HEALTHY NEPHRONE — A GUARANTY OF STABLE BLOOD PRESSURE

Chronic kidney disease is one of the most common diseases in the world. Along with damage to the kidneys, the disease carries great risks for the cardiovascular, endocrine and other systems of the body. The review presents the latest views and research data on this problem, as well as modern therapeutic solutions for the comprehensive treatment of the disease and pathogenetically justified correction of volume dynamics. The approach considered in the article goes beyond the traditional renoprotection, which involves the prescription of inhibitors of the renin-angiotensin-aldosterone system. Restoration of normal blood flow in the kidneys is possible by optimizing hydration, rheological and hydrodynamic properties of substances administered intravenously.

The author presents evidence for arginine, pentoxifylline and Rheosorbilact, which in a combined use improve the hemodynamic and metabolic parameters of renal blood flow, laying the foundation for the restoration and preservation of renal function. At the same time, the detoxifying properties of these substances help the kidneys to perform the function of cleansing the body. Thus, an integrated approach becomes a pathogenetic rationale for people with chronic kidney disease.

Keywords: chronic kidney disease, acute kidney injury, hypertension, nephroprotection, infusion therapy, Rheosorbilact, Tivortin, Latren.

Authors:

D.D. Ivanov, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

Literature:

  1. KDIGO Clinical Practice Guidelines for Glomerulonephritis. Chapter 1: Introduction, Kidney International Supplements. Vol. 2. Issue 2. 2012. 156-162. http://www.kdigo.org/clinical_practice_ guidelines/pdf/KDIGO-GN-Guideline.pdf.
  2. Xie Y. et al. Analysis of the Global burden of Disease study high-lights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018. 94. 567-581.
  3. Clark W.F., Sontrop J.M., Huang S.H., Gallo K., Moist L., House A.A., Cuerden M.S., Garg A.X. Effect of Coaching to Increase Water Intake on Kidney Function Decline in Adults With Chronic Kidney Disease: The CKD WIT Randomized Clinical Trial. JAMA. 2018 May 8. 319(18). 1870-1879. doi: 10.1001/jama.2018.4930.
  4. Ivanov D., Savytska L., Kulachek V. The association of kidney stress test with water salt loading with estimated glomerular filtration rate decline in patients with chronic kidney disease stage 1–3. Archives of the Balkan Medical Union. 2019 Sept. Vol. 54. № 3. Р. 11-17. DOI: 10,31688/ABMU.2019.54.3.06.
  5. Ivanova M., Gozhenko A., Crestanello C., Ivanov D. Early coaching to increase water intake in CKD. Ann. Nutr. Metab. 2021. DOI: 10.1159/000515276. https://www.ncbi.nlm.nih.gov/ pubmed/29801012.
  6. Ivanov D., Ivanova M.D. Hydration: the review of 3 trials. Kidneys. 2020. 9(1). 10-13. doi: 10.22141/2307-1257.9.1.2020.196911.
  7. Wagner S., Merkling T., Metzger М., Bankir, L. Laville М., Frimat L., Combe C., Jacquelinet С., Fouque D., Massy Z.A., Stengel B., for the CKD-REIN study group. The list of members of the CKD-REIN study group are in the Appendix, Water intake and progression of chronic kidney disease: the CKD-REIN cohort study. Nephrology Dialysis Transplantation. 2021. https://doi.org/10.1093/ndt/gfab036.
