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1.
Rev Med Liege ; 77(1): 18-24, 2022 Jan.
Artigo em Francês | MEDLINE | ID: mdl-35029336

RESUMO

Both renin-angiotensin-aldosterone system inhibitors (RAASi) and sodium-glucose cotransporter type 2 inhibitors (SGLT2i, gliflozins) reduce the risk of heart failure and of progressing towards end-stage renal disease, especially in patients with type 2 diabetes (T2D). Positive results reported in patients with T2D have been confirmed in people without diabetes. These two pharmacological classes now occupy a privileged place in international guidelines, in diabetology, cardiology and nephrology. The present article describes similarities and differences between these two types of medications. It emphasizes the importance of combining both approaches in order to optimize the cardiovascular and renal prognosis, while maintaining a good safety profile.


Les inhibiteurs du système rénine-angiotensine-aldostérone (iSRAA) et les inhibiteurs des cotransporteurs sodium-glucose de type 2 (iSGLT2, gliflozines) réduisent le risque d'insuffisance cardiaque et de progression vers l'insuffisance rénale terminale, notamment chez les patients avec un diabète de type 2 (DT2). Les effets positifs rapportés chez les patients DT2 ont été confirmés chez les personnes non diabétiques. Ces deux classes pharmacologiques occupent maintenant une place de choix dans les recommandations internationales, en diabétologie, en cardiologie et en néphrologie. Cet article fait le point sur les similitudes et les différences entre ces deux familles médicamenteuses. Il insiste sur l'importance de les combiner pour optimiser le pronostic cardiovasculaire et rénal, tout en maintenant un bon niveau de sécurité.


Assuntos
Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Inibidores do Transportador 2 de Sódio-Glicose , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Rim , Sistema Renina-Angiotensina , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico
2.
In Vivo ; 36(1): 510-521, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34972756

RESUMO

BACKGROUND/AIM: Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare subtype of renal cell carcinoma and generally considered a low-grade renal epithelial neoplasm. However, MTSCC with distant metastases often shows a poor prognosis. This is the first reported case of cytoreductive nephrectomy after nivolumab plus ipilimumab combination treatment. CASE REPORT: A 26-year-old man had a 72-mm tumor at the left kidney with multiple osteolytic bone metastases. A biopsy of the renal tumor and bone metastases resulted in the diagnosis of MTSCC of the kidney with bone metastases. After nivolumab plus ipilimumab combined treatment, he underwent cytoreductive nephrectomy. The excised specimen showed higher PD-L1 expression in the spindle components than in the tubular components, but CD4- and CD8-positve T-cells showed greater infiltration in the tubular components than the spindle components. CONCLUSION: Combination immunotherapy of nivolumab and ipilimumab may be an effective treatment option for metastatic MTSCC of the kidney.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias Ósseas/secundário , Ipilimumab/uso terapêutico , Neoplasias Renais , Nivolumabe/uso terapêutico , Adenocarcinoma Mucinoso/tratamento farmacológico , Adenocarcinoma Mucinoso/cirurgia , Adulto , Procedimentos Cirúrgicos de Citorredução , Humanos , Rim , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/cirurgia , Masculino , Nefrectomia
3.
Zhonghua Bing Li Xue Za Zhi ; 51(1): 23-27, 2022 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-34979749

RESUMO

Objective: To study the clinical pathological characteristics, immunophenotype, molecular changes and prognosis of the papillary renal neoplasm with reverse polarity (PRNRP). Methods: Nine cases of PRNRP, diagnosed from 2013 to 2019, were retrieved from the Department of Pathology of Nanjing Jinling Hospital, Nanjing University School of Medicine. Histomorphology, immunophenotype and molecular genetics were analyzed with review of the literatures. Results: There were five male and four female patients, aged from 49 to 70 years, with an average age of 60.1 years. During a mean follow-up of 29 months, one patient died for other cause, and the others survived without disease. Microscopically, the tumor cells arranged in papillary structure with a fibrovascular core, the surface of which was covered with a single layer of cuboidal or columnar cells. The most prominent feature was that the tumor nuclei located at the top of the cytoplasm far from the basement membrane, and they were monotonous in size and arranged neatly with no or few nucleoli. Immunohistochemically, all nine cases of PRNRP showed diffuse positive expression of CK7 and E-cadherin, various degrees of P504s expression, and no expression of CD10 and CD117, with a Ki-67 index of 1%-3%. Unlike other papillary renal cell carcinoma, the nine cases of PRNRP all showed characteristic positive expression of GATA3. The fluorescence in situ hybridization assay showed that the majority of PRNRPs (8/9) did not have triploids on chromosomes 7 and 17. The sequencing of the KRAS gene confirmed the presence of a nonsense KRAS mutation in 8 of the 9 cases. Conclusions: PRNRP is a subtype of papillary renal cell carcinoma with characteristic morphological, immunophenotypic and molecular features, and indolent behaviors. More data are needed to define PRNRP as "carcinoma", and a definitive diagnosis of PRNRP is of great significance for proper treatment choice and accurate prognostication.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Biomarcadores Tumorais , Carcinoma de Células Renais/genética , Feminino , Humanos , Hibridização in Situ Fluorescente , Rim , Neoplasias Renais/genética , Masculino , Pessoa de Meia-Idade , Prognóstico
4.
Mymensingh Med J ; 31(1): 80-87, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34999684

