RESUMEN
A 32-year-old male patient presented the clinical picture of loin pain haematuria syndrome with pain attacks accompanied by macrohaematuria. In renal biopsy, the preglomerular vessels showed segmental wall hyalinosis in the sense of low-grade nephrosclerosis, and glomerular capillaries with slightly but diffusely thickened, non-split basal membranes on electron microscopy. Notable were irregularly deformed, different dense erythrocytes in the glomerular capillaries, and several tubular lumina. The suspicion of erythrocytic enzyme deficiency could be confirmed. The enzyme activities of the erythrocytes were predominantly normal or slightly increased; only the activity of triosephosphate isomerase, a critical key enzyme of glycolysis, was reduced to 71% (resp. 57%) of the normal level, compatible with a heterozygous carrier status that could not be found. Patients with genomic triosephosphate-isomerase deficiency have degraded enzyme activities in virtually all tissues, such as leucocytes, platelets, and muscle cells. An association with neuromuscular symptoms is also known. Thus, it is possible that smooth muscle and intrarenal vascular spasms trigger clinical symptoms consisting of flank pain and phases of macrohaematuria. An aspirin-like defect (thrombocytopathy) had previously been found in connection with epistaxis (also due to TPI deficiency?). Enalapril treatment drastically reduced the frequency of macrohaematuria and pain attacks decreased to a lesser extent.
RESUMEN
A new calibration strategy for elemental bioimaging based on online isotope dilution analysis (IDA) and laser ablation-inductively coupled plasma mass spectrometry (LA-ICPMS) was developed and applied for the quantification of platinum in rat kidney tissues. A dry 194Pt spike aerosol was added in a post-cell setup, and the natural 194Pt/195Pt isotope ratio of the sample aerosol from laser ablation was changed accordingly. Spike mass flow determination was carried out based on reversed IDA using a reference standard. Quantitative data obtained by the new approach correlated well with those obtained by external calibration when analyzing parallel tissue slices of rat kidney from cisplatin perfusion studies. The novel quantification approach is traceable to SI units, as IDA is an definitive method. Signal drifts are compensated as the second isotope acts as an internal standard.
Asunto(s)
Riñón/química , Platino (Metal)/análisis , Técnica de Dilución de Radioisótopos , Animales , Terapia por Láser , Masculino , Espectrometría de Masas , Ratas , Ratas Wistar , Programas InformáticosRESUMEN
BACKGROUND: The effect of the increasing thickness of the glomerular basement membrane (GBM), which is seen in ageing rats, on the effective hydraulic conductivity (k) of the glomerular capillary wall was studied in Wistar rats aged 2 and 18 months. METHODS: With the use of micropuncture techniques, ultrafiltration characteristics of cortical glomeruli were determined in isolated cell-free perfused kidneys. Because the filtration fraction in this preparation is low (3%) as a consequence of high perfusion rates at glomerular filtration rates comparable with in vivo conditions, uniform ultrafiltration conditions are provided over the whole filtering surface. After fixation at a defined perfusion pressure, the surface of glomerular capillaries (S) was obtained morphometrically on light microscopic sections of the glomeruli studied previously. RESULTS: The glomerular ultrafiltration coefficient (K(f)) was 0.025 nl/s.mmHg in young rats and 0.038 nl/s.mmHg in old rats (P<0.0005) and S was 0.140 mm(2) in young and 0.244 mm(2) in old rats (P<0.0005). However, k was not significantly different (18.0 nl/s.mmHg.cm(2) in young and 15.8 nl/s.mmHg.cm(2) in old rats) despite a 2.4-fold increase of GBM thickness as estimated from electron microscopic sections. CONCLUSIONS: These findings indicate that the age-dependent increase of GBM thickness in rat kidneys did not substantially increase hydraulic resistance of the glomerular capillary wall.
Asunto(s)
Glomérulos Renales/patología , Glomérulos Renales/fisiología , Factores de Edad , Animales , Membrana Basal/patología , Fenómenos Biofísicos , Biofisica , Técnicas In Vitro , Glomérulos Renales/anatomía & histología , Glomérulos Renales/irrigación sanguínea , Masculino , Microcirculación , Perfusión , Ratas , Ratas WistarRESUMEN
In a previous paper, we found that low ionic strength (I) reversibly reduced the glomerular charge density, suggesting increased volume of the charge-selective barrier. Because glutaraldehyde makes most structures rigid, we considered the isolated, perfusion-fixed rat kidney to be an ideal model for further analysis. The fixed kidneys were perfused with albumin solutions containing FITC-Ficoll at two different Is (I = 151 and 34 mM). At normal I, the fractional clearance () for albumin was 0.0049 (SE -0.0017, +0.0027, n = 6), whereas for neutral Ficoll35.5A of similar size was significantly higher 0.104 (SE 0.010, n = 5, P < 0.001). At low I, for albumin was 0.0030 (SE -0.0011, +0.0018, n = 6, not significant from albumin at normal I) and for Ficoll35.5A was identical to that at normal I, 0.104 (SE 0.015, n = 6, P < 0.01 compared with albumin at low I). According to a heterogeneous charged fiber model, low I reduced the fiber density from 0.056 to 0.0315, suggesting a 78% gel volume expansion. We conclude that 1) there is a significant glomerular charge barrier. 2) Solutions with low I increase the volume of the charge barrier even in kidneys fixed with glutaraldehyde. Our findings suggest that polysaccharide-rich structures, such as the endothelial cell coat, are key components in the glomerular barrier.