  8. Perrier E.T., Buendia-Jimenez I., Vecchio M., Armstrong L.E., Tack I., Klein A. Twenty-four-hour urine osmolality as a physiological index of adequate water intake. Dis. Markers. 2015. 2015. 231063.
  9. Nerbass F.B., Pecoits-Filho R. Can your work affect your kidneyʼs health? Rev. Environ. Health. 2019 Dec 18. 34(4). 441-446. doi: 10.1515/reveh-2019-0014. PMID: 31323011.
  10. Samadian F., Dalili N., Jamalian A. Lifestyle Modifications to Prevent and Control Hypertension. Iran J. Kidney Dis. 2016 Sep. 10(5). 237-263. PMID: 27721223.
  11. Ruiz-Hurtado G., Ruilope L.M. Microvascular injury and the kidney in hypertension. Hipertens. Riesgo Vasc. 2018 Jan-Mar. 35(1). 24-29. doi: 10.1016/j.hipert.2017.03.002. Epub 2017 Apr 18. PMID: 28431922.
  12. Cheung A.K., Chang T.I., Cushman W.C., Furth S.L., Hou F.F., Ix J.H., Knoll G.A., Muntner P., Pecoits-Filho R., Sarnak M.J., Tobe S.W., Tomson C.R.V., Lytvyn L., Craig J.C., Tunnicliffe D.J., Howell M., Tonelli M., Cheung M., Earley A., Mann J.F.E. Executive summary of the KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021 Mar. 99(3). 559-569. doi: 10.1016/j. kint.2020.10.026. PMID: 33637203.
  13. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021. 99(3S). S1-S87.
  14. Hamrahian S.M., Falkner B. Hypertension in Chronic Kidney Disease. Adv. Exp. Med. Biol. 2017. 956. 307-325. doi: 10.1007/5584_2016_84. PMID: 27873228.
  15. Johnson R.J., Nangaku M. Endothelial dysfunction: the secret agent driving kidney disease. J. Am. Soc. Nephrol. 2016. 27. 3-5.
  16. Rossier B.C., Bochud M., Devuyst O. The Hypertension Pandemic: An Evolutionary Perspective. Physiology (Bethesda). 2017 Mar. 32(2). 112-125. doi: 10.1152/physiol.00026.2016. PMID: 28202622.
  17. Duann P., Lin P.H. Mitochondria Damage and Kidney Disease. Adv. Exp. Med. Biol. 2017. 982. 529-551. doi: 10.1007/978-3-319-55330-6_27. PMID: 28551805; PMCID: PMC8049117.
  18. Choi M.E. Autophagy in Kidney Disease. Annu Rev. Physiol. 2020 Feb 10. 82. 297-322. doi: 10.1146/annurev-physiol-021119-034658. Epub 2019 Oct 22. PMID: 31640469.
  19. OʼSullivan E.D., Hughes J., Ferenbach D.A. Renal Aging: Causes and Consequences. J. Am. Soc. Nephrol. 2017 Feb. 28(2). 407-420. doi: 10.1681/ASN.2015121308. Epub 2016 Nov 15. PMID: 28143966; PMCID: PMC5280008.
  20. Musso C., Liakopoulos V., Stefanidis I., De Miguel R., Imperiali N., Algranati L. Correlation between creatinine clearance and transtubular potassium concentration gradient in old people and chronic renal disease patients. Saudi J. Kidney Dis. Transpl. 2007. 18. 551-555.
  21. Melenovsky V., Cervenka L., Viklicky O., Franekova J., Havlenova T., Behounek M., Chmel M., Petrak J. Kidney Response to Heart Failure: Proteomic Analysis of Cardiorenal Syndrome. Kidney Blood Press. Res. 2018. 43(5). 1437-1450. doi: 10.1159/000493657. Epub 2018 Sep 20. PMID: 30235455.
