Thus, discrimination between C1 and C2 statements was based on expert consensus. 5. Publication and future revisions The Guidelines were published in the Japanese-language journal of the JSN and concurrently released as a Japanese-language book (by Tokyo Igakusha, Tokyo). The Guidelines were also uploaded to the homepage of the JSN. At
present, CKD-related evidence is being selleck rapidly accumulated, and this new evidence will necessitate the preparation of an updated version of the Guidelines in 3–5 years. A certain degree of turnover in the membership of the revision committee will be required in order to ensure the impartiality of the Guidelines.”
“Introduction selleck chemicals Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, with acknowledged efficacy and safety over a wide range of clinical conditions. Despite their many useful therapeutic applications, substantial evidence has shown that NSAIDs can have deleterious effects
on kidney function. For example, a nested case-controlled study using the General Practice Research Database from the United Kingdom showed that NSAID users in the general population were at threefold greater risk for a first-ever diagnosis of clinical acute kidney injury (AKI) than non-NSAID users. In addition, history of heart failure, hypertension, and diabetes were associated with a greater risk of AKI in this population [1]. Combination therapy with NSAIDs and renin–angiotensin system (RAS) inhibitors increases the risk of kidney damage [2–4]. Since RAS inhibitors are recommended as first-line antihypertensive agents in patients with diabetes, patients AZD8186 purchase with diabetic nephropathy who take NSAIDs tend to be at greater risk for NSAID-induced kidney damage. NSAIDs can affect renal function
by, for example, inhibiting the synthesis of important renal prostaglandins, especially those involved in solute homeostasis and maintenance of renal U0126 purchase blood flow [5–8]. Prostaglandin E2 (PGE2) is the most abundant vasodilatory prostaglandin in the human renal vascular bed. NSAIDs decrease PGE2 concentration by inhibiting cyclooxygenase-2 (COX-2). Adverse effects of NSAIDs may be avoided by administering these drugs as transdermal patches. These adhesive patches, which are applied to the skin at the site of pain, slowly release medication through the skin. Although NSAID patches are regarded as safe and are frequently used in patients with chronic kidney disease (CKD), the effects of NSAID patches on renal circulation in these patients have not been investigated. Loxoprofen-containing patches are one of the most widely used adhesive patches in Japan. We therefore analyzed the effects of topically applied loxoprofen sodium on kidney function in patients with diabetic nephropathy. Methods Study design This open-label, single-arm, single-dose study was performed at the Shiga University of Medical Science Hospital.