Pancake kidney in a patient with chronic kidney disease: A unique presentation.

Pancake kidney is one of the least common renal fusion anomalies encountered in medical practice. Less than 30 cases of this renal variant have been reported in the medical literature. Patients are generally asymptomatic, with the diagnosis of pancake kidney usually found incidentally on imaging study or autopsy. Given the rarity of reported cases, it is difficult to establish a relationship with specific associated clinical findings. Asymptomatic patients are managed conservatively with regular follow-up. We present the case of a 69-year-old female who was found to have pancake kidney, several renal cysts, and chronic kidney disease (CKD). No other reported cases have the diagnosis of CKD.

Lipid Rafts and Dopamine Receptor Signaling.

The renal dopaminergic system has been identified as a modulator of sodium balance and blood pressure. According to the Centers for Disease Control and Prevention, in 2018 in the United States, almost half a million deaths included hypertension as a primary or contributing cause. Renal dopamine receptors, members of the G protein-coupled receptor family, are divided in two groups: D1-like receptors that act to keep the blood pressure in the normal range, and D2-like receptors with a variable effect on blood pressure, depending on volume status. The renal dopamine receptor function is regulated, in part, by its expression in microdomains in the plasma membrane. Lipid rafts form platforms within the plasma membrane for the organization and dynamic contact of molecules involved in numerous cellular processes such as ligand binding, membrane sorting, effector specificity, and signal transduction. Understanding all the components of lipid rafts, their interaction with renal dopamine receptors, and their signaling process offers an opportunity to unravel potential treatment targets that could halt the progression of hypertension, chronic kidney disease (CKD), and their complications.