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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

545
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
545
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

532
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
532
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

287
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
287
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

79
The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
79
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

293
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
293
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

304
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
304

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Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
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FSTL3 is increased in renal dysfunction.

Susan Kralisch1,2, Annett Hoffmann1, Nora Klöting2

  • 1Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|March 25, 2017
PubMed
Summary
This summary is machine-generated.

Follistatin-like 3 (FSTL3) levels increase with worsening kidney function in chronic kidney disease (CKD) and acute kidney dysfunction (AKD). This suggests FSTL3 may counteract harmful signaling in kidney disease.

Keywords:
AKICKDFSTL3cytokineelimination

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Area of Science:

  • Endocrinology
  • Nephrology
  • Metabolic Research

Background:

  • Follistatin-like 3 (FSTL3) is a novel cytokine influencing insulin sensitivity and counteracting activin/myostatin signaling.
  • Investigated FSTL3 regulation in human chronic kidney disease (CKD) and acute kidney dysfunction (AKD).
  • Examined mouse FSTL3 expression in insulin-sensitive tissues during CKD.

Purpose of the Study:

  • To investigate the role and regulation of FSTL3 in renal dysfunction.
  • To determine the association between circulating FSTL3 levels and kidney function.
  • To explore the hepatic expression of FSTL3 in a mouse model of CKD.

Main Methods:

  • Quantified circulating FSTL3 in 581 CKD patients across eGFR categories (G1-G5) using ELISA.
  • Measured FSTL3 in 61 patients before and after unilateral nephrectomy (AKD model).
  • Analyzed hepatic FSTL3 mRNA expression in eNOS-/-db/db mice (CKD model) compared to controls.

Main Results:

  • Circulating FSTL3 levels significantly and continuously increased with declining eGFR (P < 0.001).
  • Renal dysfunction was the strongest independent predictor of FSTL3 in CKD and AKD.
  • Hepatic FSTL3 mRNA expression was significantly upregulated (>6-fold) in CKD mice.

Conclusions:

  • Circulating FSTL3 is significantly and independently linked to renal function in CKD and AKD.
  • Increased hepatic FSTL3 mRNA may contribute to elevated FSTL3 levels in CKD.
  • Findings support the hypothesis that FSTL3 is kidney-eliminated and counteracts adverse signaling in renal dysfunction.