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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

A review of the implications of chronic kidney disease in pregnancy on maternal and fetal outcomes

Belding, Emily 12 June 2020 (has links)
The prevalence of pregnancies complicated by chronic kidney disease (CKD) is increasing. Yet, CKD in pregnancy tends to be under-diagnosed, as women of childbearing age are not regularly screened for renal dysfunction, nor is screening incorporated into routine pregnancy follow up. Further, renal dysfunction has significant implications for maternal and fetal outcomes, with degree of renal dysfunction at conception being the most important prognostic factor. It is established that the risk for poorer renal, maternal and fetal outcomes, increases incrementally with severity of CKD, with intrauterine death and progression to end-stage renal disease (ESDR) associated with severe CKD. However, it is difficult to predict which CKD pregnancies will lead to poor outcomes as the definition of CKD in pregnancy is not uniform between studies, nor are measurement parameters. This paucity of data prevents the establishment of a standard of care protocol and leaves clinicians ill-equipped to care for and manage this complex patient cohort. This review discusses renal, maternal and fetal outcomes in CKD pregnancies as presented by the literature, in order to demonstrate the contradictions in data and gaps in knowledge surrounding this topic, as well as the need for a general management algorithm.
2

Urotensin II in the development of experimental chronic kidney disease

Eyre, Heather January 2015 (has links)
Urotensin II (UII) is a potent peptide hormone with a complex species and vessel-dependent vascular profile. UII and the homologous UII-related peptide (URP) bind to the g-protein coupled urotensin II receptor (UT) with high affinity. The peptide ligands and receptor have been detected in numerous human and rat tissues including heart, brain and kidney. The kidney is a major source of UII, which appears to act as both an endocrine and paracrine mediator of renal function. UII has been shown to influence renal blood flow, glomerular filtration rate and sodium handling in the renal tubules. More speculative actions of UII as a pro-fibrotic mediator include the activation of fibroblasts and promotion of collagen synthesis. Abnormally elevated UII, URP and UT expression has been highlighted in a number of cardio-renal disease states; particularly end stage renal disease, diabetes and diabetic nephropathy (DN). This work aims to investigate the role of the UII system in the development and progression of CKD using an experimental model of CKD in rodents. The first aim of the current work involved establishing the surgical 5/6th subtotal nephrectomy (SNx) model of chronic kidney disease (CKD) in the laboratory and forming a profile of UII expression in late stage experimental CKD to complement UII clinical data which are exclusively from patients in the later stages of disease. UII/URP and UT were substantially over-expressed in the kidneys of SNx rats in late stage CKD. This novel insight complements the clinical profile of CKD/DN where over expression of the UII system is routinely reported. In a second study the 5/6th SNx rat model was used to explore the effects of chronic UT receptor antagonism on the progression of CKD. Although there were no discernible differences in kidney mass or histological profile between the treatment groups at the end of the study, there was a small delay in the development of albuminuria and in the onset of systolic blood pressure elevation in the UT antagonist treated cohort. The study did not produce clear-cut evidence defining the potential therapeutic value of UT-antagonism in the treatment of CKD. Despite this the results are encouraging and suggest that the role of UT-inhibition in CKD is worth considering further.
3

Logistické řetězce automobilového průmyslu na bázi SKD/CKD automobilů / Logistic chains in automotive indstry based on SKD/CKD sets

Vrhel, Bohumil January 2007 (has links)
Obsahem této diplomové práce je představení problematiky rozložených vozů jako varianty vstupu automobilky na nové trhy. V první části jsou představeny jednotlivé kategorie rozložených vozů a zahraniční montážní závody automobilky Škoda Auto a související logistické řetězce, v druhé části jsou analyzovány vybrané ekonomické parametry expedice rozložených vozů. Ve třetí části je kritické analýze podroben právě probíhající projekt výstavby výrobního závodu Škoda Auto a Volkswagen v ruské Kaluze se zhodnocením rizikových faktorů.
4

The effect of calcifediol supplementation on renin-angiotensin-aldosterone system mediators in dogs with chronic kidney disease

