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Sample records for chronic renal allograft

  1. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  2. Leukocytic acetylcholine in chronic rejection of renal allografts

    OpenAIRE

    Wilczynska, Joanna

    2011-01-01

    Leukocytes, which accumulate in graft blood vessels during fatal acute rejection of experimental renal allografts, synthesise and release acetylcholine (ACh). In this study, I tested the hypothesis that ACh produced by leukocytes accumulating in graft blood vessels contributes to the pathogenesis of chronic renal allograft vasculopathy (CAV). Kidneys were transplanted in the allogeneic Fischer 344 to Lewis rat strain combination. Isogeneic transplantations were performed in Lew...

  3. Expression of GSK-3β in renal allograft tissue and its significance in pathogenesis of chronic allograft dysfunction

    Directory of Open Access Journals (Sweden)

    Yan Qiang

    2012-01-01

    Full Text Available Abstract Objective To explore the expression of Glycogen synthase kinase 3 beta (GSK-3β in renal allograft tissue and its significance in the pathogenesis of chronic allograft dysfunction. Methods Renal allograft biopsy was performed in all of the renal allograft recipients with proteinuria or increased serum creatinine level who came into our hospital from January 2007 to December 2009. Among them 28 cases was diagnosed as chronic allograft dysfunction based on pahtological observation, including 21 males with a mean age of 45 ± 10 years old and 7 females with a mean age of 42 ± 9 years old. The time from kidney transplantation to biopsy were 1-9 (3.5 years. Their serum creatinine level were 206 ± 122 umol/L. Immunohistochemical assay and computer-assisted genuine color image analysis system (imagepro-plus 6.0 were used to detect the expression of GSK-3β in the renal allografts of 28 cases of recipients with chronic allograft dysfunction. Mean area and mean integrated optical density of GSK-3β expression were calculated. The relationship between expression level of GSK-3β and either the grade of inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft was analyzed. Five specimens of healthy renal tissue were used as controls. Results The expression level of the GSK-3β was significantly increased in the renal allograft tissue of recipients with chronic allograft dysfunction, compared to normal renal tissues, and GSK-3β expression became stronger along with the increasing of the grade of either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy in renal allograft tissue. Conclusion There might be a positive correlation between either inflammatory cell infiltration or interstitial fibrosis/tubular atrophy and high GSK-3β expression in renal allograft tissue. Virtual slides The virtual slide(s for this article can be found here: http

  4. Doppler Ultrasound in Chronic Renal Allograft Dysfunction : Can Acute Rejection be Predicted

    International Nuclear Information System (INIS)

    To investigate Doppler sonographic findings valuable for detecting acute rejection in transplanted kidney with chronic allograft dysfunction. Forty-three renal allografts who underwent renal Doppler sonography and renal biopsy due to chronic allograft dysfunction were included. According to histopathologic findings, patients were classified into 2 groups: chronic component only(group 1, n=30) and acute rejection with or without chronic component 2 groups were performed. No definite difference in radio of renal size, cortical echogenecity, corticomedullary differentiation was noted between group 1 and group 2.Resistive index was 0.61±0.18 in group 1 and 0.64±0.22 in group 2, which showed no statistically significant difference. Characteristic Doppler sonographic findings suggesting acute rejection in cases of chronic allograft dysfunction were not found inauther's study. Therefore, minimal invasive renal biopsy to determine histopathologic status of transplanted kidney is essential in evaluation of the chronic allograft dysfunction

  5. Characteristics of cadaveric renal allograft recipients developing chronic rejection.

    OpenAIRE

    Foster, M. C.; Rowe, P. A.; Dennis, M J; Morgan, A G; Burden, R. P.; Blamey, R. W.

    1990-01-01

    As the early results of renal transplantation improve, chronic rejection is increasing in relative importance as a cause of graft loss. The aetiology of the condition is unknown. In order to identify possible predisposing factors, the characteristics of 22 patients with chronic rejection were compared with those of 50 patients with stable graft function 2 years or more after transplantation. Patients with chronic rejection had significantly more acute rejection episodes in the first 6 months ...

  6. Nanoparticle Enhanced MRI Scanning to Detect Cellular Inflammation in Experimental Chronic Renal Allograft Rejection

    Directory of Open Access Journals (Sweden)

    S. R. Alam

    2015-01-01

    Full Text Available Objectives. We investigated whether ultrasmall paramagnetic particles of iron oxide- (USPIO- enhanced magnetic resonance imaging (MRI can detect experimental chronic allograft damage in a murine renal allograft model. Materials and Methods. Two cohorts of mice underwent renal transplantation with either a syngeneic isograft or allograft kidney. MRI scanning was performed prior to and 48 hours after USPIO infusion using T2∗-weighted protocols. R2∗ values were calculated to indicate the degree of USPIO uptake. Native kidneys and skeletal muscle were imaged as reference tissues and renal explants analysed by histology and electron microscopy. Results. R2∗ values in the allograft group were higher compared to the isograft group when indexed to native kidney (median 1.24 (interquartile range: 1.12 to 1.36 versus 0.96 (0.92 to 1.04, P<0.01. R2∗ values were also higher in the allograft transplant when indexed to skeletal muscle (6.24 (5.63 to 13.51 compared to native kidney (2.91 (1.11 to 6.46 P<0.05. Increased R2∗ signal in kidney allograft was associated with macrophage and iron staining on histology. USPIO were identified within tissue resident macrophages on electron microscopy. Conclusion. USPIO-enhanced MRI identifies macrophage.

  7. Chronic Renal Allograft Dysfunction Antibody-Mediated: An Update

    Directory of Open Access Journals (Sweden)

    Maurizio Salvadori,

    2014-07-01

    Full Text Available This paper reviews the most important studies on chronic antibody-mediated rejection (cABMR, which is an important cause of late graft dysfunction after renal transplantation. Several antibodies seem to be responsible for chronic rejection; new techniques have allowed us to identify these antibodies in circulation. The pathogenetic role of the antibodies generally includes the complement pathway, but may also be complement-independent. This paper also examines the pathogenesis of chronic endothelial lesions, as well as the histopathological aspects. Antibodies responsible for chronic rejection may preexist before transplantation or may develop after transplantation. The possible therapeutic approaches are poor and principally based on early identification and desensitisation techniques. New B cell targeting drugs are aimed at an improved control of the relevant condition.

  8. Antibody Response Against Perlecan and Collagen Types IV and VI in Chronic Renal Allograft Rejection in the Rat

    OpenAIRE

    Joosten, Simone A.; van Dixhoorn, Mieneke G. A.; Borrias, Maria C.; Benediktsson, Hallgrimur; van Veelen, Peter A.; van Kooten, Cees; Paul, Leendert C.

    2002-01-01

    Chronic rejection is the leading cause of late renal transplant failure. Various structural lesions are observed in grafts undergoing chronic rejection including glomerular basement membrane (GBM) duplications. The well-established Fisher (F344) to Lewis (LEW) rat renal transplant model for chronic rejection was used to assess the presence and role of the humoral immune response against graft antigens during chronic rejection. LEW recipients of F344 allografts develop transplant glomerulopath...

  9. Stage-to-stage progression of chronic kidney disease in renal transplantation with chronic allograft dysfunction

    Directory of Open Access Journals (Sweden)

    Khalkhali H

    2009-11-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Although the short-term results of kidney transplantation have improved greatly during the past decades, the long-term results have not improved according. Graft loss due to chronic allograft dysfunction (CAD is a major concern in renal transplant recipients (RTRs. There is little data about disease progression in this patient population. In this paper, we investigated history of kidney function as the pattern, waiting time and rate of pass from intermediate stages in RTR with CAD."n"nMethods: In a single-center retrospective study, 214 RTRs with CAD investigated at the Urmia University Hospital urmia, Iran from 1997 to 2005. Kidney function at each visit assessed with GFR. We apply NKF and K/DOQI classification of chronic kidney disease (CKD staging system to determine pattern of disease progression per stage in this group of patients. "n"nResults: The pure death-censored graft loss was 26% with mean waiting time 81.7 months. 100% of RTRs passed from stage I to II in mean waiting time 26.3 months. The probability of prognostic factors transition from stage II to III was 88.9% with mean waiting time 25.5 months, transition from III to IV was 55.7% with mean waiting time of 24.9 months and transition for

  10. Relationship between European Mitochondrial Haplogroups and Chronic Renal Allograft Rejection in Patients with Kidney Transplant

    Science.gov (United States)

    JIMÉNEZ-SOUSA, María Angeles; TAMAYO, Eduardo; GUZMÁN-FULGENCIO, María; FERNÁNDEZ-RODRÍGUEZ, Amanda; HEREDIA-RODRIGUEZ, María; GARCÍA-ÁLVAREZ, Mónica; BERMEJO-MARTIN, Jesús F; PINEDA-TENOR, Daniel; RUIZ-GRANADO, Patricia; ALVAREZ-FUENTE, Elisa; GÓMEZ-SANCHEZ, Esther; GÓMEZ-HERRERAS, José I; RESINO, Salvador

    2014-01-01

    Mitochondrial DNA variants may contribute to differences in mitochondrial function, leading to an altered immune system. The aim of this study was to analyze the relationship between mtDNA haplogroups and the development of chronic allograft dysfunction in patients with kidney transplant. A retrospective observational study was carried out on 261 patients who received kidney transplant (114 had stable transplant and 147 patients developed chronic allograft dysfunction). DNA samples were genotyped for 14 mtDNA polymorphisms by using Sequenom's MassARRAY platform (San Diego, CA, USA). Only European white patients within the N macro-cluster were included. Patients with haplogroups V (odds ratio (OR)=0.32; p=0.037) and J (OR=0.36; p=0.038) showed lower odds for developing CRAD than patients with haplogroup H. After adjusting for the most significant variables, haplogroups V and J tended to statistical significance (p=0.091 and p=0.067 respectively). This is a preliminary study in which mtDNA haplogroups seem to be implicated in susceptibility or protection for developing chronic allograft dysfunction. PMID:25170295

  11. Determinants of long-term renal allograft outcome

    NARCIS (Netherlands)

    Leeuwen-Artz, M.A.

    2005-01-01

    Long-term renal allograft survival is markedly affected by premature death with a functioning graft, chronic allograft nephropathy, and recurrence of the original kidney disease. To improve long-term graft survival, focus is shifting from the prevention of acute rejections to the recognition and tre

  12. Allograft renal rejection and chemokine polymorphism

    Directory of Open Access Journals (Sweden)

    Y Gorgi

    2011-01-01

    Full Text Available Chemokines play a major role in the process by which leukocytes are recruited from the bloodstream into the sites of inflammation. Genes for the chemokine receptors CCR5, CCR2 and MCP-1 are characterized by functional polymorphisms implicated in transplant rejection. To investigate this association, we analyzed polymorphisms of CCR5-∆32, CCR5-59029-A/G, CCR2-V64I and MCP-1 G/A (-2518 in 173 renal transplant recipients and 169 healthy blood donors. The patients were classified in two groups: Group-1 (G-1 included 33 HLA-identical recipients and Group-2 (G-2 included 140 (one or more mismatched graft recipients. Forty-two patients had developed acute rejection episodes (ARs: seven in G-1 and 35 in G-2. Thirteen G-2 patients developed chronic allograft dysfunction (CAD. The genotypic and allelic frequencies of all polymorphisms studied did not reveal significant differences between patients and controls and among G-1 and G-2 recipients. However, a significant risk of acute renal transplant rejection was found in G-1 patients who possessed the CCR2-64I allele (odds ratio 0.24, 95% confidence inter-val [CI], 0.05-1.06; P = 0.035. There was no significant association of this polymorphism and CAD. In conclusion, the observed association of CCR2-64I with AR should be added to the spectrum of immunogenetic factors known to be involved in allograft renal loss.

  13. Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

    DEFF Research Database (Denmark)

    Kneifel, M; Scholze, A; Burkert, A;

    2006-01-01

    It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...... photoplethysmography. Mean age was 51 +/- 2 years (mean +/- SEM), and studies were performed 17 +/- 1 months after transplantation. The stage of chronic kidney disease was based on the glomerular filtration rate. We observed a significant association between the stage of chronic kidney disease and arterial stiffness...... of large arteries S1 and small arteries S2 in renal transplant recipients (each p older...

  14. Clinical renal allograft transplantation in a Dalmatian dog: case report.

    Science.gov (United States)

    Németh, T; Tóth, J; Balogh, L; Jánoki, G; Manczur, F; Vörös, K; Dallos, G

    1998-01-01

    A case of successful renal allograft transplantation performed in a two-year-old female Dalmatian dog suffering from end-stage chronic renal failure is reported. A one-year-old male German shepherd with severely injured spinal cord was used as kidney donor. Simultaneous kidney allograft transplantation combined with hypothermic initial perfusion as graft conservation was done, placing the donor kidney into the right iliac fossa of the recipient. The immunosuppression protocol consisted of prednisolone and azathioprine. Regular physical, laboratory, ultrasonographic and scintigraphic examinations were used for assessing both the morphology and the function of the allograft. After a two-week period of hospitalisation the patient was discharged in a remarkably improving condition. The recipient died on postoperative day 45 of respiratory insufficiency resulting from secondary pneumonia and pulmonary oedema. Neither macroscopic nor microscopic abnormalities of the allograft were revealed by necropsy. PMID:9704530

  15. Identification of β2-microglobulin as a urinary biomarker for chronic allograft nephropathy using proteomic methods.

    LENUS (Irish Health Repository)

    Johnston, Olwyn

    2011-08-01

    Chronic allograft nephropathy (CAN) remains the leading cause of renal graft loss after the first year following renal transplantation. This study aimed to identify novel urinary proteomic profiles, which could distinguish and predict CAN in susceptible individuals.

  16. Urinary calprotectin and posttransplant renal allograft injury

    DEFF Research Database (Denmark)

    Tepel, Martin; Borst, Christoffer; Bistrup, Claus;

    2014-01-01

    OBJECTIVE: Current methods do not predict the acute renal allograft injury immediately after kidney transplantation. We evaluated the diagnostic performance of urinary calprotectin for predicting immediate posttransplant allograft injury. METHODS: In a multicenter, prospective-cohort study of 144...... incipient renal transplant recipients, we postoperatively measured urinary calprotectin using an enzyme-linked immunosorbent assay and estimated glomerular filtration rate (eGFR) after 4 weeks, 6 months, and 12 months. RESULTS: We observed a significant inverse association of urinary calprotectin...... concentrations and eGFR 4 weeks after transplantation (Spearman r = -0.33; P<0.001). Compared to the lowest quartile, patients in the highest quartile of urinary calprotectin had an increased risk for an eGFR less than 30 mL/min/1.73 m2 four weeks after transplantation (relative risk, 4.3; P<0.001; sensitivity...

  17. Renal Allograft Rupture: A Clinicopathologic Review

    OpenAIRE

    Ramos, M.; Martins, L.; L. Dias; HENRIQUES, A.C.; Soares, J.; Queirós, J.; Sarmento, A M

    2000-01-01

    Transplantation Proceedings Volume 32, Issue 8, December 2000, Pages 2597-2598 -------------------------------------------------------------------------------- doi:10.1016/S0041-1345(00)01801-7 | How to Cite or Link Using DOI Copyright © 2000 Elsevier Science Inc. All rights reserved. Cited By in Scopus (4) Permissions & Reprints Renal allograft rupture: a clinicopathologic review M Ramosa, , L Martinsa, L Diasa, A.C Henriquesa, J Soaresa, J Queirósa and A.M ...

  18. Uremic escape of renal allograft rejection

    International Nuclear Information System (INIS)

    It is demonstrated in rats that, in the presence of early postoperative severe but transient uremia, the survival of first set Brown-Norway (BN) renal allografts in Lewis (LEW) recipients is at least three times prolonged when compared to non-uremic controls. This phenomenon is called 'uremic escape of renal allograft rejection'. By means of lethal X-irradiation of donors of BN kidneys transplanted into transiently uremic and non-uremic LEW recipients, the presence of passenger lymphocyte immunocompetence is demonstrated to be obilgatory for this phenomenon to occur. As a result of mobile passenger lymphocyte immunocompetence, a graft-versus-host (GVH) reaction is elicited in the spleens of LEW recipients of BN kidneys which amplifies the host response. The splenomegaly observed in LEW recipients of BN kidneys is caused not only by this GVH reaction, which is shown to be exquisitely sensitive to even mild uremia. It is also contributed to by a proliferative response of the host against the graft (which latter response is equated with an in vivo equivalent of a unilateral mixed lymphocyte reaction (MLR)), since the reduction in spleen weights caused by abrogation of mobile passenger lymphocyte immunocompetence brought about by lethal donor X-irradiation is increased significantly by early postoperative severe but transient uremia. It is concluded that in uremic escape of renal allograft rejection both reactions are suppressed by uremia during the early post-operative period. (Auth.)

  19. Urinary Calprotectin and Posttransplant Renal Allograft Injury

    Science.gov (United States)

    Bistrup, Claus; Marcussen, Niels; Pagonas, Nikolaos; Seibert, Felix S.; Arndt, Robert; Zidek, Walter; Westhoff, Timm H.

    2014-01-01

    Objective Current methods do not predict the acute renal allograft injury immediately after kidney transplantation. We evaluated the diagnostic performance of urinary calprotectin for predicting immediate posttransplant allograft injury. Methods In a multicenter, prospective-cohort study of 144 incipient renal transplant recipients, we postoperatively measured urinary calprotectin using an enzyme-linked immunosorbent assay and estimated glomerular filtration rate (eGFR) after 4 weeks, 6 months, and 12 months. Results We observed a significant inverse association of urinary calprotectin concentrations and eGFR 4 weeks after transplantation (Spearman r = −0.33; P<0.001). Compared to the lowest quartile, patients in the highest quartile of urinary calprotectin had an increased risk for an eGFR less than 30 mL/min/1.73 m2 four weeks after transplantation (relative risk, 4.3; P<0.001; sensitivity, 0.92; 95% CI, 0.77 to 0.98; specificity, 0.48; 95% CI, 0.31 to 0.66). Higher urinary calprotectin concentrations predicted impaired kidney function 4 weeks after transplantation, as well as 6 months and 12 months after transplantation. When data were analyzed using the urinary calprotectin/creatinine-ratio similar results were obtained. Urinary calprotectin was superior to current use of absolute change of plasma creatinine to predict allograft function 12 months after transplantation. Urinary calprotectin predicted an increased risk both in transplants from living and deceased donors. Multivariate linear regression showed that higher urinary calprotectin concentrations and older donor age predicted lower eGFR four weeks, 6 months, and 12 months after transplantation. Conclusions Urinary calprotectin is an early, noninvasive predictor of immediate renal allograft injury after kidney transplantation. PMID:25402277

  20. HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  1. Significance of Urinary Proteome Pattern in Renal Allograft Recipients

    Science.gov (United States)

    Suhail, Sufi M.

    2014-01-01

    Urinary proteomics is developing as a platform of urinary biomarkers of immense potential in recent years. The definition of urinary proteome in the context of renal allograft and characterization of different proteome patterns in various graft dysfunctions have led to the development of a distinct science of this noninvasive tool. Substantial numbers of studies have shown that different renal allograft disease states, both acute and chronic, could portray unique urinary proteome pattern enabling early diagnosis of graft dysfunction and proper manipulation of immunosuppressive strategy that could impact graft prognosis. The methodology of the urinary proteome is nonetheless not more complex than that of other sophisticated assays of conventional urinary protein analysis. Moreover, the need for a centralized database is also felt by the researchers as more and more studies have been presenting their results from different corners and as systems of organizing these newly emerging data being developed at international and national levels. In this context concept of urinary proteomics in renal allograft recipients would be of significant importance in clinical transplantation. PMID:24757556

  2. Significance of Urinary Proteome Pattern in Renal Allograft Recipients

    Directory of Open Access Journals (Sweden)

    Sufi M. Suhail

    2014-01-01

    Full Text Available Urinary proteomics is developing as a platform of urinary biomarkers of immense potential in recent years. The definition of urinary proteome in the context of renal allograft and characterization of different proteome patterns in various graft dysfunctions have led to the development of a distinct science of this noninvasive tool. Substantial numbers of studies have shown that different renal allograft disease states, both acute and chronic, could portray unique urinary proteome pattern enabling early diagnosis of graft dysfunction and proper manipulation of immunosuppressive strategy that could impact graft prognosis. The methodology of the urinary proteome is nonetheless not more complex than that of other sophisticated assays of conventional urinary protein analysis. Moreover, the need for a centralized database is also felt by the researchers as more and more studies have been presenting their results from different corners and as systems of organizing these newly emerging data being developed at international and national levels. In this context concept of urinary proteomics in renal allograft recipients would be of significant importance in clinical transplantation.

  3. Radionuclide evaluation of renal allografts

    International Nuclear Information System (INIS)

    In order to evaluate the blood perfusion in the transplanted kidneys, sup(99m)Tc-DTPA dynamic studies were performed 53 times in 25 cases of various stages (normal function 31, acute rejection 11, chronic rejection 8, ATN 2 and ureteral obstruction 1). Seven parameters were calculated from the Tc-DTPA dynamic studies. (A) Mean transit time (MTT): the time interval between the positive and negative peaks in the first order differential curve (Oldendorf's method). (B) Appearance time: the time interval from injection to the positive peak of differential curve. (C) T max: the time from injection to the maximum. (D) T sub(1/2) max: the time to half maximum. (E) Slope: the time interval between 10% to 90% of the maximum counts in the initial slope. (F) Uptake ratio: ratio of the RI counts in the region of the kidney over the counts in the whole field during the MTT. (G) Kidney/Background ratio. The results of this study were as follows. Significant prolongation of MTT and marked decrease of Uptake ratio were recognized during acute rejections (p < 0.001). T max, Slope and K/B ratio were also significantly changed (p < 0.05, p < 0.005, p < 0.01). In the chronic rejection group, all of the seven parameters revealed significantly different from those of the normal grafts. As to the correlations between the kidney function (creatinine clearance) and the parameters, MTT and Uptake ratio were highly correlated to Ccr (r = -0.736 and r = 0.625, respectively). In conclusion, MTT and Uptake ratio were the most valuable parameters in detecting the rejection episodes and evaluating the kidney function. (J.P.N.)

  4. Late de novo minimal change disease in a renal allograft

    Directory of Open Access Journals (Sweden)

    Madhan Krishan

    2009-01-01

    Full Text Available Among the causes of the nephrotic syndrome in renal allografts, minimal change disease is a rarity with only few cases described in the medical literature. Most cases described have occurred early in the post-transplant course. There is no established treatment for the condition but prognosis is favorable. We describe a case of minimal change disease that developed 8 years after a successful transplantation of a renal allograft in a middle-aged woman. The nephrotic syndrome was accompanied by deterioration of allograft function. Treatment with mycophenolate mofetil was successful in inducing remission and stabilizing allograft function.

  5. CD20阳性淋巴细胞在慢性移植肾肾病组织中浸润的意义%Significance of CD20-positive lymphocytes infiltrating in renal allograft biopsies with chronic allograft nephropathy

    Institute of Scientific and Technical Information of China (English)

    胡建敏; 赵明; 郭颖; 陈桦; 李民

    2012-01-01

    目的 探讨肾移植术后慢性移植物肾病(CAN)组织CD20阳性淋巴细胞浸润的临床意义及其机制.方法 选择肾移植术后2年内活检证实为CAN病例为研究对象,应用免疫组织化学方法检测补体C4d的沉积和CD20阳性淋巴细胞在移植肾组织的浸润,同时分析临床随访资料.结果 人选CAN病例44例,其中CD20阳性淋巴细胞浸润13例(29.5%),CD20阴性为31例(70.5%),移植肾组织不同病理分级者中CD20阳性者所占比例的差异无统计学意义(P>0.05).44例中,12例(27.3%)出现管周毛细血管内皮细胞(PTC)补体C4d的线性沉积,CD20阳性和阴性者中补体C4d表达阳性率的差异无统计学意义(P>0.05).确诊为CAN时移植肾组织CD20为阴性和阳性者的肾功能分别为( 140.8±22.0)μmol/L和(183.5±25.5) μmol/L(P<0.01),1年后分别为(165.6±37.6)μmol/L和(242.2±59.1 )μmol/L(P<0.01).结论 CD20阳性淋巴细胞在移植肾组织的浸润与移植物的预后相关,其机制可能不是通过慢性体液免疫反应.%Objective To investigate the action mechanism of CD20 lymphocyte infiltration in the renal allograft biopsy with chronic allograft nephropathy (CAN).Methods CAN cases confirmed by renal biopsy within 2 years after renal transplantation served as study subjects. By using immunohistochemistry,the deposition of C4d and the CD20-positive lymphocytes infiltration in the renal grafts were examined.The clinical follow-up data were analyzed.Results Forty-four cases of CAN were enrolled in the study, including 13 cases (29.5% ) of CD20-positive lymphocytes infiltration,and 31 cases (70.5% ) of CD20-negative lymphocytes infiltration. CD20-positive lymphocytes in biopsy showed nodular and scattered lymphocytes infiltration.There were 5 (26.3%)cases of CAN Ⅰ,4 cases (25.0%) of CAN Ⅱ,and 4 (44.4%) of CAN Ⅲ in CD20-positive group.There was no statistically significant difference between the only CAN group and CAN with AR group in

  6. Late post transplant HIV infection with BK viremia and allograft tuberculosis in a renal transplant recipient with Kaposi sarcoma

    OpenAIRE

    Viswanathan, V.; Kandasamy, V.; Reddy, Y. N.; Kurien, A.; Mathew, M.; Abraham, G

    2012-01-01

    In this report, we discuss a case of a 51-year-old African renal transplant who presented with metastatic Kaposi sarcoma 1 year after transplant. The Kaposi sarcoma was treated with a switch of immunosuppressants and chemotherapy. Six years after transplant, he presented with chronic allograft nephropathy, allograft tuberculosis, BK viremia, and was diagnosed to have contracted HIV infection.

  7. Risk of renal allograft rejection following angiography

    International Nuclear Information System (INIS)

    In a retrospective study of 173 immediately functioning primary kidney transplants, correlation between angiography and renal allograft rejection was studied during the first 14 days. It was found that rejection was more frequent in kidneys undergoing angiography than in those not undergoing angiography. It was also found that in kidneys undergoing angiography an overwhelming number of the rejections started the day after angiography. These differences in rejection frequency could not be explained by differences in HLA matching or the origin of the kidneys. These findings suggest a possible connection indicating that the angiography might elicit an acute rejection episode. A possible mechanism for starting this reaction might be activation of the complement system which was found in 50 percent of the patients undergoing angiography in peripheral blood and in 100 percent when studied in vitro

  8. An unusual case of a patient who lost his native kidneys and renal allograft from cholesterol crystal emboli.

    Science.gov (United States)

    Ahmed, Wasim; Al Garni, Abdulkareem; Abdelgadir, Elbadri; Khamees, Khamess Obeid; Ellouly, Mohammed Ali Ahmed; Haleem, Abdul

    2015-09-01

    Cholesterol crystal emboli (CCE) syndrome involving native kidneys is an underdiagnosed condition. CCE is rare in renal allografts. It may present with acute kidney injury, but usually not acute graft loss. CCE should be considered in patients with a history of atherosclerosis and an invasive arterial procedure who present with acute or chronic renal allograft dysfunction. Therapy for CCE is mainly supportive and carries a high rate of mortality. To the best of our knowledge, this is the first reported case of a patient who lost his native kidneys and renal allograft due to CCE arising from his own vasculature. PMID:26354570

  9. Use of local allograft irradiation following renal transplantation

    International Nuclear Information System (INIS)

    Over a 10 year period, 67 recipients of 71 renal allografts received graft irradiation following the diagnosis of rejection. The majority of kidneys were treated with a total dose of 600 rad, 150 rad per fraction, in 4 daily fractions. Fifty-three kidneys were irradiated following the failure of standard systemic immunosuppression and maximally tolerated antirejection measures to reverse an episode of acute rejection. Twenty-two (42%) of these allografts were noted to have stable (i.e. no deterioration) or improved function 1 month following the treatment with irradiation. Eleven (21%) of these allografts maintained function 1 year following transplantation. Biopsies were obtained of 41 allografts. Of the 24 renal allografts with predominantly cellular rejection, 10 (42%) had the process reversed or stabilized at 1 month following irradiation. Five (21%) of these allografts were functioning at 1 year following irradiation. Rejection was reversed or stabilized in 6 of 17 (35%) allografts at 1 month when the histologic features of renal biopsy suggested predominantly vascular rejection. Local graft irradiation has helped maintain a limited number of allografts in patients whose rejection has failed to respond to systemic immunosuppression. Irradiation may also benefit patients with ongoing rejection in whom further systemic immunosuppression is contra-indicated

  10. An unusual case of a patient who lost his native kidneys and renal allograft from cholesterol crystal emboli

    OpenAIRE

    Wasim Ahmed; Abdulkareem Al Garni; Elbadri Abdelgadir; Khamess Obeid Khamees; Mohammed Ali Ahmed Ellouly; Abdul Haleem

    2015-01-01

    Cholesterol crystal emboli (CCE) syndrome involving native kidneys is an underdiagnosed condition. CCE is rare in renal allografts. It may present with acute kidney injury, but usually not acute graft loss. CCE should be considered in patients with a history of atherosclerosis and an invasive arterial procedure who present with acute or chronic renal allograft dysfunction. Therapy for CCE is mainly supportive and carries a high rate of mortality. To the best of our knowledge, this is the firs...

  11. Renal allograft transplant recipient with ruptured hydatid native kidney

    OpenAIRE

    Riyaz Ahmad Bhat; Imtiyaz Wani; Imran Khan; Muzaffar Wani

    2014-01-01

    Echinococcosis of the kidneys in a renal transplant recipient is extremely rare and its occurrence being related to immunosuppression is a possibility which needs further characterisation. Ruptured renal hydatid in a renal transplant recipient is not reported so far to our best knowledge. We present a 42-year-old renal allograft receipient who presented one year after transplant with left flank pain, palpable left lumbar mass and gross hydatiduria. Investigations revealed a ruptured native hy...

  12. Targeting Sirtuin-1 prolongs murine renal allograft survival and function.

    Science.gov (United States)

    Levine, Matthew H; Wang, Zhonglin; Xiao, Haiyan; Jiao, Jing; Wang, Liqing; Bhatti, Tricia R; Hancock, Wayne W; Beier, Ulf H

    2016-05-01

    Current immunosuppressive medications used after transplantation have significant toxicities. Foxp3(+) T-regulatory cells can prevent allograft rejection without compromising protective host immunity. Interestingly, inhibiting the class III histone/protein deacetylase Sirtuin-1 can augment Foxp3(+) T-regulatory suppressive function through increasing Foxp3 acetylation. Here we determined whether Sirtuin-1 targeting can stabilize biological allograft function. BALB/c kidney allografts were transplanted into C57BL/6 recipients with a CD4-conditional deletion of Sirtuin-1 (Sirt1(fl/fl)CD4(cre)) or mice treated with a Sirtuin-1-specific inhibitor (EX-527), and the native kidneys removed. Blood chemistries and hematocrit were followed weekly. Sirt1(fl/fl)CD4(cre) recipients showed markedly longer survival and improved kidney function. Sirt1(fl/fl)CD4(cre) recipients exhibited donor-specific tolerance, accepted BALB/c, but rejected third-party C3H cardiac allografts. C57BL/6 recipients of BALB/c renal allografts that were treated with EX-527 showed improved survival and renal function at 1, but not 10 mg/kg/day. Pharmacologic inhibition of Sirtuin-1 also improved renal allograft survival and function with dosing effects having relevance to outcome. Thus, inhibiting Sirtuin-1 can be a useful asset in controlling T-cell-mediated rejection. However, effects on non-T cells that could adversely affect allograft survival and function merit consideration. PMID:27083279

  13. Mannan binding lectin : a two-faced regulator of renal allograft injury?

    NARCIS (Netherlands)

    Damman, Jeffrey; Seelen, Marc A.

    2013-01-01

    Complement activation plays an important role in the pathogenesis of renal allograft injury after kidney transplantation. There are three known pathways of complement activation, namely, classical, alternative, and lectin pathways. In renal allograft injury, contradictory results were reported about

  14. The Presence of Recipient-Derived Renal Cells in Kidney Allografts

    Directory of Open Access Journals (Sweden)

    Türkan METE

    2011-09-01

    Full Text Available OBJECTIVE: Stem cells may be involved in the repair processes of renal tissues during various disorders. We aimed to search the presence of recipient originated cells in renal allograft tissues from patients with various types of allograft dysfunction including acute rejection, acute tubular necrosis, calcineurin inhibitor toxicity, and chronic rejection. MATERIAL and METHODS: Eleven kidney transplant recipients were enrolled in the study. Seven patients who had sex-mismatched donors were regarded as the study group and the remaining were the controls (male-male, positive controls, n=2; female-female, negative controls, n=2. Histopathological examinations in the study group had revealed chronic rejection in four patients(together with calcineurin inhibitor toxicity in three and acute rejection, acute tubular necrosis, and cyclosporine toxicity in one patient each. Deparaffi nised biopsy specimens were examined using chromogenic in situ hybridization (CISH method for the XY cocktail probe. RESULTS: Renal cells of positive controls had XY, whereas those of negative controls had XX chromosomal signals. Examination of the biopsy samples from the study group showed variable ratios of recipient-derived tubular(2-76%, interstitial mesenchymal(5-83%, and endothelial cells(1-53%. CONCLUSION: The presence of recipient-derived renal cells in injured kidney allografts suggests that there is a possible dynamic interaction between allograft and stem cells of the recipient. Further studies are needed to clarify the origin and the function of these cells.

  15. Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

    Directory of Open Access Journals (Sweden)

    Siddhesh Prabhavalkar

    2013-01-01

    Full Text Available Acute kidney injury (AKI is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction.

  16. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2009-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  17. Renal allograft transplant recipient with ruptured hydatid native kidney.

    Science.gov (United States)

    Bhat, Riyaz Ahmad; Wani, Imtiyaz; Khan, Imran; Wani, Muzaffar

    2014-07-01

    Echinococcosis of the kidneys in a renal transplant recipient is extremely rare and its occurrence being related to immunosuppression is a possibility which needs further characterisation. Ruptured renal hydatid in a renal transplant recipient is not reported so far to our best knowledge. We present a 42-year-old renal allograft receipient who presented one year after transplant with left flank pain, palpable left lumbar mass and gross hydatiduria. Investigations revealed a ruptured native hydatid kidney. Patient was managed with a combination of chemotherapy and left native nephrectomy and discharged in a satisfactory condition. PMID:25125908

  18. Renal allograft transplant recipient with ruptured hydatid native kidney

    Directory of Open Access Journals (Sweden)

    Riyaz Ahmad Bhat

    2014-01-01

    Full Text Available Echinococcosis of the kidneys in a renal transplant recipient is extremely rare and its occurrence being related to immunosuppression is a possibility which needs further characterisation. Ruptured renal hydatid in a renal transplant recipient is not reported so far to our best knowledge. We present a 42-year-old renal allograft receipient who presented one year after transplant with left flank pain, palpable left lumbar mass and gross hydatiduria. Investigations revealed a ruptured native hydatid kidney. Patient was managed with a combination of chemotherapy and left native nephrectomy and discharged in a satisfactory condition.

  19. Minimizing the risk of chronic allograft nephropathy.

    Science.gov (United States)

    Weir, Matthew R; Wali, Ravinder K

    2009-04-27

    Chronic allograft nephropathy, now defined as interstital fibrosis and tubular atrophy not otherwise specified, is a near universal finding in transplant kidney biopsies by the end of the first decade posttransplantation. After excluding death with functioning graft, caused by cardiovascular disease or malignancy, chronic allograft nephropathy is the leading cause of graft failure. Original assumptions were that this was not a modifiable process but inexorable, likely due to past kidney injuries. However, newer understandings suggest that acute or subacute processes are involved, and with proper diagnosis, appropriate interventions can be instituted. Our method involved a review of the primary and secondary prevention trials in calcineurin inhibitor withdrawal. Some of the more important causes of progressive graft deterioration include subclinical cellular or humoral rejection, and chronic calcineurin inhibitor toxicity. Early graft biopsy, assessment of histology, and changes in immunosuppression may be some of the most important measures available to protect graft function. The avoidance of clinical inertia in pursuing subtle changes in graft function is critical. Modification in maintenance immunosuppression may benefit many patients with early evidence of graft deterioration. PMID:19384181

  20. Left versus right deceased donor renal allograft outcome.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2009-12-01

    It has been suggested that the left kidney is easier to transplant than the right kidney because of the longer length of the left renal vein, facilitating the formation of the venous anastomosis. There are conflicting reports of differing renal allograft outcomes based on the side of donor kidney transplanted (left or right).We sought to determine the effect of side of donor kidney on early and late allograft outcome in our renal transplant population. We performed a retrospective analysis of transplanted left-right deceased donor kidney pairs in Ireland between January 1, 1998 and December 31, 2008. We used a time to death-censored graft failure approach for long-term allograft survival and also examined serum creatinine at different time points post-transplantation. All outcomes were included from day of transplant onwards. A total of 646 transplants were performed from 323 donors. The incidence of delayed graft function was 16.1% in both groups and there was no significant difference in acute rejection episodes or serum creatinine from 1 month to 8 years post-transplantation.There were 47 death-censored allograft failures in the left-sided group compared to 57 in the right-sided group (P = 0.24). These observations show no difference in renal transplant outcome between the recipients of left- and right-sided deceased donor kidneys.

  1. Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction - initial results

    Energy Technology Data Exchange (ETDEWEB)

    Hueper, Katja; Gutberlet, M.; Rodt, T.; Wacker, F.; Galanski, M.; Hartung, D. [Institute for Diagnostic and Interventional Radiology, Hannover Medical School - Germany, Hannover (Germany); Gwinner, W. [Clinic for Nephrology, Hannover Medical School - Germany, Hannover (Germany); Lehner, F. [Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School - Germany, Hannover (Germany)

    2011-11-15

    To evaluate MR diffusion tensor imaging (DTI) as non-invasive diagnostic tool for detection of acute and chronic allograft dysfunction and changes of organ microstructure. 15 kidney transplanted patients with allograft dysfunction and 14 healthy volunteers were examined using a fat-saturated echo-planar DTI-sequence at 1.5 T (6 diffusion directions, b = 0, 600 s/mm{sup 2}). Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were calculated separately for the cortex and for the medulla and compared between healthy and transplanted kidneys. Furthermore, the correlation between diffusion parameters and estimated GFR was determined. The ADC in the cortex and in the medulla were lower in transplanted than in healthy kidneys (p < 0.01). Differences were more distinct for FA, especially in the renal medulla, with a significant reduction in allografts (p < 0.001). Furthermore, in transplanted patients a correlation between mean FA in the medulla and estimated GFR was observed (r = 0.72, p < 0.01). Tractography visualized changes in renal microstructure in patients with impaired allograft function. Changes in allograft function and microstructure can be detected and quantified using DTI. However, to prove the value of DTI for standard clinical application especially correlation of imaging findings and biopsy results is necessary. (orig.)

  2. Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction - initial results

    International Nuclear Information System (INIS)

    To evaluate MR diffusion tensor imaging (DTI) as non-invasive diagnostic tool for detection of acute and chronic allograft dysfunction and changes of organ microstructure. 15 kidney transplanted patients with allograft dysfunction and 14 healthy volunteers were examined using a fat-saturated echo-planar DTI-sequence at 1.5 T (6 diffusion directions, b = 0, 600 s/mm2). Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were calculated separately for the cortex and for the medulla and compared between healthy and transplanted kidneys. Furthermore, the correlation between diffusion parameters and estimated GFR was determined. The ADC in the cortex and in the medulla were lower in transplanted than in healthy kidneys (p < 0.01). Differences were more distinct for FA, especially in the renal medulla, with a significant reduction in allografts (p < 0.001). Furthermore, in transplanted patients a correlation between mean FA in the medulla and estimated GFR was observed (r = 0.72, p < 0.01). Tractography visualized changes in renal microstructure in patients with impaired allograft function. Changes in allograft function and microstructure can be detected and quantified using DTI. However, to prove the value of DTI for standard clinical application especially correlation of imaging findings and biopsy results is necessary. (orig.)

  3. Use of Contrast-Enhanced Ultrasonography to Evaluate Chronic Allograft Nephropathy in Rats and Correlations between Time-Intensity Curve Parameters and Allograft Fibrosis.

    Science.gov (United States)

    Zhang, Qiang; Yu, Zexing; Xu, Yue; Zeng, Song; Zhang, Zijian; Xue, Wenrui; Wang, Wei; Zhang, Xiaodong; Hu, Xiaopeng

    2016-07-01

    This study quantitatively analyzed changes in the hemodynamic characteristics of renal allografts at different stages in a rat chronic allograft nephropathy (CAN) model as well as the relationship between hemodynamic parameters and renal allograft fibrosis using contrast-enhanced ultrasonography (CEUS). The experimental group used a CAN rat model (n = 30), and the control group used an orthotopic syngeneic renal transplant model (n = 30). After surgery, creatinine clearance rates were regularly monitored every 2 wk. The checking times were set at 4, 12 and 24 wk after surgery, which represent early, middle and late stage of CAN, respectively. At different stages of CAN, eight rats from each group were randomly selected for CEUS examination. Time-intensity curve (TIC) parameters, including rise time, peak intensity, mean transit time, area under the curve, wash-in slope, time-to-peak and α-smooth muscle actin (α-SMA) expression; Vimentin expression; and chronic allograft damage index scores were evaluated by linear correlation analysis. Before the creatinine clearance rate showed significant abnormalities, the renal allografts in the experimental group had already presented pathologic changes associated with CAN. In the early stage after surgery, compared to the TIC curve of the control group, the experimental group showed increased rise time, mean transit time, area under the curve and time-to-peak, and decreased wash-in slope (p rate, CEUS can detect CAN at earlier stages. The correlations between TIC-related parameters and the expression levels of α-SMA and Vimentin in renal allografts indicate that CEUS is a feasible way to assess the degree of renal allograft fibrosis quantitatively. PMID:27056611

  4. Renal Allograft in a Professional Boxer

    Directory of Open Access Journals (Sweden)

    Einollahi Behzad

    2008-01-01

    Full Text Available Significant health benefits result from regular physical activity for kidney transplant recipients. Nevertheless, some adverse effects also have been shown to be associated with highly intensive exercises. We report a kidney transplant professional boxer whose kidney allograft has remained in good health, despite his violent sport activities.

  5. De Novo Renal Cell Carcinoma in a Kidney Allograft 20 Years after Transplant

    OpenAIRE

    Masataka Banshodani; Hideki Kawanishi; Seiji Marubayashi; Sadanori Shintaku; Misaki Moriishi; Fumio Shimamoto; Shinichiro Tsuchiya; Kiyohiko Dohi; Hideki Ohdan

    2015-01-01

    Renal cell carcinoma (RCC) in a kidney allograft is rare. We report the successful diagnosis and treatment of a de novo RCC in a nonfunctioning kidney transplant 20 years after engraftment. A 54-year-old man received a kidney transplant from his mother when he was 34 years old. After 10 years, chronic rejection resulted in graft failure, and the patient became hemodialysis-dependent. Intravenous contrast-enhanced computed tomography (CT) for the evaluation of gastrointestinal symptoms reveale...

  6. Efficacy of prophylactic irradiation in altering renal allograft survival

    International Nuclear Information System (INIS)

    Renal allograft rejection is a complex phenomenon involving both cell-mediated and humoral antibody responses. Most transplant programs have used a combination of therapeutic modalites to combat the immune system in an attempt to prolong both allograft and patient survival. Corticosteroids (methylprednisolone (Solu-Medrol) and prednisone and azathioprine (Imuran) are widely accepted as immunosuppressive drugs; however, both are non-specific and have the disadvantage of compromising the recipients' defense mechanisms. Nevertheless, these drugs have proved to be essential to the success of renal transplantation and they are routinely used while the efficacy of other modalities continues to be evaluated. We could find no reports of a prospective study to evaluate the efficacy of prophylactic irradiation in the complex therapeutic situation of renal transplantation with the only variable being the administration of local graft irradiation. The purpose of this study was to evaluate prophylactic graft irradiation for its effectiveness in preventing graft rejection in conjunction with Imuran and corticosteroids

  7. Efficacy of prophylactic irradiation in altering renal allograft survival

    Energy Technology Data Exchange (ETDEWEB)

    Faber, R.; Johnson, H.K.; Braren, H.V.; Richie, R.E.

    1974-01-01

    Renal allograft rejection is a complex phenomenon involving both cell-mediated and humoral antibody responses. Most transplant programs have used a combination of therapeutic modalites to combat the immune system in an attempt to prolong both allograft and patient survival. Corticosteroids (methylprednisolone (Solu-Medrol) and prednisone and azathioprine (Imuran) are widely accepted as immunosuppressive drugs; however, both are non-specific and have the disadvantage of compromising the recipients' defense mechanisms. Nevertheless, these drugs have proved to be essential to the success of renal transplantation and they are routinely used while the efficacy of other modalities continues to be evaluated. We could find no reports of a prospective study to evaluate the efficacy of prophylactic irradiation in the complex therapeutic situation of renal transplantation with the only variable being the administration of local graft irradiation. The purpose of this study was to evaluate prophylactic graft irradiation for its effectiveness in preventing graft rejection in conjunction with Imuran and corticosteroids.

  8. Renal allograft tuberculosis with infected lymphocele transmitted from the donor

    Directory of Open Access Journals (Sweden)

    Maryam Ali Al-Nesf

    2014-01-01

    Full Text Available Transmission of tuberculosis (TB from a donor through renal transplantation is a rare incident. We are reporting a 53-year-old Qatari woman diagnosed with renal allograft TB infection. The disease was confirmed by isolation of Mycobacterium tuberculosis from fluid from the lymphocele and demonstration of caseating granuloma in graft biopsy with acid-fast bacilli seen on Ziehl-Neelsen staining. The diagnosis was made quite early post-transplantation. The presence of the granuloma, which is unusual with patients on intensive immunosuppressant medications, suggests that transmission of the infection occurred from the donor rather than from the activation of latent infection. In reviewing the literature, we found ten case reports of TB in transplanted kidney with transmission of TB infection from the donor. The presence of TB in lymphocele in association with the infected transplant by TB, to the best of our knowledge, was reported only once in the literature. Our case had unfavorable outcome and ended by renal allograft nephrectomy and hemodialysis. We are presenting this case of TB infection of renal allograft and lymphocele diagnosed early post-transplantation transmitted from the donor and pertinent review from the literature.

  9. A case of primary renal allograft dysfunction due to myeloma cast nephropathy

    Directory of Open Access Journals (Sweden)

    Umesh Lingaraj

    2015-01-01

    Full Text Available We report a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no overt clinical features of multiple myeloma preceding his transplantation. A 45-year-old man on hemodialysis for six months for end-stage kidney disease due to presumed chronic glomerulonephritis developed immediate graft dysfunction post-transplantation. The graft biopsy was diagnostic of myeloma cast nephropathy. Other criteria for lambda light chain multiple myeloma were fulfilled with immunofixation electrophoresis and bone marrow biopsy. He was treated with plasmapheresis, bortezomib and high-dose dexamethasone. However, the patient succumbed to septicemia on the 37 th post-operative day. This is probably the first report of primary renal allograft dysfunction due to myeloma cast nephropathy diagnosed within the first week posttransplanation in a patient with unrecognized multiple myeloma.

  10. Imaging-based diagnosis of acute renal allograft rejection

    Science.gov (United States)

    Thölking, Gerold; Schuette-Nuetgen, Katharina; Kentrup, Dominik; Pawelski, Helga; Reuter, Stefan

    2016-01-01

    Kidney transplantation is the best available treatment for patients with end stage renal disease. Despite the introduction of effective immunosuppressant drugs, episodes of acute allograft rejection still endanger graft survival. Since efficient treatment of acute rejection is available, rapid diagnosis of this reversible graft injury is essential. For diagnosis of rejection, invasive core needle biopsy of the graft is the “gold-standard”. However, biopsy carries the risk of significant graft injury and is not immediately feasible in patients taking anticoagulants. Therefore, a non-invasive tool assessing the whole organ for specific and fast detection of acute allograft rejection is desirable. We herein review current imaging-based state of the art approaches for non-invasive diagnostics of acute renal transplant rejection. We especially focus on new positron emission tomography-based as well as targeted ultrasound-based methods. PMID:27011915

  11. Acute and Chronic Allograft Dysfunction in Kidney Transplant Recipients.

    Science.gov (United States)

    Goldberg, Ryan J; Weng, Francis L; Kandula, Praveen

    2016-05-01

    Allograft dysfunction after a kidney transplant is often clinically asymptomatic and is usually detected as an increase in serum creatinine level with corresponding decrease in glomerular filtration rate. The diagnostic evaluation may include blood tests, urinalysis, transplant ultrasonography, radionuclide imaging, and allograft biopsy. Whether it occurs early or later after transplant, allograft dysfunction requires prompt evaluation to determine its cause and subsequent management. Acute rejection, medication toxicity from calcineurin inhibitors, and BK virus nephropathy can occur early or later. Other later causes include transplant glomerulopathy, recurrent glomerulonephritis, and renal artery stenosis. PMID:27095641

  12. The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation.

    Science.gov (United States)

    Martin-Gandul, C; Mueller, N J; Pascual, M; Manuel, O

    2015-12-01

    Infectious diseases after solid organ transplantation (SOT) are a significant cause of morbidity and reduced allograft and patient survival; however, the influence of infection on the development of chronic allograft dysfunction has not been completely delineated. Some viral infections appear to affect allograft function by both inducing direct tissue damage and immunologically related injury, including acute rejection. In particular, this has been observed for cytomegalovirus (CMV) infection in all SOT recipients and for BK virus infection in kidney transplant recipients, for community-acquired respiratory viruses in lung transplant recipients, and for hepatitis C virus in liver transplant recipients. The impact of bacterial and fungal infections is less clear, but bacterial urinary tract infections and respiratory tract colonization by Pseudomonas aeruginosa and Aspergillus spp appear to be correlated with higher rates of chronic allograft dysfunction in kidney and lung transplant recipients, respectively. Evidence supports the beneficial effects of the use of antiviral prophylaxis for CMV in improving allograft function and survival in SOT recipients. Nevertheless, there is still a need for prospective interventional trials assessing the potential effects of preventive and therapeutic strategies against bacterial and fungal infection for reducing or delaying the development of chronic allograft dysfunction. PMID:26474168

  13. De novo C3 glomerulonephritis in a renal allograft.

    Science.gov (United States)

    Nahm, Ji Hae; Song, Seung Hwan; Kim, Yu Seun; Cheong, Hae-Il; Lim, Beom Jin; Kim, Beom Seok; Jeong, Hyeon Joo

    2016-01-01

    C3 glomerulonephritis (C3GN) is a recently described, rare glomerular disease characterized by predominant or sole glomerular C3 deposits. Morphologic features of C3GN are similar to those of dense deposit disease (DDD); however, ribbon-like intramembranous electron-dense deposits are absent in the former. We report a case of de novo C3GN in a renal allograft with morphologic transformation to DDD. A 6-year-old boy presented with congenital left renal agenesis and right ureteropelvic junction obstruction. The patient underwent pyeloplasty but experienced recurrent urinary tract infections. At the age of 22 years, he received a renal allograft from a living related donor. C3GN was diagnosed after 1 year of transplantation; initial histology showed minimal mesangiopathy and this progressed to mesangial proliferation and membranoproliferative features over the next 7 years. Serum creatinine levels were stabilized with anti-rejection treatments for combating repeated episodes of acute rejection; however, glomerular and tubular band-like electron-dense deposits became evident. PMID:26986539

  14. Detection of acute renal allograft rejection by analysis of renal tissue proteomics in rat models of renal transplantation

    Directory of Open Access Journals (Sweden)

    Dai Yong

    2008-01-01

    Full Text Available At present, the diagnosis of renal allograft rejection requires a renal biopsy. Clinical management of renal transplant patients would be improved if rapid, noninvasive and reliable biomarkers of rejection were available. This study is designed to determine whether such protein biomarkers can be found in renal-graft tissue proteomic approach. Orthotopic kidney transplantations were performed using Fisher (F344 or Lewis rats as donors and Lewis rats as recipients. Hence, there were two groups of renal transplant models: one is allograft (from F344 to Lewis rats; another is syngrafts (from Lewis to Lewis rats serving as control. Renal tissues were collected 3, 7 and 14 days after transplantation. As many as 18 samples were analyzed by 2-D Electrophoresis and mass spectrometry (MALDI-TOF-TOF-MS. Eleven differentially expressed proteins were identified between groups. In conclusion, proteomic technology can detect renal tissue proteins associated with acute renal allograft rejection. Identification of these proteins as diagnostic markers for rejection in patients′ urine or sera may be useful and non-invasive, and these proteins might serve as novel therapeutic targets that also help to improve the understanding of mechanism of renal rejection.

  15. Reduced CD40L expression on ex vivo activated CD4+T-lymphocytes from patients with excellent renal allograft function measured with a rapid whole blood flow cytometry procedure

    OpenAIRE

    Lederer, Stephan R.; Friedrich, N; Gruber, R; Landgraf, R; Toepfer, Marcel; Sitter, Thomas

    2004-01-01

    Background: The CD40-CD40L (CD154) costimulatory pathway plays a critical role in the pathogenesis of kidney allograft rejection. In renal transplant biopsies, CD4+ CD40L+ graft-infiltrating cells were detected during chronic rejection in contrast to acute rejection episodes. Using a rapid noninvasive FACS procedure, we were able to demonstrate CD40L upregulation in peripheral blood of patients with chronic renal allograft dysfunction. Materials and Methods: Whole blood from recipients of ren...

  16. Elevated urine heparanase levels are associated with proteinuria and decreased renal allograft function.

    Directory of Open Access Journals (Sweden)

    Itay Shafat

    Full Text Available Heparanase is an endo-β-glucuronidase that cleaves heparan sulfate side chains, leading to structural modifications that loosen the extracellular matrix barrier and associated with tumor metastasis, inflammation and angiogenesis. In addition, the highly sulfated heparan sulfate proteoglycans are important constituents of the glomerular basement membrane and its permselective properties. Recent studies suggest a role for heparanase in several experimental and human glomerular diseases associated with proteinuria such as diabetes, minimal change disease, and membranous nephropathy. Here, we quantified blood and urine heparanase levels in renal transplant recipients and patients with chronic kidney disease (CKD, and assessed whether alterations in heparanase levels correlate with proteinuria and renal function. We report that in transplanted patients, urinary heparanase was markedly elevated, inversely associated with estimated glomerular filtration rate (eGFR, suggesting a relationship between heparanase and graft function. In CKD patients, urinary heparanase was markedly elevated and associated with proteinuria, but not with eGFR. In addition, urinary heparanase correlated significantly with plasma heparanase in transplanted patients. Such a systemic spread of heparanase may lead to damage of cells and tissues alongside the kidney.The newly described association between heparanase, proteinuria and decreased renal function is expected to pave the way for new therapeutic options aimed at attenuating chronic renal allograft nephropathy, leading to improved graft survival and patient outcome.

  17. Iatrogenic Arteriovenous Fistula in a Renal Allograft: The Result of a TAD Guidewire Injury

    International Nuclear Information System (INIS)

    A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed

  18. Detection of acute renal allograft rejection by analysis of Renal TissueProteomics in rat models of renal transplantation

    International Nuclear Information System (INIS)

    At present, the diagnosis of renal allograft rejection requires a renalbiopsy. Clinical management of renal transplant patients would be improved ifrapid, noninvasive and reliable biomarkers of rejection were available. Thisstudy is designed to determine whether such protein biomarkers can be foundin renal graft tissue proteomic approach. Orthotopic kidney transplantationswere performed using Fisher (F344) or Lewis rats as donors and Lewis rats asrecipients. Hence, there were two groups of renal transplant models: one isallograft (from F344 to Lewis rats); another is syngrafts (from Lewis toLewis rats) serving as control. Renal tissues were collected 3, 7 and 14 daysafter transplantation. As many 18 samples were analyzed by 2-DElectrophoresis and mass spectrometry (MALDI-TOF-TOF-MS). Elevendifferentially expressed proteins were identified between groups. Inconclusion, proteomic technology can detect renal tissue proteins associatedwith acute renal allograft rejection. Identification of these proteins asdiagnostic markers for rejection in patient's urine or sera may be useful andnon-invasive, and these proteins might serve as novel therapeutic targetsthat also help to improve the understanding of mechanisms of renal rejection.(author)

  19. Treatment of chronic osteomyelitis with one-stage allograft

    Institute of Scientific and Technical Information of China (English)

    LU Wei-ju; LI Bin; BAO Ni-rong; QIAN Hong-bo; ZENG Xiao-feng; XU Bin; CHEN Yong; ZHAO Jian-ning

    2006-01-01

    Objective: To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs.Methods: Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis (8 cases of nonunion )underwent one-stage allograft after debridement in our hospital.Results: Thirty-five cases were followed up for an average period of 28 months (range, 13 to 55 months), in which 32 cases (91.43%) were found no infection, and 3cases (8.57 %) were confirmed recurrence of infection.Four out of 8 cases of bone nonunion healed in 9.5 months on average (range, 3 to 12 months), and another case also acquired union after redebridement and autograft of ilium due to infection recurrence 35 days after surgery.Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment.Conclusions: A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.

  20. Altered Expression of MicroRNAs Following Chronic Allograft Dysfunction with Interstitial Fibrosis and Tubular Atrophy

    Directory of Open Access Journals (Sweden)

    Ehsan Soltaninejad

    2015-11-01

    Full Text Available Chronic allograft dysfunction (CAD remains the major cause of renal transplant loss and characterized by interstitial fibrosis and tubular atrophy (IFTA. MicroRNAs (miRNAs are implicated in many biological processes as well as innate and adaptive immune responses. We aimed to investigate whether CAD with IFTA is associated with differential expression of miR-142-5p, miR-142-3p and miR-211 within biopsy and peripheral blood mononuclear cell (PBMC samples and whether expression of miRNAs are diagnostic for CAD with IFTA and predicts renal allograft function. In this study, biopsy and PBMC samples of 16 CAD with IFTA and 17 normal allografts (NA were collected. Using Taqman MicroRNA Assays the expression levels of miR-142-5p, miR-142-3p and miR-211 were determined in two groups. Our results showed that miR-142-5p and miR–142-3p were significantly (p<0.0001 up-regulated and miR-211 was significantly (p<0.0001 down-regulated in renal allograft tissues of CAD with IFTA compared with NA recipients. Moreover, miR-142-3p and miR-211 were significantly (p<0.0001 up-regulated and down-regulated respectively in PBMC samples of CAD with IFTA. According to the ROC curve analysis, miR-142-5p in biopsy samples, but miR-142-3p and miR-211 both in biopsy and PBMC samples could be used as a diagnostic biomarker of CAD with IFTA and a prediction factor of allograft function. In this study, miRNAs were differentially expressed in the kidney allograft biopsy and simultaneously in PBMC samples of patients with CAD with IFTA. We suggest that the expression of miRNAs in PBMC might be used for monitoring the post transplantation and also as potential non-invasive biomarkers of kidney graft function and CAD with IFTA. 

  1. Effect of blood transfusions on canine renal allograft survival

    Energy Technology Data Exchange (ETDEWEB)

    van der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-04-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

  2. Effect of blood transfusions on canine renal allograft survival

    International Nuclear Information System (INIS)

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Furthermore, no improvement in graft survival has been found after a peroperative transfusion of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion or irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted

  3. Effect of blood transfusions on canine renal allograft survival

    Energy Technology Data Exchange (ETDEWEB)

    Van Der Linden, C.J.; Buurman, W.A.; Vegt, P.A.; Greep, J.M.; Jeekel, J.

    1982-04-01

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Futhermore, no improvement in graft survival has been found after a peroperative transfuson of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion of irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted.

  4. Effect of blood transfusions on canine renal allograft survival

    International Nuclear Information System (INIS)

    In this study significantly prolonged canine renal allograft survival has been demonstrated after transfusion of 100 ml of third-party whole blood given peroperatively. Peroperative transfusions of third-party leukocyte-free blood or pure lymphocyte cell suspensions did not influence graft survival. Futhermore, no improvement in graft survival has been found after a peroperative transfuson of irradiated whole blood (2500 rad). These data suggest that delayed graft rejection after blood transfusions can only be expected after the administration of whole blood. The role of competent lymphocytes in whole blood is questionable, since a transfusion of irradiated whole blood in combination with nonirradiated lymphocytes did not lead to prolonged graft survival. Immunosuppression of the recipient directly after transfusion seems to be essential to induce the beneficial effect of blood transfusions. This has been demonstrated for a transfusion of whole blood 14 days before transplantation. A single transfusion of 100 ml of whole blood 14 days before transplantation could effectively prolong graft survival if immunosuppression with azathioprine and prednisone was started on the day of transfusion. No improvement in graft survival has been found with such a transfusion if preoperative immunosuppression has been omitted

  5. Trimethoprim-sulfamethoxazole induced acute interstitial nephritis in renal allografts; clinical course and outcome.

    LENUS (Irish Health Repository)

    Garvey, J P

    2009-11-01

    Acute interstitial nephritis (AIN) secondary to trimethoprim-sulfamethoxazole (TMP-SMX) is well documented as a cause of acute renal failure in native kidneys. TMP-SMX is the standard prophylactic agent against pneumocystis carinii (PCP) used in the early post-transplant period, however, it has to date only been indirectly associated with AIN in renal allografts. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We describe eleven renal transplant patients with acute allograft dysfunction in whom a transplant biopsy demonstrated primary histopathologic features of allergic AIN, all of whom were receiving TMP-SMX in addition to other medications known to cause AIN.

  6. Renal allograft loss in the first post-operative month: causes and consequences.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2013-01-15

    Early transplant failure is a devastating outcome after kidney transplantation. We report the causes and consequences of deceased donor renal transplant failure in the first 30 d at our center between January 1990 and December 2009. Controls were adult deceased donor transplant patients in the same period with an allograft that functioned >30 d. The incidence of early graft failure in our series of 2381 consecutive deceased donor transplants was 4.6% (n = 109). The causes of failure were allograft thrombosis (n = 48; 44%), acute rejection (n = 19; 17.4%), death with a functioning allograft (n = 17; 15.6%), primary non-function (n = 14;12.8%), and other causes (n = 11; 10.1%). Mean time to allograft failure was 7.3 d. There has been a decreased incidence of all-cause early failure from 7% in 1990 to <1% in 2009. Patients who developed early failure had longer cold ischemia times when compared with patients with allografts lasting >30 d (p < 0.001). Early allograft failure was strongly associated with reduced patient survival (p < 0.001). In conclusion, early renal allograft failure is associated with a survival disadvantage, but has thankfully become less common in recent years.

  7. Radiation therapy treatment of acute refractory renal allograft rejection

    International Nuclear Information System (INIS)

    radiation treatment (median 4, range 1-22), number of transplants (one transplant in 77 %), and concomitant immunosuppressive therapy. Independent factors by the Cox regression model were: Sex (P=0.005), Creatinine levels (P=0.000), HLA-DR (P=0.05), PRA-Max > 70% (P=0.014). Each factor was scored using the integral coefficients to generate four different groups. The overall actuarial graft survival from the initiation of RT was 83% at 1 month, 60% at 1 year and 36% at 5 years. The Kaplan-Meier survival analyzed by groups seems to produce an interpretable separation of the risk factors for graft loss. The number of rejections of pre-RT range from 1-6 (median 2) and post-RT range from 0-3 (median 0). Conclusions: Our experience indicates that radiation therapy provides effective treatment for acute refractory renal allograft rejection. The response to radiation therapy in patients treated with acute refractory renal graft rejection can be predicted by a new scoring system

  8. Detection and measurement of tubulitis in renal allograft rejection

    Science.gov (United States)

    Hiller, John B.; Chen, Qi; Jin, Jesse S.; Wang, Yung; Yong, James L. C.

    1997-04-01

    Tubulitis is one of the most reliable signs of acute renal allograft rejection. It occurs when mononuclear cells are localized between the lining tubular epithelial cells with or without disruption of the tubular basement membrane. It has been found that tubulitis takes place predominantly in the regions of the distal convoluted tubules and the cortical collecting system. The image processing tasks are to find the tubule boundaries and to find the relative location of the lymphocytes and epithelial cells and tubule boundaries. The requirement for accuracy applies to determining the relative locations of the lymphocytes and the tubule boundaries. This paper will show how the different sizes and grey values of the lymphocytes and epithelial cells simplify their identification and location. Difficulties in finding the tubule boundaries image processing will be illustrated. It will be shown how proximate location of epithelial cells and the tubule boundary leads to distortion in determination of the calculated boundary. However, in tubulitis the lymphocytes and the tubule boundaries are proximate.In these cases the tubule boundary is adequately resolved and the image processing is satisfactory to determining relativity in location. An adaptive non-linear anisotropic diffusion process is presented for image filtering and segmentation. Multi-layer analysis is used to extract lymphocytes and tubulitis from images. This paper will discuss grading of tissue using the Banff system. The ability to use computer to use computer processing will be argued as obviating problems of reproducability of values for this classification. This paper will also feature discussion of alternative approaches to image processing and provide an assessment of their capability for improving the identification of the tubule boundaries.