RESUMO

Glomerular disease is one of the most important causes of chronic kidney disease in developing countries like Bangladesh as well as the whole world. The pattern of glomerular disease varies in different countries and can have different clinical presentations. The aim of the study was to analyze the clinical profile and to determine the histological pattern of glomerular diseases in a large tertiary care hospital in Bangladesh. All kidney biopsies performed in Mymensingh Medical College Hospital, Bangladesh from October 2018 to March 2020 were prospectively analyzed in the study. A total of 101 patients with kidney biopsy were examined by clinical and laboratory findings and by light and immuno-fluorescence microscopy. The mean age was 30.0±14.6 years and 50(49.5%) were male and 51(50.5%) were female with a male to female ratio of 1:1. The clinical syndromes namely nephrotic syndrome, nephritic syndrome, nephrito-nephrotic presentation, RPGN like presentation, macroscopic haematuria and asymptomatic urine abnormality were present in 31.7%, 34.5%, 22.8%, 11.9%, 19.8% and 10.9% patients respectively. The most common histological varieties found in the study were mesangial proliferative glomerulonephritis (MesPGN) (18.8%) and focal segmental glomerulosclerosis (FSGS) (18.8%). Other histopathological pattern among the studied subjects revealed minimal change disease (MCD) in 5.9%, membranous nephropathy (MN) in 7.9%, membranoproliferative glomerulonephritis (MPGN) in 16.8%, IgA nephropathy in 5%, IgM nephropathy in 2%, IgG nephropathy in 2%, diffuse proliferative glomerulonephritis (DPGN) in 1%, focal proliferative glomerulo-nephritis (FPGN) in 3%, crescentic GN in 3%, lupus nephritis (LN) in 13.9%, amyloidosis in 1% and fibrillary glomerulopathy in 1% patient. The pattern of glomerular disease found in this study was similar to other studies performed in Bangladesh with a little variation. It may guide the future researchers to establish a national kidney biopsy registry in Bangladesh.


Assuntos
Insuficiência Renal Crônica , Adolescente , Adulto , Bangladesh/epidemiologia , Biópsia , Feminino , Humanos , Rim , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
5.
Orv Hetil ; 163(3): 83-91, 2022 01 16.
Artigo em Húngaro | MEDLINE | ID: mdl-35034007

RESUMO

Összefoglaló. A jelenlegi hazai gyakorlatban sokszor indokolatlanul korlátozzák a vesebetegek kontrasztanyagos vizsgálatát, és halasztódik a metformint szedok vizsgálata is, kontrasztanyag által okozott akut vesekárosodástól (contrast-induced acute kidney injury, CI-AKI) tartva. Összefoglalónk célja az ezzel kapcsolatos újabb ismeretek áttekintése és egy szakmai javaslat ismertetése annak érdekében, hogy a betegellátás szempontjából fontos vizsgálatok ne maradjanak el, ugyanakkor azok a maximális betegbiztonság jegyében készüljenek. Az elmúlt évek tanulmányai alapján a CI-AKI elofordulása a korábbinál kevésbé gyakori, és jelentosen különbözo a kontrasztanyag intravénás vagy intraarteriális alkalmazásától függoen. Legfontosabb rizikótényezoje a csökkent glomerulusfiltrációs ráta (GFR), mely stabil állapotú vesebetegnél, intravénás kontrasztanyag adásakor 30 ml/min/1,73 m2 alatt, intraarteriális alkalmazásakor 45 ml/min/1,73 m2 alatt képez magas rizikót. Proteinuria esetén a CI-AKI és a kontrasztanyaggal társult akut vesekárosodás (contrast-associated kidney injury, CA-AKI) kockázata is nagyobb, ezért a számított GFR mellett indokolt a vizelet albumin/kreatinin vagy fehérje/kreatinin hányados meghatározása is a vizsgálat elott. Az instabil állapot, az akut veseelégtelenség mindenkor magas kockázatot jelent, ilyenkor a számított GFR pontatlan, nem használható. Csökkent vesefunkció mellett figyelni kell a beadott kontrasztanyag mennyiségére, a vizsgálat 48-72 órán belüli ismétlésének kerülésére, a nemszteroid gyulladásgátlók vagy más nephrotoxicus szerek lehetoség szerinti szüneteltetésére. Prevenciós intézkedés a magas rizikóval bíró betegek esetében javasolt intravénás hidrálás formájában, fiziológiás koncentrációjú nátrium-klorid vagy nátrium-bikarbonát infúziójával. Az egyéb eljárások hatástalanok, és nem indokolt a beavatkozás utáni dialízis végzése sem végstádiumú veseelégtelen betegekben. A metformint 60 ml/min/1,73 m2 feletti eGFR-rel rendelkezo beteg vizsgálata kapcsán szükségtelen elhagyni, ettol rosszabb vesemuködés esetén kell szüneteltetni. Amennyiben a vizsgálat indikációja sürgosségi, az a metformin egyideju elhagyásával elvégezheto, de a gyógyszer csak 48 óra múlva, az akut vesekárosodás kizárását követoen adható vissza. Orv Hetil. 2022; 163(3): 83-91. Summary. In the current clinical practice, studies with iodinated contrast agents are often limited in patients with kidney disease and delayed in those on metformin therapy due to fear of contrast-induced acute kidney injury (CI-AKI). We aim to review the most recent information about CI-AKI and provide recommendations in order to avoid cancellation of important contrast-enhanced tests, but maximize safety considerations. According to the most recent findings, CI-AKI occurs less frequently nowadays than previously, and depends significantly on the route of contrast administration (intraarterial or intravenous). The most important risk factor is the decreased GFR, which, in stable patients with intravenous contrast administration provides high risk if the eGFR is less than 30 ml/min/1.73 m2, and with intraarterial contrast is less than 45 ml/min/1.73 m2. In patients with proteinuria, the risk of both CI-AKI and CA-AKI (contrast-associated kidney injury) is increased, therefore urinary albumin/creatinine or protein/creatinine ratios are recommended to measure before the contrast material administration, beside the eGFR determination. Unstable condition, acute renal failure always mean high risk; in these cases, eGFR calculation is imprecise and useless. If renal function is decreased, the amount of contrast material needs consideration, repeated contrast-enhanced studies should be avoided in 48-72 hours, the non-steroidal anti-inflammatory agents and other nephrotoxic drugs have to be discontinued. For high risk patients, preventive intravenous hydration should be given, either by physiologic saline or sodium bicarbonate infusion. Other drugs aiming prevention have proved to be useless; dialysis treatment immediately after contrast administration in end-stage renal disease patients is unnecessary. There is no indication to discontinue metformin if eGFR is higher than 60 ml/min/1.73 m2, but if the patient has less than that value, the metformin needs to be stopped. In urgent studies with contrast agent, metformin administration has to be discontinued simultaneously with the intervention, and this drug can only be readministered after ruling out acute kidney injury in 48 hours following contrast exposure. Orv Hetil. 2022; 163(3): 83-91.


