Cerebral blood flow changes in hemodialysis and peritoneal dialysis patients: an arterial-spin labeling MR imaging

Chronic diseases present a significant challenge to 21st century global health policy. In developing nations, the growing prevalence of chronic diseases such as chronic kidney disease has severe implications on health and economic output. The rapid rise of common risk factors such as diabetes, hypertension, and obesity, especially among the poor, will result in even greater and more profound burdens that developing nations are not equipped to handle. Attention to chronic diseases, chronic kidney disease in particular, has been lacking, largely due to the global health community's focus on infectious diseases and lack of awareness. There is a critical need for funding in and to developing countries to implement more comprehensive, cost-effective, and preventative interventions against chronic diseases. This paper examines the epidemiology of chronic diseases, the growing prevalence of chronic kidney disease and its implications for global public health, and the associated health and economic burdens. Finally, a summary review of cost-effective interventions and funding needs is provided. Copyright © 2011 S. Karger AG, Basel.

Oxidative stress and mitochondrial damage are implicated in the evolution of neurodegenerative diseases. Increased oxidative damage in specific brain regions during aging might render the brain susceptible to degeneration. Previously, we demonstrated increased oxidative damage and lowered antioxidant function in substantia nigra during aging making it vulnerable to degeneration associated with Parkinson's disease. To understand whether aging contributes to the vulnerability of brain regions in Alzheimer's disease, we assessed the oxidant and antioxidant markers, glutathione (GSH) metabolic enzymes, glial fibrillary acidic protein (GFAP) expression and mitochondrial complex I (CI) activity in hippocampus (HC) and frontal cortex (FC) compared with cerebellum (CB) in human brains with increasing age (0.01-80 years). We observed significant increase in protein oxidation (HC: p = 0.01; FC: p = 0.0002) and protein nitration (HC: p = 0.001; FC: p = 0.02) and increased GFAP expression (HC: p = 0.03; FC: p = 0.001) with a decreasing trend in CI activity in HC and FC compared to CB with increasing age. These changes were associated with a decrease in antioxidant enzyme activities, such as superoxide dismutase (HC: p = 0.005), catalase (HC: p = 0.02), thioredoxin reductase (FC: p = 0.04), GSH reductase (GR) (HC: p = 0.005), glutathione-s-transferase (HC: p = 0.0001; FC: p = 0.03) and GSH (HC: p = 0.01) with age. However, these parameters were relatively unaltered in CB. We suggest that the regions HC and FC are subjected to widespread oxidative stress, loss of antioxidant function and enhanced GFAP expression during aging which might make them more susceptible to deranged physiology and selective neuronal degeneration.