The Endothelin System & Its Antagonism in Chronic Kidney Disease PDF Download
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Author: Neeraj Dhaun
Publisher:
ISBN:
Category :
Languages : en
Pages : 156
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Book Description
Author: Neeraj Dhaun
Publisher:
ISBN:
Category :
Languages : en
Pages : 156
Get Book Here
Book Description
Author: Neeraj Dhaun
Publisher:
ISBN:
Category :
Languages : en
Pages : 156
Get Book Here
Book Description
Since its discovery in 1988 the powerful vasoconstrictor endothelin-1 (ET-1) has been widely implicated in the pathophysiology of chronic kidney disease (CKD) as well as the cardiovascular disease with which it is associated. ET receptor antagonists have favourable effects in experimental models of these conditions and orally acting antagonists are now licensed for the treatment of pulmonary arterial hypertension. However, there is a paucity of human data regarding the role of ET-1 in CKD. In this thesis, I have therefore explored the utility of ET-1 as a biomarker in CKD, and, using selective ET receptor antagonists, the beneficial renal and cardiovascular effects of ET receptor antagonism in CKD. I have shown that as glomerular filtration rate (GFR) declines plasma ET-1 increases linearly whereas urinary ET-1 shows an exponential increase. Furthermore, urinary ET-1 may be a useful marker of disease activity in patients with lupus nephritis. Its levels are high in those with biopsy-proven active renal inflammation and these fall with treatment. I have shown that in subjects with stable non-diabetic proteinuric CKD, acute selective ETA receptor antagonism reduces blood pressure and arterial stiffness and that these systemic benefits are associated with an increase in renal blood flow and reduction in proteinuria. Importantly, these effects are seen on top of those achieved with maximal therapy with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers. Following a study confirming unchanged pharmacokinetics in CKD, I have used an oral selective ETA receptor antagonist to show that the reductions in BP, arterial stiffness and proteinuria seen in my acute studies are maintained longer term. This results of this study also suggest that the mechanism for the reduction in proteinuria is haemodynamic and relates to a reduction in GFR and filtration fraction. In summary, these studies suggest that ET-1 may act as a potential biomarker of renal inflammation, and confirm its role in the pathophysiology of the systemic and renal vasoconstriction seen in CKD. They also suggest that selective ETA receptor antagonism may provide a novel therapeutic approach in proteinuric CKD on top of standard therapies. Larger and longer term studies are now warranted to confirm this potential.
Author: M. Barton
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805597959
Category : Medical
Languages : en
Pages : 276
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Book Description
Endothelin is a 21-amino acid peptide that exerts uniquely potent and long-lasting effects on the kidney, including regulation of water and electrolyte excretion, blood pressure, cell growth, inflammation and fibrosis. During the past 10 years, the field has evolved rapidly; we are now uncovering the potential importance of endothelin receptor antagonists (ERAs) in the treatment of kidney disease.This book reviews experimental concepts, preclinical studies and clinical data which form the basis of our current understanding of the association between endothelin and kidney disease. Acclaimed experts in pharmacology, molecular biology, physiology, cardiovascular medicine, and nephrology have contributed timely reviews dealing with renal pharmacology and physiology of endothelin, the role of endothelin in renal disease development and ERAs in preclinical studies, and the current state of clinical development of ERA therapy in renal medicine.The publication at hand will be a valuable reference source for nephrologists, internists and other healthcare professionals, renal physiologists and molecular biologists, post-doctoral researchers and students in the life sciences, as well as for scientists and decision makers in drug research and development.
Author: David Pollock
Publisher: Biota Publishing
ISBN: 1615042113
Category : Medical
Languages : en
Pages : 90
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Book Description
The discovery of a potent vasoconstrictor, endothelin (ET)-1, derived from vascular endothelial cells was among a variety of key lines of investigation that helped to fuel a major explosion of studies related to endothelial cell biology. This was particularly evident within the pharmaceutical industry where receptor antagonists were quickly developed and are now on the market for treatment of pulmonary hypertension and in development for other diseases such as diabetic nephropathy and cancer. Importantly, we know that the kidney contains the highest level of ET-1 production and receptor expression in the body where it has been demonstrated to function as a pro-natriuretic autocrine and paracrine factor that is activated in conditions of high salt intake. This eBook provides a review of the various mechanisms whereby ET-1 has been shown to function within the kidney through a wide range of actions that include direct effects on tubular transport, intrarenal hemodynamics, as well as neural and endocrine functions. Much has yet to be discerned, but it is clear that the ET system is a major physiological regulator of fluid-electrolyte balance and blood pressure through these renal actions. Table of Contents: Discovery of Endothelin / Basic Biology of the Endothelin System / Renal Localization / Renal Hemodynamics / Renal Tubular Actions of Endothelin / Endothelin in Neural Modulation of Renal Function / Physiological Role of Endothelin / Endothelin in Renal Pathology / References / Author Biographies
Author: Rebecca Claire Moorhouse
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Author: David Abraham
Publisher: Springer Science & Business Media
ISBN: 0857299204
Category : Medical
Languages : en
Pages : 268
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Book Description
Translational medicine underpins vascular medicine. It is fundamental to understanding how we treat patients with vascular disease and more importantly, how to prevent it. It is the rationale for drug design and production. Vascular medicine and translational medicine will take over and become the main reason for referring patients to hospital. Therefore, hospital-based clinicians working with basic scientists need to know about translational medicine, which educates and informs them about vascular medicine and how management should be based. This book is a primer for translational vascular medicine and discusses the evolving and exciting areas of basic science applied to vascular medicine. The book is based on the third vascular biology conference held at The Royal College of Physicians in 2008. It provides a large amount of new basic and clinical information and the contributors are world leaders.