Assuntos
Meios de Contraste , Rim , Meios de Contraste/efeitos adversos , Humanos , Rim/fisiologia
6.
Orv Hetil ; 163(3): 109-115, 2022 01 16.
Artigo em Húngaro | MEDLINE | ID: mdl-35034008

RESUMO

Összefoglaló. Bevezetés: Az aortabetegségek kezelése során az orvos által módosított sztentgraftok alkalmazása vitatott. Döntoen sürgosségi esetben, nagy rizikójú nyitott mutét alternatívájaként vagy nehéz anatómiai konfigurációk esetén alkalmazzák oket. Módszer: Cikkünkben három eseten keresztül klinikánk kezdeti tapasztalatait mutatjuk be az orvos által a mutét során módosított sztentgraftokkal kapcsolatosan. Eredmények: Elso esetünkben egy 75 éves férfi beteg 50 mm-es saccularis infrarenalis aortaaneurysma miatt került felvételre. A rövid infrarenalis tágulat proximalis rögzítési zónájának átméroje lényegesen nagyobb volt, mint a terminális aortaszakasz. A kaliberdiszkrepancia megoldására a legalkalmasabb egy reverz helyzetu iliacagraftszár volt, így egy graftszárat a felvezetorendszerérol eltávolítottunk, majd megfordítva az aorta tágulatába deponáltuk. Hasonló megoldást választottunk egy 67 éves férfi beteg jobb oldali, 65 mm-es arteria iliaca communis aneurysmájának kezelése során. Egy 81 éves nobeteg hasi aortaaneurysma tartott rupturája miatt korábban behelyezett unilateralis graft proximalis endoleakjének megoldása miatt érkezett. Az ectaticus aorta, valamint az arteria mesenterica superior és a primer intervenció során bekerült unilateralis graft elkeskenyedo része közti rövid távolság miatt konvencionális sztentgraft beültetése nem volt lehetséges. A szituáció egy rövid thoracalis sztentgrafttal volt megoldható: egy thoracalis sztentgraft distalis végébol 3 cm-t kauter segítségével levágtunk, majd az eszközt a felvezetorendszerbe visszatöltöttük. A módosított sztentgraftot az arteria mesenterica superior alá pozicionáltuk, egy 'chimney' sztentgraft segítségével biztosítottuk a jobb vese perfúzióját. Technikailag mindhárom beavatkozásunk sikeres volt. Következtetés: Az endovascularis aortamutétek azonnal elérheto eszközparkja a típusos anatómiájú betegek megoldására általában alkalmas. A szokatlan anatómiával rendelkezo elektív esetek, illetve a sürgeto beavatkozást igénylo komplex endovascularis mutétek során az orvos által módosított sztentgraftok hatékonyan alkalmazhatók. Alkalmazásuk nagy forgalmú aortacentrumokban javasolt. Orv Hetil. 2022; 163(3): 109-115. INTRODUCTION: Physician-modified endografts are mainly used in urgent cases of aortic disease as an alternative to high-risk open surgical repair or in difficult anatomical configurations. METHOD: We present our initial experiences with physician-modified stent graft implantation. RESULTS: A 75-year-old male patient was admitted with a 50 mm saccular infrarenal aortic aneurysm. However, the diameter of the proximal sealing zone was significantly larger than that of the distal sealing zone, so we decided to use an iliac limb stent graft with reverse mounting resulting in an upside-down configuration to accommodate this diameter mismatch. A similar approach was used to treat a 67-year-old male patient with a 65 mm right common iliac artery aneurysm. An 81-year-old female patient was admitted with a type I endoleak associated with an aorto-uni-iliac endograft. The wide juxtarenal aortic diameter together with the short distance between the superior mesenteric artery and the proximal end of the previously deployed uni-iliac graft made the patient unsuitable for conventional endovascular repair, thus the distal 3 cm was cut from a standard thoracic stent graft and the device was reloaded. The modified graft was positioned below the superior mesenteric artery, while renal perfusion was secured by a chimney graft. Technical success was obtained in all three cases. CONCLUSION: The available toolkit of endovascular aortic surgery is generally suitable for the treatment of patients with typical anatomy. In elective cases of patients with unusual anatomy, or in urgent cases with complex aortic pathologies, physician-modified endovascular graft implantation can be used effectively. Orv Hetil. 2022; 163(3): 109-115.