  9. T2' imaging of native kidneys and renal allografts. A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Mathys, C.; Blondin, D.; Wittsack, H.J.; Miese, F.R.; Rybacki, K.; Walther, C.; Holstein, A.; Lanzman, R.S. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Radiologie

    2011-02-15

    Purpose: To evaluate the feasibility of T2' mapping in native kidneys and renal allografts. Materials and Methods: Following approval of the local ethics committee, 24 renal allograft recipients and 10 control subjects (healthy volunteers) were included in this study. Multi-echo T2 and T2{sup *} imaging was performed on a 1.5 Tesla scanner. Allograft recipients were assigned to two groups: group (a), 8 patients with good (glomerular filtration rate of more than 40 ml/min) allograft function and no evidence of transplant rejection, transplant renal artery stenosis or ureteral obstruction; group (b), 16 patients with deterioration of renal graft function (glomerular filtration rate (GFR) of 40 ml/min or less). Two different imaging protocols were tested. Results: The mean T2' relaxation parameters were 108.33 msec {+-} 13.34, 100.00 msec {+-} 18.89 and 124.57 msec {+-} 6.51 for groups (a), (b) and for control subjects, respectively. The reduction of T2' values in patient group (b) was not statistically significant. However, significant correlations could be demonstrated between T2' values and the glomerular filtration rate (GFR) of renal allograft function. The reproducibility was tested and the coefficients of variation of T2' values in the cortex of transplanted kidneys were 11.1 % within subjects and 11.3 % between subjects. Conclusion: Our results indicate that T2' imaging is a promising non-enhanced technique, which seems to reveal information on transplant function. Further studies are required to determine the clinical value of T2' mapping for monitoring renal allograft recipients. (orig.)

  10. Total lymphoid irradiation assessed for possible enhancement of immunosuppression in hyperimmunized dogs receiving renal allografts

    International Nuclear Information System (INIS)

    With performed antibodies to human leukocyte antigens (HLA) appearing in an increasing number of patients today, hyperimmunization constitutes a major problem in clinical transplantation. In adult beagle dogs hyperimmunized with skin allografts and buffy coat injection, we performed renal allograft transplantation to assess the efficacy of total lymphoid irradiation (TLI) employed as a preoperative measure in combination with cyclosporine (CyA) and methyl-prednisolone (MPL) in effecting immunosuppression. The mean survival period were 6.5 days in dogs withheld preliminary treatment, 9.0 days in the dogs receiving CyA and MPL, 26.7 days in those administered one-stage TLI, and 68 days (terminated by euthanasia) of the dogs given two-stage TLI. TLI administered two stages is considered an effective method of enhancing immunosuppression sufficiently to enable the attenuation of adverse reaction to renal allograft in hyperimmunized recipients. (author)

  11. De Novo Fibrillary Glomerulonephritis (FGN) in a Renal Transplant with Chronic Hepatitis C

    OpenAIRE

    Filippone, Edward J.; Christine Chmielewski; Rakesh Gulati; Eric Newman; Farber, John L.

    2013-01-01

    Chronic hepatitis C viremia (HepC) has been associated with numerous renal manifestations both in native kidneys and in the setting of renal transplantation. Glomerulonephritis (GN) of the renal allograft in the setting of HepC most commonly manifests as type 1 membranoproliferative GN (MPGN), either representing recurrence of the original disease or arising de novo. Other GNs were reported after transplantation in the patient with HepC including membranous nephropathy and thrombotic microan...

  12. Trimetazidine does not modify blood levels and immunosuppressant effects of cyclosporine A in renal allograft recipients

    OpenAIRE

    Simon, Nicolas; Brunet, Philippe; Roumenov, Dimitri; Dussol, Bertrand; Barre, Jerome; Duche, Jean-Claude; Albengres, Edith; D’Athis, Philippe; Chauvet-Monges, Anne-Marie; Berland, Yvon; Tillement, Jean-Paul

    1997-01-01

    Aims In renal allograft recipients, trimetazidine (Vastarel® ) was proposed to be associated with the classic immunosuppressant treatments because it displays anti-ischaemic effects which may protect against cyclosporine A nephrotoxicity. The objective of this work was to assess the possibility of coadministering cyclosporin A, Sandimmun®, and trimetazidine.

  13. Effect of lymph leakage on renal allograft outcome from living donors

    Directory of Open Access Journals (Sweden)

    Abolfazl Bohlouli

    2012-01-01

    Full Text Available Lymph leakage is a cause of prolonged fluid discharge in renal transplant patients. Lymph leakage during early post-transplantation is responsible for extracting immune substances; therefore, it may play a role in prognosis of the transplanted kidney. In this study, we aimed to investigate the effects of lymph leakage on different factors that play significant roles in renal allograft outcome. During the present case-control study, we evaluated 62 renal allograft recipients in which 31 subjects were complicated with lymph leakage and enrolled as the study group. The other 31 subjects were included in the control group who did not experience any lymph leakage during their post-transplantation period. All kidneys were transplanted from living donors. We investigated and compared the renal allograft rejection rate, hospitalization duration, serum urea, creatinine (Cr and cyclosporine (CsA levels, antithymoglobin (ATG administration and treatment duration between the study and the control groups. There were no significant difference in the urea and Cr levels between the two groups (P >0.05. Early (one week and late (one month serum CsA levels of the study group were significantly higher than in the control group (P = 0.005 and P = 0.006. The number of days in which ATG receivers responded to therapy was significantly lower for the control group (P = 0.008. 21.93% of the study group subjects experienced allograft rejection, while this rejection probability was 28.38% for the control group (P = 0.799. Lymph leakage has no prominent role in renal function, which is estimated by Cr and urea levels in patients′ serum during the days after transplantation. CsA level was higher in patients with lymph leakage, and all cases of allograft rejection were in the subjects with lymph leakage.

  14. Evaluation of blood flow in Allograft Renal Arteries anastomosed with two different techniques

    International Nuclear Information System (INIS)

    Renal artery stenosis in renal transplantation (TRAS) is an avoidable short or long term surgical complication. The etiology is multifactorial, but faulty anastomosis is a major factor. In our transplant center, we evaluated the incidence of TRAS with the use of two different suturing techniques of the anastomosis site between allograft renal and renal and iliac arteries in two groups of renal transplant recipients, group A: 14 patients (6 males and 8 females with age 16 to 59 and mean age of 38 years) in whom allograft arteries were anastomosed with a continuous suture technique and group B: 14 patients (7 males and 7 females with age 32 to 61 and mean age of 46.6 years) in whom the allograft arteries were anastomosed with a combined suture technique (continuous and uninterrupted. Post transplantation, the velocity of blood flow in the renal and iliac arteries at the site of anastomosis was measured by color Doppler ultrasound. The ultrasonographer was blinded to the surgical technique in both study groups. The ratio of the maximum velocity of blood at the site of anastomosis to that in the iliac artery of less than 2.5 was considered as non-significant stenosis, while a ratio of more than 2.5 was considered significant stenosis. In group A there were 9 cases of non-significant stenosis in comparison to 3 cases in group B, while there were no cases of significant stenosis in group A in comparison to 3 cases in group B; the difference was not statistically significant. We conclude that there was no difference in the compared surgical techniques of anastomosis in our study groups. This suggests that other factors such as gentle handling of tissue, enough spatula, margin reversion and comparable diameter of the anastomosed vessels may be more important in the prevention of renal allograft stenosis than the type of suture technique. (author)

  15. Renal and urinary levels of endothelial protein C receptor correlate with acute renal allograft rejection.

    Directory of Open Access Journals (Sweden)

    Lionel Lattenist

    Full Text Available The Endothelial Protein C Receptor (EPCR is expressed on leukocytes, on endothelium of large blood vessels and to a lesser extent on capillaries. Membrane bound EPCR plays an important role in the activation of protein C which has anticoagulant, anti-inflammatory and cytoprotective effects. After cleavage by a protease EPCR is also found as a soluble protein. Acute rejection of kidney allografts can be divided in T-cell-mediated rejection (TCMR and antibody-mediated (ABMR rejection. The latter is characterized by strong activation of coagulation. Currently no reliable non-invasive biomarkers are available to monitor rejection. Renal biopsies were available from 81 renal transplant patients (33 without rejection, 26 TCMR and 22 ABMR, we had access to mRNA material, matched plasma and urine samples for a portion of this cohort. Renal EPCR expression was assessed by RT-PCR and immunostaining. Plasma and urine sEPCR levels were measured by ELISA. ABMR patients showed higher levels of EPCR mRNA than TCMR patients. EPCR expression on glomeruli was significantly elevated in ABMR patients than in TCMR or control patients. In the peritubular capillaries EPCR expression was higher in ABMR patients than in control patients. EPCR expression was higher in tubules and arteries of rejection patients than in control patients. Plasma sEPCR levels did not differ. Urine sEPCR levels were more elevated in the ABMR group than in patients with TCMR or without rejection. ROC analysis demonstrated that urinary sEPCR is appropriate to discriminate between ABMR patients and TCMR or control patients. We conclude that urinary sEPCR could be a novel non-invasive biomarker of antibody mediated rejection in renal transplantation.

  16. Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits complicated by immunoglobulin A nephropathy in the renal allograft.

    Science.gov (United States)

    Sawada, Anri; Kawanishi, Kunio; Horita, Shigeru; Koike, Junki; Honda, Kazuho; Ochi, Ayami; Komoda, Mizuki; Tanaka, Yoichiro; Unagami, Kohei; Okumi, Masayoshi; Shimizu, Tomokazu; Ishida, Hideki; Tanabe, Kazunari; Nagashima, Yoji; Nitta, Kosaku

    2016-07-01

    Immunoglobulin (Ig) A nephropathy (IgAN) is a known autoimmune disease due to abnormal glycosylation of IgA1, and occasionally, IgG co-deposition occurs. The prognosis of IgG co-deposition with IgAN is adverse, as shown in the previous studies. However, in the clinical setting, monoclonality of IgG co-deposition with IgAN has not been observed. We describe a case of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) combined with IgAN in a renal allograft. A-21-year-old man developed end-stage renal failure with unknown aetiology and underwent living-donor kidney transplantation from his mother 2 years after being diagnosed. One year after kidney transplantation, proteinuria 2+ and haematuria 2+ were detected; allograft biopsy revealed mesangial IgA and C3 deposits, indicating a diagnosis of IgAN. After tonsillectomy and steroid pulse therapy, proteinuria and haematuria resolved. However, 4 years after transplantation, pedal oedema, proteinuria (6.89 g/day) and allograft dysfunction (serum creatinine (sCr) 203.3 µmol/L) appeared. A second allograft biopsy showed mesangial expansion and focal segmental proliferative endocapillary lesions with IgA1λ and monoclonal IgG1κ depositions. Electron microscopic analysis revealed a massive amount of deposits, located in the mesangial and subendothelial lesions. A diagnosis of PGNMID complicated with IgAN was made, and rituximab and plasmapheresis were added to steroid pulse therapy. With this treatment, proteinuria was alleviated to 0.5 g/day, and the allograft dysfunction recovered to sCr 132.6 µmol/L. This case suggests a necessity for investigation of PGNMID and IgA nephropathy in renal allografts to detect monoclonal Ig deposition disease. PMID:26971743

  17. CT findings in ten patients with failed renal allografts: comparison with findings in functional grafts

    International Nuclear Information System (INIS)

    Our aim is to report the computed tomography (CT) features of the long-term failed renal allograft. Ten patients with failed renal transplants in whom the graft was left in situ underwent CT for various unrelated indications. The majority of the failed grafts showed marked shrinkage and coarse punctate diffuse parenchymal calcifications. Small cysts were seen in four grafts. A long-term failed renal transplant appeared on CT as a small rounded soft tissue mass. The graft was almost always heavily calcified. Lack of awareness of the nature of such a mass may mislead the radiologist in interpreting it as a space-occupying lesion

  18. A noninvasive assay for monitoring renal allograft status

    OpenAIRE

    Victor Romanov; Terry C. Whyard; Wayne C. Waltzer; Darras, Frank S.

    2014-01-01

    Transplant rejection is a serious complication, sometimes threatening life of the patient. Although recent development of the new generation of immunosuppressive drugs reduced the incidence of acute rejection in kidney transplantation, the absence of noninvasive biomarkers of the rejection does not allow often the optimization of a prompt antirejection therapy. Serum creatinine is the most widely used marker for allograft function, however, it is not sensitive and specific enough to detect ac...

  19. SPECT- and PET-Based Approaches for Noninvasive Diagnosis of Acute Renal Allograft Rejection

    Directory of Open Access Journals (Sweden)

    Helga Pawelski

    2014-01-01

    photon emission computed tomography (SPECT or positron emission tomography are promising tools for noninvasive diagnosis of acute allograft rejection (AR. Given the importance of renal transplantation and the limitation of available donors, detailed analysis of factors that affect transplant survival is important. Episodes of acute allograft rejection are a negative prognostic factor for long-term graft survival. Invasive core needle biopsies are still the “goldstandard” in rejection diagnostics. Nevertheless, they are cumbersome to the patient and carry the risk of significant graft injury. Notably, they cannot be performed on patients taking anticoagulant drugs. Therefore, a noninvasive tool assessing the whole organ for specific and fast detection of acute allograft rejection is desirable. We herein review SPECT- and PET-based approaches for noninvasive molecular imaging-based diagnostics of acute transplant rejection.

  20. Chronic allograft rejection in lung transplant recipients: assessment with paired inspiratory and expiratory CT

    OpenAIRE

    Bankier, Alexandre

    2011-01-01

    This work discusses the role of CT in the etection and quantification of chronic allograft rejection in patients after lung transplantation and provides solutions to the technical challenges involved with this approach.

  1. Chemokines in Chronic Liver Allograft Dysfunction Pathogenesis and Potential Therapeutic Targets

    Directory of Open Access Journals (Sweden)

    Bin Liu

    2013-01-01

    Full Text Available Despite advances in immunosuppressive drugs, long-term success of liver transplantation is still limited by the development of chronic liver allograft dysfunction. Although the exact pathogenesis of chronic liver allograft dysfunction remains to be established, there is strong evidence that chemokines are involved in organ damage induced by inflammatory and immune responses after liver surgery. Chemokines are a group of low-molecular-weight molecules whose function includes angiogenesis, haematopoiesis, mitogenesis, organ fibrogenesis, tumour growth and metastasis, and participating in the development of the immune system and in inflammatory and immune responses. The purpose of this review is to collect all the research that has been done so far concerning chemokines and the pathogenesis of chronic liver allograft dysfunction and helpfully, to pave the way for designing therapeutic strategies and pharmaceutical agents to ameliorate chronic allograft dysfunction after liver transplantation.

  2. Identification of common blood gene signatures for the diagnosis of renal and cardiac acute allograft rejection.

    Directory of Open Access Journals (Sweden)

    Li Li

    Full Text Available To test, whether 10 genes, diagnostic of renal allograft rejection in blood, are able to diagnose and predict cardiac allograft rejection, we analyzed 250 blood samples from heart transplant recipients with and without acute rejection (AR and with cytomegalovirus (CMV infection by QPCR. A QPCR-based logistic regression model was built on 5 of these 10 genes (AR threshold composite score >37%  = AR and tested for AR prediction in an independent set of 109 samples, where it correctly diagnosed AR with 89% accuracy, with no misclassifications for AR ISHLT grade 1b. CMV infection did not confound the AR score. The genes correctly diagnosed AR in a blood sample within 6 months prior to biopsy diagnosis with 80% sensitivity and untreated grade 1b AR episodes had persistently elevated scores until 6 months after biopsy diagnosis. The gene score was also correlated with presence or absence of cardiac allograft vasculopathy (CAV irrespective of rejection grade. In conclusion, there is a common transcriptional axis of immunological trafficking in peripheral blood in both renal and cardiac organ transplant rejection, across a diverse recipient age range. A common gene signature, initially identified in the setting of renal transplant rejection, can be utilized serially after cardiac transplantation, to diagnose and predict biopsy confirmed acute heart transplant rejection.

  3. Functional genomics in renal transplantation and chronic kidney disease

    International Nuclear Information System (INIS)

    For the past decade, the development of genomic technology has revolutionized modern biological research. Functional genomic analyses enable biologists to study genetic events on a genome wide scale. Examples of applications are gene discovery, biomarker determination, disease classification, and drug target identification. Global expression profiles performed with microarrays enable a better understanding of molecular signature of human disease, including acute and chronic kidney disease. About 10 % of the population in western industrialized nations suffers from chronic kidney disease (CKD). Treatment of end stage renal disease, the final stage of CKD is performed by either hemo- or peritoneal dialysis or renal transplantation. The preferred treatment is renal transplantation, because of the higher quality of life. But the pathophysiology of the disease on a molecular level is not well enough understood and early biomarkers for acute and chronic kidney disease are missing. In my studies I focused on genomics of allograft biopsies, prevention of delayed graft function after renal transplantation, anemia after renal transplantation, biocompatibility of hemodialysis membranes and peritoneal dialysis fluids and cardiovascular diseases and bone disorders in CKD patients. Gene expression profiles, pathway analysis and protein-protein interaction networks were used to elucidate the underlying pathophysiological mechanism of the disease or phenomena, identifying early biomarkers or predictors of disease state and potentially drug targets. In summery my PhD thesis represents the application of functional genomic analyses in chronic kidney disease and renal transplantation. The results provide a deeper view into the molecular and cellular mechanisms of kidney disease. Nevertheless, future multicenter collaborative studies, meta-analyses of existing data, incorporation of functional genomics into large-scale prospective clinical trials are needed and will give biomedical

  4. Injury to Allografts: innate immune pathways to acute and chronic rejection

    International Nuclear Information System (INIS)

    An emerging body of evidence suggests that innate immunity, as the first line of host defense against invading pathogens or their components [pathogen-associated molecular patterns, (PAMPs)], plays also a critical role in acute and chronic allograft rejection. Injury to the donor organ induces an inflammatory milieu in the allograft, which appears to be the initial key event for activation of the innate immune system. Injury-induced generation of putative endogenous molecular ligand, in terms of damaged/danger-associated molecular patterns (DAMPs) such as heat shock proteins, are recognized by Toll-like receptors (TLRs), a family of pattern recognition receptors on cells of innate immunity. Acute allograft injury (e.g. oxidative stress during donor brain-death condition, post-ischemic reperfusion injury in the recipient) includes DAMPs which may interact with, and activate, innate TLR-bearing dendritic cells (DCs) which, in turn, via direct allo-recognition through donor-derived DCs and indirect allo-recogntion through recipient-derived DCs, initiate the recipient's adaptive alloimmune response leading to acute allograft rejection. Chronic injurious events in the allograft (e.g. hypertension, hyperlipidemia, CMV infection, administration of cell-toxic drugs [calcineurin-inhibitors]) induce the generation of DAMPs, which may interact with and activate innate TLR-bearing vascular cells (endothelial cells, smooth muscle cells) which, in turn, contribute to the development of atherosclerosis of donor organ vessels (alloatherosclerosis), thus promoting chronic allograft rejection. (author)

  5. High Pre-Transplant Serum Levels of CXCL10 Predict Early Renal Allograft Failure

    OpenAIRE

    Salvadori, M; De Serio, M.; G. La Villa; V. FOSSOMBRONI; F. Pradella; Lazzeri, E.; Lasagni, L; A.Buonamano; A. Rosati; M. ROTONDI; Romagnani, P.; E. Bertoni

    2003-01-01

    Background: The chemokine CXCL10 is a potent chemoattractant for activated lymphocytes and dendritic cells and mediates vascular injury by inducing intimal hyperplasia and inhibition of endothelial cell growth. Neutralisation of CXCL10 prolongs allograft survival and transplant knock-out models have shown that this chemokine is required for the initiation and development of graft failure due to both acute and chronic rejection. In the present study, we investigated whether pre-transplant CXCL...

  6. US-guided biopsy of renal allografts using 18G biopsy gun: analysis of 200 cases

    International Nuclear Information System (INIS)

    We evaluated the effectiveness and safety of 18G biopsy gun with US guidance in the transplanted kidneys. We performed 200 US-guided percutaneous biopsies using 18G biopsy gun. Diagnostic efficacy and complication of the biopsy in these patients were analyzed. Biopsy specimens were adequate for histologic diagnoses in 193 patients(96.5%). The mean of the biopsy frequency was 3, the mean of total glomerular number was 21.64 and the mean glomerular number per one biopsy was 6.93. Major complications occurred in 3 (1.5%) of the 200 biopsies; hematuria developed in two patients, AV fistula in one. These complications were successfully controlled either by only transfusion or by coil embolization. There were no statistical differences in blood pressure, hemoglobin, BUN/Cr between pre-and post-renal biopsies. US-guided percutaneous biopsy of renal allograft with 18G biopsy gun is simple, safe, and accurate method in evaluating the renal allograft dysfunction

  7. MicroRNA-10b downregulation mediates acute rejection of renal allografts by derepressing BCL2L11

    International Nuclear Information System (INIS)

    Kidney transplantation is the major therapeutic option for end-stage kidney diseases. However, acute rejection could cause allograft loss in some of these patients. Emerging evidence supports that microRNA (miRNA) dysregulation is implicated in acute allograft rejection. In this study, we used next-generation sequencing to profile miRNA expression in normal and acutely rejected kidney allografts. Among 75 identified dysregulated miRNAs, miR-10b was the most significantly downregulated miRNAs in rejected allografts. Transfecting miR-10b inhibitor into human renal glomerular endothelial cells recapitulated key features of acute allograft rejection, including endothelial cell apoptosis, release of pro-inflammatory cytokines (interleukin-6, tumor necrosis factor α, interferon-γ, and chemokine (C–C motif) ligand 2) and chemotaxis of macrophages whereas transfection of miR-10b mimics had opposite effects. Downregulation of miR-10b directly derepressed the expression of BCL2L11 (an apoptosis inducer) as revealed by luciferase reporter assay. Taken together, miR-10b downregulation mediates many aspects of disease pathogenicity of acute kidney allograft rejection. Restoring miR-10b expression in glomerular endothelial cells could be a novel therapeutic approach to reduce acute renal allograft loss. - Highlights: • miR-10b was the most downregulated microRNAs in acutely rejected renal allografts. • miR-10b downregulation triggered glomerular endothelial cell apoptosis. • miR-10b downregulation induced release of pro-inflammatory cytokines. • miR-10b downregulation derepressed its pro-apoptotic target BCL2L11

  8. MicroRNA-10b downregulation mediates acute rejection of renal allografts by derepressing BCL2L11

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xiaoyou [Department of Organ Transplantation, Zhujiang Hospital, Guangzhou 510282 (China); Dong, Changgui [Institute of Molecular Ecology and Evolution, East China Normal University, Shanghai 200062 (China); Jiang, Zhengyao [Department of Organ Transplantation, Zhujiang Hospital, Guangzhou 510282 (China); Wu, William K.K. [Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong (China); State Key Laboratory of Digestive Diseases, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong (China); Chan, Matthew T.V. [Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong (China); Zhang, Jie [Department of Organ Transplantation, Zhujiang Hospital, Guangzhou 510282 (China); Li, Haibin; Qin, Ke [Guangxi Key Laboratory for Transplantation Medicine Department of Organ Transplantation in Guangzhou Military Region, Institute of Transplant Medicine, 303 Hospital of People' s Liberation Army, Nanning, Guangxi 530021 (China); Sun, Xuyong, E-mail: sunxuyong0528@163.com [Guangxi Key Laboratory for Transplantation Medicine Department of Organ Transplantation in Guangzhou Military Region, Institute of Transplant Medicine, 303 Hospital of People' s Liberation Army, Nanning, Guangxi 530021 (China)

    2015-04-10

    Kidney transplantation is the major therapeutic option for end-stage kidney diseases. However, acute rejection could cause allograft loss in some of these patients. Emerging evidence supports that microRNA (miRNA) dysregulation is implicated in acute allograft rejection. In this study, we used next-generation sequencing to profile miRNA expression in normal and acutely rejected kidney allografts. Among 75 identified dysregulated miRNAs, miR-10b was the most significantly downregulated miRNAs in rejected allografts. Transfecting miR-10b inhibitor into human renal glomerular endothelial cells recapitulated key features of acute allograft rejection, including endothelial cell apoptosis, release of pro-inflammatory cytokines (interleukin-6, tumor necrosis factor α, interferon-γ, and chemokine (C–C motif) ligand 2) and chemotaxis of macrophages whereas transfection of miR-10b mimics had opposite effects. Downregulation of miR-10b directly derepressed the expression of BCL2L11 (an apoptosis inducer) as revealed by luciferase reporter assay. Taken together, miR-10b downregulation mediates many aspects of disease pathogenicity of acute kidney allograft rejection. Restoring miR-10b expression in glomerular endothelial cells could be a novel therapeutic approach to reduce acute renal allograft loss. - Highlights: • miR-10b was the most downregulated microRNAs in acutely rejected renal allografts. • miR-10b downregulation triggered glomerular endothelial cell apoptosis. • miR-10b downregulation induced release of pro-inflammatory cytokines. • miR-10b downregulation derepressed its pro-apoptotic target BCL2L11.

  9. Extensive cerebral venous thrombosis in a renal allograft recipient

    International Nuclear Information System (INIS)

    An increased risk of venous thromboembolism has been demonstrated following renal transplantation. Commonly reported sites have been deep vein thrombosis, pulmonary thromboembolism and vascular thrombosis involving the graft. Cerebral venous thrombosis (CVT) has not been reported in literature so far. A 36-year-old male patient, transplanted in January 2005 with normal graft functions, was admitted with history of headache, blurring of vision and vomiting. Examination revealed papilledema and no neurological deficits. Baseline investigations and analysis of cerebrospinal liquid were normal. Cerebral magnetic resonance venogram revealed extensive CVT involving superior sagittal sinus, bilateral transverse sinuses and the right sigmoid sinus. He was investigated for a thrombophilic disorder; serum homocysteine, protein C and S levels, antiphospholipid antibody and antithrombin-III levels were done despite which no conclusive diagnosis could be arrived at. To our knowledge, this is the first report of extensive CVT described in a transplant recipient. Ne definite prothrombotic or predisposing factors could be identified in our patient and the cause of CVT remains unclear. (author)

  10. Utility of Double Filtration Plasmapheresis in Acute Antibody Mediated Renal Allograft Rejection: Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Yalçın SOLAK

    2011-09-01

    Full Text Available Plasmapheresis is an extracorporeal procedure, which is often employed to rapidly lower circulating titers of autoantibodies, immune complexes or toxins. There are two types of plasmapheresis namely, regular plasmapheresis (RPP by centrifugation and membrane filtration, and double filtration plasmapheresis (DFPP which is a special form of membrane filtration in which two membranes called as plasma separator and plasma fractionator are employed to filter macromolecules more selectively. DFPP have several advantages over RP. Despite widespread utilization of DFPP in the setting of ABO blood group incompatible kidney transplantation, there is no report regarding DFPP in patients with antibody mediated acute renal allograft rejection who are good candidates for beneficial effects of DFPP. Here we report three renal transplant recipients in whom DFPP was applied as a component of anti-rejection treatment regimen.

  11. Immunosuppression of canine renal allograft recipients by CD4 and CD8 monoclonal antibodies

    International Nuclear Information System (INIS)

    A state of tolerance to MHC mismatched allografts can be generated in rodents by treatment with CD4 and CD8 monoclonal antibodies (mAb). In order to transpose this type of therapy to large animals and ultimately to the clinic, a suitable model is required. To this end we have generated a series of mAb to the canine CD4, CD8, and Thy-l antigens and have tested their ability to prevent rejection of renal allografts. Donor-recipient pairs were selected from a colony of mongrel dogs in which untreated rejection of two haplotype-mismatched kidneys occurred by day 7 (defined as a serum creatinine > 300 μmol/l). Therapy with either the CD4 or the CD8 mAb, using no other immunosuppression, did not prolong graft survival. Depletion of T cells by a Thy-l mAb prior to surgery only extended graft survival to day 9. However, treating with combinations of mAb up to day 10 (CD4 plus Thy-l; CD4 plus CD8; or CD4 plus CD8 plus Thy-l) prolonged renal allograft function up to 25 days. Combination of the triple mAb therapy with a sub-therapeutic immunosuppressive drug regimen (cyclosporin A plus azathioprine that alone gave a median survival of 15 days) favored survival to a median of 38 days. This protocol also inhibited the antiglobulin response that had curtailed the effects of mAb treatment, opening the way to more extended, and potentially tolerizing, mAb plus drug regimens. (au) (23 refs.)

  12. Immunosuppression of canine renal allograft recipients by CD4 and CD8 monoclonal antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Watson, C.J.E.; Davies, H.S.; Rebello, P.R.U.B.; McNair, R.; Rasmussen, A.; Calne, R.Y.; Metcalfe, S.M. (Department of Surgery, University of Cambridge (United Kingdom)); Cobbold, S.P.; Thiru, S.; Waldmann, H. (Department of Pathology, University of Cambridge (United Kingdom))

    1994-01-01

    A state of tolerance to MHC mismatched allografts can be generated in rodents by treatment with CD4 and CD8 monoclonal antibodies (mAb). In order to transpose this type of therapy to large animals and ultimately to the clinic, a suitable model is required. To this end we have generated a series of mAb to the canine CD4, CD8, and Thy-l antigens and have tested their ability to prevent rejection of renal allografts. Donor-recipient pairs were selected from a colony of mongrel dogs in which untreated rejection of two haplotype-mismatched kidneys occurred by day 7 (defined as a serum creatinine > 300 [mu]mol/l). Therapy with either the CD4 or the CD8 mAb, using no other immunosuppression, did not prolong graft survival. Depletion of T cells by a Thy-l mAb prior to surgery only extended graft survival to day 9. However, treating with combinations of mAb up to day 10 (CD4 plus Thy-l; CD4 plus CD8; or CD4 plus CD8 plus Thy-l) prolonged renal allograft function up to 25 days. Combination of the triple mAb therapy with a sub-therapeutic immunosuppressive drug regimen (cyclosporin A plus azathioprine that alone gave a median survival of 15 days) favored survival to a median of 38 days. This protocol also inhibited the antiglobulin response that had curtailed the effects of mAb treatment, opening the way to more extended, and potentially tolerizing, mAb plus drug regimens. (au) (23 refs.).

  13. Infuence of donor specific transfusion on renal allograft outcome

    Directory of Open Access Journals (Sweden)

    Jovičić-Pavlović Svetlana

    2003-01-01

    -year graft survival was 100% for grafts from groups 1 and 3, while it is gradually decreased for group 2 grafts: 84.5% and 57%. Our results confirmed the beneficial effect of blood transfusion on LRTx renal graft function and survival and DST on the incidence of acute rejection.

  14. Macrophage mediated endothelial injury and proliferation in renal transplant rejection.

    OpenAIRE

    Adair, Anya

    2008-01-01

    Macrophages (Mφ) have previously been implicated in both acute and chronic renal allograft rejection however the mechanisms remain unclear. In this thesis I set out to explore the effect of the Mφ on the endothelium in the context of renal graft rejection. Initial studies focussed upon human renal allograft tissue from transplant nephrectomies performed because of chronic allograft nephropathy (CAN). Immunostaining was carried out on these tissues (n=29) and control kidne...

  15. Regulatory Allospecific T Cell Clones Abrogate Chronic Allograft Rejection

    OpenAIRE

    Waaga-Gasser, Ana Maria; Grimm, Martin R.; Lutz, Jens; Lange, Volkmar; Lenhard, Susanne M.; Aviles, Beatriz; Kist-van Holthe, Joana E; Lebedeva, Tatiana; Samsonov, Dimitry; Meyer, Detlef; Hancock, Wayne W.; Heemann, Uwe; Gasser, Martin; Chandraker, Anil

    2009-01-01

    True alloantigen-specific tolerance is the ultimate goal of solid organ transplantation, eliminating the need for long-term immunosuppression. Recent evidence suggests that Th1-derived cytokines are associated with rejection and Th2-derived cytokines with long-term allograft survival, but the roles of these subsets in rejection and tolerance are incompletely understood. Here, we analyzed the functional and regulatory capacities of T cell clones derived from tolerant and rejecting rats (Wistar...

  16. Chronic Renal Transplant Rejection and Possible Anti-Proliferative Drug Targets.

    Science.gov (United States)

    Bhatti, Adnan Bashir; Usman, Muhammad

    2015-01-01

    The global prevalence of renal transplants is increasing with time, and renal transplantation is the only definite treatment for end-stage renal disease. We have limited the acute and late acute rejection of kidney allografts, but the long-term survival of renal tissues still remains a difficult and unanswered question as most of the renal transplants undergo failure within a decade of their transplantation. Among various histopathological changes that signify chronic allograft nephropathy (CAN), tubular atrophy, fibrous thickening of the arteries, fibrosis of the kidney interstitium, and glomerulosclerosis are the most important. Moreover, these structural changes are followed by a decline in the kidney function as well. The underlying mechanism that triggers the long-term rejection of renal transplants involves both humoral and cell-mediated immunity. T cells, with their related cytokines, cause tissue damage. In addition, CD 20+ B cells and their antibodies play an important role in the long-term graft rejection. Other risk factors that predispose a recipient to long-term graft rejection include HLA-mismatching, acute episodes of graft rejection, mismatch in donor-recipient age, and smoking. The purpose of this review article is the analyze current literature and find different anti-proliferative agents that can suppress the immune system and can thus contribute to the long-term survival of renal transplants. The findings of this review paper can be helpful in understanding the long-term survival of renal transplants and various ways to improve it. PMID:26677426

  17. HBV Vaccination in Chronic Renal Failure Patients

    OpenAIRE

    Mir-davood Omrani; Mohammad Hassan Khadem Ansari

    2006-01-01

    HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unre...

  18. Comparison of Ultrasound Corticomedullary Strain with Doppler Parameters in Assessment of Renal Allograft Interstitial Fibrosis/Tubular Atrophy.

    Science.gov (United States)

    Gao, Jing; Rubin, Jonathan M; Weitzel, William; Lee, Jun; Dadhania, Darshana; Kapur, Sandip; Min, Robert

    2015-10-01

    To compare the capability of ultrasound strain and Doppler parameters in the assessment of renal allograft interstitial fibrosis/tubular atrophy (IF/TA), we prospectively measured ultrasound corticomedullary strain (strain) and intra-renal artery Doppler end-diastolic velocity (EDV), peak systolic velocity (PSV) and resistive index (RI) in 45 renal transplant recipients before their kidney biopsies. We used 2-D speckle tracking to estimate strain, the deformation ratio of renal cortex to medulla produced by external compression using the ultrasound transducer. We also measured Doppler EDV, PSV and RI at the renal allograft inter-lobar artery. Using the Banff scoring system for renal allograft IF/TA, 45 patients were divided into the following groups: group 1 with ≤5% (n = 12) cortical IF/TA; group 2 with 6%-25% (n = 12); group 3 with 26%-50% (n = 11); and group 4 with >50% (n = 10). We performed receiver operating characteristic curve analysis to test the accuracy of these ultrasound parameters and duration of transplantation in determining >26% cortical IF/TA. In our results, strain was statistically significant in all paired groups (all p EDV was significant only between high-grade (>26%, including 26%-50% and >50%) and low-grade (≤25%, including 0.05). The areas under the receiver operating characteristic curve for strain, EDV, PSV, RI and duration of transplantation in determining >26% cortical IF/TA were 0.99, 0.94, 0.88, 0.52 and 0.92, respectively. Our results suggest that corticomedullary strain seems to be superior to Doppler parameters and duration of transplantation in assessment of renal allograft cortical IF/TA. PMID:26219696

  19. Fatal Progressive Multifocal Leukoencephalopathy in a Kidney Transplant Recipient 19 Years After Successful Renal Allograft Transplantation

    DEFF Research Database (Denmark)

    Carlson, N; Hansen, Jesper Melchior

    2014-01-01

    circumstances of extreme immunodeficiency. Development of fulminant PML is rare and treatment options are limited. CASE REPORT: We have presented a case of JCV reactivation resulting in PML 19 years after renal allograft transplantation and after recent conversion of immunosuppressive treatment. One year after...... conversion of immunosuppressive therapy owing to biopsy-proven acute humoral rejection, our patient presented with symptoms of deteriorating neurologic status. Cerebral computed tomography showed abnormal signals in the frontal lobe suspect for PML. Diagnosis was confirmed by qualitative polymerase chain...... progressive neurologic decline and death rapidly ensued. CONCLUSION: Development of PML in transplant recipients remains rare. Despite advances in our understanding of JCV infection and PML, treatment options remain limited and prognosis is often poor....

  20. De Novo Fibrillary Glomerulonephritis (FGN in a Renal Transplant with Chronic Hepatitis C

    Directory of Open Access Journals (Sweden)

    Edward J. Filippone

    2013-01-01

    Full Text Available Chronic hepatitis C viremia (HepC has been associated with numerous renal manifestations both in native kidneys and in the setting of renal transplantation. Glomerulonephritis (GN of the renal allograft in the setting of HepC most commonly manifests as type 1 membranoproliferative GN (MPGN, either representing recurrence of the original disease or arising de novo. Other GNs were reported after transplantation in the patient with HepC including membranous nephropathy and thrombotic microangiopathy, as well as an enhanced susceptibility to transplant glomerulopathy. We describe the first case of de novo fibrillary GN in a renal transplant patient with HepC where the primary renal disease was biopsy proven type 1 MPGN. We discuss this relationship in detail.

  1. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    International Nuclear Information System (INIS)

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

  2. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    Energy Technology Data Exchange (ETDEWEB)

    Kroepelin, T.; Ziupa, J.; Wimmer, B.

    1983-05-01

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to.

  3. Interaction between omeprazole and tacrolimus in renal allograft recipients: a clinical-analytical study.

    Science.gov (United States)

    Pascual, J; Marcén, R; Orea, O E; Navarro, M; Alarcón, M C; Ocaña, J; Villafruela, J J; Burgos, F J; Ortuño, J

    2005-11-01

    Omeprazole is a proton pump inhibitor with a number of pharmacokinetic drug interactions due to interference with cytochrome P450. Some studies show absence of relevant interaction between omeprazole and cyclosporine, but little is known about possible interactions between omeprazole and tacrolimus. In vitro studies suggest such interference, but no clinical data are available so far. We assessed interactions between omeprazole and tacrolimus among patients fulfilling two criteria: (1) renal allograft recipients receiving immunosuppression based on tacrolimus and acid-related disorder prophylaxis with omeprazole 20 mg/d since the day of the transplant procedure and (2) stopped omeprazole when it was considered unnecessary. Fifty-one transplant recipients received concomitant immunosuppression with MMF-prednisone (n = 47) or azathioprine-prednisone (n = 1), or rapamycin-prednisone (n = 2) or only prednisone (n = 1). omeprazole was stopped after 6.2 +/- 3 months of treatment. Tacrolimus doses and levels were recorded during 3 outpatient visits before omeprazole withdrawal (Pre3/Pre2/Pre1), at the withdrawal visit (Susp), and at 3 visits after withdrawal (Pos1/Pos2/Pos3). Weight gain was significant (72.5 +/- 13 kg Pre3; 73.4 +/- 13 kg Susp; 74 +/- 12.9 kg Pos3, P level/dose ratio remained constant. Tacrolimus doses and levels continued a slow, progressive and significant decrease without any relevant change between visits during on versus off omeprazole. This clinical-analytical study supported the conclusion that an omeprazole-tacrolimus interaction is not clinically relevant. Despite possible competition or interaction at the molecular level, clinical management was not significantly affected in renal allograft recipients. PMID:16386527

  4. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Loffroy, R. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)], E-mail: loffroy.romaric@neuf.fr; Guiu, B.; Lambert, A. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Mousson, C.; Tanter, Y. [Department of Nephrology and Renal Transplantation (France); Martin, L. [Department of Pathology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Cercueil, J.-P.; Krause, D. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)

    2008-06-15

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization.

  5. High serum enalaprilat in chronic renal failure

    DEFF Research Database (Denmark)

    Elung-Jensen, T; Heisterberg, J; Kamper, A L;

    2001-01-01

    renal failure. METHODS: Fifty nine out-patients with plasma creatinine >150 micromol/L and chronic antihypertensive treatment with enalapril were investigated, in a cross-sectional design. RESULTS: Median glomerular filtration rate (GFR) was 23(range 6-60) ml/minute/1.73 m2. The daily dose of enalapril......-68) ml/minute and correlated linearly with GFR (r=0.86, p=0.003). Intra-subject day-to-day variation in trough concentrations was 19.7%. CONCLUSION: Patients with chronic renal failure given small or moderately high doses of enalapril may thus have markedly elevated levels of serum enalaprilat. Whether......BACKGROUND: Most angiotensin-converting enzyme (ACE) inhibitors and their metabolites are excreted renally and doses should hence be reduced in renal insufficiency. We studied whether the dosage of enalapril in daily clinical practice is associated with drug accumulation of enalaprilat in chronic...

  6. 28 CFR 79.67 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.67... renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... claimant. A conclusion that a claimant developed chronic renal disease must be supported by...

  7. Chronic allograft rejection: A significant hurdle to transplant success

    OpenAIRE

    Malgorzata Kloc; Ghobrial, Rafik M.

    2014-01-01

    The state-of-the-art immunosuppression drugs do not ensure indefinite transplant survival, and most transplants are continuously lost to chronic rejection even years posttransplantation. This form of rejection is responsible for long-term failure of transplanted organs. The mechanisms involved in development of chronic rejection are not well-understood. One of the main features of chronic rejection is progressive luminal narrowing of graft vessels, which results in compromised blood flow, isc...

  8. MIP-3alpha/CCL20 in renal transplantation and its possible involvement as dendritic cell chemoattractant in allograft rejection.

    Science.gov (United States)

    Woltman, Andrea M; de Fijter, Johan W; van der Kooij, Sandra W; Jie, Kim E; Massacrier, Catherine; Caux, Christophe; Daha, Mohamed R; van Kooten, Cees

    2005-09-01

    Graft-infiltrating dendritic cells (DC) and alloreactive T lymphocytes play a critical role in renal allograft rejection. Renal proximal tubular epithelial cells (TEC) are considered as active players in the attraction of leukocytes during renal inflammatory responses. Macrophage inflammatory protein (MIP)-3alpha/CCL20 is a major chemokine expressed by epithelial cells that attracts immature DC. In the present study, we present evidence that also the transplanted kidney can be a major source of MIP-3alpha/CCL20. Renal transplant recipients with rejection showed significantly increased excretion of urinary MIP-3alpha/CCL20 that correlated with transplant function. The tubular staining for MIP-3alpha/CCL20 in renal biopsies of patients with rejection as well as in vitro studies with primary human TEC indicated that TEC might be responsible for the increased urinary MIP-3alpha/CCL20. Furthermore, MIP-3alpha/CCL20 produced by activated TEC was highly potent in the attraction of CD1a+CD34+-derived DC precursors. These data suggest a role for MIP-3alpha/CCL20 in amplification of the immune response during renal allograft rejection by attraction of CCR6+ inflammatory cells, which may include DC, to the site of inflammation. PMID:16095490

  9. Chronic allograft rejection: A significant hurdle to transplant success

    Directory of Open Access Journals (Sweden)

    Malgorzata Kloc

    2014-01-01

    Full Text Available The state-of-the-art immunosuppression drugs do not ensure indefinite transplant survival, and most transplants are continuously lost to chronic rejection even years posttransplantation. This form of rejection is responsible for long-term failure of transplanted organs. The mechanisms involved in development of chronic rejection are not well-understood. One of the main features of chronic rejection is progressive luminal narrowing of graft vessels, which results in compromised blood flow, ischemia, cell death, and finally graft failure. All the existing immunosuppressive regimens are targeting acute rejection, and at present there is no available therapy for prevention of chronic rejection. Chronic rejection involves two major, but interrelated responses: The first is the host immune response against the transplant mediated primarily by alloreactive T and B cells, and the second is injury and repair of the graft (vasculopathy of graft vessels. Here we focus on recent advances in understanding the cellular and molecular aspects of chronic transplant vasculopathy and function of macrophages, topics pivotal for development of novel antichronic rejection therapies.

  10. DISTURBANCE OF THE CARDIOMYOCYTE’S MACROMOLECULAR STRUCTURE IN HEART ALLOGRAFTS AS A SIGN OF CHRONIC REJECTION

    OpenAIRE

    A. G. Kupriyanova; L. V. Beletskaya; I. M. Ilyinsky; V. A. Zaidenov; N. P. Mozeiko; R. S. Saitgareev; A. Y. Kormer; A. M. Golts; V. M. Zakharevich; S. V. Gautier

    2012-01-01

    Chronic rejection, especially cardiac allograft vasculopathy, is a major limiting factor for long-term transplant survival. This process affects not only the blood vessels, but also cardiomyocytes. However, there are extremely few reports on the evaluation of their macromolecular structure state. The aim of the study was to evaluate the structural proteins of cardiomyocytes (actin, myosin, troponin I, titin, desmin, vinculin) of heart allografts in different periods after the operation (from ...

  11. Pathological and clinical correlates of FOXP3+ cells in renal allografts during acute rejection.

    Science.gov (United States)

    Veronese, F; Rotman, S; Smith, R N; Pelle, T D; Farrell, M L; Kawai, T; Benedict Cosimi, A; Colvin, R B

    2007-04-01

    The localization and significance of regulatory T cells (Treg) in allograft rejection is of considerable clinical and immunological interest. We analyzed 80 human renal transplant biopsies (including seven donor biopsies) with a double immunohistochemical marker for the Treg transcription factor FOXP3, combined with a second marker for CD4 or CD8. Quantitative FOXP3 cell counts were performed and analyzed for clinical and pathologic correlates. FOXP3(+) cells were present in the interstitium in acute cellular rejection (ACR) type I and II, at a greater density than in acute humoral rejection or CNI toxicity (p attraction or generation at that site. Considering only patients with ACR, a higher density of FOXP3(+) correlated with HLA class II match (p = 0.03), but paradoxically with worse graft survival. We conclude that infiltration of FOXP3(+) cells occurs in ACR to a greater degree than in humoral rejection, however, within the ACR group, no beneficial effect on outcome was evident. Tregs concentrate in tubules, probably contributing to FOXP3 mRNA in urine; the significance and pathogenesis of 'Treg tubulitis' remains to be determined. PMID:17286616

  12. A single center's approach to discriminating donor versus host origin of renal neoplasia in the allograft kidney.

    Science.gov (United States)

    Robin, Adam J; Cohen, Eric P; Chongkrairatanakul, Tepsiri; Saad, Ehad; Mackinnon, A Craig

    2016-08-01

    Renal cell carcinoma (RCC) in the allograft of kidney transplant recipient (KTR) patients is rare and may represent a de novo process arising from the transplanted organ or metastasis from a clinically undetectable host primary. Determination of host versus donor origin is important for staging and management. We report our experience utilizing Penta-C (PC) and Penta-D (PD) short-tandem repeat (STR) microsatellite analysis to discriminate between host and donor origin of RCC identified in renal allografts. We identified 5 KTR patients with RCC in the allograft kidney. The PC and PD microsatellite analysis was applied to tumor, host, and donor formalin-fixed, paraffin-embedded tissue sections and/or fresh blood leukocytes to identify the origin of the neoplastic cells. The PC and PD microsatellite alleles were robustly amplified in all samples. Each case showed one or more informative alleles indicating that the neoplastic cells originate from donor tissue. Allele frequency data indicate that by using both PC and PD markers, we will be able to discriminate between host and donor cell of origin in over 99% of cases. The PC and PD microsatellite analysis is a convenient, robust, and efficient strategy to determine donor versus host origin or RCC in transplant kidney specimens. PMID:27402221

  13. Association of FAS -670A/G and FASL –843C/T Gene Polymorphisms on Allograft Nephropathy in Pediatric Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Afig Berdeli

    2010-12-01

    Full Text Available Objective: FAS and FASL polymorphisms are suggested to play an important role in tubulitis that is a major component of acute rejection. The aim of this study was to investigate the role of FAS-670A/G and FASL-843C/T gene polymorphisms on allograft nephropathy in pediatric renal transplant patients Methods: Fifty three patients (22 males 31 females aged 2 to 20 years (mean 12.3±0.6 who had renal transplantation and fifty healthy control subjects (25 males 25 females were enrolled in the study. Pearsons Chi Square test was used for the statistical analysis. Survival rates were estimated with the Kaplan Meier method. Age, sex, chronic renal failure etiology, treatment modality and duration and donor type were recorded. FAS-670A/G and FASL-843C/T gene polymorphisms were compared between renal transplant patients and normal healthy population as well as between renal transplant patients with and without acute rejection. Findings: FAS-670A/G genotypes or alleles were not significantly different between control and transplant patients and among transplant patients with and without acute rejection (P>0.05 for all. FASL-843C/T genotypes and alleles were not different between transplantation and control groups (P>0.05 for all. However, FASL-843C/T alleles were significantly different between patients with and without AR (P=0.02. The percentages of C allele were higher in children with acute rejection (68.8% vs 44.6%. Conclusion: FASL gene polymorphisms may play a major role in acute rejection while FAS polymorphisms have not been found to be different between patients with and without acute renal graft rejection.

  14. Clinical Significance of HLA-DQ Antibodies in the Development of Chronic Antibody-Mediated Rejection and Allograft Failure in Kidney Transplant Recipients.

    Science.gov (United States)

    Lee, Hyeyoung; Min, Ji Won; Kim, Ji-Il; Moon, In-Sung; Park, Ki-Hyun; Yang, Chul Woo; Chung, Byung Ha; Oh, Eun-Jee

    2016-03-01

    With the development of the single antigen beads assay, the role of donor specific alloantibody (DSA) against human leukocyte antigens in kidney transplantation (KT) has been highlighted. This study aimed to investigate the clinical significance of DQ-DSA detected at renal allograft biopsy. We evaluated 263 KT recipients who underwent allograft biopsy and DSA detection at the same time. Among them, 155 patients who were nonsensitized before transplantation were selected to investigate the role of de-novo DQ-DSA. Both the total and nonsensitized subgroup was categorized into 4 groups each according to DSA results as: DQ only, DQ + non-DQ, non-DQ, and no DSA. In the total patient group, post-KT DSA was positive in 79 (30.0%) patients and DQ-DSA was most prevalent (64.6%). In the nonsensitized subgroup, de-novo DSAs were detected in 45 (29.0%) patients and DQ-DSA was also most prevalent (73.3%). The DQ only group showed a significantly longer post-KT duration compared to the other groups (P < 0.05). The overall incidence of antibody-mediated rejection (AMR) was 17.9%. B-DSA, DR-DSA, and DQ-DSA were associated with AMR (P < 0.05), but in the analysis for chronic AMR, only DQ-DSA showed significance in both the total and the nonsensitized subgroup (P < 0.05). On comparison of Banff scores among groups, those representing humoral immunity were significantly dominant in all DSA positive groups compared to the no DSA group (P < 0.05), and higher scores of markers representing chronic tissue injury were more frequently detected in the groups with DQ-DSA. The worst postbiopsy survival was seen in the DQ + non-DQ group of the total patient group, and patients with de-novo DQ-DSA showed poorer graft survival in the nonsensitized subgroup compared to the no DSA group (P < 0.05). In the multivariate analysis, de-novo DQ-DSA was the only significant risk factor associated with late allograft failure (P < 0.05). Our study is the first to demonstrate

  15. Case report: parenchymal pseudoaneurysm of a renal allograft after core needle biopsy: a rare cause of allograft injury.

    Science.gov (United States)

    Selim, M; Goldstein, M J

    2011-09-01

    There are multiple causes of worsening graft function after initial good function in cadaveric kidney transplant. In this report, we discuss a rare one: a traumatic pseudoaneurysm caused by a 14-gauge core needle biopsy in a 55-year-old woman. She had immediate graft function followed by rapid decline in the first postoperative week. Imaging studies showed an intraparenchymal 2-cm pulsatile mass with turbulent blood flow in the upper pole at the corticomedullary junction. Angiography the following morning confirmed the diagnosis of pseudoaneurysm. It was coiled successfully, with restoration of graft function. Although development of a pseudoaneurysm is a rare event, transplant centers must be cognizant of allograft injuries like this one. PMID:21911162

  16. Post-transplantation lymphoproliferative disorders in renal vs. simultaneous renal-pancreas allograft recipients: A survey and analysis of data from the literature

    Directory of Open Access Journals (Sweden)

    Hossein Khedmat

    2013-01-01

    Full Text Available The epidemiology and other aspects of post-transplantation lymphoproliferative disorders (PTLD are different in different transplant populations. In this study, we sought to determine the clinical, histopathological and various other features of PTLD in recipients of pancreas-renal allografts and to compare their data with renal-only transplant patients, based on the current available literature. We conducted a comprehensive search for the available data using the Pubmed and Google scholar search engines for reports of lymphoproliferative disorders after renal and simultaneous pancreas-renal (SPR transplantations. A total of 229 recipients of renal and pancreas-renal allografts were included in the analysis. Localizations for SPR recipients were significantly higher than renal recipients in the pancreas (P <0.0001, skin (P = 0.035, liver (P = 0.043 and bone marrow (P = 0.022. Involvement of lymph nodes was more prevalent in renal recipients (P = 0.046. The occurrence of metastasis was more common among SPR recipients (P = 0.005. Hodgkin′s and Hodgkin′s-like PTLD were also more prevalent among SPR transplant patients (P <0.0001. Time to development of PTLD was significantly shorter among recipients of SPR (P <0.0001. In this study of international data, we found that PTLD in SPR transplant recipients have various characteristics in their site of involvement, disease presentation time and histopathological features. However, no difference in outcome was detected in these groups of PTLD patients. Future studies with larger study populations are needed for confirming and extending our study results.

  17. 28 CFR 79.57 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.57... disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... conclusion that a claimant developed chronic renal disease must be supported by medical documentation. (b)...

  18. Parathyroid hormone secretion in chronic renal failure

    DEFF Research Database (Denmark)

    Madsen, J C; Rasmussen, A Q; Ladefoged, S D;

    1996-01-01

    The aim of study was to introduce and evaluate a method for quantifying the parathyroid hormone (PTH) secretion during hemodialysis in secondary hyperparathyroidism due to end-stage renal failure. We developed a method suitable for inducing sequential hypocalcemia and hypercalcemia during...... failure. By the use of a standardized method we show that the calcium set-point is normal or slightly elevated, indicating normal parathyroid reactivity to calcium in chronic renal failure......., blood PTH/ionized calcium curves were constructed, and a mean calcium set-point of 1.16 mmol/liter was estimated compared to the normal mean of about 1.13 mmol/liter. In conclusion, we demonstrate that it is important to use a standardized method to evaluate parathyroid hormone dynamics in chronic renal...

  19. New scoring system identifies kidney outcome with radiation therapy in acute renal allograft rejection

    International Nuclear Information System (INIS)

    Purpose: To evaluate the role of radiation therapy for acute refractory renal rejection after failure of medical intervention, and to identify risk factors that influence graft survival following radiation therapy. Methods: Between June 1989 and December 1995, 53 renal transplant recipients (34 men and 19 women) were treated with localized radiation therapy for acute renal allograft rejection. Graft rejection was defined as an increase in serum creatinine with histologic evidence of rejection on renal biopsy. Ninety-one percent were cadaveric transplant recipients. The majority of patients who experienced acute graft rejection initially received corticosteroid therapy, except for 25% who were referred for radiation therapy and steroids for the first rejection. In more recent years, patients with moderate or severe steroid-resistant or recurrent rejection received OKT3, a polyclonal antilymphocyte antibody (ATGAM), tacrolimus (FK506), or mycophenolate mofetil (MMF). Patients who failed to respond to medical treatment were then referred for radiation therapy. Ultrasound was performed for kidney localization. Treatment consisted of a dose of 600 cGy given in 3 or 4 fractions using 6 MV photons, delivered AP or AP/PA. Results: The overall actuarial graft survival from the initiation of RT was 83% at 1 month, 60% at 1 year, and 36% at 5 years. The median follow-up from the date of transplant to the last follow-up was 22 months. The median time from the date of transplant to the initiation of radiotherapy was 3 months, and the median time from the initiation of radiotherapy to the last follow-up was 10 months. Variables evaluated were as follows: human leukocyte antigen matching on HLA-A, HLA-B, and HLA-DR, the transplant panel-reactive antibodies (PRA) at transplantation, number of acute rejection episodes, interval from the date of the transplant to the first rejection, serum creatinine levels at the time of the first radiation treatment, number of transplants, and

  20. Efficacy of total lymphoid irradiation for chronic allograft rejection following bilateral lung transplantation

    International Nuclear Information System (INIS)

    Purpose: To assess the safety and efficacy of total lymphoid irradiation (TLI) in patients experiencing chronic rejection following bilateral lung transplantation (BLT). Patients and Materials: Eleven patients received TLI for chronic allograft rejection (bronchiolitis obliterans syndrome) refractory to conventional treatment modalities. Radiation therapy (RT) was prescribed as 8 Gy delivered in 10 0.8-Gy fractions, 2 fractions/week, via mantle, paraaortic, and inverted-Y fields. Serial pre- and post-RT pulmonary function values, complete blood counts, and immunosuppressive augmentation requirements [use of methylprednisolone, murine anti-human mature T-cell monoclonal antibody (OKT3), polyclonal antithymocyte globulin (ATG), and tacrolimus] were monitored. Results: In the 3 months preceding TLI, the average decrease in forced expiratory volume in 1 s (FEV1) was 34% (range 0-75%) and the median number of immunosuppression augmentations was 3 (range 0-5). Only 4 of 11 patients completed all 10 TLI treatment fractions. Reasons for discontinuation included progressive pulmonary decline (four patients), worsening pulmonary infection (two patients), and persistent thrombocytopenia (one patient). Seven of the 11 patients failed within 8 weeks of treatment cessation. One patient had unabated rejection and received bilateral living related-donor transplants; he is alive and well. Six patients died. Two of these deaths were due to pulmonary infection from organisms isolated prior to the start of RT; the other four deaths were from progressive pulmonary decline. The four remaining patients had durable positive responses to TLI (mean follow-up of 47 weeks; range 24-72). Comparing the 3 months preceding RT to the 3 months following treatment, these four patients had improvements in average FEV1 (40% decline vs. 1% improvement) and fewer median number of immunosuppressive augmentations (3.5 vs. 0). None of these patients has developed lymphoproliferative disease or has died

  1. Studies of the effects of FK506 on renal allografting in the beagle dog.

    Science.gov (United States)

    Ochiai, T; Nagata, M; Nakajima, K; Suzuki, T; Sakamoto, K; Enomoto, K; Gunji, Y; Uematsu, T; Goto, T; Hori, S

    1987-12-01

    The immunosuppressive activities of a newly discovered macrolide extracted from Streptomyces tsukubaensis, FK506, were examined using 38 renal allografts in the beagle dog. The median survival time was 15.5 days in dogs without treatment, 61 days with a dose of 0.08 mg/kg/day and 176 days with a dose of 0.16 mg/kg/day of intramuscularly administered FK506. Prolongation of survival was statistically significant when compared with controls (P = 0.02, 0.0044, respectively). None of 6 recipient dogs receiving the agent at a dose of 0.16 mg/kg/day encountered rejection during the treatment course. Three of them survived over 200 days. Oral administration of FK506 at a dose of 0.32 mg/kg/day did not prolong the median survival time (20.5 days) compared with the placebo treated control (16.5 days), but oral treatment with 1.0 mg/kg/day resulted in all of the recipient dogs surviving over 130 days. Histological studies of 7 kidney graft biopsy specimens of the dogs surviving over 3 months revealed no cell infiltration or only some degree of reversible interstitial cell infiltration, but vascular and glomerular changes were not observed in any of the specimens. Irregularity of nuclear shape and cytoplasmic vacuolation of the pars recta of the proximal tubules were observed in one dog each. Liver biopsy specimens showed no consistent evidence of hepatocellular damage. Three dogs died of intussusception 2-3 weeks posttransplant. The dogs treated intramuscularly with 0.32 mg/kg/day suffered from anorexia. Two dogs receiving oral treatment at a dose of 1.0 mg/kg developed papilloma of the skin around day 60, but the tumors disappeared by day 120. We conclude that FK506 is a powerful immunosuppressant in the dog with tolerable side effects. PMID:2447688

  2. DISTURBANCE OF THE CARDIOMYOCYTE’S MACROMOLECULAR STRUCTURE IN HEART ALLOGRAFTS AS A SIGN OF CHRONIC REJECTION

    Directory of Open Access Journals (Sweden)

    A. G. Kupriyanova

    2012-01-01

    Full Text Available Chronic rejection, especially cardiac allograft vasculopathy, is a major limiting factor for long-term transplant survival. This process affects not only the blood vessels, but also cardiomyocytes. However, there are extremely few reports on the evaluation of their macromolecular structure state. The aim of the study was to evaluate the structural proteins of cardiomyocytes (actin, myosin, troponin I, titin, desmin, vinculin of heart allografts in different periods after the operation (from 6 days to 15 years. Major changes of macromolecular structure were revealed in late period after transplantation (6 months – 15 years. The contribution of humoral immune response in the process of chronic cardiac allograft rejection was observed: in eight of twelve recipients episodes of acute humoral rejection had been repeatedly registered; disorders of the expression of 5 proteins out of 6 characterized were found in recipients with recurrent and persistent antibody-mediated rejection. 

  3. Malnutrition in patients with chronic renal failure

    OpenAIRE

    Qureshi, Abdul Rashid Tony

    2000-01-01

    Protein-energy malnutrition is common in patients with chronic renal failure (CRF) and may contribute to a poor clinical outcome. However, the role of nutrition in this regard has not been clearly defined. Malnutrition in patients with CRF may have many causes, including disturbances in protein and energy metabolism, hormonal derangements, as well as low food intake because of anorexia, caused by uremic toxicity, various superimposed illnesses and psychosocial problems. Alth...

  4. Nuclear medicine in acute and chronic renal failure

    International Nuclear Information System (INIS)

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

  5. Ultrasound strain zero-crossing elasticity measurement in assessment of renal allograft cortical hardness: a preliminary observation.

    Science.gov (United States)

    Gao, Jing; Rubin, Jonathan M

    2014-09-01

    To determine whether ultrasound strain zero-crossing elasticity measurement can be used to discriminate moderate cortical fibrosis or inflammation in renal allografts, we prospectively assessed cortical hardness with quasi-static ultrasound elastography in 38 renal transplant patients who underwent kidney biopsy from January 2013 to June 2013. With the Banff score criteria for renal cortical fibrosis as gold standard, 38 subjects were divided into two groups: group 1 (n = 18) with ≤25% cortical fibrosis and group 2 (n = 20) with >26% cortical fibrosis. We then divided this population again into group 3 (n = 20) with ≤ 25% inflammation and group 4 (n = 18) with >26% inflammation based on the Banff score for renal parenchyma inflammation. To estimate renal cortical hardness in both population divisions, we propose an ultrasound strain relative zero-crossing elasticity measurement (ZC) method. In this technique, the relative return to baseline, that is zero strain, of strain in the renal cortex is compared with that of strain in reference soft tissue (between the abdominal wall and pelvic muscles). Using the ZC point on the reference strain decompression slope as standard, we determined when cortical strain crossed zero during decompression. ZC was negative when cortical strain did not return or returned after the reference, whereas ZC was positive when cortical strain returned ahead of the reference. Fisher's exact test was used to examine the significance of differences in ZC between groups 1 and 2 and between groups 3 and 4. The accuracy of ZC in determining moderate cortical fibrosis and moderate inflammation was examined by receiver operating characteristic analysis. The intra-class correlation coefficient and analysis of variance were used to test inter-rater reliability and reproducibility. ZC had good inter-observer agreement (ICC = 0.912) and reproducibility (p = 0.979). ZCs were negative in 18 of 18 cases in group 1 and positive in 19 of 20 cases in

  6. Length of time on dialysis prior to renal transplantation is a critical factor affecting patient survival after allografting.