Miller, Matthew Scott 01 October 2021 (has links)
No description available.
5

SHROOM3 IN THE KIDNEY / SHROOM3 PLAYS A ROLE IN PODOCYTE CYTOARCHITECTURE

Khalili, Hadiseh 06 1900 (has links)
Chronic kidney disease (CKD), defined as an irreversible reduction in glomerular filtration rate, is a large public health concern. Dissecting the genetic components of CKD is required to improve our understanding of disease pathogenesis. Researchers have identified that SHROOM3, has very high associations with kidney disease and function. Shroom3 encodes an actin-binding protein important in regulating cell and tissue morphogenesis. However, there is a lack of evidence supporting a role for Shroom3 in kidney function or disease. Here, I investigated the developmental and functional role of Shroom3 in the mammalian kidney. For the first time, I described the expression pattern of Shroom3 in the embryonic and adult mouse kidneys. By performing in situ hybridization and immunohistochemistry, I demonstrated that Shroom3 is expressed in the condensing mesenchyme, podocytes, and collecting ducts. I further showed that Shroom3 protein is localized in the foot processes of podocytes, utilizing immunogold labeling and transmission electron microscopy. In order to uncover a potential role of Shroom3 in the kidney, we utilized Shroom3 knockout mice. Shroom3 mutants demonstrated marked glomerular abnormalities including cystic and degenerating glomeruli, and reduced glomerular number. Scanning and transmission electron microscopic analyses of Shroom3 mutant glomeruli revealed disruptions in podocyte morphology characterized by disorganized foot processes with less interdigitation and segmental foot processes effacement. Furthermore, immunofluorescence analysis of mutant kidneys revealed aberrant distribution of podocyte actin-associated proteins. Elucidating the underlying molecular mechanism of this abnormal podocyte architecture; v we demonstrated that in the absence of Shroom3, Rho kinase is mislocalized in the apical membrane of podocytes. As a result, mislocalized Rho kinase failed to phosphorylate non-muscle myosin and induce actomyosin contraction resulting in a patchy granular distribution of actin in the podocytes of Shroom3 mutants. Taken together, our findings established that Shroom3 is essential for proper actin organization in the podocytes through interaction with Rock. Furthermore, we took advantage of a haploinsufficiency phenotype of Shroom3 heterozygote adult mice and demonstrated these mice develop glomerulosclerosis and proteinuria. In conclusion, our studies provided evidence to support a role for Shroom3 in kidney development and disease and support the GWAS studies that suggested a correlation between SHROOM3 variants and kidney function in humans. / Thesis / Master of Science (MSc)
6

ATP-Citrate Lyase Inhibition Improves Chronic Kidney Disease Through Multiple Mechanisms / ACLY Inhibition In CKD

O'Neil, Kian 11 1900 (has links)
ATP-citrate lyase (ACLY), upregulated in chronic kidney disease (CKD), catalyzes the synthesis of acetyl-coA from citrate. Acetyl-CoA is a vital precursor for lipid/cholesterol synthesis and histone acetylation that regulates gene expression. In renal cells, ACLY regulates fibrogenic, lipogenic and inflammatory gene expression; its inhibition reduced fibrosis in the unilateral ureteral obstruction (UUO) model. The ACLY metabolic by-product malonyl-coA is also an important inhibitor of fatty acid oxidation (FAO), and defective FAO in proximal tubular epithelial cells (PTEC) is now established as a major contributor to fibrosis. Here we tested the efficacy of a novel ACLY inhibitor on reducing fibrosis and its potential role in improving FAO in UUO. 8-week-old male C57BL/6J mice underwent UUO surgery and were treated orally with an ACLY inhibitor (EVT0185, Espervita Therapeutics) for 10 days. Kidneys were assessed by immunohistochemistry, immunoblotting, and RNAseq. Effects of ACLY inhibition were tested on the HK2 PTEC cell line and primary renal fibroblast responses to TGFβ1 (5ng/ml, 48h), a cytokine known to promote fibrosis and reduce FAO. Lipid accumulation was assessed by Oil Red O staining and LC/MS analysis. ACLY inhibition significantly and dose-dependently decreased fibrosis in the UUO model determined by trichrome, PSR, fibronectin, and α-smooth muscle actin (SMA) expression. ACLY inhibition decreased macrophage (F4/80) infiltration including that of the profibrotic M2 phenotype marked by CD206. RNAseq analysis showed upregulation of FAO-related hallmark pathways and reduction in inflammation pathways with ACLY inhibition. Defective FAO is known to result in PTEC apoptosis and lipid accumulation. ACLY inhibition reduced both apoptosis, as assessed by the presence of cleaved caspase 3, as well as lipid accumulation, with a particular decrease in cholesteryl esters. In HK2 cells and renal fibroblasts, TGFβ1-induced fibrotic protein expression was inhibited by ACLY inhibition, and lipid accumulation was reduced in PTECs. ACLY inhibition reduced renal fibrosis, apoptosis, and lipid accumulation in UUO mice. ACLY inhibition also prevented profibrotic responses to TGFβ1 in PTECs and fibroblasts. Current studies are ongoing to confirm beneficial effects on restoring FAO. / Thesis / Master of Science (MSc) / Chronic kidney disease (CKD) is the leading cause of kidney failure in Canada, affecting 4 million Canadians. There is no cure for CKD and current treatments are only able to slow down disease progression. CKD is caused by scarring in the kidney. The kidney requires a lot of energy to do its job filtering our blood and creating urine, and with CKD the ability to create and use energy is reduced. The protein ATP-citrate lyase (ACLY) that is present in the kidney contributes to CKD. Research has shown that people and mice with CKD have higher levels of this protein than healthy individuals. ACLY creates a molecule called acetyl-coA that is likely to cause our kidneys to produce less energy. This study will test if ACLY is causing the kidneys to produce and use less energy. This will be done by using mice with CKD and blocking the activity of ACLY using a drug to see if this will help the kidney create more energy for itself. The kidneys of the mice will be tested to see if the drug worked in increasing energy levels and if it prevented kidney scarring. A type of cell in the kidney, called tubular cells, makes up most of the kidney and requires a lot of energy to function. We performed experiments with tubular cells and gave them stressors, like those found in CKD, and ACLY-blockers to test if the energy levels are restored and if scarring was reduced. This study is important because there is no cure for CKD and many patients will eventually develop end-stage kidney disease, requiring dialysis or transplant. Research needs to be done to create new medications for those suffering from CKD. Current studies are testing ACLY-blocking drugs to treat heart disease. If our study is successful, this drug is well-positioned to be developed into a new treatment for CKD.
7

