Renal toxicity of the nonsteroidal anti-inflammatory drugs

T he only important pathological condition that causes a significant increase in the serum creatinine level is damage to a large number of nephrons. Unlike the BUN, the serum creatinine level is not affected by hepatic protein metabolism. Tests to measure serum creatinine, urine creatinine, and creatinine clearance are all used only to evaluate renal function. Only renal dysfunction changes the results. The serum creatinine level does not rise until at least half of the kidney's nephrons are destroyed or damaged. Because creatinine levels rise and fall more slowly than BUN levels, creatinine levels are often preferred to monitor renal function on a long-term basis.

Acute rejection is still a common complication of kidney transplantation. IL-17 is known to be associated with allograft rejection but the cellular source and the role of this cytokine remains unclear. We investigated IL-17 graft expression in renal transplant recipients with acute antibody-mediated rejection (ABMR), acute T-cell-mediated rejection (TCMR), interstitial fibrosis and tubular atrophy (IFTA) and acute tubular damage due to calcineurin-inhibitor toxicity (CNI). In acute ABMR, tubular IL-17 protein expression was significantly increased compared to TCMR, where most of the IL-17⁺ cells were CD4⁺ graft infiltrating lymphocytes, IFTA and CNI control groups. The tubular expression of IL-17 in acute ABMR colocalized with JAK2 phosphorylation and peritubular capillaries C4d deposition. In addition, IL-17 tubular expression was directly and significantly correlated with the extension of C4d deposits. In cultured proximal tubular cells, C3a induced IL-17 gene and protein expression along with an increased in JAK2 phosphorylation. The inhibition of JAK2 abolished C3a-induced IL-17 expression. The use of steroids and monoclonal antibodies reduced IL-17 expression, JAK2 phosphorylation and C4d deposition in acute ABMR patients. Our data suggest that tubular cells represent a significant source of IL-17 in ABMR and this event might be mediated by the complement system activation featuring this condition.

After surgical excision, up to 30% of patients with localized tumors experience relapse. The lung is the most common site of distant recurrence, seen in 50% to 60% of patients. The median time to relapse after surgery is approximately 2 years, with most relapses occurring within 5 years. Interferon alpha and high-dose interleukin-2 (IL-2) have been tested as adjuvant treatments following resection of stage 1-2 kidney cancer. However, no benefit has been seen in randomized trials. 29,30 Observation remains standard care after nephrectomy, and eligible patients should be offered enrollment in randomized clinical trials.

Q. experiencing sharp pain in my right kidney region... pain is acute and doesnt radiate... recently PE left lung have been taking warfrin, panadiene forte, two kinds of cholesterol/triglycerine reducing meds and champix quit smoking medication... recently tests showed the hight cholesterol and triglys' levels and also a swollen liver... pain is not in my liver area... past pain in this kidney recurrent but never as bad. always dull.. many years ago had a uti, which caused high protiene levels.. very bad at finishing anti-biotics... recently had tonsilitis.. This hurts and is tender to touch but does not bring on sharp pain when touched, sharp pain comes and goes after taking pain relief A. Go to see a doctor - although its tempting to make the diagnosis over the net (I have several ideas about what it might be), it sounds like serious, especially if you had a PE lately - it could be a thrombus in the vein of the kidney, or maybe a stone (sounds like that according to the description of the pain). However, as I said, making the diagnosis without even seeing you isn't the wisest thing to do.

Take care,

Renal toxicity of the nonsteroidal anti-inflammatory drugs

renal toxicity of the nonsteroidal anti-inflammatory drugs

Q. experiencing sharp pain in my right kidney region... pain is acute and doesnt radiate... recently PE left lung have been taking warfrin, panadiene forte, two kinds of cholesterol/triglycerine reducing meds and champix quit smoking medication... recently tests showed the hight cholesterol and triglys' levels and also a swollen liver... pain is not in my liver area... past pain in this kidney recurrent but never as bad. always dull.. many years ago had a uti, which caused high protiene levels.. very bad at finishing anti-biotics... recently had tonsilitis.. This hurts and is tender to touch but does not bring on sharp pain when touched, sharp pain comes and goes after taking pain relief A. Go to see a doctor - although its tempting to make the diagnosis over the net (I have several ideas about what it might be), it sounds like serious, especially if you had a PE lately - it could be a thrombus in the vein of the kidney, or maybe a stone (sounds like that according to the description of the pain). However, as I said, making the diagnosis without even seeing you isn't the wisest thing to do.

Take care,

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renal toxicity of the nonsteroidal anti-inflammatory drugsrenal toxicity of the nonsteroidal anti-inflammatory drugsrenal toxicity of the nonsteroidal anti-inflammatory drugsrenal toxicity of the nonsteroidal anti-inflammatory drugsrenal toxicity of the nonsteroidal anti-inflammatory drugs

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