    Science.gov (United States)

    West, J C; Bisordi, J E; Squiers, E C; Latsha, R; Miller, J; Kelley, S E

    1992-01-01

    Within the past year at our transplant center we have had the experience of performing renal allografts in two patients older than 65 years, each of whom had been on hemodialysis more than 10 years. Both resulted in patient mortality within 90 days of transplant (one due to myocardial infarction, the other due to visceral ischemia with infarction). This prompted us to review retrospectively our own data (n = 204) and the national (UNOS) data (n = 10,971) regarding transplant outcome, patient age, and length of time on dialysis prior to renal transplantation. This review revealed that patient mortality after transplant increased with the length of end-stage renal disease (dialysis, regardless of type) independent of age, the greatest mortality occurring within the first 6 months of transplant (and not thereafter); graft survival was similar for all age cohorts analyzed. Our review of the literature reveals a paucity of articles pertaining to post-transplant mortality and length of time on dialysis prior to transplant. Our results indicate the following possible conclusions. (1) The length of time of end-stage renal disease therapy prior to renal transplantation is a significant and independent risk factor for post-transplant mortality. (2) Higher priority should be given to this factor when formulating strategies for allocation of scarce resources. (3) Patients on dialysis for extended periods of time who are elderly may be at particularly high risk. (4) Patients being considered for renal transplant should be informed of their individual risk factors for mortality post-transplant based on length of ESRD therapy. (5) Renal transplantation should be considered as early as possible in patients with ESRD (or imminent ESRD). PMID:14621760

  7. Gastrointestinal Angiodysplasia in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Kaaroud H

    2008-01-01

    Full Text Available Gastrointestinal (GI hemorrhage is a frequent and sometimes life-threatening complication of end-stage renal failure. Angiodysplasia (AD, vascular malformation, is the most common cause of recurrent lower-intestinal hemorrhage in patients with renal failure. We report four chronic hemodialysis patients with AD. All patients presented with severe anemia requiring transfusion. GI hemorrhage ceased spontaneously in three cases and after treatment with argon plasma coagulation in another. Diagnosis of AD is usually challenging, since its cause is still unknown, and its clinical presentation is variable. Lesions are multiple in 40-75% of cases, often located in the stomach and duodenum but can affect the colon and the jejunum. Diagnosis is improved by endoscopy which has a much higher sensitivity compared to angiography. Capsular endoscopy may reveal the hemorrhage site in the small intestine when regular endoscopy fails, and therapeutic intervention usually include argon plasma coagulation.

  8. HBV Vaccination in Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Mir-davood Omrani

    2006-12-01

    Full Text Available HBV infection in chronic renal failure (CRF becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α| and interleukin (IL 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. Moreover, human leukocyte antigen (HLA genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response. Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID administered second-generation S antigen vaccines. Both intramuscular (IM and intradermal (ID vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.

  9. Biomarkers for early and late stage chronic allograft nephropathy by proteogenomic profiling of peripheral blood.

    Directory of Open Access Journals (Sweden)

    Sunil M Kurian

    Full Text Available BACKGROUND: Despite significant improvements in life expectancy of kidney transplant patients due to advances in surgery and immunosuppression, Chronic Allograft Nephropathy (CAN remains a daunting problem. A complex network of cellular mechanisms in both graft and peripheral immune compartments complicates the non-invasive diagnosis of CAN, which still requires biopsy histology. This is compounded by non-immunological factors contributing to graft injury. There is a pressing need to identify and validate minimally invasive biomarkers for CAN to serve as early predictors of graft loss and as metrics for managing long-term immunosuppression. METHODS: We used DNA microarrays, tandem mass spectroscopy proteomics and bioinformatics to identify genomic and proteomic markers of mild and moderate/severe CAN in peripheral blood of two distinct cohorts (n = 77 total of kidney transplant patients with biopsy-documented histology. FINDINGS: Gene expression profiles reveal over 2400 genes for mild CAN, and over 700 for moderate/severe CAN. A consensus analysis reveals 393 (mild and 63 (moderate/severe final candidates as CAN markers with predictive accuracy of 80% (mild and 92% (moderate/severe. Proteomic profiles show over 500 candidates each, for both stages of CAN including 302 proteins unique to mild and 509 unique to moderate/severe CAN. CONCLUSIONS: This study identifies several unique signatures of transcript and protein biomarkers with high predictive accuracies for mild and moderate/severe CAN, the most common cause of late allograft failure. These biomarkers are the necessary first step to a proteogenomic classification of CAN based on peripheral blood profiling and will be the targets of a prospective clinical validation study.

  10. Noninvasive cardiac risk stratification of diabetic and nondiabetic uremic renal allograft candidates using dipyridamole-thallium-201 imaging and radionuclide ventriculography

    International Nuclear Information System (INIS)

    The ability of noninvasive risk stratification using dipyridamole-thallium-201 (Tl-201) imaging and radionuclide ventriculography to predict perioperative and long-term cardiac events (myocardial infarction or cardiac death) was evaluated in 36 uremic diabetic and 29 nondiabetic candidates for renal allograft surgery. Of the 35 patients who underwent renal allograft surgery 8 +/- 7 months after the study, none had transient Tl-201 defects (although 13 had depressed left ventricular ejection fraction) and none developed perioperative cardiac events. During a mean follow-up of 23 +/- 11 months, 6 (9%) patients developed cardiac events. Logistic regression analysis was used to compare the predictive value of clinical data (including age, sex, diabetes, chest pain history, allograft recipient) and radionuclide data. Presence of transient Tl-201 defect and left ventricular ejection fraction were the only significant predictors of future cardiac events (p less than 0.01). No other patient variables, including diabetes or receiving a renal allograft, had either univariate or multivariate predictive value. All 3 patients with transient Tl-201 defects had cardiac events compared with only 3 of 62 (5%) patients without transient Tl-201 defect (p less than 0.0001). Mean left ventricular ejection fraction was lower in patients with cardiac events (44 +/- 13%) compared with patients without cardiac events (57 +/- 9%, p less than 0.005). Overall, 5 of 6 patients with cardiac events had either transient Tl-201 defects or depressed left ventricular ejection fraction. Dipyridamole-Tl-201 imaging and radionuclide ventriculography may be helpful in identifying uremic candidates for renal allograft surgery who are at low risk for perioperative and long-term cardiac events

  11. Do the outcomes of living donor renal allograft recipients differ with peritoneal dialysis and hemodialysis as a bridge renal replacement therapy?

    Directory of Open Access Journals (Sweden)

    Narayan Prasad

    2014-01-01

    Full Text Available This study was undertaken to compare the outcomes of living donor renal transplant recipients using peritoneal dialysis (PD and hemodialysis (HD as a bridge modality for renal replacement therapy till renal transplantation. The demographic profiles of the recipients and donors, the patients′ native kidney disease (diabetic versus non-diabetic, duration on dialysis, requirement of anti-hypertensive drugs, number of blood transfusions, human leukocyte antigen (HLA mismatch status, pre- and post-transplant infectious complications, and post-transplant outcomes of patients were compared between the two groups. The demographic features of the study patients were similar in the two groups. The duration of dialysis prior to transplant was significantly longer in the PD group than in the HD group of patients. The anti-hypertensive drug requirement was lower and the hemoglobin level and residual urine volume at the time of transplant were relatively better in the PD patients compared to the HD patients. The number of acute rejection episodes, delayed graft function, surgical complications, glomerular filtration rate at one month and at the last follow-up, were also similar in both groups. The short-term and long-term graft survival was similar in both groups of patients. The one-, two-, five-, and eight-year death-censored graft survival rates of the PD patients were 98, 95, 85, and 73%, respectively, and in the HD group of patients, they were 100, 93, 84, and 79%, respectively. The one-, two-, five-, and eight-year patient survival rates in the PD group were 97, 92, 77, and 66%, respectively, and in the HD group, they were 97, 92, 79, and 69%, respectively. Our study suggests that the outcomes of the living donor renal allograft recipients did not differ between the groups of patients who used PD or HD as renal replacement therapy prior to renal transplantation.

  12. Efficacy of total lymphoid irradiation for chronic allograft rejection following double lung transplantation

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to assess the safety and efficacy of total lymphoid irradiation in a series of patients experiencing chronic rejection following bilateral lung transplantation. Patients and Materials: Eleven patients (10 males, 1 female) received total lymphoid irradiation for chronic allograft rejection (bronchiolitis obliterans syndrome) refractory to conventional treatment modalities. Treatment was delivered between March, 1995, and September, 1996. Mean patient age was 33 years (range 15-51). Indications for transplantation included cystic fibrosis (7 patients), alpha1 anti-trypsin deficiency (2 patients), primary pulmonary hypertension (1 patient), and emphysema (1 patient). Radiation therapy was prescribed as 800 cGy delivered in ten 80 cGy fractions, 2 fractions per week, via AP/PA mantle and inverted-Y fields. Radiation was withheld for total wbc count 3, absolute neutrophil count 3, or platelets 3. Serial pre- and post-radiation therapy pulmonary function values, complete blood counts, and immunosuppressive augmentation requirements (use of methylprednisolone, azathioprine, mycophenolate mofetil, OKT3, and FK506) were monitored. Results: In the 3 months preceding total lymphoid irradiation, the average decrease in FEV1 was 34% (range 0-75%) and the median number of immunosuppression augmentations was 3 (range 0-5). At initiation of radiation therapy, the average FEV1 was 1.4 liters (range 0.77-2.28). Only (4(11)) patients completed all 10 treatment fractions. Reasons for discontinuation included unabated rejection (4 patients), worsening pulmonary infection (2 patients), and persistent thrombocytopenia (1 patient). No treatment course was discontinued because of persistent neutropenia or leukopenia. Seven of the 11 patients failed within 8 weeks of treatment cessation. One patient had unabated rejection and received bilateral living related donor transplants. He is alive and well. Six patients died. Two of these deaths were due to

  13. Oral disorders in patients with chronic renal failure. Narrative review.

    OpenAIRE

    Carolina Hernández

    2016-01-01

    Chronic renal failure (CRF) is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, wh...

  14. Renal cell carcinoma in a setting of chronic lithium toxicity

    OpenAIRE

    Zardawi, Ibrahim; Nagonkar, Santoshi; Patel, Purvish

    2013-01-01

    Patient: Female, 72 Final Diagnosis: Renal cell carcinoma Symptoms: — Medication: — Clinical Procedure: — Specialty: Oncology Objective: Challenging differential diagnosis Background: Lithium salts are widely used in the treatment of affective disorders of the bipolar type. Lithium is a nephrotoxic substance which can cause both acute and chronic renal disease, including cyst formation. Cysts appear to predispose the kidney to renal cell carcinoma. Case Report: A case of renal cell carcinoma ...

  15. Immuno-histological assessment of sub-clinical acute and borderline rejection in renal allograft recipients: Data from a transplant center in India

    Directory of Open Access Journals (Sweden)

    Sonia Badwal

    2015-01-01

    Full Text Available This single-center study was carried out on living related and unrelated renal transplant recipients (RTRs to evaluate the usefulness of surveillance biopsies in monitoring stable renal allografts using immuno-histological markers for immune-activation. This is a prospective, longitudinal study. Protocol biopsies of 60 RTRs with stable graft function were evaluated at three, six and 12 months post-transplant. Immuno-histological evaluation was carried out using immune-activation markers (perforins, granzyme and interleukin-2R, phenotypic markers (CD-3 and CD-20, viral markers and C4d. The demographic and clinical profile was recorded for each patient. All cases of acute sub-clinical rejection (SCR were treated and borderline SCR cases were followed-up without treatment. SCR at three and six months post-transplant was evident in 16.7% and 3.7% of RTRs, respectively. Positive statistical association of SCR was seen with HLA-DR mismatches, whereas patients receiving induction therapy and tacrolimus-based immunosuppression exhibited a lower incidence of SCR. T cell phenotype with persistent expression of immune-activation markers exhibited positive statistical association with interstitial fibrosis and tubular atrophy at 12-month follow-up biopsy. The mean creatinine levels were significantly lower in the protocol biopsy group than the non-protocol biopsy group. No significant difference was found between the mean creatinine levels of the SCR group after treatment and the non-SCR cases within the protocol biopsy group. Early treatment of sub-clinical acute rejection leads to better functional outcomes. However, persistent immune-activation is associated with chronicity and may have implications on long-term graft survival.

  16. Immuno-histological assessment of sub-clinical acute and borderline rejection in renal allograft recipients: Data from a transplant center in India.

    Science.gov (United States)

    Badwal, Sonia; Kumar, Arun; Hooda, A K; Varma, P P

    2015-11-01

    This single-center study was carried out on living related and unrelated renal transplant recipients (RTRs) to evaluate the usefulness of surveillance biopsies in monitoring stable renal allografts using immuno-histological markers for immune-activation. This is a prospective, longitudinal study. Protocol biopsies of 60 RTRs with stable graft function were evaluated at three, six and 12 months post-transplant. Immuno-histological evaluation was carried out using immune-activation markers (perforins, granzyme and interleukin-2R), phenotypic markers (CD-3 and CD-20), viral markers and C4d. The demographic and clinical profile was recorded for each patient. All cases of acute sub-clinical rejection (SCR) were treated and borderline SCR cases were followed-up without treatment. SCR at three and six months post-transplant was evident in 16.7% and 3.7% of RTRs, respectively. Positive statistical association of SCR was seen with HLA-DR mismatches, whereas patients receiving induction therapy and tacrolimus-based immunosuppression exhibited a lower incidence of SCR. T cell phenotype with persistent expression of immune-activation markers exhibited positive statistical association with interstitial fibrosis and tubular atrophy at 12-month follow-up biopsy. The mean creatinine levels were significantly lower in the protocol biopsy group than the non-protocol biopsy group. No significant difference was found between the mean creatinine levels of the SCR group after treatment and the non-SCR cases within the protocol biopsy group. Early treatment of sub-clinical acute rejection leads to better functional outcomes. However, persistent immune-activation is associated with chronicity and may have implications on long-term graft survival. PMID:26586064

  17. Noninvasive monitoring of mouse renal allograft rejection using micro-CT

    OpenAIRE

    Hou, Jiangang; Fujino, Masayuki; Cai, Songjie; Ding, Qiang; Li, Xiao-Kang

    2015-01-01

    Purpose Acute renal graft rejection can only be definitively diagnosed by renal biopsy. However, biopsies carry a risk of renal transplant injury and loss. Micro-CT is widely used in preclinical studies of small animals. Here, we propose micro-CT could noninvasively monitor and evaluate renal location and function in a mouse kidney transplant model. Methods Orthotopic kidney transplantation was performed in a BALB/c -to- C57BL/6j or C57BL/6j-to- C57BL/6j mouse model. After optimizing imaging ...

  18. Growth hormone in chronic renal disease

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2012-01-01

    Full Text Available Severe growth retardation (below the third percentile for height is seen in up to one-third children with chronic kidney disease. It is thought to be multifactorial and despite optimal medical therapy most children are unable to reach their normal height. Under-nutrition, anemia, vitamin D deficiency with secondary hyperparathyroidism, metabolic acidosis, hyperphosphatemia, renal osteodystrophy; abnormalities in the growth hormone/insulin like growth factor system and sex steroids, all have been implicated in the pathogenesis of growth failure. Therapy includes optimization of nutritional and metabolic abnormalities. Failure to achieve adequate height despite 3-6 months of optimal medical measures mandates the use of recombinant GH (rGH therapy, which has shown to result in catch-up growth, anywhere from 2 cm to 10 cm with satisfactory liner, somatic and psychological development.

  19. Renal Response to Chronic Centrifugation in Rats

    Science.gov (United States)

    Ortiz, Rudy M.; Wang, T. J.; Corbin, B. J.; Wade, C. E.; Hargens, Alan R. (Technical Monitor)

    1996-01-01

    Previously reported effects of chronic centrifugation on renal function in mammals are contradictory. The present study was conducted as an effort to provide a comprehensive analysis of renal response to chronic centrifugation (12 days at +2 Gz). Sixteen male Sprague-Dawley rats (210-230 g) were used: eight centrifuged (EC) and eight off centrifuge controls (OCC). During centrifugation EC had lower body weight and food consumption. EC showed a decrease (72%) in water intake for the first two days (T1 and T2) followed by significant increases from T4-T6. EC urine output increased two-fold over the first four days, returning to baseline by T9. EC urea excretion was elevated on T3 through T5. Creatinine, Na(+), K(+), and osmolar excretion were lower than OCC over the last four days of the study. Assuming constant plasma osmolarity and creatinine levels, EC free water clearance (C(sub H2O)) was elevated significantly on T4 when the peak urine output was exhibited. EC also had a greater C(sub H2O) over the last four days, associated with a significantly lower osmolar clearance and GFR. The initial diuresis exhibited during centrifugation can be attributed to a reduced water resorption and increased urea excretion. This diuresis was mediated independent of changes in GFR over the first eight days. However, differences in excretion seen after eight days of centrifugation are probably GFR mediated which would imply animals established a new homeostatic setpoint by that time. Centrifugation elicites an acute alteration in fluid homeostasis followed by adaptation within a week.

  20. Role of mobile passenger lymphocytes in the rejection of renal and cardiac allografts in the rat. A passenger lymphocyte-mediated graft-versus-host reaction amplifies the host response

    International Nuclear Information System (INIS)

    It is demonstrated that passenger lymphocytes migrate out of rat renal allografts into host spleens in a radioresistant fashion. These mobile passenger lymphocytes within BN kidney and heart transplants are immunocompetent, since they elicit a graft-versus-host (GVH) reaction in the spleens of (LEW x BN)F2 hybrid hosts. The greater GVH reaction in (LEW x BN)F1 recipients of BN kidneys reflects the greater number of mobile passenger lymphocytes in the kidney when compared to the heart. The mobile passenger lymphocytes within BN renal allografts also cause a proliferative response in the spleens of the LEW hosts as well as an accelerated rejection of BN renal allografts when compared to BN cardiac allografts, for the differences between BN kidney and heart, both in terms of splenomegaly elicited in LEW as well as tempo of rejection, are abolished by total body x-irradiation of the donor with 900 rad. Results indicate that a mobile passenger lymphocyte mediated GVH reaction in the central lymphoid organs of the host augments the host response to allogenic kidneys and contributes materially to first-set renal allograft rejection; this GVH reaction on the other hand is not conspicuously present in LEW recipients of BN cardiac allografts and has therefore little effect on first-set cardiac allograft rejection

  1. Loss of Renal Allografts Secondary to Candida Vascular Complications in Two Recipients from the Same Donor

    Directory of Open Access Journals (Sweden)

    Govardhana Rao Yannam

    2012-01-01

    Full Text Available Infections remain a major cause of morbidity and mortality in transplant patients. Organ recipients are also susceptible to donor-derived pathogens and the majority of donor infections are easily treatable. Rarely, some pathogens have produced life-threatening complications by compromising the vascular anastomosis. In this case series we report loss of two kidney allografts secondary to vascular complications due to Candida albicans. Both recipients received grafts from a common donor, in whom Candida bacteremia in the donor was not apparent at the time of organ acceptance but became apparent on delayed cultures.

  2. CT of the kidney in chronic renal failure

    International Nuclear Information System (INIS)

    The transverse size of the kidneys was measured by CT, and CT findings of the kidneys were studied in 94 patients with chronic renal failure under hemodialysis (HD), 58 patients with chronic renal failure not under hemodialysis (CRF) and 100 controls. The transverse size of the kidneys decreased according to the deterioration of renal function. The ratio of the maximal renal transverse size to the minimal vertebral size, which the author proposed as a new criterion for renal atrophy, was 1.8 in controls, 1.2 in CRF and 0.8 in HD. A kidney smaller than the vertebral body indicated chronic renal failure. Characteristic CT features in CRF were mild renal atrophy and cystic changes (41.4 %). In HD, renal atrophy was more advanced, the occurrence of cystic changes was more frequent (64.9 %), and there were frequent renal (68.1 %) and aortic calcifications. Furthermore acquired cystic disease of the kidney (ACD) was observed (27.7 %) only in HD. In this study no renal neoplasm was found in ACD. However, several complications in HD, one perirenal hematoma and six hydronephroses, were observed. (author)

  3. CT of the kidney in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Kanji

    1988-10-01

    The transverse size of the kidneys was measured by CT, and CT findings of the kidneys were studied in 94 patients with chronic renal failure under hemodialysis (HD), 58 patients with chronic renal failure not under hemodialysis (CRF) and 100 controls. The transverse size of the kidneys decreased according to the deterioration of renal function. The ratio of the maximal renal transverse size to the minimal vertebral size, which the author proposed as a new criterion for renal atrophy, was 1.8 in controls, 1.2 in CRF and 0.8 in HD. A kidney smaller than the vertebral body indicated chronic renal failure. Characteristic CT features in CRF were mild renal atrophy and cystic changes (41.4 %). In HD, renal atrophy was more advanced, the occurrence of cystic changes was more frequent (64.9 %), and there were frequent renal (68.1 %) and aortic calcifications. Furthermore acquired cystic disease of the kidney (ACD) was observed (27.7 %) only in HD. In this study no renal neoplasm was found in ACD. However, several complications in HD, one perirenal hematoma and six hydronephroses, were observed.

  4. [CHRONIC RENAL FAILURE AND PREGNANCY--A CASE REPORT].

    Science.gov (United States)

    Amaliev, G M; Uchikova, E; Malinova, M

    2015-01-01

    Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure. Determining the optimum time for authorization birth depends on the condition of the mother, the condition of the fetus and the rate of progression of renal failure, and the deadline the pregnancy should be terminated is 35 weeks. We present a case of a patient with chronic renal failure, with favorable perinatal outcome. PMID:26137779

  5. A non-parametric meta-analysis approach for combining independent microarray datasets: application using two microarray datasets pertaining to chronic allograft nephropathy

    Directory of Open Access Journals (Sweden)

    Archer Kellie J

    2008-02-01

    Full Text Available Abstract Background With the popularity of DNA microarray technology, multiple groups of researchers have studied the gene expression of similar biological conditions. Different methods have been developed to integrate the results from various microarray studies, though most of them rely on distributional assumptions, such as the t-statistic based, mixed-effects model, or Bayesian model methods. However, often the sample size for each individual microarray experiment is small. Therefore, in this paper we present a non-parametric meta-analysis approach for combining data from independent microarray studies, and illustrate its application on two independent Affymetrix GeneChip studies that compared the gene expression of biopsies from kidney transplant recipients with chronic allograft nephropathy (CAN to those with normal functioning allograft. Results The simulation study comparing the non-parametric meta-analysis approach to a commonly used t-statistic based approach shows that the non-parametric approach has better sensitivity and specificity. For the application on the two CAN studies, we identified 309 distinct genes that expressed differently in CAN. By applying Fisher's exact test to identify enriched KEGG pathways among those genes called differentially expressed, we found 6 KEGG pathways to be over-represented among the identified genes. We used the expression measurements of the identified genes as predictors to predict the class labels for 6 additional biopsy samples, and the predicted results all conformed to their pathologist diagnosed class labels. Conclusion We present a new approach for combining data from multiple independent microarray studies. This approach is non-parametric and does not rely on any distributional assumptions. The rationale behind the approach is logically intuitive and can be easily understood by researchers not having advanced training in statistics. Some of the identified genes and pathways have been

  6. [Chronic renal insufficiency. A permanent public health problem].

    Science.gov (United States)

    Legrain, M; Jacobs, C

    1999-01-01

    Chronic renal insufficiency raises an ever-increasing public-health problem due to its permanent growth among the general population and the escalating cost of renal replacement therapies. By the end of 1995 there were close to 33,700 patients with end-stage renal failure maintained alive with renal replacement methods in France. About 11,200 had a functioning kidney graft, whereas 22,500 were treated with various dialysis techniques, in and out-of-center hemodialysis and peritoneal dialysis. An optimal health policy should contribute both to prevent renal insufficiency and offer each patient his/her best specific mode of treatment at the lowest cost for the community. Renal transplantation should be much more widely promoted and utilized through measures aiming at reducing the too high refusal rates of organ donation in subjects with brain-death. Promotion and extension of out-of-center dialysis techniques are also necessary. Design of reliable epidemiological studies dealing not only with end-stage renal failure patients but with the early stage and time-course of renal insufficiency is also mandatory. A deeper investigation in the area of renal-risk factors and a qualified follow-up of patients with mild/moderate renal insufficiency are essential to avoid or delay an evolution towards end-stage renal failure. Prevention of renal fibrosis has a central role in such a long-term public health-policy. PMID:10371761

  7. Renal imaging in children with chronic kidney disease

    OpenAIRE

    Wiwit Rahmawati; Heru Muryawan; Farah Prabowo

    2013-01-01

    Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were in...

  8. Investigating Awareness in Chronic Renal Failure Among Family Physicians

    Directory of Open Access Journals (Sweden)

    Birgül ATAMAN

    2014-05-01

    Full Text Available OBJECTIVE: The conditions underlying chronic renal failure have become epidemics in the world. The aim of this study was to reveal the degree of awareness of chronic renal failure among family physicians. MATERIAL and METHODS: Using data collected with a structured questionnaire and considering physicians’ socio-demographic features and their education on nephrology, we evaluated physicians’ awareness of the definition, frequency and clinical features of chronic renal failure. The questionnaire was filled in by volunteering family medicine specialists (FMS, family medicine assistants (FMA and family physicians (FP during a family medicine meeting. RESULTS: Out of 310 physicians, 25.2% (n=78 were FMS, 27.7% (n=86 FMA and 47.1% (n=146 FP. %35,2 of physicians (n=109 (FMS: % 62,8 (n=49, FMA: %52.3 (n=45, FP: %10.3 (n=15, p0.05. However, less than 15% of the physicians reported that they felt competent enough to follow patients with chronic renal failure. The rate of the physicians who felt the need to refer these patients to health institutions was high. However, the Fps did not like the patient care style of internal medicine specialists and thought that patients faced financial problems to access the nephrologist. CONCLUSION: Appropriate care and management of referrals are life-saving for patients with chronic renal failure. New strategies should be developed to increase awareness concerning chronic renal failure and the management of this condition.

  9. Implication of Ia-positive bone marrow interstitial stem cells in the induction of unresponsiveness to canine renal allografts

    International Nuclear Information System (INIS)

    The removal from stored autologous host bone marrow of a monocytoid cell population by exposure to methylprednisolone is associated with successful introduction of unresponsiveness to renal allografts in irradiated recipients reconstituted with such treated marrow. The eliminated cells are a prominent component of the canine long bone marrow interstitium and share a number of important properties with dendritic cells (DC), including size and shape; poor or nonadherence to plastic or glass surfaces; negative staining for neutral esterase, acid phosphatase, or peroxidase; nonphagocytic; Ia positive, but negative for IgG or IgM; ability to act as accessory cells in augmenting the intensity of allogeneic mixed-lymphocyte reactions. Both cell types are of bone marrow origin and are susceptible to steroids in vitro. The results suggest that the bone marrow interstitial cells identified in the course of this study may be enriched with populations of canine dendritic cell precursors and dendritic cells at various stages of differentiation. The detection of a receptor site for Helix promatia on the surface of such cells may be of usefulness in their further characterization and in the analysis of their precise role in the modulation of allogeneic unresponsiveness

  10. Implication of Ia-positive bone marrow interstitial stem cells in the induction of unresponsiveness to canine renal allografts

    Energy Technology Data Exchange (ETDEWEB)

    Rapaport, F.T.; Arnold, A.N.; Asari, H.; Sato, K.; Miura, S.; Chanana, A.; Cronkite, E.P.

    1987-02-01

    The removal from stored autologous host bone marrow of a monocytoid cell population by exposure to methylprednisolone is associated with successful introduction of unresponsiveness to renal allografts in irradiated recipients reconstituted with such treated marrow. The eliminated cells are a prominent component of the canine long bone marrow interstitium and share a number of important properties with dendritic cells (DC), including size and shape; poor or nonadherence to plastic or glass surfaces; negative staining for neutral esterase, acid phosphatase, or peroxidase; nonphagocytic; Ia positive, but negative for IgG or IgM; ability to act as accessory cells in augmenting the intensity of allogeneic mixed-lymphocyte reactions. Both cell types are of bone marrow origin and are susceptible to steroids in vitro. The results suggest that the bone marrow interstitial cells identified in the course of this study may be enriched with populations of canine dendritic cell precursors and dendritic cells at various stages of differentiation. The detection of a receptor site for Helix promatia on the surface of such cells may be of usefulness in their further characterization and in the analysis of their precise role in the modulation of allogeneic unresponsiveness.

  11. Hepatitis C, Chronic Renal Failure, Control Is Possible!

    Directory of Open Access Journals (Sweden)

    Seyed-Moayed Alavian

    2006-06-01

    Full Text Available Hepatitis C virus (HCV infection has come to the top of virus-induced liver diseases in many parts of the world. In Iran, it seems that HCV prevalence in general population is less than one percent, which is much lower than in most of the regional countries(1. However, the infection is emerging in Iran mostly due to problem of intravenous drug abuse and needle-sharing in the country (2, 3. The patients receiving maintenance transfusion such as chronic renal failure (CRF patients and the patients with thalassemia major are the other population who are at the high risk of HCV acquisition although compulsory blood screening has been able to remarkably decrease the HCV incidence in these patients (4. The prevalence of HCV infection among CRF patients on hemodialysis in Tehran, the capital of Iran, was around 13 percent in 2002 (5. There is no valid data regarding HCV incidence rate among CRF patients in country. However, according to the most recent official report of Management of Special Diseases and Transplantation Center (MSDT, the prevalence of HCV infection among patients on hemodialysis in the whole country has decreased from 14.4% in 1999 to 4.5% in 2005. Various reasons might be responsible for this reduction such as blood screening; developing technology of alternative modalities instead of transfusion in Iran like producing domestic Erythropoietin which has been resulted in decreasing transfusion; early transplantation; and training health staffs. On the other hand, the other reason such as mortality ofHCV infected CRF patients should not be neglected. Although there is no data in this regard in Iran, a meta-analysis, demonstrated that HCV infected patients on dialysis have an increased risk of mortality compared to HCV negative cases (6. Therefore, with the lack of data defining incidence rate in Iran, the reduction of HCV prevalence in the country should not overlook the necessity of designing a comprehensive strategy to control HCV

  12. Captopril for refractory hypertension in patients with chronic renal failure and renal transplantation.

    OpenAIRE

    Hamilton, D V; Evans, D. B.; Maidment, G; Pryor, J S

    1981-01-01

    The converting-enzyme inhibitor, captopril, was given to ten patients with refractory severe hypertension of renal origin: 6 patients had chronic renal failure, 3 patients had hypertension following renal transplantation, and one patient had hypertension and congestive cardiac failure. Control of blood pressure was achieved with doses from 78 to 400 mg/day. Severe hyperkalaemia occurred in one patients, ageusia (dose dependent) in another, and one patients withdrew from treatment because of n...

  13. Indium-111 labelled platelet scintigraphy can predict the immunological origin of fever in patients on dialysis carrying a non-functioning renal allograft

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the usefulness of labelled platelet scintigraphy in the differential diagnosis of a prolonged febrile syndrome (PFS) in patients on dialysis carrying a non-functioning renal allograft. We prospectively performed an indium-111 mercaptopyridine-labelled platelet scan on 91 patients (54 men, 37 women; mean age 39.6±12 years). The mean duration of PFS was 35 days (range 7-122). Forty-six of the 91 patients underwent steroid therapy (2- 10 mg/day). Platelet labelling was carried out following Thakur's method. Platelet scans were performed 48 h after reinjection of labelled platelets. The platelet uptake index (PUI) was calculated by dividing the cpm/pixel in the allograft ROI by cpm/pixel in a mirror background ROI. The final diagnosis of PFS was established depending on the outcome after treatment. In 61/91 patients the fever had an immunological origin because it disappeared after graft embolisation or transplantectomy. In 30/91 patients the PFS disappeared after antibiotic therapy (non-immunological origin). The PUI in patients with immunological PFS was 1.80±0.7, while in patients with non-immunological PFS it was 1.12±0.1 (P111In-labelled platelet scintigraphy can accurately predict an immunological PFS in patients on dialysis carrying a non-functioning renal allograft. Therapy with steroids could reduce the sensitivity of 111In-labelled platelet scintigraphy in detecting immunological PFS. (orig.)

  14. Acute Regeneration and Chronic Acellular Transformation of Rabbit Cryopreserved Aortic Allografts

    International Nuclear Information System (INIS)

    An analysis of rabbit cryopreserved aortic allografts excised on postoperative days (POD) 2, 5, 11, 60, 210, 360, and 720, as well as controls that were untransplanted native aortas and cryopreserved aortas, was performed. On POD2, the number of medial smooth muscle cells in the allografts was reduced to approximately 50%. Ki-67 analysis revealed that medial smooth muscle cells in the allografts proliferated from the 2nd day. By the 11th day, their proliferation ceased and the number of medial smooth muscle cells was restored to almost at the same level as in the controls. Polymorphic microsatellite DNA marker analysis disclosed that the restored medial smooth muscle cells were of donor origin. From 7 months through 2 years, the media of cryopreserved aortic allografts were transformed into acellular structures, in which the elastic fibers were preserved. On the other hand, newly accumulated smooth muscle cells were observed in the adventitia just outside of acellular media after 7 months. In some cases, scattered lamellar calcium deposition was observed in the same regions. This study presents a comprehensive documentation of regeneration and acellular transformation in cryopreserved aortic allografts based on short and long-term analysis

  15. Renal imaging in children with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Wiwit Rahmawati

    2013-04-01

    Full Text Available Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were inpatients at Dr. Kariadi Hospital from January 2008 to June 2011. Data were taken from medical records. Chronic kidney disease was confirmed by clinical manifestations, laboratory findings, and radiologic imaging. Renal ultrasound findings were determined by the radiologist responsible at that time. Results were presented as frequency distributions. Results Of 37 chronic kidney disease cases, 27 were males and 10 were females. Subjects’ most common complaints were dyspnea (7 out of 37 and edema (30 out of 37. Renal ultrasound imaging of subjects with chronic kidney disease yielded the following findings: reduced cortico-medullary differentiation (30 out of 37, bilateral echogenic kidneys (21 out of 37, reduced renal cortex thickness (4 out of 37 and small-sized kidneys (4 out of 37. Eight of the 37 children died. These 8 subjects had the following radiologic imaging findings: both kidneys appeared small in size (4 out of 8, reduced ‘renal cortex’ thickness (4 out of 8, echogenic kidneys (6 out of 8, and reduced cortico-medullary differentiation (8 out of 8. Conclusion Renal ultrasound imaging of pediatric subjects with chronic kidney disease revealed findings of reduced cortico-medullary differentiation, bilateral echogenic kidneys, reduced renal cortex thickness, and small kidneys bilaterally. [Paediatr Indones. 2013;53:193-9.].

  16. Segmental Renal Ischemia following Transplantation of Horseshoe Kidney as Separate Allografts

    Directory of Open Access Journals (Sweden)

    J. T. Foster

    2013-01-01

    Full Text Available Introduction. Horseshoe kidney is a congenital anomaly that presents unique challenges for the transplant surgeon. The mere presence of horseshoe kidney should not preclude consideration for transplantation. Case Report. A 33-year-old women suffering from end-stage renal disease underwent deceased donor renal transplant with a divided horseshoe kidney. We present a postoperative complication and the technical strategy for transplant salvage. The patient currently has excellent graft function. Discussion. Horseshoe kidneys do present challenges for successful transplantation. Though case reports of successful transplantation are increasing, we present a technical complication and successful transplant salvage strategy. Technical descriptions in the literature of successful back-table preparation strategies should help more transplant surgeons to begin to utilize this resource. Conclusion. This study concludes that horseshoe kidneys can be successfully used for transplantation and provides a technical strategy to salvage the transplant after a unique complication associated with these donor kidneys.

  17. Renal Contrast-Enhanced Sonography Findings in a Model of Acute Cellular Allograft Rejection.

    Science.gov (United States)

    Grabner, A; Kentrup, D; Pawelski, H; Mühlmeister, M; Biermann, C; Edemir, B; Heitplatz, B; Van Marck, V; Bettinger, T; Pavenstädt, H; Schlatter, E; Stypmann, J; Tiemann, K; Reuter, S

    2016-05-01

    Noninvasive methods to diagnose and differentiate acute cellular rejection from acute tubular necrosis or acute calcineurin inhibitor toxicity are still missing. Because T lymphocytes play a decisive role in early states of rejection, we investigated the suitability and feasibility of antibody-mediated contrast-enhanced ultrasound by using microbubbles targeted to CD3(+) , CD4(+) , or CD8(+) T cells in different models of renal disease. In an established rat renal transplantation model, CD3-mediated ultrasound allows the detection of acute rejection as early as on postoperative day 2. Ultrasound signal intensities increased with the severity of inflammation. Further, an early response to therapy could be monitored by using contrast-enhanced sonography. Notably, acute tubular necrosis occurring after ischemia-reperfusion injury as well as acute calcineurin inhibitor toxicity could easily be differentiated. Finally, the quantified ultrasound signal correlated significantly with the number of infiltrating T cells obtained by histology and with CD3 mRNA levels, as well as with chemokine CXCL9, CXCL11, and CCL19 mRNA but not with KIM-1 mRNA expression, thereby representing the severity of graft inflammation but not the degree of kidney injury. In summary, we demonstrate that antibody-mediated contrast-enhanced ultrasound targeting T lymphocytes could be a promising tool for an easy and reproducible assessment of acute rejection after renal transplantation. PMID:26613381

  18. The Effect of Adding Low dose Daclizumab to Renal Transplantation Standard Protocol on Reduction the Risk of Kidney Rejection in Renal Allograft Recipients

    OpenAIRE

    Jalal Azmandian; Zahra Shafii; Seyed Mojtaba Sohrevardi; Faramarz Fazeli; Abbas Etminan; Sara AziziShoul

    2012-01-01

    Introduction: Transplantation of the kidney is the choice treatment of advanced chronic renal failure. One of the most important therapeutic problems in these patients is the prevention of acute graft rejection. The purpose of this study was to investigate the efficiency of low dose Daclizumab for prevention of acute kidney graft rejection in living donor recipients. Methods: This clinical trial study was performed on 120 living donor kidney recipients who were admitted to kidney transplant w...

  19. Renal Tissue Oxygenation in Essential Hypertension and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Menno Pruijm

    2013-01-01

    Full Text Available Animal studies suggest that renal tissue hypoxia plays an important role in the development of renal damage in hypertension and renal diseases, yet human data were scarce due to the lack of noninvasive methods. Over the last decade, blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI, detecting deoxyhemoglobin in hypoxic renal tissue, has become a powerful tool to assess kidney oxygenation noninvasively in humans. This paper provides an overview of BOLD-MRI studies performed in patients suffering from essential hypertension or chronic kidney disease (CKD. In line with animal studies, acute changes in cortical and medullary oxygenation have been observed after the administration of medication (furosemide, blockers of the renin-angiotensin system or alterations in sodium intake in these patient groups, underlining the important role of renal sodium handling in kidney oxygenation. In contrast, no BOLD-MRI studies have convincingly demonstrated that renal oxygenation is chronically reduced in essential hypertension or in CKD or chronically altered after long-term medication intake. More studies are required to clarify this discrepancy and to further unravel the role of renal oxygenation in the development and progression of essential hypertension and CKD in humans.

  20. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim of...... the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

  1. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D;

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim was to...... compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  2. Recurrence of light chain deposit disease after renal allograft transplantation: potential role of rituximab?

    Science.gov (United States)

    Kuypers, Dirk R J; Lerut, Evelyne; Claes, Kathleen; Evenepoel, Pieter; Vanrenterghem, Yves

    2007-04-01

    Light chain deposit disease (LCDD) is a monoclonal plasma cell disorder characterized by tissue deposition of nonamyloid immunoglobulin light chains, predominantly kappa chains, causing renal insufficiency. LCDD reoccurs almost invariably after renal grafting, leading to early graft loss, usually within a time span of months to years. We describe a female patient with LCDD who lost her first living donor graft after 1 year due to extensive recurrence of kappa chain deposition. Rituximab was administered on the seventh day after her second transplantation with a graft from a deceased donor, in order to prevent early recurrence of LCDD. The 2-year protocol biopsy - similarly to the completely normal 1-year protocol biopsy - revealed persistent absence of light chain deposition on light microscopy but immunohistochemical staining and electron microscopy showed very mild recurrence of light chain deposits. A second 4-week course of rituximab was repeated because of these electron microscopic findings. Subsequently, free kappa light chain concentration decreased from 693 to 74 mg/l and remained low 4 months after completion of therapy. Rituximab could be considered for delaying early LCDD recurrence in patients in whom treatment of the underlying bone marrow disorder failed or is contraindicated, but maintenance therapy is apparently necessary to consolidate this response. PMID:17326779

  3. Growth Hormone Therapy in Children with Chronic Renal Failure

    OpenAIRE

    Cayir, Atilla; Kosan, Celalettin

    2014-01-01

    Growth is impaired in a chronic renal failure. Anemia, acidosis, reduced intake of calories and protein, decreased synthesis of vitamin D and increased parathyroid hormone levels, hyperphosphatemia, renal osteodystrophy and changes in growth hormone-insulin-like growth factor and the gonadotropin-gonadal axis are implicated in this study. Growth is adversely affected by immunosuppressives and corticosteroids after kidney transplantation. Treating metabolic disorders using the recombinant huma...

  4. Urinary Peptide Levels in Patients with Chronic Renal Failure

    OpenAIRE

    Mungli Prakash; Phani, Nagaraj M; Kavya R; Supriya M

    2010-01-01

    Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF) patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary pepti...

  5. Impaired renal function in relatives of chronic kidney disease patients

    OpenAIRE

    Pradip Kumar Dutta; Md Shafiul Haider; Abul Kashem

    2015-01-01

    Background: Chronic kidney disease (CKD) is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR) and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD). Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional compa...

  6. Zhang Qi's Experience in Treating Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    LIN Qi-zhan; XU Da-ji; MA Yu-peng

    2008-01-01

    @@ Chronic renal failure is a result of the parenchymatous injury of kidney and progressive exacerbation due to many reasons.It is a svstematic clinical syndrome caused by the disturbance in excreting metabolites,adjusting water-electrolyte and acid-base balance as well as production and inactivation of active substances of endocrine.Prof Zhang Qi has rich clinical experience in treating renal failure.A report follows.

  7. Sympatho-renal axis in chronic disease

    OpenAIRE

    Sobotka, Paul A.; Mahfoud, Felix; Schlaich, Markus P; Hoppe, Uta C.; Böhm, Michael; Krum, Henry

    2011-01-01

    Essential hypertension, insulin resistance, heart failure, congestion, diuretic resistance, and functional renal disease are all characterized by excessive central sympathetic drive. The contribution of the kidney’s somatic afferent nerves, as an underlying cause of elevated central sympathetic drive, and the consequences of excessive efferent sympathetic signals to the kidney itself, as well as other organs, identify the renal sympathetic nerves as a uniquely logical therapeutic target for d...

  8. ANAESTHESIA FOR CHRONIC RENAL DISEASE AND RENAL TRANSPLANT: AN UPDATE

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-03-01

    Full Text Available Patients with chronic k idney disease have unique pathophysiology relating to both CKD and its underlying cause and therefore present a challenge to anaesthesiologists & surgeons . The aim of this article is to present the features of chronic kidney disease (CKD that influence th e conduct of anaesthesia and to introduce some of the anaesthetic techniques used for this challenging group of patients.

  9. Clinical Study on Treatment of Chronic Renal Failure with Shenshuailing

    Institute of Scientific and Technical Information of China (English)

    鞠建伟; 郭亚玲; 梁延平; 孙世宁; 杨建华; 杨素云

    2001-01-01

    The therapeutic effects of Shenshuailing Kou Fu Ye (SKFY肾衰灵口服液, the Oral Liquid for Renal Failure) and Shenshuailing Guan Chang Ye (SGCY肾衰灵灌肠液, the Enema for Renal Failure) were evaluated in treatment of chronic renal failure, with coateg aldehyde oxystarch as the controls. The changes in the clinical symptoms, serum creatinine, blood urea nitrogen and creatinine clearance rate were observed. The total effective rate in the former was 90.46%, and the latter 60.43%.

  10. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Kirk, O; Lundgren, J D;

    2013-01-01

    Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death.......Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death....

  11. Association of dyslipidemia with renal outcomes in chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Szu-Chia Chen

    Full Text Available Dyslipidemia is highly prevalent in patients with chronic kidney disease (CKD and the relationship between dyslipidemia with renal outcomes in patients with moderate to advanced CKD remains controversial. Hence, our objective is to determine whether dyslipidemia is independently associated with rapid renal progression and progression to renal replacement therapy (RRT in CKD patients. The study analyzed the association between lipid profile, RRT, and rapid renal progression (estimated glomerular filtration rate [eGFR] slope <-6 ml/min/1.73 m(2/yr in 3303 patients with stages 3 to 5 CKD. During a median 2.8-year follow-up, 1080 (32.3% participants commenced RRT and 841 (25.5% had rapid renal progression. In the adjusted models, the lowest quintile (hazard ratios [HR], 1.23; 95% confidence interval [CI], 1.01 to 1.49 and the highest two quintiles of total cholesterol (HR, 1.25; 95% CI, 1.02 to 1.52 and HR, 1.35; 95% CI, 1.11 to 1.65 respectively increased risks for RRT (vs. quintile 2. Besides, the highest quintile of total cholesterol was independently associated with rapid renal progression (odds ratio, 1.36; 95% CI, 1.01 to 1.83. Our study demonstrated that certain levels of dyslipidemia were independently associated with RRT and rapid renal progression in CKD stage 3-5. Assessment of lipid profile may help identify high risk groups with adverse renal outcomes.

  12. Preemptive Renal Transplantation-The Best Treatment Option for Terminal Chronic Renal Failure.

    Science.gov (United States)

    Arze Aimaretti, L; Arze, S

    2016-03-01

    Renal transplantation is the best therapeutic option for end-stage chronic renal disease. Assuming that it is more advisable if performed early, we aimed to show the clinical, social, and economic advantages in 70% of our patients who were dialyzed only for a short period. For this purpose, we retrospectively collected data over 28 years in 142 kidney transplants performed in patients with sports, and reproduction. Immunosuppression consisted of 3 drugs, including steroids, cyclosporine, and azathioprine or mycophenolate. The cost in the 1st year, including patient and donor evaluation, surgery, immunosuppression, and follow-up, was $13,300 USD versus $22,320 for hemodialysis. We conclude that preemptive renal transplantation with <6 weeks on dialysis is the best therapeutic option for end-stage renal failure, especially in developing countries such as Bolivia, where until last year, full public support for renal replacement therapy was unavailable. PMID:27110013

  13. Long-term efficacy of atorvastatin in allograft rejection following renal transplantation: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mohammad A Amirzargar

    2015-01-01

    Full Text Available Statins are a class of drug that can efficiently reduce the level of low-density lipoprotein (LDL as well as increase the LDL receptors. Several non-lipid-lowering effects of this type of drug have been described. It is reported that they have an influence in preventing graft rejection, especially of the acute type. In this study, patients with end-stage renal disease and candidates for kidney transplantation were divided into two groups. Group A (intervention group received atorvastatin for two weeks prior to their transplant surgery while group B (control group received placebo. The lipid profile was tested (triglycerides, cholesterol, LDL in all patients two weeks before the transplantation. After transplantation, drug use was stopped. We also checked the LDL serum levels in patients with raised lipid levels (LDL >100 every two weeks. After this period, the serum lipid levels were checked monthly up to six months. Hyperlipidemia, when present, was controlled by fibrates. Concerning the rejection episodes, there was no significant difference between the two groups. In group A (13 men and nine women, three (14.3% cases of rejection were observed whereas four (21.3% cases of rejection were seen in group B (11 men and 10 women (P = 0.5. Within group A, five (22.7% cases of delayed graft function were found while four (19% similar cases were observed in group B (P = 0.7. There was no statistically significant difference concerning delayed graft function between the two groups. Despite all the mechanisms attributed to the probable anti-rejection properties of statins, we found no significant correlation with the administration of these drugs before transplantation and the protection against graft rejection episodes.

  14. Bone scan appearance of renal osteodystrophy in diabetic chronic renal failure patients

    International Nuclear Information System (INIS)

    To investigate Tc-99m methylenediphosphonate (MDP) bone scan appearance in diabetic chronic renal failure patients, we compared the bone scan images of chronic renal failure patients with and without diabetes. The number of patients studied was 134, of whom 43 had diabetes. Two nuclear medicine physicians read Tc-99m MDP bone scan images and for six areas - the axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction, and sternum - assigned a score of either 1 or 0. The sums of scores were compared. We also performed multivariate analysis including sex, age, and serum creatinine level using analysis of covariance. DM group patients scored significantly lower (2.01±0.95) than those of the non-DM group (3.26±1.16). Analysis of covariance revealed that the lower DM group score was independent of sex, age, and serum creatinine level. The bone scans of diabetic chronic renal failure patients showed less Tc-99m MDP uptake than those of non-diabetic patients. Thus, diagnosing renal osteodystrophy in diabetic chronic renal failure patients on bone scan images could be difficult. (author)

  15. Urinary Citrate: A view in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    SANTHOSH KUMAR.N

    2013-12-01

    Full Text Available Aim & Objective: To evaluate the 24 hour urinary citrate levels in chronic renal failure and healthy controls and to define the role of urinary citrates in the chronic renal failures. Materials and Methods: The 24 hours urinary citrates, Blood urea, Serum creatinine, Na+, K+were evaluated in 25 chronic renal failure patients and25 healthy subjects taken as controls. In both groups participants were on their usual diet. In addition, none of the participant was taking any drugs that could interfere with the citrate excretion. Results: The mean 24 hour urinary citrate excretion in patients and healthy controls was 296.3 ± 8.543mg and 323.9 ± 4.304mg respectively. Using previously defined values of normal urinary citrates as more than 320 mg.The difference in 24 hour urinary citrateexcretion in all patients and healthy control was statistically significant (

    renal failures and healthy controls. Uniformly low citrate excretion in patients indicates that low citrate levels may be a feature seen in predisposing factor for renal failure

  16. Recurrence of light-chain deposition disease after renal transplantation

    DEFF Research Database (Denmark)

    Larsen, Thomas; Hammer, Anne; Jørgensen, Kaj Anker

    2008-01-01

    A 51-year-old male with a history of chronic renal disease received a renal allograft, in which disease recurred. Light-chain deposition disease was confirmed through biopsies of the native kidney and graft, and detection of free kappa light chains in serum. Udgivelsesdato: 2007-Sep-6...

  17. Uterine Prolapse as a Cause of Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Savaş SİPAHİ

    2014-09-01

    Full Text Available Uterine prolapse, common in old and multiparous women, has been reported as a rare cause of obstructive uropathy. In this case, the management of a 75-year-old female patient who presented at the outpatient clinic with a history of anuresis and diagnosed with total uterine prolapse, bilateral hydronephrosis, urinary infection and acute renal failure is presented. The renal failure clinical picture regressed with appropriate treatment. However, the patient refused surgery and chose to have a pessary implemented. Four months after dismissal, she was readmitted to the hospital with recurrent renal failure that required dialysis treatment. The patient did not respond to therapy and was placed on a chronic dialysis program with a diagnosis of end-stage renal disease due to posterenal causes.

  18. Evaluation of renal allografts using {sup 99m} Tc mononuclear leukocytes; Avaliacao de transplantes renais utilizando-se {sup 99m} Tc-leucocitos mononucleares

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Sergio Augusto Lopes de; Martins, Flavia Paiva Proenca; Carvalho, Antonio Carlos Pires; Gutfilen, Bianca [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: sergioalsouza@ufrj.br; Goncalves, Renato Torres; Pontes, Daniela Salomao [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Nefrologia; Fonseca, Lea Mirian Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Medicina Nuclear

    2004-02-01

    Renal allograft acute rejection must be promptly diagnosed since its reversibility is related to the readiness in which treatment is initiated. The aim of this study was: to establish a quantitative method to evaluate kidney rejection and acute tubular necrosis (Attn); to assess the potential role of {sup 99m} Tc-mononuclear leukocytes scintigraphy in the diagnosis of renal rejection and differential diagnosis of Attn. One hundred and sixty studies were performed in 80 renal transplant patients at the first and fifth day after transplantation. Autologous cells were used for labeling. Images were obtained at 30 minutes, 3 hours and 24 hours after intravenous administration of 444 MBq (12 mCi) of labeled cells. There was abnormal labeled cells uptake in 27 of 31 cases of rejection and in 6 of 8 cases of Attn. The results of each patient were compared with clinical findings. Doppler scanning detected 18 of 31 cases of rejection. Rejection diagnosis sensitivity and specificity rates using scintigraphy were 87.1 per cent and 100 per cent, respectively, and 58.1 per cent and 100 per cent, respectively using ultrasound. Renal biopsy was performed in eight patients which demonstrated seven cases of rejection and one case of ATN. These results suggest that {sup 99m} Tc-mononuclear leukocytes imaging may be useful in the early diagnosis of rejection and in the differential diagnosis of ATN. (author)

  19. Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft.

    Science.gov (United States)

    Mrugala, Andrew; Sui, Audrey; Plummer, Malgorzata; Altman, Igor; Papineau, Elaine; Frandsen, Devn; Hill, Danielle; Ennis, William J

    2016-08-01

    A case series of five patients with a total of six chronic non-healing wounds (>30 day duration) were non-randomly selected to evaluate the performance, safety and handling properties of dehydrated human amnion/chorion membrane allograft, an amniotic membrane scaffolding product. The patients had lower extremity wounds that had previously failed standard of care within a university outpatient/inpatient wound healing programme. Five wounds treated with dehydrated amnion/chorion membrane allograft showed a mean 43% area reduction from baseline (51% median) at 3 weeks into treatment and completely healed with a 64-day median time to closure (SD ±27·6 days). One wound worsened at 3 weeks and was found to have a complete central vein obstruction that was treated with long-term mild compression but still eventually healed at 6 months. Removing this outlier, the four responding wounds had a 72% mean and 69% median change in area from baseline, at the 3 week point. All five patients received only one application of dehydrated human amnion/chorion membrane allograft, and there were no adverse events. The product was easy to use, administer and handle. In summary, dehydrated human amnion/chorion membrane allograft appears to be a safe, effective and easy to use therapy for chronic non-healing wounds. This study describes the details of these clinical cases and provides an overview of the current evidence on the use of amniotic tissue in clinical practice. PMID:25974156

  20. Chronic renal failure in Al-Anbar of Iraq

    Directory of Open Access Journals (Sweden)

    Sami M Awad

    2011-01-01

    Full Text Available There is no precise study of the epidemiology and prevalence of chronic renal failure in Al-Anbar, Iraq. Therefore, we studied 230 hemodialysis (HD patients at the HD unit of Al-Ramadi teaching hospital during the period from April 1, 2008 to April 1, 2009. There were 124 (53% male patients with a mean age of 48 ± 18.5 years, and 146 (63% patients were older than 40 years. The estimated prevalence of chronic renal failure was 141 patients per million population. Diabetes mellitus (33% and hypertension (22.6% were the most common causes of chronic renal failure, followed in order by obstructive uropathy in 17.3%, undetermined causes in 14%, pyelonephritis in 4.7%, glomerulonephritis in 4.3%, and polycystic kidney disease in 3.9%. This study suggests that large number of patients with end-stage renal disease (ESRD have diabetes and hypertension. However, those patients with undetermined cause still form a significant portion of etiology of ESRD, and this reflects late referral combined with diagnostic limitations.

  1. Estatinas na doença renal crônica Statins in chronic renal disease

    Directory of Open Access Journals (Sweden)

    Soraia R. C. Ferreira

    2005-10-01

    Full Text Available Hipertrigliceridemia e o HDL baixo são aspectos comuns em pacientes com insuficiência renal crônica. A mortalidade cardiovascular está substancialmente aumentada na presença de doença renal crônica (10-20 vezes maior. Existem evidências de estudos clínicos com estatinas sugerindo uma ação protetora dessas drogas na progressão da doença renal. Além disso, pacientes pós-transplante renal recebendo fluvastatina, experimentaram redução na incidência de infartos não fatais e de mortalidade cardíaca. Entretanto, um estudo recente com atorvastatina não demonstrou reduções na morbi-mortalidade cardiovascular entre pacientes diabéticos em hemodiálise. Estudos em andamento definirão o preciso papel das estatinas neste grupo especial de pacientes.Hypertriglyceridemia and low HDL-c are common features in patients with chronic renal failure. Cardiovascular mortality is substantially increased in the presence of chronic renal disease (10-20 times higher. There is evidence from clinical trials with statins suggesting their protective role in the progression of renal disease. In addition, reduced rates of non-fatal myocardial infarction and cardiac mortality were seen after renal transplant in patients receiving fluvastatin. However, a recent study with atorvastatin failed to demonstrate reduction in cardiovascular morbidity and mortality among diabetic patients on hemodyalisis therapy. Ongoing trials will define the precise role of statins in this subset of patients.

  2. Exercise training and the progression of chronic renal failure

    DEFF Research Database (Denmark)

    Eidemak, I; Haaber, A B; Feldt-Rasmussen, B;

    1997-01-01

    The possible beneficial effect of regular exercise training on the progression of chronic renal failure was studied in a prospective randomized controlled study. Thirty patients with a median glomerular filtration rate (GFR) of 25 ml/(min.1.73 m2) (range 10-43) were randomized to physical training...... rate of progression judged by the slope of GFR versus time plot was equal in the two groups. Hence, the beneficial effect of exercise training, earlier observed in rat studies, could not be reproduced in our patients. Physical exercise had no untoward effect on progression of renal disease....

  3. X-ray changes of children with chronic renal insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W.; Balzar, E. (Vienna Univ. (Austria). Kinderklinik)

    1983-01-01

    The typical changes of renal osteopathy are shown in the X-rays of 7 children with end-stage renal disease treated with chronic intermittent hemodialysis. The exact evaluation of the granular structural changes of the cranium, the evidence of osteomalacia because of the hazy appearance of the vertebrae and the broadening of the sacroilical joints depend highly on subjective judgement and the technical X-ray procedures used. Unmistakable radiological diagnoses can be made when a broadening of the metalphyseal zones, epiphysioloysis as well as characteristic changes in the finder phalanges (acroosteolyses, spiculae, tunnelation) are present.

  4. Is chronic renal failure a risk factor for the development of erosive osteoarthritis?

    Science.gov (United States)

    Duncan, I J; Hurst, N P; Disney, A; Sebben, R; Milazzo, S C

    1989-03-01

    Erosive osteoarthritis of the hands of unusually early onset and severity was seen in two patients treated for chronic renal failure by long term haemodialysis and renal homograft respectively. The significance of this observation is discussed in the light of previous studies of erosive arthropathy in patients with chronic renal failure. Factors associated with chronic renal failure may predispose to the development of erosive osteoarthritis. PMID:2649026

  5. Is chronic renal failure a risk factor for the development of erosive osteoarthritis?

    OpenAIRE

    Duncan, I J; Hurst, N P; Disney, A; Sebben, R; Milazzo, S C

    1989-01-01

    Erosive osteoarthritis of the hands of unusually early onset and severity was seen in two patients treated for chronic renal failure by long term haemodialysis and renal homograft respectively. The significance of this observation is discussed in the light of previous studies of erosive arthropathy in patients with chronic renal failure. Factors associated with chronic renal failure may predispose to the development of erosive osteoarthritis.

  6. FUROSEMIDE TEST: ITS PATTERN IN NOT SEVERE CHRONIC RENAL DISEASE

    Directory of Open Access Journals (Sweden)

    Carlos G. Musso

    2008-01-01

    Full Text Available Furosemide test is a simple and useful test of renal physiology used to evaluate the capability of the collecting tubules to secrete potassium under the effect of serum aldosterone. Its behaviour pattern has already been established in children and young adults but not described in chronic renal disease patients yet, which we explored in this study.Material & Method: Twenty-six young volunteers (between 20 and 40 years old, chronically on a low potassium diet (40 mmol of K day were studied: twenty of them were healthy young ( they were neither suffering form diseases nor on any medication, and the rest were young patients suffering from stage II / III chronic renal disease (damaged kidney with GFR between 83.1 ml-min to 39.2 ml-min secondary to glomerular diseases documented by kidney biopsy. None of the studied chronic renal disease patients were suffering from diabetes mellitus, urinary obstruction, nor treated with dyskalemia generating drugs, such as: diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, etc. Before, while the test was being carried out and after 180 minutes of a single dose of intravenous furosemide (1 mg/kg, urine and blood samples were obtained, for creatinine and potassium levels. From these data we calculated fractional excretion (FE of potassium. Statistical analysis was performed applying Student´s t-test.Results: There was no significant difference neither in pre-furosemide (basal and post-furosemide average FE of potassium between the healthy and chronic renal disease (CRD group: 16.4 ± 8.6% (CRD vs 11.5 ± 4.6% (healthy (p = NS ; 40.8 ± 3.2 % (CRD vs 35.4 ± 8.9% (healthy (p = NS respectively. Conversely, there was a significant difference in post-furosemide peak FE of potassium value, which was higher and delayed in the CRD group compared to the healthy one: 49.5 ± 8.2 % at 118 mins (CRD vs 31.6 ± 11% at 30 mins (healthy (p = 0.001.Conclusion: Furosemide test showed a

  7. Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

    Directory of Open Access Journals (Sweden)

    Samia Rafael Yamashita

    2015-02-01

    Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

  8. Urinary Peptide Levels in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Mungli Prakash

    2010-10-01

    Full Text Available Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary peptide levels in CRF patients and Urinary % peptides were significantly decreased in CRF patients as compared to healthy controls. Urinary % peptides correlated negatively with proteinuria. Conclusion: we have found decrease in urinary peptides and % urinary peptides in CRF patients and possibly measurement of % urinary peptides may possibly serve as better indicator in early detection of impairment in renal function.

  9. Radiological features of progressive tumoral calcinosis in chronic renal failure.

    LENUS (Irish Health Repository)

    Hodnett, P

    2012-02-03

    We present the case of a young adult patient with chronic renal failure who developed painful subcutaneous nodules after failed renal transplant and recommencing dialysis. These nodules were juxta-articular in location and initially located over both shoulders. Radiological evaluation suggested tumoral calcinosis. The patient was placed on a strict dialysis and dietary regimen but was suboptimally compliant with same. The patient developed progressive disease with an increase in size and number of juxta-articular calcified soft-tissue masses. However, 6 months following a second renal transplant clinical and radiological follow up demonstrated marked resolution both in symptomatology and radiographic findings. We present the plain radiographic, CT and MRI findings which demonstrate the typical radiological features of tumoral calcinosis. We correlate these findings with clinical course and histological findings following surgical excision of one of these masses.

  10. Albuminuria, Proteinuria, and Novel Urine Biomarkers as Predictors of Long-term Allograft Outcomes in Kidney Transplant Recipients

    NARCIS (Netherlands)

    Nauta, Ferdau L.; Bakker, Stephan J. L.; van Oeveren, Wim; Navis, Gerjan; van der Heide, Jaap J. Homan; van Goor, Harry; de Jong, Paul E.; Gansevoort, Ron T.

    2011-01-01

    Background: Proteinuria is an established marker of decreased kidney function after kidney transplant. It recently has been suggested that albuminuria might be a more reliable marker. Although albuminuria often is regarded as a marker of glomerular damage, because chronic renal allograft damage is b

  11. [Carbonyl stress and oxidatively modified proteins in chronic renal failure].

    Science.gov (United States)

    Bargnoux, A-S; Morena, M; Badiou, S; Dupuy, A-M; Canaud, B; Cristol, J-P

    2009-01-01

    Oxidative stress is commonly observed in chronic renal failure patients resulting from an unbalance between overproduction of reactive oxygen species and impairement of defense mechanisms. Proteins appear as potential targets of uremia-induced oxidative stress and may undergo qualitative modifications. Proteins could be directly modified by reactive oxygen species which leads to amino acid oxydation and cross-linking. Proteins could be indirectly modified by reactive carbonyl compounds produced by glycoxidation and lipo-peroxidation. The resulting post-traductional modifications are known as carbonyl stress. In addition, thiols could be oxidized or could react with homocystein leading to homocysteinylation. Finally, tyrosin could be oxidized by myeloperoxidase leading to advanced oxidative protein products (AOPP). Oxidatively modified proteins are increased in chronic renal failure patients and may contribute to exacerbate the oxidative stress/inflammation syndrome. They have been involved in long term complications of uremia such as amyloidosis and accelerated atherosclerosis. PMID:19297289

  12. HEARING ASSESSMENT IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    Arjun Singh

    2014-01-01

    Full Text Available The auditory sensitivity of 63 patient of chronic renal failure on hemodialysis was assessed in order to know the effect of dialysis on hearing threshold. All selected patient were non diabetic with normal tympanic membrane and with no history of ototoxic drug and any hereditary hearing problems. Pure tone audiometry was done before and after dialys is and all cases were followed for 3 month. A high incidence of high frequency sensorineural hearing loss was obtained which could not be attributed to age , noise exposure and ottotoxicity. An association between high frequency sensorineural hearing loss a nd hemodialysis is thus suggested KEYWORDS: Hemodialysis ; Pure tone audiometry ; High frequency sensorineural hearing loss ; Duration of disease ; Chronic renal failure

  13. The clinical meanings of leptin RIA in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between chronic renal failure and serum leptin levels in patients with chronic renal failure. Methods: Serum leptin levels (with RIA) were determined in 134 patients (male, 73, female 61) with chronic renal failure and 40 controls. Results: The serum levels of leptin in the chronic renal failure group were significantly higher than those in the controls (t=2.39, P<0.01). There were no significant differences among the leptin levels in patients with different stages of renal failure. Conclusion: There were hyper-leptinemia and leptin resistance in patients with chronic renal failure. The increase of leptin levels is thought to be harmful in patients with chronic renal failure, however, the precise mechanism remains to be studied further. (authors)

  14. Calciphylaxis in chronic, non-dialysis-dependent renal disease

    Directory of Open Access Journals (Sweden)

    Paschke Ralf

    2003-09-01

    Full Text Available Abstract Background Calciphylaxis cutis is characterized by media calcification of arteries and, most prominently, of cutaneous and subcutaneous arterioles occurring in renal insufficiency patients. Case Report A 53-year-old woman with chronic cardiac and renal failure complained of painful crural, non-varicosis ulcers. She was hospitalized in an immobilized condition due to both the crural ulcerations and the existing heart-failure state (NYHA III-IV having pleural and pericardial effusions, atrial fibrillation and weight loss of 30 kg over the past year. Despite normalization of calcium-phosphorus balance and improvement of renal function, the clinical course of crural ulcerations deteriorated during the following 3 months. After failure of surgical debridements, multiple courses of sterile-maggot therapy were introduced at a late stage to stabilize the wounds. The patient died of recurrent wound infections and sepsis paralleled by exacerbations of renal malfunction. Conclusions The role of renal disease in vascular complications is discussed. Sterile-maggot debridement may constitute a therapy for the ulcerated calciphylaxis at an earlier stage, i.e. when first ulcerations appear.

