Simultaneous Occurrence of Malignant Fibrous Histiocytoma of the Ureter and Dioctophyma Renale Infection: A Case Report

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Park, Hye Young; Seo, Jung Wook; Lee, Byung Hoon; Lee, Ji Young; Kim, Su Young; Cha, Soon Joo; Kim, Yong Hoon; Hwang, Yoon Joon; Kim, You Sung [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

2013-03-15

A common soft-tissue tumor, malignant fibrous histiocytoma (MFH) occurs in mainly limbs, retroperitoneal and peritoneal space, and occurrence in kidneys or the ureter is very rare. Dioctophyma renale (D. renale) since first discovered in dog's kidney was found in the kidneys of animals such as mink, coyote and weasel, and human infection has only been reported in only approximately 20 cases worldwide. MFH of the ureter and D. renale infection very rarely occur in humans, and has not been reported in our country. Here, we described the case of an adult man in whom MFH of the ureter simultaneously occurred with D. renale infection. An initial CT scan showed a well-defined, persistent, enhancing polypoid mass-like lesion in the upper ureter. After 10 months, D. renale was excreted in the urine and a follow-up CT scan showed an increase in the size of that lesion and irregular thickening of the ureter wall. The diagnosis of MFH was pathologically verified.

Ectopic ureterocele and ectopic ureter in pediatric patients

International Nuclear Information System (INIS)

Lloret, M. T.; Ricart, V.; Muro, M. D.; Perez, D.; Martinez, I.; Brugger, S.; Romero, M. J.; Cortina, H.

2000-01-01

To describe the radiological findings associated with ectopic ureterocele and ectopic ureter in pediatric patients. To assess the role of ultrasound (US), serial micturating cystourethrography (SM-CU) and intravenous urography (IVU) in the diagnosis of these two entities. The authors performed a retrospective study of 132 patients, 73 with ectopic ureterocele and 59 with ectopic ureter. The imaging studies used were US, SMCU, IVU and methods to determine renal function (diuretic renography and renal scintigraphy). The findings were confirmed during surgery in every case. The most common radiological findings in ectopic ureterocele were renal duplication (86,3%). vesicoureteral reflux (VUR) to the lower half of the kidney (46.6%), dilatation of the lower pole of the kidney (38.4%) and contralateral duplication (30.1%). In boys, the ectopic ureter entered via bladder neck and posterior urethra (73.7%) or into seminal vesicles (15.8%); in girls, it went to vagina (32.5%), bladder neck (30%) or urethra (22.5%). Renal duplication was associated in 64.4%, with VUR to the ectopic ureter in 21% while there was a single renal system in 35.6%, with VUR to the ectopic ureter in 57.1% and contralateral renal agenesis in 19%. Eighteen patients (13.6%) presented a single, dy plastic, nonfunctioning renal system (6 cases of ureterocele and 12 of ectopic ureter). Knowledge of the embryological development of ureteral duplication is essential for the understanding of these two entities and helps to differentiate between them, thus facilitating a sometimes complicated diagnosis. Ectopic ureters and ureteroceles accompanied by a single, dysplastic renal system are associated with a greater incidence of congenital anomalies and a higher rate of complications than the duplicate systems. A prenatal US examination enables early diagnosis. The anatomical information provided by US is, on occasion, more valuable than that resulting from IVU or SMCU, However, IVU is indispensable in girls

Cryptorchidism as a caudal developmental field defect. A new description of cryptorchidism associated with malformations and dysplasias of the kidneys, the ureters and the spine from T10 to S5

DEFF Research Database (Denmark)

Cortes, Dina; Thorup, J M; Beck, Bjarne Lomholdt

1998-01-01

Cryptorchidism is a feature of abnormalities in the hypothalamo-pituitary-testicular axis, and almost all disorders of sexual differentiation in which a testis is present. We found cryptorchidism to be associated with malformations and dysplasias of the kidneys, the ureters and the spine from T10...... field defect. Study of cryptorchid patients exhibiting malformations or dysplasias of the kidneys, the ureters or the spine from T10 to S5 is essential in order to isolate new genetic disorders and to spot environmental factors causing cryptorchidism....

Case Report of Left Retrocaval Ureter: Pre-Transplant CT Urographic Findings and Post-Transplant Outcomes

Energy Technology Data Exchange (ETDEWEB)

Kim, Ah Yeong; Park, Byung Kwan; Kim, Chan Kyo; Park, Sung Yoon; Han, Deok Hyun [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2013-02-15

A left retrocaval ureter is an extremely rare congenital anomaly, in which the left ureter passes behind the left inferior vena cava (IVC). The compression of the ureter between the IVC and the vertebrae results in a progressive hydronephrosis. Recently, the left kidney with a retrocaval ureter was detected on CT urographic images in a living-related donor and achieved a good outcome after allograft transplantation. We report the CT urographic findings of a left retrocaval ureter and the short-term outcome of allograft transplantation.

Intravesical ligation as a new technique to manage a refluxing native ureter without simultaneous nephrectomy in renal transplantation.

Science.gov (United States)

Guzmán, J A

2012-12-01

This article aims to describe an original technique to correct refluxing native ureters observed during a prerenal transplantation study. The correction is performed by intravesical ligation of the native refluxing ureters at the same time as renal transplantation without simultaneous nephrectomy. Between January 2004 and December 2010 we performed intravesical ligation of a refluxing ureter simultaneous with a transplantation procedure without a concomittant native nephrectomy in 12 of 345 subjects (3.47%). The 8 bilateral and 4 unilateral ligations were performed on 11 cadaveric and 1 living-related nonidentical donor transplantations. The implantation of the kidney donor ureter was performed anatomically in the bladder trigone through a transvesical ureteroneocystostomy with a transmural, submucosal antireflux tunnel. Early and late postoperative recovery was satisfactory in all patients. There was no documented kidney area pain, proven urinary tract infection, morbidity or mortality attributed to the procedure. Intravesical ligation is a practical technique to manage vesicoureteral reflux into the native ureters simultaneously with the ureteral implantation of the kidney donor in a single surgical renal transplant procedure without native kidney nephrectomy. Copyright © 2012 Elsevier Inc. All rights reserved.

Pure robotic retrocaval ureter repair

Directory of Open Access Journals (Sweden)

Ashok k. Hemal

2008-12-01

Full Text Available PURPOSE: To demonstrate the feasibility of pure robotic retrocaval ureter repair. MATERIALS AND METHODS: A 33 year old female presented with right loin pain and obstruction on intravenous urography with the classical "fish-hook" appearance. She was counseled on the various methods of repair and elected to have a robot assisted repair. The following steps are performed during a pure robotic retrocaval ureter repair. The patient is placed in a modified flank position, pneumoperitoneum created and ports inserted. The colon is mobilized to expose the retroperitoneal structures: inferior vena cava, right gonadal vein, right ureter, and duodenum. The renal pelvis and ureter are mobilized and the renal pelvis transected. The ureter is transposed anterior to the inferior vena cava and a pyelopyelostomy is performed over a JJ stent. RESULTS: This patient was discharged on postoperative day 3. The catheter and drain tube were removed on day 1. Her JJ stent was removed at 6 weeks postoperatively. The postoperative intravenous urography at 3 months confirmed normal drainage of contrast medium. CONCLUSION: Pure robotic retrocaval ureter is a feasible procedure; however, there does not appear to be any great advantage over pure laparoscopy, apart from the ergonomic ease for the surgeon as well the simpler intracorporeal suturing.

Assessment of ureterovesical jet dynamics in obstructed ureter by urinary stone with color Doppler and duplex Doppler examinations.

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Jandaghi, Ali Babaei; Falahatkar, Siavash; Alizadeh, Ahmad; Kanafi, Alireza Rajabzadeh; Pourghorban, Ramin; Shekarchi, Babak; Zirak, Amin Keshavarz; Esmaeili, Samaneh

2013-04-01

This study was designed to evaluate ureterovesical jet dynamics in obstructed ureter and to compare it with those of contralateral unobstructed side. Forty-six patients with diagnosis of ureteral stone, based on imaging findings in computed tomography were enrolled in this study. The gray-scale ultrasound exam from both kidneys and urinary bladder was performed. Then, ureterovesical jet characteristics including ureteral jet frequency, duration and peak velocity were assessed by color Doppler and duplex Doppler studies in both obstructed and unobstructed ureters by a radiologist, 15-30 min after oral hydration with 750-1,000 mL of water. When compared with contralateral normal side, the ureterovesical jet in obstructed ureter showed less frequency (0.59 vs. 3.04 jets/min; P < 0.05), shorter duration (1.24 vs. 5.26 s; P < 0.05) and lower peak velocity (5.41 vs. 32.09 cm/s; P < 0.05). The cut-off points of 1.5 jets/min, 2.5 s and 19.5 cm/s for difference of ureteral jet frequency, duration and peak velocity between obstructed and contralateral normal ureters yielded sensitivities of 97.8, 95.6 and 100 % and specificities of 87, 87.9 and 97.8 %, respectively for diagnosis of ureteral obstruction. Given the safety of Doppler study and significant differences in flow dynamics of obstructed versus unobstructed ureters, our findings demonstrated the utility of Doppler ultrasound examination as a useful adjunct to gray-scale ultrasound by improving the accuracy of ultrasound exam in diagnosis of ureteral obstruction.

Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter

Directory of Open Access Journals (Sweden)

Yutaro Hayashi

2017-01-01

Full Text Available Introduction. Xanthogranulomatous pyelonephritis (XGP is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter.

Simple ectopic kidney in three dogs.

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Choi, Jiyoung; Lee, Heechun; Lee, Youngwon; Choi, Hojung

2012-10-01

Simple ectopic kidney was diagnosed in three dogs by means of radiography and ultrasonography. A 2-year-old castrated male Schnauzer, a 13-year-old female Schnauzer and a 9-year-old male Jindo were referred with vomiting, hematuria and ocular discharge, respectively. In all three dogs, oval-shaped masses with soft tissue density were observed in the mid to caudal abdomen bilaterally or unilaterally, and kidney silhouettes were not identified at the proper anatomic places on abdominal radiographs. Ultrasonography confirmed the masses were malpositioned kidney. The ectopic kidneys had relatively small size, irregular shape and short ureter but showed normal function on excretory urography.

