2503.[Abstract] [FREE Full Text] - The cost of implementing UK guidelines for the management of chronic kidney disease
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NDT 2007 22: 2504-2512.[Abstract] [FREE Full Text] - No clear evidence of ACEi efficacy on the progression of chronic kidney disease in children with hypodysplastic nephropathy—report from the ItalKid Project database
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NDT 2007 22: 2525-2530.[Abstract] [FREE Full Text] - The long-term outcome of 93 patients with proliferative lupus nephritis
- Gabriella Moroni, Silvana Quaglini, Beniamina Gallelli, Giovanni Banfi, Piergiorgio Messa, and Claudio Ponticelli
NDT 2007 22: 2531-2539.[Abstract] [FREE Full Text] - Accelerated increase of arteriovenous fistula use in haemodialysis centres: results of the multicentre CIMINO initiative
- Henricus J. T. A. M. Huijbregts, Michiel L. Bots, Frans L. Moll, Peter J. Blankestijn, and on behalf of the CIMINO members
NDT 2007 22: 2595-2600.[Abstract] [FREE Full Text] - Reduced residual renal function is a risk of peritonitis in continuous ambulatory peritoneal dialysis patients
- Seung Hyeok Han, Sang Choel Lee, Song Vogue Ahn, Jung Eun Lee, Dong Ki Kim, Tae Hee Lee, Sung Jin Moon, Beom Seok Kim, Shin-Wook Kang, Kyu Hun Choi, Ho Yung Lee, and Dae-Suk Han
NDT 2007 22: 2653-2658.[Abstract] [FREE Full Text] - Comparison between creatinine and cystatin C-based GFR equations in renal transplantation
- Ahmed Zahran, Mabood Qureshi, and Ahmed Shoker
NDT 2007 22: 2659-2668.[Abstract] [FREE Full Text]
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