Comparison of early and delayed strategy for renal replacement therapy initiation for severe acute kidney injury with heart failure: a retrospective comparative cohort study

Guo, Shaohan; Chen, Yuhong; Zhao, Chao; Zhang, Kun; Liu, Mingzhe; Hu, Zhenjie

doi:10.21037/tau-23-146

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…It is an independent risk factor for death, with mortality rates of 25% overall ( 2 ). The pathogenesis of AKI involves vasoconstriction, oxidative stress, apoptosis, inflammation, and hypoxia ( 3 - 5 ). At present, except for intermittent hemodialysis and continuous renal replacement therapy, there are no effective drugs or treatment measures that can significantly contribute to AKI prevention.…”

Section: Introductionmentioning

confidence: 99%

The effect of Astragali Radix-Radix Angelica Sinensis on acute kidney injury: a network pharmacology and molecular docking study

Wang,

Zhen,

Lippi

et al. 2024

Transl Androl Urol

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Background Acute kidney injury (AKI) is a devastating clinical syndrome with high mortality rate attributed to lack of effective treatment. The herbal pair of Astragali Radix (AR) and Radix Angelica Sinensis (RAS) is a commonly prescribed herbal formula or is added to other traditional Chinese medicine (TCM) prescriptions for the treatment of kidney diseases. AR-RAS has certain protective effects on AKI in experiments, but the relevant mechanisms have yet to be clear. So this study aims to explore the mechanism of action of AR-RAS in AKI by combining network pharmacology and molecular docking methods. Methods In Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), the major AR-RAS chemical components and associated action targets were found and screened. The DrugBank and GeneCards databases were used to find AKI-related targets. The targets that are in close relationship with AKI were obtained from Therapeutic Target database (TTD), Online Mendelian Inheritance in Man (OMIM), and PharmGKB databases. The “herb-active ingredient-target” network was drawn by Cytoscape 3.8.0 software. The Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database was used to build the protein-protein interaction network. Bioconductor/R was used to examine Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. AR-RAS components and critical targets were docked using the AutoDock Vina program. Results A compound-target network, built by screening and analyzing the results, allowed to identify 19 active components and 101 possible therapeutic targets for AKI. The main ingredients were quercetin, kaempferol, 7-o-methylisocronulatol, formononetin and isorhamnetin. The key targets included AKT serine/threonine kinase 1 (AKT1), nuclear receptor coactivator 1 (NCOA1), JUN, estrogen receptor alpha (ESR1) and mitogen-activated protein kinase 8 (MAPK8). These molecules are targeted by pathways such as the calcium signaling route, the tumor necrosis factor (TNF) signaling pathway and the interleukin-17 (IL-17) signaling pathway, as well as the development of T helper 17 cells. Molecular docking demonstrated that AR-active RAS components exhibited strong binding activities to probable targets of AKI. Conclusions We described here the potential active ingredients, possible targets responsible for the efficacy of AR-RAS in AKI treatment, providing a theoretical basis for further research.

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Section: Introductionmentioning

confidence: 99%

The effect of Astragali Radix-Radix Angelica Sinensis on acute kidney injury: a network pharmacology and molecular docking study

Wang,

Zhen,

Lippi

et al. 2024

Transl Androl Urol

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“…However, previous studies had been limited by small sample sizes and incomprehensive risk factors, leading to unclear elucidation of the correlation between chronic heart failure and kidney injury. It had been demonstrated that timely intervention for heart failure patients with kidney damage can reduce mortality and improve prognosis ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Analysis of the clinical features and risk factors of kidney injury in patients with chronic heart failure—a retrospective cohort study

Shen¹,

Guo²,

Mantica³

et al. 2023

J Thorac Dis

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Background Heart failure (HF) often leads to kidney injury and increased morbidity and mortality. Factors contributing to kidney injury in HF patients had not been elucidated completely. This study sought to comprehensively evaluate the risk factors and clinical features of kidney injury in patients with chronic heart failure (CHF) and to provide more evidence for the management of these patients. Methods Adult patients with CHF admitted to Beijing Anzhen Hospital, Capital Medical University from January 2022 to May 2022 were included in this study. The primary endpoints were the independent risk factors for the development of kidney injury. A multivariate logistic regression model was used for the exploration of the risk factors. Results A total of 193 patients were included in this study, of whom 86 (44.5%) developed kidney injury. The independent risk factors for kidney injury in patients with CHF included sex (male) [odds ratio (OR): 4.30, 95% confidence interval (CI): 1.72–10.7, P=0.001], hypertension (OR: 3.68, 95% CI: 1.64–8.29, P=0.001), and stroke (OR: 3.82, 95% CI: 1.25–11.6, P=0.01). Kidney injury was significantly positively correlated with age (OR: 1.03, 95% CI: 1.008–1.06, P=0.01) and potassium (OR: 3.70, 95% CI: 1.58–8.67, P=0.002), and significantly negatively correlated with angiotensin receptor blocker (ARB) application (OR: 0.26, 95% CI: 0.11–0.61, P=0.001), serum albumin concentration (OR: 0.88, 95% CI: 0.81–0.96, P=0.005), hemoglobin concentration (OR: 0.97, 95% CI: 0.95–0.99, P=0.006), and left ventricular ejection fraction (LVEF; OR: 0.95, 95% CI: 0.92–0.98, P=0.01). Conclusions Kidney injury occurred in more than half of the patients with CHF during hospitalization. The independent risk factors for kidney injury in the CHF patients included sex (male), hypertension, and stroke. Kidney injury was positively correlated with age and serum potassium, and negatively correlated with serum albumin, hemoglobin concentration, LVEF, and ARB application.

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Comparison of early and delayed strategy for renal replacement therapy initiation for severe acute kidney injury with heart failure: a retrospective comparative cohort study

Cited by 2 publications

References 41 publications

The effect of Astragali Radix-Radix Angelica Sinensis on acute kidney injury: a network pharmacology and molecular docking study

The effect of Astragali Radix-Radix Angelica Sinensis on acute kidney injury: a network pharmacology and molecular docking study

Analysis of the clinical features and risk factors of kidney injury in patients with chronic heart failure—a retrospective cohort study

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