Incontinence due to an infrasphincteric ectopic ureter: why the delay in diagnosis and what the radiologist can do about it

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Carrico, C.; Lebowitz, R.L. [Children`s Hospital Medical Center, Boston, MA (United States). Dept. of Radiology

1998-12-01

Purpose. To determine (1) the reasons for the frequently long delay in the diagnosis of an infrasphincteric ectopic ureter in girls, and (2) what role the radiologist can play in decreasing the delay. Materials and methods. Twelve girls were referred to our hospital from June 1994 until April 1997 for evaluation of constant urinary dribbling and/or vaginal discharge. Available imaging studies, radiology reports, and clinic notes were reviewed. Results. Mean age at the time of diagnosis was 6 years 7 months (range 2 years 10 months to 11 years 11 months). Mean delay until diagnosis after presentation was 2 years 5 months. Excluding the one girl whose ectopic ureter was diagnosed while she was still in diapers, mean age at the time of the first parental ``complaint`` was 4 years 9 months. The significance of the classic history of constant urinary dribbling was not recognized by physicians in 7 girls for 4 months to 7 years 10 months after presentation. Physical exam was not meticulously performed, as the ectopic orifice was visible in 8 of 12 girls. Imaging studies were ineffectively utilized: no imaging was done (for 2 years in 2 girls), inappropriate studies were done (ultrasound and voiding cystourethrography) and were misleading, studies were called normal when they were not (ultrasound and excretory urography), or perinatal imaging led to the incorrect assumption of a congenitally absent kidney in one girl and a multicystic dysplastic kidney in another. Excretory urography (EU) was diagnostic in all 10 girls with a duplex kidney, and computed tomography (CT) was supportive in 2 with a dysplastic kidney. CT was an adjunct in 3 girls; a Tc-99m-dimercaptosuccinic acid (DMSA) scan was needed in 2. Conclusion. The classic history of constant urinary dribbling in a successfully toilet-trained girl should immediately lead to an imaging search for the portion of kidney (or entire kidney) drained by an infrasphincteric ectopic ureter. EU should usually be the first

Incontinence due to an infrasphincteric ectopic ureter: why the delay in diagnosis and what the radiologist can do about it

International Nuclear Information System (INIS)

Carrico, C.; Lebowitz, R.L.

1998-01-01

Purpose. To determine (1) the reasons for the frequently long delay in the diagnosis of an infrasphincteric ectopic ureter in girls, and (2) what role the radiologist can play in decreasing the delay. Materials and methods. Twelve girls were referred to our hospital from June 1994 until April 1997 for evaluation of constant urinary dribbling and/or vaginal discharge. Available imaging studies, radiology reports, and clinic notes were reviewed. Results. Mean age at the time of diagnosis was 6 years 7 months (range 2 years 10 months to 11 years 11 months). Mean delay until diagnosis after presentation was 2 years 5 months. Excluding the one girl whose ectopic ureter was diagnosed while she was still in diapers, mean age at the time of the first parental ''complaint'' was 4 years 9 months. The significance of the classic history of constant urinary dribbling was not recognized by physicians in 7 girls for 4 months to 7 years 10 months after presentation. Physical exam was not meticulously performed, as the ectopic orifice was visible in 8 of 12 girls. Imaging studies were ineffectively utilized: no imaging was done (for 2 years in 2 girls), inappropriate studies were done (ultrasound and voiding cystourethrography) and were misleading, studies were called normal when they were not (ultrasound and excretory urography), or perinatal imaging led to the incorrect assumption of a congenitally absent kidney in one girl and a multicystic dysplastic kidney in another. Excretory urography (EU) was diagnostic in all 10 girls with a duplex kidney, and computed tomography (CT) was supportive in 2 with a dysplastic kidney. CT was an adjunct in 3 girls; a Tc-99m-dimercaptosuccinic acid (DMSA) scan was needed in 2. Conclusion. The classic history of constant urinary dribbling in a successfully toilet-trained girl should immediately lead to an imaging search for the portion of kidney (or entire kidney) drained by an infrasphincteric ectopic ureter. EU should usually be the first

Retrocaval ureter and anomalies of inferior vena cava

International Nuclear Information System (INIS)

Tsubogo, Yoshitaka; Hiraoka, Hisaki; Tonariya, Yoshito; Miyamae, Tatsuya; Fujioka, Mutsumi

1980-01-01

We report two cases of retrocaval ureter: one with the usual hook-shaped pattern of the course of ureter (Type 1 according to Kenawi and Williams) and the other with the ureter medially displaced in a large curving fashion without kinking or obstruction. (Type 2). The second case was diagnosed on CT without resorting to any invasive procedure. It can be classified as Type 2 of Kenawi and Williams because of the absence of obstruction and kinking of ureter. The first case is associated with a complicated anomaly of inferior vena cava previously not reported which shows the duplication of infrarenal segment of cava with azygos continuation via the right persistent supracardinal vein. This anomaly is also complicated by the persistent posterior cardinal vein which is continuous with the normal prerenal segment of cava after receiving the right renal vein. This persistent posterior cardinal vein is the cause of retrocaval ureter in this case. It is also stressed that the knowledge of various caval anomalies is important in the interpretation of CT. (author)

New techniques for stenting severely strictured or occluded ureters

Energy Technology Data Exchange (ETDEWEB)

Mygind, T; Dorph, S; Nielsen, H; Nielsen, L

1985-11-01

Percutaneous stenting of the severely strictured ureter is facilitated by catheterization through a rigid curved tube leading through the kidney. Alternatively, bidirectional traction tensioning of a guide wire pulled through the entire urinary tract permits antegrade dilatation and stent drainage. Complete occlusion near the ureteric orifice may be bypassed by transureteral puncture of the bladder followed by stent insertion.

Collecting Duct Carcinoma of the Kidney Mimicking Invasive Transitional Cell Carcinoma: A Case Report

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Byun, Joo Nam; Lim, Hyung Guhn; Lim, Sung Chul [Chosun University College of Medicine, Gwangju (Korea, Republic of)

2007-06-15

Approximately 100 cases of collecting duct carcinoma have been reported in the medical literature. We herein report on a case of collecting duct carcinoma of the kidney in a 75-year-old patient. The abdominal sonography depicted a relatively poorly defined 7x6 cm sized, isoechoic mass lesion, as compared to the normal parenchyma, at the left kidney lower pole and the affected kidney showed preservation of the reniform shape. CT revealed a heterogeneous poorly defined low-attenuation mass that was mainly located in the medulla with involvement of the cortex and the lower half of the renal pelvis. Retrograde ureter opyelography showed a filling defect at the lower renal pelvis and severe narrowing of the left proximal ureter. We initially thought this lesion was invasive transitional cell carcinoma. Subsequent surgery confirmed a collecting duct carcinoma

Diagnosis of Unilateral Single System Ectopic Ureter in Girls in the ...

African Journals Online (AJOL)

Objective: The ectopic ureter frequently drains an ectopic dysplastic or hypoplastic kidney. The present study aims at defining the role of MRU in establishing the diagnosis of this anomaly. Patients and Methods: Between February 1996 and March 2000, 11 girls presented or were referred to our department for management ...

[Multiple non-responding ESWL lithiasis in ectopic pelvic kidney: laparotomic surgical management].

Science.gov (United States)

Abed El Rahman, D; Zanetti, G; Cozzi, G; Cozzi, L A; Abed El Rahman, S; Maggioni, A; Rocco, F

2010-01-01

A 34 year-old male with multiple lithiasis of ectopic pelvic left kidney, which for 5 years had been causing pain in the left iliac region irradiating to ipsilateral inguinal region and testis. 4 ESWL treatments were unsuccessful. The diagnostic imaging (Angio-CT + Uro-CT) showed ectopic pelvic left kidney with abnormal vascularisation, characterised by multiple lithiasis extending in total area of 4x2 cm with shorter ureter. Right kidney was in normal position. A left pyelocalicolithotomy after DJ stent positioning was performed.

[Experimental work: reconstruction of the pelvi-ureteric junction and ureter using testicular tunica vaginalis autograft].

Science.gov (United States)

Usupbaev, A Ch; Kurbanaliev, R M; Chernetsova, G S; Kolesnichenko, I V; Sultanov, B M; Myrzakanov, N M; Zolotukhin, A O; Vagner, N A

2017-12-01

To evaluate the results of surgical reconstruction of the upper urinary tract using an autograft of testicular tunica vaginalis in experimental animals. The article presents the results of partial replacement of the renal pelvis and ureter with an autograft in 25 male dogs. The grafts were harvested by resection of the parietal layer of the testicular tunica vaginalis, which was transplanted into the region of the pelvi-ureteric junction and the proximal ureter. The upper urinary tract was drained using a ureteral stent catheter. The results were evaluated at week 1 and months 1, 3 and six after the operation. The functional state of the kidneys and ureters was analyzed using excretory urography and ultrasound; the autograft biopsy specimens were examined histologically. In all cases, the viability of the autograft was completely preserved, there were no signs of secondary infection, necrosis and impaired patency in the anastomosis zone. Histological examination revealed signs of epithelialization, connective tissue substitution and neovasculogenesis in the implantation zone. The proposed surgical modality is an alternative method to restore normal urine flow in the upper urinary tract in obstructive urological diseases. The group of obstructive urological diseases was studied using the model of the strictures of the pelvi-ureteric junction in the intrarenal pelvis and ureteral strictures measuring up to 3-4 cm in length.

Ectopic ureterocele and ectopic ureter in pediatric patients; Ureterocele ectopico y ectopia ureteral en pacientes pediatricos

Energy Technology Data Exchange (ETDEWEB)

Lloret, M. T.; Ricart, V.; Muro, M. D.; Perez, D.; Martinez, I.; Brugger, S.; Romero, M. J.; Cortina, H. [hospital General Universitario La Fe. Valencia (Spain)

2000-07-01

To describe the radiological findings associated with ectopic ureterocele and ectopic ureter in pediatric patients. To assess the role of ultrasound (US), serial micturating cystourethrography (SM-CU) and intravenous urography (IVU) in the diagnosis of these two entities. The authors performed a retrospective study of 132 patients, 73 with ectopic ureterocele and 59 with ectopic ureter. The imaging studies used were US, SMCU, IVU and methods to determine renal function (diuretic renography and renal scintigraphy). The findings were confirmed during surgery in every case. The most common radiological findings in ectopic ureterocele were renal duplication (86,3%). vesicoureteral reflux (VUR) to the lower half of the kidney (46.6%), dilatation of the lower pole of the kidney (38.4%) and contralateral duplication (30.1%). In boys, the ectopic ureter entered via bladder neck and posterior urethra (73.7%) or into seminal vesicles (15.8%); in girls, it went to vagina (32.5%), bladder neck (30%) or urethra (22.5%). Renal duplication was associated in 64.4%, with VUR to the ectopic ureter in 21% while there was a single renal system in 35.6%, with VUR to the ectopic ureter in 57.1% and contralateral renal agenesis in 19%. Eighteen patients (13.6%) presented a single, dy plastic, nonfunctioning renal system (6 cases of ureterocele and 12 of ectopic ureter). Knowledge of the embryological development of ureteral duplication is essential for the understanding of these two entities and helps to differentiate between them, thus facilitating a sometimes complicated diagnosis. Ectopic ureters and ureteroceles accompanied by a single, dysplastic renal system are associated with a greater incidence of congenital anomalies and a higher rate of complications than the duplicate systems. A prenatal US examination enables early diagnosis. The anatomical information provided by US is, on occasion, more valuable than that resulting from IVU or SMCU, However, IVU is indispensable in girls

Using the renal pelvis flap to replace the whole hypoplastic ureter: a ...

