The majority of cases of chronic kidney disease (CKD) worldwide are driven by the presence of type 2 diabetes (T2D), resulting in an increase in CKD rates over the past few decades. The existence of CKD alongside diabetes is associated with increased burden of cardiovascular disease and increased risk of death. Optimal glycaemic control is essential to prevent progression of CKD, but achieving glycaemic targets in people with CKD and diabetes can be challenging because of increased risk of hypoglycaemia and limitations on glucose-lowering therapeutic options. This review considers the challenges in management of T2D in people with impaired kidney function and assesses evidence for use of basal insulin analogues in people with CKD.
- MeSH
- chronická renální insuficience * komplikace farmakoterapie chemicky indukované MeSH
- diabetes mellitus 2. typu * komplikace farmakoterapie chemicky indukované MeSH
- hypoglykemie * chemicky indukované prevence a kontrola komplikace MeSH
- hypoglykemika terapeutické užití MeSH
- inzulin terapeutické užití MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- acidóza laktátová chemicky indukované diagnóza terapie MeSH
- alkoholy škodlivé účinky MeSH
- Amanita patogenita MeSH
- biologické toxiny škodlivé účinky MeSH
- chronická renální insuficience chemicky indukované terapie MeSH
- dialýza ledvin MeSH
- diferenciální diagnóza MeSH
- kardiovaskulární látky škodlivé účinky MeSH
- komorbidita MeSH
- lidé MeSH
- metformin škodlivé účinky MeSH
- otrava * diagnóza farmakoterapie klasifikace patologie terapie MeSH
- oxid uhelnatý škodlivé účinky MeSH
- paracetamol metabolismus škodlivé účinky MeSH
- poruchy vědomí etiologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- MeSH
- bezpečnost MeSH
- chronická renální insuficience * epidemiologie chemicky indukované MeSH
- epidemiologické studie MeSH
- inhibitory protonové pumpy * škodlivé účinky terapeutické užití MeSH
- kauzalita MeSH
- lidé MeSH
- nežádoucí účinky léčiv MeSH
- progrese nemoci MeSH
- rizikové faktory MeSH
- ukazatele zdravotního stavu MeSH
- zkreslení výsledků (epidemiologie) MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Adenine-induced model of chronic kidney disease (CKD) is a widely used model especially in studies testing novel nephroprotective agents. We investigated the effects of adenine-induced CKD in rats on the activities of some xenobiotic metabolizing enzymes in liver and kidneys, and on some in vivo indicators of drug metabolism (viz pentobarbitone sleeping time, and plasma concentration of theophylline 90 min post administration). CKD was induced by orally feeding adenine (0.25 % w/w) for 35 days. Adenine induced all the characteristics of CKD, which was confirmed by biochemical and histological findings. Glutathione concentration and activities of some enzymes involved in its metabolism were reduced in kidneys and livers of rats with CKD. Renal CYP450 1A1 activity was significantly inhibited by adenine, but other measured isoenzymes (1A2, 3A4 and 2E1) were not significantly affected. Adenine significantly prolonged pentobarbitone-sleeping time and increased plasma theophylline concentration 90 min post administration. Adenine also induced a moderate degree of hepatic damages as indicated histologically and by significant elevations in some plasma enzymes. The results suggest that adenine-induced CKD is associated with significant in vivo inhibitory activities on some drug-metabolizing enzymes, with most of the effect on the kidneys rather than the liver.
- MeSH
- adenin * MeSH
- chronická renální insuficience chemicky indukované patofyziologie MeSH
- farmakokinetika * MeSH
- játra účinky léků enzymologie MeSH
- krysa rodu rattus MeSH
- ledviny účinky léků enzymologie MeSH
- modely nemocí na zvířatech MeSH
- potkani Wistar MeSH
- systém (enzymů) cytochromů P-450 metabolismus MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Chronic kidney disease (CKD) represents a serious public health problem with increasing prevalence and novel approaches to renal protection are continuously under investigation. The aim of this study was to compare the effect of melatonin and angiotensin II type 2 receptor agonist compound 21 (C21) to angiotensin converting enzyme inhibitor captopril and angiotensin II type 1 receptor blocker olmesartan on animal model of doxorubicin nephrotoxicity. Six groups of 3-month-old male Wistar rats (12 per group) were treated for four weeks. The first group served as a control. The remaining groups were injected with a single dose of doxorubicin (5 mg/kg i.v.) at the same day as administration of either vehicle or captopril (100 mg/kg/day) or olmesartan (10 mg/kg/day) or melatonin (10 mg/kg/day) or C21 (0.3 mg/kg/day) was initiated. After four week treatment, the blood pressure and the level of oxidative stress were enhanced along with reduced glomerular density and increased glomerular size. Captopril, olmesartan and melatonin prevented the doxorubicin-induced increase in systolic blood pressure. All four substances significantly diminished the level of oxidative burden and prevented the reduction of glomerular density and modestly prevented the increase of glomerular size. We conclude that captopril, olmesartan, melatonin and C21 exerted a similar level of renoprotective effects in doxorubicin-induced nephrotoxicity.
- MeSH
- antioxidancia terapeutické užití MeSH
- blokátory receptoru 1 pro angiotenzin II terapeutické užití MeSH
- chronická renální insuficience chemicky indukované farmakoterapie patofyziologie MeSH
- doxorubicin MeSH
- hodnoty glomerulární filtrace účinky léků MeSH
- imidazoly terapeutické užití MeSH
- inhibitory ACE terapeutické užití MeSH
- kaptopril terapeutické užití MeSH
- krysa rodu rattus MeSH
- ledvinné látky terapeutické užití MeSH
- melatonin terapeutické užití MeSH
- oxidační stres účinky léků MeSH
- potkani Wistar MeSH
- reaktivní formy kyslíku metabolismus MeSH
- receptor angiotensinu typ 2 agonisté MeSH
- tetrazoly terapeutické užití MeSH
- výsledek terapie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