Assuntos
Endometriose , Médicos , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Artéria Ilíaca , Rim , Masculino
7.
Afr J Paediatr Surg ; 19(2): 83-88, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35017377

RESUMO

Background: Over the last two decades, there has been significant improvement in the outcomes of children with Wilms' tumour (WT) in high income countries (HICs) with approximately 85% survival rate globally. This is partly attributable to a multi-disciplinary team approach to care and the evolution of more robust treatment measures. A previous review in our centre prior to multi-disciplinary team shows a survival rate of 31.48%, However, the survival rates from low- and middle-income countries are still low when compared to HICs due to delays in access to care at all levels, poor to non-existent health insurance coverage, limited workforce resources, weak health-care systems and infrastructure. The aim of this study is to determine the impact of a multi-disciplinary team approach on the treatment outcomes of children with WT. Methodology: This is a 5-year retrospective review of all patients managed with WT at the Lagos University Teaching Hospital, Lagos, Nigeria. Information was extracted from the patients' case notes, operation notes and ward admission records. The data were analysed with SPSS 25, and P < 0.05 was considered to be statistically significant. Results: Forty patients were included in the study; male to female ratio was 1.6:1. The disease occurred in the right kidney in 23 patients (57.5%) and on the left in 17 patients (42.5%). The average duration of symptoms before presentation was 3.6 months (range 1-7 months), majority of patients presented with abdominal masses and were assessed as per unit protocol with abdominal Computerized tomography scan, chest X-ray and abdominal ultrasound scan to assign the patient International Society of Paediatric oncology regimen. The predominant stage at surgery was Stage III 26 (65%), while Stage IV was 9 (22.5%). Morbidity after chemotherapy was 10 (25%). Twenty-five patients (63%) completed chemotherapy while 15 patients (37%) started chemotherapy but defaulted midway. The 5-year survival rate was 75%. Increasing age and male sex were associated with reduced odds of mortality; however, this was not statistically significant. Increased duration of treatment, being treated with chemotherapy alone, as well as advanced tumour stage and histology were associated with increased odds of mortality, however, this was not statistically significant. Conclusion: The development of an institutional WT treatment pathway involving a multidisciplinary team has resulted in improved outcomes. There is need for increased community awareness to improve the time to presentation.


Assuntos
Neoplasias Renais , Tumor de Wilms , Feminino , Humanos , Lactente , Rim , Neoplasias Renais/terapia , Masculino , Nigéria , Estudos Retrospectivos , Tumor de Wilms/terapia
8.
Environ Int ; 158: 107018, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34991270

RESUMO

In 2011, phthalates, mainly di-(2-ethylhexyl) phthalate (DEHP), were found to have been added to a variety of foods in Taiwan, increasing the risk of microalbuminuria in children. Exposure to melamine perhaps modifies that risk. This prospective cohort study investigates whether renal injury resulting from exposure to DEHP-tainted foods from the 2011 Taiwan Food Scandal is reversed over time. The temporal and interactive effects of past daily DEHP intake, current daily DEHP intake, and urinary melamine levels on oxidative stress and renal injury were also examined. Two hundred possibly DEHP-affected children (aged < 18 years) were enrolled in the first survey wave (August 2012-January 2013), with 170 and 159 children in the second (July 2014-February 2015) and third waves (May 2016-October 2016), respectively. The first wave comprised questionnaires that were used to collect information about possible past daily DEHP intake from DEHP-tainted foods. One-spot first morning urine samples were collected to measure melamine levels, phthalate metabolites, and markers indicating oxidative stress (malondialdehyde and 8-oxo-2'-deoxyguanosine), and renal injury (albumin/creatinine ratio (ACR) and N-acetyl-beta-D-glucosaminidase) in all three waves. Generalized estimating equation (GEE) modeling revealed that both past daily DEHP intake and time might affect urinary ACR. However, most interactions were negative and significant correlation was observed only during the second wave (P for interaction = 0.014) in the group with the highest past daily DEHP intake (>50 µg/kg/day). Urinary melamine levels were found to correlate significantly with both urinary ACR and oxidative stress markers. The highest impact associated with exposure to DEHP-tainted foods in increasing urinary ACR of children was observed during the first wave, and the effect may partially diminish over time. These results suggest that continuous monitoring of renal health and other long-term health consequences is required in individuals who were affected by the scandal in 2011.