African Journals Online (AJOL)

Background Hypoplastic ureter is a rare condition usually associated with hypoplastic kidney, and it ends with nephrectomy in most of the cases. Many techniques have been described as ureteric substitutes in the literature. Here, we describe a new technique using the renal pelvis flap to replace the whole hypoplastic ...

Asymmetric BMP4 signalling improves the realism of kidney organoids.

Science.gov (United States)

Mills, Christopher G; Lawrence, Melanie L; Munro, David A D; Elhendawi, Mona; Mullins, John J; Davies, Jamie A

2017-11-01

We present a strategy for increasing the anatomical realism of organoids by applying asymmetric cues to mimic spatial information that is present in natural embryonic development, and demonstrate it using mouse kidney organoids. Existing methods for making kidney organoids in mice yield developing nephrons arranged around a symmetrical collecting duct tree that has no ureter. We use transplant experiments to demonstrate plasticity in the fate choice between collecting duct and ureter, and show that an environment rich in BMP4 promotes differentiation of early collecting ducts into uroplakin-positive, unbranched, ureter-like epithelial tubules. Further, we show that application of BMP4-releasing beads in one place in an organoid can break the symmetry of the system, causing a nearby collecting duct to develop into a uroplakin-positive, broad, unbranched, ureter-like 'trunk' from one end of which true collecting duct branches radiate and induce nephron development in an arrangement similar to natural kidneys. The idea of using local symmetry-breaking cues to improve the realism of organoids may have applications to organoid systems other than the kidney.

CT examination of the kidneys

International Nuclear Information System (INIS)

Handa, Youji; Ishida, Ken; Arita, Takeshi; Ishine, Kenji; Tezen, Takashi; Ohta, Nobuhiro

1985-01-01

Plain CT scanning of the kidney was performed in 16 patients with renal failure whose basic renal disorder had been not necessarily known beforehand. The findings of the CT examination were composed of renal atrophy of various degree (12 cases), cystic lesions (8 cases), polycystic renal disease (one case), nephrosclerosis (2 cases), hydronephrosis (2 cases), ureter and renal stones (one case), and normal CT profile (2 cases). Being based on these CT findings and other clinical informations, basic renal disorders could be either presumed or confirmed. It was concluded that plain CT scanning of the kidney was useful to decide a method of treatment and to estimate prognosis in patients with renal failure. (author)

Comprehensive data analysis of human ureter proteome

Directory of Open Access Journals (Sweden)

Sameh Magdeldin

2016-03-01

Full Text Available Comprehensive human ureter proteome dataset was generated from OFFGel fractionated ureter samples. Our result showed that among 2217 non-redundant ureter proteins, 751 protein candidates (33.8% were detected in urine as urinary protein/polypeptide or exosomal protein. On the other hand, comparing ureter protein hits (48 that are not shown in corresponding databases to urinary bladder and prostate human protein atlas databases pinpointed 21 proteins that might be unique to ureter tissue. In conclusion, this finding offers future perspectives for possible identification of ureter disease-associated biomarkers such as ureter carcinoma. In addition, Cytoscape GO annotation was examined on the final ureter dataset to better understand proteins molecular function, biological processes, and cellular component. The ureter proteomic dataset published in this article will provide a valuable resource for researchers working in the field of urology and urine biomarker discovery.

A rare pediatric case of grossly dilated ureter presenting as abdominal mass

International Nuclear Information System (INIS)

Srivastava, Madhur Kumar; Govindarajan, Krishna Kumar; Chakkalakkoombil, Sunitha Vellathussery; Halanaik, Dhanapathi

2016-01-01

Renal masses account for 55% of cases presenting as palpable abdominal mass in children.[1] An eight year male presented with palpable abdominal mass and pain. The patient underwent renal dynamic scan, which raised possibility of left duplex kidney with non-functioning moiety, as the size of left kidney was smaller than seen on Ultrasonography (USG). Magnetic resonance (MR)urography confirmed the findings with patient undergoing left hemi-nephrectomy and is doing well. In case of discrepancy in size of kidney on USG and renal scan, duplex kidney should be considered as differential, other causes being, renal cyst, benign/malignant mass and renal calculi. Gross hydro-ureter presenting as palpable abdominal mass is very rare with few reported cases.[234

Prolonged CT urography in duplex kidney.

Science.gov (United States)

Gong, Honghan; Gao, Lei; Dai, Xi-Jian; Zhou, Fuqing; Zhang, Ning; Zeng, Xianjun; Jiang, Jian; He, Laichang

2016-05-13

Duplex kidney is a common anomaly that is frequently associated with multiple complications. Typical computed tomography urography (CTU) includes four phases (unenhanced, arterial, parenchymal and excretory) and has been suggested to considerably aid in the duplex kidney diagnosi. Unfortunately, regarding duplex kidney with prolonged dilatation, the affected parenchyma and tortuous ureters demonstrate a lack of or delayed excretory opacification. We used prolonged-delay CTU, which consists of another prolonged-delay phase (1- to 72-h delay; mean delay: 24 h) to opacify the duplicated ureters and affected parenchyma. Seventeen patients (9 males and 8 females; age range: 2.5-56 y; mean age: 40.4 y) with duplex kidney were included in this study. Unenhanced scans did not find typical characteristics of duplex kidney, except for irregular perirenal morphology. Duplex kidney could not be confirmed on typical four-phase CTU, whereas it could be easily diagnosed in axial and CT-3D reconstruction using prolonged CTU (prolonged-delay phase). Between January 2005 and October 2010, in this review board-approved study (with waived informed consent), 17 patients (9 males and 8 females; age range: 2.5 ~ 56 y; mean age: 40.4 y) with suspicious duplex kidney underwent prolonged CTU to opacify the duplicated ureters and confirm the diagnosis. Our results suggest the validity of prolonged CTU to aid in the evaluation of the function of the affected parenchyma and in the demonstration of urinary tract malformations.

Extraintestinal Complications: Kidney Disorders

Science.gov (United States)

... the ureters, bladder, and urethra for the passage, storage, and voiding of urine. Serious kidney complications associated with IBD are rare, ... Proteinuria, an elevated level of protein in the urine, is one sign of amyloidosis. A biopsy (tissue sample) of the kidney can confirm the diagnosis. Various ...

Magnetic resonance urography in duplex kidney with ectopic ureteral insertion

Directory of Open Access Journals (Sweden)

Conjeevaram Rajendrarao Thambidorai

2011-01-01

Full Text Available This is a report on the use of magnetic resonance urography (MRU in a 6-year-old girl who presented with urinary incontinence. She had a left duplex kidney with poorly functioning upper moiety and ectopic insertion of the dilated upper pole ureter. MRU has been shown to be superior to conventional imaging techniques in delineating poorly functioning moieties of duplex kidneys and ectopic ureters.

Kidney (Renal Cell) Cancer—Health Professional Version

Science.gov (United States)

Kidney cancer has three main types. Renal cell cancer, or renal cell adenocarcinoma, forms in the tubules of the kidney. Transitional cell carcinoma forms in the renal pelvis and ureter. Wilms tumors are common in children. Find evidence-based information on kidney cancer treatment, research, genetics, and statistics.

Diagnostic accuracy of neonatal kidney ultrasound in children having antenatal hydronephrosis without ureter and bladder abnormalities.

Science.gov (United States)

Rianthavorn, Pornpimol; Limwattana, Sorawan

2015-10-01

To determine the diagnostic accuracy of anteroposterior renal pelvic diameter (APD) measurement and the society for fetal urology (SFU) grading in neonatal ultrasonography (USG) for detecting uropathy in newborns having antenatal isolated hydronephrosis (IH), characterized by hydronephrosis without ureter and bladder abnormalities, and to study time to resolution and factors predicting resolution of insignificant hydronephrosis. Ninety-six healthy newborns (129 kidneys) with IH, who underwent USG at age 7-30 days and voiding cystourethrography (VCUG) in conjunction with diuretic renography (DR) if APD > 10 mm or SFU grade 3-4 in neonatal USG, and at least a 12-month follow-up were divided into significant and insignificant hydronephrosis using the combined data of sequential USG, VCUG, and DR as the reference standard. Areas under the receiver operating characteristic plots (95 % CI) were 0.86 (0.79-0.94) versus 0.81 (0.73-0.89); p = 0.08, and 87.6 versus 79.8 % of cases were correctly classified, for APD ≥ 16 mm versus SFU grade 4, respectively. Ureteropelvic junction obstruction (UPJO) was the most common uropathy diagnosed. Of 85 kidneys with insignificant hydronephrosis, 57 underwent spontaneous resolution. The resolution rates were 24, 40, and 68 % at age 6, 12, and 24 months, respectively. APD was the only independent factor predicting resolution with the hazard ratio of 0.83 (95 % CI 0.74-0.92; p = 0.001). In IH, neonatal USG was a useful diagnostic tool to detect uropathy, mainly UPJO. Further investigation should be recommended when APD ≥ 16 mm or SFU grade 4.

Influence of volume on intraoperatively irradiated canine ureters

International Nuclear Information System (INIS)

Gillette, S.M.; Powers, B.E.; Thames, H.D.; Vujaskovic, Z.; LaRue, S.M.; Park, R.D.; Gillette, E.L.

1995-01-01

Purpose/Objective: Intraoperative radiation therapy (IORT) is used to deliver high single doses of radiation to the tumor bed following surgical removal of various abdominal malignancies. The advantage of IORT is the ability to remove sensitive normal tissues from the treatment field and limit the volume of normal tissue irradiated. The purpose of this study was to determine dose-volume relationships for retroperitoneal tissues. Materials and methods: 134 adult beagle dogs were irradiated to the surgically exposed paraaortic area. Normal tissues included in the treatment field were aorta, peripheral nerve, ureter, bone and the muscle. Groups of 4 - 8 dogs were irradiated to doses ranging from 18 - 54 Gy for a 2x5 cm field, from 12 - 46 Gy for a 4x5 cm field, and 12 - 42 Gy to an 8x5 cm field. The radiations were done using 6 MeV electrons from a linear accelerator. Dogs were observed for three years after radiation at which time they were euthanatized, perfused and tissues taken for histologic and histomorphometric evaluation. Transverse sections of the ureter were taken from the proximal, middle and distal segments. Histologically, proximal portions of the ureters with greater than 5 times normal diameter were considered to have severe hydroureter. Ureteral strictures and hydroneophrosis were evaluated by excretory urograms. Excretory urograms were done prior to treatment and annually after treatment or prior to necropsy for each dog in the experiments. A grading system was devised for predicting ureteral stenosis based on ureteral and renal pelvic dilatation. Results: A strong dose and volume relationship was identified for ureteral injury using the mixture model analysis which takes into account latency as well as dose. Subsequent to earlier edema, fibrin and vessel damage, progressive fibrosis developed and likely caused uteral stricture resulting in hydroureter. Severe hydroureter was observed as early as three months. The ED 50 for hydroureter determined

Comparison of effective atomic numbers of the cancerous and normal kidney tissue

International Nuclear Information System (INIS)

Manjunatha, H.C.

