Journal of Clinical & Experimental Nephrology

Description

Diabetes drives a rising weight of cardiovascular and renal illness around the world, propelling the quest for new hypoglycemic specialists that give heart and renal defensive impacts. Although they were initially developed as hypoglycemic agents, sodium-glucose co-transporter 2 inhibitors have since been studied for the treatment of heart failure and chronic kidney disease in diabetic and non-diabetic patients. A developing group of proof backings the viability and security of SGLT-2 inhibitors in patients with persistent kidney illness, in light of perplexing systems of activity that reach out a long ways past glucosuria and that present useful consequences for cardiovascular and renal hemodynamics, fibrosis, irritation, and end-organ assurance. The pharmacology and pathophysiology of SGLT-2 inhibitors in CKD patients, as well as their effects on cardiovascular and renal function in this population, are the primary topics of this review.

Glomerular Filtration Rate

We are concentrating on the five agents that have been approved in either North America or Europe for use in cardiovascular outcome trials: empagliflozin, dapagliflozin, canagliflozin, ertugliglozin, and sotagliflozin are among the medications. The term chronic kidney disease refers to a progressive loss of kidney function that can last from a few months to several years. This is described by the slow supplanting of ordinary kidney structure with fibrotic tissues. The Estimated Glomerular Filtration Rate is calculated based on height, weight, gender, and serum creatinine level. Numerous CKD risk factors have been identified and categorized as initiating and perpetuating factors in various studies. The most significant risk factors for the onset and progression of chronic kidney disease are diabetes and hypertension. Hyperglycemia is a hallmark of a group of common metabolic disorders known as diabetes mellitus. Diabetes that is not managed properly can damage the vasculature of the kidneys, which remove waste products from the body. Damage to the kidneys and elevated blood pressure were both consequences of this. By increasing pressure in the delicate kidney filtering system, high blood pressure can further damage the kidneys. Adult blindness, non-traumatic lower-extremity amputations, and end-stage renal disease are all thought to be linked to DM. Cardiovascular disease is extremely prevalent in CKD; Patients with chronic kidney disease often present atypically and may present with acute myocardial infarction as opposed to stable angina. Following coronary catheterization, patients with chronic kidney disease are more likely to experience cardiovascular events. The ideal time to measure biomarkers and estimate risk for subsequent cardiovascular events is prior to coronary catheterization.

A major issue in public health, chronic kidney disease is linked to rising health care costs, morbidity, and mortality. Pediatric CKD can be reversed, postponed, or averted from progressing to advanced kidney disease with prompt diagnosis and treatment. It is important to note that African American children are more likely to develop CKD with a poor prognosis and rapid progression. Therefore, it may be essential for social equity to develop a universal pediatric CKD screening program for high-risk children. A complex interaction between biological and nonbiological risk factors that influence the development and progression of CKD in children of African descent is likely to account for the disparity in prevalence and severity of CKD. Polydextrose, or PDX for short, is a complex, non-digestible oligosaccharide that is frequently utilized in the food industry. Polydextrose has been shown to have a number of health benefits, such as changing the lipid profile, improving the immune system, modifying the gut microbiota, and enhancing bowel function.

Hypoxic Respiratory Failure

Dysbiosis in the gastrointestinal tract, inflammation, dyslipidemia, and constipation are all symptoms of chronic kidney disease. These are significant issues that have an impact on quality of life. PDX may promote beneficial effects in this setting. PDX in CKD, on the other hand, is poorly understood. The potential beneficial effects of PDX on the gut health of CKD patients, particularly its effect on constipation, are the subject of this review. Due to its medical and economic effects, chronic kidney disease is a major public health issue. According to a number of studies, diabetes is the most widely recognized reason for CKD since it harms little blood veins, particularly those in the kidneys. In addition, significant risk factors for renal disease include conditions that increase cardiovascular risk, such as smoking, high blood pressure, obesity, diabetes, and advanced age. In a similar vein, polycystic kidney disease, renal parenchymal infections, the use of non-steroidal anti-inflammatory drugs, and frequent use of poisonous chemicals or medicinal plants are all risk factors for chronic renal failure.

People are presented to cadmium by means of different anthropogenic and regular pathways. After that, DMT-1 expression rises in the majority of organs, particularly the kidney and duodenum. DMT-1 is a transporter of iron; However, it is able to transport highly toxic divalent cations like cadmium as well as other elements that are vital to the body's function, such as manganese and zinc. Non-communicable chronic obstructive pulmonary disease, which affects people over the age of 40, is the leading cause of death worldwide. Mortality and treatment costs rise when COPD is accompanied by comorbidities like chronic kidney disease and osteoporosis. It has been demonstrated that cadmium has significant osteo- and nephrotoxic effects, making it a likely environmental factor in the development of comorbidity because of its potential to harm bone microarchitecture and kidney function. We emphasize the significant role that hypoxia-induced DMT-1 expression plays in mediating the CKD and osteoporosis axes induced by cadmium overload. Additionally, hypoxic respiratory failure-related chronic lung diseases, such as severe COPD, appear to be significantly more susceptible to cadmium poisoning than healthy individuals.