Assuntos
Dietilexilftalato , Ácidos Ftálicos , Criança , Dietilexilftalato/toxicidade , Exposição Ambiental/efeitos adversos , Contaminação de Alimentos , Humanos , Rim/química , Estresse Oxidativo , Estudos Prospectivos , Taiwan , Triazinas
9.
Trials ; 23(1): 18, 2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-34991694

RESUMO

BACKGROUND: One of the main effectors on the quality of life of living-kidney donors is postoperative fatigue. Caloric restriction (CR) and short-term fasting (STF) are associated with improved fitness and increased resistance to acute stress. CR/STF increases the expression of cytoprotective genes, increases immunomodulation via increased anti-inflammatory cytokine production, and decreases the expression of pro-inflammatory markers. As such, nutritional preconditioning by CR or STF represents a non-invasive and cost-effective method that could mitigate the effects of acute surgery-induced stress and postoperative fatigue. To investigate whether preoperative STF contributes to a reduction in fatigue after living-kidney donation, a randomized clinical trial is indicated. METHODS: We aim to determine whether 2.5 days of fasting reduces postoperative fatigue score in subjects undergoing living-kidney donation. In this randomized study, the intervention group will follow a preoperative fasting regime for 2.5 days with a low-dose laxative, while the control group will receive standard care. The main study endpoint is postoperative fatigue, 4 weeks after living-kidney donation. Secondary endpoints include the effect of preoperative fasting on postoperative hospital admission time, the feasibility of STF, and the postoperative recovery of donor and recipient kidney function. This study will provide us with knowledge of the feasibility of STF and confirm its effect on postoperative recovery. DISCUSSION: Our study will provide clinically relevant information on the merits of caloric restriction for living-kidney donors and recipients. We expect to reduce the postoperative fatigue in living-kidney donors and improve the postoperative recovery of living-kidney recipients. It will provide evidence on the clinical merits and potential caveats of preoperative dietary interventions. TRIAL REGISTRATION: Netherlands Trial Register NL9262 . EudraCT 2020-005445-16 . MEC Erasmus MC MEC-2020-0778. CCMO NL74623.078.21.


Assuntos
Transplante de Rim , Qualidade de Vida , Jejum , Humanos , Rim/cirurgia , Transplante de Rim/efeitos adversos , Doadores Vivos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
In Vivo ; 36(1): 206-211, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34972716

RESUMO

BACKGROUND/AIM: This study performed 99mTc-MAG3 renal scintigraphy on rabbit kidneys and evaluated its ability to identify obstructive or non-obstructive kidneys. MATERIALS AND METHODS: Renal function was assessed during a four-week post-obstruction period by obtaining planar images of 99mTc-MAG3 activity following an ear vein injection. The individual renal function was evaluated by renal scintigraphy in conjunction with histopathological and morphological examinations. RESULTS: The renal perfusion of 99mTc-MAG3 in the right kidney with a ureteral obstruction decreased with time. The width, height, and cortical thickness of the obstructed right kidney were significantly larger than those of the left kidney. A histopathological examination four weeks after the ureteral obstruction revealed a typical pattern of urinary tract obstruction, including multiple tubules, enlargement of the interstitial area, and cytoplasmic vacuoles. CONCLUSION: 99mTc-MAG3 renal scintigraphy provides the kidney shape and size and can identify potential obstructive and non-obstructive kidneys in rabbits.


Assuntos
Renografia por Radioisótopo , Obstrução Ureteral , Animais , Rim/diagnóstico por imagem , Rim/fisiologia , Coelhos , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Mertiatida , Obstrução Ureteral/diagnóstico por imagem
11.
J Synchrotron Radiat ; 29(Pt 1): 214-223, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34985438

RESUMO

Renal oxalosis is a rare cause of renal failure whose diagnosis can be challenging. Synchrotron deep ultraviolet (UV) fluorescence was assayed to improve oxalosis detection on kidney biopsies spatial resolution and sensitivity compared with the Fourier transform infrared microspectroscopy gold standard. The fluorescence spectrum of synthetic mono-, di- and tri-hydrated calcium oxalate was investigated using a microspectrometer coupled to the synchrotron UV beamline DISCO, Synchrotron SOLEIL, France. The obtained spectra were used to detect oxalocalcic crystals in a case control study of 42 human kidney biopsies including 19 renal oxalosis due to primary (PHO, n = 11) and secondary hyperoxaluria (SHO, n = 8), seven samples from PHO patients who received combined kidney and liver transplants, and 16 controls. For all oxalocalcic hydrates samples, a fluorescence signal is detected at 420 nm. These spectra were used to identify standard oxalocalcic crystals in patients with PHO or SHO. They also revealed micrometric crystallites as well as non-aggregated oxalate accumulation in tubular cells. A nine-points histological score was established for the diagnosis of renal oxalosis with 100% specificity (76-100) and a 73% sensitivity (43-90). Oxalate tubular accumulation and higher histological score were correlated to lower estimated glomerular filtration rate and higher urinary oxalate over creatinine ratio.