2015-01-01

The effective atomic number (Z eff ) and electron density (N e ) of normal kidney and cancerous kidney have been computed for total and partial photon interactions by computing the molecular, atomic, and electronic cross section in the wide energy range of 1 keV-100 GeV using WinXCOM. The mean Z eff and N e of normal kidney and cancerous kidney in the various energy ranges and for total and partial photon interactions are tabulated. The variation of effective N e with energy is shown graphically for all photon interactions. In addition to this computer tomography (CT), numbers of normal kidney and cancerous kidney for photon interaction and energy absorption is also computed. The role of Z eff in the dual-energy dividing radiography is also discussed. The values of Z eff and N e for cancerous kidney are higher than normal kidney. This is due to the levels of elements K, Ca, Fe, Ni, and Se are lower and those of the elements Ti, Co, Zn, As, and Cd are higher in the cancer tissue of kidney than those observed in the normal tissue. The soft tissue and cancerous tissue are very similar, but their atomic number differs. The cancerous tissue exhibits a higher Z eff than the normal tissue. This fact helps in the dual-energy dividing radiography which enables to improve the diagnosis of the kidney cancer. Hence, the computed values may be useful in the diagnosis of the kidney cancer. CT numbers for normal kidney are higher than cancerous kidney. (author)

Laparoscopic kidney orthotopic transplant: preclinical study in the pig model.

Science.gov (United States)

He, B; Musk, G C; Mou, L; Waneck, G L; Delriviere, L

2013-06-01

Laparoscopic surgery has rapidly expanded in clinical practice replacing conventional open surgery over the last three decades. Laparoscopic donor nephrectomy has been favored due to its multiple benefits. The aim of this study was to explore the safety and feasibility of kidney transplantation by a laparoscopic technique in a pig model. The study was approved by the university animal ethics committee. Eight female pigs (Sus Scrofra, weighing 45-50 kg) were divided into 2 groups: group I included 4 animals that underwent laparoscopic kidney orthotopic transplantation on the left side. The right kidney was remained functional in situ. The pigs recovered and were observed for 1 week. In the 4 hosts group II pigs underwent a laparoscopic kidney transplantation on the left side. With simultaneous clipping of the right ureter. After recovery, the pigs were observed for 4 weeks. A laparotomy for examination was performed prior to euthanasia. All 4 group I pigs survived for 1 week. The laparotomy showed normal graft perfusion with wall patent renal artery and vein as well as satisfactory urine output upon transection of ureter in 3 hosts. Renal artery stenosis occurred in one pig. In The Immediate kidney graft function was achieved in 3 group II pigs. The fourth died following extubation due to laryngospasm despite a functional graft. The average creatinine levels were 195.5 μmol/L on day 3; 224.5 μmol/L at week 1; 127 μmol/L at week 2; 182.7 umol/L at week 3; and 154.7 umol/L at week 4. Laparoscopic kidney transplantation was feasible and safe in a pig model with immediate graft function. This study will provide further evidence to support application of laparoscopic technique to human kidney transplant. Copyright © 2013 Elsevier Inc. All rights reserved.

Ion transport by the amphibian primary ureter

DEFF Research Database (Denmark)

Møbjerg, Nadja

2008-01-01

putative ion transport mechanisms in the primary ureter of the freshwater amphibian Ambystoma mexicanum (axolotl). Primary ureters isolated from axolotl larvae were perfused in vitro and single cells were impaled across the basal cell membrane with glass microelectrodes. In 42 cells the membrane potential......+] steps from 3 to 20 mmol/l and a hyperpolarization of Vm upon lowering [Na+] from 102 to 2 mmol/l, indicating the presence of luminal K+ and Na+ conductances. This study provides the first functional data on the vertebrate primary ureter. The data show that the primary ureter of axolotl larvae...

Human Alpha Defensin 5 Expression in the Human Kidney and Urinary Tract

Science.gov (United States)

Porter, Edith; Bevins, Charles L.; DiRosario, Julianne; Becknell, Brian; Wang, Huanyu

2012-01-01

Background The mechanisms that maintain sterility in the urinary tract are incompletely understood. Recent studies have implicated the importance of antimicrobial peptides (AMP) in protecting the urinary tract from infection. Here, we characterize the expression and relevance of the AMP human alpha-defensin 5 (HD5) in the human kidney and urinary tract in normal and infected subjects. Methodology/Principal Findings Using RNA isolated from human kidney, ureter, and bladder tissue, we performed quantitative real-time PCR to show that DEFA5, the gene encoding HD5, is constitutively expressed throughout the urinary tract. With pyelonephritis, DEFA5 expression significantly increased in the kidney. Using immunoblot analysis, HD5 production also increased with pyelonephritis. Immunostaining localized HD5 to the urothelium of the bladder and ureter. In the kidney, HD5 was primarily produced in the distal nephron and collecting tubules. Using immunoblot and ELISA assays, HD5 was not routinely detected in non-infected human urine samples while mean urinary HD5 production increased with E.coli urinary tract infection. Conclusions/Significance DEFA5 is expressed throughout the urinary tract in non-infected subjects. Specifically, HD5 is expressed throughout the urothelium of the lower urinary tract and in the collecting tubules of the kidney. With infection, HD5 expression increases in the kidney and levels become detectable in the urine. To our knowledge, our findings represent the first to quantitate HD5 expression and production in the human kidney. Moreover, this is the first report to detect the presence of HD5 in infected urine samples. Our results suggest that HD5 may have an important role in maintaining urinary tract sterility. PMID:22359618

Polyuria due to vasopressin V2 receptor antagonism is not associated with increased ureter diameter in ADPKD patients

NARCIS (Netherlands)

Casteleijn, Niek F.; Messchendorp, A. Lianne; Bae, Kyong T.; Higashihara, Eiji; Kappert, Peter; Torres, Vicente; Meijer, Esther; Leliveld, Anna M.

Tolvaptan, a vasopressin V2 receptor antagonist, has been shown to reduce the rates of growth in total kidney volume (TKV) and renal function loss in ADPKD patients, but also leads to polyuria because of its aquaretic effect. Prolonged polyuria can result in ureter dilatation with consequently renal

Congenital giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn

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Rajendran Ramaswamy

2016-01-01

Full Text Available Congenital giant megaureter presents as abdominal mass and impose diagnostic difficulties. It can be associated with other upper urinary tract anomalies. A female newborn with antenatal diagnosis of polycystic kidneys was admitted at birth due to lower abdominal mass. Ultrasound and CT scans diagnosed a multiloculated cystic lesion in the mid and lower abdomen along with right side multicystic kidney. At laparotomy, an extaperitoneal, lobulated cystic swelling was found due to rightside giant megaureter. Its lower end was of normal caliber and orthotopic. End cutaneous ureterostomy was done. Intravenous urogram and isotope renograms showed nonfunctioning right kidney. She also had grade II vesicoureteral reflux on left side. Child suffered urinary infection twice. At 9m age, right nephroureterectomy was done. Histopathologic examination was consistent with cystic renal dysplasia and dilated ureter. This is the first case report of giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn.

Clinical presentation and outcome of cats with circumcaval ureters associated with a ureteral obstruction.

Science.gov (United States)

Steinhaus, J; Berent, A C; Weisse, C; Eatroff, A; Donovan, T; Haddad, J; Bagley, D

2015-01-01

Circumcaval ureters (CU) are a rare embryological malformation resulting in ventral displacement of the caudal vena cava, which crosses the ureter, potentially causing a ureteral stricture. To evaluate cats with obstructed CU(s) and report the presenting signs, diagnostics, treatment(s), and outcomes. Cats with obstructed CU(s) were compared to ureterally obstructed cats without CU(s). 193 cats; 22 circumcaval obstructed (Group 1); 106 non-circumcaval obstructed (Group 2); 65 non-obstructed necropsy cases (Group 3). Retrospective study, review of medical records for cats treated for benign ureteral obstructions from AMC and University of Pennsylvania between 2009 and 2013. surgical treatment of benign ureteral obstruction, complete medical record including radiographic, ultrasonographic, biochemistry, and surgical findings. Seventeen percent (22/128) of obstructed cats had a CU (80% right-sided) compared to 14% (9/65) non-obstructed necropsy cats (89% right-sided). Clinical presentation, radiographic findings, and creatinine were not statistically different between Groups 1 and 2. Strictures were a statistically more common (40%) cause of ureteral obstruction in Group 1 compared to Group 2 (17%) (P = .01). The MST for Groups 1 and 2 after ureteral decompression was 923 and 762 days, respectively (P = .62), with the MST for death secondary to kidney disease in both groups being >1,442 days. Re-obstruction was the most common complication in Group 1 (24%) occurring more commonly in ureters of cats treated with a ureteral stent(s) (44%) compared to the subcutaneous ureteral bypass (SUB) device (8%) (P = .01). Ureteral obstructions in cats with a CU(s) have a similar outcome to those cats with a ureteral obstruction and normal ureteral anatomy. Long-term prognosis is good for benign ureteral obstructions treated with a double pigtail stent or a SUB device. The SUB device re-obstructed less commonly than the ureteral stent, especially when a ureteral stricture was

Morphological characteristics of the double ureter from its origin up to the end

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M. Vărgău

2014-02-01

Full Text Available Duplication of the ureters is a common anomaly and is frequently encountered by radiologists. Duplication may be either complete or incomplete and is often accompanied by various complications. Incomplete duplication is most often associated with ureteroureteral reflux or ureteropelvic junction obstruction of the lower pole of the kidney. Complete duplication is most often associated with vesicoureteral reflux, ectopic ureterocele, or ectopic ureteral insertion, all of which are more common in girls than in boys. Vesicoureteral reflux affects the lower pole

Clinical study of retrocaval ureter diagnosed by CT scan

International Nuclear Information System (INIS)

Kiriyama, Isao; Hata, Ryosuke; Amemiya, Hiroshi

1987-01-01

Although retrocaval ureter is relatively uncommon congenital anomaly, surgical intervention is often necessary to alleviate the clinical signs and symptoms of the patients. Vena cavography has been indispensable imaging modality for the definitive diagnosis of this anomaly. Recently, however, CT scan in addition to excretory urography (IVP) and retrograde pyelography(RP) has been utilized in many reported cases in the diagnosis of retrocaval ureter. We have experienced 3 cases of retrocaval ureter consecutively. In this paper we report these 3 cases of retrocaval ureter, in which CT scan enabled us to confirm the definitive diagnosis. We also report another case of pelviureteric stenosis that was taken for retrocaval ureter by CT scan. Causes of the misdiagnosis is discussed. In conclusion CT scan is useful diagnostic modality in the diagnosis of retrocaval ureter and this lesser invasive technique might lessen the need for vena cavography. (author)