  15. Chronic lead poisoning: a "forgotten" cause of renal disease.

    Science.gov (United States)

    Benjelloun, Meryem; Tarrass, Faissal; Hachim, Khadija; Medkouri, Ghislaine; Benghanem, Mohamed Gharbi; Ramdani, Benyounes

    2007-03-01

    Chronic lead nephropathy occurs as a result of years of lead exposure. Nowadays, with the induction of high standards for industrial hygiene, symptomatic lead intoxication has become extremely rare. We report a case of chronic lead nephropathy in a 59-year-old man who worked in a battery-recycling unit and was diagnosed with plumbism during a regular health screening few years ago. The diagnosis was suggested by the following findings: serum creatinine 160 microg/L, creatinine clearance 46 ml/min, daily urine protein excretion 0.1 g, uric acid 9.7 mg/dl, blood lead 9.2 microg/dl, and a urinary excretion of 850 microg lead/72 h after a mobilisation test by a Na2-Ca-EDTA chelating agent. Renal ultrasound showed bilateral borderline small kidneys. The kidney biopsy revealed moderate focal atrophy, loss of proximal tubules, and prominent interstitial fibrosis. The patient was prescribed angiotensin-converting-enzyme inhibitors to slow the progression of renal insufficiency and control the blood pressure. Hyperuricemia was also treated and controlled. During the regular follow-up, renal function remained stable with no proteinuria. A high index of suspicion for lead intoxication in chronic kidney disease patients should be practiced, especially in patients with hyperuricemia. Chelation of lead urinary excretion is helpful in the diagnosis of this disease. PMID:17237897

  16. Managing acute and chronic renal stone disease.

    Science.gov (United States)

    Moran, Conor P; Courtney, Aisling E

    2016-02-01

    Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones. CT KUB should be the primary mode of imaging for all patients with colic unless contraindicated. In such instances, or if a CT KUB is not available, an ultrasound KUB is an alternative. This has advantages in terms of radiation exposure and cost, but is limited in sensitivity, particularly for ureteric stones. Once diagnosed, a plain film KUB can be used for follow-up of radiopaque stones. For most patients diclofenac is a reasonable first choice of analgesia, e.g. 50-100 mg rectally, or 75 mg IM. Opioid medication can worsen nausea and be less effective, but should be used if there is a contraindication to NSAIDs. A combination of diclofenac, paracetamol, and/or codeine regularly can provide adequate pain control in many cases. Failure of this analgesic combination should prompt consideration of secondary care support. If a ureteric stone 10 mm in diameter should be discussed with the urology service as they are unlikely to pass spontaneously. PMID:27032222

  17. Use of nonsteroidal anti-inflammatory drugs prior to chronic renal replacement therapy initiation

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Kamper, Anne-Lise; Køber, Lars;

    2012-01-01

    PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with severe renal complications, including acute renal failure, reduced glomerular filtration rate and interstitial nephritis. Caution against NSAIDs is therefore recommended in advanced chronic kidney disease. In this study...

  18. Effect of TGF-β1 antisense oligodeoxynucleotide on renal function in chronic renal failure rats

    Institute of Scientific and Technical Information of China (English)

    Law Chung HIONG; Kiew Lik VOON; Nor Azizan ABDULLAH; Munavvar A SATTAR; Nazarina AbduRAHMAN; Abdul Hye KHAN; Edward James JOHNS

    2008-01-01

    Aim:The aim of the present study was to investigate the effectiveness of trans-forming growth factor (TGF)-β1 antisense oligodeoxynucleotides (ODN) in ame-liorating deteriorated kidney function in rats with puromycin-induced chronic renal failure (CRF). Methods:Saline, puromycin, puromycin+TGF-β1 antisense ODN or puromycin+scrambled ODN were administered to unilaterally nephrecto-mized rats. Renal hemodynamic and excretory measurements were taken in the anaesthetized rats that had undergone surgical procedure. Results:It was ob-served that in the CRF rats, there was a marked reduction in the renal blood flow (RBF), glomerular filtration rate (GFR), severe proteinuria, and almost 6-fold in-creased fractional excretion of sodium (FE Na+) as compared to that in the control rats (all P<0.05). It was further observed that in the CRF rats, the treatment with TGF-β1 antisense, but not scrambled ODN, markedly attenuated the reduction of RBF, GFR, and proteinuria and markedly prevented the increase of the FE Na+ (all P<0.05). In addition, the renal hypertrophy in the CRF group (P<0.05 vs non-renal failure control) was markedly attenuated after treatment with TGF-1 antisense ODN (P<0.05). Focal segmental glomerulosclerosis was evident only in the un-treated and scrambled ODN-treated CRF groups. An interesting observation of this study was that in the CRF rats, although there was marked attenuating and preventive effects of the TGF-β1 antisense ODN on the deteriorated renal functions, the antisense treatment did not cause any marked change in the renal expression of TGF-β1 at the protein level. Conclusion:Collectively, the data obtained sug-gests that TGF-β1 antisense ODN possesses beneficial effects in puromycin-induced chronic renal failure and that the deterioration in morphology and im-paired renal function in this pathological state is in part dependent upon the action of TGF-β1 within the kidney.

  19. Evaluation of renal donors and recipients using intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Renal IV DSA was applied to evaluate 15 potential renal donors and 14 examinations of 12 renal allograft recipients. We evaluate the angiographic acute or chronic rejection, alteration of renal size after transplantation, excretion time of the contrast media and pre, post DSA serum creatinine level. DSA is a safe, easily performed, outpatient procedure and useful in evaluation and distinguishing status of surgical anastomosis, intrarenal vasculatures, arterial exception time and rejection phenomenon.

  20. Long-Term Impact of Cyclosporin Reduction with MMF Treatment in Chronic Allograft Dysfunction: REFERENECE Study 3-Year Follow Up

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    L. Frimat

    2010-01-01

    Full Text Available Calcineurin inhibitor (CNI toxicity contributes to chronic allograft nephropathy (CAN. In the 2-year, randomized, study, we showed that 50% cyclosporin (CsA reduction in combination with mycophenolate mofetil (MMF treatment improves kidney function without increasing the risk for graft rejection/loss. To investigate the long-term effect of this regimen, we conducted a follow up study in 70 kidney transplant patients until 5 years after REFERENCE initiation. The improvement of kidney function was confirmed in the MMF group but not in the control group (CsA group. Four graft losses occurred, 2 in each group (graft survival in the MMF group 95.8% and 90.9% in control group. One death occurred in the control group. There was no statistically significant difference in the occurrence of serious adverse events or acute graft rejections. A limitation is the weak proportion of patient still remaining within the control group. On the other hand, REFERENCE focuses on the CsA regimen while opinions about the tacrolimus ones are still debated. In conclusion, CsA reduction in the presence of MMF treatment seems to maintain kidney function and is well tolerated in the long term.

  1. Oral disorders in patients with chronic renal failure. Narrative review.

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2016-02-01

    Full Text Available Chronic renal failure (CRF is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent organ rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.

  2. Quality of life in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Petrović Lada

    2006-01-01

    Full Text Available Introduction. Hemodialysis and transplantation are performed not only to replace renal function, but also to improve patients' quality of life. The aim of our investigation was to compare the quality of life in patients with chronic renal failure (CRF before and after the introduction of active therapy. Material and methods. We tested 76 patients (pts: 20 pts on conservative therapy (CT, 21 pts on chronic hemodialysis and 35 pts with renal transplantation. A questionnaire (combining two questionnaires was used to investigate the physical, emotional and social aspects of health. Results. In regard to physical health of transplantation patients (TP it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40% than in hemodialysis patients (HD (19%, while family relationships were most damaged in pts on HD (28.57%. Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good; 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good. .

  3. Impaired renal function in relatives of chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Pradip Kumar Dutta

    2015-01-01

    Full Text Available Background: Chronic kidney disease (CKD is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD. Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional comparative study conducted at Chittagong Medical College Hospital (CMCH, Chittagong, Bangladesh, a tertiary hospital in the southern part of Bangladesh. Materials and Methods: We screened the relatives of CKD patients, as a risk population, by urine albumin and estimated GFR (eGFR. Results: We observed a significant difference in urine albumin (29% vs 10% in relatives and nonrelatives, respectively and abnormal renal function [albuminuria/creatinine clearance (CCr criteria] (30% vs 11% in relatives and nonrelatives, respectively between relatives and nonrelatives. Relatives of glomerulonephritis-CKD (GN-CKD patients had more albuminuria than others. Risk factors like hypertension (HTN, impaired glucose tolerance (IGT/diabetes mellitus (DM, and family history of DM/HTN/cardiovascular disease (CVD were significant among relatives and might have some link to familial influence on developing CKD. Conclusion: Relatives of CKD patients should be screened as a risk population to evaluate abnormal renal function.

  4. Decrease rate of the renal diameter in chronic hemodialysis patients.

    Science.gov (United States)

    Aoyagi, Teiichiro; Tachibana, Masaaki; Naganuma, Shinji

    2013-01-01

    We here present the results of ultrasonographic (US) evaluations on the alteration of renal diameter of chronic HD patients. Of 109 outpatient HD patients who had neither severe acquired cystic disease of the kidney nor hereditary polycystic kidney disease, we performed US two or three times to measure their maximum renal diameter (mean of both kidneys), and the yearly alteration rate was calculated. The average interval of the two measurements was 35.9 months, and the average HD duration from the HD induction to the first measurement was 29.5 months. The average decrease rate of renal diameter was 4.34 ± 0.4 (SE) mm/year. No statistical difference was seen on the decrease rate in relation to gender, age and original disease (among three groups, glomerulonephritis and IgA nephropathy, diabetes, and others including hypertension). However, the decrease rate was large when the first measurement was close to the induction of hemodialysis, suggesting that the alteration rate reduced according to the hemodialysis vintage (5.3 ± 0.8 mm/year, first measurement not more than 10 months after induction of HD and 1.5 ± 1.6 mm/year, first measurement more than 80 months after induction of HD). Renal diameter decreased approximately 4.3 mm each year, and the decrease rate slowed as the length of time on dialysis increased. PMID:24967236

  5. Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease

    Science.gov (United States)

    Fernandes, Sheila Marques; Martins, Daniel Malisani; da Fonseca, Cassiane Dezoti; Watanabe, Mirian; Vattimo, Maria de Fátima Fernandes

    2016-01-01

    Iodinated contrast (IC) is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI). Chronic kidney disease (CKD) and chronic hyperglycemia (CH) are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH); Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL) and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance) were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI. PMID:27034930

  6. HEPATITIS C VIRUS INFECTION IN PATIENTS WITH CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION ECIPIENTS

    Directory of Open Access Journals (Sweden)

    MR. Ganji

    1997-07-01

    Full Text Available 'Die presence anil significance of hepatitis C virus infection among patients with chronic renal failure (CRF on hemodialysis and renal transplant recipient were evaluated a pcrioil of 30 months. A total of 125 patients, comprising 25 recieving chronic hemodialysis, 47 renal transplant candidates and 5.1 renal transplant recipients, were studied with a second generation immunoassay (ELISA II. We detected HCV antibody in 13% of hemodialysis patients which is 40 folds higher than the prevalence of HCV antihotly in general population of Iran (0.3%, as expected. Fortynine (39.2% of our patients were HCV antihotly positive, 2H of them were transplanted and 21 were renal transplant candidates. We compared HCV antihotly positive (group I and HCV antibody negative (group 2 patients. Die results of this study showed a positive correlation between HCV seroconversion, CRF, duration on hemodialysis and elevated liver enzyme levels. Duration of follow-up were 29.62 ± 15.62 months and 31.25 ± 17.50 months in group I and 2 respectively (I' = NS. Duration of preoperative hemodialysis were 54.14 ± 41.18 months and 16.00 ± 10.25 months in group 1 ami 2 respectively (I1 = 0.000}. During follow-up, elevated ALT levels were present in 43.3% and 9.26% of patients in group I ami 2 respectively (I'=0.0001. Immunosuppressive drug toxicity, 1'ostopeative complications including hyperacute rejection and acute tubular necrosis were more common in group I.

  7. Soluble CD59 is a Novel Biomarker for the Prediction of Obstructive Chronic Lung Allograft Dysfunction After Lung Transplantation.

    Science.gov (United States)

    Budding, Kevin; van de Graaf, Eduard A; Kardol-Hoefnagel, Tineke; Kwakkel-van Erp, Johanna M; Luijk, Bart D; Oudijk, Erik-Jan D; van Kessel, Diana A; Grutters, Jan C; Hack, C Erik; Otten, Henderikus G

    2016-01-01

    CD59 is a complement regulatory protein that inhibits membrane attack complex formation. A soluble form of CD59 (sCD59) is present in various body fluids and is associated with cellular damage after acute myocardial infarction. Lung transplantation (LTx) is the final treatment for end-stage lung diseases, however overall survival is hampered by chronic lung allograft dysfunction development, which presents itself obstructively as the bronchiolitis obliterans syndrome (BOS). We hypothesized that, due to cellular damage and activation during chronic inflammation, sCD59 serum levels can be used as biomarker preceding BOS development. We analyzed sCD59 serum concentrations in 90 LTx patients, of whom 20 developed BOS. We observed that BOS patients exhibited higher sCD59 serum concentrations at the time of diagnosis compared to clinically matched non-BOS patients (p = 0.018). Furthermore, sCD59 titers were elevated at 6 months post-LTx (p = 0.0020), when patients had no BOS-related symptoms. Survival-analysis showed that LTx patients with sCD59 titers ≥400 pg/ml 6 months post-LTx have a significant (p < 0.0001) lower chance of BOS-free survival than patients with titers ≤400 pg/ml, 32% vs. 80% respectively, which was confirmed by multivariate analysis (hazard ratio 6.2, p < 0.0001). We propose that circulating sCD59 levels constitute a novel biomarker to identify patients at risk for BOS following LTx. PMID:27215188

  8. Helicobacter Pylori in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    B Allahverdi

    2004-07-01

    Full Text Available Background: Helicobacter pylori (H.Pylori is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD. Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2% had pathologic defect in endoscopy and 57 patients (82.6% had gastrointestinal symptoms. Prevalence of H pylori positive was 21.7% (15 patients. H pylori was positive in 21% patients with gastrointestinal symptoms. Conclusion: Chronic renal failure and dialysis had no effect on prevalence of H pylori.

  9. Chronic renal failure among HIV-1-infected patients

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Kirk, Ole; Gatell, Jose;

    2007-01-01

    BACKGROUND: The role of exposure to antiretrovirals in chronic renal failure (CRF) is not well understood. Glomerular filtration rates (GFR) are estimated using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations. METHODS: Baseline was arbitrarily defined as the first...... recorded GFR; patients with two consecutive GFR determine odds ratio (OR) of CRF at baseline. ART exposure (yes/no or cumulative exposure) prior to baseline was included in multivariate models (adjusted for region...... of Europe, age, prior AIDS, CD4 cell count nadir, viral load, hypertension and use of nephrotoxic anti-infective therapy). RESULTS: Using CG, the median GFR at baseline (n = 4474) was 94.4 (interquartile range, 80.5-109.3); 158 patients (3.5%) had CRF. Patients with CRF were older (median, 61.9 versus 43...

  10. An Epidermolysis Bullosa Patient Complicated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Özkan Ulutaş

    2013-03-01

    Full Text Available A 32-yr-old man with epidermolysis bullosa presented with clinical and laboratory findings of chronic renal failure. The patient was supposed to be suffering from mesangial IgA glomerulonephritis in view of the repeated persistent macroscopic episodes of hematuria and raised serum IgA levels, especially polimeric IgA. Because continuous vascular access could not be established, the patient died due to uremia and sepsis. Renal complications are associated with life-threatening problems in this inherited mechanobullous disease because it is impossible to obtain a continuous vascular access or a continuous peritoneal access. The possibility of IgA nephropathy should be considered in patients with epidermolysis bullosa. They should be periodically set up screened for IgA levels and hematuria.

  11. Acute renal failure: outcomes and risk of chronic kidney disease.

    Science.gov (United States)

    Block, C A; Schoolwerth, A C

    2007-09-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. The incidence of ARF is increasing. Efforts such as the Acute Dialysis Quality Initiative (ADQI) are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury that might confer a different prognosis. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease and more information regarding recovery from ARF is available. Controversy exists regarding the optimal management of ARF. Recent publications emphasize the importance of timing and dose of renal replacement therapy rather than the modality of treatment (intermittent hemodialysis vs continuous therapies). These issues are explored in this review. PMID:17912228

  12. Clinicopathologic findings associated with chronic renal disease in cats: 74 cases (1973-1984).

    Science.gov (United States)

    DiBartola, S P; Rutgers, H C; Zack, P M; Tarr, M J

    1987-05-01

    The historic, physical, laboratory, and histologic findings for 74 cats with chronic renal disease were reviewed. Most cats were older, and no breed or sex predilection was detected. This most common clinical signs detected by owners were lethargy, anorexia, and weight loss. Dehydration and emaciation were common physical examination findings. Common laboratory findings were nonregenerative anemia, lymphopenia, azotemia, hypercholesterolemia, metabolic acidosis, hyperphosphatemia, and isosthenuria. The most common morphologic diagnosis was chronic tubulointerstitial nephritis of unknown cause. The other pathologic diagnoses were renal lymphosarcoma, renal amyloidosis, chronic pyelonephritis, chronic glomerulonephritis, polycystic renal disease, and pyogranulomatous nephritis secondary to feline infectious peritonitis. PMID:3583899

  13. Hiperhomocisteinemia na insuficiência renal crônica Hyperhomocysteinemia in chronic renal failure

    Directory of Open Access Journals (Sweden)

    Fabiana Baggio Nerbass

    2005-04-01

    Full Text Available A homocisteína é um aminoácido sulfurado proveniente do metabolismo da metionina, cujo acúmulo anormal no plasma é um fator de risco para doenças vasculares, tanto na população em geral como nos pacientes com insuficiência renal crônica. Nestes, a prevalência de indivíduos com hiperhomocisteinemia é bastante elevada, mesmo na fase não dialítica da doença, em que a função renal está diminuída, mas ainda não é necessário tratamento dialítico. O principal fator que parece estar implicado na elevação dos níveis de homocisteína nestes pacientes com insuficiência renal crônica é a perda da massa renal, já que esta exerce uma importante função no metabolismo desse aminoácido. O tratamento da hiperhomocisteinemia na população em geral consiste na suplementação com as vitaminas envolvidas no seu metabolismo (folato, B6 e B12. Porém, em pacientes com insuficiência renal crônica, este tratamento não é completamente eficaz, pois apesar de promover a redução dos níveis de homocisteína, não alcança a normalização dos mesmos na maioria dos pacientes. Este estudo compreende uma revisão da etiologia da hiperhomocisteinemia na insuficiência renal crônica, sua relação com as doenças vasculares, seus principais determinantes e as formas de tratamento.Homocysteine is a sulfur-containing amino acid derived from the metabolism of methionine, whose abnormal accumulation in plasma is a risk factor for vascular disease in the general population and in patients with chronic renal disease. In these patients, the prevalence of individuals with hyperhomocysteinemia is very high, even in the pre-dialysis stage of the disease. The main factor that seems to be implicated on the elevation of homocysteine levels in this population is the renal mass loss, considering that the kidney has an important role in the metabolism of such amino acid. The treatment of hyperhomocysteinemia consists on supplementation of the vitamins

  14. Na+-K+ pump in chronic renal failure

    International Nuclear Information System (INIS)

    This review summarizes the evidence for the defect in Na+-K+ pump in chronic renal failure, considers the role of various factors in causing this defect, and discusses the clinical implications thereof. Intracellular Na is elevated in erythrocytes, leukocytes, and muscle cells from some patients with chronic renal failure (CRF). Recent evidence suggest that this elevation of cell Na may be, in large part, a consequence of decreased number of Na+-K+ pump units per cell. Maintenance dialysis over a period of weeks ameliorates the defect in intracellular Na+, and this improvement is contemporaneous with an increase in the number of Na+-K+ pump sites per cell. In erythrocytes with normal cell Na+, acute hemodialysis increases the rate of 22Na+ and 42K+ transport. Many factors such as the presence of retained toxic metabolite or circulating inhibitor in the uremic plasma, or biochemical changes produced by acute hemodialysis, may explain this finding. In cells with high cell Na+, the pump-mediated 42K+ transport is normalized at the expense of a raised cell Na+. The decreased muscle membrane potential in uremic subjects has been attributed to a decreased activity of Na+-K+ pump. The authors discuss the role of hormonal abnormalities and circulating inhibitors, which may cause an acute inhibition of the pump and of other factors such as K+ depletion, which may cause more chronic alterations. The implications of alteration of Na+ and K+ pump transport and raised cell Na+ on other non-pump-mediated transport pathways are discussed. Raised cell Na+ may be a marker for the adequacy of maintenance dialysis in patients with end-stage renal failure

  15. Clinical Scenarios in Chronic Kidney Disease: Parenchymal Chronic Renal Diseases - Part 2.

    Science.gov (United States)

    Petrucci, Ilaria; Samoni, Sara; Meola, Mario

    2016-01-01

    Secondary nephropathies can be associated with disreactive immunological disorders or with a non-inflammatory glomerular damage. In systemic lupus erythematosus (SLE), scleroderma and rheumatoid arthritis as in other connective tissue diseases, kidney volume and cortex echogenicity are the parameters that best correlate with clinical severity of the disease, even if the morphological aspect is generally non-specific. Doppler studies in SLE document the correlation between resistance indexes (RIs) values and renal function. Acquired immunodeficiency syndrome (HIV) causes different types of renal damage. At ultrasound (US), kidneys have almost a normal volume, while during superinfection they enlarge (coronal diameter >13 cm) and become globular, loosing their normal aspect. Cortex appears highly hyperechoic, uniform or patchy. Microcalcifications of renal cortex and medulla are a US sign that can suggest HIV. In amyloidosis, kidneys appear normal or increased in volume in the early stages of disease. Renal cortex is diffusely hyperechoic and pyramids can show normal size and morphology, but more often they appear poorly defined and hyperechoic. RIs are very high since the early stages of the disease. Nephromegaly with normal kidney shape is the first sign of lymphoma or multiple myeloma. In systemic vasculitis, renal cortex is diffusely hyperechoic, while pyramids appear hypoechoic and globular due to interstitial edema. When vasculitis determines advanced chronic kidney disease stages, kidneys show no specific signs. Microcirculation damage is highlighted by increased RIs values >0.70 in the chronic phase. PMID:27169551

  16. Abnormalities of the breast in chronic renal failure and renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bae Young; Kim, Hak Hee; Choi, Kyu Ho; Park, Seog Hee [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2000-12-15

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

  17. Abnormalities of the breast in chronic renal failure and renal transplantation

    International Nuclear Information System (INIS)

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

  18. Chronic renal failure and macrogenitalia associated with genitourinary neurofibromatosis.

    Science.gov (United States)

    Dündar, Bumin Nuri; Oktem, Faruk; Armağan, Abdullah; Dündar, Nihal Olgaç; Bircan, Sema; Yesildag, Ahmet

    2010-02-01

    Neurofibromatosis (NF) is a genetic disorder of the nervous system that primarily affects the development and growth of neural cell tissues. This disorder is characterized by the development of various tumors, including neurofibromas, neuroniomas, malignant and benign peripheral nerve sheath tumors, and meningiomas. Accompanying skin changes and bone deformities are also common in NF. However, genitourinary involvement in NF is a rare condition, and penile enlargement has been reported only in a few males with plexiform NF. We report a 6-year-old boy with chronic renal failure associated with plexiform neurofibromas of the bladder and prostatic urethra which led to urinary obstruction and macrogenitalia due to genitourinary NF. PMID:19826840

  19. Arteriovenous thrombosis in chronic renal failure patients receving renal replacement therapy

    International Nuclear Information System (INIS)

    To determine the frequency of thrombotic complications and to identify factors associated with arteriovenous thrombosis in patients of chronic renal failure receiving renal replacement therapy. Of the 3000 patients evaluated, 61 End Stage Renal Disease (ESRD) patients on regular dialysis, having recent renal transplant, were selected for the study after informed consent. These patients had arteriovenous thrombosis with temporary central lines thrombosis and vascular access problems. Cases of congenital or acquired thrombotic disorders, e.g. with malignancy, DIC, liver disease, systemic lupus erythematosus or other immunologic diseases, pregnancy or women using oral contraceptives, were excluded. Similarly, patients taking any type of anticoagulant therapy during the preceding one week were not included in the study. Findings were recorded in a structured questionnaire. Laboratory analysis was done after clinical and radiological evaluation. Thrombophilia screening included antithrombin, protein C, protein S deficiencies and lupus anticoagulant. Forty-seven out of 61 patients selected were positive for thrombophilia screening with protein C deficiency in 26.2%, protein S deficiency in 16.3%, antithrombin in 5%, lupus anticoagulant in 13.1% and combined deficiency was observed in 16.3%. Of the 3000 patients, 61 with frequency of 2% were found to be deficient in one or had combined deficiency of these. Thus, the study of ESRD patients presenting with arteriovenous thromboembolism emphasizes the need to reconsider the perception that this clinical entity is rare and requires further studies. (author)

  20. Children with chronic renal failure have reduced numbers of memory B cells.

    NARCIS (Netherlands)

    Bouts, A.H.M.; Davin, J.C.; Krediet, R.T.; Monnens, L.A.H.; Nauta, J.; Schröder, C.H.; Lier, R.A.W. van; Out, T.A.

    2004-01-01

    Reduced serum IgG and subclass levels have been demonstrated in children with chronic renal failure. To study possible causes of this reduction, we analysed B cell subset composition, T helper cell frequencies and immunoglobulin (Ig) production capacity in vitro in children with chronic renal failur

  1. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    OpenAIRE

    Perihan Öztürk; Neslihan Dokur; Ergül Kurutaş; Ekrem Doğan; Tuğba Karakaş; Murat Kalender; Hasan Ekerbiçer

    2012-01-01

    Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined fo...

  2. Upper Digestive Endoscopic Findings in Patients with Chronic Renal Insufficiency in Phase of Dialysis

    OpenAIRE

    Marcos Félix Osorio Pagola; David Rodríguez Zamora; Juan Luís de Pasos Carrazana; Libán Álvarez Cáceres; Orelvis Martínez Martínez; Anagalys Ortega Alvelay

    2009-01-01

    Background: Patients with chronic renal insufficiency in phase of dialysis present clinical manifestations that can include different symptoms. Morbidity due to gastric, esophageal and duodenal disturbances is significant and constitutes a considerable risk before, while and after a renal transplant. Objective: To identify the most frequent disturbances of the upper digestive tract in patients with chronic renal insufficiency who require dialysis. Methods: An observational, descriptive and r...

  3. Ear, nose and throat manifestations in pediatric chronic renal failure patients undergoing peritoneal dialysis

    OpenAIRE

    Kumar, Sandeep; Chakravarti, A; Sahni, J. K.; Dubey, N. K.

    2004-01-01

    Ear, Nose and Throat manifestations have been frequently observed in patients with chronic renal failure. Many factors viz. ototoxic drugs, associated conditions of renal failure such as electrolyte imbalance, alteration in blood urea etc. have been implicated for these manifestations. The present study has been conducted to evaluate ear, nose and throat manifestations in thirty pediatric patients (age group 4-16 year) of chronic renal failure undergoing peritoneal dialysis. Probable patho-ph...

  4. Impact of human leukocyte antigen matching and recipients' panel reactive antibodies on two-year outcome in presensitized renal allograft recipients

    Institute of Scientific and Technical Information of China (English)

    MENG Hui-lin; JIN Xun-bo; LI Xiang-tie; WANG Hong-wei; L(U) Jia-ju

    2009-01-01

    Background Renal transplantation in sensitized candidates remains a highly significant challenge worldwide. The production of panel reactive antibody (PRA) against human leukocyte antigen (HLA) is a major risk factor in presensitized recipients. The aim of this study was to evaluate the impact of HLA matching and recipients' PRA on two-year outcome in presensitized renal allograft recipients.Methods We determined the percentage of panel reactivity and specificity of anti-HLA immunoglobulin (Ig) G antibodies in 73 presensitized renal allograft recipients compared with 81 unsensitized recipients (control group). HLA genotyping of both recipients and corresponding donors was performed by PCR with sequence-specific primers (PCR-SSP). We analyzed the factors influencing the early graft outcome (two-year rejection rates and survival rates of the grafts), including HLA mismatching, class and degree of panel reactivity, and target antigen of donors.Results Presensitized recipients had a worse two-year outcome than unsensitized recipients (P=0.019 for rejection rate, P=0.01 for survival rate). The difference in number of HLA-mismatched alleles with either 6-antigen matching (Ag M) standard or amino acid residue matching (Res M) standard was not significant between the rejection and non-rejection groups of presensitized recipients or between the graft survival group and graft loss group. Compared with the control group, recipients with both PRA-Ⅰ and PRA-Ⅱ antibodies had a significantly worse two-year outcome (P=0.001 for rejection rate, P=0.002 for survival rate). The two-year outcomes of the peak PRA ≥50% group and its subgroup, at-transplant PRA ≥50% group, were significantly worse compared with the control group (P=0.025 and P=0.001 for rejection rate, P=0.043 and P=0.024 for survival rate). The rejection rates of the at-transplant target antigen positive group and its subgroup, HLA-Ⅰ target antigen positive group, were significantly higher than the control

  5. Proteomics for rejection diagnosis in renal transplant patients: Where are we now?

    OpenAIRE

    Gwinner, Wilfried; Metzger, Jochen; Husi, Holger; Marx, David

    2016-01-01

    Rejection is one of the key factors that determine the long-term allograft function and survival in renal transplant patients. Reliable and timely diagnosis is important to treat rejection as early as possible. Allograft biopsies are not suitable for continuous monitoring of rejection. Thus, there is an unmet need for non-invasive methods to diagnose acute and chronic rejection. Proteomics in urine and blood samples has been explored for this purpose in 29 studies conducted since 2003. This r...

  6. Non-invasive imaging of acute renal allograft rejection in rats using small animal F-FDG-PET.

    Directory of Open Access Journals (Sweden)

    Stefan Reuter

    Full Text Available BACKGROUND: At present, renal grafts are the most common solid organ transplants world-wide. Given the importance of renal transplantation and the limitation of available donor kidneys, detailed analysis of factors that affect transplant survival are important. Despite the introduction of new and effective immunosuppressive drugs, acute cellular graft rejection (AR is still a major risk for graft survival. Nowadays, AR can only be definitively by renal biopsy. However, biopsies carry a risk of renal transplant injury and loss. Most important, they can not be performed in patients taking anticoagulant drugs. METHODOLOGY/PRINCIPAL FINDINGS: We present a non-invasive, entirely image-based method to assess AR in an allogeneic rat renal transplantation model using small animal positron emission tomography (PET and (18F-fluorodeoxyglucose (FDG. 3 h after i.v. injection of 30 MBq FDG into adult uni-nephrectomized, allogeneically transplanted rats, tissue radioactivity of renal parenchyma was assessed in vivo by a small animal PET-scanner (post operative day (POD 1,2,4, and 7 and post mortem dissection. The mean radioactivity (cps/mm(3 tissue as well as the percent injected dose (%ID was compared between graft and native reference kidney. Results were confirmed by histological and autoradiographic analysis. Healthy rats, rats with acute CSA nephrotoxicity, with acute tubular necrosis, and syngeneically transplanted rats served as controls. FDG-uptake was significantly elevated only in allogeneic grafts from POD 1 on when compared to the native kidney (%ID graft POD 1: 0.54+/-0.06; POD 2: 0.58+/-0.12; POD 4: 0.81+/-0.06; POD 7: 0.77+/-0.1; CTR: 0.22+/-0.01, n = 3-28. Renal FDG-uptake in vivo correlated with the results obtained by micro-autoradiography and the degree of inflammatory infiltrates observed in histology. CONCLUSIONS/SIGNIFICANCE: We propose that graft FDG-PET imaging is a new option to non-invasively, specifically, early detect, and follow

  7. Vascularized composite allotransplantation: current standards and novel approaches to prevent acute rejection and chronic allograft deterioration.

    Science.gov (United States)

    Kueckelhaus, Maximilian; Fischer, Sebastian; Seyda, Midas; Bueno, Ericka M; Aycart, Mario A; Alhefzi, Muayyad; ElKhal, Abdallah; Pomahac, Bohdan; Tullius, Stefan G

    2016-06-01

    The advent of more potent immunosuppressants led to the first successful human upper extremity transplantation in 1998. At this time, >100 upper extremity transplants, 30 face transplants, and a variety of other vascularized composite allotransplantation (VCA) procedures have been performed around the world. VCA recipients present unique challenges for transplantation. The incidence of acute rejection exceeds 80% in hand and face transplantation and is well documented, whereas reports about antibody-mediated rejection and chronic rejection remain scarce. Immunosuppression protocols commonly used at US centers are derived from solid organ transplantation protocols. Novel approaches to minimize rejections in VCA may include improved HLA matching and considerations toward cytomegalovirus infection status. New graft preservation techniques may decrease immunogenicity prior to transplant. Novel monitoring methods such as valid biomarkers, ultrasound biomicroscopy, and sentinel flaps may enable earlier diagnosis of rejection. Cell-based therapies are being explored to achieve immunosuppressive regimen minimization or even tolerance induction. The efficacy of local immunosuppression in clinical VCA remains controversial. In conclusion, although immunosuppressive strategies adapted from SOT have demonstrated good midterm results, focusing on the unique features of VCA grafts may enable additional, more specific treatment strategies in the future and improved long-term graft outcomes. PMID:26265179

  8. Plasma homocysteine concentration in children with chronic renal failure.

    Science.gov (United States)

    Merouani, A; Lambert, M; Delvin, E E; Genest, J; Robitaille, P; Rozen, R

    2001-10-01

    Hyperhomocysteinemia, a risk factor for vascular disease, is commonly found in adult patients with end-stage renal disease. Major determinants of elevated plasma homocysteine levels in these patients include deficiencies in folate and vitamin B12, methylenetetrahydrofolate reductase (MTHFR) genotype and renal function. Little information is available for children with chronic renal failure (CRF). The prevalence and the factors that affect plasma homocysteine concentration were determined in children. Twenty-nine children with various degrees of CRF (15 were dialyzed, 14 were not dialyzed) were compared with 57 age- and sex-matched healthy children. Homocysteine concentrations were higher in patients than controls (17.3 micromol/l vs 6.8 micromol/l, P95th percentile for controls: 14.0 micromol/l) was seen in 62.0% of patients and 5.2% of controls. Folate concentrations were lower in patients (9.9 nmol/l) than controls (13.5 nmol/l), P<0.01. Vitamin B12 was similar in patients (322 pmol/l) and controls (284 pmol/l). Dialyzed patients have a higher prevalence of hyperhomocysteinemia than nondialyzed patients (87% vs 35%). Dialyzed patients with MTHFR mutation have higher plasma homocysteine (28.5 micromol/l) than nondialyzed patients with the mutation (10.7 micromol/l), P<0.002. In our study, differences between controls and patients in plasma homocysteine concentrations are observed when age is greater then 92 months, folate less than 21.6 nmol/l and vitamin B12 less than 522 pmol/l. Our study shows that hyperhomocysteinemia is common in children with CRF and is associated with low folate and normal vitamin B12 status, compared to normal children. Among the patients, the dialyzed patients with the MTHFR mutation are particularly at risk for hyperhomocysteinemia. Further studies are needed to investigate therapeutic interventions and the potential link with vascular complications in these patients. PMID:11605787

  9. Clinical Scenarios in Chronic Kidney Disease: Cystic Renal Diseases.

    Science.gov (United States)

    Meola, Mario; Samoni, Sara; Petrucci, Ilaria

    2016-01-01

    Cysts are frequently found in chronic kidney disease (CKD) and they have a different prognostic significance depending on the clinical context. Simple solitary parenchymal cysts and peripelvic cysts are very common and they have no clinical significance. At US, simple cyst appears as a round anechoic pouch with regular and thin profiles. On the other hand, hereditary polycystic disease is a frequent cause of CKD in children and adults. Autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) are the best known cystic hereditary diseases. ADPKD and ARPKD show a diffused cystic degeneration with cysts of different diameters derived from tubular epithelium. Medullary cystic disease may be associated with tubular defects, acidosis and lithiasis and can lead to CKD. Acquired cystic kidney disease, finally, is secondary to progressive structural end-stage kidney remodelling and may be associated with renal cell carcinoma. PMID:27169740

  10. Radiological diagnosis of pulmonary edema in chronic renal failure

    International Nuclear Information System (INIS)

    Pulmonary edema has been revealed in 132 patients (51.6 %) during radiologic examination of 256 patients with chronic renal failure. The performance of anterio-posterior chest radiographs was in most cases necessary and quite sufficient for making diagnostic conclusions. Follow up study of patients with pulmonary edema and analysis of radiologic picture of the alterations permitted physicians to distinguish approximately 3 stages of the process development, which transit from one into another. Stage 1 involves early disorders and prodromes of pulmonary edema; Stage 2 interstitial lung edema; Stage 3 alveolar edema. The circulation enforcement of the upper lobar vessels has been the main feature of stage 1. Radiogramometry provided additional information for the pulmonary edema diagnosis. For instance, cardioradiometric data are useful for pulmonary edema diagnosis and evidence in favour of its close connection with heart disorders

  11. Did Ugo Foscolo suffer from chronic renal insufficiency?

    Science.gov (United States)

    Stamatiou, Konstantinos; Sgouridou, Maria; Christopoulos, Georgios

    2016-01-01

    Ugo Foscolo, was an Italian poet whose works rank among the masterpieces of Italian literature. Talented and well educated in philosophy, classics, and Italian literature, Foscolo gave literary expression to his ideological aspirations and to the numerous amorous experiences in odes, sonnets, plays, poems and an epistolary novel. Concurrent with his rich literary output, Foscolo's correspondence represents a unique perspective from which to monitor his literary and political views and investigate aspects of his everyday life. Among other interesting information, one can find elements of Foscolo's medical history which is generally unknown. Based on his testimonies we suggest that he suffered of longstanding bladder outlet obstruction presumably due to urethral stricture. In the present article we investigate the possibility that chronic bladder outlet obstruction and the consequent renal insufficiency was attributed to the death of Ugo Foscolo. PMID:26885466

  12. Complementary and Alternative Medicine Methods in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Zeynep Erdogan

    2014-08-01

    Full Text Available Despite its long history, use of complementary and alternative medicine (CAM methods has increased dramatically only after 1990s. Up to 57% of patients with chronic renal use CAM methods.These patienys use CAM methods to overcome hypertension, fatigue, constipation, leg edema, pain, cramps, anxiety, depression, sleep disorders, to cope with symptoms such as itching, to stop the progression of kidney disease and to improve their quality of life. Methods used are herbal products and food supplements, acupressure, acupuncture, homeopathy, exercise, aromatherapy, yoga and reflexology. Nephrotoxic effect of several CAM therapies used in patients with renal impairment could disturb hemodynamics by reducing the glomerular filtration rate. For this reason, health care providers should question patients about used of CAM, methods. Communication with patients should be clear and should not act judgmental. Health care personnel should learn more about CAM methods in order to avoid unwanted situations that could develop after the application of CAM methods. Patients should be informed correctly and scientifically about these methods to avoid harmful and unnecessary uses. [Archives Medical Review Journal 2014; 23(4.000: 770-786

  13. Total and free thyroid hormone levels in chronic renal failure.

    Directory of Open Access Journals (Sweden)

    Mehta H

    1991-04-01

    Full Text Available The levels of serum total thyroxine (TT4, triiodothyronine (TT3, free T3, (FT3 free T4 (FT4 and thyrotropin (TSH were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF; and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals. Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001 as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05 as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.

  14. Evaluation of renal allograft dysfunction employing dynamic SPECT with 99mTc-MAG3 and graph plot analysis

    International Nuclear Information System (INIS)

    To estimate renal blood flow and tubular function in transplanted kidneys, we applied the 4 compartments model and the graphic analysis method to 99mTc-MAG3 dynamic SPECT and calculated some parameters, i.e. K1 (renal influx rate constant), K3 (tubular transporting rate constant), Vd12 (intrarenal distribution volume), and others. Twenty-three renal transplant recipients were examined and divided into following 3 groups according to their serum creatinine levels (SCr); Group I: less than 13 mg/dl (1.1±0.3, n=7), Group II: 1.4-2.5 mg/dl (1.8±0.3, n=11), and Group III more than 2.6 mg/dl (3.9±0.9, n=5). The K3 value became lower in the order of Group I>II>III, and well correlated with blood urea nitrogen (BUN, r=-0.95, p99mTc-MAG3 uptake function, respectively. (author)

  15. Periodontal disease characterization in dogs with normal renal function or chronic renal failure

    Directory of Open Access Journals (Sweden)

    Barbudo-Selmi Glenda Ramalho

    2004-01-01

    Full Text Available The purpose of this study was to evaluate periodontal disease (PD in dogs with chronic renal failure (CRF and to compare it to PD in dogs with normal renal function (NRF. Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivitis, gingival recession, pocket, calculus, dental mobility, dental loss, and ulcers. These data were used to calculate plaque index (PI, gingival index (GI and periodontal destruction index (PDI. PD was graded as mild, moderate or severe based on the results. Mild, moderate or severe PD was observed in dogs with NRF, whereas dogs with CRF presented either mild or severe PD. Dogs with NRF showed higher involvement of the maxillary teeth, whereas dogs with CRF showed a higher involvement of the mandibular teeth. Plaque index was significantly higher in dogs with NRF. It was concluded that lesion distribution and periodontal disease progression may be altered in dogs with CRF, and gingival inflammatory response differs in dogs with NRF and CRF regarding to the stage of periodontal disease.

  16. Towards individualized controlled drug exposure in renal transplantation

    OpenAIRE

    Scholten, Eduard Maximiliaan

    2007-01-01

    After successful renal transplantation a gradual decline of renal function can be detected about 40 % of the transplant recipients. The histological substrate for this condition is chronic allograft nephropathy (CAN). Nephrotoxicity of immunosuppressive drugs and rejection mechanisms, due to insufficient immunosuppression, are known to play a central role in this process. In this thesis we focus on the improvement of drug monitoring of calcineurin-inhibitors, to prevent structural damage impo...

  17. Critical appraisal on the use of everolimus in renal transplantation as an immunosuppressant to prevent organ transplant rejection

    OpenAIRE

    Fernando Giron; Yenny Baez

    2010-01-01

    Fernando Giron, Yenny BaezKidney Transplant Service, Colombiana de Trasplantes, Bogota, ColombiaAbstract: Everolimus is a proliferation inhibitor designed to target chronic allograft nephropathy including prevention of acute rejection. Acute renal allograft rejection incidence varies with the therapy used for immunosuppression. Registry data show that 15% to 35% of kidney recipients will undergo treatment for at least one episode of acute rejection within the first post-transplant year. Evero...

  18. Monitorização seqüencial do transplante renal com citologia aspirativa Aspiration citology in the sequential monitorization of kidney allografts

    Directory of Open Access Journals (Sweden)

    R.C. Manfro

    1998-06-01

    and the number of immunoactivated cells were higher during acute rejection as compared to normal allograft function, acute tubular necrosis, and cyclosporine nephrotoxicity. The parameters to the diagnosis of acute rejection were: sensitivity: 71.8%, specificity: 87.3%, positive predictive value: 50.9%, negative predictive value: 94.9% and accuracy 84.9%. The false positive results were mainly related to cytomegalovirus infection or to the administration of OKT3. In 10 out of 11 false negative results incipient immunoactivation was present alerting to the possibility of acute rejection. CONCLUSIONS: Kidney aspiration cytology is a useful tool for the sequential monitorization of acute rejection in renal transplant patients. The best results are reached when the results of aspiration cytology are analyzed with the clinical data.

  19. Prevalence of Epstein Barr Virus Infection and Effecting Factors in Renal Allograft Recipients for Controlling Ptld in Imam Khomeini Hospital from 2001 to 2004

    Directory of Open Access Journals (Sweden)

    Sh Salari lak

    2007-12-01

    Full Text Available Introduction: EBV is categorized as Herpesviridans and by nature is a Lymph crypto Virus. Studies have demonstrated that EBV will infect 80 to 90 percent of patients during the first year and there is a close relation between kidney malfunction and EBV infection. Reactivation of the virus excites the immune system, and ultimately leads to rejection of kidney. The purpose of this study was to determine the prevalence and identify the affecting factors of EBV infection among renal allograft recipients. Methods: This descriptive study was conducted on 68 renal allograft recipients hospitalized in Imam Khomeini medical center from 2001 to 2004. Blood sample was taken from subjects before kidney transplantation and it was being taken every 3 months during the first year after transplantation. Elisa Serologic tests were implemented to determine the antibody virus EBV antigens, such as VCAIgM, VCAIgG and EBNAIgG. Information about patients was obtained from their medical records and necessary forms were filled. Types of prescribed immunosuppressive agents and the status of kidney rejection was closely observed to identify the factors affecting rejection. Results: This study showed that EBV infection was previously developed in 85.3 %of subjects (58 patients and Active Infection was found in14.7 % of subjects (10 patients. EBV Seronegativity and Primary infection was not found in this sturdy. Active infection and secondary EBV was detected in 58.8% of subjects (40 patients during the first year after transplantation. 95.6 % (65 of recipients before transplantation were seropositive for EBNAIgG and after transplantation, 100% (All of them were positive. 92.6 % (63 of recipients before transplantation were seropositive forVCAIgG and after transplantation, 96.9% (66 of them were positive. 95.6% of recipients (65 of them were seropositive for EBNAIgG before transplantation, while after transplantation the rate was 100% (all of the recipients. Active and

  20. The impact of chronic heamodialysis on the personality of patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evgenia Vlachu D.

    2009-07-01

    Full Text Available People with chronic diseases, deal with permanent changes in their everyday life. At the same time these patients appear to have different pathological behavior and personality disturbances as aresult of the disorders of their biological functions.AIM: The aim of this study is the examination of the psychological behavior of patients with chronic renal failure who submit themselves to recurrent heamodialysis (CRH.MATERIAL METHODS:The research was based on the completion of a questionnaire which has been used on foreigners and Greek patients who complained about chronic diseases. This questionnaire guarantees the highest reliability of all so that it will be possible to specify the negative influence of their disease upon the different sides of their life. Emphasis should be given on the fact that the personality questionnaire of Eysenck has been intensively evaluated on the Greek population as very trustworthy for secure conclusions. It included 84 questions in four different disorders (psychotism, neurotism, ex/introversion and check inversion for inaccuracies. The questionnaire has been proved very useful for the evaluation of the influence of the different interventions upon the quality of life of patients under heamodialysis. It appeared also that it was more reliable in comparison with the Sickness Impact Profile and with a test, whhb ic was aout the exercise under stress conditions. RESULTS: It has been discovered that all the three scales of control of the personality disturbances have systematically been influenced according to the control group of 138 persons from different age and sex groups. Furthermore, it has been found that the men patients underthe CRH were in lower region of the scale of neurotism while women patients appeared to be lower in the scale of psychotism. The T‐test shows that there is no important statistic difference between the two sexes according to the quality of their job. There is also no important difference

  1. Renal T-cell lymphoma with cerebral metastasis in a dog with chronic canine ehrlichiosis

    Directory of Open Access Journals (Sweden)

    E.P. Lane

    2002-07-01

    Full Text Available A renal T-cell lymphoma with exclusive cerebral metastasis was diagnosed in a 5-year-old Staffordshire bull terrier bitch euthanased for aggression. This is the first recorded case of primary renal lymphoma in a dog. Immune suppression, due to chronic canine monocytic ehrlichiosis, mayaccount for the unusual primary site and metastatic patternof the tumour.

  2. Contrast Free Duplex-Assisted EVAR in Patients with Chronic Renal Insufficiency

    OpenAIRE

    Krasznai, Attila G; Sigterman, Tim A.; Bouwman, Lee H.

    2014-01-01

    Renal insufficiency and allergy for iodinated contrast are the main contra-indications for Endovascular Aortic Repair (EVAR). Various techniques have been used to minimize utilization of contrast in order to prevent contrast induced nephropathy. EVAR can be performed without nephrotoxic contrast, using additional duplex-guidance. This report describes three cases of duplex-assisted EVAR in patients with chronic renal insufficiency.

  3. Circadian variation of blood pressure in patients with chronic renal failure on continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Clausen, P; Feldt-Rasmussen, B; Ladefoged, Jens

    1995-01-01

    The circadian pattern of blood pressure variation was investigated in 10 patients with advanced chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) and in an age-matched group of controls without renal disease with similar office blood pressure level. Monitoring was done using...

  4. Renal Tissue Oxygenation in Essential Hypertension and Chronic Kidney Disease

    OpenAIRE

    Menno Pruijm; Lucie Hofmann; Bruno Vogt; Marie-Eve Muller; Maciej Piskunowicz; Matthias Stuber; Michel Burnier

    2013-01-01

    Animal studies suggest that renal tissue hypoxia plays an important role in the development of renal damage in hypertension and renal diseases, yet human data were scarce due to the lack of noninvasive methods. Over the last decade, blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), detecting deoxyhemoglobin in hypoxic renal tissue, has become a powerful tool to assess kidney oxygenation noninvasively in humans. This paper provides an overview of BOLD-MRI studies perform...

  5. [Ultrasonographic study on kidneys in patients with chronic renal failure. Part I. Ultrasonic measurement of renal size and analysis of renal ultrasonotomograms].

    Science.gov (United States)

    Yamaguchi, S; Fujii, H; Kaneko, S; Yachiku, S; Anzai, T; Inada, F; Kobayashi, T; Furuta, K; Ishida, H

    1990-08-01

    Ultrasonograms of 546 kidneys were obtained in 280 patients undergoing chronic dialysis. Dialysed kidneys could be detected in 529 of the 546 kidneys (96.9%) by ultrasonic examination. The ultrasonic diagnoses on dialysed kidneys were contracted kidney in 313 kidneys (59.2%) and acquired cystic disease of the kidney in 107 kidneys (20.2%). Ultrasonic measurement of the size of kidney (length and thickness) revealed that the kidneys in patients with chronic renal failure were much smaller than normal ones. But the kidneys in patients undergoing dialysis for more than 8 years gradually increased in size with incidence of acquired renal cysts. The kidneys in patients with diabetic nephropathy were greater in length and thickness than those with chronic glomerulonephritis. Sonographic features of dialysed kidneys were unclear renal imaging, unidentified central echoes, cortico-medulla + border and increased parenchymal echogenicity. Irregularity of the renal contour had a tendency to increase in number with incidence of cysts in long-term dialysis patients. The ultrasonograms of the kidneys with diabetic nephropathy showed fewer changes than normal ones. No major complication of the kidney was detected in the present study. However, two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. We believe that regular screening of the kidneys by ultrasonic examination is mandatory in patients on chronic dialysis for early diagnosis and treatment of these complications. PMID:2232408

  6. Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.

    OpenAIRE

    Duncan, I J; Hurst, N P; Sebben, R; Milazzo, S C; Disney, A

    1990-01-01

    The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipi...

  7. Renal Cell Protection of Erythropoietin beyond Correcting The Anemia in Chronic Kidney Disease Patients

    OpenAIRE

    Hamid Nasri

    2013-01-01

    Currently many patients with chronic renal failure have profited from the use of erythropoietin to correct anemia (1,2). In chronic kidney disease, anemia is believed to be a surrogate index for tissue hypoxia that continues preexisting renal tissue injury (1-3). Erythropoietin is an essential glycoprotein that accelerates red blood cell maturation from erythroid progenitors and facilitates erythropoiesis. It is a 30.4 kD glycoprotein and class I cytokine containing 165 amino acids (3,4). App...

  8. Antibody Response Rates To Hepatitis B Vaccination in Children With Chronic Renal Failure: An Observational Study

    OpenAIRE

    Ece, İbrahim; Kibar, Ayse Esin; Oflaz, Burhan; Cakar, Nilgun; Balli, Sevket; Akkok, Nermin; Kara, Nazli

    2013-01-01

    Introduction: Hepatitis B virus (HBV) infection is one of the most important factors increasing the mortality and the mobility in patients with chronic renal failure (CRF). There are a limited number of studies of pediatric patients with CRF regarding the response to double doses and protection rates. In this study, our aim was to compare the antibody levels and the respond rates to recombinant hepatitis B vaccine in children with chronic renal failure (CRF). Materials and Methods: In this pr...

  9. Effect of Atracylodes Rhizome Polysaccharide in Rats with Adenine-Induced Chronic Renal Failure

    OpenAIRE

    Yang, C.; C. Liu; Zhou, Q.; Xie, Y. C.; Qiu, X. M.; X. Feng

    2015-01-01

    The aim of the study was to elucidate the therapeutic effects of Atracylodes rhizome polysaccharide on adenine-induced chronic renal failure in rats. Fifty male Sprague Dawley rats were selected and randomly divided in to 5 groups (n=10 rats per group): The normal control group, the chronic renal failure pathological control group, the dexamethasone treatment group and two Atracylodes rhizome polysaccharide treatment groups, treated with two different concentrations of the polysaccharide, the...

  10. The Renal Nerves in Chronic Heart Failure: Afferent and Efferent Mechanisms

    Directory of Open Access Journals (Sweden)

    Alicia Marie Schiller

    2015-08-01

    Full Text Available The function of the renal nerves has been an area of scientific and medical interest for many years. The recent advent of a minimally invasive catheter-based method of renal denervation has renewed excitement in understanding the afferent and efferent actions of the renal nerves in multiple diseases. While hypertension has been the focus of much this work, less attention has been given to the role of the renal nerves in the development of chronic heart failure (CHF. Recent studies from our laboratory and those of others implicate an essential role for the renal nerves in the development and progression of CHF. Using a rabbit tachycardia model of CHF and surgical unilateral renal denervation, we provide evidence for both renal efferent and afferent mechanisms in the pathogenesis of CHF. Renal denervation prevented the decrease in renal blood flow observed in CHF while also preventing increases in Angiotensin-II receptor protein in the microvasculature of the renal cortex. Renal denervation in CHF also reduced physiological markers of autonomic dysfunction including an improvement in arterial baroreflex function, heart rate variability, and decreased resting cardiac sympathetic tone. Taken together, the renal sympathetic nerves are necessary in the pathogenesis of CHF via both efferent and afferent

  11. Relation of aortic valve calcium to chronic kidney disease (from the Chronic Renal Insufficiency Cohort Study).

    Science.gov (United States)

    Guerraty, Marie A; Chai, Boyang; Hsu, Jesse Y; Ojo, Akinlolu O; Gao, Yanlin; Yang, Wei; Keane, Martin G; Budoff, Matthew J; Mohler, Emile R

    2015-05-01

    Although subjects with chronic kidney disease (CKD) are at markedly increased risk for cardiovascular mortality, the relation between CKD and aortic valve calcification has not been fully elucidated. Also, few data are available on the relation of aortic valve calcification and earlier stages of CKD. We sought to assess the relation of aortic valve calcium (AVC) with estimated glomerular filtration rate (eGFR), traditional and novel cardiovascular risk factors, and markers of bone metabolism in the Chronic Renal Insufficiency Cohort (CRIC) Study. All patients who underwent aortic valve scanning in the CRIC study were included. The relation between AVC and eGFR, traditional and novel cardiovascular risk factors, and markers of calcium metabolism were analyzed using both unadjusted and adjusted regression models. A total of 1,964 CRIC participants underwent computed tomography for AVC quantification. Decreased renal function was independently associated with increased levels of AVC (eGFR 47.11, 44.17, and 39 ml/min/1.73 m2, respectively, pAVC risk factors. Adjusted regression models identified several traditional and novel risk factors for AVC in patients with CKD. There was a difference in AVC risk factors between black and nonblack patients. In conclusion, our study shows that eGFR is associated in a dose-dependent manner with AVC in patients with CKD, and this association is independent of traditional cardiovascular risk factors. PMID:25791240

  12. High-NaCl diet impairs dynamic renal blood flow autoregulation in rats with adenine-induced chronic renal failure

    DEFF Research Database (Denmark)

    Saeed, Aso; DiBona, Gerald F; Grimberg, Elisabeth;

    2014-01-01

    This study examined the effects of 2 wk of high-NaCl diet on kidney function and dynamic renal blood flow autoregulation (RBFA) in rats with adenine-induced chronic renal failure (ACRF). Male Sprague-Dawley rats received either chow containing adenine or were pair-fed an identical diet without...... increase the susceptibility to hypertensive end-organ injury and progressive renal failure by facilitating pressure transmission to the microvasculature....... adenine (controls). After 10 wk, rats were randomized to either remain on the same diet (0.6% NaCl) or to be switched to high 4% NaCl chow. Two weeks after randomization, renal clearance experiments were performed under isoflurane anesthesia and dynamic RBFA, baroreflex sensitivity (BRS), systolic...

  13. Turnover of VLDL-apoliporprotein b in chronic renal failure

    International Nuclear Information System (INIS)

    Chronic renal failure (CRF) has been known to be associated with apolipoprotein (Apo) and lipid abnormalities, leading to accelerated atherosclerosis (AS). This work is aimed at studying the lipoprotein (LP) metabolism of CRF patients in order to elucidate how this metabolism is linked with AS. The fractional synthesis rate (FSR) of ApoB in very low density lipoprotein (vLDL) was determined by using endogenous 15N-glycine labeling and GC-MS analysis in 5 patients with CRF. Plasma lipid profiles of CRF patients were also studied. The FSR of vLDL-ApoB obtained by this method was 3.19 ± 0.43%/day in CRF patients, while that in the normal subjects (5.6 ± 0.45%/day) was significantly higher (P<0.0001). The CRF patients also had reduced levels of HDL-cholesterol (34.6 ± 4.6% mg/dl) in comparison with the control (63.2 ± 4.6 mg/dl)

  14. Hearing evaluation in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Evis Bendo; Margarita Resuli; Spiros Metaxas

    2015-01-01

    Objective:To evaluate hearing threshold and the severity of hearing loss at different frequencies in patients with chronic renal failure (CRF), and to analyze the role of duration of disease on hearing threshold in patients of CRF by measuring pure-tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE). Methods: There were analysed 61 subjects (122 ears) from which 12 were patients starting hemodialise (A), 24 subjects were patients undergoing hemodialise over a year (B), 15 subjects were patients undergoing conservative treatment (C) and 10 controls (D). We did hearing evaluation by testing them using tympanometry, PTA and DPOAEs. Other parameters (blood pressure, body weight, blood chemistries) were also evaluated. Results:It was found a severe high-frequency hearing loss among patients with CRF comparing to the control group. Duration on haemodialysis treatment does not seem to have a significant impact on the incidence of hearing loss, although the method of treatment may influence the impact of the disease on hearing. Hearing loss among patients with CRF seemed to deteriorate further a year after the first evaluation. Conclusions:DPOAE raised the percentages of detection of SNHL indicating that it is a better technique than the conventional PTA for evaluation of hearing acuity.

  15. How to differentiate renal senescence from chronic kidney disease in clinical practice.

    Science.gov (United States)

    Musso, Carlos G; Jauregui, Jose R

    2016-09-01

    Renal aging is frequently confused with chronic nephropathy in clinical practice, since there are some similarities between them, particularly regarding reduced glomerular filtration rate (GFR). However, there are many differences between these two entities which can help any practitioner to distinguish between them, such as: GFR deterioration rate, hematocrit, renal handling of urea, creatinine and some electrolytes, tubular acidification, urinalysis, and renal imaging. Differentiation between renal aging and chronic renal disease is crucial in order to avoid unnecessary medicalization of what is a physiological change associated with the healthy aging process, and the potential harmful consequences of such overdiagnosis. A recently described equation (HUGE), as well as an adequate nephrological evaluation and follow up can help physicians to distinguish both entities. PMID:27383288

  16. Positive correlations between cerebral choline and renal dysfunction in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Osamu; Nakahama, Hajime; Nakamura, Satoko; Inenaga, Takashi; Kawano, Yuhei [National Cardiovascular Center, Division of Hypertension and Nephrology, Department of Internal Medicine, Osaka (Japan); Hattori, Noriaki; Inoue, Noriko; Sawada, Tohru [BF Research Institute, Osaka (Japan); Kohno, Shigeru [Nagasaki University School of Medicine, Second Department of Internal Medicine, Nagasaki (Japan)

    2006-05-15

    Cerebral metabolism in chronic renal failure (CRF) patients has not been fully evaluated. This study examined cerebral metabolites in CRF, using proton magnetic resonance spectroscopy (MRS). Subjects comprised 19 CRF patients and 21 healthy volunteers. Spectra were acquired from voxels of interest positioned in the parietal gray and white matter, and concentrations of the following cerebral metabolites were measured: N-acetyl group (NA), creatine + phosphocreatine (Cr), choline-containing compounds (Cho), myo-inositol and glutamate + glutamine. Among the 19 CRF patients, 9 who were started on hemodialysis (HD) underwent careful follow-up. Proton MRS was performed before and about 2 weeks after starting HD. In six patients in whom follow-up was possible, a third MRS was performed after about 18 months. The NA/Cr ratio was not significantly changed in CRF. However, elevations in the Cho/Cr ratio were found in both gray and white matter compared with controls. To the best of our knowledge, this is the first report of positive correlations between the Cho/Cr ratio in both regions and serum osmotic pressure. (orig.)

  17. Renal complications in chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis: the Mayo Clinic experience.

    Science.gov (United States)

    Strati, Paolo; Nasr, Samih H; Leung, Nelson; Hanson, Curtis A; Chaffee, Kari G; Schwager, Susan M; Achenbach, Sara J; Call, Timothy G; Parikh, Sameer A; Ding, Wei; Kay, Neil E; Shanafelt, Tait D

    2015-09-01

    While the renal complications of plasma cell dyscrasia have been well-described, most information in patients with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis is derived from case reports. This is a retrospective analysis of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who underwent kidney biopsy for renal insufficiency and/or nephrotic syndrome. Between January 1995 and June 2014, 49 of 4,024 (1.2%) patients with chronic lymphocytic leukemia (n=44) or monoclonal B-cell lymphocytosis (n=5) had a renal biopsy: 34 (69%) for renal insufficiency and 15 (31%) for nephrotic syndrome. The most common findings on biopsy were: membranoproliferative glomerulonephritis (n=10, 20%), chronic lymphocytic leukemia interstitial infiltration as primary etiology (n=6, 12%), thrombotic microangiopathy (n=6, 12%), and minimal change disease (n=5, 10%). All five membranoproliferative glomerulonephritis patients treated with rituximab, cyclophosphamide and prednisone-based regimens had recovery of renal function compared to 0/3 patients treated with rituximab with or without steroids. Chronic lymphocytic leukemia infiltration as the primary cause of renal abnormalities was typically observed in relapsed/refractory patients (4/6). Thrombotic microangiopathy primarily occurred as a treatment-related toxicity of pentostatin (4/6 cases), and resolved with drug discontinuation. All cases of minimal change disease resolved with immunosuppressive agents only. Renal biopsy plays an important role in the management of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who develop renal failure and/or nephrotic syndrome. PMID:26088927

  18. Chronic kidney disease related to renal tuberculosis: a case report

    Directory of Open Access Journals (Sweden)

    Geraldo Bezerra da Silva Junior

    2016-06-01

    Full Text Available Abstract: Genitourinary tuberculosis (TB is the third most common form of extrapulmonary TB. A 34-year-old man with severe kidney function loss secondary to renal TB initially presented with urinary symptoms, including dysuria and polacyuria. The diagnosis was based on clinical history and laboratory tests; the urinalysis revealed acid-fast bacilli. The patient's condition stabilized after beginning TB-specific treatment, but the right kidney function loss persisted. Renal TB can lead to irreversible loss of renal function. As such, renal function should be considered in all patients from TB-endemic areas who present with urinary symptoms and whose urine cultures are negative for common pathogens.