Assuntos
Oxalato de Cálcio , Síncrotrons , Estudos de Casos e Controles , Humanos , Rim/diagnóstico por imagem , Microscopia de Fluorescência
12.
Int J Immunogenet ; 49(1): 46-62, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34919330

RESUMO

INTRODUCTION: Kidney dysfunction is a highly significant disease, both in the United Kingdom and globally. Many previous studies have reported associations between human leukocyte antigens (HLA) and renal function; this systematic review attempts to identify, summarize and appraise all published studies of these associations. METHODS: A literature search was performed using Medline, Embase and Cochrane Central Register of Controlled Trials to identify papers whose keywords included each of the following concepts: HLA, renal failure and genetic association. A total of 245 papers were identified and assessed for eligibility; 35 of these were included in the final study. RESULTS: A total of 95 HLA types and 14 three-locus haplotypes were reported to be associated with either increased or decreased renal function. A number of these findings were replicated by independent studies that reported 16 types were protective against renal dysfunction and 15 types were associated with reduced renal function. A total of 20 HLA types were associated with both increased risk of renal disease and decreased risk by independent studies. DISCUSSION: There is very little consensus on which HLA types have a protective or deleterious effect on renal function. Ethnicity may play a role, with HLA types possibly having different effects among different populations, and it is possible that the different primary diseases that lead to ESRD may have different HLA associations. Some of the studies may contain type I and type II errors caused by insufficient sample sizes, cohort selection and statistical methods. Although we have compiled a comprehensive list of published associations between renal function and HLA, in many cases, it is unclear which associations are reliable. Further studies are required to confirm or refute these findings.


Assuntos
Antígenos HLA , Haplótipos , Humanos , Rim/fisiologia , Reino Unido
13.
J Asian Nat Prod Res ; 24(1): 76-87, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34937462

RESUMO

Renal fibrosis is a critical pathological process lead to a progressive loss of renal function. Jolkinolide B (JB) is a natural compound with anti-inflammatory activity from Euphorbia fischeriana Steud. The study evaluated the effect of JB on renal fibrosis in mice with unilateral ureteral obstruction (UUO). The results showed that JB could decrease renal fibrotic area, reduce phosphorylation of NF-κB p65 and the release of TNF-α, IL-6 and IL-1ß, restore the expression of vementin, α-SMA and E-cadherin, as well as TGF-ß1 and p-smad2/3. In conclusion, JB might reduce renal fibrosis by inhibiting inflammation induced by NF-κB pathway and EMT mediated by TGF-ß1/Smad pathway.


Assuntos
Obstrução Ureteral , Animais , Anti-Inflamatórios/farmacologia , Diterpenos , Transição Epitelial-Mesenquimal , Fibrose , Rim/patologia , Camundongos , Estrutura Molecular , Transdução de Sinais , Fator de Crescimento Transformador beta1/farmacologia , Fator de Crescimento Transformador beta1/uso terapêutico , Obstrução Ureteral/tratamento farmacológico , Obstrução Ureteral/patologia
14.
Clin Chim Acta ; 525: 23-28, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34906559

RESUMO

BACKGROUND: PAX2-related disorder is an autosomal dominant disorder characterized by renal and eye abnormalities. Some patients may present with isolated renal abnormalities without obvious ocular abnormalities. It is associated with mutations in paired box gene 2 (PAX2), which is one of the families of paired box transcription factor genes. Studies on mosaicism have been limited in PAX2-related disorder, as only three families with mosaic PAX2 mutations have been reported in the literature. METHODS: The proband with multicystic dysplastic kidneys from a Chinese family was recruited in our study. Detailed clinical symptoms were enquired. Trio-based whole exome sequencing (WES), SNP array, sanger sequencing and droplet digital PCR (ddPCR) were used to characterize etiology in the proband. Prenatal diagnosis was performed through amniocentesis and prenatal ultrasound when the proband's mother was further pregnant at 20 weeks. RESULTS: A heterozygous missense mutation in PAX2 (c.194 T > C) was identified in the proband. His asymptomatic mother has the same mutation with somatic mosaicism ratio of 22%. The mutation was also detected in the fetus. Prenatal ultrasound showed that bilateral hyperechogenic kidneys with decrease of renal size. CONCLUSIONS: This is the first report on PAX2 mosaicism in a Chinese family. Identifying PAX2 mosaicism provides more evidence for estimating recurrence risk. Our findings have important implications on genetic counseling for patients with PAX2-related disorder and provide an effective diagnostic technology for mosaicism.