  22. Roedl K., Jarczak D., Fuhrmann V. Organinteraktion Leber und Niere [Organinteraction between liver and kidney]. Dtsch Med. Wochenschr. 2017 Sep. 142(18). 1365-1372. doi: 10.1055/s-0043-104465. Epub 2017 Sep 8. PMID: 28902382.
  23. Kumar S. Cellular and molecular pathways of renal repair after acute kidney injury. Kidney Int. 2018 Jan. 93(1). 27-40. doi: 10.1016/j.kint.2017.07.030. PMID: 29291820.
  24. Strausser S.A., Nakano D., Souma T. Acute kidney injury to chronic kidney disease transition: insufficient cellular stress response. Curr. Opin. Nephrol. Hypertens. 2018 Jul. 27(4). 314-322. doi: 10.1097/MNH.0000000000000424. PMID: 29702491.
  25. Wang K., Kestenbaum B. Proximal Tubular Secretory Clearance: A Neglected Partner of Kidney Function. Clin. J. Am. Soc. Nephrol. 2018 Aug 7. 13(8). 1291-1296. doi: 10.2215/CJN.12001017. Epub 2018 Feb 28. PMID: 29490976; PMCID: PMC6086711.
  26. https://compendium.com.ua/info/171576/tivortin-sup-sup-/
  27. Gunina L.M., Vinnichuk Yu.D., Dmitriev A.V., Vysochina N.L., Bezuglaya V.V., Nosach E.V. Tivortin Aspartate: a New Safe and Effective Non-Prohibited Medical Drug for Stimulation the Performance of Athletes. Ukrainian Journal of Medicine, Biology and Sports. 2017. № 3(5). 229-244. 10.26693/ jmbs02.03.229.
  28. Ostrovskyy M.M., Varunkiv O.I., Todoriko L.D., Savelikhina I.O., Kulynych-Miskiv M.O., Zuban A.B., Molodovets O.B., Ostrovska K.M. Nitric oxide metabolism in patients with community-acquired pneumonia associated with coronary heart disease and the possibility of its medicamentous management. Wiad. Lek. 2020. 73(8). 1707-1711. PMID: 33055338.
  29. Burya L.V., Vakhnenko A.V., Moiseieva N.V., Kapustianska A.A., Zviagolska I.M. Current strategy for treatment of comorbid states: complicated community-acquired pneumonia with arterial hypertension. Wiad. Lek. 2020. 73(6). 1257-1260. PMID: 32723964.
  30. Bobieva N., Gadoev S., Rashidov I. Optimization of therapy in patients with renal hypertension by stabilizing hemovascular hemostasis. Infusion & Chemotherapy. 2020. 3.1. 90-90.
  31. Красюк Е.К., Мойсеєнко В.О., Никула Т.Д., Паламар Б.І. Вплив Реосорбілакту® на кардіогемодинамічні та мікроциркуляторні параметри у хворих на хронічну хворобу нирок. Український хіміотерапевтичний журнал. 2008. № 1–2 (22). 25.
  32. Ivanov D.D. Safety and effectiveness of rheosorbilact detoxification therapy in stage 1–3 CKD. Kidneys. 2021. 10(2). 65-69.
  33. Исследование РЕОСТАТ — изучение эффективности и безопасности применения препарата Реосорбилакт у пациентов с различными нозологиями, сопровождающимися синдромом эндогенной интоксикации. Новини медицини та фармації. 2019. № 1 (678).
  34. Ніконов В.В., Лизогуб К.І., Лизогуб М.В. Інфузійна терапія при пневмонії: що нового? Медицина невідкладних станів. 2020. 16(2). 118-123.
  35. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Inter. Suppl. 2012. 2. 1-138.
  36. Резолюція та відео «Школа інфузійної терапії». 2021. https://infusiontherapy.org/news/resolution-and-video-of-the-teleconference-infusion-therapyschool–p441.
  37. Annamaraju P., Baradhi K.M. Pentoxifylline. 2021 Jun 28. StatPearls. Treasure Island (FL): StatPearls Publishing; 2021 Jan. PMID: 32644522.