Evidence for Alpha Receptors in the Human Ureter

Science.gov (United States)

Madeb, Ralph; Knopf, Joy; Golijanin, Dragan; Bourne, Patricia; Erturk, Erdal

2007-04-01

An immunohistochemical and western blot expression analysis of human ureters was performed in order to characterize the alpha-1-adrenergic receptor distribution along the length of the human ureteral wall. Mapping the distribution will assist in understanding the potential role alpha -1-adrenergic receptors and their subtype density might have in the pathophysiology of ureteral colic and stone passage. Patients diagnosed with renal cancer or bladder cancer undergoing nephrectomy, nephroureterectomy, or cystectomy had ureteral specimens taken from the proximal, mid, distal and tunneled ureter. Tissues were processed for fresh frozen examination and fixed in formalin. None of the ureteral specimens were involved with cancer. Serial histologic sections and immunohistochemical studies were performed using antibodies specific for alpha-1-adrenergic receptor subtypes (alpha 1a, alpha 1b, alpha 1d). The sections were examined under a light microscope and scored as positive or negative. In order to validate and quantify the alpha receptor subtypes along the human ureter. Western blotting techniques were applied. Human ureter stained positively for alpha -1-adrenergic receptors. Immunostaining appeared red, with intense reaction in the smooth muscle of the ureter and endothelium of the neighboring blood vessels. There was differential expression between all the receptors with the highest staining for alpha-1D subtype. The highest protein expression for all three subtypes was in the renal pelvis and decreased with advancement along the ureter to the distal ureter. At the distal ureter, there was marked increase in expression as one progressed towards the ureteral orifice. The same pattern of protein expression was exhibited for all three alpha -1-adrenergic receptor subtypes. We provide preliminary evidence for the ability to detect and quantify the alpha-1-receptor subtypes along the human ureter which to the best of our knowledge has never been done with

LAPAROSCOPIC RECONSTRUCTION OF THE URINARY TRACT IN PATIENTS WITH URETERAL STRICTURE AFTER KIDNEY TRANSPLANTATION

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D. V. Perlin

2013-01-01

Full Text Available Aim. Ureteral obstruction secondary to ischemia is the most common urologic complication of kidney trans- plantation. Pyeloureteral anastomosis with recipient ureter has shown most satisfactory long-term results in its management. Existing urinary infection and immunosupression determine the high risk of wound complications. We have experience more than 50 reconstructive procedures of urinary tract after kidney transplantation by open surgery during 25 years. Till last time this procedure has been performed through open surgery. Method. We used pyeloureteral anastomosis with recipient ureter in two patients with ureteral stricture after kidney transplantation by laparoscopic approach. The operations lasted 215 and 275 min respectively. In both cases the surgery was per- formed after percutaneous nephrostomy because of deterioration of transplanted kidney function. Internal stent was indwelled laparoscopicaly. No drain tube was left. Results. The nephrostomy tubes were removed after 10 and 7 days respectively. The stents were removed after 27 and 20 days respectively. No complications were seen during the surgery and postoperative period. Now serum creatinine level is 0.12 mmol/l and 0.15 mmol/l after 15 and 12 months after surgery respectively. Conclusion. In spite of some difficulties related with topographic land- marks and severe tissues fibrosis after transplantation laparoscopic pyeloureterostomy in transplanted kidney is safe and feasible procedure. The main advantage is absence of risk of most serious complications related with wound infection in immune compromised patients. Moreover, early recovery to usual activity and diet facilita- tes to prevent pulmonary infections and to normalize intestinal absorbability of the immunosuppressive drugs. 

Shear wave velocity measurements using acoustic radiation force impulse in young children with normal kidneys versus hydronephrotic kidneys

International Nuclear Information System (INIS)

Shon, Beom Seok; Kim, Myung Joon; Han, Sang Won; Im, Young Jae; Lee, Mi Jung

2014-01-01

To measure shear wave velocities (SWVs) by acoustic radiation force impulse (ARFI) ultrasound elastography in normal kidneys and in hydronephrotic kidneys in young children and to compare SWVs between the hydronephrosis grades. This study was approved by an institutional review board, and informed consent was obtained from the parents of all the children included. Children under the age of 24 months were prospectively enrolled. Hydronephrosis grade was evaluated on ultrasonography, and three valid ARFI measurements were attempted using a high-frequency transducer for both kidneys. Hydronephrosis was graded from 0 to 4, and high-grade hydronephrosis was defined as grades 3 and 4. Fifty-one children underwent ARFI measurements, and three valid measurements for both kidneys were obtained in 96% (49/51) of the patients. Nineteen children (38.8%) had no hydronephrosis. Twenty-three children (46.9%) had unilateral hydronephrosis, and seven children (14.3%) had bilateral hydronephrosis. Seven children had ureteropelvic junction obstruction (UPJO). Median SWVs in kidneys with high-grade hydronephrosis (2.02 m/sec) were higher than those in normal kidneys (1.75 m/sec; P=0.027). However, the presence of UPJO did not influence the median SWVs in hydronephrotic kidneys (P=0.362). Obtaining ARFI measurements of the kidney is feasible in young children with median SWVs of 1.75 m/sec in normal kidneys. Median SWVs increased in high-grade hydronephrotic kidneys but were not different between hydronephrotic kidneys with and without UPJO.

Shear wave velocity measurements using acoustic radiation force impulse in young children with normal kidneys versus hydronephrotic kidneys

Energy Technology Data Exchange (ETDEWEB)

Shon, Beom Seok; Kim, Myung Joon; Han, Sang Won; Im, Young Jae; Lee, Mi Jung [Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2014-04-15

To measure shear wave velocities (SWVs) by acoustic radiation force impulse (ARFI) ultrasound elastography in normal kidneys and in hydronephrotic kidneys in young children and to compare SWVs between the hydronephrosis grades. This study was approved by an institutional review board, and informed consent was obtained from the parents of all the children included. Children under the age of 24 months were prospectively enrolled. Hydronephrosis grade was evaluated on ultrasonography, and three valid ARFI measurements were attempted using a high-frequency transducer for both kidneys. Hydronephrosis was graded from 0 to 4, and high-grade hydronephrosis was defined as grades 3 and 4. Fifty-one children underwent ARFI measurements, and three valid measurements for both kidneys were obtained in 96% (49/51) of the patients. Nineteen children (38.8%) had no hydronephrosis. Twenty-three children (46.9%) had unilateral hydronephrosis, and seven children (14.3%) had bilateral hydronephrosis. Seven children had ureteropelvic junction obstruction (UPJO). Median SWVs in kidneys with high-grade hydronephrosis (2.02 m/sec) were higher than those in normal kidneys (1.75 m/sec; P=0.027). However, the presence of UPJO did not influence the median SWVs in hydronephrotic kidneys (P=0.362). Obtaining ARFI measurements of the kidney is feasible in young children with median SWVs of 1.75 m/sec in normal kidneys. Median SWVs increased in high-grade hydronephrotic kidneys but were not different between hydronephrotic kidneys with and without UPJO.

Indocyanine green for intraoperative localization of ureter.

Science.gov (United States)

Siddighi, Sam; Yune, Junchan Joshua; Hardesty, Jeffrey

2014-10-01

Intraurethral injection of indocyanine green (ICG; Akorn, Lake Forest, IL) and visualization under near-infrared (NIR) light allows for real-time delineation of the ureter. This technology can be helpful to prevent iatrogenic ureteral injury during pelvic surgery. Patients were scheduled to undergo robot-assisted laparoscopic sacrocolpopexy. Before the robotic surgery started, the tip of a 6-F ureteral catheter was inserted into the ureteral orifice. Twenty-five milligrams of ICG was dissolved in 10-mL of sterile water and injected through the open catheter. The same procedure was repeated on the opposite side. The ICG reversibly stained the inside lining of the ureter by binding to proteins on urothelial layer. During the course of robotic surgery, the NIR laser on the da Vinci Si surgical robot (Intuitive Surgical, Inc, Sunnyvale, CA) was used to excite ICG molecules, and infrared emission was captured by the da Vinci filtered lens system and electronically converted to green color. Thus, the ureter fluoresced green, which allowed its definitive identification throughout the entire case. In all cases of >10 patients, we were able to visualize bilateral ureters with this technology, even though there was some variation in brightness that depended on the depth of the ureter from the peritoneal surface. For example, in a morbidly obese patient, the ureters were not as bright green. There were no intraoperative or postoperative adverse effects attributable to ICG administration for up to 2 months of observation. In our experience, this novel method of intraurethral ICG injection was helpful to identify the entire course of ureter and allowed a safe approach to tissues that were adjacent to the urinary tract. The advantage of our technique is that it requires the insertion of just the tip of ureteral catheter. Despite our limited cohort of patients, our findings are consistent with previous reports of the excellent safety profile of intravenous and intrabiliary ICG

Ureter smooth muscle cell orientation in rat is predominantly longitudinal.

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Bart Spronck

Full Text Available In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels.

Ureter smooth muscle cell orientation in rat is predominantly longitudinal.

Science.gov (United States)

Spronck, Bart; Merken, Jort J; Reesink, Koen D; Kroon, Wilco; Delhaas, Tammo

2014-01-01

In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels.

Shear wave velocity measurements using acoustic radiation force impulse in young children with normal kidneys versus hydronephrotic kidneys

Directory of Open Access Journals (Sweden)

Beomseok Sohn

2014-04-01

Conclusion: Obtaining ARFI measurements of the kidney is feasible in young children with median SWVs of 1.75 m/sec in normal kidneys. Median SWVs increased in high-grade hydronephrotic kidneys but were not different between hydronephrotic kidneys with and without UPJO.

ECTOPIC ureters misdiagnosed as ureterocele

International Nuclear Information System (INIS)

Bader, I.; Akhter, N.; Anwar-ul-Haq; Chaudhary, A.; Khan, N.Z.

2004-01-01

Ectopic ureters may be difficult to diagnose unless there is high index of suspicion. Examination for continuous dribbling may be difficult in infants who are still using diapers. We are reporting a case of ectopic ureter which was erroneously diagnosed as ureterocele on a cystourethrogram. Further investigations for accurate diagnosis and emerging abnormalities during the course of management are presented in this case report. Review of literature to high- light the various forms of investigations and management are also presented. (author)

Human renin biosynthesis and secretion in normal and ischemic kidneys

International Nuclear Information System (INIS)

Pratt, R.E.; Carleton, J.E.; Richie, J.P.; Heusser, C.; Dzau, V.J.