  19. Hepatitis E virus: an underdiagnosed cause of chronic hepatitis in renal transplant recipients

    OpenAIRE

    Halleux, D; Kanaan, Nada; Kabamba-Mukadi, Benoît; Thomas, Isabelle; Hassoun, Ziad

    2012-01-01

    Hepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients leading to rapidly progressive cirrhosis. Proper diagnosis is therefore important, as reducing immunosuppressive therapy can allow clearance of the virus. We report a case of chronic HEV infection in a renal transplant recipient that went undiagnosed for many years, discuss the therapeutic options, and review the current available literature.

  20. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  1. Colchicine-induced neuromyopathy in a patient with chronic renal failure: the role of clarithromycin.

    NARCIS (Netherlands)

    Velden, W van der; Huussen, J.; Laak, H ter; Sevaux, R de

    2008-01-01

    Neuromyopathy is a rare side effect of chronic colchicine therapy, most often occurring in patients with chronic renal failure. Drugs interacting with colchicine metabolism through CYP(3)A(4) and P-glycoprotein can accelerate accumulation and toxicity. We describe a case of an interaction between cl

  2. From outward appearance to inner essence:the unique role of pathological diagnosis of renal allograft biopsy in renal transplantation%由表象到实质--论移植肾活检病理学诊断在肾移植中的独特作用

    Institute of Scientific and Technical Information of China (English)

    郭晖

    2015-01-01

    随着活检设备及技术的改良和经验的积累,移植肾经皮穿刺活检已经成为国际公认的诊断移植术后多种并发症的最佳途径,其在移植肾并发症的鉴别诊断、指导临床针对性的治疗和基础研究方面具有独特作用。随着移植肾缺血/再灌注损伤、排斥反应、免疫抑制剂毒性损伤和机会性病毒感染等主要并发症的发病机制和病理学特征的逐渐明了,以及移植肾 Banff 病理学诊断体系的建立,更有利于移植肾活检的规范开展。希望我国各肾移植中心能更好地应用这一手段,进一步促进移植肾和受者的长期存活。%With improvement and experience accumulation in biopsy device and technology ,percutaneous needle core biopsy of the renal allograft has become an internationally recognized diagnostic approach for posttransplant complications .It plays a unique and critical role in differential diagnosis,guiding clinical treatment and posttransplant management ,as well as basic research in renal trans -plantation.The renal graft biopsy could be standadizedly developed with pathogenesis and pathological featuresthe of main complications of renal allograft,such as ischemia /reperfusion injury,rejection,immunosuppressant toxicity and opportunistic viral infection ,are gradu-ally understood,and Banff Schema on renal allograft pathology is established .It is hoped that renal transplantation centers in China can better apply the method,and further promote the long-term survival of renal allografts and recipients .

  3. Dry Eye in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Pınar Yüksekkaya

    2014-05-01

    Full Text Available Objectives: To evaluate the dry eye symptoms based on objective test and subjective findings in children with chronic renal failure (CRF and to compare the results with those in healthy subjects. Materials and Methods: Thirty-four children with CRF and 89 age- and sex-matched healthy subjects were included in this prospective study. Tear break-up time (TBUT and Schirmer test, subjective symptoms (burning, foreign-body sensation, hyperemia, itching, tearing, calcification of the conjunctiva, and corneal staining were evaluated. In the study group, relation between TBUT and Schirmer test results and duration of disease, duration of dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were recorded. For statistical analysis, t-test, chi-square test, and Pearson’s correlation test were used. Results: In the study group, burning sensation was statistically higher than in the control group. Except this, according to the other subjective tests and corneal staining, there were no significant differences between the two groups (p>0.05. Conjunctival calcification was seen in 3 patients in the study group. The mean Schirmer test result was 21.1±8.0 and 23.7±8.0 mm in the study and control groups, respectively (p=0.101. The mean TBUT was 12.5±5.2 seconds (s in the study and 16.0±5.5 s in the control groups (p=0.002. None of the disease-related variables (the mean duration of disease and dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were associated with dry eye syndrome (p>0.05. Conclusion: TBUT was statistically significantly lower, but Schirmet test result was not significantly different between children with CRF and age- and sex-matched healthy subjects. The disease-related variables have no effect in the development of dry eyes. (Turk J Ophthalmol 2014; 44: 196-200

  4. Efficacy of regional renal nerve blockade in patients with chronic refractory heart failure

    Institute of Scientific and Technical Information of China (English)

    DAI Qi-ming; FEN Yi; LU Jing; MA Gen-shan

    2013-01-01

    Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure.We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance.Methods Eighteen patients with chronic refractory heart failure were enrolled (mean age (64±11) years).The patients were randomly divided into two groups (renal nerve blockade group and standard therapy group,n=9 each).Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance.Heart rate,mean arterial blood pressure,plasma and urine electrolytes,neurohormones,factional excretion of sodium (FENa),24-hour urine volume were monitored at baseline and the first 24 hours after therapy.Dyspnea and oedema were also evaluated.The major adverse cardiovascular events (MACE),plasma brain natriuretic peptide (BNP) level and left ventricular ejection fraction (LVEF) were compared between the two groups during the 3-12 months follow-up period.Results No complication was observed during the acute phase of renal nerve blockade.After renal nerve blockade,the 24-hour urine volume and FENa were significantly increased,while the level of plasma rennin,angiotensin Ⅱ,aldosterone,BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group.During three to 12 months of follow-up,the rate of MACE and plasma BNP level were significantly lower,while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group.Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.

  5. Growth speed in patients with chronic renal failure undergoing to renal transplantation between 2000 and 2009 in the Hospital Nacional de Ninos: research protocol

    International Nuclear Information System (INIS)

    The growth speed was investigated in children with chronic renal failure after renal transplantation, in the Hospital Nacional de Ninos during the study period January 2000-December 2009. Factors that have influenced are analyzed: age of onset of renal disease, etiology of renal disease, metabolic acidosis, anemia, renal osteodystrophy, episodes of infection and rejection. Besides, on the growth rate and expected family size, to intervene or prevent them in future cases. Also, the use that has given in the hospital to growth hormone, before and after renal transplantation is determined to eventually use parallel therapies to the transplantation. An echocardiographic study is recommended to perform as part of the treatment of chronic renal failure to identify the existence of left ventricular hypertrophy and heart failure, which may occur as a result of complications of the failure

  6. Prevalence and association of post-renal transplant anemia

    Directory of Open Access Journals (Sweden)

    Hesham Elsayed

    2012-01-01

    Full Text Available In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5% patients were males and 69 (34.5% patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF. Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk factors for prevalence of anemia post-renal transplant. In our study, we did not find an association between MMF and cyclosporine nor angiotensin-converting enzyme inhibitors (ACEIs or angiotensin receptors blocker (ARBs with anemia. This study demonstrates that anemia is a common complication during the first six months after kidney transplantation, with several risk factors precipitating this complication.

  7. Depressive Symptomatology in Children and Adolescents with Chronic Renal Insufficiency Undergoing Chronic Dialysis

    Directory of Open Access Journals (Sweden)

    Edith G. Hernandez

    2011-01-01

    Full Text Available This paper presents a descriptive study, using the Birleson Scale to determine the frequency of depressive symptomatology in children and adolescents with chronic renal insufficiency (CRI undergoing hemodialysis (HD and chronic peritoneal dialysis (CPD. There were 67 patients (40 female and 27 male with a mean age of 14.76±2.71 years, duration of illness ≥3 months, 43 (64.18% patients with CPD and 24 (35.82% undergoing HD. The frequency of high occurrence, low occurrence, and absence of depressive symptomatology was 10.45% (=7, 43.28% (=29, and 46.27% (=31, respectively; all of the seven (100% patients with high occurrence of depressive symptomatology were female (=0.04, and none of these (0% had a friend to confide in (=0.03. Depressive symptomatology in patients with CPD was associated with a lower weekly / compared to those without depressive symptomatology (2.15±0.68 versus 2.52±0.65; =0.01. There was no association with patient age, caregiver, time and dialysis type, anemia, bone disease, nutritional or financial status, origin, schooling, or employment.

  8. Effect of castration on renal glycosaminoglycans and their urinary excretion in male and female rats with chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Lemos, C.C.S. [Disciplina de Nefrologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Tovar, A.M.F. [Laboratório de Tecido Conjuntivo, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Guimarães, M.A.M. [Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Bregman, R. [Disciplina de Nefrologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2013-08-10

    Glycosaminoglycans (GAGs) participate in a variety of processes in the kidney, and evidence suggests that gender-related hormones participate in renal function. The aim of this study was to analyze the relationship of GAGs, gender, and proteinuria in male and female rats with chronic renal failure (CRF). GAGs were analyzed in total kidney tissue and 24-h urine of castrated (c), male (M), and female (F) Wistar control (C) rats (CM, CMc, CF, CFc) and after 30 days of CRF induced by 5/6 nephrectomy (CRFM, CRFMc, CRFF, CRFFc). Total GAG quantification and composition were determined using agarose and polyacrylamide gel electrophoresis, respectively. Renal GAGs were higher in CF compared to CM. CRFM presented an increase in renal GAGs, heparan sulfate (HS), and proteinuria, while castration reduced these parameters. However, CRFF and CRFFc groups showed a decrease in renal GAGs concomitant with an increase in proteinuria. Our results suggest that, in CRFM, sex hormones quantitatively alter GAGs, mainly HS, and possibly the glomerular filtration barrier, leading to proteinuria. The lack of this response in CRFMc, where HS did not increase, corroborates this theory. This pattern was not observed in females. Further studies of CRF are needed to clarify gender-dependent differences in HS synthesis.

  9. Effect of castration on renal glycosaminoglycans and their urinary excretion in male and female rats with chronic renal failure

    International Nuclear Information System (INIS)

    Glycosaminoglycans (GAGs) participate in a variety of processes in the kidney, and evidence suggests that gender-related hormones participate in renal function. The aim of this study was to analyze the relationship of GAGs, gender, and proteinuria in male and female rats with chronic renal failure (CRF). GAGs were analyzed in total kidney tissue and 24-h urine of castrated (c), male (M), and female (F) Wistar control (C) rats (CM, CMc, CF, CFc) and after 30 days of CRF induced by 5/6 nephrectomy (CRFM, CRFMc, CRFF, CRFFc). Total GAG quantification and composition were determined using agarose and polyacrylamide gel electrophoresis, respectively. Renal GAGs were higher in CF compared to CM. CRFM presented an increase in renal GAGs, heparan sulfate (HS), and proteinuria, while castration reduced these parameters. However, CRFF and CRFFc groups showed a decrease in renal GAGs concomitant with an increase in proteinuria. Our results suggest that, in CRFM, sex hormones quantitatively alter GAGs, mainly HS, and possibly the glomerular filtration barrier, leading to proteinuria. The lack of this response in CRFMc, where HS did not increase, corroborates this theory. This pattern was not observed in females. Further studies of CRF are needed to clarify gender-dependent differences in HS synthesis

  10. Chronic renal failure (CRF in children in Jugoslavia

    Directory of Open Access Journals (Sweden)

    Peco-Antić Amira

    2003-01-01

    Full Text Available The aim of this study was to analyse the demographic variables of chronic non-terminal (CRF and terminal (TRF renal failure patients (pts younger than 19 years treated in Serbia in June 2001. The prevalence of CRF pts was registered as 4,7 per million total population (pmtp or 14,1 per million child population (pmcp while corresponding values for TRF pts were 4,5 pmtp or 13,5 pmcp. The incidence of TRF pts during the period Jan.2000-Jan.2002 was 4,35 pmcp. Boys dominated only among CRF pts (34:14; 60,4% beeing between the ages of 6 and 19 yrs while at the time of diagnosis of HBI, 33,3 % of boys were yanger than 2 yrs.The causes of CRF were: reflux nephropathy 58,3%, congenital kidney disease 16,7%, familial/hereditary 14,6% glomerulonephritis 6,2% and Willms tu 4,1%. Reflux nephropathy was also the most common underlying disease of TRF accounted for 36,9% of total cases while glomerulonephritis was responsible for 23,9 %. Reflux nephropathy was associated with neural tube defect in 53,3% and with congenital lower urinary tract obstruction in 66,7%. The most of CRF (81,25% and TRF pts (95,6% were from Serbia, the others were from Monte Negro and Republic Srpska. The most of CRF (65% and TRF (80% pts were treated in University Children’s Hospital in Belgrade. Of CRF pts 46% had serum sreatinine 100-200 μmol/l, in 11% of pts it was 400-600 μmol/l and 2% of pts were in pre-terminal CRF. One third of CRF pts had proteinuria 150-500 mg/l, and second third had proteinuria greater of 1000 mg/l. Anemia was present in 54% of CRf pts, and arterial hypertension in 56%. Hemodialysis was dominant treatment modality for TRF pts and only 23,9% had functioning transplant. Conclusion: This is the first national study of demographic characteristics of pediatric CRF in Serbia. Since its prevalence is considerably lower than that in Western and North European countries the true prevalence is some what higher. The increasing incidence of pediatric TRF from 2

  11. Impact of renal transplantation on erectile dysfunction due to chronic renal failure in male patients

    International Nuclear Information System (INIS)

    Erectile dysfunction can be defined as the persistent inability of man to achieve penile erection and maintain it sufficient for satisfactory coitus. The objectives of this study were to find out the impact of successful renal transplantation on the degree and frequency of erectile dysfunction. Thirty patients of end stage renal disease that were on regular haemodialysis and candidates of renal transplantation of age range 20-55 years were included in the study after getting informed consent. Erectile functions were assessed by history, examination, investigations and international index of erectile function (IIEF) before and 3 and 6 months after renal transplantation, other information regarding disease and patient were collected in the performa. Out of thirty patients 14 (46.6%) patients had sever erectile dysfunction while 16 (53.3%) patients had moderate erectile dysfunction in the pre renal transplantation period. After three months of renal transplantation 15 (50%) had severe erectile dysfunction, 6 (20%) patients moderate erectile dysfunction and 9 (30%) patients mild erectile dysfunction. After six months 11 (36.6%), 10 (33.3%) and 8 (26.6%) patients had severe, moderate and mild erectile dysfunction respectively. There was improvement in 40%, no change in 53.3% and deterioration in 6.6% patients in the erectile functions after getting renal transplantation for end stage renal disease. (author)

  12. Association between the presence of anti-HLA antibodies with acute rejection and chronic allograft nephropathy in the first year after kidney transplantation.

    Science.gov (United States)

    Toresan, R; Manfro, R C; Proença, M C C; Veronese, F J V; Salim, P H; da Silva, D M; Ribeiro, A R; Edelweiss, M I A; Pegas, K L; Jobim, L F J

    2008-04-01

    The clinical relevance of anti-HLA antibodies following kidney transplantation has been a recent focus of research. Patients who present anti-HLA antibodies in the posttransplantation period have shown higher incidences of acute rejection episodes (ARE) and chronic allograft nephropathy (CAN). The objective of this study was to evaluate the presence of anti-HLA antibodies during the first year after kidney transplantation and their association with the occurrence of ARE and CAN. Eighty-eight kidney transplant recipients were evaluated for the presence of IgG anti-HLA antibodies using an enzyme-linked immunosorbent assay (LAT-M and LAT-1240, One Lambda Inc, Calif, United States). Protocol kidney biopsies were performed in consenting patients. ARE and CAN were diagnosed by clinical, laboratory, and histopathological criteria. Anti-HLA antibodies were observed in 20 (22.7%) patients. At 1 year follow-up, 26.1% presented ARE and 51.2% developed CAN. Nine patients (45%) with antibodies developed ARE as opposed to 20.6% without antibodies and 64.7% developed CAN as opposed to 47.8% of those without antibodies. In the histological analysis, the anti-HLA antibodies were associated with Banff IIA ARE (P = .001) and Banff grade II CAN (P = .012). Routine posttransplantation search for antibodies may identify cases at higher risk for acute and chronic rejection, and perhaps help to tailor the immunosuppressive regimen. PMID:18454996

  13. Anemia, renal impairment and in-hospital mortality, in acute worsening chronic heart failure patients

    OpenAIRE

    Bojovski, Ivica; Vavlukis, Marija; Caparovska, Emilija; Pocesta, Bekim; Shehu, Enes; Taravari, Hajber; Kitanoski, Darko; Kotlar, Irina; Janusevski, Filip; Taneski, Filip; Jovanovska, Ivana; Kedev, Sasko

    2014-01-01

    Aim of the study: To analyze the impact of anemia and renal impairment on in-hospital mortality(IHD), in patients with acute worsening chronic heart failure. Methods: 232 randomly selected patients with symptoms of HF were retrospectively analyzed. Analyzed variables: gender, age, risk factors and co-morbidities: HTA, HLP, DM, COPD, CAD, PVD, CVD, anemia(defined as Hgb ≤10mg/dl), renal failure. Measured variables: systolic and diastolic BP, Hgb, sodium, BUN, creatinine, length of hospital sta...

  14. Serum Lipoprotein (a) Levels in Chronic Renal Failure and Liver Cirrhosis Patients. Relationship with Atherosclerosis

    OpenAIRE

    Essam Mady; Gehane Wissa; Ali Khalifa; Mahmoud El-Sabbagh

    1999-01-01

    This study was carried out to investigate the relationship between lipoprotein (a) levels and the development of atherosclerosis in chronic renal failure (CRF) patients with the possible role of the liver. Serum Lp (a) levels were measured in samples from 20 CRF patients on hemodialysis (HD), 20 liver cirrhosis (LC) patients, 20 patients having both CRF and LC and undergoing HD, and 20 normal control subjects. Renal function (blood urea nitrogen (BUN) and creatinine), hepatic function (transa...

  15. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    OpenAIRE

    Mashayekhi, A.; Ahmadi, M; Ramezani, N.; R. Ahmadi; Seraj, B.

    2011-01-01

    Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Having knowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic ...

  16. Roles of organic anion transporters in the progression of chronic renal failure.

    Science.gov (United States)

    Enomoto, Atsushi; Niwa, Toshimitsu

    2007-10-01

    Renal proximal and distal tubules carry out specialized directional transport of various solutes. The family of organic anion transporters (OATs), which belongs to the major facilitator superfamily (SLC22A), are expressed in the renal epithelial cells to regulate the excretion and the reabsorption of endogenous and exogenous organic anions that include various kinds of drugs and their metabolites. In recent years, it is revealed that indoxyl sulfate, one of uremic toxins, is a novel physiological substrate for OAT family, and its accumulation within the renal tubules via OATs induces renal dysfunction. The OATs are also expressed in the blood-brain barrier, muscle cells, and bone osteoblasts, which hint at various pathogenic roles of OAT-mediated transport of uremic toxins. In this review, we introduce and discuss the function of OATs in the context of their roles in the progression of chronic renal disease. PMID:17976081

  17. Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.

    Science.gov (United States)

    Duncan, I J; Hurst, N P; Sebben, R; Milazzo, S C; Disney, A

    1990-06-01

    The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipients and those receiving haemodialysis. Over the age of 65 there was no significant difference in prevalence. Metabolic bone disease, including osteopenia, might contribute to the development of erosive osteoarthritis in chronic renal failure. PMID:2383060

  18. Tumoral calcinosis in a dog with chronic renal failure : clinical communication

    Directory of Open Access Journals (Sweden)

    T.C. Spotswood

    2003-06-01

    Full Text Available A 2-year-old male German shepherd dog in poor bodily condition was evaluated for thoracic limb lameness due to a large, firm mass medial to the left cranial scapula. Radiography revealed several large cauliflower-like mineralized masses in the craniomedial left scapula musculature, pectoral region and bilaterally in the biceps tendon sheaths. Urinalysis, haematology and serum biochemistry showed that the dog was severely anaemic, hyperphosphataemic and in chronic renal failure. The dog was euthanased and a full post mortem performed. A diagnosis of chronic renal failure with secondary hyperparathyroidism was confirmed. The mineralized masses were grossly and histopathologically consistent with a diagnosis of tumoral calcinosis. Tumoral calcinosis associated with chronic renal failure that does not involve the foot pads is rarely seen.

  19. An aggressive merkel cell carcinoma in a patient with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Sevda Gizlenti

    2014-12-01

    Full Text Available Merkel cell carcinoma (MCC is a rare cutaneous tumor arising from neuroendocrine cells and Merkel cells. Early diagnosis and treatment is important because of its aggressive course. We here report a 61 years old man with chronic renal failure, 3x5 cm mass on his right leg and inguinal-paraaortic lymph node metastases and resulting in death. MCC in the literature of the AIDS disease, organ transplantation, immunosuppressive therapy areas, and additional malignancies (multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and melanoma have been reported in patients with increased incidence. Up to date a patient with renal transplantation and Merkel cell carcinoma have been reported in the literature, Merkel cell carcinoma with chronic renal failure have not been reported.

  20. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    A. Mashayekhi

    2011-09-01

    Full Text Available Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Havingknowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic renal failure through the crisis, with an aesthetically satisfying and functioning dentition.

  1. Renal Bleeding Due to Extramedullary Hematopoiesis in a Patient With Chronic Myelogenous Leukemia

    Directory of Open Access Journals (Sweden)

    Stephanie Zettner

    2014-11-01

    Full Text Available Chronic myelogenous leukemia (CML is a myeloproliferative disorder that normally presents in middle-aged adults. Renal infiltration and extramedullary hematopoiesis in renal tissue has been rarely reported. This case report presents a patient with CML and renal insufficiency who developed gross hematuria. Efforts at controlling the hematuria led to a cascade of events propelled by the underlying disorder that ultimately led to a radical nephrectomy, multiorgan failure, and prolonged hospitalization. We suggest that management of gross hematuria in clinically stable patients with CML, suspected of having extramedullary hematopoiesis, should prioritize treatment of the myeloproliferative disorder over efforts to control bleeding.

  2. NADPH-Oxidase 4 Protects against Kidney Fibrosis during Chronic Renal Injury

    OpenAIRE

    Nlandu Khodo, Stellor; Dizin, Eva; Sossauer, Gaetan; Szanto, Ildiko; Martin, Pierre-Yves; Feraille, Eric; Krause, Karl Heinz; De Seigneux, Sophie

    2012-01-01

    NADPH oxidases synthesize reactive oxygen species that may participate in fibrosis progression. NOX4 and NOX2 are NADPH oxidases expressed in the kidneys, with the former being the major renal isoform, but their contribution to renal disease is not well understood. Here, we used the unilateral urinary obstruction model of chronic renal injury to decipher the role of these enzymes using wild-type, NOX4-, NOX2-, and NOX4/NOX2-deficient mice. Compared with wild-type mice, NOX4-deficient mice exh...

  3. Sensorineural Hearing Affection In Sickle Cell Disease Patients With Chronic Renal Failure Under Dialysis

    Directory of Open Access Journals (Sweden)

    Saeed Abdelwhab Saeed MD*, Magdy M El Sharkawy

    2002-09-01

    Full Text Available Objective: to study the problem of hearing loss in patients of chronic renal failure on regular haemodialysis and The factors which affect it. And to study the effect of sickle cell disease on hearing loss. we studied hearing loss in dialysis patients, sickle cell disease patients and patients of sickle cell disease with chronic renal failure under dialysis compared to normal control subjects. Design: !"",include sickle cell disease patients with chronic renal fa"# $%& ' ", i ,nclude ( # #"# $%&'", , ,( #&'", i 9nclude the normal *+&*+' All groups are subjected to full history, thorough clinical examination including neurological and ENT examination, investigations includes Hb, s. creatinine, s.albumen, s.calcium and calculation of kt/v for dialysis patients. Full audiological assessment, using #,-GSI audiometer was done for all groups with special concentration at frequency of - .Results: hearing loss was found in patients with chronic renal failure more than normal control. Patient with sickle cell disease have hearing disorders significantly higher than $/%- .% 0( # #cell disease have significantly. Marked degree of SNHL than those with SCD only. Hearing loss in patients with 12( # * 3 &4 !4! '#"#"patients with chronic renal failure with or without SCD correlate with duration of dialysis , presence of peripheral neuropathy, s. calcium level, efficiency of dialysis marked by kt/v. Conclusion and recommendation: hearing disorder is common in patients with chronic renal failure under regular haemodialysis and it increase with duration of dialysis it should be suspected if there is Peripheral neuropathy. It can be reduced with efficient dialysis, correction of anemia, adjustment of calcium level. Patients with SCD suffer also some degree of hearing loss especially at higher frequency and this degree of hearing loss

  4. Chronic pyelonephritis presenting as a renal sinus tumor with retroperitoneal extension: a case report

    Directory of Open Access Journals (Sweden)

    Papadopoulos Georgios I

    2009-09-01

    Full Text Available Abstract Introduction Chronic pyelonephritis is associated with progressive renal scarring and occurs, most of the time, in patients with major anatomical anomalies, including urinary tract obstruction, calculi, renal dysplasia or vesicoureteric reflux. We report the computed tomography imaging findings of a patient with chronic pyelonephritis appearing as a renal sinus mass. To our knowledge, it is the first time that such a case has been published in the literature. Case presentation We present a case of a 68-year-old woman who underwent a computed tomography scan of the abdomen in the work-up for recently diagnosed hypertension. A non-enhancing left renal sinus mass was detected extending to the para-aortic space. The initial diagnosis was that of a tumor of the collecting system. Nephro-ureterectomy was performed and the pathology results revealed changes of chronic pyelonephritis. Conclusion Chronic pyelonephritis presenting as a renal sinus mass is reported for the first time in the literature. This may lead to the conclusion that diagnostic ureteropyeloscopy and biopsy should be performed prior to radical surgery for possible upper tract urothelial tumors.

  5. Progress of magnetic resonance spectroscopy in chronic renal failure patients with vertebral bone change

    International Nuclear Information System (INIS)

    Bone changes caused by kidney diseases affect the quality of life in the patients with chronic renal failure. How to improve evaluation of the bone change, and consequently start early intervention and treatment is an important topic. Magnetic resonance spectroscopy (MRS) has been successfully used in the evaluations of central nervous system, breast and prostate, etc. Evaluation of bone changes with MRS is under studied. This article reviewed the MRS in evaluation of vertebral body bone changes in patients with chronic renal failure. (authors)

  6. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...

  7. Predictors of advanced chronic kidney disease and end-stage renal disease in HIV-positive persons

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Mocroft, Amanda; Kirk, Ole;

    2014-01-01

    Whilst several antiretroviral drugs have been associated with moderate chronic kidney disease (CKD), their contribution to advanced CKD and end-stage renal disease (ESRD) remain unknown.......Whilst several antiretroviral drugs have been associated with moderate chronic kidney disease (CKD), their contribution to advanced CKD and end-stage renal disease (ESRD) remain unknown....

  8. Salt-induced changes in cardiac phosphoproteome in a rat model of chronic renal failure.

    Directory of Open Access Journals (Sweden)

    Zhengxiu Su

    Full Text Available Heart damage is widely present in patients with chronic kidney disease. Salt diet is the most important environmental factor affecting development of chronic renal failure and cardiovascular diseases. The proteins involved in chronic kidney disease -induced heart damage, especially their posttranslational modifications, remain largely unknown to date. Sprague-Dawley rats underwent 5/6 nephrectomy (chronic renal failure model or sham operation were treated for 2 weeks with a normal-(0.4% NaCl, or high-salt (4% NaCl diet. We employed TiO2 enrichment, iTRAQ labeling and liquid-chromatography tandem mass spectrometry strategy for phosphoproteomic profiling of left ventricular free walls in these animals. A total of 1724 unique phosphopeptides representing 2551 non-redundant phosphorylation sites corresponding to 763 phosphoproteins were identified. During normal salt feeding, 89 (54% phosphopeptides upregulated and 76 (46% phosphopeptides downregulated in chronic renal failure rats relative to sham rats. In chronic renal failure rats, high salt intake induced upregulation of 84 (49% phosphopeptides and downregulation of 88 (51% phosphopeptides. Database searches revealed that most of the identified phospholproteins were important signaling molecules such as protein kinases, receptors and phosphatases. These phospholproteins were involved in energy metabolism, cell communication, cell differentiation, cell death and other biological processes. The Search Tool for the Retrieval of Interacting Genes analysis revealed functional links among 15 significantly regulated phosphoproteins in chronic renal failure rats compared to sham group, and 23 altered phosphoproteins induced by high salt intake. The altered phosphorylation levels of two proteins involved in heart damage, lamin A and phospholamban were validated. Expression of the downstream genes of these two proteins, desmin and SERCA2a, were also analyzed.

  9. Hemodynamic and neurochemical determinates of renal function in chronic heart failure.

    Science.gov (United States)

    Gilbert, Cameron; Cherney, David Z I; Parker, Andrea B; Mak, Susanna; Floras, John S; Al-Hesayen, Abdul; Parker, John D

    2016-01-15

    Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications. PMID:26561645

  10. Antioxidants deficiency: a sensitive indicator of cardiometabolic risk in chronic renal failure?

    Directory of Open Access Journals (Sweden)

    Pooja S.K. Rai

    2013-04-01

    Full Text Available Background: Antioxidant depletion occurring in chronic renal failure patients is an important cause of associated morbidity & mortality, which in turn imposes a great socioeconomic burden of health care. Early diagnosis & targeted management of this preventable deficiency may have a positive impact on the management of co morbidities associated with chronic renal failure. Aims & Objectives: To evaluate the status of antioxidants as an early indicator of cardiometabolic risk in chronic renal failure patients. Settings & Design: This was a randomised case Control study including 10 controls of either sex with normal renal function between age group 20-60 years and 15 patients of chronic renal failure on dialysis between the age group of 16 - 60 years. Methods: 12 hour fasting venous blood samples were collected from all the participants and were assayed for various antioxidants. Statistical analysis: Results were analyzed by unpaired t test, p value was determined & Correlation coefficient was calculated amongst various parameters. Results: In the present study, significantly low levels of vitamin C ( Cases: 0.367 ± 0.13 mg/dl controls: 1.324 ± 0.61 mg/dl; p < 0.01 & vitamin E (cases: 0.235 ± 0.102 mg/dl, controls (0.854 ± 0.28 mg/dl; p < 0.01 were observed in chronic renal failure patients as compared to controls. Conclusion: Diminished levels of Vitamin C & E in our study may be an indicator of increased oxidative stress which can be a responsible factor for increased incidence of cardiovascular complications. Supplementing these patients with recommended dosage of these vitamins may provide an essential tool to reduce the burden of suffering. [Int J Res Med Sci 2013; 1(2.000: 87-92

  11. Liver disease and the e antigen in HBsAg carriers with chronic renal failure.

    Science.gov (United States)

    Coughlin, G P; Van Deth, A G; Disney, A P; Hay, J; Wangel, A G

    1980-02-01

    This study was undertaken to assess the frequency of development and the stages of evolution of chronic liver disease in patients with renal failure who are chronic carriers of hepatitis B surface antigen. Cirrhosis or chronic active hepatitis developed in five of 21 patients and could not be predicted by the initial histological appearance or by HLA-A and B typing but was associated with the e antigen in four of the five patients. However, the antigen was not a consistent indicator of a poor prognosis, as the four other e antigen positive patients did not develop chronic liver disease during the period of the study. Transmission of hepatitis B to spouses occurred in four cases, was fatal in one instance, and was associated with e antigen in three of the four. Determination of e antigen status in renal unit patients who are carriers of hepatitis B surface antigen may be of value to the patient and his home environment. PMID:7380332

  12. Gastric metaplasia and Campylobacter pylori infection of duodenum in patients with chronic renal failure.

    OpenAIRE

    Shousha, S; Keen, C; Parkins, R A

    1989-01-01

    Duodenal biopsy specimens from 80 patients with chronic renal failure, who were undergoing haemodialysis, were examined by light microscopy for evidence of inflammation, gastric metaplasia, and Campylobacter pylori infection. Chronic duodenitis was present in 47 (59%) of patients, of whom only seven (9%) showed evidence of active inflammation. Gastric metaplasia was present in 50 (62.5%) of patients, yet Campylobacter pylori was identified in only two patients (2.5%). It is suggested that the...

  13. Renal pigmentation due to chronic bismuth administration in a rhesus macaque (Macaca mulatta).

    Science.gov (United States)

    Johnson, A L; Blaine, E T; Lewis, A D

    2015-05-01

    Renal pigmentation due to the administration of exogenous compounds is an uncommon finding in most species. This report describes renal pigmentation and intranuclear inclusions of the proximal convoluted tubules due to chronic bismuth administration in a rhesus macaque. An 11-year-old Indian-origin rhesus macaque with a medical history of chronic intermittent vomiting had been treated with bismuth subsalicylate, famotidine, and omeprazole singly or in combination over the course of 8 years. At necropsy, the renal cortices were diffusely dark green to black. Light and electron microscopy revealed intranuclear inclusions within the majority of renal proximal tubular epithelial cells. These inclusions appeared magenta to brown when stained with hematoxylin and eosin and were negative by the Ziehl-Neelsen acid-fast stain. Elemental analysis performed on frozen kidney measured bismuth levels to be markedly elevated at 110.6 ppm, approximately 500 to 1000 times acceptable limits. To our knowledge, this is the first report of renal bismuth deposition in a rhesus macaque resulting in renal pigmentation and intranuclear inclusions. PMID:24990482

  14. Inflammatory Cytokines, Endothelial Function, and Chronic Allograft Vasculopathy in Children: An Investigation of the Donor and Recipient Vasculature After Heart Transplantation.

    Science.gov (United States)

    Fenton, M; Simmonds, J; Shah, V; Brogan, P; Klein, N; Deanfield, J; Burch, M

    2016-05-01

    Chronic allograft vasculopathy (CAV) limits the lifespan of pediatric heart transplant recipients. We investigated blood markers of inflammation, endothelial dysfunction, and damage to both the native and transplanted vasculature in children after heart transplantation. Serum samples were taken from pediatric heart transplant recipients for markers of inflammation and endothelial activation. The systemic vasculature was investigated using brachial artery flow-mediated dilatation and carotid artery intima-medial hyperplasia. CAV was investigated using intravascular ultrasound. Mean intima-media thickness (mIMT) > 0.5 mm was used to define significant CAV. Forty-eight children (25 male) aged 8-18 years were enrolled in the study. Patients were a median (interquartile range) 4.1 (2.2-8.7) years after transplant. Patients had increased levels of circulating IL6 (3.86 [2.84-4.95] vs. 1.66 [1.22-2.63] p 0.5 mm. This suggests that subclinical inflammation is present and that natural anticoagulant/thrombomodulin activity is important after transplant. PMID:26614396

  15. Effect of medical ozone therapy on renal blood flow and renal function of patients with chronic severe hepatitis

    Institute of Scientific and Technical Information of China (English)

    GU Xi-bing; YANG Xiao-juan; ZHU Hong-ying; XU Yue-qin; LIU Xia-ying

    2010-01-01

    Background Medical ozone therapy system was reported to have certain effects on the treatment of severe hepatitis,but its mechanism is not very clear. One of the causes of death of severe hepatitis is complication of renal damage or hepatorenal syndrome. The present study aimed to observe effects of medical ozone therapy system on plasma renin activity (PRA), angiotensin Ⅱ (AⅡ), aldosterone (ALD), renal blood flow and renal function of patients with chronic severe hepatitis and explore mechanisms of medical ozone therapy in the treatment of severe hepatitis.Methods Eighty-five cases with chronic severe hepatitis were randomly divided into ozone therapy group (43 cases)and control group (42 cases). The patients in the ozone therapy group were treated with basic treatments plus ozone therapy system. Basic autohemotherapy was used. One hundred milliliter venous blood was drawn from each patient,and was mixed with 100 ml (35 μg/ml) medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days. Only the basic treatments were given to the control group. PRA, All, ALD, renal blood flow and damage to renal function of the two groups before treatment and 20 days after treatment were compared. Survival rates were also compared.Results Twenty days after the treatment, in ozone therapy group, PRA was (1.31±0.12) ng·ml-1·h-1, All (111.25±17.35)pg/ml, ALD (251.31 ±22.60) pg/ml, which decreased significantly compared with those before treatment (PRA (2.23±0.13)ng·ml-1 ·h1, AⅡ (155.18±19.13) pg/ml, ALD (405.31±29.88) pg/ml, t=4.67-14.23, P <0.01), also lower than those of control group 20 days after the treatment (PRA (2.02±0.11) ng·ml-1·h-1, All (162.21±15.32) pg/ml, ALD (401.20±35.02) pg/ml,t=4.97-15.61, P <0.01); renal blood flow was (175.15±28.20) ml/min, which increased compared with that before the treatment ((125.68±21.25) ml/min) and was higher than that of control group 20 days after the treatment

  16. Non-inferiority of creatinine excretion rate to urinary L-FABP and NGAL as predictors of early renal allograft function

    OpenAIRE

    Pajek, Jernej; Škoberne, Andrej; Šosterič, Klara; Adlešič, Barbara; Leskošek, Bojan; Bučar Pajek, Maja; Osredkar, Joško; Lindič, Jelka

    2014-01-01

    Background We evaluated accuracy of urinary liver type fatty acid-binding protein (L-FABP) for prediction of early allograft function and compared it to neutrophil gelatinase associated lipocalin (NGAL), diuresis and urinary creatinine excretion rate (UCr). Methods Urine samples from 71 consecutive patients were taken 4, 10, 24 and 48 h after transplantation. We classified recipients into two groups: immediate graft function (IGF), with more than 70% reduction of serum Cr at 7th day post-tran...

  17. Blood pressure response to conventional and low-dose enalapril in chronic renal failure

    DEFF Research Database (Denmark)

    Elung-Jensen, Thomas; Heisterberg, Jens; Kamper, Anne-Lise;

    2003-01-01

    AIMS: In chronic renal failure, the clearance of most ACE inhibitors including enalapril is reduced. Hence, with conventional dosage, plasma enalaprilat may be markedly elevated. It is unclear whether this excess of drug exposure affords an improved control of blood pressure. The aim of the present...... study was to evaluate short-term blood pressure response to two different plasma levels of enalaprilat. METHODS: As part of an open, randomized, controlled trial of the effect of high and low dosage of enalapril on the progression of renal failure, short-term blood pressure response was evaluated. Data...... potassium concentrations at day 90 and patients in the low group experienced a slight increase in GFR. CONCLUSIONS: In moderate to severe chronic renal insufficiency the same degree of blood pressure control was achieved on low as well as moderate daily doses of enalapril. This was irrespective of...

  18. Obstetric outcomes in women with end-stage renal disease on chronic dialysis: a review

    Science.gov (United States)

    Yang, L Y; Thia, E W H; Tan, L K

    2010-01-01

    Pregnancies in women on chronic dialysis for end-stage renal disease are high risk, but outcomes appear to have improved with increasing experience and advances in dialysis care. This paper reviews the existing data on outcomes in such pregnancies to enable evidence-based preconception counselling and anticipation of antenatal complications.

  19. Vascular endothelial cell function and cardiovascular risk factors in patients with chronic renal failure

    DEFF Research Database (Denmark)

    Haaber, A B; Eidemak, I; Jensen, T;

    1995-01-01

    Cardiovascular risk factors and markers of endothelial cell function were studied in nondiabetic patients with mild to moderate chronic renal failure. The transcapillary escape rate of albumin and the plasma concentrations of von Willebrand factor, fibrinogen, and plasma lipids were measured in 29...

  20. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  1. Epigallocatechin-3-gallate attenuates cadmium-induced chronic renal injury and fibrosis.

    Science.gov (United States)

    Chen, Jinglou; Du, Lifen; Li, Jingjing; Song, Hongping

    2016-10-01

    Cadmium (Cd) pollution is a serious environmental problem. Kidney is a main target organ of Cd toxicity. This study was undertaken to investigate the potential protective effects of epigallocatechin-3-gallate (EGCG) against chronic renal injury and fibrosis induced by CdCl2. Rat model was induced by exposing to 250 mg/L CdCl2 through drinking water. The renal function was evaluated by detecting the levels of blood urea nitrogen (BUN) and serum creatinine (SCR). The oxidative stress was measured by detecting the levels of malondialdehyde (MDA), nitric oxide (NO), reduced glutathione/oxidized glutathione (GSH/GSSG) and renal enzymatic antioxidant status. Additionally, the renal levels of transforming growth factor-β1 (TGF-β1), Smad3, phosphorylation-Smad3 (pp-Smad3), α-smooth muscle actin (α-SMA), vimentin and E-cadherin were measured by western blot assay. Renal levels of microRNA-21 (miR-21), miR-29a/b/c and miR-192 were measured by quantitative RT-PCR. It was found that EGCG ameliorated the CdCl2-induced renal injury, inhibited the level of oxidative stress, normalized renal enzymatic antioxidant status and E-cadherin level, as well as attenuated the over generation of TGF-β1, pp-Smad3, vimentin and α-SMA. EGCG also decreased the production of miR-21 and miR-192, and enhanced the levels of miR-29a/b/c. These results showed that EGCG could attenuate Cd induced chronic renal injury. PMID:27474435

  2. Assessment of renal fibrosis in chronic kidney disease using diffusion-weighted MRI

    International Nuclear Information System (INIS)

    Aim: To assess the performance of diffusion-weighted magnetic resonance imaging (MRI) for the assessment of renal fibrosis in chronic kidney disease (CKD), with histopathology as a reference standard. Materials and methods: Forty patients with CKD and 30 healthy volunteers were recruited for the study. All participants underwent diffusion-weighted MRI. Renal biopsy was performed in 25 patients with CKD. Mean renal medullary and cortical apparent diffusion coefficient (ADC) values were compared between CKD patients and the healthy volunteers. Pearson's correlation coefficient was calculated to investigate the relationship between ADC values, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), 24 h urinary protein (24h-UPRO), and renal histopathological scores. Results: Cortical and medullary ADC values in the CKD group were significantly lower compared to those in the healthy controls. In the CKD group, a significant negative correlation was found between cortical ADC values and SCr/24h-UPRO, and significant positive correlation was found between cortical ADC and eGFR. There was also a significant negative correlation between medullary ADC values and SCr. Both cortical and medullary ADC values were significantly correlated with histopathological fibrosis score. Conclusion: Renal ADC values strongly correlate with histological measures of fibrosis, and have the potential to enhance the non-invasive monitoring of chronic kidney disease. - Highlights: • Renal ADC values in the CKD patients were lower than those in controls. • Renal ADC values were strongly correlated with histological fibrosis score. • Renal ADC values have the potential to enhance the noninvasive monitoring of CKD

  3. SDF-1/CXCR4 signaling preserves microvascular integrity and renal function in chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Li-Hao Chen

    Full Text Available The progressive decline of renal function in chronic kidney disease (CKD is characterized by both disruption of the microvascular architecture and the accumulation of fibrotic matrix. One angiogenic pathway recently identified as playing an essential role in renal vascular development is the stromal cell-derived factor-1α (SDF-1/CXCR4 pathway. Because similar developmental processes may be recapitulated in the disease setting, we hypothesized that the SDF-1/CXCR4 system would regulate microvascular health in CKD. Expression of CXCR4 was observed to be increased in the kidneys of subtotally nephrectomized (SNx rats and in biopsies from patients with secondary focal segmental glomerulosclerosis (FSGS, a rodent model and human correlate both characterized by aberration of the renal microvessels. A reno-protective role for local SDF-1/CXCR4 signaling was indicated by i CXCR4-dependent glomerular eNOS activation following acute SDF-1 administration; and ii acceleration of renal function decline, capillary loss and fibrosis in SNx rats treated with chronic CXCR4 blockade. In contrast to the upregulation of CXCR4, SDF-1 transcript levels were decreased in SNx rat kidneys as well as in renal fibroblasts exposed to the pro-fibrotic cytokine transforming growth factor β (TGF-β, the latter effect being attenuated by histone deacetylase inhibition. Increased renal SDF-1 expression was, however, observed following the treatment of SNx rats with the ACE inhibitor, perindopril. Collectively, these observations indicate that local SDF-1/CXCR4 signaling functions to preserve microvascular integrity and prevent renal fibrosis. Augmentation of this pathway, either purposefully or serendipitously with either novel or existing therapies, may attenuate renal decline in CKD.

  4. Helicobacter Pylori in Patients with Chronic Renal Failure

    OpenAIRE

    B Allahverdi; Esfahani ST; Najafi, M.

    2004-01-01

    Background: Helicobacter pylori (H.Pylori) is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD). Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2%) had pathologic defect...

  5. Pleural effusion as a result of chronic renal ischemia.

    Science.gov (United States)

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-09-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

  6. Pleural effusion as a result of chronic renal ischemia

    Science.gov (United States)

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-01-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

  7. Erectile dysfunction in patients with chronic renal failure

    OpenAIRE

    Leonardo E. Messina; Joaquim A. Claro; Nardozza Archimedes; Enrico Andrade; Valdemar Ortiz; Miguel Srougi

    2007-01-01

    OBJECTIVE: Determine the prevalence of erectile dysfunction in patients undergoing hemodialysis MATERIALS AND METHODS: This cross-sectional study was carried out to determine the prevalence of erectile dysfunction in a population of 58 patients in hemodialysis program. Erectile dysfunction was assessed by using the International Index of Erectile Function (IIEF). Information on demographic data, renal failure, comorbidities, laboratory tests and search for medical treatment for erectile dysfu...

  8. Liver disease and the e antigen in HBsAg carriers with chronic renal failure.

    OpenAIRE

    Coughlin, G P; Van Deth, A G; Disney, A P; Van Hay, J.; Wangel, A. G.

    1980-01-01

    This study was undertaken to assess the frequency of development and the stages of evolution of chronic liver disease in patients with renal failure who are chronic carriers of hepatitis B surface antigen. Cirrhosis or chronic active hepatitis developed in five of 21 patients and could not be predicted by the initial histological appearance or by HLA-A and B typing but was associated with the e antigen in four of the five patients. However, the antigen was not a consistent indicator of a poor...

  9. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-05-01

    Full Text Available Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

  10. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...... were unchanged. The conclude that, in spite of changes in rheologic variables, increasing viscosity of the blood and thus possibly increasing the peripheral resistance, these had no effect on the cardiovascular state. Erythropoietin treatment improves the subjective well-being in patients on chronic...

  11. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Houda Mbarki

    2015-01-01

    Full Text Available Fasting during Ramadan is prohibited when an individual′s health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD. We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years. All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF, active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of <60 mL/min/1.73 m 2 . However, the small sample size does not allow us to draw any firm conclusions on fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended.

  12. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease.

    Science.gov (United States)

    Mbarki, Houda; Tazi, Nada; Najdi, Adil; Tachfouti, Nabil; Arrayhani, Mohamed; Sqalli, Tarik

    2015-03-01

    Fasting during Ramadan is prohibited when an individual's health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD). We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years). All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF), active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended. PMID:25758882

  13. Renal function markers and thyroid hormone status in undialyzed chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Balaji Rajagopalan

    2013-01-01

    Full Text Available Objective: The study was undertaken to quantify thyroid hormones in undialyzed chronic kidney disease patients’ verses controls and to study the correlation between renal function markers and thyroid hormones. Background: Chronic kidney disease (CKD is associated with a higher prevalence of primary hypothyroidism (HT, but at the same studies on thyroid hormone status in uremic patients has reported conflicting results. Methods: Thyroid hormones and renal function parameters like serum urea, creatinine, creatinine clearance, total protein and albumin were estimated and correlations between thyroid hormones and renal function parameters were studied in 60 undialyzed chronic kidney disease patients’ verses 100 healthy controls. Results: We found both T3 and T4 were significantly reduced (p<0.0001 for T3 and 0.007 for T4 whereas TSH remains to be unchanged in patient group compared to controls. We also observed that urea and creatinine were negatively correlated whereas creatinine clearance was positively correlated with both T3 and T4 that has high statistical (two-tailed significance at 0.01 level. But urea alone is negatively correlated with TSH that has statistical (two-tailed significance at 0.05 level. Conclusion: From our data, we speculate that renal insufficiency may lead to thyroid hormone disturbances.

  14. Mild systemic thermal therapy ameliorates renal dysfunction in a rodent model of chronic kidney disease.

    Science.gov (United States)

    Iwashita, Yoshihiro; Kuwabara, Takashige; Hayata, Manabu; Kakizoe, Yutaka; Izumi, Yuichiro; Iiyama, Junichi; Kitamura, Kenichiro; Mukoyama, Masashi

    2016-06-01

    Thermal therapy has become a nonpharmacological therapy in clinical settings, especially for cardiovascular diseases. However, the practical role of thermal therapy on chronic kidney disease remains elusive. We performed the present study to investigate whether a modified thermal protocol, repeated mild thermal stimulation (MTS), could affect renal damages in chronic kidney disease using a mouse renal ablation model. Mice were subjected to MTS or room temperature (RT) treatment once daily for 4 wk after subtotal nephrectomy (Nx) or sham operation (Sh). We revealed that MTS alleviated renal impairment as indicated by serum creatinine and albuminuria in Nx groups. In addition, the Nx + MTS group showed attenuated tubular histological changes and reduced urinary neutrophil gelatinase-associated lipocalin excretion approximately by half compared with the Nx + RT group. Increased apoptotic signaling, such as TUNEL-positive cell count and cleavage of caspase 3, as well as enhanced oxidative stress were significantly reduced in the Nx + MTS group compared with the Nx + RT group. These changes were accompanied with the restoration of kidney Mn-SOD levels by MTS. Heat shock protein 27, a key molecular chaperone, was phosphorylated by MTS only in Nx kidneys rather than in Sh kidneys. MTS also tended to increase the phosphorylation of p38 MAPK and Akt in Nx kidneys, possibly associated with the activation of heat shock protein 27. Taken together, these results suggest that modified MTS can protect against renal injury in a rodent model of chronic kidney disease. PMID:27029428

  15. The chronic renal disease course: from early symptons to discovery

    Directory of Open Access Journals (Sweden)

    Vera Lucia Fortunato Fortes

    2013-07-01

    Full Text Available An exploratory and descriptive study with a qualitative approach aim at understanding the significance of the discovery of chronic kidney disease and the need for the hemodialysis machine. The research was made with twenty patients from two hemodialysis services of the city of RS. The data collection took place between September and December of 2007, throughout semi-structured interviews. The thematic analysis generated the following categories: history of chronic kidney disease, from the silence of the disease to the classical clinical symptoms; the discovery and its immediate effects; life after the discovery; acceptance of the dependence on a machine. We conclude that there is a need to adapt the daily life of patients with chronic kidney disease, because the hemodialysis causes physical and social changes, requiring support from health-team to manage the disease. The professional should not abdicate knowledge, safety and technical skill, as requirements to care.

  16. A CLINICAL STUDY OF CARDIOVASCULAR ABNORMALITIES IN PATIENTS WITH CHRONIC RENAL FAILURE AT VIMS HOSPITAL, BELLARY.

    Directory of Open Access Journals (Sweden)

    Huggi

    2014-12-01

    Full Text Available BACKGROUND: Chronic Renal Failure (CRF is one of the common conditions which a physician comes across in day to day practice. Chronic Renal Failure affects every aspect of the lives of the patients who suffer it and involves all systems of body & results in various abnormalities. Today , cardiovascular complications are a major clinical problem in ureamic patients accounting for 4 4% of all deaths in this population. Left Ventricular Hypertrophy (LVH is a major Echocardiographic finding in Chronic Renal Failure (CRF. Prevalence of LVH increases with decline of renal function. Left ventricular hypertrophy is an independent predictor of survival , present in approximately 70% of patients at the initiation of dialysis. MATERIALS AND METHODS : The data for this study was collected from the one hundred subjects fulfilling the inclusion /exclusion criteria admitted and patients vis iting OPD and patients undergoing dialysis in dialysis unit of VIMS Hospital during the period from Jan 2010 To June 2011. RESULTS : LVH is a major echocardiographic finding in uremic patients. In the present study , 12 (17% patients of mild , 18(26% patien ts of moderate and 39(57% patients of severe Chronic Renal Failure group had Left Ventricular Hypertrophy. In the present study , the most common cause of CRF in the Severe CRF group was Diabetes plus Hypertension in 47% followed by Diabetes alone in 33% a s compared to Moderate CRF group where in Diabetes plus Hypertension accounted for 47% , followed by Diabetes in 47% , whereas in Mild CRF group Diabetes was the cause 38% , followed by Diabetes plus Hypertension in 33% of cases. Pericardial effusion was seen in 25% of cases (15 cases had mild and 10 cases had moderate pericardial effusion . CONCLUSIONS : The high prevalence of Left ventricular hypertrophy in these populations on echocardiography implies that these patients require detailed cardiovascular evalua tion despite absence of symptoms and control of

  17. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    OpenAIRE

    Adriana P. Castilho Dugaich; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Mirian A. Boim; Cássia T. Bergamaschi; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction ...

  18. Hiperhomocisteinemia na insuficiência renal crônica Hyperhomocysteinemia in chronic renal failure

    OpenAIRE

    Fabiana Baggio Nerbass; Sérgio Antonio Draibe; Lilian Cuppari

    2005-01-01

    A homocisteína é um aminoácido sulfurado proveniente do metabolismo da metionina, cujo acúmulo anormal no plasma é um fator de risco para doenças vasculares, tanto na população em geral como nos pacientes com insuficiência renal crônica. Nestes, a prevalência de indivíduos com hiperhomocisteinemia é bastante elevada, mesmo na fase não dialítica da doença, em que a função renal está diminuída, mas ainda não é necessário tratamento dialítico. O principal fator que parece estar implicado na elev...

  19. Potential benefits of renal diets on cardiovascular risk factors in chronic kidney disease patients.

    Science.gov (United States)

    Cupisti, Adamasco; Aparicio, Michel; Barsotti, Giuliano

    2007-01-01

    Dietary manipulation, including protein, phosphorus, and sodium restriction, when coupled with the vegetarian nature of the renal diet and ketoacid supplementation can potentially exert a cardiovascular protective effect in chronic renal failure patients by acting on both traditional and nontraditional cardiovascular risk factors. Blood pressure control may be favored by the reduction of sodium intake and by the vegetarian nature of the diet, which is very important also for lowering serum cholesterol and improving plasma lipid profile. The low protein and phosphorus intake has a crucial role for reducing proteinuria and preventing and reversing hyperphosphatemia and secondary hyperparathyroidism, which are major causes of the vascular calcifications, cardiac damage, and mortality risk of uremic patients. The reduction of nitrogenous waste products and lowering of serum PTH levels may also help ameliorate insulin sensitivity and metabolic control in diabetic patients, as well as increase the responsiveness to erythropoietin therapy, thus allowing greater control of anemia. Protein-restricted diets may have also anti-inflammatory and anti-oxidant properties. Thus, putting aside the still debatable effects on the progression of renal disease and the more admitted effects on uremic signs and symptoms, it is possible that a proper nutritional treatment early in the course of renal disease may be useful also to reduce the cardiovascular risk in the renal patient. However, conclusive data cannot yet be drawn because quality studies are lacking in this field; future studies should be planned to assess the effect of renal diets on hard outcomes, as cardiovascular events or mortality. PMID:17654313

  20. Role of 11β-hydroxysteroid dehydrogenase 2 renal activity in potassium homeostasis in rats with chronic renal failure

    Directory of Open Access Journals (Sweden)

    N.L. Yeyati

    2010-01-01

    Full Text Available Aldosterone concentrations vary in advanced chronic renal failure (CRF. The isozyme 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2, which confers aldosterone specificity for mineralocorticoid receptors in distal tubules and collecting ducts, has been reported to be decreased or normal in patients with renal diseases. Our objective was to determine the role of aldosterone and 11β-HSD2 renal microsome activity, normalized for glomerular filtration rate (GFR, in maintaining K+ homeostasis in 5/6 nephrectomized rats. Male Wistar rats weighing 180-220 g at the beginning of the study were used. Rats with experimental CRF obtained by 5/6 nephrectomy (N = 9 and sham rats (N = 10 were maintained for 4 months. Systolic blood pressure and plasma creatinine (Pcr concentration were measured at the end of the experiment. Sodium and potassium excretion and GFR were evaluated before and after spironolactone administration (10 mg·kg-1·day-1 for 7 days and 11β-HSD2 activity on renal microsomes was determined. Systolic blood pressure (means ± SEM; Sham = 105 ± 8 and CRF = 149 ± 10 mmHg and Pcr (Sham = 0.42 ± 0.03 and CRF = 2.53 ± 0.26 mg/dL were higher (P < 0.05 while GFR (Sham = 1.46 ± 0.26 and CRF = 0.61 ± 0.06 mL/min was lower (P < 0.05 in CRF, and plasma aldosterone (Pald was the same in the two groups. Urinary sodium and potassium excretion was similar in the two groups under basal conditions but, after spironolactone treatment, only potassium excretion was decreased in CRF rats (sham = 0.95 ± 0.090 (before vs 0.89 ± 0.09 µEq/min (after and CRF = 1.05 ± 0.05 (before vs 0.37 ± 0.07 µEq/min (after; P < 0.05. 11β-HSD2 activity on renal microsomes was lower in CRF rats (sham = 0.807 ± 0.09 and CRF = 0.217 ± 0.07 nmol·min-1·mg protein-1; P < 0.05, although when normalized for mL GFR it was similar in both groups. We conclude that K+ homeostasis is maintained during CRF development despite normal Pald levels. This adaptation may be mediated by

  1. Application of Label-free Quantitative Peptidomics for the Identification of Urinary Biomarkers of Kidney Chronic Allograft Dysfunction*

    OpenAIRE

    Quintana, Luis F; Campistol, Josep M.; Alcolea, Maria P.; Bañon-Maneus, Elisenda; Sol-González, Amandaé; Cutillas, Pedro R.

    2009-01-01

    The advent of quantitative proteomics opens new opportunities in biomedical and clinical research. Although quantitative proteomics methods based on stable isotope labeling are in general preferred for biomolecular research, biomarker discovery is a case example of a biomedical problem that may be better addressed by using label-free MS techniques. As a proof of concept of this paradigm, we report the use of label-free quantitative LC-MS to profile the urinary peptidome of kidney chronic allo...

  2. Risk Factors for Renal Functional Decline in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents.

    Science.gov (United States)

    Shin, Jung-Ho; Kwon, Hee Jin; Jang, Hye Ryoun; Lee, Jung Eun; Gwak, Geum-Youn; Huh, Wooseong; Jung, Sin-Ho; Lee, Joon Hyeok; Kim, Yoon-Goo; Kim, Dae Joong; Oh, Ha Young

    2016-01-01

    Renal functional decline that is frequently seen during chronic hepatitis B (CHB) treatment can exert adverse effects on overall prognosis. It, however, is difficult to distinguish vulnerable patients who may experience renal dysfunction because most previous CHB studies were conducted in relatively healthy individuals. In this retrospective observational study, renal functional decline in CHB patients receiving oral antiviral agents for more than 6 months was analyzed and risk factors of chronic kidney disease (CKD) progression were determined. Renal functional decline was defined when the estimated glomerular filtration rate (eGFR) decreased by more than 25% from baseline and rapid CKD progression was defined as eGFR decreased by more than 5 mL/min/1.73 m2/y among patients who experienced renal functional decline. A total of 4178 patients were followed up for a median 23 months. Antiviral agents included lamivudine (17.0%), adefovir (3.7%), entecavir (70.4%), telbivudine (0.6%), tenofovir (4.0%), or clevudine (4.3%). Renal functional decline occurred in 706 (16.9%) patients. Based on multivariate Cox regression analysis, age, hypertension, diabetes, history of liver or kidney transplantation, underlying underlying CKD, and simultaneous administration of diuretics increased the hazard ratio for renal functional decline; however, clevudine reduced risk. The eGFR significantly increased over time in patients receiving telbivudine or clevudine compared with lamivudine. Among the 3175 patients followed up for more than 1 year, 407 (12.8%) patients experienced rapid CKD progression. Patients with rapid CKD progression showed lower serum albumin, higher total bilirubin, and prolonged prothrombin time compared with patients with stable renal function, but hepatitis B envelope antigen positivity and hepatitis B virus deoxyribonucleic acid level did not differ between the control and rapid CKD progression groups. Age, diabetes, kidney transplantation, underlying CKD, and

  3. Ex vivo exposure of bone marrow from chronic kidney disease donor rats to pravastatin limits renal damage in recipient rats with chronic kidney disease

    NARCIS (Netherlands)

    Koppen, A. van; Papazova, D.A.; Oosterhuis, N.R.; Gremmels, H.; Giles, R.H.; Fledderus, J.O.; Joles, J.A.; Verhaar, M.C.

    2015-01-01

    Introduction: Healthy bone marrow cell (BMC) infusion improves renal function and limits renal injury in a model of chronic kidney disease (CKD) in rats. However, BMCs derived from rats with CKD fail to retain beneficial effects, demonstrating limited therapeutic efficacy. Statins have been reported

  4. Pseudomelanosis duodeni in a female adult with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Wei-Chih Sun

    2014-12-01

    Full Text Available Pseudomelanosis duodeni is a rare endoscopic finding that manifests as dark speckled spots in the duodenum. It is considered a benign condition and is associated with certain diseases and the use of certain medications. This study reports a case of a 74-year-old woman, with end-stage renal disease under maintenance hemodialysis, hypertension under regular medical control, iron deficiency anemia under oral iron supplement, and progressive anemia with suspicious occult gastrointestinal bleeding. Upper gastrointestinal endoscopy revealed multiple tiny brownish-black pigmentation throughout the proximal second portion of the duodenum. The histopathological examination showed pigment-laden macrophages with positive iron stain and negative melanin stain in the lamina propria of the mucosal villi.

  5. A girl with Peters plus syndrome associated with myelomeningocele and chronic renal failure.

    Science.gov (United States)

    Motoyama, Osamu; Arai, Hiroko; Harada, Ryoko; Hasegawa, Kei; Iitaka, Kikuo

    2010-08-01

    A girl was born with sclerocornea of the right eye, corneal staphyloma of the left eye and lumbar myelomeningocele. The myelomeningocele was repaired soon after birth. The corneal staphyloma was perforated during infancy. She received keratoplasty and achieved light perception. Her right kidney revealed multicystic dysplasia and was non-functioning at birth. She had neurogenic bladder, and her renal function deteriorated gradually. Peters plus syndrome was diagnosed based on anterior ocular segment anomalies, short stature, developmental delay and characteristic face. Anterior ocular segment anomalies are rare findings, but seem to be occasionally associated with spina bifida and renal anomalies. Myelomeningocele and chronic renal failure in patients with Peters plus syndrome have not been reported to our knowledge. PMID:20424881

  6. Serum leptin level and its significance in chronic renal failure hemodialysis patients

    International Nuclear Information System (INIS)

    To study serum leptin level in chronic renal failure (CRF) hemodialysis patients and the relationship between serum leptin level and residue renal function, body composition, and indices of malnutrition, 31 end-stage CRF hemodialysis patients and 38 healthy people were enrolled. Serum leptin levels were detected by radioimmunoassay. BMI, %Fat and LBM were measured by bioelectrical impedance analysis device. Alb, Chol, Hgb, BUN, SCr and Ccr of the patients were also examined. Results showed that Serum leptin level in end-stage CRF hemodialysis patients was markedly higher than that in healthy controls (P0.05). Conclusion: Hyperleptinemia existed in end-stage CRF hemodialysis patients and might cause the loss of LBM. The leptin level was not correlated with residue renal function, but it could reflect the fat content. However, serum leptin did not play a significant role in protein malnutrition in end-stage CRF hemodialysis patients

  7. Proteinuria in Egyptian renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Essam Khedr

    2015-01-01

    Full Text Available To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8% patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2% patients, acute rejection in 40 (32% patients, transplant glomerulopathy in eight (6.4% patients, glomerular disease in 16 (12.8% patients and other etiology in 17 (13.6% patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862. We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.

  8. End-Stage Renal Disease after Liver Transplantation in Patients with Pre-Transplant Chronic Kidney Disease

    OpenAIRE

    Bahirwani, Ranjeeta; Forde, Kimberly A.; Mu, Yifei; Lin, Fred; Reese, Peter; Goldberg, David; Abt, Peter; Reddy, K. Rajender; Levine, Matthew

    2014-01-01

    Renal dysfunction prior to liver transplantation has a marked impact on post-transplant kidney outcomes. The aim of this study was to assess post-transplant renal function in patients with chronic kidney disease (CKD) receiving orthotopic liver transplantation (OLT) alone.

  9. Mechanisms of epoxyeicosatrienoic acids to improve cardiac remodeling in chronic renal failure disease.

    Science.gov (United States)

    Zhang, Kun; Wang, Ju; Zhang, Huanji; Chen, Jie; Zuo, Zhiyi; Wang, Jingfeng; Huang, Hui

    2013-02-15

    Both clinical and basic science studies have demonstrated that cardiac remodeling in patients with chronic renal failure (CRF) is very common. It is a key feature during the course of heart failure and an important risk factor for subsequent cardiac mortality. Traditional drugs or therapies rarely have effects on cardiac regression of CRF and cardiovascular events are still the first cause of death. Epoxyeicosatrienoic acids (EETs) are the products of arachidonic acids metabolized by cytochrome P450 epoxygenases. It has been found that EETs have important biological effects including anti-hypertension and anti-inflammation. Recent data suggest that EETs are involved in regulating cardiomyocyte injury, renal dysfunction, chronic kidney disease (CKD)-related risk factors and signaling pathways, all of which play key roles in cardiac remodeling induced by CRF. This review analyzes the literature to identify the possible mechanisms for EETs to improve cardiac remodeling induced by CRF and indicates the therapeutic potential of EETs in it. PMID:23313758

  10. [Cardiovascular responses during laryngeal mask airway insertion in normotensive, hypertensive and chronic renal failure patients].