  38. https://compendium.com.ua/info/170734/latren-sup-sup-/
  39. Liu D., Wang L.N., Li H.X., Huang P., Qu L.B., Chen F.Y. Pentoxifylline plus ACEIs/ARBs for proteinuria and kidney function in chronic kidney disease: a meta-analysis. J. Int. Med. Res. 2017 Apr. 45(2). 383-398. doi: 10.1177/0300060516663094. Epub 2017 Jan 1. PMID: 28415944; PMCID: PMC5536675.
  40. Goicoechea M., García de Vinuesa S., Quiroga B., Verdalles U., Barraca D., Yuste C., Panizo N., Verde E., Muñoz M.A., Luño J. Effects of pentoxifylline on inflammatory parameters in chronic kidney disease patients: a randomized trial. J. Nephrol. 2012 Nov-Dec. 25(6). 969-75.
  41. Inacio M.D., Costa M.C., Lima T.F.O., Figueiredo I.D., Motta B.P., Spolidorio L.C., Assis R.P., Brunetti I.L., Baviera A.M. Pentoxifylline mitigates renal glycoxidative stress in obese mice by inhibiting AGE/RAGE signaling and increasing glyoxalase levels. Life Sci. 2020 Oct 1. 258. 118196. doi: 10.1016/j.lfs.2020.118196. Epub 2020 Aug 5. PMID: 32763295.
  42. Yang H., Juang S.Y., Liao K.F., Chen Y.H. Comparing the Effect of Folic Acid and Pentoxifylline on Delaying Dialysis Initiation in Patients with Advanced Chronic Kidney Disease. Nutrients. 2019 Sep 12. 11(9). 2192. doi: 10.3390/nu11092192. PMID: 31547288; PMCID: PMC6769878.
  43. de Morales A.M., Goicoechea M., Verde E., Carbayo J., Barbieri D., Delgado A., Verdalles U., de Jose A.P., Luño J. Pentoxifylline, progression of chronic kidney disease (CKD) and cardiovascular mortality: long-term follow-up of a randomized clinical trial. J. Nephrol. 2019 Aug. 32(4). 581-587. doi: 10.1007/s40620-019-00607-0. Epub 2019 Apr 4. PMID: 30949987.
  44. Murkamilov I.T., Aitbaev K.A., Fomin V.V., Murkamilova Z.A., Bayzhigitova A.A. Pentoxifylline and nephroprotection: effects on renal dysfunction and cardiovascular risks. Ter. Arkh. 2019 Mar 11. 91(1). 95-100. doi: 10.26442/00403660.2019.01.000037. PMID: 31090379.
  45. Donate-Correa J., Tagua V.G., Ferri C., Martín-Núñez E., Hernández-Carballo C., Ureña-Torres P., Ruiz-Ortega M., Ortiz A., Mora-Fernández C., Navarro-González J.F. Pentoxifylline for Renal Protection in Diabetic Kidney Disease. A Model of Old Drugs for New Horizons. J. Clin. Med. 2019 Feb 27. 8(3). 287. doi: 10.3390/ jcm8030287. PMID: 30818852; PMCID: PMC6463074.
  46. El-Sadek H.M., Al-Shorbagy M.Y., Awny M.M., Abdallah D.M., El-Abhar H.S. Pentoxifylline treatment alleviates kidney ischemia/reperfusion injury: Novel involvement of galectin-3 and ASK-1/JNK & ERK1/2/NF-κB/HMGB-1 trajectories. J. Pharmacol. Sci. 2021 Jul. 146(3). 136-148. doi: 10.1016/j.jphs.2021.03.011. Epub 2021 Apr 9. PMID: 34030796.
  47. Seirafianpour F., Mozafarpoor S., Fattahi N., Sadeghzadeh-Bazargan A., Hanifiha M., Goodarzi A. Treatment of COVID-19 with pentoxifylline: Could it be a potential adjuvant therapy? Dermatol. Ther. 2020 Jul. 33(4). e13733. doi: 10.1111/dth.13733. Epub 2020 Jun 26. PMID: 32473070; PMCID: PMC7300917.
  48. Соколова Л.К., Пушкарьов В.М., Тронько М.Д. L-аргінін у нормі та патології. Ендокринологія. 2019. Vol. 24. № 4. 373-385. DOI: 10.31793/1680-1466.2019.24-4.373.