Assuntos
Nefropatias , Mosaicismo , Feminino , Humanos , Rim , Mutação , Fator de Transcrição PAX2/genética , Linhagem , Gravidez , Irmãos
15.
Life Sci ; 289: 120230, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34919900

RESUMO

The application of atmospheric pressure low-temperature plasma (LTP) in medical treatment has received extensive attention owing to its redox regulatory and anti-inflammatory properties. Nephrotoxicity due to oxidative stress and inflammation is the main adverse effect of cisplatin. In the present study, rats with cisplatin-induced nephrotoxicity were treated with LTP to investigate its potential protective effect. The results showed that LTP treatment has multiple protective effects on cisplatin-induced nephrotoxicity. It significantly improved clinical indicators such as survival rate, water intake, food intake, body weight, and mobility, as well as physiological indexes such as reduced renal index and levels of serum urea, creatinine, and total bilirubin; pathological indicators such as reduced tubular injury, inflammatory infiltration, tubulointerstitial fibrosis, and apoptosis; cell survival indicators such as decreased protein levels of Caspase-3 and Bax and increased Bcl-2; anti-oxidation status such as reduced malondialdehyde content and increased activities of catalase, superoxide dismutase, and glutathione peroxidase; and reduced inflammatory factors such as TNF-α in kidney tissues. Specially, LTP treatment did not influence the anticancer effect of cisplatin as observed in the solid tumor mouse model established by subcutaneously inoculating H22 cells. Moreover, LTP did not influence the physiological and pathological indicators of normal rats, suggesting its biological safety. In conclusion, LTP can protect against cisplatin-induced nephrotoxicity through its anti-oxidation, anti-inflammation, and anti-apoptosis effects, without influencing the anticancer effect of cisplatin.


Assuntos
Cisplatino , Regulação da Expressão Gênica/efeitos dos fármacos , Nefropatias , Rim , Gases em Plasma/farmacologia , Animais , Linhagem Celular Tumoral , Cisplatino/efeitos adversos , Cisplatino/farmacologia , Rim/metabolismo , Rim/patologia , Nefropatias/induzido quimicamente , Nefropatias/metabolismo , Nefropatias/patologia , Nefropatias/prevenção & controle , Masculino , Camundongos , Camundongos Endogâmicos ICR , Neoplasias Experimentais/tratamento farmacológico , Neoplasias Experimentais/metabolismo , Neoplasias Experimentais/patologia , Ratos , Ratos Wistar
16.
Life Sci ; 289: 120237, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34922942

RESUMO

Tadalafil, a phosphodiesterase-5 (PDE5) inhibitor, shown to exert a protection to heart failure (HF) associated damage or lower urinary tract symptoms (LUTS). Thus, we investigated the contribution of tadalafil chronic treatment in the alterations of LUTS in HF rats. Male rats were subjected to aortocaval fistula model for HF induction. Echocardiography, cystometric, renal function and redox cell balance, as well as concentration-response curves to carbachol, KCl, ATP and frequency-response curves to electrical field stimulation (EFS) were evaluated in Sham, HF, Tadalafil and HF-Tadalafil (12 weeks endpoint) groups. HF group to present increased in left-ventricle (LV) mass and in LV end-diastolic- and LV end-systolic volume, with a decreased ejection fraction. Tadalafil treatment was able to decrease in hypertrophy and improve the LV function restoring cardiac function. For micturition function (in vivo), HF animals shown an increase in basal pressure, threshold pressure, no-voiding contractions and decreased bladder capacity, being that the tadalafil treatment restored the cystometric parameters. Contractile mechanism response (in vitro) to carbachol, KCl, ATP and EFS in the detrusor muscles (DM) were increased in the HF group, when compared to Sham group. However, tadalafil treatment restored the DM hypercontractility in the HF animals. Moreover, renal function as well as the oxidative mechanism was impaired in the HF animals, and the tadalafil treatment improved all renal and oxidative parameters in HF group. Our data shown that tadalafil has potential as multi-therapeutic drug and may be used as a pharmacological strategy for the treatment of cardiovascular, renal and urinary dysfunctions associated with HF.


Assuntos
Insuficiência Cardíaca , Rim , Sintomas do Trato Urinário Inferior , Tadalafila/farmacologia , Bexiga Urinária , Animais , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Rim/metabolismo , Rim/fisiopatologia , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/metabolismo , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Oxirredução/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Bexiga Urinária/metabolismo , Bexiga Urinária/fisiopatologia
17.
FASEB J ; 36(1): e22122, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34958158

RESUMO

Lysine-specific histone demethylase 1 (LSD1) as the first identified histone/lysine demethylase regulates gene expression and protein functions in diverse diseases. In this study, we show that the expression of LSD1 is increased in mouse kidneys with unilateral ureteral obstruction (UUO) and in cultured NRK-52E cells undergoing TGF-ß1-induced epithelial-mesenchymal transition (EMT). Inhibition of LSD1 with its specific inhibitor ORY1001 attenuated renal EMT and fibrosis, which was associated with decreased the deposition of extracellular matrix proteins and the expression of fibrotic markers, including α-smooth muscle actin (α-SMA) and fibronectin, and the recovery of E-cadherin expression and decrease of N-cadherin expression in UUO kidneys and in NRK-52E cells induced with TGF-ß1. Targeting LSD1 also decreased the expression of Snail family transcriptional repressor 1 (Snail-1) and its interaction with LSD1 in UUO kidneys and in NRK-52E cells treated with TGF-ß1. In addition, we identified a novel LSD1-14-3-3ζ-PKCα axis in the regulation of the activation of AKT and Stat3 and then the activation of fibroblasts. This study suggests that LSD1 plays a critical role in regulation of renal EMT and fibrosis through activation of diverse signaling pathways and places an emphasis that LSD1 has potential as a therapeutic target for the treatment of renal fibrosis.