1987-01-01

The pathway of renin biosynthesis and secretion in normal and ischemic human kidneys has been investigated by pulse-labeling experiments. The results indicate that in normal human kidney, preprorenin is rapidly processed to 47-kDa prorenin. Microradiosequencing showed that this molecule was generated by cleavage between Gly-23 and Leu-24, yielding a 43-amino acid proregion. Analysis of prorenin secreted by the kidney tissue yielded an identical sequence, indicating that prorenin is secreted without any further proteolysis. An examination of the kinetics of processing and secretion suggested that a majority of the newly synthesized prorenin is quickly secreted, while only a small fraction is processed intracellularly to the mature renin. The differences in secretion kinetics between prorenin and mature renin and the selective inhibition of prorenin secretion by monensin suggest that they are secreted independently via two pathways: a constitutive pathway probably from the Golgi or protogranules that rapidly release prorenin and a regulated pathway that secretes mature renin from the mature granules. A comparison of the kinetics of processing between normal and ischemic tissues suggests that renal ischemia leads to an overall increase in the rate of processing or prorenin to mature renin. In addition, prolonged biosynthetic labeling of renin in the ischemic kidney yielded two smaller molecular weight immunoreactive forms suggestive of renin fragments that may be degradative products. These fragments were not detected in normal kidney tissue labeled for similar lengths of time

Polyuria due to vasopressin V2 receptor antagonism is not associated with increased ureter diameter in ADPKD patients.

Science.gov (United States)

Casteleijn, Niek F; Messchendorp, A Lianne; Bae, Kyong T; Higashihara, Eiji; Kappert, Peter; Torres, Vicente; Meijer, Esther; Leliveld, Anna M

2017-06-01

Tolvaptan, a vasopressin V2 receptor antagonist, has been shown to reduce the rates of growth in total kidney volume (TKV) and renal function loss in ADPKD patients, but also leads to polyuria because of its aquaretic effect. Prolonged polyuria can result in ureter dilatation with consequently renal function loss. Therefore, we aimed to investigate the effect of tolvaptan-induced polyuria on ureter diameter in ADPKD patients. 70 ADPKD patients were included (51 were randomized to tolvaptan and 19 to placebo). At baseline and after 3 years of treatment renal function was measured (mGFR) and MRI was performed to measure TKV and ureter diameter at the levels of renal pelvis and fifth lumbar vertebral body (L5). In these patients [65.7 % male, age 41 ± 9 years, mGFR 74 ± 27 mL/min/1.73 m 2 and TKV 1.92 (1.27-2.67) L], no differences were found between tolvaptan and placebo-treated patients in 24-h urine volume at baseline (2.5 vs. 2.5 L, p = 0.8), nor in ureter diameter at renal pelvis and L5 (4.0 vs. 4.2 mm, p = 0.4 and 3.0 vs. 3.1 mm, p = 0.3). After 3 years of treatment 24-h urine volume was higher in tolvaptan-treated patients when compared to placebo (4.7 vs. 2.3 L, p polyuria did not lead to an increase in ureter diameter, suggesting that tolvaptan is a safe therapy from a urological point of view.

Comparative histomorphometry ureter in infants with megaureter

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Tertyshniy S.I.

2016-11-01

Full Text Available Urgency megaureter is one of the most serious defects of the urinary system. The frequency of this disease remains high and population studies of the data from 10 to 20% in the overall structure malformations of the urinary tract in children in recent years. Objective: to study features histoarchitectonics ureter in children with megaureter. Materials and methods observed and treated 16 children aged 3 to 12 months with megaureter II–IV degree. Clinical diagnosis of vice was carried out on the basis of standard complex urological examination. The material of the study is based on sections of the resected ureteral. The control group consisted of observations of autopsy material — sections of the ureter in children under 1 year old who died of intercurrent diseases (n=5. We studied the relation of the muscular layer and the mucous membranes, the severity of degenerative and inflammatory changes. Results and Discussion. The characteristic structural changes and statistically significant differences that characterize the poorly expressed, moderate and severe neuromuscular dysplasia recorded in the wall of the ureter in children with megaureter. Pathological changes in the muscular layer of the ureter are inversely proportional to dystrophic and degenerative changes of the cover transitional epithelium, which together determine the motor dysfunction of the ureters, promotes the development of secondary renal disease and justifies the need for surgical correction of the defect. Conclusion: Our study emphasizes the importance of accounting gistomorfologii indicators in predicting the outcome of surgical treatment and its timing in infants with megaureter.

Sensitivity of the ureter to radiation before and after ureterojejuno-implantation

International Nuclear Information System (INIS)

Schenk, K.J.

1981-01-01

The investigation refers to dexhal ureterosigmoidostomies, carried out on 15 dogs. The implanted right ureters and the left ureters left in the bladders of 5 dogs were then treated with radiation of a total focal dose of 60 Gy. The investigation referred to the comparison of different ureter modalities and their sensibility to radiation in respect to statements on the various sorts of therapy strategies. The test animals which has been only operated on were killed 68 d.p.o at earliest and 295 d.p.o. The survival time of the 5 animals which has been operated on and irradiated was 156-269 d.p.o. and 22-59 d after the last irradiation, respectively. While the non-altered ureters remained without pathological findings, there were anastomotic stenoses with ascending infections of the upper urinary tract in 40% of the ureters only implanted into the sigma and another increase in the anastomotic stenoses (80%) was observed in the ureters which had been implanted and irradiated with a total focal dose of 60 Gy. It was also shown by means of X-ray method, macro and micropathology, that those ureters which had only been irradiated tolerated 30 and 60 Gy, resp., well and that the implanted ureters with subradical total focal dose of 30 Gy showed exact passage conditions in the i.v. urogram. (orig./MG) [de

Laparoscopic radical nephroureterectomy: dilemma of the distal ureter.

Science.gov (United States)

Steinberg, Jordan R; Matin, Surena F

2004-03-01

Laparoscopic nephroureterectomy has recently emerged as a safe, minimally invasive approach to upper tract urothelial cancers. The most controversial and challenging feature of laparoscopic nephroureterectomy is the management of the distal ureter. We review the most common methods of managing the distal ureter, with emphasis on contemporary oncologic outcomes, indications, advantages, and disadvantages. There are currently in excess of five different approaches to the lower ureter. These techniques often combine features of endoscopic, laparoscopic, or open management. They include open excision, a transvesical laparoscopic detachment and ligation technique, laparoscopic stapling of the distal ureter and bladder cuff, the "pluck" technique, and ureteral intussusception. Each technique has distinct advantages and disadvantages, differing not only in technical approach, but oncological principles as well. While the existing published data do not overwhelmingly support one approach over the others, the open approach remains one of the most reliable and oncologically sound procedures. The principles of surgical oncology dictate that a complete, en-bloc resection, with avoidance of tumor seeding, remains the preferred treatment of all urothelial cancers. The classical open technique of securing the distal ureter and bladder cuff achieves this principle and has withstood the test of time. Transvesical laparoscopic detachment and ligation is an oncologically valid approach in patients without bladder tumors, but is limited by technical considerations. The laparoscopic stapling technique maintains a closed system but risks leaving behind ureteral and bladder cuff segments. Both transurethral resection of the ureteral orifice (pluck) and intussusception techniques should be approached with caution, as the potential for tumor seeding exists. Additional long-term comparative outcomes are needed to solve the dilemma of the distal ureter.

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient.

Science.gov (United States)

Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

2016-03-01

Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis

Normal standards for kidney length as measured with US in premature infants

International Nuclear Information System (INIS)

Schlesinger, A.E.; Hedlund, G.L.; Pierson, W.P.; Null, D.M.

1986-01-01

In order to develop normal standards for kidney length in premature infants, the authors measured kidney length by US imaging in 39 (to date) premature infants less than 72 hours old and without known renal disease. Kidney length was compared with four different parameters of body size, including gestational age, birth weight, birth length, and body surface area. Similar standards have been generated previously for normal renal length as measured by US imaging in full-term infants and older children. These standards have proven utility in cases of congenital and acquired disorders that abnormally increase or decrease renal size. Scatter plots of kidney length versus body weight and kidney length versus body surface area conformed well to a logarithmic distribution, with a high correlation coefficient and close-fitting 95% confidence limits (SEE = 2.05)

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

International Nuclear Information System (INIS)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young

2014-01-01

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

Energy Technology Data Exchange (ETDEWEB)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

2014-12-15

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

The value of MR perfusion weighted imaging in normal and abnormal kidneys

International Nuclear Information System (INIS)

Shi Hao; Ding Hongyu; Duan Ruiping; Sun Yongping; Xing Yiyong

2008-01-01

Objective: To explore the characteristics and the clinical application of MR perfusion weighted imaging (PWI) in the normal kidneys and the renal diseases. Methods: Thirty-one subjects including 9 cases without urinary diseases, 14 cases with renal carcinoma, 6 cases with renal cyst and 2 cases with renal tuberculosis who had been examined with T 1 WI, T 2 WI and PWI were analyzed retrospectively. All the data were processed by a workstation to obtain time-signal intensity curves, color perfusion maps and relative perfusion value. The relative renal blood volume (RBV), relative renal blood flow (RBF), mean transition time (MTY) and the time to peak (TTP) in the normal renal cortex and medulla and the renal lesions were calculated. Comparisons between the right and the left normal kidneys, and between the cortex and the medulla of the normal kidneys were performed using t test, and comparisons between the normal and the abnormal kidneys were performed using q test. Results: Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively, and for medulla were 0.58± 0.05 and 0.78±0.13 respectively (t=9.2241 and 5.0336, P 0.05). The values of relative RBF of the renal carcinoma (1.35±0.34) were significantly higher than that of the normal tissues (1.02±0.06) (q=3.0882, P< 0.01). Conclusion: PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions, and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases. (authors)

Bilateral congenital midureteric strictures associated with multicystic dysplastic kidney and hydronephrosis: evaluation with MR urography

Energy Technology Data Exchange (ETDEWEB)

Grattan-Smith, J.D.; Little, Stephen [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Jones, Richard A. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Emory University School of Medicine, Department of Radiology, Atlanta, GA (United States); Kirsch, Andrew J. [Emory University School of Medicine, Department of Pediatric Urology, Atlanta, GA (United States)

2011-01-15

We report a case of bilateral congenital midureteric strictures diagnosed using MR urography. The severity of obstruction differed in the two ureters, resulting in a multicystic dysplastic kidney (MCDK) with an atretic ureter on one side and hydronephrosis that worsened over time due to progressive stenosis on the other. Although midureteric strictures are usually misdiagnosed as ureteropelvic junction (UPJ) or ureterovesical junction (UVJ) obstruction on conventional imaging, MR urography was able to clearly demonstrate both the anatomical and functional abnormalities. Additionally, because of the excellent anatomical resolution, similarities in the underlying pathological lesions could be contrasted with the severity of the pathophysiological impact upon each kidney. (orig.)