Management of Chronic kidney Disease by Advanced Practice Nurses

Amagwu, Anthony C 01 January 2018 (has links)
Despite best available care, uncontrolled chronic kidney disease (CKD) - a complex disease that impacts millions in the United States, will eventually progress to end stage renal disease which is associated with high morbidity and mortality. New evidence suggests management of earlier stages of CKD is effective in delaying disease progression. This project evaluated the impact of a CKD class, led by a nephrology nurse practitioner, on preventing disease progression in advanced CKD patients with diabetes and hypertension. The purpose of the class was to validate the need for the advanced practice nurse (APN) in the care continuum of CKD. CKD education is a quality improvement project based on the chronic illness trajectory nursing model by Corbin and Strauss. Using a case-control method and a simple descriptive statistic to compare the mean values, retrospective data from 52 patients were analyzed. Twelve non-participating patients had a mean 7% increase in serum creatinine levels at the 1-year mark. Forty participating patients saw a mean decrease of 30% serum creatinine. With significant evidence suggesting that disease progression is delayed and renal function is improved in all study markers for patients who participated in a CKD education class led by a nephrology nurse practitioner and who received usual care - an argument can be made for updating the APN role in the continuum of care for those with CKD. The results may contribute to social change by providing improved access to quality care that addresses the socioeconomic devastation of end stage renal disease.
8

Livet med hemodialys : en litteraturstudie om patienters upplevelser av att leva med hemodialys / Life on haemodialysis : a literature review of patient experiences from living with haemodialysis

Krantz, Malin, Loefler, Titti January 2009 (has links)
No description available.
9

Avaliação das alterações hemorrágicas e tromboembólicas em cães com doença renal crônica