    Science.gov (United States)

    Yamauchi, M; Igarashi, M; Tsunoda, K; Edanaga, M; Suzuki, H; Tohdoh, Y; Namiki, A

    1999-08-01

    The hemodynamic response to the insertion of the laryngeal mask airway (LM) following induction with propofol 2 mg.kg-1 was assessed and compared in normotensive (Normal), hypertensive (HT) and chronic renal failure (CRF) patients (n = 23 in each group). Before induction, in HT and CRF groups blood pressure and rate pressure products (RPP) were higher than in Normal group (P < 0.05). Although blood pressure and RPP were decreased in every patient by induction with propofol, no patients needed vasopressor drugs. The decreases of blood pressure and RPP were larger in HT and CRF groups than in Normal group (P < 0.05). There were no differences between groups in heart rate and rate of successful LM insertion. We concluded that LM insertion with propofol 2 mg.kg-1 was an effective induction method preventing the adverse circulatory responses in normotensive, hypertensive and chronic renal failure patients. PMID:10481421

  11. Treatment of Chronic Renal Failure by Supplementing the Kidney and Invigorating Blood Flow

    Institute of Scientific and Technical Information of China (English)

    张勉之; 张大宁; 张文柱; 刘树松; 张敏英

    2004-01-01

    Objective: To evaluate the effectiveness of treatment of chronic renal failure by supplementing the kidney and invigorating blood flow. Method: The eligible patients were assigned to a treatment group (N =120)treated with the above principle and a control group (N = 128) treated with western drugs, and the effectiveness was evaluated when the study was completed in one year. Results: The total effective rate of 92.5% was achieved in the treatment group, better than that in the control group (49.2%); the difference was significant (P<0.01), especially in patients of stage Ⅰ and Ⅱ. Conclusion: The treatment of chronic renal failure by supplementing the kidney and invigorating blood flow proved to be very effective.

  12. Brown tumors in patients with chronic renal failure and secondary hyperparathyroidism: Report of 12 cases

    Directory of Open Access Journals (Sweden)

    Fatma Lilia

    2010-01-01

    Full Text Available Brown tumors are unusual but serious complications of renal osteodystrophy. We retrospectively studied 12 patients presenting with chronic renal failure and brown tumor related to secondary hyperparathyroidism. Eleven patients were on chronic hemodialysis. The median duration between renal failure and end stage renal failure was 36 months (range: 12-190 months and the median duration in dialysis for 11 cases: 92 months (range: 72-252 months. The bone pain was noted in all cases (100%, pathological fracture in one case (8% and a palpable bone tumor in 10 cases (83%. Elevated serum Calcium (> 2.35 mmol/L was noted in four cases (33%, elevated serum Phosphate (> 1.78 mmol/L in ten cases (80%, elevated serum Alkaline Phosphate (> 290 UI/L in all cases and intact PTH was > 300 pg/mL in all cases with a serum median rate at 1475 pg/mL (range: 682-3687 pg/L. Subtotal parathyroidectomy was performed in all cases with a resultant decrease in size of brown tumors. We report here patient with CKD with unusual frequency and variable locations. This may be attributed tothe lack of the new calcium free phosphate binders and calcimimetics.

  13. Histomorphometry of feline chronic kidney disease and correlation with markers of renal dysfunction.

    Science.gov (United States)

    Chakrabarti, S; Syme, H M; Brown, C A; Elliott, J

    2013-01-01

    Chronic kidney disease is common in geriatric cats, but most cases have nonspecific renal lesions, and few studies have correlated these lesions with clinicopathological markers of renal dysfunction. The aim of this study was to identify the lesions best correlated with renal function and likely mediators of disease progression in cats with chronic kidney disease. Cats were recruited through 2 first-opinion practices between 1992 and 2010. When postmortem examinations were authorized, renal tissues were preserved in formalin. Sections were evaluated by a pathologist masked to all clinicopathological data. They were scored semiquantitatively for the severity of glomerulosclerosis, interstitial inflammation, and fibrosis. Glomerular volume was measured using image analysis; the percentage of glomeruli that were obsolescent was recorded. Sections were assessed for hyperplastic arteriolosclerosis and tubular mineralization. Kidneys from 80 cats with plasma biochemical data from the last 2 months of life were included in the study. Multivariable linear regression (P glomerular hypertrophy, whereas higher time-averaged systolic blood pressure was associated with glomerulosclerosis and hyperplastic arteriolosclerosis. PMID:22773469

  14. The use of everolimus in renal-transplant patients

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    Julio Pascual

    2009-06-01

    Full Text Available Julio PascualServicio de Nefrología, Hospital Ramón y Cajal, 28034 Madrid, SpainAbstract: Despite advances in immunosuppressive therapy, long-term renal-transplantation outcomes have not significantly improved over the last decade. The nephrotoxicity of calcineurin inhibitors (CNIs is an important cause of chronic allograft nephropathy (CAN, the major driver of long-term graft loss. Everolimus is a proliferation signal inhibitor with a mechanism of action that is distinct from CNIs. The efficacy and tolerability of everolimus in renal-transplant recipients have been established in a wide range of clinical trials. Importantly, synergism between everolimus and the CNI cyclosporine (CsA permits CsA dose reduction, enabling nephrotoxicity to be minimized without compromising efficacy. Currently, everolimus is being investigated in regimens where reduced exposure CNIs are used from the initial post-transplant period to improve renal function and prevent CAN. By inhibiting the proliferation of smooth muscle cells, everolimus may itself delay the progression or development of CAN. Although everolimus is associated with specific side effects, these can generally be managed. By targeting the main causes of short- and long-term graft loss, everolimus has a key role to play in renal transplantation, which is being explored further in a number of ongoing Phase III–IV trials.Keywords: calcineurin inhibitors, chronic allograft nephropathy, cyclosporine, everolimus, renal function, renal transplantation

  15. THE RELATIONSHIP OF THE CHRONIC RENAL FAILURE WITH CAROTID ARTERY CALCIFICATIONS, DENTAL PULP CALCIFICATIONS AND DENTAL PULP STONES

    OpenAIRE

    DAĞISTAN, Saadettin; MİLOĞLU, Özkan

    2015-01-01

    ABSTRACT Objective: The aim of this study was to investigate the existence of carotid artery calcifications in dental panoramic radiographs and dental pulp calcifications together with dental pulp stones in periapical radiographs in patients with chronic renal failure undergoing haemodialysis and healthy individuals, and to identify the relationship between the two groups.Patients and methods: A total of 115 cases (57 patients on haemodialysis for chronic renal failure and 58 healthy individu...

  16. Predictive models for chronic renal disease using decision trees, naïve bayes and case-based methods

    OpenAIRE

    Khan, Saqib Hussain

    2010-01-01

    Data mining can be used in healthcare industry to “mine” clinical data to discover hidden information for intelligent and affective decision making. Discovery of hidden patterns and relationships often goes intact, yet advanced data mining techniques can be helpful as remedy to this scenario. This thesis mainly deals with Intelligent Prediction of Chronic Renal Disease (IPCRD). Data covers blood, urine test, and external symptoms applied to predict chronic renal disease. Data from the databas...

  17. [Determinants of vascular wall stiffness in patients with chronic renal disease undergoing hemodialysis].

    Science.gov (United States)

    Kharlamova, U V; Il'icheva, O E

    2012-01-01

    Examination of 109 patients with chronic renal disease undergoing hemodialysis revealed significant impairment of arterial wall distensibility (accordingly, decreased Peterson's and Young's elastic moduli, distensibility coefficient). The relative thickness of the common carotid artery and pulse wave velocity were significantly greater than in practically healthy subjects. Independent factors influencing arterial wall rigidity included age, arterial pressure, total cholesterol and homocystein, stable metabolites of nitric oxide, creatinine, calcium, phosphorus levels, calcium x phosphorus product, duration of hemodialysis, interdialytic weight gain. PMID:23516853

  18. ELEVATION OF SERUM POTASSIUM AND ITS OUTCOME IN CHRONIC RENAL FAILURE PATIENTS

    OpenAIRE

    Punam Yadav; Dinkar Malik; Sandeep Kumar; Vijai Malik

    2014-01-01

    Potassium is the principal metallic ion inside the cells. During physical activity potassium ion leaves muscle cells and this leads to fatigue. When aldosteron instructs the kidney to retain sodium ion, they generally excrete more potassium ion. The kidneys are the principal organ of excretion for potassium, not only potassium is filtered by the kidneys in the glomeruli but it is also secreted by the tubules. Chronic renal failure does not cause severe or progressive hyperkala...

  19. Upper Digestive Endoscopic Findings in Patients with Chronic Renal Insufficiency in Phase of Dialysis

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    Marcos Félix Osorio Pagola

    2009-12-01

    Full Text Available Background: Patients with chronic renal insufficiency in phase of dialysis present clinical manifestations that can include different symptoms. Morbidity due to gastric, esophageal and duodenal disturbances is significant and constitutes a considerable risk before, while and after a renal transplant. Objective: To identify the most frequent disturbances of the upper digestive tract in patients with chronic renal insufficiency who require dialysis. Methods: An observational, descriptive and retrospective study was carried out in this search. The universe was composed by all the patients with a diagnosis of chronic renal insufficiency in a dialysis phase, who had been included in the Hemodialysis Program at the University Hospital “Dr. Gustavo Aldereguía Lima” from Cienfuegos and who had undergone an upper digestive endoscopy from January to May, 2008. The patient’s health record was studied to get information for the variables under study. Results: the average age was 46,7 years and the most affected patients were males. The mean value for serum creatinine was 929,7 mMol/L, for serum urea 21,4 mMol/L and for hemoglobin 8,4 g/L. The most frequent cause of chronic nephropathy was High Blood Pressure in 25 patients (56,8 %, followed by Diabetes Mellitus in 9 patients (20,5 %. 52,3 % of the patients were asymptomatic, but the most frequent symptoms reported by the patients were flatulence (25 % and nausea (15,9 %. Endoscopy revealed normal results in most of the patients (40,9 %. Conclusions: Antral erythematous endoscopic gastritis was the most frequent endoscopic diagnosis followed by duodenal ulcer

  20. Early oxidative change in low density lipoproteins during progressive chronic renal failure

    OpenAIRE

    Sasikala, M.; Subramanyam, C.; Sadasivudu, B.

    1999-01-01

    Modified low density lipoproteins (LDL), including their oxidized forms, have been widely implicated in the etiology of atherosclerosis and concomitant cardiovascular disease (CVD) in chronic renal failure (CRF). The nature of events that lead to oxidative changes in LDL proteins are not clearly understood. Thus, patients suffering from CRF were grouped into mild, moderate and severe categories based on their blood urea and serum creatinine levels. Progression of CRF was accompanied not only ...

  1. Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

    OpenAIRE

    Hawash, Yousry A.; Laila Sh. Dorgham; Amir, El-Amir M.; Sharaf, Osama F.

    2015-01-01

    It has been hypothesized that chronic renal failure (CRF) predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases) from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were colle...

  2. Accumulation of Scandium in Plasma in Patients with Chronic Renal Failure

    OpenAIRE

    Cristina Sánchez-González; Carlos López-Chaves; Lorenzo Rivas-García; Pilar Galindo; Jorge Gómez-Aracena; Pilar Aranda; Juan Llopis

    2013-01-01

    Scandium (Sc) is an element with many industrial applications, but relatively little is known about its physiological and/or toxicological effects, and very little data are available concerning the role of Sc in chronic renal failure (CRF). This paper examines the changes in plasma levels of Sc in predialysis patients with CRF and the relationship with blood parameters. The participants in this trial were 48 patients with CRF in predialysis and 53 healthy controls. Erythrocyte, haemoglobin, a...

  3. HEARING LOSS IN CHRONIC RENAL FAILURE - AN ASSESSMENT OF MULTIPLE AETIOLOGICAL FACTORS

    OpenAIRE

    Suja Sreedharan; Vishnu Prasad; Jayashree Bhatt; Mahesh Chandra Hegde; Salil Agarwal; Cherukattil Waheeda

    2015-01-01

    Introduction: Sensorineural hearing loss in chronic renal failure is believed to be of multifactorial etiology. Associated hypertension and diabetes mellitus, use of ototoxic drugs, hemodialysis and the changes in metabolic parameters are the various reasons quoted for the hearing loss. Objectives: Our study attempts to correlate the hearing thresholds with the multiple parameters like blood levels of urea, serum creatinine, sodium, potassium, calcium and hemoglobin values incriminated in...

  4. Effects of Sodium Citrate on Salt Sensitivity and Kidney Injury in Chronic Renal Failure

    OpenAIRE

    Kim, Sejoong; Yang, Jin Young; Jung, Eun Sook; Lee, Jeonghwan; Heo, Nam Ju; Lee, Jae Wook; Na, Ki Young; Han, Jin Suk

    2014-01-01

    Metabolic acidosis, which is observed in salt-sensitive hypertension, is also associated with kidney injury. Alkali therapy in chronic renal failure (CRF) may ameliorate the progression of kidney disease; however, few studies have examined the effects of alkali therapy on salt sensitivity and kidney injury in CRF. We randomly administered standard diet (SD), sodium chloride with 20% casein diet (NACL), or sodium citrate with 20% casein diet (NACT) to Sprague-Dawley rats after a CRF or a sham ...

  5. Tentorial and dural calcification with tertiary hyperparathyroidism: a rare entity in chronic renal failure

    International Nuclear Information System (INIS)

    A case of rare calcification of the tentorium cerebelli, the thoracal dura mater of the spine, and the sclera in an adult male patient with tertiary hyperparathyroidism is presented. The often reported feature in the skull is that of a combination of osteopenia and osteosclerosis giving a granular bone texture. Extensive dura calcification with this condition has very rarely been reported. It is the aim of this paper to document the latter in a patient with chronic renal failure and tertiary hyperparathyroidism. (orig.)

  6. Effects of chronic renal failure on protein synthesis and albumin messenger ribonucleic acid in rat liver.

    OpenAIRE

    Zern, M A; Yap, S.H.; Strair, R K; Kaysen, G A; Shafritz, D A

    1984-01-01

    Previously we reported that chronic renal failure in rats leads to preferential disaggregation of liver membrane-bound polysomes associated with a decrease in albumin synthesis. To determine whether reduced albumin synthesis results from reduced cellular levels of albumin messenger RNA (mRNA) or some other molecular mechanism, we have employed mRNA-DNA hybridization in conjunction with cell-free protein synthesis to determine albumin mRNA sequence content and biological activity in subcellula...

  7. Erythropoietin production in renal cell carcinoma and renal cysts in autosomal dominant polycystic kidney disease in a chronic dialysis patient with polycythemia: A case report

    OpenAIRE

    Ito, Keiichi; Asano, Takako; TOMINAGA, SUSUMU; Yoshii, Hidehiko; SAWAZAKI, HARUTAKE; ASANO, TOMOHIKO

    2014-01-01

    In patients undergoing chronic hemodialysis (HD), erythropoietin (EPO) production from the kidney generally decreases and renal anemia develops. Patients without anemia, but with high serum EPO (sEPO) levels are rare among HD patients. The current study presents the case of a 67-year-old female HD patient with autosomal dominant polycystic kidney disease (ADPKD) and renal cell carcinoma (RCC), manifesting polycythemia with elevated sEPO levels. A radical nephrectomy was performed, which dimin...

  8. Pandigital and subcutaneous chronic tophaceous gout with acute renal failure

    Directory of Open Access Journals (Sweden)

    J Shashibhushan

    2015-01-01

    Full Text Available Gout (Podagra is a disorder of purine metabolism characterized by the deposition of monosodium urate crystals in joints and connective tissue and risk of deposition in kidney interstitium. Although acute gouty arthritis is familiar for most physicians, chronic gouty arthritis, which affects small joints of the hands can be difficult to distinguish from other common interphalangeal arthropathies such as rheumatoid arthritis (RA, psoriatic arthritis, and erosive osteoarthritis because of very similar presentations. Here we describe a 60-year-old male diabetic patient with pandigital, extensive subcutaneous tophaceous gout presented with uremic encephalopathy and joint deformities. He had been treated mistakenly as RA for 10 years.

  9. Effects of olmesartan on arterial stiffness in rats with chronic renal failure

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    Chuang Yao-Chen

    2012-06-01

    Full Text Available Abstract Background It has been suggested that the antioxidant properties of olmesartan (OLM, an angiotensin II type 1 receptor (AT1R blocker, contribute to renal protection rather than blood pressure lowering effects despite the fact that causal relationships between hypertension and renal artery disease exist. This study aimed to examine the hypothesis whether the antioxidative activities of OLM were correlated to arterial stiffness, reactive oxygen species and advanced glycation end products (AGEs formation in rats with chronic renal failure (CRF. Methods CRF rats were induced by 5/6 nephrectomy and randomly assigned to an OLM (10 mg/day group or a control group. Hemodynamic states, oxidative stress, renal function and AGEs were measured after 8 weeks of OLM treatment. Results All the hemodynamic derangements associated with renal and cardiovascular dysfunctions were abrogated in CRF rats receiving OLM. Decreased cardiac output was normalized compared to control (p p p p p p p  Conclusion OLM treatment could ameliorate arterial stiffness in CRF rats with concomitant inhibition of MDA and AGEs levels through the reduction of oxidative stress in aortic wall.

  10. Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qinghai; Li, Jinning; Zhang, Lan; Chen, Ying; Zhang, Minming [Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009 (China); Yan, Fuhua, E-mail: zemylife@163.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China)

    2014-05-15

    Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal–Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r = −0.633, P < 0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F = 19.512, P < 0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ{sup 2} = 9.929, P = 0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t = −4.586, P = 0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up.

  11. Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal–Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r = −0.633, P < 0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F = 19.512, P < 0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ2 = 9.929, P = 0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t = −4.586, P = 0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up

  12. Variations in the lipid profile of patients with chronic renal failure treated with pyridoxine

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    Touceda Luis A

    2003-09-01

    Full Text Available Abstract Background Hyperhomocysteinemia and lipid abnormalities are commonly found in patients with chronic renal failure; both are recognized as risk factors for atherosclerosis. The homocysteine-lowering effect of pyridoxine is controversial. This study was performed to determine the effect of a high dose of pyridoxine (300 mg i.v. three times a week on plasma and red blood cell lipid profile and plasma homocysteine concentration in twelve chronic renal failure patients on regular hemodialysis. Fasting blood samples were taken at the beginning of the study (basal 1, after 30 and 60 days of treatment and 4 months after withdrawal (basal 2. Results Pyridoxine supplementation induced a significant decrease in total plasma homocysteine level and also a lowering effect in plasma total cholesterol and triglycerides. These biochemical data increased when the samples were taken at basal 2, reaching the levels obtained at the beginning of the experiment. LDL cholesterol increased whereas HDL cholesterol was reduced during the treatment. In erythrocyte membranes vitamin B6 therapy enhanced the cholesterol/phospholipid ratio as well as the fluorescence anisotropy of diphenyl-hexatriene. Conclusions We conclude that high doses of pyridoxine represent an effective strategy to ameliorate both plasma homocysteine levels and lipid profiles in chronic renal failure patients, protecting them from atherosclerosis. Further research using a long-term treatment would be necessary in an attempt to restore the fatty acid pattern and the fluidity of red cell membranes.

  13. Developmental Origins of Chronic Renal Disease: An Integrative Hypothesis

    Directory of Open Access Journals (Sweden)

    F. Boubred

    2013-01-01

    Full Text Available Cardiovascular diseases are one of the leading causes of mortality. Hypertension (HT is one of the principal risk factors associated with death. Chronic kidney disease (CKD, which is probably underestimated, increases the risk and the severity of adverse cardiovascular events. It is now recognized that low birth weight is a risk factor for these diseases, and this relationship is amplified by a rapid catch-up growth or overfeeding during infancy or childhood. The pathophysiological and molecular mechanisms involved in the “early programming” of CKD are multiple and partially understood. It has been proposed that the developmental programming of arterial hypertension and chronic kidney disease is related to a reduced nephron endowment. However, this mechanism is still discussed. This review discusses the complex relationship between birth weight and nephron endowment and how early growth and nutrition influence long term HT and CKD. We hypothesize that fetal environment reduces moderately the nephron number which appears insufficient by itself to induce long term diseases. Reduced nephron number constitutes a “factor of vulnerability” when additional factors, in particular a rapid postnatal growth or overfeeding, promote the early onset of diseases through a complex combination of various pathophysiological pathways.

  14. Comparative study on second harmonic contrast imaging with power Doppler sonography for quantification of the renal allografts microcirculation%二次谐波声学造影与多普勒能量图对移植肾血流灌注的对比研究

    Institute of Scientific and Technical Information of China (English)

    王新明; 牟善初; 周桂芳; 敖建华

    2000-01-01

    Objective To assess the value of second harmonic contrast imaging(SHCI) in identifying viable the renal allografts blood flow perfusion in microcirculation.Methods Blood flow perfusion of thirty-six patients with renal allografts,included 6 renal allografts defeat,age range 20~61 years,were investigated by power Doppler imaging(PDI) and SHCI.The intravenous injection of agent was SHU-508A,and compared with pre-injection by quantitative assessment of acoustic densitometry (AD) of SHCI for the renal microstructure.Results There were sigllificant differences in the peak intensity,the area under the curve and the half-time of wash-out between pre-injection and injection contrast agent.The wash-in and wash-out curve showed the mountain peak shape.AD in the renal allografts with acute rejection was significantly lower than that in the control group(P<0.05).No contrast opacification of renal microstructure was present in 6 renal allografts defeat and the wash-in and wash-out curve appeared the straight line shape.Conclusions SHCI is a safe,efficient technology for assessing blood flow perfusion of renal allografts,which is different form the Doppler ultrasound and may prove a more sensitive indicator of allograft complication than PDI.%目的 谐波声学造影(SHCI)与声学定量(AD)和多普勒能量图成像(PDI)相对比,探讨SHCI对移植肾灌注诊断的价值.方法 对术后10 d内36例移植肾脏应用PDI和SHCI进行对比分析.结果 6例移植术失败者,灌注一清除曲线呈平直状,AD值无改变.其余病例造影剂灌注区的灌注-清除曲线均呈山峰状,峰值密度(PD)、灌注曲线下面积(AUC)、降支减半时间(HT)均较造影前显著增高(P<0.05),视觉判断差异有显著性.灌注不良区呈充盈缺损,AD值低,与正常区和正常移植肾比较差异有显著性(P<0.05),SHCI与PDI比较肾皮质灌注显像差异有显著性(P<0.05).结论 ①移植肾排异反应区灌注不良,AD值低;②SHCI在诊断肾皮质灌

  15. HLA-E(⁎)01:03 Allele in Lung Transplant Recipients Correlates with Higher Chronic Lung Allograft Dysfunction Occurrence.

    Science.gov (United States)

    Di Cristofaro, Julie; Pelardy, Mathieu; Loundou, Anderson; Basire, Agnès; Gomez, Carine; Chiaroni, Jacques; Thomas, Pascal; Reynaud-Gaubert, Martine; Picard, Christophe

    2016-01-01

    Lung transplantation (LTx) is a valid therapeutic option for selected patients with end-stage lung disease. HLA-E seems to play a major role in the immune response to different viral infections and to affect transplantation outcome, in Hematopoietic Stem Cell Transplantation, for example. Two nonsynonymous alleles, HLA-E(⁎)01:01 and HLA-E(⁎)01:03, have functional differences, involving relative peptide affinity, cell surface expression, and potential lytic activity of NK cells. The aim of this retrospective study was to determine the impact of these two alleles for LTx recipients on anti-HLA alloimmunization risk, overall survival, and chronic rejection (CLAD). HLA-E was genotyped in 119 recipients who underwent LTx from 1998 to 2010 in a single transplantation center. In univariate analysis, both HLA-E homozygous states were associated with impaired overall survival compared to heterozygous HLA-E alleles (p = 0.01). In multivariate analysis, HLA-E(⁎)01:03 allele showed increased CLAD occurrence when compared to homozygous HLA-E(⁎)01:01 status (HR: 3.563 (CI 95%, 1.016-12), p = 0.047). HLA-E allele did not affect pathogen infection or the production of de novo DSA. This retrospective study shows an uninvestigated, deleterious association of HLA-E alleles with LTx and requires verification using a larger cohort. PMID:27493971

  16. HLA-E⁎01:03 Allele in Lung Transplant Recipients Correlates with Higher Chronic Lung Allograft Dysfunction Occurrence

    Directory of Open Access Journals (Sweden)

    Julie Di Cristofaro

    2016-01-01

    Full Text Available Lung transplantation (LTx is a valid therapeutic option for selected patients with end-stage lung disease. HLA-E seems to play a major role in the immune response to different viral infections and to affect transplantation outcome, in Hematopoietic Stem Cell Transplantation, for example. Two nonsynonymous alleles, HLA-E⁎01:01 and HLA-E⁎01:03, have functional differences, involving relative peptide affinity, cell surface expression, and potential lytic activity of NK cells. The aim of this retrospective study was to determine the impact of these two alleles for LTx recipients on anti-HLA alloimmunization risk, overall survival, and chronic rejection (CLAD. HLA-E was genotyped in 119 recipients who underwent LTx from 1998 to 2010 in a single transplantation center. In univariate analysis, both HLA-E homozygous states were associated with impaired overall survival compared to heterozygous HLA-E alleles (p=0.01. In multivariate analysis, HLA-E⁎01:03 allele showed increased CLAD occurrence when compared to homozygous HLA-E⁎01:01 status (HR: 3.563 (CI 95%, 1.016–12, p=0.047. HLA-E allele did not affect pathogen infection or the production of de novo DSA. This retrospective study shows an uninvestigated, deleterious association of HLA-E alleles with LTx and requires verification using a larger cohort.

  17. Oro-dental health in children with chronic renal failure and after renal transplantation: a clinical review.

    Science.gov (United States)

    Lucas, Victoria S; Roberts, Graham J

    2005-10-01

    As a consequence of chronic renal failure (CRF) and its treatment, a number of oro-dental changes occur that persist after the end-stage is reached. An early effect is enamel hypoplasia due to a defect of enamel development and mineralisation. This is usually reparable to a high aesthetic standard using dental composite filling material. Children with CRF have significantly less dental caries than healthy children due to the inhibitory effect of increased salivary urea levels. Grafted patients frequently develop gingival enlargement as a result of immunosuppression with cyclosporine A, which is further exacerbated by the additional use of antihypertensive calcium-blocking agents. Surgical reduction of gingival hyperplasia is effective and is required in approximately one third of adolescents. A very high standard of home care should be encouraged for all children with CRF in the form of thorough mechanical tooth cleaning and plaque inhibition through the use of an antibacterial mouthwash. In transplanted children presenting an increased risk of infection, antibiotic prophylaxis may be indicated for dental treatment procedures. The drug dosage should be adapted to the reduced renal function. Pediatric nephrologists should be aware that dental surgeons can make a considerable contribution to the general health and well-being of children with CRF. Thus, only oro-dental problems that are mainly encountered and treated by dental surgeons are reviewed. PMID:15947987

  18. Failure of renal dopamine response to salt loading in chronic renal disease.

    OpenAIRE

    Casson, I. F.; Lee, M R; Brownjohn, A. M.; Parsons, F M; Davison, A. M.; Will, E J; Clayden, A D

    1983-01-01

    Eight patients with chronic glomerulonephritis and five age-matched normal volunteers were given additional sodium chloride by mouth under conditions of metabolic balance. Whereas in the normal volunteers plasma renin activity was suppressed and urinary excretion of free dopamine increased, in the patients dopamine was not mobilised and plasma renin activity was not completely suppressed. Abnormal retention of sodium and water in glomerulonephritis may be due partly to a failure to mobilise d...

  19. LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS

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    E.S. Stolyarevich

    2014-01-01

    Full Text Available Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation allograft dysfunction caused by late acute rejection (LAR, n = 193 or chronic rejection (CR, n = 78 or both (n = 23. C4d staining was performed by immunofl uorescence (IF on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy. 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01 better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d− was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%. Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection. 

  20. Dynamic magnetic resonance imaging in the assessment of chronic medical nephropathies with impaired renal function

    Energy Technology Data Exchange (ETDEWEB)

    Dalla-Palma, L.; Pozzi-Mucelli, R.S.; Cova, M.; Meduri, S. [Dept. of Radiology, University of Trieste (Italy); Panzetta, G.; Galli, G. [Hemodialysis Service, Ospedale Maggiore, Trieste (Italy)

    2000-02-01

    We examined the value of dynamic magnetic resonance imaging (MRI) in chronic renal disease with renal insufficiency. In 33 consecutive patients (21 vascular nephropathy, 12 glomerular nephropathy) MRI was performed using a 1.5-T unit and a body coil, with SE T1-weighted (TR/TE = 600/19 ms) and dynamic TFFE T1-weighted sequences (TR/TE = 12/5 ms, flip angle = 25 ) after manual bolus injection (via a cubital vein) of 0.1 mmol/kg Gd-DTPA-BMA. Morphological evaluation was performed in unblinded fashion by three radiologists, evaluating renal size, cortical thickness, and corticomedullary differentiation. Functional analysis was performed by one reviewer. Time-signal intensity curves, peak intensity value (P), time to peak intensity (T), and the P/T ratio were obtained at the cortex, medulla, and pyelocaliceal system of each kidney. The relationship of these parameters to serum creatinine and with creatinine clearance was investigated. A good correlation between morphological features of the kidneys and serum creatinine values was found. Morphological findings could not distinguish between vascular and glomerular nephropathies. A statistically significant correlation (P <0.01) between cortical P, cortical P/T, medullary P, and serum creatinine and creatinine clearance was found. A significant correlation (P <0.01) was also found between cortical T, medullary P/T, T of the excretory system, and creatinine clearance. The cortical T value was significantly higher (P <0.01) in vascular nephropathy than in glomerular nephropathy. Thus in patients with chronic renal failure dynamic MRI shows both morphological and functional changes. Morphological changes are correlated with the degree of renal insufficiency and not with the type of nephropathy; the functional changes seem to differ in vascular from glomerular nephropathies. (orig.)

  1. Acute cytomegalovirus infection induces a subendothelial inflammation (endothelialitis) in the allograft vascular wall. A possible linkage with enhanced allograft arteriosclerosis.

    OpenAIRE

    Koskinen, P.; Lemström, K.; Bruggeman, C; Lautenschlager, I.; Häyry, P

    1994-01-01

    Clinical and experimental studies have established the accelerating role of cytomegalovirus (CMV) infection on cardiac allograft arteriosclerosis, ie, chronic rejection. We have investigated the mechanisms behind the interaction between CMV infection and chronic rejection. In the first part of the study, 762 endomyocardial biopsy specimens obtained from 47 heart allograft recipients were analyzed. Of these, 28 patients developed CMV infection during the first postoperative year. In 24 of 28 C...

  2. Chronic sleep restriction during pregnancy--repercussion on cardiovascular and renal functioning of male offspring.

    Directory of Open Access Journals (Sweden)

    Ingrid L B Lima

    Full Text Available Changes in the maternal environment can induce fetal adaptations that result in the progression of chronic diseases in the offspring. The objective of the present study was to evaluate the effects of maternal chronic sleep restriction on blood pressure, renal function and cardiac baroreflex response on male offspring at adult age. Female 3-month-old Wistar rats were divided in two experimental groups: control (C and chronic sleep restricted (CSR. Pregnancy was confirmed by vaginal smear. Chronic sleep restricted females were subjected to sleep restriction by the multiple platform technique for 20 h daily, between the 1st and 20th day of pregnancy. After birth, the litters were reduced to 6 rats per mother, and were designated as offspring from control (OC and offspring from chronic sleep restricted (OCSR. Indirect blood pressure (BPi - tail cuff was measured by plethysmography in male offspring at 3 months old. Following, the renal function and cardiac baroreflex response were analyzed. Values of BPi in OCSR were significantly higher compared to OC [OC: 127 ± 2.6 (19; OCSR: 144 ± 2.5 (17 mmHg]. The baroreflex sensitivity to the increase of blood pressure was reduced in OCSR [Slope: OC: -2.6 ± 0.15 (9; OCRS: -1.6 ± 0.13 (9]. Hypothalamic activity of ACE2 was significantly reduced in OCSR compared to OC [OC: 97.4 ± 15 (18; OSR: 60.2 ± 3.6 (16 UAF/min/protein mg]. Renal function alteration was noticed by the increase in glomerular filtration rate (GFR observed in OCSR [OC: 6.4 ± 0.2 (10; OCSR: 7.4 ± 0.3 (7]. Chronic sleep restriction during pregnancy caused in the offspring hypertension, altered cardiac baroreflex response, reduced ACE-2 activity in the hypothalamus and renal alterations. Our data suggest that the reduction of sleeping time along the pregnancy is able to modify maternal homeostasis leading to functional alterations in offspring.

  3. SONOGRAPHIC GRADING OF RENAL CORTICAL ECHOGENICITY AND RAISED SERUM CREATININE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

    Directory of Open Access Journals (Sweden)

    Arvinder

    2016-05-01

    Full Text Available BACKGROUND Chronic Kidney Disease (CKD is a worldwide public health problem and the world’s 12th commonest cause of mortality and 17th cause of morbidity. The approximate prevalence of CKD in India is 800 with an incidence of about 150-200 per million population. The most common cause of CKD is diabetic nephropathy. PURPOSE OF STUDY The purpose was to study various renal sonographic changes in patients with chronic kidney disease and to correlate renal length, parenchymal thickness, cortical thickness and echogenicity of the kidney with serum creatinine levels. MATERIAL AND METHODS The study was conducted on hundred patients in the Department of Radiodiagnosis and Imaging, Government Medical College, Amritsar, from August 2013 to October 2015. Patients were subjected to sonographic examination on Philips Envisor C Ultrasound machine/Toshiba ultrasound machine model–SSA. 510A/Esaote ultrasound machines using curvilinear probe of 3.5 MHz - 5 MHz or linear high frequency probe 7-12 MHz. Ultrasound of kidneys for renal length, parenchymal thickness, cortical thickness and cortical echogenicity was performed. The mean values of both kidneys were calculated from length, parenchymal thickness and cortical echogenicity. These parameters were compared with serum creatinine. Statistical analysis was performed using one-way ANOVA. RESULTS AND CONCLUSIONS The grade of renal disease was determined by cortical echogenicity with Grade 1 mild form, Grade 2 moderate and Grade 3 severe form and Grade 4 as end-stage renal disease. The mean serum creatinine was 2.87 mg/dL for Grade 1, 3.27 mg/dL for Grade 2, 4.3 mg/dL for Grade 3 and 5.8 mg/dL for Grade 4. No correlation was observed between renal length, parenchymal thickness and cortical thickness with serum creatinine levels. The grading of renal echogenicity on sonography correlated well with serum creatinine in CKD than any other sonographic parameters with a statistically significant positive correlation

  4. Quantitative study of Indium-111-oxine platelet kinetics in acute and chronic renal transplant rejection

    Energy Technology Data Exchange (ETDEWEB)

    Heyns, A.duP.; Pieters, H.; Badenhorst, P.N.; Wessels, P.; Loetter, M.G.; Minnaar, P.C.; Pauw, F.H.

    1982-01-01

    Thirteen patients were investigated on 22 occasions at times varying from 1 day to 10 years after living family donor or cadaver renal transplantation. Platelet survival in the circulation, and in vivo platelet distribution and sites of deposition and sequestration was quantitatively determined with Indium-111-oxine (In-111-oxine) labelled platelets and a scintillation camera interfaced with a computer assisted imaging system. In all patients platelet survival was shortened and the platelet survival curve exponential. In patients with no evidence of transplant rejection and those with chronic rejection, there was no measurable or visible accumulation of labelled platelets in the kidney. The sequestration pattern of In-111 labelled platelets at the end of platelet life span was within normal limits and located in the reticuloendothelial system. In those patients with acute transplant rejection, platelet survival was shortened. Labelled platelets accumulated in the kidney: this was clearly visualized on scintigraphy and reflected by a significant increase in the radioactivity count density of the kidney. Platelets not deposited in the transplant were sequestrated in the reticuloendothelial system. This study demonstrates the diagnostic value of In-111 labelled platelet kinetics in the investigation of acute renal failure after renal transplantation. This investigation appears of limited clinical value in chronic rejection.

  5. A quantitative study of Indium-111-oxine platelet kinetics in acute and chronic renal transplant rejection

    International Nuclear Information System (INIS)

    Thirteen patients were investigated on 22 occasions at times varying from 1 day to 10 years after living family donor or cadaver renal transplantation. Platelet survival in the circulation, and in vivo platelet distribution and sites of deposition and sequestration was quantitatively determined with Indium-111-oxine (In-111-oxine) labelled platelets and a scintillation camera interfaced with a computer assisted imaging system. In all patients platelet survival was shortened and the platelet survival curve exponential. In patients with no evidence of transplant rejection and those with chronic rejection, there was no measurable or visible accumulation of labelled platelets in the kidney. The sequestration pattern of In-111 labelled platelets at the end of platelet life span was within normal limits and located in the reticuloendothelial system. In those patients with acute transplant rejection, platelet survival was shortened. Labelled platelets accumulated in the kidney: this was clearly visualized on scintigraphy and reflected by a significant increase in the radioactivity count density of the kidney. Platelets not deposited in the transplant were sequestrated in the reticuloendothelial system. This study demonstrates the diagnostic value of In-111 labelled platelet kinetics in the investigation of acute renal failure after renal transplantation. This investigation appears of limited clinical value in chronic rejection. (orig.)

  6. Effect of Heme Oxygenase-1 Inducer Hemin on Chronic Renal Failure Rats

    Institute of Scientific and Technical Information of China (English)

    刘慎微; 石黎明; 刘晓城

    2004-01-01

    Summary: The role of HO 1 inducer, hemin, in chronic renal failure (CRF) rats and its possible mechanism of action was studied. 5/6 subtotal nephrectomy was performed to establish chronic renal failure model. Rats were randomly assigned to 4 groups: sham-operated group, CRF group,ferrous gluconate group and hemin group. At the 10th week after operation, serum creatinine,BUN, RBC, HGB and HCT were measured. Renal pathologic changes were observed. RT-PCR and immunohistochemistry were used to detect the expression and distribution of HO-1. RT-PCR and radioimmunoassay was used to determine the expression of ET-1 in the kidney and plasma. The results showed that as compared with CRF group, serum creatinine and BUN in hemin group were reduced significantly and nephrogenic anemia was improved markedly. Glomerular mesangial proliferation and interstitial lesion were also ameliorated significantly. Hemin not only increased the expression of HO-1 but also reduced the expression of ET-1 in the kidney. The level of ET-1 protein in the plasma was also reduced after hemin treatment. Most of these indexes were not obviously changed in ferrous gluconate group. It was suggested that through inducing the expression of HO-1 and reducing the level of ET-1 in the kidney and plasma, hemin plays an important protective role in 5/6 subtotal nephrectomized rats.

  7. Inhibition of lysosomal protease cathepsin D reduces renal fibrosis in murine chronic kidney disease.

    Science.gov (United States)

    Fox, Christopher; Cocchiaro, Pasquale; Oakley, Fiona; Howarth, Rachel; Callaghan, Krystena; Leslie, Jack; Luli, Saimir; Wood, Katrina M; Genovese, Federica; Sheerin, Neil S; Moles, Anna

    2016-01-01

    During chronic kidney disease (CKD) there is a dysregulation of extracellular matrix (ECM) homeostasis leading to renal fibrosis. Lysosomal proteases such as cathepsins (Cts) regulate this process in other organs, however, their role in CKD is still unknown. Here we describe a novel role for cathepsins in CKD. CtsD and B were located in distal and proximal tubular cells respectively in human disease. Administration of CtsD (Pepstatin A) but not B inhibitor (Ca074-Me), in two mouse CKD models, UUO and chronic ischemia reperfusion injury, led to a reduction in fibrosis. No changes in collagen transcription or myofibroblasts numbers were observed. Pepstatin A administration resulted in increased extracellular urokinase and collagen degradation. In vitro and in vivo administration of chloroquine, an endo/lysosomal inhibitor, mimicked Pepstatin A effect on renal fibrosis. Therefore, we propose a mechanism by which CtsD inhibition leads to increased collagenolytic activity due to an impairment in lysosomal recycling. This results in increased extracellular activity of enzymes such as urokinase, triggering a proteolytic cascade, which culminates in more ECM degradation. Taken together these results suggest that inhibition of lysosomal proteases, such as CtsD, could be a new therapeutic approach to reduce renal fibrosis and slow progression of CKD. PMID:26831567

  8. Biodegradable Magnesium (Mg) Implantation Does Not Impose Related Metabolic Disorders in Rats with Chronic Renal Failure

    Science.gov (United States)

    Wang, Jiali; Xu, Jiankun; Liu, Waiching; Li, Yangde; Qin, Ling

    2016-05-01

    Mg and its alloys have been considered as one of the most promising biodegradable medical devices, but it was still unclear whether hypermagnesemia involved health risks would occur in persons with kidney disease due to their deteriorated kidney function for Mg ions excretion from their body. In this study, we established a chronic renal failure (CRF) model in rats induced by adenine administration prior to Mg implantation, aiming to predict if CRF patients are suitable for the use of Mg implants. The results showed that Mg levels in serum, urine, feces and internal organs had no significant changes after Mg implantation for both normal and CRF rats. Biochemical indices detection and histopathological analysis in kidney, liver and heart tissue confirmed that Mg implants did not induce any extra damage in animals even with renal failure. Our study indicates that Mg based orthopaedic medical device may be considered for use in CRF patients without biosafety concerns.

  9. Clinical significance of determination of plasma homocysteine (HCY) levels in chronic renal failure patients on hemodialysis

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between the plasma homocysteine (HCY) level and the development of cardio-vascular complication in chronic renal failure (CRF) patients on hemodialysis. Methods: Plasma HCY levels were measured in 38 renal failure patients on hemodialysis both before and after 8 weeks oral administration of folic acid (5 mg tid) and VitB12 (500 μg tid) as well as in 40 controls. Results: The plasma levels of HCY in CRF patients on dialysis before taking folic acid and VitB12 (25.12 ± 12.51 μmol/L) were significantly higher than those in controls (8.2 ± 4.5 μmol/L) (P12 were significantly lowered (13.2 ± 5.74 μmol/L, vs before treatment, P12 might be beneficial in lessening the complications. (authors)

  10. The influence of angiotensin-converting enzyme inhibition on renal tubular function in progressive chronic nephropathy

    DEFF Research Database (Denmark)

    Kamper, A L; Holstein-Rathlou, N H; Leyssac, P P; Strandgaard, S

    1996-01-01

    The influence of angiotensin-converting enzyme (ACE) inhibition on renal tubular function in progressive chronic nephropathy was investigated in 69 patients by the lithium clearance (C(Li)) method. Studies were done repeatedly for up to 2 years during a controlled trial on the effect of enalapril...... on progression of renal failure. The pattern of proteinuria was followed over the first 9 months. At baseline, the glomerular filtration rate (GFR) was 5 to 68 mL/min. Absolute proximal tubular reabsorption rate of fluid (APR), estimated as the difference between GFR and C(Li), was 1 to 54 m......L/min. Calculated fractional proximal reabsorption (FPR) was moderately subnormal. During the study, GFR decreased and sodium clearance was unchanged; fractional excretion of sodium therefore increased. In the group of patients randomized to treatment with enalapril (n = 34), GFR at 1 month was 83% (P < 0.001) and...

  11. Effect of trimethoprim on serum creatinine in healthy and chronic renal failure volunteers.

    Science.gov (United States)

    Myre, S A; McCann, J; First, M R; Cluxton, R J

    1987-06-01

    The effect of trimethoprim (TMP) on serum creatinine concentration (SCr) was studied in 10 healthy (H) subjects and nine subjects with chronic renal failure (CRF). Each volunteer was given TMP 100 mg perorally every 12 h for 10 days followed by a 7-day washout period. SCr was measured colorimetrically immediately before the study (baseline), on day 10 of TMP, and 7 days after TMP had been discontinued. SCr increased an average of 14.8% from baseline during TMP administration in the H volunteers, but this increase was not statistically significant. During TMP administration to the CRF volunteers, a pronounced elevation (34.6%) of mean SCr from baseline was observed (p less than 0.05). SCr returned to baseline values in both groups following the 7-day washout period. These results are consistent with the hypothesis that TMP competitively inhibits the renal tubular secretion of creatinine. PMID:3617154

  12. Dysregulation of apoptosis: a possible mechanism leading to chronic progressive renal histological changes in lupus nephritis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To evakuate apoptosis in lupus nephritis and the relationship between the existence of apoptotic cells in renal tissue and histopathological or clinical changes. Methods Apoptosis was detected by in situ nick-end labeling techniques (TUNEL) in renal biopsies from 25 patients with type Ⅳ lupus nephritis (LN),12 patientswith lgA nephropathy lgAN, 4 patients with idiopathic easangnioproliferative lomerulonephritis(MsPGN) and 3 patients with acute poststreptococcal gornerulonephritis (APGN).Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adults wes used as control. Proliferating cells were identified by proliferating cell nuclear antigen (PCNA) in these patiants. Results Compared to other proliferative glomerulonephritis and controls, the patients with lupus nephritis had lase apoptotic cells, a higher ratio of PCNA+cells/TdT+cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubulointerstitium correlated with the chronicity index, r=0.4983 (P=0.0132), r -0.8399 (P<0.001), r=0.6614 (,P=0.0033),respactively. P/T retios in the glomerulus and tubule had a positive correlation with 24-hour urinary protein,r=0.8554(P<0.001) and r=0.7134 (P=0.001); and a negative correlation with crsetinine clearance (Ccr), r=-0.4880(P=0.0133) and r=-0.7229(P=0.001),which in tubules positively correlated with serum creatinine (Scr), r=0.4107 (P=0.0414). Conclusions Apoptosis is reduced in proliferative lupus nephritis. Intense proliferation without a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renalhistopathological changes.

  13. Renal Function Reserve in Chronic Obstructive Pulmonary Disease with Type II Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Manal Mahmoud*, Nesriene El Margoushy**, Hassan Shalby* and Aya

    2007-06-01

    Full Text Available Background and objective: increase in renal blood flow in response to certain stimuli such as dopamine infusion, oral protein load, and amino acid infusion. Reduced or absent renal functional reserve (RFR is an early index of renal impairment. Our work studies the (RFR in Chronic Obstructive Pulmonary Disease (COPD patients with chronic compensated type II respiratory failure. Methods: Our study included 15 COPD patients with compensated type II respiratory failure and 5 normal controls. The patient group had mean Pa O2 56.5±6.4 and Pa CO2 56.5±3.2, while in normal controls the mean Pa O2 was 97.4 ± o.3 and Pa CO2 was 42.3 ± 1.2. Hypoxic patients (Pa O2or = 60 mm Hg and Sa O2 > or = 90 % without rise of PaCO2 within 2 hours before and during the study. The pulsatility index (PI, an index of reno-vascular resistance (RVR, was measured non invasively by Doppler Ultrasonograghy at baseline and 20 minutes after infusion of dopamine in diuretic dose. Results: The baseline PI was nearly similar in the control group and in COPD patients (no significant difference, the PI fell significantly in the control group after dopamine infusion from 1.03 ± 0.14 to 0.83 ± 0.1(P< 0.05, but increased significantly in COPD patients from 1.02 ± 0.12 to1.18 ± 0.13 (P<0.05 after dopamine infusion. Conclusion: Renal functional reserve is impaired in hypercapnic COPD patients and this may be a factor in the development of edema frequently seen in these patients

  14. Evaluation of Pleiotropic Effects of Statins in Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Sultan ÖZKURT

    2011-05-01

    Full Text Available OBJECTIVES: Atherosclerosis is seen more frequently in patients with chronic renal failure (CRF due to the oxidative stress, chronic inflammation and endothelial dysfunction. Besides lowering total and low density lipoprotein (LDL cholesterol levels, statins also lower the frequency of cardiovascular incidents in patients with chronic renal failure by their pleiotropic effects. We aimed to investigate whether atorvastatin had pleiotropic effects in dialysis patients. MATERIAL and METHODS: 21 hyperlipidemic dialysis patients (12 on hemodialysis and 9 peritoneal dialysis with LDL cholesterol levels over 130 mg/dl were included in this study. Atorvastatin was titrated and given to patients for 6 months. After LDL cholesterol level were reduced to under 100mg/day, we evaluated oxidized LDL, malondialdehyde (MDA, interleukin-6 (IL-6, high sensitive C reactive protein (hsCRP, fibrinogen, platelet count, sedimentation rate, nitric oxide (NO, Von Willebrand factor antigen (vWF ag, factor VIII (FVIII and homocysteine. RESULTS: Significant reductions were obtained in total cholesterol, LDL-cholesterol (p<0.001, triglyceride (p<0.05, oxidized LDL (p<0.001, sedimentation value (p<0.01 and platelet count (p<0.05 with atorvastatin treatment. No differences were seen in the other parameters. CONCLUSION: Atorvastatin is associated with significant improvement of lipid profile and reduction of ox-LDL, platelet count, and sedimentation in dialysis patients.

  15. Sulphasalazine induced renal failure.

    OpenAIRE

    Dwarakanath, A D; Michael, J.; Allan, R. N.

    1992-01-01

    Two men with longstanding ulcerative colitis who were treated with sulphasalazine for several years and who developed chronic renal failure are reported. Renal biopsy specimens showed histological changes consistent with drug induced chronic intestinal nephritis. Extensive investigation made other causes of chronic renal failure unlikely. One of these patients underwent renal transplantation, the other has impaired but stable renal function.

  16. Graft vasculopathy in the skin of a human hand allograft: implications for diagnosis of rejection of vascularized composite allografts.

    Science.gov (United States)

    Kanitakis, Jean; Karayannopoulou, Georgia; Lanzetta, Marco; Petruzzo, Palmina

    2014-11-01

    Whereas vascularized composite allografts often undergo acute rejections early in the postgraft period, rejection manifesting with severe vascular changes (graft vasculopathy) has only been observed on three occasions in humans. We report a hand-allografted patient who developed severe rejection following discontinuation of the immunosuppressive treatment. It manifested clinically with erythematous maculopapules on the skin and pathologically with graft vasculopathy that affected both large vessels and smaller cutaneous ones. The observation that graft vasculopathy can affect skin vessels shows that it is amenable to diagnosis with usual skin biopsy as recommended for the follow-up of these allografts. Graft vasculopathy developing in the setting of vascularized composite allografts likely represents chronic rejection due to under-immunosuppression and, if confirmed, should be included in a future update of the Banff classification of vascularized composite allograft rejection. PMID:25041139

  17. Upper gastrointestinal lesions in chronic renal failure and frequency of helicobacter pylori

    International Nuclear Information System (INIS)

    Objective: To highlight the commonest upper gastrointestinal (UGI) lesions in patients with chronic renal failure (CRF) and compare it to a control group of patients with symptoms of UGI disease without renal disease. And also to determine the prevalence of Helicobacter pylori (HP) infection in both groups of patients. Design: a case-control prospective study. Place and Duration of Study: The Department of Nephrology, and the Department of Gastroenterology and pathology, medical unit III, Jinnah Postgraduate Medical Center, Karachi, (Pakistan). Study conducted over a period of two years (01-97 to 31-12-98). Patients and methods: One hundred consecutive patients divided into two equal groups, those with CRF with or without symptoms of acid peptic disease (the study group), and the other (the control group) had symptoms of UGI disease with no evidence of renal disease. The stages of CRF, symptoms of acid peptic disease, type of UGI lesions, and the presence or absence of halicobacter pylori(HP) were noted. Result: The commonest UGI lesions in patients of CRF were gastric erosions 17(34%) followed by inflammatory lesions 16(32%), the incidence increasing with the severity of the renal disease. In the control Group 20 (42%) had gastric erosions and 17 (34%) had inflammatory lesions. HP infection occurred in 76-83% of patients in the study group, and in the control group it was found in 75-88% of patients. Conclusion: In both groups the commonest UGI lesions were gastric erosions, followed by inflammatory lesions mainly gastritis and esophagitis. These lesions occurred more frequently with increasing severity of renal disease. HP infection was common in both group almost equally. (author)

  18. Nosogogy: when the learner is a patient with chronic renal failure.

    Science.gov (United States)

    Ballerini, L; Paris, V

    2006-11-01

    Patient education approaches are currently derived from a biomedical 'acute' model characterized by the sequence of health, disease, and recovery resulting from our professional intervention. Unfortunately, this model proves to be totally inadequate when applied to a chronic disease such as kidney failure. Our patients never fully regain their health and may continue to worsen under our care, even after many state-of-the-art treatments. The solution is represented in acquiring a new professional identity, shifting from the 'biomedical' acute model to a 'bio-psycho-social-educational model'. Within this model, a Therapeutic Education approach in predialysis has been proven to provide both short- and long-term positive results for renal patients. There is a tremendous difference between the learning processes in children and adults and two different sciences have already been described. 'Pedagogy' deals with child learning and 'Andragogy' with adult learning. Nevertheless, when the learner is a patient with a chronic disease, we believe that new considerations must be taken into account. We propose to create a novel science and to call it 'Nosogogy', derived from the ancient Greek word (see text), meaning 'disease'. Nosogogy could be defined as the science of teaching adults affected by chronic disease. The new educator is someone deeply involved in renal care who knows and understands the characteristic conflicts and dynamics that arise in the renal patient, and possesses adequate communication skills to deal with him. In our experience, we prefer to have educational sessions run by nephrologists and nurses who have great experience in the field. PMID:17080103

  19. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  20. Evaluation of renal allograft dysfunction using 99mTc-DTPA dynamic SPECT. Analysis with two compartment model and graph plot

    International Nuclear Information System (INIS)

    To estimate renal blood flow and glomerular function in transplanted kidneys, we applied the 2 compartment model and the graphic analysis method to 99mTc-DTPA dynamic SPECT and calculated some parameters, i.e. K1 (renal influx rate constant), K3 (glomerular filtration rate constant), Vdl (function phase distribution volume), and others. Twenty-three renal transplant recipients were examined and divided into following 3 groups according to their serum creatinine levels (SCr); Group I; less than 1.3 mg/dl (1.1±0.3, n=7), Group II: 1.4-2.5 mg/dl (1.8±0.3, n=7), and Group III more than 2.6 mg/dl (4.8±2.9, n=5). The K3 value became lower in the order of Group I>II>III, and well correlated with blood urea nitrogen (BUN, r=99mTc-DTPA uptake function, respectively. (author)

  1. Diabetes, Renal and Cardiovascular Disease in p47phox−/− Chronic Granulomatous Disease

    OpenAIRE

    Leiding, Jennifer W; Marciano, Beatriz E.; Zerbe, Christa S.; DeRavin, Suk See; Malech, Harry L.; Holland, Steven M.

    2013-01-01

    Chronic granulomatous disease is a rare immunodeficiency due to defects in the phagocyte NADPH oxidase. The X-linked form (gp91phox deficiency) accounts for about 70 % of cases; autosomal recessive p47phox deficiency accounts for about 25 % of cases. We identified a 10 % incidence of diabetes in p47phox deficient CGD, but none in X-linked CGD. Renal and cardiovascular diseases were also higher in p47phox deficiency. p47phox deficient CGD has noninfectious morbidities distinct from those in X-...

  2. Metabolism of red blood cells in chronic renal failure. I. Glycolytic enzyme levels.

    Science.gov (United States)

    Rodríguez-Commes, J L; Tabernero, J M; Martin-Vasallo, P; De Castro, S; Battaner, E

    1979-01-01

    This paper starts a series on red blood cell (RBC) metabolism in patients with chronic renal failure (CRF). The glycolytic enzyme levels and in vitro half-lives of these patients' RBCs were determined. A number of enzymes (hexokinase, glucose-6-phosphate isomerase, fructose-6-phosphate kinase, aldolase, glyceraldehyde-3-phosphate dehydrogenase and lactate dehydrogenase) showed higher activities than in normal control RBCs. Other enzyme activities were normal. These results were discussed and several possible mechanisms considered. We favour the point of view of a shortened life span of the RBCs in CRF, making the most unstable enzymes of the glycolytic sequence appear increase as compared with normal controls. PMID:226898

  3. Hyperprolactinemia as a rare cause of hypertension in chronic renal failure.

    Science.gov (United States)

    Gulleroglu, Kaan; Olgac, Asburce; Bayrakci, Umut; Erdogan, Ozlem; Kinik, Sibel Tulgar; Baskin, Esra

    2012-01-01

    Chronic renal failure (CRF) is associated with a high risk for hypertension. An individualized treatment should be initiated after the diagnosis of hypertension and underlying etiology. Many metabolic and endocrinal abnormalities are encountered in CRF. We present an 11-year-old boy with CRF developing galactorrhea and hyperprolactinemia associated with α-methyldopa, defective dopaminergic control, and resistance to multi-antihypertensive therapy. Cabergoline, a dopamine receptor agonist, was effectively used in the treatment of hypertension. It is important to remember that sometimes treatment of an illness becomes the cause of this illness. PMID:22462393

  4. Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease.

    OpenAIRE

    Vendrely Benoit; Beauvieux Marie-Christine; Barthe Nicole; Raffaitin Christelle; Montaudon Michel; Laurent François; Lasseur Catherine; Garcia Magalie; Rigalleau Vincent; Chauveau Philippe; Combe Christian; Gin Henri

    2010-01-01

    Abstract Background Renal hypertrophy occurs early in diabetic nephropathy, its later value is unknown. Do large kidneys still predict poor outcome in patients with diabetes and Chronic Kidney Disease (CKD)? Methods Seventy-five patients with diabetes and CKD according to a Glomerular Filtration Rate (GFR, by 51Cr-EDTA clearance) below 60 mL/min/1.73 m2 or an Albumin Excretion Rate above 30 mg/24 H, had an ultrasound imaging of the kidneys and were cooperatively followed during five years by ...

  5. Severe pulmonary hypertension in a young patient with end-stage renal disease on chronic hemodialysis

    International Nuclear Information System (INIS)

    Severe pulmonary hypertension in a teenager with end-stage renal disease on chronic hemodialysis via arteriovenous access is reported. Clinical presentation included persistent volume overload and pericardial effusion. Serial hemodynamic data obtained at cardiac catheterization confirmed the diagnosis. In addition, detailed biochemical and imaging data (echo- Doppler, computed tomography of chest, computed tomographic pulmonary angiography, VQ lung scan, etc.) were obtained to find out the mechanism. The exact cause of pulmonary hypertension remains unclear, and a multi- factorial mechanism is postulated. This rare case is presented to highlight the role of aggressive dialysis, pericardiocentesis, and use of sildenafil and bosentan in the management

  6. Gene therapy by electroporation for the treatment of chronic renal failure in companion animals

    OpenAIRE

    Pope Melissa A; Bodles-Brakhop Angela M; Brown Patricia A; Draghia-Akli Ruxandra

    2009-01-01

    Abstract Background Growth hormone-releasing hormone (GHRH) plasmid-based therapy for the treatment of chronic renal failure and its complications was examined. Companion dogs (13.1 ± 0.8 years, 29.4 ± 5.01 kg) and cats (13.2 ± 0.9 years, 8.5 ± 0.37 kg) received a single 0.4 mg or 0.1 mg species-specific plasmid injection, respectively, intramuscularly followed by electroporation, and analyzed up to 75 days post-treatment; controls underwent electroporation without plasmid administration. Res...

  7. Chronic renal disease in diabetic and prediabetic subjects:a community-based study in Shanghai

    Institute of Scientific and Technical Information of China (English)

    王文霞

    2006-01-01

    Objective The aim of the present study was to assess the prevalence and risk factors of chronic renal disease in hyperglycetnic population of Shanghai Caoyang Community. Methods Microalbuminuria was determined by measuring urinary albumin-to-creatinine ratio (ACR) and glomerular filtration rate (GFR) was estimated from fasting serum creatinine. Results A total of 406 Shanghainese, with the average age of 67.5±13.8 years (244 with diabetes mellitus and 162 with impaired glucose regulation) from the established hyperglycemic cohort were

  8. Effects of chronic inflammatory reaction status on the development of complications in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between changes of serum contents of CRP, IL-6, TNF-α, IL-10 and the development of complications (anemia, malnutrition, atherosclerosis) in patients with chronic renal failure. Methods: Serum IL-6, TNF-α (with RIA) and CRP, IL-10 (with ELISA) levels were determined in 126 patients with chronic renal failure and 36 controls. Blood hemoglobin, albumin, glucose and triglycerides levels were also determined in all these patients. Echocardiography was performed in 95 patients. Results: (1) Serum contents of CRP, IL-6, TNF-α and IL-10 were all significantly higher in the patients than those in the controls (P6mmol/L, n=83) were significantly higher than those in the corresponding patients without anemia, malnutrition and hyperglycemia ( all P 1.71mmol/L, n=68), the levels were lower than those in patients without high TG (P<0.001 for IL-6, P<0.01 for CRP and IL-10). In patients with aortic arteriosclerosis shown on echocardiography (n=37), levels of the markers were higher than those in patients without arteriosclerosis (n=58) (P<0.001 for IL-10, P<0.001 for CRP and IL-6, P<0.05 for TNF-α). Correlation studies showed that levels of all the four markers were negatively correlated with levels of hemoglobin and albumin, TNF-α levels were correlated with levels of glucose and CRP, IL-6, IL-10 levels were negatively correlated with triglyceride levels. (3) Levels of each of the pro-inflammatory markers (CRP, IL-6, TNF-α) were correlated with levels of the anti-inflammatory cytokine IL-10 (r=0.463, 0.546 and 0.402 respectively). Conclusion: (1) Serum levels of CRP, IL-6, TNF-α and IL-10 were increased in patients with chronic renal failure. (2) Levels of these markers were correlated in some degree with the development of complications (anemia, malnutrition, arteriosclerosis......) in the patients. (3) Levels of pro-inflammatory markers were correlated with levels of anti-inflammatory cytokine IL-10. (authors)

  9. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    Directory of Open Access Journals (Sweden)

    Hadi Rokni Yazdi

    2012-03-01

    Full Text Available Background: Endothelial injury is a well-known complication in chronic kidney disease (CKD and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases.Objectives: In previous studies on CKD patients who underwent chronic hemodialysis, hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis can produce these changes. In this study, we tried to answer this question.Patients and Methods: Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes with chronic renal failure (CRF who underwent hemodialysis, 17 patients (34 eyes with CRF without a history of hemodialysis and 17 normal patients (34 eyes. The peak systolic velocity (PSV, end diastolic velocity (EDV and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease.Results: The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value = 0.001 with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI] in the central retinal artery.Conclusions: The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV of the central retinal artery were noted between different groups.These findings suggest

  10. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    International Nuclear Information System (INIS)

    Endothelial injury is a well-known complication in chronic kidney disease (CKD) and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases. In previous studies on CKD patients who underwent chronic hemodialysis,hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis) can produce these changes. In this study, we tried to answer this question. Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes) with chronic renal failure (CRF) who underwent hemodialysis, 17 patients (34 eyes)with CRF without a history of hemodialysis and 17 normal patients (34 eyes). The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease. The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value =0.001) with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI)] in the central retinal artery. The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV) of the central retinal artery were noted between different groups. These findings suggest that microvascular disease and endothelial cell dysfunction of the orbital

  11. The Presence of HLA-E-Restricted, CMV-Specific CD8+ T Cells in the Blood of Lung Transplant Recipients Correlates with Chronic Allograft Rejection

    Science.gov (United States)

    Sullivan, Lucy C.; Westall, Glen P.; Widjaja, Jacqueline M. L.; Mifsud, Nicole A.; Nguyen, Thi H. O.; Meehan, Aislin C.; Kotsimbos, Tom C.; Brooks, Andrew G.

    2015-01-01

    The human cytomegalovirus (CMV) immune evasion protein, UL40, shares an identical peptide sequence with that found in the leader sequence of many human leukocyte antigen (HLA)-C alleles and when complexed with HLA-E, can modulate NK cell functions via interactions with the CD94-NKG2 receptors. However the UL40-derived sequence can also be immunogenic, eliciting robust CD8+ T cell responses. In the setting of solid organ transplantation these T cells may not only be involved in antiviral immunity but also can potentially contribute to allograft rejection when the UL40 epitope is also present in allograft-encoded HLA. Here we assessed 15 bilateral lung transplant recipients for the presence of HLA-E-restricted UL40 specific T cells by tetramer staining of peripheral blood mononuclear cells (PBMC). UL40-specific T cells were observed in 7 patients post-transplant however the magnitude of the response varied significantly between patients. Moreover, unlike healthy CMV seropositive individuals, longitudinal analyses revealed that proportions of such T cells fluctuated markedly. Nine patients experienced low-grade acute cellular rejection, of which 6 also demonstrated UL40-specific T cells. Furthermore, the presence of UL40-specific CD8+ T cells in the blood was significantly associated with allograft dysfunction, which manifested as Bronchiolitis Obliterans Syndrome (BOS). Therefore, this study suggests that minor histocompatibility antigens presented by HLA-E can represent an additional risk factor following lung transplantation. PMID:26302084

  12. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  13. Determinants of renal tissue oxygenation as measured with BOLD-MRI in chronic kidney disease and hypertension in humans.