Author: Vinood B. Patel
Publisher: Springer
ISBN: 9789400776982
Category : Medical
Languages : en
Pages : 0
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Book Description
In the past decade there has been a major sea change in the way disease is diagnosed and investigated due to the advent of high throughput technologies, such as microarrays, lab on a chip, proteomics, genomics, lipomics, metabolomics etc. These advances have enabled the discovery of new and novel markers of disease relating to autoimmune disorders, cancers, endocrine diseases, genetic disorders, sensory damage, intestinal diseases etc. In many instances these developments have gone hand in hand with the discovery of biomarkers elucidated via traditional or conventional methods, such as histopathology or clinical biochemistry. Together with microprocessor-based data analysis, advanced statistics and bioinformatics these markers have been used to identify individuals with active disease or pathology as well as those who are refractory or have distinguishing pathologies. New analytical methods that have been used to identify markers of disease and is suggested that there may be as many as 40 different platforms. Unfortunately techniques and methods have not been readily transferable to other disease states and sometimes diagnosis still relies on single analytes rather than a cohort of markers. There is thus a demand for a comprehensive and focused evidenced-based text and scientific literature that addresses these issues. Hence the formulation of Biomarkers in Disease. The series covers a wide number of areas including for example, nutrition, cancer, endocrinology, cardiology, addictions, immunology, birth defects, genetics, and so on. The chapters are written by national or international experts and specialists.
Author: Karl Skorecki
Publisher: Elsevier Health Sciences
ISBN: 0323550851
Category : Medical
Languages : en
Pages : 2748
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Book Description
Put the world’s most well-known kidney reference to work in your practice with the 11th Edition of Brenner & Rector’s The Kidney. This two-volume masterwork provides expert, well-illustrated information on everything from basic science and pathophysiology to clinical best practices. Addressing current issues such as new therapies for cardiorenal syndrome, the increased importance of supportive or palliative care in advanced chronic kidney disease, increasing live kidney donation in transplants, and emerging discoveries in stem cell and kidney regeneration, this revised edition prepares you for any clinical challenge you may encounter. Extensively updated chapters throughout, providing the latest scientific and clinical information from authorities in their respective fields. Lifespan coverage of kidney health and disease from pre-conception through fetal and infant health, childhood, adulthood, and old age. Discussions of today’s hot topics, including the global increase in acute kidney injury, chronic kidney disease of unknown etiology, cardiovascular disease and renal disease, and global initiatives for alternatives in areas with limited facilities for dialysis or transplant. New Key Points that represent either new findings or "pearls" of information that are not widely known or understood. New Clinical Relevance boxes that highlight the information you must know during a patient visit, such as pertinent physiology or pathophysiology. Hundreds of full-color, high-quality photographs as well as carefully chosen figures, algorithms, and tables that illustrate essential concepts, nuances of clinical presentation and technique, and clinical decision making. A new editor who is a world-renowned expert in global health and nephrology care in underserved populations, Dr. Valerie A. Luyckx from University of Zürich. Board review-style questions to help you prepare for certification or recertification.
Author: Denis F. Geary
Publisher: Springer
ISBN: 3662529726
Category : Medical
Languages : en
Pages : 1968
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Book Description
The new edition of this valuable clinical resource offers a state of the art, comprehensive review on every clinical condition encountered in pediatric nephrology. International experts present the latest knowledge on epidemiology, diagnosis, management, and prognosis in one concise, clinically focused text, in which care has been taken to couple just the right amount of "need-to-know" basic science with practical clinical guidance that will enable the reader to make efficient, informed decisions. The topics covered include: disorders of renal development, glomerular disorders, the kidney and systemic disease, renal tubular disorders, tubulointerstitial disease, urinary tract disorders, acute kidney injury, hypertension, chronic and end-stage renal disease, and renal replacement therapy. The full-color, highly visual, meticulously crafted format will ensure that the practitioner is able to source and apply information with remarkable ease.
Author: Alan S. L. Yu
Publisher: Elsevier Health Sciences
ISBN: 0323262597
Category : Medical
Languages : en
Pages : 3585
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Book Description
Overcome the toughest clinical challenges in nephrology with Brenner & Rector’s The Kidney -- the most well-known nephrology resource in the world. A diverse team of more than 200 international contributors brings you the latest knowledge and best practices on every front in nephrology worldwide. From basic science and pathophysiology to clinical best practices, Brenner & Rector’s The Kidney is your go-to resource for any stage of your career. Review of the basic science that underpins clinical nephrology, comprehensive selection of the most important bibliographical sources in nephrology, and Board Review-style questions help you prepare for certification or recertification. Coverage of kidney health and disease from pre-conception through fetal and infant health, childhood, adulthood, and into old age. Expanded sections and chapter on global perspective and ethical considerations. Uniform terminology and nomenclature in line with emerging consensus in world kidney community. More than 700 full-color high-quality photographs as well as carefully chosen figures, algorithms, and tables to illustrate essential concepts, nuances of clinical presentation and technique, and decision making provide a visual grasp and better understanding of critical information. Internationally diverse, trusted guidance and perspectives from a team of well-respected global contributors . An editorial team headed by Dr. Skorecki and handpicked by Dr. Brenner ensures the ongoing adherence to previous standards of excellence. All chapters have been extensively updated or entirely rewritten by authorities in their respective fields. The latest clinical information including recent clinical trials, genetic causes of kidney disease, cardiovascular and renal risk prediction in chronic kidney disease, new paradigms in fluid and electrolyte management, and pediatric kidney disease, keep you current with the rapid development of care and research worldwide.