Gonçalves, Daniele Silvano January 2016 (has links)
Orientador: Regina Kiomi Takahira / Resumo: A doença renal crônica (DRC) acomete principalmente cães idosos e tem como característica principal a perda irreversível da função renal. A DRC em cães promove alterações metabólicas graves, caracterizadas frequentemente pela azotemia, hipoalbuminemia e anemia não regenerativa. Tanto a azotemia quanto a uremia predispõem a alterações hemostáticas que podem levar a quadros hemorrágicos. Além das disfunções plaquetárias, deficiência de anticoagulantes naturais e redução da fibrinólise são fatores que predispõem ao tromboembolismo. Este trabalho tem como objetivo avaliar as possíveis tendências hemorrágicas ou trombóticas em cães com DRC. Foram selecionados 20 cães saudáveis (grupo controle) com exames dentro da normalidade e 17 cães com DRC em estágios III ou IV classificados segundo a IRIS e a relação proteína/creatirina urinária maior que um (grupo DRC). As amostras de sangue para a realização da tromboelastometria (TEM), agregação plaquetária, tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA) e concentração de fibrinogênio foram colhidas em momento único para ambos os grupos após os critérios de inclusão serem confirmados. A análise estatística foi realizada de acordo com a distribuição das variáveis, ao nível de 5% de significância. No presente estudo foi possível observar um estado de hipercoagulabilidade sanguínea nos cães com DRC. Na TEM com o ativador de via extrínseca, observou-se encurtamento no tempo de coagulação e do tempo de formação do coá... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Chronic kidney disease (CKD) affects mostly older dogs and its main characteristic is the irreversible loss of kidney function. CKD in dogs promotes serious metabolic alterations, often characterized by azotemia, hypoalbuminemia and non-regenerative anemia. Azotemia and uremia predispose the hemostatic abnormalities that can lead to hemorrhagic cases. In addition to platelet dysfunction, deficiency of natural anticoagulants and reduced fibrinolysis are factors that predispose to thromboembolism. This work aims to evaluate the possible bleeding or thrombotic tendencies in dogs with CKD. 20 healthy dogs were selected (control group) with tests within normal limits and 17 dogs with CKD in stages III or IV classified according to IRIS and urine protein to creatinine ratio greater than one (CKD group). Blood samples for the realization of thromboelastometry (TEM), platelet aggregation, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen concentration were collected at one time for both groups after the inclusion criteria had been confirmed. Statistical analysis performed according to the distribution of the variable at the 5% level of significance. In the present study, we observed a state of hypercoagulable blood in dogs with CKD. In TEM with the extrinsic pathway activator, there was shortening of the clotting time and clot formation time, increasing the alpha angle and the maximum clot firmness, and reducing the maximum lysis in dogs with CKD comp... (Complete abstract click electronic access below) / Mestre
10

Imagerie IRTF tridimensionnelle pour l'étude de l'insuffisance rénale chronique / Three-dimensional infrared imaging for chronic kidney disease investigation

Chen, Hsiang-Hsin 16 December 2015 (has links)
L’insuffisance rénale chronique (IRC) et l’une des pires maladies chroniques dans les pays développés. Les grades de l’IRC sont principalement basés sur la mesure ou l’estimation du taux de filtration rénale (GFR). Cependant, cette méthode est peu sensible sur les premiers stades de la pathologie et n’apporte donc pas de valeur diagnostique. La détection de la pathologie à des stades précoces et son traitement peuvent éviter ou limiter les effets délétères de la chronicité. Cette thèse se penche sur le développement de la microscopie IRTF en tant qu’outil diagnostic pour l’identification par histopathologie à l’échelle du glomérule dans un modèle d’IRC. Nous avons développé la technique de reconstruction 3D pour l’imagerie IRTF des modifications biochimiques à l’échelle du glomérule pour déterminer des marqueurs de l’IRC. La déconvolution spectrale et le clustering sont appliqués après analyses IRTF pour distinguer les modèles sains et pathologiques. Ensuite, la microvasculature glomérulaire est révélée par agent de contraste pour en déterminer les anomalies morphologiques. Grâce aux résultats obtenus en 3D et l’utilisation de méthodes statistiques avancées, la microscopie IRTF est utilisée comme une technique fonctionnelle pour déterminer les modifications morphologiques et moléculaires apparaissant au cours du développement de l’IRC. / CKD (Chronic Kidney Disease) is one of the worst public diseases in developing countries. The stages of CKD are mainly based on measured or estimated GFR (Glomerular Filtration Rate). However, this method is not sensitive enough on early stages of the pathology and thus do not offer accurate diagnostic value. Early detection and treatment can often limit or avoid the chronicity effects of the disease. This thesis focuses on the development of FTIR microscopy as a diagnostic tool for the identification by histopathology at glomerulus level of the kidney in CKD model. We developed a technique of 3D reconstruction for the FTIR imaging of biochemical components changes in glomeruli for identifying the pathological marker of CKD. The curve-fitting and spectral clustering are applied on the FTIR microscopy analysis to distinguish between healthy and pathological glomeruli of a kidney. Then, the glomerular microvasculatureis highlighted to reveal the morphological abnormalities by perfusing contrast agents into blood vessels. With advanced 3D statistical methods and 3D image visualization by microscopy, FTIR spectro-imaging can be used as a functional technique to determine the morphological and molecular changes occurring along CKD development.

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