Assuntos
Sistemas de Liberação de Medicamentos , Inibidores Enzimáticos/farmacologia , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Histona Desmetilases , Rim/enzimologia , Animais , Linhagem Celular , Transição Epitelial-Mesenquimal/genética , Fibrose , Histona Desmetilases/antagonistas & inibidores , Histona Desmetilases/genética , Histona Desmetilases/metabolismo , Nefropatias/tratamento farmacológico , Nefropatias/enzimologia , Nefropatias/genética , Masculino , Camundongos , Ratos
18.
Biol Trace Elem Res ; 200(1): 206-216, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33547999

RESUMO

T-2 toxin is produced by the Fusarium genus. Ingestion of food or feed contaminated by T-2 toxin will cause damage to kidney. Selenium (Se), an essential trace element, showed the significant protective effects against kidney and renal cell damage induced by toxic substances. To explore the protective effects and mechanisms of Se against T-2-induced renal lesions, forty-eight male Kunming mice were exposed to T-2 toxin (1.0 mg/kg) and/or Se (0.2 mg/kg) for 28 days. In this study, we found that Se alleviated T-2-induced nephrotoxicity, presenting as increasing the body weight and kidney coefficient, relieving the renal structure injury, decreasing the contents of renal function-related biomarkers, decreasing the levels of reactive oxygen species (ROS), and increasing the mitochondrial membrane potential in T-2 toxin-treated mice. In addition, inhibition of renal cell apoptosis by Se was associated with blocking the mitochondrial pathway in T-2 toxin-treated mice, presenting as decreasing the protein expression of cytochrome-c, activities of caspase-3/9, as well as regulating the protein and mRNA expressions of Bax and Bcl-2. These results documented that the alleviating effect of Se on T-2-induced nephrotoxicity is related to the inhibition of ROS-mediated renal apoptosis.


Assuntos
Selênio , Animais , Apoptose , Rim/metabolismo , Masculino , Potencial da Membrana Mitocondrial , Camundongos , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Selênio/metabolismo , Selênio/farmacologia
19.
Chemosphere ; 286(Pt 1): 131706, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34346322

RESUMO

Due to the use of di-isobutyl-phthalate (DiBP) in the production of soft-polyvinyl chloride articles, it is currently a hazardous substance prevalent in human daily life. However, reports on DiBP's toxicokinetics are still very scarce. And no studies have been reported on gender differences in DiBP toxicokinetics. Therefore, this study was conducted in accordance with these research needs. DiBP of 100 mg/kg has been exposed to male and female rats single or multiple times. DiBP and its major metabolite, mono-isobutyl-phthalate (MiBP), were quantified from various biological samples obtained from rats administered with DiBP. Based on these results, several toxicokinetic parameters were estimated. Toxicokinetic results between genders were compared, and from this, existence and extent of gender differences in DiBP's toxicokinetics were explored. Investigation of presence and extent of subacute toxicity in male and female rats following multiple exposures to DiBP were also conducted. This study provided comprehensive information on DiBP toxicity and gender differences that have not been reported in detail. Results of these studies imply that subacute toxicity in liver, kidney, lung, and testis of rats at 100 mg/kg of DiBP is modest and that there is little difference in toxicokinetics between genders. And in both male and female rats, the metabolism of DiBP (to MiBP) was significant, and excretion of MiBP into urine was a major indicator of DiBP exposure.


Assuntos
Poluentes Ambientais , Ácidos Ftálicos , Animais , Exposição Ambiental , Feminino , Rim , Masculino , Ácidos Ftálicos/toxicidade , Ratos , Fatores Sexuais , Testículo , Toxicocinética
20.
Environ Res ; 204(Pt A): 112014, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34506780

RESUMO

BACKGROUND: Early-life renal maturation is susceptible to nephrotoxic environmental chemicals. Given the widespread consumption of fluoride and the global obesity epidemic, our main aim was to determine whether childhood fluoride exposure adversely affects kidney function in preadolescence, and if adiposity status modifies this association. METHODS: Our study included 438 children from the PROGRESS cohort. Urinary fluoride (uF) was assessed at age 4 by diffusion analysis; outcomes studied included estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), selected kidney proteins and blood pressure measured at age 8-12 years. We modeled the relationship between uF and outcomes, and adjusted for body mass index (BMI), age, sex, and socioeconomic status. RESULTS: The median uF concentration was 0.67 µg/mL. We observed null associations between 4-year uF and preadolescent eGFR, although effect estimates were in the expected inverse direction. A single unit increase in ln-transformed uF was associated with a 2.2 mL/min decrease in cystatin C-based eGFR (95% CI: 5.8, 1.4; p = 0.23). We observed no evidence of sex-specific effects or effect modification by BMI status. Although uF was not associated with BMI, among children with obesity, we observed an inverse association (ß: 4.8; 95% CI: 10.2, 0.6; p = 0.08) between uF and eGFR. CONCLUSIONS: Low-level fluoride exposure in early childhood was not associated with renal function in preadolescence. However, given the adverse outcomes of chronic fluoride consumption it is possible that the preadolescent age was too young to observe any effects. Longitudinal follow-up in this cohort and others is an important next step.


Assuntos
Fluoretos , Rim , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Fluoretos/toxicidade , Taxa de Filtração Glomerular , Humanos , Testes de Função Renal , Masculino
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