Sphingolipids (SLs) are bioactive signaling molecules essential for various cellular processes, including cell survival, proliferation, migration, and apoptosis. Key SLs such as ceramides, sphingosine, and their phosphorylated forms play critical roles in cellular integrity. Dysregulation of SL levels is implicated in numerous diseases, notably chronic kidney disease (CKD). This review focuses on the role of SLs in CKD, highlighting their potential as biomarkers for early detection and prognosis. SLs maintain renal function by modulating the glomerular filtration barrier, primarily through the activity of podocytes. An imbalance in SLs can lead to podocyte damage, contributing to CKD progression. SL metabolism involves complex enzyme-catalyzed pathways, with ceramide serving as a central molecule in de novo and salvage pathways. Ceramides induce apoptosis and are implicated in oxidative stress and inflammation, while sphingosine-1-phosphate (S1P) promotes cell survival and vascular health. Studies have shown that SL metabolism disorders are linked to CKD progression, diabetic kidney disease, and glomerular diseases. Targeting SL pathways could offer novel therapeutic approaches for CKD. This review synthesizes recent research on SL signaling regulation in kidney diseases, emphasizing the importance of maintaining SL balance for renal health and the potential therapeutic benefits of modulating SL pathways.

Type 2 diabetes (T2D) poses a growing global health challenge, impacting patients’ and their caregivers’ well-being. This study investigates the influence of T2D complications on caregivers’ quality of life (QoL) using the WHOQOL-BREF questionnaire, accounting for factors like age, disease duration, and control. The research involved 382 T2D patients and 300 caregivers from Vuk Vrhovac University Clinic for Diabetes, Endocrinology, and Metabolic Diseases. The WHOQOL-BREF questionnaire assessed caregivers’ QoL across physical, psychological, social, and environmental domains. Complications, including retinopathy, neuropathy, and kidney disease, were examined for their effects on QoL. Patients’ age impact, gender differences, and disease duration were analyzed. T2D complications had varying impacts on different QoL domains. Caregivers of patients with multiple complications showed significant social functioning impairment. Those without complications reported lower psychological health. Age correlated with poorer physical health scores. Female caregivers rated higher in psychological and environmental health. Disease duration and T2D control had no significant impact on caregiver QoL. Caregivers’ concerns included medication adherence and worry about their partner’s health. This study illustrates the delicate interplay between T2D patients and caregivers, highlighting the multifaceted effects of chronic illness. Comprehensive healthcare techniques that address emotional and social components in addition to medical care are critical for improving the well-being of both patients and their caregivers. The findings contribute to a broader understanding of T2D care dynamics, advocating for empathetic and all-encompassing healthcare practices.

Background and aims: In the past few years, some reports have shown that serum chloride concentration is a more powerful prognostic predictor than serum sodium levels in heart failure (HF). Elevated Na/Cl ratio has shown to be independently associated with all-cause death in acute HF. We evaluated changes in serum chloride concentrations and Na/Cl ratio in correlation with various clinical factors during 12 months of follow-up in patients in whom SGLT2is were initiated as part of HF therapy. Patients and methods: This was a prospective observational study conducted at University Hospital Dubrava and involving patients with HF. We included 241 participants between May 2021 and April 2023. All data were obtained before the introduction of SGLT2is, and the same parameters were obtained at 6 and 12 months of follow-up as well. Results: The results show that higher chloride concentration at both 6 and 12 months is an independent predictor of lower NT-proBNP levels. The chloride concentrations did not differ significantly between these groups in the follow-up period. There were no statistically significant differences in the Na/Cl ratio at different timepoints. The presence of cardiovascular risk factors did not significantly affect the increase in chloride concentration. Conclusions: Our results suggest that hypochloremia could be a potentially modifiable risk factor, given the influence of SGLT2is on chloride concentration, but also an ominous sign of a poor outcome in patients with HF. We believe that the determination of chloride concentrations should become routine in the monitoring of patients with HF.