Duplicated Renal System with H Shaped Ureter: An Extraordinary Anomaly

Directory of Open Access Journals (Sweden)

Fatih Akbulut

2016-01-01

Full Text Available Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone.

General Information about Wilms Tumor and Other Childhood Kidney Tumors

Science.gov (United States)

... through the urethra and leaves the body. Enlarge Anatomy of the female urinary system showing the kidneys, adrenal glands, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of ...

Sonographic Dimensions of Normal Kidney in Korean Male

International Nuclear Information System (INIS)

Lee, Hyeon Kyeong

1996-01-01

This study was performed to determine the sonographic dimensions of normal kidney in Korean male and to investigate their correlation with age, height, and weight. The ultrasound examinations were performed in 532healthy Korean male from July 1993 to December 1993. We measured the length, the width, and the thickness of both kidneys and those of both central echogenic area. Then renal shape index (RSI), renal volume (RV), volume of central (CEV) echogenic area, and renal parenchymal volume (RPV) were calculated from these measurements. The mean RV of the right kidney was 129.30 ± 30.20 cm 3 (Mean ± Standard Deviation) and that of the left kidney was 137.06± 29.73 cm 3 . Meanwhile the mean renal length of right kidney was 10.42 ± 0.61 cm and that of the left kidney was 10.63 ± 0.62 cm being distributed more compactly near mean value than the RV. Therefore the renal length could be more useful than RV in discrimination of abnormally increased or decreased kidney. While renal width, thickness and RV were increased with age, CEV showed no corresponding change. Therefore, the increase in RV could be attributed to the increase in RPV. Meanwhile the RSI was decreased with age. The renal length, renal thickness,thickness of central echogenic area, RV, CEV, and RPV showed strong correlation with weight. The renal length and the length of central echogenic area showed good correlation with height

Equivalence of the blockage of ureter and the action of the urethane in {sup 99m}Tc-DMSA biodistribution in rats

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Martins, Patricia de A.; Fukumori, Neuza T.O.; Matsuda, Margareth M.N.; Vicente, Irene; Silva, Laercio da; Evedove, Sueli D.; Muramoto, Emiko [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mails: patyosborne@yahoo.com; ntfukumo@ipen.br; lsilva@ipen.br; mmatsusa@ipen.br; sevedove@yahoo.com

2007-07-01

The indication of the United States Pharmacopoeia (USP) for biological control of {sup 99m}Tc-DMSA is the experiment in rats with ureter occlusion. Urethane has a vessel constriction action in the urinary system and keeps the eliminatory mechanism functioning through glomerular filtration. The objective of this work is to show that the use of urethane in animals without blockage of ureteres has total credibility, even if the expressed value of the renal retention does not correspond to 40% injected dose (I.D.) related in the literature. The experiments were performed in 2 groups of 12 rats each, the first using urethane and the second, urethane and blockage of ureter. Four lots of DMSA were labeled with 10 mCi/3 mL of {sup 99m}Tc solution, and 300 {mu}Ci/0.1 mL was injected intravenously in each animal. After one hour, they were sacrificed and kidneys, bladder, liver, spleen and carcass were taken out for determination of the retained radiation in function of the injected dose. The USP establishes two parameters for the metabolism of {sup 99m}Tc-DMSA: renal retention equal or higher than 40% and kidneys/liver plus spleen relation equal or higher than 6. In animals whose ureteres were obstructed, it was clearly observed that the urine was not transferred from kidneys to bladder 0.05 {+-} 0.35% I.D., while the first group presented 0.50 {+-} 6.50 % I.D. The kidneys/liver plus spleen relation were above 6 for both. Considering the deviation, all results were in the USP limit of acceptability, and for routine evaluation, urethane can be used without surgical intervention. (author)

Transperitoneal laparoscopic approach for retrocaval ureter

Directory of Open Access Journals (Sweden)

Nagraj H

2006-01-01

Full Text Available We had a 14 year old boy, who presented with recurrent attacks of right loin pain. Investigations revealed a retrocaval ureter. A transperitoneal three port laparoscopic approach was undertaken. The retrocaval portion of ureter was excised. A double J stent was placed laparoscopically and ureteroureterostomy was done with intracorporeal suturing. The patient was discharged after 72 hours and the stent was removed on the 15th day. Follow up showed regression of hydronephrosis. We recommend this approach compared to open surgery, as it offers several advantages compared to conventional open surgery like decreased postoperative pain, decreased hospital stay and a cosmetically more acceptable surgical scar.

Klotho & Activin A in kidney injury Plasma Klotho is maintained in unilateral obstruction despite no upregulation of Klotho biosynthesis in contralateral kidney

DEFF Research Database (Denmark)

Nordholm, Anders; Mace, Maria L; Gravesen, Eva

2018-01-01

In a new paradigm of etiology related to Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) kidney injury may cause induction of factors in the injured kidney that are released into the circulation and thereby initiate and maintain renal fibrosis and CKD-MBD. Klotho is believed to amelior......In a new paradigm of etiology related to Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) kidney injury may cause induction of factors in the injured kidney that are released into the circulation and thereby initiate and maintain renal fibrosis and CKD-MBD. Klotho is believed...... to ameliorate renal fibrosis and CKD-MBD, while ActivinA might have detrimental effects. The unilateral ureter obstruction (UUO) model is used here to examine this concept by investigating early changes related to renal fibrosis in obstructed kidney, untouched contralateral kidney and vasculature, which might...

Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases

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Y. El Harrech

2016-01-01

Full Text Available Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU. Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110–190. No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4–6 days. All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter.

Does Side Make a Difference? Anatomical Differences Between the Left and Right Ureter.

Science.gov (United States)

Odegard, Stephen E; Abernethy, Melinda G; Mueller, Elizabeth R

2015-01-01

Seventy to eighty percent of iatrogenic ureteral injuries involve the left ureter. We sought to evaluate potential anatomical differences between the left and right ureters that may contribute to this discrepancy. A retrospective image review was undertaken of women who underwent computed tomography urograms between 2012 and 2013. The distance to the ureters from the midline was measured at the level of the sacral promontory (S1) and the cervix. Cervical deviation from the midline was measured, and distance between the cervix and ureters was calculated. The anterior-posterior distance between ureters was also measured. Ninety-five computed tomography urograms were analyzed. The mean age was 56 years (range, 23-92 years). Mean cervical deviation was 2.9 mm left of the midline (P = 0.028). The left ureter was 4.2 mm more lateral than the right at S1 and 2.7 mm more lateral at the cervix (P = 0.000 and 0.001). There was no significant difference when accounting for cervical deviation (P = 0.220). The left ureter was 1.9 mm more anterior than the right at the cervix (P = 0.012). Age, body mass index, and ethnicity did not affect the ureteral position. Based on midline measurements, the left ureter courses 2 to 4 mm more lateral and anterior than does the right ureter. The cervix is also positioned 2 to 4 mm to the left side, and as a result, the ureters are actually symmetric to the cervix. Although seemingly small, 2 to 4 mm is the width range of a Heaney clamp. These anatomic differences may be a contributing factor to the increase in ureteral injuries on the left side compared with the right.

A case report of a bifid ureter and renal pelvis

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zahed Safikhani

2004-11-01

Conclusion: The majority of the investigations have reported this anomaly in association with other disease conditions but the present case is the unilateral incomplete bifid ureter & pelvis were associated with no other abnormality. The possible embryological reasons for the formation of bifid ureter are discussed.

Partial ureterectomy for a huge primary leiomyoma of the ureter

International Nuclear Information System (INIS)

Nouralizadeh, A.; Tabib, A.; Taheri, M.; Torbati, P.M.

2010-01-01

A case of a huge primary leiomyoma of the ureter in which only partial ureterectomy was performed is presented. The benign nature of the mass was primarily confirmed with frozen section at the time of surgery and then with immunohistochemistry (IHC). To the best of our knowledge, this case is a unique form of leiomyoma of the ureter due to its large size. There have been only ten cases of primary leiomyoma of the ureter reported since 1955 and all of them were very small in size. Our case is considered to be the eleventh. (author)

Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate

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Grbić Dragan

2014-01-01

Full Text Available Introduction. In males the ectopic ureter usualy drains into the prostate (50%. During ureteric developement a thin membrane (Chawalla’s membrane separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. Case report. A subfebrile (37.3°C, 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS, but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient’s recovery was uneventful. Conclusion. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too craniall sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

Meaning of ureter dilatation during ultrasonography in infants for evaluating vesicoureteral reflux

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Park, Yae-won, E-mail: yaewonpark@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Kim, Myung-Joon, E-mail: mjkim@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Han, Sang Won, E-mail: swhan58@yuhs.ac [Department of Pediatric Urology, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of); Kim, Dong Wook, E-mail: kimdw@yuhs.ac [Biostatistics Collaboration Unit, Yonsei University, College of Medicine, 120-752 Seoul (Korea, Republic of); Lee, Mi-Jung, E-mail: mjl1213@yuhs.ac [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, 120-752 Seoul (Korea, Republic of)

2015-02-15

Purpose: To investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). Materials and methods: We retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0–4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0–5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. Results: Four hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups (p = 0.252). Hydronephrosis grade was not related to VUR in either group (p > 0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group (p = 0.015), even among patients with a high-grade VUR (p = 0.005). Whereas, ureter dilatation was not associated with VUR in the control group (p = 0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades (p = 0.014) and high-grade (p = 0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. Conclusion: Ureter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI.

Meaning of ureter dilatation during ultrasonography in infants for evaluating vesicoureteral reflux

International Nuclear Information System (INIS)

Park, Yae-won; Kim, Myung-Joon; Han, Sang Won; Kim, Dong Wook; Lee, Mi-Jung

2015-01-01

Purpose: To investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). Materials and methods: We retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0–4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0–5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. Results: Four hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups (p = 0.252). Hydronephrosis grade was not related to VUR in either group (p > 0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group (p = 0.015), even among patients with a high-grade VUR (p = 0.005). Whereas, ureter dilatation was not associated with VUR in the control group (p = 0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades (p = 0.014) and high-grade (p = 0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. Conclusion: Ureter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI

Uro-words making history: ureter and urethra.