    OpenAIRE

    Pruijm, Menno; Hofmann, Lucie; Piskunowicz, Maciej; Muller, Marie-Eve; Zweiacker, Carole; Bassi, Isabelle; Vogt, Bruno; Stuber, Matthias; Burnier, Michel

    2014-01-01

    Experimentally renal tissue hypoxia appears to play an important role in the pathogenesis of chronic kidney disease (CKD) and arterial hypertension (AHT). In this study we measured renal tissue oxygenation and its determinants in humans using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) under standardized hydration conditions. Four coronal slices were selected, and a multi gradient echo sequence was used to acquire T2* weighted images. The mean cortical and medullar...

  14. Determinants of Renal Tissue Oxygenation as Measured with BOLD-MRI in Chronic Kidney Disease and Hypertension in Humans

    OpenAIRE

    Menno Pruijm; Lucie Hofmann; Maciej Piskunowicz; Marie-Eve Muller; Carole Zweiacker; Isabelle Bassi; Bruno Vogt; Matthias Stuber; Michel Burnier

    2014-01-01

    Experimentally renal tissue hypoxia appears to play an important role in the pathogenesis of chronic kidney disease (CKD) and arterial hypertension (AHT). In this study we measured renal tissue oxygenation and its determinants in humans using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) under standardized hydration conditions. Four coronal slices were selected, and a multi gradient echo sequence was used to acquire T2* weighted images. The mean cortical and medullar...

  15. Acoustic Radiation Force Impulse Imaging for Non-Invasive Assessment of Renal Histopathology in Chronic Kidney Disease

    OpenAIRE

    Qiao Hu; Xiao-Yan Wang; Hong-Guang He; Hai-Ming Wei; Li-Ke Kang; Gui-Can Qin

    2014-01-01

    OBJECTIVE: To investigate the stiffness values obtained by acoustic radiation force impulse (ARFI) quantification in assessing renal histological fibrosis of chronic kidney disease (CKD). METHODS: 163 patients with CKD and 32 healthy volunteers were enrolled between June 2013 and April 2014. ARFI quantification, given as shear wave velocity (SWV), was performed to measure renal parenchyma stiffness. Diagnostic performance of ARFI imaging and conventional ultrasound (US) were compared with his...

  16. Clinical significance of determination of plasma leptin, NPY and serum Hcy levels in patients with chronic renal diseases

    International Nuclear Information System (INIS)

    Objective: To study the relationship between progress of disease and blood levels of leptin, NPY, Hcy in patients with chronic renal diseases. Methods: Plasma leptin, NPY (with RIA) and serum Hcy (with CLIA) were determined in (1) 32 patients with chronic pyelonephritis (2) 28 patients with dibetic nephropathy (3) 30 patients with chronic renal failure and (4) 30 controls. Results: Blood levels of leptin, NPY and Hcy were slightly higher in patients with chronic pyelonephritis than those in controls but without significance (P>0.05). In patients with diabetic nephropathy, the plasma leptin and serum Hcy levels were significantly higher than those in controls (P0.05). In patients with chronic renal failure,the blood levels of NPY (P<0.05) and leptin, Hcy (P<0.01) were all significantly higher than those in controls. Conclusion: Blood levels of these three parameters especially leptin and Hcy, were increased in patients with chronic renal diseases and the increase was most significant in advanced cases. (authors)

  17. Radiological evaluation of renal transplantation

    International Nuclear Information System (INIS)

    Briefly discussed the nephrologic complications, episodes of rejection, acute tubular necrosis, cyclosporine, urologic complications, perirenal fluid collections, small asymptomatic hematomas, urinomas, abscesses, lymphocele, ureteral obstruction, cascular complications, imaging of the renal allograft, radionuclide imaging, ultrasonography, conventional radiography, cystograhy (8 refs.)

  18. Rapid Progression of Metastatic Pulmonary Calcification and Alveolar Hemorrhage in a Patient with Chronic Renal Failure and Primary Hyperparathyroidism

    International Nuclear Information System (INIS)

    Metastatic pulmonary calcification (MPC) is common in patients with chronic renal failure. The authors experienced a patient with chronic renal failure and primary hyperparathyroidism by parathyroid adenoma accompanied with rapid progressions of MPC and alveolar hemorrhage. Recent chest radiographs, compared with previous chest radiographs, showed rapid accumulation of calcification in both upper lungs. Following up on the high-resolution CT scan after five years demonstrates more increased nodules in size and ground glass opacity. The patient was diagnosed with MPC and alveolar hemorrhage by transbronchial lung biopsy. We assumed rapid progression of MPC and alveolar hemorrhage in underlying chronic renal failures could be a primary hyperparathyroidism which may be caused by parathyroid adenoma detected incidentally. Therefore parathyroid adenoma was treated with ethanol injections. Herein, we have reported on CT findings of MPC with alveolar hemorrhage and reviewed our case along with other articles.

  19. Rapid Progression of Metastatic Pulmonary Calcification and Alveolar Hemorrhage in a Patient with Chronic Renal Failure and Primary Hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eun Joo; Kim, Dong Hun; Yoon, Seong Ho [Chosun University College of Medicine, Gwangju (Korea, Republic of); Suk, Eun Ha [Dept. of Anaesthesiology and Pain Medicine, Seonam University College of Medicine, Namwon (Korea, Republic of)

    2013-06-15

    Metastatic pulmonary calcification (MPC) is common in patients with chronic renal failure. The authors experienced a patient with chronic renal failure and primary hyperparathyroidism by parathyroid adenoma accompanied with rapid progressions of MPC and alveolar hemorrhage. Recent chest radiographs, compared with previous chest radiographs, showed rapid accumulation of calcification in both upper lungs. Following up on the high-resolution CT scan after five years demonstrates more increased nodules in size and ground glass opacity. The patient was diagnosed with MPC and alveolar hemorrhage by transbronchial lung biopsy. We assumed rapid progression of MPC and alveolar hemorrhage in underlying chronic renal failures could be a primary hyperparathyroidism which may be caused by parathyroid adenoma detected incidentally. Therefore parathyroid adenoma was treated with ethanol injections. Herein, we have reported on CT findings of MPC with alveolar hemorrhage and reviewed our case along with other articles.

  20. Effects of Low-Molecular-Weight-Chitosan on the Adenine- Induced Chronic Renal Failure Ratsin vitro andin vivo

    Institute of Scientific and Technical Information of China (English)

    ZHI Xuan; HAN Baoqin; SUI Xianxian; HU Rui; LIU Wanshun

    2015-01-01

    Theeffects of low-molecular-weight-chitosan (LMWC) on chronic renal failure (CRF) rats induced by adenine were investigatedin vivoand in vitro. Chitosan were hydrolyzed using chitosanase at pH 6–7 and 37℃ for 24h to obtain LMWC.In vitro, the effect of LMWC on the proliferation of renal tubular epithelial cells (RTEC) showed that it had no cytotoxic effect and could promote cell growth. For theinvivo experiment, chronic renal failure rats induced by adenine were randomly divided into control group, Niaoduqing group, and high-, medium- and low-dose LMWC groups. For each group, we detected serum creatinine (SCR), blood urea nitrogen (BUN), and total superoxide dismutase (T-SOD), glutathione oxidase (GSH-Px) activities of renal tissue, and obtained the ratio of kidney weight/body weight, pathological changes of kidney. The levels of serum SCR, BUN were higher in the adenine-induced rats than those in the controlgroup, indicating that the rat chronic renal failure model worked successfully. The re-sults after treatment showed that LMWC could reduce the SCR and BUN levels and enhance the activities/levels of T-SOD and GSH-PX in kidney compared to control group. Histopathological examination revealed that adenine-induced renal alterations were restored by LMWC at three tested dosages, especially at the low dosage of 100mgkg−1d−1.

  1. Renal cell carcinomas of chronic kidney disease patients harbor the mutational signature of carcinogenic aristolochic acid.

    Science.gov (United States)

    Jelaković, Bojan; Castells, Xavier; Tomić, Karla; Ardin, Maude; Karanović, Sandra; Zavadil, Jiri

    2015-06-15

    Aristolochic acid (AA) is a potent dietary cytotoxin and carcinogen, and an established etiological agent underlying severe human nephropathies and associated upper urinary tract urothelial cancers, collectively designated aristolochic acid nephropathy (AAN). Its genome-wide mutational signature, marked by predominant A:T > T:A transversions occurring in the 5'-CpApG-3' trinucleotide context and enriched on the nontranscribed gene strand, has been identified in human upper urinary tract urothelial carcinomas from East Asian patients and in experimental systems. Here we report a whole-exome sequencing screen performed on DNA from formalin-fixed, paraffin-embedded renal cell carcinomas (RCC) arising in chronic renal disease patients from a Balkan endemic nephropathy (EN) region. In the EN regions, the disease results from the consumption of bread made from wheat contaminated by seeds of Aristolochia clematitis, an AA-containing plant. In five of eight (62.5%) tested RCC tumor specimens, we observed the characteristic global mutational signature consistent with the mutagenic effects of AA. This signature was absent in the control RCC samples obtained from patients from a nonendemic, metropolitan region. By identifying a new tumor type associated with the AA-driven genome-wide mutagenic process in the context of renal disease, our results suggest new epidemiological and public health implications for the RCC incidence worldwide, particularly for the high-risk regions with unregulated use of AA-containing traditional herbal medicines. PMID:25403517

  2. Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Vendrely Benoit

    2010-03-01

    Full Text Available Abstract Background Renal hypertrophy occurs early in diabetic nephropathy, its later value is unknown. Do large kidneys still predict poor outcome in patients with diabetes and Chronic Kidney Disease (CKD? Methods Seventy-five patients with diabetes and CKD according to a Glomerular Filtration Rate (GFR, by 51Cr-EDTA clearance below 60 mL/min/1.73 m2 or an Albumin Excretion Rate above 30 mg/24 H, had an ultrasound imaging of the kidneys and were cooperatively followed during five years by the Diabetology and Nephrology departments of the Centre Hospitalier Universitaire de Bordeaux. Results The patients were mainly men (44/75, aged 62 ± 13 yrs, with long-standing diabetes (duration:17 ± 9 yrs, 55/75 type 2, and CKD: initial GFR: 56.5 (8.5-209 mL/min/1.73 m2, AER: 196 (20-2358 mg/24 H. Their mean kidney lenght (108 ± 13 mm, 67-147 was correlated to the GFR (r = 0.23, p Conclusions Large kidneys still predict progression in advanced CKD complicating diabetes. In these patients, ultrasound imaging not only excludes obstructive renal disease, but also provides information on the progression of the renal disease.

  3. Critical appraisal on the use of everolimus in renal transplantation as an immunosuppressant to prevent organ transplant rejection

    Directory of Open Access Journals (Sweden)

    Fernando Giron

    2010-01-01

    Full Text Available Fernando Giron, Yenny BaezKidney Transplant Service, Colombiana de Trasplantes, Bogota, ColombiaAbstract: Everolimus is a proliferation inhibitor designed to target chronic allograft nephropathy including prevention of acute rejection. Acute renal allograft rejection incidence varies with the therapy used for immunosuppression. Registry data show that 15% to 35% of kidney recipients will undergo treatment for at least one episode of acute rejection within the first post-transplant year. Everolimus has been used as therapy with full- or reduced-dose cyclosporine A without evidence of increasing the acute rejection incidence. This review will summarize the available clinical trial data on the use of everolimus and its role in preventing acute rejection incidence in renal transplantation.Keywords: calcineurin inhibitors, cyclosporine, everolimus, biopsy-proven acute rejection, renal transplantation, acute rejection

  4. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Perihan Öztürk

    2012-06-01

    Full Text Available Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined for nail signs. Groups were compared for the incidence of nail findings. Results: 74.4% of hemodialysis patients, and 51.9% of controls had at least one nail finding. The most common signs in hemodialysis patients were (58.7% absence of lunula, (40.5% streaking, (15.7% terry nail and (14.9% half and half nail. In the control group, the most common signs were vertical streaking (36.5%, absence of lunula (8.7% and coilonichi (2.9%. In hemodialysis patients, absence of lunula, beau lines, onycomycosis, terry nail, half and half nail and splinter hemorrhages were found to be significantly higher (p<0.05. Conclusion: The frequency of nail diseases in hemodialysis patients is higher than in the healthy control group. In our study, absence of lunula is the most frequently observed finding in hemodialysis patients. Although the second most common nail change was vertical streaking, it was not different from the control group statistically. We recommend that, when hemodialysis patients are examined, nail examination (as a part of physical examination should be performed. (Turk J Dermatol 2012; 6: 35-8

  5. Renal function is impaired in normotensive chronic HCV patients: role of insulin resistance.

    Science.gov (United States)

    Sciacqua, Angela; Perticone, Maria; Tassone, Eliezer J; Cimellaro, Antonio; Caroleo, Benedetto; Miceli, Sofia; Andreucci, Michele; Licata, Anna; Sesti, Giorgio; Perticone, Francesco

    2016-06-01

    Renal dysfunction is an independent predictor for cardiovascular morbidity and mortality. We investigated whether chronic hepatitis C virus (HCV) infection and the related insulin resistance/hyperinsulinemia influence renal function in comparison with a group of healthy subjects and with another group with metabolic syndrome. We enrolled 130 newly diagnosed HCV outpatients matched for age and gender with 130 patients with metabolic syndrome and 130 healthy subjects. Renal function was evaluated by calculation of glomerular filtration rate (e-GFR, mL/min/1.73 m(2)) using the CKD-EPI equation. The following laboratory parameters were measured: fasting plasma glucose and insulin, total, LDL- and HDL-cholesterol, triglyceride, creatinine, and HOMA to evaluate insulin sensitivity. HCV patients with respect to both healthy subjects and metabolic syndrome patients have a decreased e-GFR: 86.6 ± 16.1 vs 120.2 ± 23.1 mL/min/1.73 m(2) (P analysis, the correlation between e-GFR and HOMA is similar in the metabolic syndrome (r = -0.555, P analysis, HOMA is the major determinant of e-GFR in both groups, accounting for, respectively, 30.8 and 27.8 % of its variation in the metabolic syndrome and HCV. In conclusion, we demonstrate that HCV patients have a significant reduction of e-GFR and that insulin resistance is the major predictor of renal dysfunction. PMID:26597876

  6. Glomerular endothelial vesicles in a renal allograft: an unusual pattern of immunoglobulin deposition in a patient with biclonal gammopathy of unknown significance.

    Science.gov (United States)

    Flatley, Ellen M; Segal, Gerald M; Batiuk, Thomas D; Bennett, William M; Houghton, Donald C; Troxell, Megan L

    2015-06-01

    Paraproteins have varied effects on the kidney on the basis of molecular structure, concentration, and renal function. Prototypical patterns include myeloma cast nephropathy, monoclonal immunoglobulin deposition disease, and amyloid, among others. We report a 69-year-old man with end-stage diabetic nephropathy and biclonal gammopathy of unknown significance. Serum monoclonal immunoglobulin G (IgG)-κ and urine monoclonal free λ light chains were identified during workup for nephrotic syndrome. A native renal biopsy demonstrated diabetic nephropathy, without indication of paraprotein-related pathology. After transplantation, a surveillance biopsy showed endothelialitis (type 2 rejection) and abundant eosinophilic droplets, nearly occluding glomerular capillary loops. Electron microscopy localized tightly packed electron-dense vesicles in glomerular endothelial cells. Immunofluorescence studies revealed IgG-κ-dominant endothelial staining, along with λ monotypic protein resorption droplets in tubules. Two additional biopsies within the following year showed this same paraprotein distribution, with some increase in mesangial sclerosis. Two years after transplant the patient remains asymptomatic with normal creatinine levels. Literature review yields rare cases of immunoglobulin crystalline deposits in multiple glomerular cell types, rarely including endothelial cells; however, this appears to be the first report of monoclonal immunoglobulin vesicles localized solely to endothelial cells. As these vesicles were not seen in the native kidney biopsy, we hypothesize an interaction of alloimmune-mediated endothelial injury and the physiochemical properties of the IgG-κ paraprotein. In addition, this case illustrates simultaneous different patterns of accumulation of monoclonal immunoglobulin and light chain components in this unique patient with biclonal gammopathy of unknown significance. PMID:25723111

  7. Las células T reguladoras y su influencia en la sobrevida del trasplante renal Regulatory T cells and their influence in kidney allograft survival

    Directory of Open Access Journals (Sweden)

    Sonia Y. Velásquez

    2007-10-01

    Full Text Available La respuesta inmune desencadenada frente a un trasplante alogénico conduce usualmente a una respuesta efectora que resulta en el rechazo del aloinjerto; sin embargo, algunos individuos mantienen un trasplante funcionante a largo plazo sin signos de rechazo (tolerancia operacional, aun en ausencia de inmunosupresión. Se ha sugerido que los mismos mecanismos son responsables para la tolerancia hacia antígenos propios y aloantígenos. Uno de estos mecanismos es la regulación inmune y se han identificado varias subpoblaciones de células con propiedades reguladoras. Entre ellas, la población celular mejor caracterizada corresponde a las células T reguladoras (Tregs. Aunque las Tregs en ratones son CD4+CD25+, en humanos el fenotipo de las Treg está restringida a las células T CD4 con alta expresión de CD25 (CD25high y del factor de transcripción Foxp3. El análisis fenotípico y funcional de las células T reguladoras o supresoras circulantes en pacientes trasplantados tal vez sea útil para la detección de pacientes tolerantes operacionales. Además, una futura manipulación in vitro de estas células con fines terapéuticos podría conducir a lograr la inducción de tolerancia in vivo en el trasplante clínico. Aquí, revisamos la evidencia experimental y clínica del papel de las células reguladoras en la biología del trasplante.The immune response elicited by an allogenic transplant usually leads to an effector response resulting in allograft rejection; however, some individuals maintain a long-term functioning transplant without signs of rejection (operational tolerance even in the absence of immunosuppression. It has been suggested that the same mechanisms are responsible for tolerance to self-antigens and alloantigens. One of such mechanisms is immune regulation and several cell subsets with regulatory properties have been identified. Among them, the best characterized cell populations are the regulatory T cells (Treg. Although

  8. Vitaminas B y homocisteína en la insuficiencia renal crónica Vitamin B complex and homocysteine in chronic renal failure

    Directory of Open Access Journals (Sweden)

    C. Sánchez

    2007-12-01

    Full Text Available Durante la insuficiencia renal crónica ocurren cambios metabólicos, bioquímicos y hormonales que suelen ir acompañados frecuentemente de estados de malnutrición. En pacientes en prediálisis, conocer el estado nutricional en vitaminas hidrosolubles como la tiamina, riboflavina, piridoxina, cianocobalamaina y ácido fólico cobra cada vez más importancia ya que algunas de las manifestaciones de la insuficiencia renal crónica podrían deberse a la deficiencia de algunas de estas vitaminas hidrosolubles. Las rutas metabólicas en las que participan la mayoría de ellas se encuentran interrelacionadas y resulta complejo comprender de qué manera afecta individualmente la deficiencia de cada vitamina a la patología renal. Este trabajo trata de revisar no sólo este aspecto, sino también el estatus en estas vitaminas hidrosolubles que diferentes autores han encontrado en grupos de pacientes en prediálisis. Por otra parte se aborda la problemática de la elevada prevalencia de hiperhomocisteinemia en la insuficiencia renal crónica como principal factor de riesgo de mortalidad por patologías cardiovasculares, así como la implicación de las vitaminas objeto de esta revisión en el metabolismo de la homocisteína y por consiguiente en los niveles plasmáticos de dicho metabolito en pacientes en prediálisis.Metabolic, biochemical, and hormonal changes occur in chronic renal failure usually associated with hyponutrition states. In predialysis patients, knowing the nutritional state about water-soluble vitamins such as thiamine, riboflavin, pyridoxine, cianocobalamine, and folic acid is becoming more and more important since some of the manifestations of chronic renal failure may be due to the deficiency of some of these water-soluble vitamins. The metabolic pathways in which most of these vitamins participate are interrelated and it is difficult to understand how the individual deficits of each vitamin affect renal pathology. This work aims

  9. Female cotton rats (Sigmodon hispidus) develop chronic anemia with renal inflammation and cystic changes.

    Science.gov (United States)

    Ichii, Osamu; Nakamura, Teppei; Irie, Takao; Kouguchi, Hirokazu; Nakamura, Daisuke; Nakamura, Saori; Sato, Shinobu; Yokoyama, Keisuke; Horino, Taro; Sunden, Yuji; Elewa, Yaser Hosny Ali; Kon, Yasuhiro

    2016-09-01

    The cotton rat (Sigmodon hispidus) is a laboratory rodent that has been used for studies on human infectious diseases. In the present study, we observed that female cotton rats, not the male cotton rats, developed chronic anemia characterized by reduced red blood cell, hemoglobin, and hematocrit levels from 5 to 9 months of age without any changes in the mean corpuscular hemoglobin and volume levels. In peripheral blood, the reticulocyte count did not increase in response to anemia in female cotton rats, and no extramedullary hematopoiesis was observed in the liver or spleen. Further, the serum levels of urea nitrogen and creatinine increased from 5 to 9 months of age in female cotton rats compared to male cotton rats, and these increases became more prominent from 10 months of age onward, indicating chronic kidney disease. Histopathologically, female cotton rats manifested tubulointerstitial lesions characterized by the infiltration of mononuclear cells, including plasma cells and CD3(+) T-cells, as well as the dilation of calbindin-D28k(+) distal tubules from 5 to 9 months of age. The severity of these lesions progressed from 10 months of age onward, and renal fibrotic features and numerous tubular cysts appeared without any obvious glomerular lesions. A significant decrease in the erythropoietin protein levels was observed in the kidney of aged female cotton rats, and significant correlations were detected between anemia and tubulointerstitial damage. These results suggest that aged female cotton rats chronically develop renal anemia, and this rodent may serve as a novel model to elucidate its pathogenesis. PMID:27099161

  10. Darbepoetin alpha reduces oxidative stress and chronic inflammation in atherosclerotic lesions of apo E deficient mice in experimental renal failure.

    Directory of Open Access Journals (Sweden)

    Nicole Arend

    Full Text Available BACKGROUND: Cardiovascular morbidity and mortality is very important in patients with chronic renal failure. This occurs even in mild impairment of renal function and may be related to oxidative stress and chronic inflammation. The nephrectomized apo E knockout mouse is an accepted model for evaluating atherosclerosis in renal dysfunction. Erythropoietin derivates showed anti-oxidative and anti-inflammatory effects. Therefore, this study evaluates the effects of Darbepoetin on markers of oxidative stress and chronic inflammation in atherosclerotic lesions in apo E knockout mice with renal dysfunction. METHODS: Apo E knockout mice underwent unilateral (Unx, n = 20 or subtotal (Snx, n = 26 nephrectomy or sham operation (Sham, n = 16. Mice of each group were either treated with Darbepoetin or saline solution, a part of Snx mice received a tenfold higher dose of Darbepoetin. The aortic plaques were measured and morphologically characterized. Additional immunhistochemical analyses were performed on tissue samples taken from the heart and the aorta. RESULTS: Both Unx and Snx mice showed increased expression of markers of oxidative stress and chronic inflammation. While aortic plaque size was not different, Snx mice showed advanced plaque stages when compared to Unx mice. Darbepoetin treatment elevated hematocrit and lowered Nitrotyrosin as one marker of oxidative stress, inflammation in heart and aorta, plaque stage and in the high dose even plaque cholesterol content. In contrast, there was no influence of Darbepoetin on aortic plaque size; high dose Darbepoetin treatment resulted in elevated renal serum parameters. CONCLUSION: Darbepoetin showed some protective cardiovascular effects irrespective of renal function, i.e. it improved plaque structure and reduced some signs of oxidative stress and chronic inflammation without affecting plaque size. Nevertheless, the dose dependent adverse effects must be considered as high Darbepoetin treatment

  11. Post-renal Transplantation de novo Renal Cell Carcinoma in a Middle-aged Man

    OpenAIRE

    Pandya, V. K.; Sutariya, H. C.

    2016-01-01

    Renal cell carcinoma is usually seen in the native kidney but may be seen in the renal allograft. We report a rare case of renal cell carcinoma in a 56-year-old renal allograft recipient who was transplanted for end-stage renal disease induced by analgesic nephropathy. This complication developed after 13 years of renal transplantation. Patient was investigated for hematuria and abdominal pain with a normal renal function. Computed tomography depicted a mass sized 9.0×7.3×6.8 cm that involved...

  12. Rupture of Renal Transplant

    OpenAIRE

    Shona Baker; Maria Popescu; Jacob A Akoh

    2015-01-01

    Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L). LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day th...

  13. Proximal renal tubular injury in rats sub-chronically exposed to low fluoride concentrations

    International Nuclear Information System (INIS)

    Fluoride is usually found in groundwater at a very wide range of concentration between 0.5 and 25 ppm. At present, few studies have assessed the renal effects of fluoride at environmentally relevant concentrations. Furthermore, most of these studies have used insensitive and nonspecific biomarkers of kidney injury. The aim of this study was to use early and sensitive biomarkers to evaluate kidney injury after fluoride exposure to environmentally relevant concentrations. Recently weaned male Wistar rats were exposed to low (15 ppm) and high (50 ppm) fluoride concentrations in drinking water for a period of 40 days. At the end of the exposure period, kidney injury biomarkers were measured in urine and renal mRNA expression levels were assessed by real time RT-PCR. Our results showed that the urinary kidney injury molecule (Kim-1), clusterin (Clu), osteopontin (OPN) and heat shock protein 72 excretion rate significantly increased in the group exposed to the high fluoride concentration. Accordingly, fluoride exposure increased renal Kim-1, Clu and OPN mRNA expression levels. Moreover, there was a significant dose-dependent increase in urinary β-2-microglobulin and cystatin-C excretion rate. Additionally, a tendency towards a dose dependent increase of tubular damage in the histopathological light microscopy findings confirmed the preferential impact of fluoride on the tubular structure. All of these changes occurred at early stages in which, the renal function was not altered. In conclusion using early and sensitive biomarkers of kidney injury, we were able to found proximal tubular alterations in rats sub-chronically exposed to fluoride. - Highlights: • Exposure to low concentrations of fluoride induced proximal tubular injury • Increase in urinary Kim-1, Clu, OPN and Hsp72 in 50 ppm fluoride-exposed group • Increase in urinary B2M and CysC in 15 and 50 ppm fluoride-exposed groups • Fluoride exposure increased renal Kim, Clu and OPN mRNA expression levels.

  14. Proximal renal tubular injury in rats sub-chronically exposed to low fluoride concentrations

    Energy Technology Data Exchange (ETDEWEB)

    Cárdenas-González, Mariana C.; Del Razo, Luz M. [Departmento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México, D. F., México (Mexico); Barrera-Chimal, Jonatan [Unidad de Fisiología Molecular, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D. F., México (Mexico); Jacobo-Estrada, Tania [Departmento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México, D. F., México (Mexico); López-Bayghen, Esther [Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México, D. F., México (Mexico); and others

    2013-11-01

    Fluoride is usually found in groundwater at a very wide range of concentration between 0.5 and 25 ppm. At present, few studies have assessed the renal effects of fluoride at environmentally relevant concentrations. Furthermore, most of these studies have used insensitive and nonspecific biomarkers of kidney injury. The aim of this study was to use early and sensitive biomarkers to evaluate kidney injury after fluoride exposure to environmentally relevant concentrations. Recently weaned male Wistar rats were exposed to low (15 ppm) and high (50 ppm) fluoride concentrations in drinking water for a period of 40 days. At the end of the exposure period, kidney injury biomarkers were measured in urine and renal mRNA expression levels were assessed by real time RT-PCR. Our results showed that the urinary kidney injury molecule (Kim-1), clusterin (Clu), osteopontin (OPN) and heat shock protein 72 excretion rate significantly increased in the group exposed to the high fluoride concentration. Accordingly, fluoride exposure increased renal Kim-1, Clu and OPN mRNA expression levels. Moreover, there was a significant dose-dependent increase in urinary β-2-microglobulin and cystatin-C excretion rate. Additionally, a tendency towards a dose dependent increase of tubular damage in the histopathological light microscopy findings confirmed the preferential impact of fluoride on the tubular structure. All of these changes occurred at early stages in which, the renal function was not altered. In conclusion using early and sensitive biomarkers of kidney injury, we were able to found proximal tubular alterations in rats sub-chronically exposed to fluoride. - Highlights: • Exposure to low concentrations of fluoride induced proximal tubular injury • Increase in urinary Kim-1, Clu, OPN and Hsp72 in 50 ppm fluoride-exposed group • Increase in urinary B2M and CysC in 15 and 50 ppm fluoride-exposed groups • Fluoride exposure increased renal Kim, Clu and OPN mRNA expression levels.

  15. Erythropoietin production in renal cell carcinoma and renal cysts in autosomal dominant polycystic kidney disease in a chronic dialysis patient with polycythemia: A case report.

    Science.gov (United States)

    Ito, Keiichi; Asano, Takako; Tominaga, Susumu; Yoshii, Hidehiko; Sawazaki, Harutake; Asano, Tomohiko

    2014-11-01

    In patients undergoing chronic hemodialysis (HD), erythropoietin (EPO) production from the kidney generally decreases and renal anemia develops. Patients without anemia, but with high serum EPO (sEPO) levels are rare among HD patients. The current study presents the case of a 67-year-old female HD patient with autosomal dominant polycystic kidney disease (ADPKD) and renal cell carcinoma (RCC), manifesting polycythemia with elevated sEPO levels. A radical nephrectomy was performed, which diminished the polycythemia, but the sEPO levels remained high. To determine the origin of the EPO production, immunohistochemistry was performed to detect EPO in the RCC and the renal cysts of the surgically resected kidney. In addition, the sEPO and EPO levels in a renal cyst were determined by enzyme immunoassay. EPO expression was demonstrated in RCC and cyst epithelial cells using immunohistochemistry, revealing extremely high EPO levels in the cyst fluid. Due to the remission of polycythemia following the nephrectomy, EPO production from the resected kidney appeared to have been the cause of the polycythemia. Positive EPO staining of the renal cysts in the resected polycystic kidney and sustained sEPO elevation following nephrectomy led to the hypothesis of EPO production in the renal cysts of the contralateral polycystic kidney. Although the postoperative EPO level was higher than the normal range, the hematocrit (Hct) level gradually decreased and recombinant human EPO was required again three months following the nephrectomy. Eight months after the nephrectomy, the Hct level was 30.2% with the use of rHuEPO. In conclusion, EPO production from RCC and renal cysts in ADPKD appeared to cause polycythemia in the HD patient. PMID:25295086

  16. Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition

    DEFF Research Database (Denmark)

    Kamper, A L; Thomsen, H S; Nielsen, S L; Strandgaard, S

    1990-01-01

    function. Scintigrams of the kidneys showed an unaltered distribution of DMSA during treatment. GFR estimated by 51Cr-EDTA plasma clearance fell by 14% (P less than 0.01), but renal uptake of 99mTc-DMSA increased by 10% (P less than 0.01). It is concluded that DMSA in chronic renal failure is mainly taken......Glomerular filtration rate (GFR) and renal uptake of dimercaptosuccinic acid (DMSA) were measured in 31 patients with progressive chronic nephropathy before and immediately after the start of treatment with angiotensin converting enzyme (ACE) inhibitor in order to control adverse effects on kidney...... up by the tubular cells from the peritubular capillaries since the uptake was unaffected by the acute decrease in GFR....

  17. How should renin-angiotensin system blockade be applied in chronic kidney disease for optimal renal protection?

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xun; HOU Fan-fan

    2007-01-01

    @@ Chronic kidney disease (CKD) is a significant interactive disease in patients with diabetes,hypertension, and cardiovascular disease with major morbidity and mortality consequences and high costs to the healthcare system.1 CKD is characterized by a gradual loss of renal function.

  18. The Function of MicroRNAs in Renal Development and Pathophysiology

    Institute of Scientific and Technical Information of China (English)

    Liming Ma; Lianghu Qu

    2013-01-01

    MicroRNAs (miRNAs) are a class of endogenous small non-coding RNAs that modulate diverse biological processes predominantly by translation inhibition or induction of mRNA degradation.They are important regulatory elements involved in renal physiology and pathology.Dysregulation of miRNAs disrupts early kidney development,renal progenitor cell differentiation and the maintenance of mature nephrons.miRNAs are also reported to participate in various renal diseases,including chronic kidney disease,acute kidney injury,allograft acute rejection and renal cell carcinoma.Differentially regulated miRNAs may represent innovative biomarkers for diagnosis and prognosis.Therefore,determining the roles of miRNAs in different types of renal diseases will help to clarify the pathogenesis and facilitate the development of novel therapies.

  19. Prolonged Pulmonary Exposure to Diesel Exhaust Particles Exacerbates Renal Oxidative Stress, Inflammation and DNA Damage in Mice with Adenine-Induced Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Abderrahim Nemmar

    2016-05-01

    Full Text Available Background/Aims: Epidemiological evidence indicates that patients with chronic kidney diseases have increased susceptibility to adverse outcomes related to long-term exposure to particulate air pollution. However, mechanisms underlying these effects are not fully understood. Methods: Presently, we assessed the effect of prolonged exposure to diesel exhaust particles (DEP on chronic renal failure induced by adenine (0.25% w/w in feed for 4 weeks, which is known to involve inflammation and oxidative stress. DEP (0.5m/kg was intratracheally (i.t. instilled every 4th day for 4 weeks (7 i.t. instillation. Four days following the last exposure to either DEP or saline (control, various renal endpoints were measured. Results: While body weight was decreased, kidney weight increased in DEP+adenine versus saline+adenine or DEP. Water intake, urine volume, relative kidney weight were significantly increased in adenine+DEP versus DEP and adenine+saline versus saline. Plasma creatinine and urea increased and creatinine clearance decreased in adenine+DEP versus DEP and adenine+saline versus saline. Tumor necrosis factor α, lipid peroxidation and reactive oxygen species were significantly increased in adenine+DEP compared with either DEP or adenine+saline. The antioxidant calase was significantly decreased in adenine+DEP compared with either adenine+saline or DEP. Notably, renal DNA damage was significantly potentiated in adenine+DEP compared with either adenine+saline or DEP. Similarly, systolic blood pressure was increased in adenine+DEP versus adenine+saline or DEP, and in DEP versus saline. Histological evaluation revealed more collagen deposition, higher number of necrotic cell counts and dilated tubules, cast formation and collapsing glomeruli in adenine+DEP versus adenine+saline or DEP. Conclusion: Prolonged pulmonary exposure to diesel exhaust particles worsen renal oxidative stress, inflammation and DNA damage in mice with adenine-induced chronic

  20. Gene therapy by electroporation for the treatment of chronic renal failure in companion animals

    Directory of Open Access Journals (Sweden)

    Pope Melissa A

    2009-01-01

    Full Text Available Abstract Background Growth hormone-releasing hormone (GHRH plasmid-based therapy for the treatment of chronic renal failure and its complications was examined. Companion dogs (13.1 ± 0.8 years, 29.4 ± 5.01 kg and cats (13.2 ± 0.9 years, 8.5 ± 0.37 kg received a single 0.4 mg or 0.1 mg species-specific plasmid injection, respectively, intramuscularly followed by electroporation, and analyzed up to 75 days post-treatment; controls underwent electroporation without plasmid administration. Results Plasmid-treated animals showed an increase in body weight (dogs 22.5% and cats 3.2% compared to control animals, and displayed improved quality of life parameters including significant increases in appetite, activity, mentation and exercise tolerance levels. Insulin-like growth factor I (IGF-I, the downstream effector of GHRH levels were increased in the plasmid treated animals. Hematological parameters were also significantly improved. Protein metabolism changes were observed suggesting a shift from a catabolic to an anabolic state in the treated animals. Blood urea nitrogen and creatinine did not show any significant changes suggesting maintenance of kidney function whereas the control animal's renal function deteriorated. Treated animals survived longer than control animals with 70% of dogs and 80% of cats surviving until study day 75. Only 17% and 40% of the control dogs and cats, respectively, survived to day 75. Conclusion Improved quality of life, survival and general well-being indicate that further investigation is warranted, and show the potential of a plasmid-based therapy by electroporation in preventing and managing complications of renal insufficiency.

  1. Radiologic alterations of the pelvis in patients affected with chronic renal insufficiency and undergoing periodic dialysis

    International Nuclear Information System (INIS)

    Bone alteration in the patients undergoing periodic dialysis represent a frequent and invaliding complication and cause the pattern called uremic osteodystrophy. In this study we have examined 173 pelvic X-rays of 73 patients affected with chronic renal insufficiency and undergoing periodic dialysis. The results indicate the presence of all the lesions characterizing uremic osteodystrophy. Arterial calcifications and osteoporosis are the most frequent patterns; with various incidence, osteomalacia, osteitis fibrosa, osteosclerosis and brown tumors are associated. In this group of patients, who were followed for many years, a non-univocal behavior was observed: next to patters of progressive aggravation, such as vascular calcifications, phases of stabilization/improvement were observed, e.g. in case of brown tumors and osteitis fibrosa

  2. Chronic Renal Failure in a Patient Due to Gluteal Compartment Syndrome After a Nephrectomy Operation

    Directory of Open Access Journals (Sweden)

    Özkan ULUTAŞ, , ,

    2013-09-01

    Full Text Available Gluteal compartment syndrome is a rare reason of rhabdomyolysis resulting from atraumatic origin, and leading to renal failure. Beside to other atraumatic causes like drug abuse, alcohol intoxication, and antihyperlipidemic medications prolonged operation duration in a fixed position is an important cause of this syndrome. Male sex, diabetes mellitus, hypertension and obesity are risk factors for gluteal compartment syndrome associated kidney failure. We report a 56 year old obese patient with a medical history of diabetes mellitus, and hypertension who undergo a nephrectomy operation resulting with gluteal compartment syndrome, and chronic kidney disease. We also highlight the importance of preventive cares and early recognition of gluteal compartment syndrome to avoid further morbidity.

  3. Disseminated coccidioidomycosis in a captive Indochinese tiger (Panthera tigris corbetti) with chronic renal disease.

    Science.gov (United States)

    Helmick, Kelly E; Koplos, Peter; Raymond, James

    2006-12-01

    A 19-yr-old, 78.2-kg captive female Indochinese tiger (Panthera tigris corbetti) from the El Paso Zoo (El Paso, Texas, USA) with chronic renal disease was euthanized after a 10-day course of anorexia, depression, progressive rear limb weakness, muscle fasciculations, and head tremors. Postmortem findings included pericardial effusion, generalized lymphadenopathy, glomerulosclerosis, glomerular atrophy with membranous glomerulonephropathy, and pancreatic adenocarcinoma. Pyogranulomatous pneumonia, pericarditis, and lymphadenitis were associated with fungal spherules histomorphologically consistent with Coccidioides immitis. Rising antibodies to C. immitis were detected on samples obtained perimortem and 2 mo before euthanasia. Retrospective serology was negative for two additional Indochinese tigers, two Iranian leopards (Panthera pardus saxicolor), two jaguars (Panthera onca), two bobcats (Lynx rufus texensis), two ocelots (Leopardus pardalis), and three Amur leopards (Panthera pardus orientalis) housed at the zoo over an 8-yr period. Despite being located within the endemic region for C. immitis, this is only the second case of coccidioidomycosis reported from this institution. PMID:17315442

  4. Evaluation of bone metabolism in patients with chronic renal failure treated by continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    Bone metabolism inpatients with chronic renal failure treated by continuous ambulatory peritoneal dialysis (CAPD) was evaluated. IRMA, RRA and RIA were used to detect PTH, 25 (OH)D3, 1,25(OH)2D3, BGP, Ca and P levels in the blood of 24 CAPD patients. PTH and BGP were increased in uremic patients ad decreased after CAPD. 25(OH)D3 and 1,25 (OH)2D3 were decreased in the patients, but their levels were not changed further after CAPD. PTH had negative correlation with 25 (OH)D3 (r = -0.379, P 2D3 (r = -0.451, P < 0.01). PTH had positive correlation with BGP (r 0.501, P < 0.01) in CAPD patients, and the correlativity was decreased by CAPD. The results showed: PTH hypersecretion is a main factor inducing bone metabolism disturbance, and bone turnover rate is decreased in these patients by CAPD

  5. The epidemiology and outcome of acute renal failure and the impact on chronic kidney disease.

    Science.gov (United States)

    Block, Clay A; Schoolwerth, Anton C

    2006-01-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. Recent publications have highlighted changes in the epidemiology and improvement in mortality that was long thought to be static despite improvements in clinical care. The incidence of ARF is increasing. Efforts, such as the Acute Dialysis Quality Initiative, are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease. Two brief case reports are offered to help frame the context and clinical impact of this disorder, followed by a review of some of the recent literature that addresses these points. PMID:17150044

  6. Expression of decoy receptor 3 in kidneys is associated with allograft survival after kidney transplant rejection.

    Science.gov (United States)

    Weng, Shuo-Chun; Shu, Kuo-Hsiung; Wu, Ming-Ju; Wen, Mei-Chin; Hsieh, Shie-Liang; Chen, Nien-Jung; Tarng, Der-Cherng

    2015-01-01

    Decoy receptor 3 (DcR3) expression in kidneys has been shown to predict progression of chronic kidney disease. We prospectively investigated a cohort comprising 96 renal transplant recipients (RTRs) undergoing graft kidney biopsies. Computer-assisted quantitative immunohistochemical staining value of DcR3 in renal tubular epithelial cells (RTECs) was used to determine the predictive role of DcR3 in kidney disease progression. The primary end point was doubling of serum creatinine and/or graft failure. A multivariate Cox proportional hazards model was used to assess the risk of DcR3 expression in rejected kidney grafts toward the renal end point. In total, RTRs with kidney allograft rejection were evaluated and the median follow-up was 30.9 months. The greater expression of DcR3 immunoreactivity in RTECs was correlated with a higher rate of the histopathological concordance of acute T cell-mediated rejection. Compared with 65 non-progressors, 31 progressors had higher DcR3 expression (HDE) regardless of the traditional risk factors. Cox regression analysis showed HDE was significantly associated with the risk of renal end point with a hazard ratio of 3.19 (95% confidence interval, 1.40 to 7.27; P = 0.006) after adjusting for other variables. In repetitive biopsies, HDE in tissue showed rapid kidney disease progression due to persistent inflammation. PMID:26335204

  7. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    Science.gov (United States)

    Dugaich, Adriana P. Castilho; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Boim, Mirian A.; Bergamaschi, Cássia T.; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction of Ang II type 1 receptors (AT1) mRNA in the brainstem compared to controls (C). Tempol but not candesartan into the RVLM decreased MAP in CRF but not in C rats. GABA into the RVLM decreased MAP in CRF (63 ± 8 mmHg) more intensely than in C (33 ± 3 mmHg). The results suggest that increased oxidative stress within the RVLM has an important participation to maintain hypertension in CRF rats apparently independently of AT1 Ang II receptors. PMID:21253520

  8. Magnesium pyridoxal 5-phosphate glutamate reduces hyperlipidaemia in patients with chronic renal insufficiency.

    Science.gov (United States)

    Kirsten, R; Heintz, B; Nelson, K; Sieberth, H G; Oremek, G; Hasford, J; Speck, U

    1988-01-01

    Chronic renal insufficiency is often accompanied by hyperlipidaemia and subsequent coronary heart disease. Two groups of 15 patients with serum creatinine greater than 2 mg/100 ml and serum cholesterol less than 250 mg/100 ml were given 3 x 50 mg magnesium pyridoxal 5-phosphate glutamate (MPPG) or placebo for 12 weeks in a double-blind, randomised study. Total cholesterol in the MPPG group (282.4 mg.100 ml-1) was lower than in the placebo group (354.3 mg.100 ml-1) after 12 weeks of treatment. Triglycerides in the MPPG group were 265.1 mg.100 ml-1 compared to 361.9 mg.100 ml-1. After 12 weeks on MPPG the LDL/HDL ratio of 3.56 was lower than in the placebo group-6.83. Side effects in the MPPG group were similar to those in the placebo group. Thus, MPPG was an effective antihyperlipidaemic agent in patients with renal insufficiency. PMID:3383985

  9. [Analysis of hemodialysis and graft representations in patients with chronic renal failure: an anthropological approach].

    Science.gov (United States)

    Desseix, Aurélie; Merville, Pierre; Couzi, Lionel

    2010-04-01

    Hemodialysis and kidney transplant are two treatments for renal failure, which lead to numerous changes in the patients' way of life. We have questioned ourselves on the different ways they could deal with those changes by studying the representations and the ritualisation that surrounds the sick. From 2005 to 2007, qualitative interviews, based on the method of life stories, were conducted with 35 patients with chronic renal failure in three Aquitaine's centres. The results show three main groups of representation both in pre-transplant and in post-transplant. Specific behaviours are tied to each group of representation that are beneficial or deleterious with respect to treatment or the patient's social life. We will show that, on the one hand, the patients who see the hemodialysis treatment as a traditional rite of passage cope with the situation more easily and on the other hand, we will stress that this representation is closely linked to how the patients will later accept the kidney transplant. So, we have been able to link the representations of hemodialysis patients and transplant experience. Then these results have a practical consequence for the caregivers who can use the tools of anthropology (the interview guide, analysis grid) through a program of therapeutic education, to precociously take care of patients who are likely to come up against issues after their kidney transplant. PMID:20299298

  10. Effects of Sub-chronic Aluminum Exposure on Renal Structure in Rats

    Institute of Scientific and Technical Information of China (English)

    Li Yan-fei; Liu Jian-yu; Cao Zheng

    2015-01-01

    To investigate the effects of aluminum (Al) exposure on renal structure of rats, 60 Wistar rats were randomly divided into four treatment groups and were orally exposed to 0 (control group, GC), 64.18 (low-dose group, GL), 128.36 (middle-dose group, GM), and 256.72 (high-dose group, GH) mg• kg-1 BW AlCl3 in drinking water for 120 days. The body weight of different rats was recorded, the kidney pathologic structure and the ultrastructure were observed. The results showed that the body weight of different rats was markedly lower in Al-treated rats than those in GC (P<0.05;P<0.01). After masson staining, the collagen was deposited in the renal interstitium and aggravated with Al dose increases in Al-treated rats. Under electron microscope, the infolding of the plasma membrane was slight swollen, the mitochondrion was abundant with different sizes, the mitochondrion cristae was fused, the microvillus was swollen and fused in GH. Our findings indicated that sub-chronic Al exposure slowed the weight of rats and caused the kidney pathologic damage in rats.

  11. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil......A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated......-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography...... (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions....

  12. Chronic tempol treatment attenuates the renal hemodynamic effects induced by a heme oxygenase inhibitor in streptozotocin diabetic rats.

    Science.gov (United States)

    Rodriguez, Francisca; Lopez, Bernardo; Perez, Cayetano; Fenoy, Francisco J; Hernandez, Isabel; Stec, David E; Li Volti, Giovanni; Salom, Miguel G

    2011-11-01

    Heme oxygenase-1 (HO-1) is induced by oxidative stress and plays an important role in protecting the kidney from oxidant-mediated damage in the streptozotocin (STZ) rat model of type-1 diabetes mellitus (DM-1). HO-derived metabolites, presumably carbon monoxide (CO), mediate vasodilatory influences in the renal circulation, particularly in conditions linked to elevated HO-1 protein expression or diminished nitric oxide (NO) levels. We tested the hypothesis that diabetes increases oxidative stress and induces HO-1 protein expression, which contributes to regulate renal hemodynamics in conditions of low NO bioavailability. Two weeks after the induction of diabetes with STZ (65 mg/kg iv), Sprague-Dawley rats exhibited higher renal HO-1 protein expression, hyperglycemia, and elevated renal nitrotyrosine levels than control normoglycemic animals. In anesthetized diabetic rats, renal vascular resistance (RVR) was increased, and in vivo cortical NO levels were reduced (P SnMP; 40 μmol/kg iv) did not alter renal hemodynamics in control rats, but greatly decreased glomerular filtration rate and renal blood flow, markedly increasing RVR in hyperglycemic diabetic rats. Chronic oral treatment with the SOD mimetic tempol prevented the elevation of nitrotyrosine, the HO-1 protein induction, and the increases in RVR induced by SnMP in the diabetic group, without altering basal NO concentrations or RVR. Increasing concentrations of a CO donor (CO-releasing molecule-A1) on pressurized renal interlobar arteries elicited a comparable relaxation in vessels taken from control or diabetic animals. These results suggest that oxidative stress-induced HO-1 exerts vasodilatory actions that partially maintain renal hemodynamics in uncontrolled DM-1. PMID:21849637

  13. Arterial baroreceptor reflex control of renal sympathetic nerve activity following chronic myocardial infarction in male, female, and ovariectomized female rats.

    Science.gov (United States)

    Pinkham, Maximilian I; Whalley, Gillian A; Guild, Sarah-Jane; Malpas, Simon C; Barrett, Carolyn J

    2015-07-15

    There is controversy regarding whether the arterial baroreflex control of renal sympathetic nerve activity (SNA) in heart failure is altered. We investigated the impact of sex and ovarian hormones on changes in the arterial baroreflex control of renal SNA following a chronic myocardial infarction (MI). Renal SNA and arterial pressure were recorded in chloralose-urethane anesthetized male, female, and ovariectomized female (OVX) Wistar rats 6-7 wk postsham or MI surgery. Animals were grouped according to MI size (sham, small and large MI). Ovary-intact females had a lower mortality rate post-MI (24%) compared with both males (38%) and OVX (50%) (P < 0.05). Males and OVX with large MI, but not small MI, displayed an impaired ability of the arterial baroreflex to inhibit renal SNA. As a result, the male large MI group (49 ± 6 vs. 84 ± 5% in male sham group) and OVX large MI group (37 ± 3 vs. 75 ± 5% in OVX sham group) displayed significantly reduced arterial baroreflex range of control of normalized renal SNA (P < 0.05). In ovary-intact females, arterial baroreflex control of normalized renal SNA was unchanged regardless of MI size. In males and OVX there was a significant, positive correlation between left ventricle (LV) ejection fraction and arterial baroreflex range of control of normalized renal SNA, but not absolute renal SNA, that was not evident in ovary-intact females. The current findings demonstrate that the arterial baroreflex control of renal SNA post-MI is preserved in ovary-intact females, and the state of left ventricular dysfunction significantly impacts on the changes in the arterial baroreflex post-MI. PMID:25994953

  14. Chronic angiotensin (1-7) injection accelerates STZ-induced diabetic renal injury

    Institute of Scientific and Technical Information of China (English)

    Ying SHAO; Ming HE; Li ZHOU; Tai YAO; Yu HUANG; Li-min LU

    2008-01-01

    Aim: The renin-angiotensin system (RAS) plays a critical role in blood pressure control and body fluid and electrolyte homeostasis. In the past few years, angio-tensin (Ang) (1-7) has been reported to counteract the effects of Ang Ⅱ and was even considered as a new therapeutical target in RAS. The present study aimed to investigate the effect of Ang (1-7) administration on a diabetic animal model and the modulation on local RAS. Methods: Streptozotocin (STZ) injection-induced diabetic rats were used in the experiment. The animals were divided into 3 groups: (1) control; (2) STZ-induced diabetes; and (3) STZ-induced diabetes with chronic Ang (1-7) treatment [D+Ang(1-7)]. In the D+Ang(1-7) group, a dose of 25 μg-kg-1.h-1 of Ang (1-7) was continually injected through the jugular vein by embedding mini-osmotic pump for 6 weeks. Plasma glucose, ratio of kidney to body weight, and 24 h urine protein and serum creatinine were monitored by conventional measurement. Plasma and renal Ang Ⅱ levels were measured by radioimmunoassay. Ang-con-verting enzyme (ACE), ACE2, Ang Ⅱ type 1 (AT1) receptor, Ang Ⅱ type 2 (AT2) receptor, Ang (1-7) Mas receptor, and TGF-β1 mRNA levels were measured by real time PCR; ACE, ACE2, and TGF-β1 protein levels were analyzed by Western blotting. Results: The renal function of diabetic rats was significantly retrogressed when compared with that of control rats. After the treatment by constant Ang (1-7) vein injection for 6 weeks, renal function was found to be even worse than diabetic rats, and both TGF-β1 mRNA and protein levels were elevated in the D+Ang(1-7) group compared with the diabetic rats. The real-time PCR result also showed an increase in ACE mRNA expression and decrease in ACE2 mRNA level in the D+Ang(1-7) group when compared with diabetic rats. The number of AT1 receptors increased in the Ang (1-7)-injected group, while the number of AT2 and Mas receptors decreased. Conclusion: Exogenous Ang (1-7) injection did not

  15. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease

    OpenAIRE

    Collins, Allan J.; Foley, Robert N; Gilbertson, David T.; Chen, Shu-Cheng

    2015-01-01

    The United States Renal Data System (USRDS) began in 1989 through US Congressional authorization under National Institutes of Health competitive contracting. Its history includes five contract periods, two of 5 years, two of 7.5 years, and the fifth, awarded in February 2014, of 5 years. Over these 25 years, USRDS reporting transitioned from basic incidence and prevalence of end-stage renal disease (ESRD), modalities, and overall survival, as well as focused special studies on dialysis, in th...

  16. Chronic renal insufficiency among Asian Indians with type 2 diabetes: I. Role of RAAS gene polymorphisms

    Directory of Open Access Journals (Sweden)

    Chandra T Satish

    2006-05-01

    Full Text Available Abstract Background Renal failure in diabetes is mediated by multiple pathways. Experimental and clinical evidences suggest that renin-angiotensin-aldosterone system (RAAS has a crucial role in diabetic kidney disease. A relationship between the RAAS genotypes and chronic renal insufficiency (CRI among type 2 diabetes subjects has therefore been speculated. We investigated the contribution of selected RAAS gene polymorphisms to CRI among type 2 diabetic Asian Indian subjects. Methods Twelve single nucleotide polymorphisms (SNPs from six genes namely-renin (REN, angiotensinogen (ATG, angiotensin converting enzyme I (ACE, angiotensin II type 1 receptor (AT1 and aldosterone synthase (CYP11B2 gene from the RAAS pathway and one from chymase pathway were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP method and tested for their association with diabetic CRI using a case-control approach. Successive cases presenting to study centres with type 2 diabetes of ≥2 years duration and moderate CRI diagnosed by serum creatinine ≥3 mg/dl after exclusion of non-diabetic causes of CRI (n = 196 were compared with diabetes subjects with no evidence of renal disease (n = 225. Logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study pair wise interactions between SNPs of different genes. Results Of the 12 SNPs genotyped, Glu53Stop in AGT and A>T (-777 in AT1 genes, were monomorphic and not included for further analysis. We observed a highly significant association of Met235Thr SNP in angiotensinogen gene with CRI (O.R. 2.68, 95%CI: 2.01–3.57 for Thr allele, O.R. 2.94, 95%CI: 1.88–4.59 for Thr/Thr genotype and O.R. 2.68, 95%CI: 1.97–3.64 for ACC haplotype. A significant allelic and genotypic association of T>C (-344 SNP in aldosterone synthase gene (O.R. 1.57, 95%CI: 1.16–2.14 and O.R. 1.81, 95%CI: 1.21–2.71 respectively, and genotypic association of

  17. Aortic Valve Replacement for Infective Endocarditis in a Renal Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Masmoudi Sayda

    2000-01-01

    Full Text Available Renal transplant recipients are more prone to developing infections. We report a 37-year old renal transplant recipient who developed infective endocarditis of the aortic valve, heart failure and renal allograft dysfunction. He underwent aortic valve replacement which was followed by improvement in cardiac as well as allograft function.

  18. Aortic Valve Replacement for Infective Endocarditis in a Renal Transplant Recipient

    OpenAIRE

    Masmoudi Sayda; Frikha Imed; Trigui Walid; Karoui Abdelhamid; Daoud Moncef; Sahnoun Youssef

    2000-01-01

    Renal transplant recipients are more prone to developing infections. We report a 37-year old renal transplant recipient who developed infective endocarditis of the aortic valve, heart failure and renal allograft dysfunction. He underwent aortic valve replacement which was followed by improvement in cardiac as well as allograft function.

  19. A re-appraisal of volume status and renal function impairment in chronic heart failure : combined effects of pre-renal failure and venous congestion on renal function

    NARCIS (Netherlands)

    Sinkeler, Steef J.; Damman, Kevin; van Veldhuisen, Dirk J.; Hillege, Hans; Navis, Gerjan

    2012-01-01

    The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal imp

  20. Recipient-derived EDA fibronectin promotes cardiac allograft fibrosis.

    Science.gov (United States)

    Booth, Adam J; Wood, Sherri C; Cornett, Ashley M; Dreffs, Alyssa A; Lu, Guanyi; Muro, Andrés F; White, Eric S; Bishop, D Keith

    2012-03-01

    Advances in donor matching and immunosuppressive therapies have decreased the prevalence of acute rejection of cardiac grafts; however, chronic rejection remains a significant obstacle for long-term allograft survival. While initiating elements of anti-allograft immune responses have been identified, the linkage between these factors and the ultimate development of cardiac fibrosis is not well understood. Tissue fibrosis resembles an exaggerated wound healing response, in which extracellular matrix (ECM) molecules are central. One such ECM molecule is an alternatively spliced isoform of the ubiquitous glycoprotein fibronectin (FN), termed extra domain A-containing cellular fibronectin (EDA cFN). EDA cFN is instrumental in fibrogenesis; thus, we hypothesized that it might also regulate fibrotic remodelling associated with chronic rejection. We compared the development of acute and chronic cardiac allograft rejection in EDA cFN-deficient (EDA(-/-)) and wild-type (WT) mice. While EDA(-/-) mice developed acute cardiac rejection in a manner indistinguishable from WT controls, cardiac allografts in EDA(-/-) mice were protected from fibrosis associated with chronic rejection. Decreased fibrosis was not associated with differences in cardiomyocyte hypertrophy or intra-graft expression of pro-fibrotic mediators. Further, we examined expression of EDA cFN and total FN by whole splenocytes under conditions promoting various T-helper lineages. Conditions supporting regulatory T-cell (Treg) development were characterized by greatest production of total FN and EDA cFN, though EDA cFN to total FN ratios were highest in Th1 cultures. These findings indicate that recipient-derived EDA cFN is dispensable for acute allograft rejection responses but that it promotes the development of fibrosis associated with chronic rejection. Further, conditions favouring the development of regulatory T cells, widely considered graft-protective, may drive production of ECM molecules which enhance

  1. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment...

  2. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U; Møller, M L; Ladefoged, S D; Mehlsen, J; Jensen, H A

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment with a...

  3. [Treatment of anemia in patients with chronic renal insufficiency with recombinant human erythropoietin].

    Science.gov (United States)

    Djukanović, Lj; Lezaić, V

    1996-01-01

    The discovery of recombinant human erythropoietin has enabled treatment of anaemia in patients whose anaemia was primarily caused by the lack of erythropoietin. This agent was most widely used in the treatment of anaemia in chronic renal failure patients. Non-regulated hypertension is considered to be the only absolute contraindication for recombinant human erythropoietin application, but thrombocytosis, predisposition to thromboses of arterio-venous fistulae, and convulsions are regarded as relative contraindications. Recombinant human erythropoietin may be administered intravenously, but the subcutaneous route is considered more rational. The treatment is initiated by low doses with gradual dose increase, what enables gradual anaemia correction and prevents the appearance of adverse effects. Haemoglobin level of around 100 g/l is considered the target haemoglobin level. The majority of patients respond well to treatment by human recombinant erythropoietin and the absence of anaemia improvement may be the result of iron deficiency, occult haemorrhages, chronic infection, inadequate dialysis, secondary hyperparathyroidism, aluminium intoxication. Anaemia improvement during the treatment with recombinant erythropoietin leads to the improvement of function of most organs and the quality of life in general as well as avoidance of blood transfusions and their adverse effects. The most frequent adverse effect of recombinant erythropoietin is the development of iron deficiency or hypertension aggravation. PMID:9102827

  4. Effect of vitamin C on endothelial function of children with chronic renal failure: An experimental study

    Science.gov (United States)

    Sabri, Mohammad Reza; Tavana, Esfandiar Najafi; Ahmadi, Alireza; Gheissari, Alaleh

    2015-01-01

    Background: It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF). Materials and Methods: In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial. Results: In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05). Conclusion: The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed. PMID:26918242

  5. Risk factors for chronic renal failure in Ivory coast: A prospective study of 280 patients

    Directory of Open Access Journals (Sweden)

    Ackoundou-N′Guessan K

    2011-01-01

    Full Text Available Chronic renal failure (CRF represents the major cause of mortality in the nephro-logy unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hos-pital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population. A total of 280 patients and 113 controls were recruited. The mean age of the patients was 37.88 ± 13.33 years and that of the controls was 41.5 ± 9.72 years. Both genders were equally represented. The main causes of CRF were chronic glomerulonephritis (47.48%, with HIV infec-tion accounting for 15% of them, and essential hypertension (HTA (25%. Essential HTA repre-sented the only factor which, if untreated, inevitably leads to CRF. Thus, our study indicates that HTA is a major public health concern. All efforts should be implemented to reduce the high prevalence of HTA and the deleterious effect of this disorder in Ivory Coast.

  6. RIPK3-Mediated Necroptosis and Apoptosis Contributes to Renal Tubular Cell Progressive Loss and Chronic Kidney Disease Progression in Rats

    Science.gov (United States)

    Zhu, Yongjun; Cui, Hongwang; Xia, Yunfeng; Gan, Hua

    2016-01-01

    Tubulointerstitial fibrosis (TIF) is caused by the progressive loss of renal tubular cells and the consequent replacement of the extracellular matrix. The progressive depletion of renal tubular cells results from apoptosis and necroptosis; however, the relative significance of each of these cell death mechanisms at different stages during the progression of chronic kidney disease (CKD) remains unclear. We sought to explore the mechanisms of renal tubular cell death during the early and intermediate stages of chronic renal damage of subtotal nephrectomied (SNx) rats. The results of tissue histological assays indicated that the numbers of necrotic dying cells and apoptotic cells were significantly higher in kidney tissues derived from a rat model of CKD. In addition, there was a significant increase in necroptosis observed by transmission electron microscopy (TEM) and an increase in the proportion of TUNEL-positive cells in kidney tissues from SNx rats compared with control rats, and necrostatin-1 (Nec-1) could inhibit necroptosis and reduce the proportion of TUNEL-positive cells. More importantly, we observed a significant increase in the incidence of necroptosis compared with apoptosis by TEM in vivo and in vitro and a significant increase in the proportion of TUNEL-positive tubular epithelial cells that did not express caspase-3 compared with those expressing cleaved caspase-3 in vitro. Furthermore, treatment with Nec-1 and zVAD strongly reduced necroptosis- and apoptosis-mediated renal tubular cell death and decreased the levels of blood urea nitrogen and serum creatinine and tubular damage scores of SNx rats. These results suggest that necroptotic cell death plays a more significant role than apoptosis in mediating the loss of renal tubular cells in SNx rats and that effectively blocking both necroptosis and apoptosis improves renal function and tubular damage at early and intermediate stages of CKD. PMID:27281190

  7. Renal embolism as a primary manifestation of Streptococcus dysgalactiae subspecies equisimilis endocarditis in a patient with chronic aortic dissection.

    Science.gov (United States)

    Ishimaru, Naoto; Kinami, Saori; Ohnishi, Hisashi; Takagi, Asuka; Kawamoto, Megumi; Doukuni, Ryota; Umezawa, Kanoko; Oozone, Sachiko; Yoshimura, Sho; Sakamoto, Susumu

    2015-06-01

    We report a case of renal embolism as an initial manifestation of Streptococcus dysgalactiae subspecies equisimilis (SDSE) endocarditis in a patient with chronic aortic dissection. A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain. The endocarditis affected the native aortic valve and was complicated by a renal embolism. Blood culture results were positive for SDSE. Intravenous penicillin resulted in satisfactory clinical and echocardiographic recovery. PMID:26110298

  8. Variability in Estimated Glomerular Filtration Rate by Area under the Curve Predicts Renal Outcomes in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Szu-Chia Chen

    2014-01-01

    Full Text Available Greater variability in renal function is associated with mortality in patients with chronic kidney disease (CKD. However, few studies have demonstrated the predictive value of renal function variability in relation to renal outcomes. This study investigates the predictive ability of different methods of determining estimated glomerular filtration rate (eGFR variability for progression to renal replacement therapy (RRT in CKD patients. This was a prospective observational study, which enrolled 1,862 CKD patients. The renal end point was defined as commencement of RRT. The variability in eGFR was measured by the area under the eGFR curve (AUC%. A significant improvement in model prediction was based on the −2 log likelihood ratio statistic. During a median 28.7-month follow-up, there were 564 (30.3% patients receiving RRT. In an adjusted Cox model, a smaller initial eGFR AUC%_12M (P<0.001, a smaller peak eGFR AUC%_12M (P<0.001, and a larger negative eGFR slope_12M (P<0.001 were associated with a higher risk of renal end point. Two calculated formulas: initial eGFR AUC%_12M and eGFR slope_12M were the best predictors. Our results demonstrate that the greater eGFR variability by AUC% is associated with the higher risk of progression to RRT.

  9. Renal function assessment in atrial fibrillation: Usefulness of chronic kidney disease epidemiology collaboration vs reexpressed 4 variable modification of diet in renal disease

    Institute of Scientific and Technical Information of China (English)

    Rami; Riziq-Yousef; Abumuaileq; Emad; Abu-Assi; Andrea; López-López; Sergio; Raposeiras-Roubin; Moisés; RodríguezMa?ero; Luis; Martínez-Sande; Francisco; Javier; García-Seara; Xesus; Alberte; Fernandez-López; Jose; Ramón; GonzálezJuanatey

    2015-01-01

    AIM: To compare the performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation.METHODS: We studied 911 consecutive patients with non-valvular atrial fibrillation on vitamin-K antagonist. The performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation with respect to either a composite endpoint of major bleeding, thromboembolic events and all-cause mortality or each individual component of the composite endpoint was assessed using continuous and categorical ≥ 60, 59-30, and < 30 m L/min per 1.73 m2 estimated glomerular filtration rate.RESULTS: During 10 ± 3 mo, the composite endpoint occurred in 98(10.8%) patients: 30 patients developed major bleeding, 18 had thromboembolic events, and 60 died. The new equation provided lower prevalence of renal dysfunction < 60 m L/min per 1.73 m2(32.9%),compared with the re-expressed equation(34.1%). Estimated glomerular filtration rate from both equations was independent predictor of composite endpoint(HR = 0.98 and 0.97 for the re-expressed and the new equation, respectively; P < 0.0001) and all-cause mortality(HR = 0.98 for both equations, P < 0.01). Strong association with thromboembolic events was observed only when estimated glomerular filtration rate was < 30 m L/min per 1.73 m2: HR is 5.1 for the re-expressed equation, and HR = 5.0 for the new equation. No significant association with major bleeding was observed for both equations.CONCLUSION: The new equation reduced the prevalence of renal dysfunction. Both equations performed similarly in predicting major adverse outcomes.

  10. Response Rate to Hepatitis B Vaccination in Patients with Chronic Renal Failure and End-Stage-Renal-Disease: Influence of Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Sh Taheri

    2005-11-01

    Full Text Available Background: Hepatitis B vaccination is recommended for all individuals with renal failure. Nevertheless, the response rate for this vaccine in hemodialysis patients is low. This study was designed to determine the response rate to hepatitis B vaccination in chronic renal failure (CRF and end stage renal disease (ESRD patients and those factors that Methods: We evaluated antiHBs level after primary vaccination in 32 predialysis and 93 dialysis patients. HBsAg positive patients were excluded. AntiHBs titers were determined in the period of 1 to 6 months after completion of vaccination. Results: Seroconversion (antiHBs>10mIU/ml was found in 100 patients (80%, but an excellent response (titer>100 mIU/ml was observed only in 74 (59.2%. Response rate were 71.9 and 82.8 in predialysis CRF and ESRD patients, respectively, but this difference was not significant (χ2-test; p=0.183. Predialysis patients showed an excellent response more than dialysis patients (χ2-test; p<0.05. Age, sex, and initial serum creatinine didn’t influence response rate. Response rate in patients with diabetic mellitus was lower than others (62.2% vs. 87.5% (χ2-test; p=0.001, and multiple logistic regression analysis showed a significant risk for vaccination nonresponse when patients were diabetics (oddsratio 4.38; 95% confidence interval: 1.70-11.24, p=0.002. Conclusion: Our result showed that 1 hepatitis B vaccine nonresponders are more likely to have diabetes mellitus and 2 response rate in predialysis patients is the same as in dialysis patients but predialysis patients, as compared with dialysis patients, were more inclined to show an excellent response. Key words: HBV vaccination, Chronic Renal Failure, dialysis, Diabetes Mellitus

  11. Concentrations of serum soluble transferring receptors in anemic children suffering from chronic renal failure

    International Nuclear Information System (INIS)

    Inappropriate erythropoietin production is the main reason responsiblefor anemia in chronic renal failure children. Iron deficiency is the commonest cause of erythropoietin resistance in dialyzed children treated with recombinant human erythropoietin (r-HuEPO). Early detection of iron deficiency is vital to optimize management of chronic anemia associated with renal failure that is being treated with r-HuEPO but bclinical or functional iron deficiency is difficult to be diagnosed in these patients by the commonly used tests. This study was conducted in order to evaluate the role of serum soluble transferrin receptor (sTfR) in identifying iron deficiency among uremic children. Twenty-five patients with end stage renal failure were studied. They were classified into two groups; group I included 15 patients under conservative treatment and their ages ranged between 2-1] years with a mean value of 9.3 ± 3.79. Group II included 10 patients under regular hemodialysis treatment. This group was evaluated before receiving treatment (group IIa) and after treatment of anemia by r-HuEPO and intravenous iron for 8 weeks (group IIb). Their ages ranged between 4-10 years with a mean value of 8.1 ± 1.79 years. Ten healthy subjects, matched in age and sex, were served as controls (group III). All subjects were evaluated regarding renal function test, hematopoietic indices am ferrokinetic parameters including hypochromic cell percentage, serum iron, serum ferritin, total iron binding capacity (TIBC), sTfR and sTfR/log ferritu index. The study showed that the hypochromic cell percentage was significantly increased in both groups I and Ila when compared to controls (P < 0.0001). Also, a highly significant increase was detected in group Ila when compared with group I (P < 0.0001). Serum iron values showed reduction in both studied groups, which were not statistically significant. Serum ferritin showed high significant elevation in all the studied groups as compared to controls. There

  12. Clinical utility of labeled cells for detection of allograft rejection and myocardial infarction

    International Nuclear Information System (INIS)

    The choice of a specific radiolabeled blood component for use in detection of allograft rejection depends on several factors including the immunosuppressive agents used, the type of organ allografted, and particularly the length of time the allograft resides in the host and the duration of rejection. To date, only the use of 111In-labeled platelets in renal allograft recipients immunosuppressed with azathioprine and corticosteroids has shown clinical promise in the detection of early allograft rejection. Radiolabeled blood components are unlikely to play a significant role in detection of myocardial infarction. The use of these agents for monitoring therapeutic interventions or as indicators of prognosis in patients with myocardial infarction continues to be investigated

  13. Clinical utility of labeled cells for detection of allograft rejection and myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Fawwaz, R.A.

    1984-07-01

    The choice of a specific radiolabeled blood component for use in detection of allograft rejection depends on several factors including the immunosuppressive agents used, the type of organ allografted, and particularly the length of time the allograft resides in the host and the duration of rejection. To date, only the use of 111In-labeled platelets in renal allograft recipients immunosuppressed with azathioprine and corticosteroids has shown clinical promise in the detection of early allograft rejection. Radiolabeled blood components are unlikely to play a significant role in detection of myocardial infarction. The use of these agents for monitoring therapeutic interventions or as indicators of prognosis in patients with myocardial infarction continues to be investigated.

  14. Renal unit practitioners’ knowledge, attitudes and practice regarding the safety of unfractionated heparin for chronic haemodialysis

    Directory of Open Access Journals (Sweden)

    Debra Ockhuis

    2015-02-01

    Full Text Available Background: Chronic haemodialysis for adult patients with end-stage kidney failure requires a patent extracorporeal circuit, maintained by anticoagulants such as unfractionated heparin (UFH. Incorrect administration of UFH has safety implications for patients.Objectives: Firstly, to describe renal practitioners’ self-reported knowledge, attitudes and practice (KAP regarding the safe use of UFH and its effects; secondly, to determine an association between KAP and selected independent variables.Method: A cross-sectional descriptive survey by self-administered questionnaire and non-probability convenience sampling was conducted in two tertiary hospital dialysis units and five private dialysis units in 2013.Results: The mean age of 74/77 respondents (96.1%, was 41.1 years. Most (41/77, 53.2% had 0–5 years of renal experience. The odds of enrolled nurses having poorer knowledge of UFH than registered nurses were 18.7 times higher at a 95% Confidence Interval (CI (1.9–187.4 and statistically significant (P = 0.013. The odds of delivering poor practice having ≤ five years of experience and no in-service education were 4.6 times higher at a 95% CI (1.4–15.6, than for respondents who had ≥ six years of experience (P = 0.014 and 4.3 times higher (95% CI 1.1–16.5 than for respondents who received in-service education (P = 0.032, the difference reaching statistical significance in both cases.Conclusion: Results suggest that the category of the professional influences knowledge and, thus, safe use of UFH, and that there is a direct relationship between years of experience and quality of haemodialysis practice and between having in-service education and quality of practice.

  15. Direct conscious telemetry recordings demonstrate increased renal sympathetic nerve activity in rats with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Ibrahim M Salman

    2015-08-01

    Full Text Available Chronic kidney disease (CKD is associated with sympathetic hyperactivity and impaired blood pressure control reflex responses, yet direct evidence demonstrating these features of autonomic dysfunction in conscious animals is still lacking. Here we measured renal sympathetic nerve activity (RSNA and mean arterial pressure (MAP using telemetry-based recordings in a rat model of CKD, the Lewis Polycystic Kidney (LPK rat, and assessed responses to chemoreflex activation and acute stress. Male LPK and Lewis control animals (total n=16 were instrumented for telemetric recording of RSNA and MAP. At 12–13 weeks-of-age, resting RSNA and MAP, sympathetic and haemodynamic responses to both peripheral (hypoxia: 10% O2 and central chemoreflex (hypercapnia: 7% CO2 activation and acute stress (open-field exposure, were measured. As indicators of renal function, urinary protein (UPro and creatinine (Ucr levels were assessed. LPK rats had higher resting RSNA (1.2±0.1 vs. 0.6±0.1 µV, p<0.05 and MAP (151±8 vs. 97±2 mmHg, p<0.05 compared to Lewis. MAP was negatively correlated with Ucr (r=-0.80, p=0.002 and positively correlated with RSNA (r=0.66, p=0.014, with multiple linear regression modeling indicating the strongest correlation was with Ucr. RSNA and MAP responses to activation of the central chemoreflex and open-field stress were reduced in the LPK relative to the Lewis (all p<0.05. This is the first description of dual conscious telemetry recording of RSNA and MAP in a genetic rodent model of CKD. Elevated RSNA is likely a key contributor to the marked hypertension in this model, while attenuated RSNA and MAP responses to central chemoreflex activation and acute stress in the LPK indicate possible deficits in the neural processing of autonomic outflows evoked by these sympathoexcitatory pathways.

  16. Clinical value of renal injury biomarkers in diagnosis of chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Cheng-lu ZHANG

    2011-12-01

    Full Text Available Objective To investigate the levels of renal injury biomarkers in patients with chronic kidney disease(CKD and evaluate their clinical significances in diagnosis of CKD.Methods A total of 66 subjects(37 patients with CKD and 29 healthy individuals were involved in this study.Serum blood urea nitrogen(SBUN was determined by Glutamate dehydrogenase method;serum creatinine(SCr and urinary creatinine(UCr were detected by sarcosine oxidase method;serum uric acid(SUA was measured by uricase colorimetry;serum cystatin C(Cys C and urinary microalbumin(UmAlbwere analyzed by immunological transmission turbidimetry;urinary protein(U-PROwas measured by Coomassies Brilliant Blue(CBB assay.The UmAlb and U-PRO levels were expressed in units of mg/mmolUCr.Results The results of independent samples t test indicated that significant differences were found in SBUN,SCr,SUA,Cys C,UmAlb and U-PRO(P < 0.05 between patient group and healthy control group.The evaluation of diagnostic effects showed that the areas under the curve at ROC plot for SBUN,SCr,SUA,Cys C,UmAlb and U-PRO were 0.907,0.912,0.742,0.982,0.984 and 0.991,respectively.Conclusions U-PRO,UmAlb and Cys C are ideal biomarkers,SCr and SBUN come next,SUA is the weakest when the above biomarkers are applied to evaluate the renal injury and its severity of the patients with CKD.

  17. Assessment of leptin and some Antioxidants in Blood of Chronic Renal Failure Patients

    International Nuclear Information System (INIS)

    The aim of the present work is to study the effect of haemodialysis on the state of the antioxidants glutathione peroxidase (GPx) and vitamin C and the role of leptin hormone on the redox homeostasis in patients with chronic renal failure (CRF). This study was carried out on 25 patients (15 females and 10 males) with CRF,aged 19-55 years, in addition to 25 healthy control (10 females and 15 males). Patients were subjected to regular haemodialysis for 4 hours three times weekly and blood samples were collected before haemodialysis. In this study, plasma leptin was significantly increased in CRF group than normal control. Vitamin C and GPx were decreased significantly in CRF group in comparison with normal control. There was non-significant difference in serum leptin level between males and females in both control and patient groups. Patients showed significant lower body mass index (BMI) and albumin and higher cholesterol. In the control group, serum leptin levels showed significant positive correlation with BMI, while CRF group had significant negative correlation. In CRF group, serum leptin showed significant negative correlation with serum albumin and non-significant negative correlation with both creatinine and cholesterol. This is probably due to malnutrition status commonly occurs in renal failure. Serum leptin levels showed non-significant negative correlation between both GPx and Vitamin C in control group while in patient group, leptin showed significant positive correlation with GPx and vitamin C. In conclusion leptin acts on energy metabolism and plays a role in the modulation of cellular redox balance while the oxidative stress plays a role in many disease states. These diseases had increased incidence in uremia and particularly in haemodialysis

  18. Effects of Chronic Renal Failure on Brain Cytochrome P450 in Rats.

    Science.gov (United States)

    Naud, Judith; Harding, Jessica; Lamarche, Caroline; Beauchemin, Stephanie; Leblond, Francois A; Pichette, Vincent

    2016-08-01

    Chronic renal failure (CRF) impedes renal excretion of drugs and their metabolism by reducing the expression of liver cytochrome P450 (P450). Uremic serum contains factors, such as parathyroid hormone (PTH), that decrease liver P450s. The P450s are also involved in the metabolism of xenobiotics in the brain. This study investigates: 1) the effects of CRF on rat brain P450, 2) the role of PTH in the downregulation of brain P450s in CRF rats, and 3) the effects of PTH on P450s in astrocytes. Protein and mRNA expression of P450s were assessed in the brain of CRF and control (CTL) rats, as well as from CTL or CRF rats that underwent parathyroidectomy (PTX) 1 week before nephrectomy. CYP3A activity was measured using 3-[(3, 4-difluorobenzyl) oxy]-5, 5-dimethyl-4-[4-methylsulfonyl) phenyl] furan-2(5H)-1 metabolism in brain microsomal preparation. CYP3A protein expression was assessed in primary cultured astrocytes incubated with serum obtained from CRF or CTL rats or with PTH. Significant downregulations (≥40%) of CYP1A, CYP2C11, and CYP3A proteins were observed in microsomes from CRF rat brains. CYP3A activity reduction was also observed. CYP3A expression and activity were unaffected in PTX-pretreated CRF rats. Serum of PTX-treated CRF rats had no impact on CYP3A levels in astrocytes compared with that of untreated CRF rats. Finally, PTH addition to normal calf serum induced a reduction in CYP3A protein similar to CRF serum, suggesting that CRF-induced hyperparathyroidism is associated with a significant decrease in P450 drug-metabolizing enzymes in the brain, which may have implications in drug response. PMID:27271372

  19. Effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Selim Aydemir; Binnaz Handan Ozdemir; Gurden Gur; Ibrahim Dogan; Ugur Yilmaz; Sedat Boyacioglu

    2005-01-01

    AIM: To evaluate the effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure (CRF).METHODS: Forty-four patients were enrolled in this study and divided into four groups with respect to their Helicobacter pylori (H pylori) and CRF status. Groups were labeled as follows: 1a: normal renal function, H pylori negative (n = 12), 1b: normal renal function,H pylori positive (n = 11), 2a: CRF, H pylori negative (n = 10), 2b: CRF, H pylori positive (n = 11). Upper gastrointestinal endoscopy was done in all the patients involved in the study. During endoscopical investigation,antral biopsy specimens were taken from each patient.In order to evaluate the cell apoptosis and proliferation in gastric epithelial cells, Bax and proliferating cell nuclear antigen (PCNA) labeling indexes (LI) were assessed with immunohistochemical staining method.RESULTS: For groups 1a, 1b, 2a, and 2b, mean Bax LI was identified as 34.4±13.7, 44.1±16.5, 46.3±20.5,60.7±13.8, respectively and mean PCNA LI was identified as 36.2±17.2, 53.6±25.6, 59.5±25.6, 67.2±22,respectively. When the one-way ANOVA test was applied,statistically significant differences were detected between the groups for both Bax LI (P = 0.004 <0.01) and PCNA LI (P = 0.009 <0.01). When groups were compared further in terms of Bax LI and PCNA LI with Tukey's HSD test for multiple pairwise comparisons, statistically significant difference was observed only between groups 1a and 2b (P = 0.006 <0.01).CONCLUSION: In gastric epithelial cells, expression of both the pre-apoptotic protein Bax and the proliferation marker PCNA increase with H pylori infection. This increase is more evident in patients with uremia. These findings suggest that uremia accelerates apoptosis and proliferation in gastric epithelial cells.

  20. The Role of Cardiac Arrhythmias in a Sudden Death Prognosis in Patients with a Terminal Chronic Renal Insufficiency

    Directory of Open Access Journals (Sweden)

    Suvorov A.V.

    2011-03-01

    Full Text Available The aim of investigation is to reveal the most frequent rhythm disturbances in patients with a terminal renal insufficiency and determine their role in prognosis in this group of patients. Materials and Methods. 145 patients with a terminal chronic renal insufficiency who underwent a program hemodialysis were examined; Holter monitoring was performed in 50 of them. A control group consisted of 15 patients in a predialysis period. Diagnostic techniques: a clinicoanamnestic method, laboratory and instrumental studies. Results. Unfavorable rhythm disturbances (including life-threatening ones are more common in patients with a terminal renal insufficiency who underwent a program hemodialysis compared to patients in a predialysis period. This allows referring them to a group of patients with high risk of a sudden arrhythmic death.

  1. Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Con View.

    Science.gov (United States)

    Scherk, Margie A; Laflamme, Dottie P

    2016-11-01

    Renal diets typically incorporate protein and phosphorus restriction, supplement with potassium and Omega-3 fatty acids, and address metabolic acidosis. Compared to "maintenance" diets, these modifications appear to benefit cats with chronic kidney disease (CKD). However, there is limited data in cats justifying the specific amounts of the nutrients used in these diets, and there is little evidence supporting protein restriction in cats with CKD. Energy intake, maintenance of body weight, and muscle and body condition need to be addressed, and may take precedence over special diets. Further research is needed to better define optimum diets for cats with CKD. PMID:27593575

  2. Periodontal parameters and BANA test in patients with chronic renal failure undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Sérgio Aparecido Torres

    2010-06-01

    Full Text Available OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2 years with chronic renal failure (CRF and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD, gingival recession (GR, dental plaque index (PLI, gingival index (GI, and dental calculus index (CI were the clinical parameters recorded for the entire dentition (at least 19 teeth, while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B. RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36; PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and 0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001 in the control group. Comparison of the other clincial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05 in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05. None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9% for the CRF group and 35.7% for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

  3. Chronic Activation of Heme Free Guanylate Cyclase Leads to Renal Protection in Dahl Salt-Sensitive Rats.

    Directory of Open Access Journals (Sweden)

    Linda S Hoffmann

    Full Text Available The nitric oxide (NO/soluble guanylate cyclase (sGC/cyclic guanosine monophasphate (cGMP-signalling pathway is impaired under oxidative stress conditions due to oxidation and subsequent loss of the prosthetic sGC heme group as observed in particular in chronic renal failure. Thus, the pool of heme free sGC is increased under pathological conditions. sGC activators such as cinaciguat selectively activate the heme free form of sGC and target the disease associated enzyme. In this study, a therapeutic effect of long-term activation of heme free sGC by the sGC activator cinaciguat was investigated in an experimental model of salt-sensitive hypertension, a condition that is associated with increased oxidative stress, heme loss from sGC and development of chronic renal failure. For that purpose Dahl/ss rats, which develop severe hypertension upon high salt intake, were fed a high salt diet (8% NaCl containing either placebo or cinaciguat for 21 weeks. Cinaciguat markedly improved survival and ameliorated the salt-induced increase in blood pressure upon treatment with cinaciguat compared to placebo. Renal function was significantly improved in the cinaciguat group compared to the placebo group as indicated by a significantly improved glomerular filtration rate and reduced urinary protein excretion. This was due to anti-fibrotic and anti-inflammatory effects of the cinaciguat treatment. Taken together, this is the first study showing that long-term activation of heme free sGC leads to renal protection in an experimental model of hypertension and chronic kidney disease. These results underline the promising potential of cinaciguat to treat renal diseases by targeting the disease associated heme free form of sGC.

  4. Effects of Chinese herbal enema therapy combined basic treatment on BUN,SCr,UA,and IS in chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    邹川

    2012-01-01

    Objective To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients,thus providing evidence for further optimizing the comprehensive treatment. Methods Using nonrandomized concurrent control

  5. Obesity-induced chronic inflammation in high fat diet challenged C57BL/6J mice is associated with acceleration of age-dependent renal amyloidosis

    NARCIS (Netherlands)

    van der Heijden, Roel A.; Bijzet, Johan; Meijers, Wouter C.; Yakala, Gopala K.; Kleemann, Robert; Nguyen, Tri Q.; de Boer, Rudolf A.; Schalkwijk, Casper G.; Hazenberg, Bouke P. C.; Tietge, Uwe J. F.; Heeringa, Peter

    2015-01-01

    Obesity-induced inflammation presumably accelerates the development of chronic kidney diseases. However, little is known about the sequence of these inflammatory events and their contribution to renal pathology. We investigated the effects of obesity on the evolution of age-dependent renal complicat

  6. Computed tomography of renal cell carcinoma in patients with terminal renal impairment

    International Nuclear Information System (INIS)

    Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC's. Bilateral renal tumors were found in our study

  7. Computed tomography of renal cell carcinoma in patients with terminal renal impairment

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic)], E-mail: ferda@fnplzen.cz; Hora, Milan [Department of Urology, Charles University Hospital Plzen, Dr. Edvarda Benese 13, CZ-306 40 Plzen (Czech Republic); Hes, Ondrej [Institut of Pathology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Reischig, Tomas [Department of Internal Medicine, Nephrology Unit, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Kreuzberg, Boris; Mirka, Hynek; Ferdova, Eva; Ohlidalova, Kristyna; Baxa, Jan [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Urge, Tomas [Department of Urology, Charles University Hospital Plzen, Dr. Edvarda Benese 13, CZ-306 40 Plzen (Czech Republic)

    2007-08-15

    Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC

  8. Efficacy and Safety of Sitagliptin Versus Glipizide in Patients With Type 2 Diabetes and Moderate-to-Severe Chronic Renal Insufficiency

    OpenAIRE

    Arjona Ferreira, Juan Camilo; Marre, Michel; Barzilai, Nir; Guo, Hua; Golm, Gregory T.; Sisk, Christine McCrary; Kaufman, Keith D.; Goldstein, Barry J.

    2013-01-01

    OBJECTIVE Patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease have an increased risk of micro- and macrovascular disease, but limited options for antihyperglycemic therapy. We compared the efficacy and safety of sitagliptin with glipizide in patients with T2DM and moderate-to-severe chronic renal insufficiency and inadequate glycemic control. RESEARCH DESIGN AND METHODS Patients (n = 426) were randomized 1:1 to sitagliptin (50 mg every day [q.d.] for moderate renal insuff...

  9. A rare case of reversible acquired AA-type renal amyloidosis in a chronic filariasis patient receiving antifilarial therapy.

    Science.gov (United States)

    Nayak, Hemanta Kumar; Daga, Mradul Kumar; Garg, Sandeep kumar; Sinha, Nitin kumar; Kumar, Rakshit; Mohanty, Pankaj Kumar; Pandey, Binay Kumar

    2011-08-01

    Lymphatic filariasis is a major health problem in India with a large number of patients tending to be asymptomatic. In the Southeast and South Asian regions, Wuchereria bancrofti is the most prevalent parasite, causing filariasis in 99.4% of cases. While kidney involvement is a rare event in chronic filariasis, this case is unique because AA-type renal amyloidosis occurs in chronic W. bancrofti infection. We present here a unique case of lymphatic filariasis. The patient, a 25-year-old male who was previously diagnosed with right lower limb filarial lymphedema and had undergone lymphovenous anastomosis, was admitted for evaluation of persistent nephrotic-range proteinuria. Autoimmune markers in the form of anti-nuclear antibodies, anti-double-stranded DNA and anti-neutrophil cytoplasmic antibody were negative; C3 was normal. Urine analysis revealed inactive sediment with moderate proteinuria. Both serum and urine electrophoresis were negative for paraproteins and bone marrow aspirate and biopsy were normal. Evidence of active filarial infection was established on the basis of microfilariae in the peripheral smear and a positive W. bancrofti antigen test. Kidney biopsy revealed renal amyloidosis when stained with Congo red and anti-AA immunostain. The patient's proteinuria improved on conservative management with angiotensin-converting enzyme inhibitors and a course of antifilarial drugs. His proteinuria returned to amyloidosis. Repeat demonstration of filarial antigen and microfilariae in the peripheral smear were negative on multiple occasions during the follow-up period. Although various chronic infections can lead to secondary renal amyloidosis, this is the first case reported in world literature where secondary amyloidosis developed as a complication of chronic filarial infection due to W. bancrofti. This is probably also the first case reported in world literature where renal amyloidosis has an etiological association with W. bancrofti infection and where

  10. Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction

    OpenAIRE

    D. Scrutinio; Agostoni, P; Gesualdo, L.; U. Corra; Mezzani, A; Piepoli, M; Di Lenarda, A.; Iorio, A.; Passino, C; Magri, D.; Masarone, D; Battaia, E; Girola, D; Re, F.; Cattadori, G

    2015-01-01

    Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V˙O2) in heart failure (HF) patients. Methods and Results: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerula...

  11. Assessment of metabolomic and proteomic biomarkers in detection and prognosis of progression of renal function in chronic kidney disease

    OpenAIRE

    Nkuipou-Kenfack, Esther; Duranton, Flore; Gayrard, Nathalie; Argilés, Àngel; Lundin, Ulrika; Weinberger, Klaus M.; Dakna, Mohammed; Delles, Christian; Mullen, William; Husi, Holger; Klein, Julie; Koeck, Thomas; Zürbig, Petra; Mischak, Harald

    2014-01-01

    Chronic kidney disease (CKD) is part of a number of systemic and renal diseases and may reach epidemic proportions over the next decade. Efforts have been made to improve diagnosis and management of CKD. We hypothesised that combining metabolomic and proteomic approaches could generate a more systemic and complete view of the disease mechanisms. To test this approach, we examined samples from a cohort of 49 patients representing different stages of CKD. Urine samples were analysed for proteom...

  12. Effect of L-arginine on renal blood flow in normal subjects and patients with hypoxic chronic obstructive pulmonary disease.

    OpenAIRE

    Howes, T. Q.; Keilty, S. E.; Maskrey, V. L.; Deane, C. R.; Baudouin, S. V.; Moxham, J

    1996-01-01

    BACKGROUND: L-arginine is the precursor of endothelium derived nitric oxide (NO) and increasing the available substrate may increase the production of NO. This has been shown by local infusion in peripheral vascular beds but there are few studies of the effects during systemic infusion. Renal vasoconstriction is known to be important in the pathogenesis of cor pulmonale in patients with hypoxic chronic obstructive pulmonary disease (COPD). The effects of a systemic infusion of L-arginine on r...

  13. Allograft Pancreatectomy: Indications and Outcomes.

    Science.gov (United States)

    Nagai, S; Powelson, J A; Taber, T E; Goble, M L; Mangus, R S; Fridell, J A

    2015-09-01

    This study evaluated the indications, surgical techniques, and outcomes of allograft pancreatectomy based on a single center experience. Between 2003 and 2013, 47 patients developed pancreas allograft failure, excluding mortality with a functioning pancreas allograft. Early graft loss (within 14 days) occurred in 16, and late graft loss in 31. All patients with early graft loss eventually required allograft pancreatectomy. Nineteen of 31 patients (61%) with late graft loss underwent allograft pancreatectomy. The main indication for early allograft pancreatectomy included vascular thrombosis with or without severe pancreatitis, whereas one recipient required urgent allograft pancreatectomy for gastrointestinal hemorrhage secondary to an arterioenteric fistula. In cases of late allograft pancreatectomy, graft failure with clinical symptoms such as abdominal discomfort, pain, and nausea were the main indications (13/19 [68%]), simultaneous retransplantation without clinical symptoms in 3 (16%), and vascular catastrophes including pseudoaneurysm and enteric arterial fistula in 3 (16%). Postoperative morbidity included one case each of pulmonary embolism leading to mortality, formation of pseudoaneurysm requiring placement of covered stent, and postoperative bleeding requiring relaparotomy eventually leading to femoro-femoral bypass surgery 2 years after allograftectomy. Allograft pancreatectomy can be performed safely, does not preclude subsequent retransplantation, and may be lifesaving in certain instances. PMID:25912792

  14. Comparison of renal dynamic imaging and modified MDRD equation in determining the stage of chronic kidney disease patients

    International Nuclear Information System (INIS)

    Objective: To compare the accuracy of 99Tcm-diethylene triamine pentaacetic acid (99Tcm-DTPA) renal dynamic imaging and modified modification of diet in renal disease trail (MDRD) equation in determining the stage of the chronic kidney disease (CKD) patients in clinical practice. Methods: A total of 169 patients were enrolled whose glomerular filtration rate (GFR) were determined simultaneously by 3 methods: dual plasma sample clearance method, renal dynamic imaging and modified MDRD equation. The dual plasma sample clearance method was employed as the reference method. The accuracy of the other methods in determining the stage of CKD patients was compared and the comparison was repeated based on the different stages. Results: The accuracy of renal dynamic imaging and modified MDRD equation was 56.80% and 68.64%, respectively (P=0.019<0.05). And only in the stage of uremia, the difference of the above-mentioned two method reached statistical significance (P=0.012<0.05), while in other stages they showed similar performance (P=0.180, 0.424, 0.629 and 0.754, all P>0.05). Conclusion: Modified MDRD equation showed better performance than renal dynamic imaging or as good as the second one in determining the stage of CKD patients and the former one should be the first choice in clinical practice because of its simplicity and economy. (authors)

  15. The effect of renal diet in association with enalapril or benazepril on proteinuria in dogs with proteinuric chronic kidney disease.

    Science.gov (United States)

    Zatelli, A; Roura, X; D'Ippolito, P; Berlanda, M; Zini, E

    2016-01-01

    Treating proteinuria in dogs reduces the progression of chronic kidney disease (CKD); renal diets and angiotensin-converting enzyme (ACE)-inhibitors are cornerstones of treatment. Whether different ACE-inhibitors have distinct kidney protective effects is unknown; it is therefore hypothesized that renal diets and enalapril or benazepril have different beneficial effects in proteinuric CKD dogs. Forty-four dogs with proteinuric CKD (IRIS stages 1-4) were enrolled in the study and were fed renal diet for 30 days. Thereafter, they were randomly assigned to one of 2 groups. Dogs in group A (n=22) received enalapril (0.5 mg/kg, q12h) and in group B (n=22) benazepril (0.5 mg/kg, q24h); in both groups, dogs were fed the same renal diet. After randomization, dogs were monitored for 120 days. Body weight and body condition score (BCS), serum concentrations of creatinine, blood urea nitrogen (BUN), albumin and total proteins, and urine protein-to-creatinine (UPC) ratio were compared at different time-points. After 30 days of renal diet, creatinine, BUN and UPC ratio decreased significantly (p<0.0001). Compared to randomization, body weight, BCS, albumin, total proteins, creatinine and BUN did not vary during follow-up in the 44 dogs and differences between group A and B were not observed. However, the UPC ratio of group A at day 60, 90 and 150 was significantly lower than in group B and compared to randomization (p<0.05). In group B it did not vary overtime. It is concluded that the renal diet is beneficial to decrease creatinine, BUN and UPC ratio in proteinuric CKD dogs. Enalapril further ameliorates proteinuria if administered along with renal diet. PMID:27540513

  16. Mining the human urine proteome for monitoring renal transplant injury.

    Science.gov (United States)

    Sigdel, Tara K; Gao, Yuqian; He, Jintang; Wang, Anyou; Nicora, Carrie D; Fillmore, Thomas L; Shi, Tujin; Webb-Robertson, Bobbie-Jo; Smith, Richard D; Qian, Wei-Jun; Salvatierra, Oscar; Camp, David G; Sarwal, Minnie M

    2016-06-01

    The human urinary proteome provides an assessment of kidney injury with specific biomarkers for different kidney injury phenotypes. In an effort to fully map and decipher changes in the urine proteome and peptidome after kidney transplantation, renal allograft biopsy matched urine samples were collected from 396 kidney transplant recipients. Centralized and blinded histology data from paired graft biopsies was used to classify urine samples into diagnostic categories of acute rejection, chronic allograft nephropathy, BK virus nephritis, and stable graft. A total of 245 urine samples were analyzed by liquid chromatography-mass spectrometry using isobaric Tags for Relative and Absolute Quantitation (iTRAQ) reagents. From a group of over 900 proteins identified in transplant injury, a set of 131 peptides were assessed by selected reaction monitoring for their significance in accurately segregating organ injury causation and pathology in an independent cohort of 151 urine samples. Ultimately, a minimal set of 35 proteins were identified for their ability to segregate the 3 major transplant injury clinical groups, comprising the final panel of 11 urinary peptides for acute rejection (93% area under the curve [AUC]), 12 urinary peptides for chronic allograft nephropathy (99% AUC), and 12 urinary peptides for BK virus nephritis (83% AUC). Thus, urinary proteome discovery and targeted validation can identify urine protein panels for rapid and noninvasive differentiation of different causes of kidney transplant injury, without the requirement of an invasive biopsy. PMID:27165815

  17. Changes in the Conformational State of Hemoglobin in Hemodialysed Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Anna Pieniazek

    2015-01-01

    Full Text Available The aim of this study was to evaluate the properties of internal components of erythrocytes in chronic renal failure (CRF patients undergoing hemodialysis (HD in comparison to control subjects. For investigation of conformational state of hemoglobin and nonheme proteins (NHP the maleimide spin label (MSL in electron paramagnetic resonance (EPR was applied. The studies were performed using MSL in whole cells and hemolysate as well as proteins separated by ion exchange chromatography and checked by electrophoresis. Additionally the level of –SH groups in hemolysate and isolated internal proteins of CRF erythrocytes was determined using 4,4′-dithiodipyridine. All measurements were performed before and after hemodialysis. Oxidative stress accompanying CRF/hemodialysed patients caused a significant decrease in the mobility of internal components inside erythrocytes indicated by MSL (P < 0.02. The significant decrease in mobility of spin labeled HbA1c and HbA both before and after HD (P < 0.0002 as well as in nonheme proteins before hemodialysis (P < 0.05 versus control was indicated. Decrease in mobility of internal components of erythrocytes was accompanied by loss of thiols before and after hemodialysis versus control in NHP (P < 0.05, HbA1c (P < 0.0002, and HbA (P < 0.0005. These findings showed oxidative influence of hemodialysis on hemoglobins and internal nonheme proteins in erythrocytes of CRF patients.

  18. HEARING LOSS IN CHRONIC RENAL FAILURE - AN ASSESSMENT OF MULTIPLE AETIOLOGICAL FACTORS

    Directory of Open Access Journals (Sweden)

    Suja Sreedharan

    2015-04-01

    Full Text Available Introduction: Sensorineural hearing loss in chronic renal failure is believed to be of multifactorial etiology. Associated hypertension and diabetes mellitus, use of ototoxic drugs, hemodialysis and the changes in metabolic parameters are the various reasons quoted for the hearing loss. Objectives: Our study attempts to correlate the hearing thresholds with the multiple parameters like blood levels of urea, serum creatinine, sodium, potassium, calcium and hemoglobin values incriminated in decreased hearing in CRF patients. Materials and methods:Prospective study of 25 patients receiving treatment for CRF. The threshold of the worsen ear was considered for statistical analysis. Results:18% of the patients at low frequencies (250 and 500 Hz, 32% of the patients at mid-frequencies (1000 and 2000 Hz, and 72% of the patients at high frequencies (4000 and 8000 Hz had decreased hearing for both bone and air conduction hearing. We found a positive correlation between hearing loss and increasing number of hemodialysis sessions, the levels of blood urea, serum creatinine, serum sodium and use of ototoxic drugs; while serum calcium, serum potassium and hemoglobin levels had a negative correlation. Conclusion:Though the management of CRF including hemodialysis has been refined, hearing loss continues to cause disability in CRF patients.

  19. [The observation of therapy of anemia in chronic renal failure with recombinant human erythropoietin].

    Science.gov (United States)

    Jiang, Y; Liu, P; Wang, E J

    1994-02-01

    Anemia is one of the serious complications of chronic renal failure, therapy with recombinant human erythropoietin (r-HuEPO) can correct such anemia officiently. For most patients, the initial dose of r-HuEPO is 100U/kg, by intravenously or subcutaneous, three times a week. After 6 weeks of treatment, Hb could increase to 100g/L, and Hct to above 0.33-0.35. Then 500/kg 3 time a week can be used as maintaining dose. 4 patients need maintaining dose of 150U/kg, for pulmonary infection, poor nutrition, and poor iron supply. Therefore, during the treatment, iron folie acid and Vit B12 should be applied sufficiently and treat the infection effectively with the increasing of Hb and Hct, 2/3 of the patients have hypertension which can be controlled with medication. If there is thrombosis in the dialyzer, the dose of heparin should be increased. The patients on r-HuEPO should be dialysised sufficiently to prevent hyperkalemia. PMID:8070295

  20. [Erectile dysfunction and quality of life in patients with chronic renal failure].

    Science.gov (United States)

    Bellinghieri, G; Santoro, D; Satta, E; Savica, V

    2008-01-01

    Erectile dysfunction (ED) is associated with a reduced quality of life; it represents a risk factor for the development of depression. ED may induce depression, loss of self-esteem, poor self-image, anxiety, and tension in the relationship with the partner. These emotional disturbances can create physical conditions that lead to increased difficulty in achieving an erection. Depression can deprive a person of the ability to experience many of life's pleasures. It not only affects the mind but also the body--often in unexpected ways. As a result, many men who have been diagnosed with depression find themselves suffering from another condition: ED. Sexual dysfunction is a big problem also in patients with chronic renal failure and seriously affects their quality of life. About 40% of men on dialysis suffer from ED. Many uremic patients have additional symptoms including reduction of libido and a decreased frequency of sexual intercourse. With the start of dialysis some of these symptoms may improve, without, however, returning to normal. PMID:19048573

  1. PATHOGENESIS OF IMMUNE ALTERATIONS AND CORRECTIVE ROLE OF AMLODIPINE IN EXPERIMENTAL CHRONIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    M. V. Osikov

    2016-01-01

    Full Text Available The purpose of this study was to assess some mechanisms of changes in immune state, and to evaluate a role of amlodipine, a known calcium channel blocker, as a potential corrective drug in experimental chronic renal failure (CRF. An animal CRF model was produced in rats by a two-stage operative resection of 5/6 of the renal tissue. Amlodipine is used per os at a daily dose of 0.25 mg/kg for 7 days. Flow cytofluorimetric approach was used to discern peripheral blood lymphocytes: CD3+ (mainly, T lymphocytes, CD45RA+ (mainly, B cells, as well as the following cell markers: Annexin 5-FITC+/7-AAD- (early apoptosis, Annexin 5-FITC+/7-AAD+ (late apoptosis and, in part, necrotic cells. Moreover, we have measured serum concentrations of urea, creatinine, phosphate, total calcium, parathyroid hormone (PTH, IL-1β, IL-4, interferon-γ, superoxide dismutase (SOD and catalase activities. Evaluation of Th1- and Th2-dependent immune response was carried out, respectively, by detection of delayed-type hypersensitivity, and scoring the antibody-forming cells in rat spleen induced by immunization with allogeneic erythrocytes. Primary, secondary and final products of lipid peroxidation were evaluated in lipid extracts from peripheral blood lymphocytes. Changes of immune state in CRF included depression of Th1 and Th2 dependent immune response, reduced number of lymphocytes bearing T and В cell markers, increased IL-1β concentrations in blood, along with decreased amounts of IFNγ and IL-4. Probable pathogenesis of the altered immune state may be associated with increased number of peripheral lymphocytes being at early and late stages of apoptosis/necrosis, elevated blood levels of IL-1β, total calcium, parathyroid hormone, reduced concentrations of IFNγ, and increased contents of primary, secondary and final peroxidation products in peripheral blood lymphocytes, being accompanied by inhibition of the SOD and catalase activity in blood plasma

  2. 中国肾移植患者钙蛋白酶10基因多态性与移植后糖尿病的相关性研究%Calpain10 gene polymorphisms are associated with posttransplantation diabetes mellitus in Chinese renal allograft recipients

    Institute of Scientific and Technical Information of China (English)

    余爱荣; 范星; 刘慧明; 辛华雯

    2012-01-01

    目的:探讨中国肾移植患者钙蛋白酶10(CAPN10)基因多态性与移植后糖尿病(PTDM)的相关性.方法:采用等位基因特异性PCR、限制性片断长度多态性PCR (PCR-RFLP)分别检测了97例PTDM患者(PTDM组)和301例未发生PTDM的肾移植患者(对照组)的CAPN10基因SNP-19、SNP-43、SNP-63的基因型,采用lo-gistic回归分析该基因多态性与PTDM的相关性.结果:PTDM组患者SNP-19的11+12基因型频率和SNP-43的GG基因型频率明显高于对照组(P<0.05).用性别、移植时年龄、体重和BMI进行校正后,SNP-19的11基因型和12基因型携带者移植术后发生PTDM的风险分别是22基因型的1.502倍(OR=1.502,95% CI:1.016~2.347,P=0.048)和1.764倍(O)R=1.764,95%CI:1.055~2.947,P=0.030),SNP-43的GG基因型携带者移植术后发生PTDM的风险是AA和GA基因型患者的2.19倍(OR=2.190,95%CI:1.047~~3.473,P=0.044),SNP-63与PTDM的发生无明显相关性(P>0.05).结论:CAPN10基因SNP-19的1等位基因和SNP-43的GG基因型是肾移植后发生PTDM的独立危险因素.%AIM: To investigate the association between the CalpainlO gene polymorphism and the risk of PTDM in Chinese renal allograft recipients. METHODS; Three single nucleotide polymorphisms (CAPN10 gene SNP-19, SNP-43, SNP-63) were genotyped in the cohort, which consisted of 97 renal allograft recipients with PTDM (PTDM group) and 301 renal allograft recipients without PTDM ( control group). The genotypes of polymorphisms were performed by allele specific polymerase chain reaction ( ASPCR ) , PCR-restriction fragment length polymorphism (PCR-RFLP). Logistic regression test was used to identify risk factors for PTDM development and calculate the odds ratio, RESULTS: The 11 and 12 genotypes of SNP-19 and the GG genotypes of SNP-43 were more common in patients with PTDM than those without PTDM (F<0. 05). After adjustments for age, sex, body weight and BMI, the effect of genotype remained significant (11 vs 22, OR = 1.502, 95

  3. Chronic Kidney Pain in Autosomal Dominant Polycystic Kidney Disease : A Case Report of Successful Treatment by Catheter-Based Renal Denervation

    NARCIS (Netherlands)

    Casteleijn, Niek F.; de Jager, Rosa L.; Neeleman, M. Peer; Blankestijn, Peter J.; Gansevoort, Ron T.

    2014-01-01

    Chronic pain is a common concern in patients with autosomal dominant polycystic kidney disease (ADPKD). We report what to our knowledge is the first catheter-based renal denervation procedure in a patient with ADPKD resulting in successful management of chronic pain. The patient was a 43-year-old wo

  4. Carotid artery intima media thickness as a surrogate marker of atherosclerosis in patient with chronic renal failure on hemodialysis

    Directory of Open Access Journals (Sweden)

    Jayanta Paul

    2012-01-01

    Full Text Available Background: In patients with chronic renal failure (CRF, carotid artery intima media thickness (CAIMT is increased when the patients are on hemodialysis. Vascular events caused by atherosclerosis are the major cause of death in patients undergoing hemodialysis. Aims: This study was done to find out the relationship between carotid artery intima media thickness and hemodialysis in chronic renal failure patients independent of classical risk factors and also the relationship between CAIMT of hemodialyzed patients and nonhemodialyzed CRF patients. Materials and Methods: In this observational study, CAIMT of 78 CRF patients was examined by B-mode ultrasonography. Glomerular filtration rate (GFR was calculated by using the "Modification of Diet in Renal Disease" formula. CRF patients, who had been on regular hemodialysis treatment (treated thrice weekly for at least 6 months, were identified as hemodialyzed patients. Data were analyzed by software Statistical package for the social Sciences (SPSS (17 th version. Results: There was significant positive correlation between CAIMT and hemodialysis (P=0.045 independent of traditional risk factors. Hemodialyzed patients had higher mean CAIMT (1136.30±21.21 μm, P<0.001 than mean CAIMT of age and sex matched nondialyzed patients (959.30±23.01 μm. Conclusion: Hemodialysis is an independent risk factor for atherosclerosis in CRF patents. Hemodialyzed patients have significantly higher CAIMT than nondialyzed CRF patients.

  5. Effect of gum arabic on oxidative stress and inflammation in adenine-induced chronic renal failure in rats.

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    Badreldin H Ali

    Full Text Available Inflammation and oxidative stress are known to be involved in the pathogenesis of chronic kidney disease in humans, and in chronic renal failure (CRF in rats. The aim of this work was to study the role of inflammation and oxidative stress in adenine-induced CRF and the effect thereon of the purported nephroprotective agent gum arabic (GA. Rats were divided into four groups and treated for 4 weeks as follows: control, adenine in feed (0.75%, w/w, GA in drinking water (15%, w/v and adenine+GA, as before. Urine, blood and kidneys were collected from the rats at the end of the treatment for analysis of conventional renal function tests (plasma creatinine and urea concentration. In addition, the concentrations of the pro-inflammatory cytokine TNF-α and the oxidative stress markers glutathione and superoxide dismutase, renal apoptosis, superoxide formation and DNA double strand break frequency, detected by immunohistochemistry for γ-H2AX, were measured. Adenine significantly increased the concentrations of urea and creatinine in plasma, significantly decreased the creatinine clearance and induced significant increases in the concentration of the measured inflammatory mediators. Further, it caused oxidative stress and DNA damage. Treatment with GA significantly ameliorated these actions. The mechanism of the reported salutary effect of GA in adenine-induced CRF is associated with mitigation of the adenine-induced inflammation and generation of free radicals.

  6. Aortic Arch Calcification Predicts the Renal Function Progression in Patients with Stage 3 to 5 Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Lung-Chih Li

    2015-01-01

    Full Text Available Introduction. The presence of aortic arch calcification (AoAC and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD. However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3–5 CKD. Methods. We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR. Results. Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly. Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3–5.

  7. Cardiovascular and Renal Effects of Bromocriptine in Diabetic Patients with Stage 4 Chronic Kidney Disease

    Science.gov (United States)

    Mejía-Rodríguez, Oliva; Herrera-Abarca, Jorge E.; Ceballos-Reyes, Guillermo; Avila-Diaz, Marcela; Prado-Uribe, Carmen; Belio-Caro, Francisco; Salinas-González, Antonio; Vega-Gomez, Helios; Alvarez-Aguilar, Cleto; Lindholm, Bengt; García-López, Elvia; Paniagua, Ramón

    2013-01-01

    Objective. The objective of this study was to investigate the effect of bromocriptine (BEC) on left ventricular mass index (LVMI) and residual renal function (RRF) in chronic kidney disease (CKD) patients with type 2 diabetes (T2D). Research Design and Methods. A 6-month double-blind randomized controlled trial was conducted in 28 patients with T2D and stage 4 CKD with increased LVMI. Fourteen patients received BEC (2.5 mg, initially 1 tablet with subsequent increase to three times a day) and 14 received a placebo (PBO; initially 1 tablet with subsequent increase to three times a day). Cardiovascular changes were assessed by monitoring 24 h ambulatory blood pressure, two-dimensional-guided M-mode echocardiography, and N-terminal brain natriuretic peptide (NT-proBNP) plasma levels. RRF was evaluated by creatinine clearance and cystatin-C plasma levels. Results. Both BEC and PBO groups decreased blood pressure—but the effect was more pronounced in the BEC group. Average 24 h, diurnal and nocturnal blood pressures, and circadian profile showed improved values compared to the PBO group; LVMI decreased by 14% in BEC and increased by 8% in PBO group. NT-proBNP decreased in BEC (0.54 ± 0.15 to 0.32 ± 0.17 pg/mL) and increased in PBO (0.37 ± 0.15 to 0.64 ± 0.17 pg/mL). Creatinine clearance did not change in the BEC group and decreased in the PBO group. Conclusions. BEC resulted in a decrease on blood pressure and LVMI. BEC also prevented the progression of CKD while maintaining the creatinine clearance unchanged. PMID:23984312

  8. Effects of chronic renal failure on the expression of connexin 43 in the rat's corpus cavernosum

    Institute of Scientific and Technical Information of China (English)

    Qiang Fu; Jia-Jv Lv; Hui Zhang

    2008-01-01

    Aim: To explore the mechanism of chronic renal failure (CRF)-related erectile dysfunction (ED). Methods: CRF experimental models were established by 5/6 nephrectomy from male Sprague-Dawley rats. Both the rats from the control group (NCRF group, n = 6) and the experimental group (CRF group, n = 30) were injected with a low dose (80 μg/kg) of apomorphine in the 12th week after resection surgery to measure corresponding penile erections.Western blot method was thereafter conducted to measure the expression of connexin 43 (CX43) in the rat corpus cavernosum in the 12th week after the resection surgery. Results: There was one death in the NCRF group and five in the CRF group. The penile erection ratio of the CRF group was 28% (7/25), whereas that of the NCRF group was 100% (5/5), which presents a significant difference between the two groups (P < 0.05). In terms of penile erection frequency, the average of the CRF group was 1.0±0.0, which was significantly different from that of the NCRF group (2.2±0.8) (P < 0.05). As for the expression of CX43 in the rat corpus cavernosum, a notable difference existed between the CRF group (0.21±0.07) and the NCRF group (0.53±0.27) (P < 0.01). Conclusion: CRF signifi-cantly reduces the erectile function of rats. A close correlation exists between the expression of CX43 in rats' corpus cavemosum and CRF-related ED.

  9. Effects of L-Carnitine Added to Erythropoietin in Anemic Chronic Renal Failure Patients on Hemodialysis.

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    N Taheri

    2006-10-01

    Full Text Available Introduction: Chronic renal disease (C.R.D is a pathophysiological process due to progressive and irreversible decrease in number and function of nephrons in the kidney. Anemia is one of the most important complications in CRD patients. Anemia is caused mainly due to diminished production of erythropoietin (EPO, which is treated by weekly injection of the EPO. L-carnitine added to EPO can increase the efficacy of EPO. Methods: Present study, from March 2003 until September 2004 (18 months, evaluates the effects of L-carnitine added to EPO in 30 patients at Shaheed Rahnemon hemodialysis center of Yazd. Each patient was administered one oral table (250 mg of L-carnitine, twice a day along with EPO for 90 days. EPO was in the form of injection 2000 iu/sc after dialysis.(three times per week. One questionnaire was completed for each patient, which included demographic characteristics, type of disease, duration of the hemodialysis, Hb and Hct levels, transferrin saturation and ferritin levels. Hb ,Hct and transferrin saturations were measured on days 1, 45 and 90. Results were analyzed by paired t test and analysis of variance. Results: Results of this study showed that the mean Hb levels and Hct were significantly raised up to 1.1 mg/dl (P.value<0.001 and 2.7% (P.Value<0.001, respectively. In addition, significant decrease of 5.75% in transferrin (P.Value< 0.001 and 121ng/ml in ferritin levels (P.Value< 0.001 was observed. Efficacy of EPO plus L-carnitine was affected only by duration of hemodialysis and not by age, sex or causes of CRD. Conclusion: L-carnitine added to EPO increases the efficacy of EPO after 3 months.

  10. Con: Nutritional vitamin D replacement in chronic kidney disease and end-stage renal disease.

    Science.gov (United States)

    Agarwal, Rajiv; Georgianos, Panagiotis I

    2016-05-01

    Insufficiency of 25-hydroxyvitamin D [25(OH)D] is highly prevalent among patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) and is a critical component in the pathogenesis of secondary hyperparathyroidism. Accordingly, current National Kidney Foundation-Kidney Disease Outcomes Quality Initiative and Kidney Disease: Improving Global Outcomes guidelines recommend the correction of hypovitaminosis D through nutritional vitamin D replacement as a first-step therapeutic approach targeting secondary hyperparathyroidism. In this Polar Views debate, we summarize the existing evidence, aiming to defend the position that nutritional vitamin D replacement is not evidence-based and should not be applied to patients with CKD. This position is supported by the following: (i) our meta-analysis of randomized controlled trials shows that whereas nutritional vitamin D significantly increases serum 25(OH)D levels relative to placebo, there is no evidence either in predialysis CKD or in ESRD that parathyroid hormone (PTH) is lowered; (ii) on the other hand, in randomized head-to-head comparisons, nutritional vitamin D is shown to be inferior to activated vitamin D analogs in reducing PTH levels; (iii) nutritional vitamin D is reported to exert minimal to no beneficial actions in a series of surrogate risk factors, including aortic stiffness, left ventricular mass index (LVMI), epoetin utilization and immune function among others; and (iv) there is no evidence to support a benefit of nutritional vitamin D on survival and other 'hard' clinical outcomes. Whereas nutritional vitamin D replacement may restore 25(OH)D concentration to near normal, the real target of treating vitamin D insufficiency is to treat secondary hyperparathyroidism, which is untouched by nutritional vitamin D. Furthermore, the pleotropic benefits of nutritional vitamin D remain to be proven. Thus, there is little, if any, benefit of nutritional vitamin D replacement in CKD. PMID:27190392

  11. Evaluation of patients with upper gastrointestinal bleeding in chronic renal failure

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    Mehmet Sinan Dal

    2011-06-01

    Full Text Available Incidence of gastrointestinal complications especially gastric bleeding increased in patients with chronic renal failure (CRF. The aim of this study was to comparatively investigate upper gastrointestinal bleeding (UGB in patients with non-hemodialysis CRF and the patients without CRF.Materials and Methods: Seventy-six patients (55 men and 21 women with and without CRF and UGB was included. The first group who had CRF consisted of 23 patients and the control group 53. All patients were evaluated in the view point of age, gender, smoking status, other illnesses, medicine usage, laboratory parameters, endoscopic evidence and endoscopic intervention (scleroteraphy.Results: Calcium levels of patients with a history of previous UGB was significantly lower compared with those bleeding for the first time (p<0.05. The mean parathormon level was higher in patients with CRF (171.24 ± 141.96 pg/ml (p<0.05. Serum albumin level was negatively correlated with urea and creatinine (p<0.001, and positively correlated with hemoglobin and hematocrit levels (p=0.003 and p=0.005. The patients undergoing sclerotherapy more frequently needed transfusions (p<0.05. The hospitalization time found to be shortening with increasing hemoglobin, hematocrit, calcium and albumin levels; and lengthens with increased urea and creatinine.Conclusion: The history of previous gastrointestinal bleeding and detection of pathological findings in endoscopy were more frequent in patients with CRF. Gastrointestinal bleeding risk did not reduce using by gastric protection against acetylsalicylic acid and other non-steroidal antiinflammatory drugs. Also, low albumin levels and secondary hiperparathyroidism in these patients may be risky for gastrointestinal bleeding. J Clin Exp Invest 2011;2(2:207-13

  12. Costos de intervenciones para pacientes con insuficiencia renal crónica Costs of intervention for patients with chronic renal disease

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    Armando Arredondo

    1998-06-01

    ças resultam significativas para o desenho e avaliação de padrões de designação de recursos.INTRODUCTION: The results of a study which identified the cost of health interventions in the management of patients with chronic renal disease are presented. MATERIAL AND METHOD: The costing method was based on a consensus technique and the instrumentation of case management through the identification of the materials used and functions of production for the demand of each service solicited. The interventions included: peritoneal dialysis, hemodialysis, and renal transplant. RESULTS: The cost per event in U.S. dollars was $3.71, $57.95, and $8,778.32, respectively. The annual cost of case management was: Peritoneal Dialysis $5,643.07, Hemodialysis $9,631.60 and renal transplant $3,021.67. CONCLUSIONS: The information generated from the costs of the events differed considerably from the information that was generated by the annual cost of case management. These differences are significant for the design and evaluation of patterns for allocating resources.

  13. Effect of enalapril on the progression of chronic renal failure. A randomized controlled trial

    DEFF Research Database (Denmark)

    Kamper, A L; Strandgaard, S; Leyssac, P P

    1992-01-01

    conventional antihypertensive treatment. The patients were followed for at least 2 years or until they needed dialysis. The groups were comparable with respect to age and sex distribution, etiology of renal diseases, initial levels of renal function and arterial blood pressure (BP), and protein intake. The...

  14. PLASMA-LIPOPROTEINS AND RENAL APOLIPOPROTEINS IN RATS WITH CHRONIC ADRIAMYCIN NEPHROSIS

    NARCIS (Netherlands)

    JOLES, JA; VANTOL, A; JANSEN, EHJM; KOOMANS, HA; RABELINK, TJ; VANGOOR, H

    1993-01-01

    The relation between plasma lipoprotein composition and renal apolipoprotein deposition was studied in nephrotic rats in which stable renal function had been monitored for 7 months after a single low dose of adriamycin (ADR, 3 mg/kg). Proteinuria was observed 3 weeks after ADR and increased progress

  15. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases.

    Science.gov (United States)

    Özdemir-van Brunschot, Denise M D; de Sévaux, Ruud G L; van Hamersvelt, Henk W; Warlé, Michiel C

    2016-09-01

    Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min) led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion. PMID:27313989

  16. Management of chronic hepatitis C virus infection in patients with end-stage renal disease: a review

    Directory of Open Access Journals (Sweden)

    Aguirre Valadez J

    2015-02-01

    Full Text Available Jonathan Aguirre Valadez,1 Ignacio García Juárez,1 Rodolfo Rincón Pedrero,2 Aldo Torre11Department of Gastroenterology, 2Department of Nephrology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico Abstract: Infection with hepatitis C virus (HCV is highly prevalent in chronic kidney disease (CKD patients, mainly in those on hemodialysis (HD. The seroprevalence of HCV in developing countries ranges between 7% and 40%. Risk factors for this infection in the CKD population include the number of blood transfusions, duration of end-stage renal disease (ESRD, and prevalence of HCV in HD. Chronic HCV infection in patients with ESRD is associated with an increase in morbidity and mortality in the pre and post kidney transplant periods. The increase in mortality is directly associated with liver complications and an elevated cardiovascular risk in HCV-infected patients on hemodialysis. Antiviral treatment may improve the prognosis of patients with HCV, and standard interferon remains the cornerstone of treatment. Treatment of HCV in patients with CKD is complex, but achieving a sustained viral response may decrease the frequency of complications after transplantation. It appears that HCV-infected patients who remain on maintenance dialysis are at increased risk of death compared with HCV patients undergoing renal transplantation.Keywords: hepatitis C virus, chronic kidney disease, hemodialysis, interferon

  17. Unilateral Renal Ischemia-Reperfusion as a Robust Model for Acute to Chronic Kidney Injury in Mice.

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    Nathalie Le Clef

    Full Text Available Acute kidney injury (AKI is an underestimated, yet important risk factor for development of chronic kidney disease (CKD. Even after initial total recovery of renal function, some patients develop progressive and persistent deterioration of renal function and these patients are more likely to progress to end-stage renal disease (ESRD. Animal models are indispensable for unravelling the mechanisms underlying this progression towards CKD and ESRD and for the development of new therapeutic strategies in its prevention or treatment. Ischemia (i.e. hypoperfusion after surgery, bleeding, dehydration, shock, or sepsis is a major aetiology in human AKI, yet unilateral ischemia-reperfusion is a rarely used animal model for research on CKD and fibrosis. Here, we demonstrate in C57Bl/6J mice, by both histology and gene expression, that unilateral ischemia-reperfusion without contralateral nephrectomy is a very robust model to study the progression from acute renal injury to long-term tubulo-interstitial fibrosis, i.e. the histopathological hallmark of CKD. Furthermore, we report that the extent of renal fibrosis, in terms of Col I, TGFβ, CCN2 and CCN3 expression and collagen I immunostaining, increases with increasing body temperature during ischemia and ischemia-time. Thus, varying these two main determinants of ischemic injury allows tuning the extent of the long-term fibrotic outcome in this model. Finally, in order to cover the whole practical finesse of ischemia-reperfusion and allow model and data transfer, we provide a referenced overview on crucial technical issues (incl. anaesthesia, analgesia, and pre- and post-operative care with the specific aim of putting starters in the right direction of implementing ischemia in their research and stimulate them, as well as the community, to have a critical view on ischemic literature data.

  18. Determinants of renal tissue oxygenation as measured with BOLD-MRI in chronic kidney disease and hypertension in humans.

    Directory of Open Access Journals (Sweden)

    Menno Pruijm

    Full Text Available Experimentally renal tissue hypoxia appears to play an important role in the pathogenesis of chronic kidney disease (CKD and arterial hypertension (AHT. In this study we measured renal tissue oxygenation and its determinants in humans using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI under standardized hydration conditions. Four coronal slices were selected, and a multi gradient echo sequence was used to acquire T2* weighted images. The mean cortical and medullary R2* values ( = 1/T2* were calculated before and after administration of IV furosemide, a low R2* indicating a high tissue oxygenation. We studied 195 subjects (95 CKD, 58 treated AHT, and 42 healthy controls. Mean cortical R2 and medullary R2* were not significantly different between the groups at baseline. In stimulated conditions (furosemide injection, the decrease in R2* was significantly blunted in patients with CKD and AHT. In multivariate linear regression analyses, neither cortical nor medullary R2* were associated with eGFR or blood pressure, but cortical R2* correlated positively with male gender, blood glucose and uric acid levels. In conclusion, our data show that kidney oxygenation is tightly regulated in CKD and hypertensive patients at rest. However, the metabolic response to acute changes in sodium transport is altered in CKD and in AHT, despite preserved renal function in the latter group. This suggests the presence of early renal metabolic alterations in hypertension. The correlations between cortical R2* values, male gender, glycemia and uric acid levels suggest that these factors interfere with the regulation of renal tissue oxygenation.

  19. Acoustic radiation force impulse imaging for non-invasive assessment of renal histopathology in chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Qiao Hu

    Full Text Available OBJECTIVE: To investigate the stiffness values obtained by acoustic radiation force impulse (ARFI quantification in assessing renal histological fibrosis of chronic kidney disease (CKD. METHODS: 163 patients with CKD and 32 healthy volunteers were enrolled between June 2013 and April 2014. ARFI quantification, given as shear wave velocity (SWV, was performed to measure renal parenchyma stiffness. Diagnostic performance of ARFI imaging and conventional ultrasound (US were compared with histologic scores at renal biopsy. Intra- and inter-observer reliability of SWV measurement was analyzed. RESULTS: In CKD patients, SWV measurements correlated significantly with pathological parameters (r = -0.422--0.511, P<0.001, serum creatinine (r = -0.503, P<0.001, and glomerular filtration rate (r = 0.587, P<0.001. The mean SWV in kidneys with severely impaired (histologic score: ≥19 points was significant lower than that mildly impaired (histologic score: ≤9 points, moderately impaired (histologic score: 10-18 points, and control groups (all P<0.001. Receiver operating characteristic (ROC curves analyses indicated that the area under the ROC curve for the diagnosis of renal histological fibrosis using ARFI imaging was superior to these conventional US parameters. Using the optimal cut-off value of 2.65 m/s for the diagnosis of mildly impaired kidneys, 2.50 m/s for moderately impaired kidneys, and 2.33 m/s for severely impaired kidneys, the corresponding area under the ROC curves were 0.735, 0.744, and 0.895, respectively. Intra- and intre-observer agreement of SWV measurements were 0.709 (95% CI: 0.390-0.859, P<0.001 and 0.627 (95% CI: 0.233-0.818, P = 0.004, respectively. CONCLUSIONS: ARFI may be an effective tool for evaluating renal histological fibrosis in CKD patients.

  20. sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

    International Nuclear Information System (INIS)

    Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1. (author)