Science.gov (United States)

Marx, Franz Josef; Karenberg, Axel

2010-06-15

We comprehensively review the history of the terms "ureter" and "urethra" from 700 BC to the present. Using a case study approach, ancient medical texts were analyzed to clarify the etymology and use of both terms. In addition, selected anatomy textbooks from the 15th to 17th centuries were searched to identify and compare descriptions, illustrations, and various expressions used by contemporary authors to designate the upper and lower parts of the urinary tract. The Ancient Greek words "ureter" and "urethra" appear early in Hippocratic and Aristotelian writings. However, both terms designated what we today call the urethra. It was only with increasing anatomical knowledge in Greek medical texts after the 1st century AD that definitions of these words evolved similar to those we employ today. Numerous synonyms were used which served as a basis for translation into Arabic and later Latin during the transfer of ancient knowledge to the cultures of the medieval period. When Greek original texts and their Arabic-Latin version were compared during the Renaissance, this led to terminological confusion which could only be gradually overcome. Around the year 1600, the use of the latinized terms "ureter" and "urethra" became generally accepted. The dissemination of these terms in modern national languages and the emergence of clinical derivatives complete this historical development. The history of the terms "ureter" and "urethra" is exemplary of the difficulties with which the development of a precise urologic terminology had to struggle. The story behind the words also clarifies why even today we still have imprecise or misleading terms.

Congenital anatomic variants of the kidney and ureter: a pictorial essay.

Science.gov (United States)

Srinivas, M R; Adarsh, K M; Jeeson, Riya; Ashwini, C; Nagaraj, B R

2016-03-01

Congenital renal parenchymal and pelvicalyceal abnormalities have a wide spectrum. Most of them are asymptomatic, like that of ectopia, cross fused kidney, horseshoe kidney, etc., while a few of them become complicated, leading to renal failure and death. It is very important for the radiologist to identify these anatomic variants and guide the clinicians for surgical and therapeutic procedures. Cross-sectional imaging with a volume rendered technique/maximum intensity projection has overcome ultrasonography and IVU for identification and interpretation of some of these variants.

Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

Science.gov (United States)

Gulwani, Hanni; Jain, Aruna

2010-01-01

Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome. PMID:21151719

Gene Expression in the Normal Adult Human Kidney Assessed by Complementary DNA Microarray

OpenAIRE

Higgins, John P.T.; Wang, Lingli; Kambham, Neeraja; Montgomery, Kelli; Mason, Veronica; Vogelmann, Stefanie U.; Lemley, Kevin V.; Brown, Patrick O.; Brooks, James D.; van de Rijn, Matt

2004-01-01

The kidney is a highly specialized organ with a complex, stereotyped architecture and a great diversity of functions and cell types. Because the microscopic organization of the nephron, the functional unit of the kidney, has a consistent relationship to the macroscopic anatomy of the kidney, knowledge of the characteristic patterns of gene expression in different compartments of the kidney could provide insight into the functions and functional organization of the normal nephron. We studied g...

Excretory urography and ultrasonography in the diagnosis of bilateral ectopic ureters in a foal

International Nuclear Information System (INIS)

Blikslager, A.T.; Green, E.M.; MacFadden, K.E.; Fagin, B.; Johnson, G.C.

1992-01-01

A 7-week-old Appaloosa filly was admitted for persistent urinary incontinence since birth. Vaginal speculum examination revealed urine flowing from an opening in the right vaginal wall. Cytoscopy demonstrated that the ureters did not terminate at the bladder. The endoscope passed easily from the vagina directly into a dilated right ureter. An excretory urogram confirmed the vaginal termination of at least one ureter, based upon extensive filling of the vagina with contrast media in the absence of bladder filling. Bilateral hydroureter and dilated renal pelves were demonstrated both by excretory urography and by urtrasonography. Euthanasia was required by the owner in lieu of attempted surgical correction. At necroscopy, it was confirmed that the right ureter entered the vagina and the left ureter terminated at the urethra. The diagnosis of bilateral ectopic ureter in this foal was suggested by this history and clinical signs, supported by endoscopy and ultrasonography, and confirmed by excretory urography and necropsy. This case establishes the value of diagnostic imaging techniques in the antemortem diagnosis of ectopic ureter

Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

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Hanni Gulwani

2010-01-01

Full Text Available Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome.

Efficacy of pamiray as a nonionic intravenous contrast material; experimental study suing normal rabbits

International Nuclear Information System (INIS)

Lee, Joon Woo; Kim, Tae Kyoung; Kim, Seung Hyup; Kim, Hyun Beom; Kim, Se Hyung; Hwang, Sung Il; Yeon, Kyung Mo

2000-01-01

To evaluate the efficacy of Pamiray as an intravenous nonionic contrast material by comparing it with an established nonionic contrast material (Iopamiro). Forty adult New Zealand white rabbits weighing about 3.0 kg were used in this study. Aortography and urography (scout, 5, 15 and 30 minutes delay after injection) were performed in ten rabbits with Pamiray (370 mgI/mL) and in other ten rabbits with Iopamiro (370 mgI/mL). All twenty rabbits underwent abdominal triple-phase spiral CT before and 5 and 30 seconds after injection of the contrast material. The degree of contrast enhancement seen on aortograms and intravenous urograms was determined using a three-point scale by two radiologists, who reached a consensus. CT attenuation expressed in Hounsfield units (HU) was measured using the regions of interest (ROIs) facility in the liver, bilateral kidneys, aorta, portal vein, and inferior vena cave. The Mann-Whitney U test was used in image evaluation for intergroup comparisons. There was no significant difference between the two groups in the degree of contrast enhancement seen on aortograms. In urography, however, Iopamiro was superior to Pamiray in demonstrating calyces of the right kidney on 15-minute delay images and Pamiray was superior to Iopamiro in demonstrating the right ureter and the renal pelvis on five minute-delay images and the left ureter on 30 minutes delay (p less than 0.05). Peak enhancement of the aorta during the first phase of abdominal CT was higher in the group in which Pamiray was used. When normal rabbits were used for aortography, abdominal CT, and urography, Pamiray provided more effective contrast enhancement than a previously used nonionic contrast material, namely Iopamiro. There were, however, slight differences in the enhancement features of renal calyces and ureters seen on 5- and 15-minute urograms. (author)

Double obstruction of ureter: A diagnostic challenge.

Science.gov (United States)

Halder, Pankaj; Shukla, Ram Mohan; Mandal, Kartik Chandra; Mukhopadhyay, Biswanath; Barman, Shibsankar

2014-07-01

Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population.[1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO) and vesico-ureteric junction obstruction (VUJO) in the ipsilateral ureter and their management protocol. This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years) had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

Resistive index for kidney evaluation in normal and diseased cats.

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Tipisca, Vlad; Murino, Carla; Cortese, Laura; Mennonna, Giuseppina; Auletta, Luigi; Vulpe, Vasile; Meomartino, Leonardo

2016-06-01

The objectives were to determine the resistive index (RI) in normal cats and in cats with various renal diseases, and to evaluate the effect of age on RI. The subjects were cats that had ultrasonography (US) of the urinary tract and RI measurement at our centre between January 2003 and April 2014. Based on clinical evaluation, biochemical and haematological tests, urinalysis and US, the cats were classified as healthy or diseased. RI measurements were made from the interlobar or arcuate arteries. Data were analysed for differences between the right and the left kidney, the two sexes, different age groups in healthy cats, and between healthy and diseased cats. A total of 116 cats (68 males, 48 females) were included: 24 healthy and 92 diseased. In the healthy cats, RI (mean ± SD) differed significantly (P = 0.02) between the right kidney (0.54 ± 0.07) and the left kidney (0.59 ± 0.08). For the left kidney, RI was significantly higher in cats with chronic kidney disease (0.73 ± 0.12) and acute kidney injury (0.72 ± 0.08) (P = 0.0008). For the right kidney, RI was significantly higher in cats with chronic kidney disease (0.72 ± 0.11), acute kidney injury (0.74 ± 0.08), polycystic kidney disease (0.77 ± 0.11) and renal tumour (0.74 ± 0.001) (P cats, useful in the differential diagnosis of diffuse renal diseases. While it does not change with the age of the cat, ultrasonographers should be aware that RI may differ between the two kidneys. © ISFM and AAFP 2015.

Evaluation of the Normal Fetal Kidney Length and Its Correlation with Gestational Age

OpenAIRE

Farrokh Seilanian Toosi; Hossein Rezaie-Delui

2013-01-01

A true estimation of gestational age (GA) plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL) and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive e...

Embryonic kidney function in a chronic renal failure model in rodents.

Science.gov (United States)

Fujimoto, Eisuke; Yamanaka, Shuichiro; Kurihara, Sho; Tajiri, Susumu; Izuhara, Luna; Katsuoka, Yuichi; Yokote, Shinya; Matsumoto, Kei; Kobayashi, Eiji; Okano, Hirotaka James; Chikaraishi, Tatsuya; Yokoo, Takashi

2017-08-01

Rapid advancements have been made in alternative treatments for renal diseases. Our goal for renal regeneration is to establish a kidney graft derived from human embryonic tissues. In this study, we investigated the effects of host renal failure on the structure and activity of transplanted embryonic kidney and bladder, and found that diuretics effectively induced urine production in the transplanted kidney. Uremic conditions were reproduced using a 5/6 renal infarction rat model. An embryonic kidney plus bladder (embryonic day 15) was isolated from a pregnant Lewis rat and transplanted into the para-aortic area of a 5/6 renal-infarcted Lewis rat. Following growth, the embryonic bladder was successfully anastomosed to the host ureter. We assessed graft function in terms of survival rates and found no differences between normal (n = 5) and renal failure (n = 8) groups (median survival: 70.5 vs 74.5 h; p = 0.331) in terms of survival, indicating that the grafts prolonged rat survival, even under renal failure conditions. Furosemide (n = 9) significantly increased urine volume compared with saline-treated controls (n = 7; p < 0.05), confirming that the grafts were functional. We also demonstrated the possibilities of an in vivo imaging system for determining the viability of transplanted embryonic kidney with bladder. The results of this study demonstrate that transplanted embryonic kidney and bladder can grow and function effectively, even under uremic conditions.

Normal tissue consequences

International Nuclear Information System (INIS)

Anon.

1989-01-01

This chapter discusses radiotherapy planning and irradiation effects on the following: pelvis (bone, bone marrow, muscles, genital organs, urinary bladder, urethra, ureter, small intestine, rectum, anus); abdomen (stomach, liver, small intestine, kidneys, adrenal glands, pancreas, spleen); thorax (respiratory system, esophagus, heart, ribs, breasts, brachial plexus, spinal cord); head and neck (salivary glands, teeth, mandible, mucosa, ears, eyes, facial muscles, larynx, thyroid gland, pituitary gland, brain, spinal cord); central nervous system (brain, optic nerves, pituitary gland, scalp, skull, spinal cord); and the extremities

Double obstruction of ureter: A diagnostic challenge

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Pankaj Halder

2014-01-01

Full Text Available Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population. [1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO and vesico-ureteric junction obstruction (VUJO in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

Appearances of the circumcaval ureter on excretory urography and MR urography: A single-center case series

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Prakash Muthusami

2013-01-01

Full Text Available Objectives: To describe Magnetic Resonance Urography (MRU appearances of the circumcaval ureter, a rare congenital cause of hydronephrosis. Materials and Methods: Seven cases of circumcaval ureter, suspected on intravenous urography (IVU, underwent subsequent static MRU using heavily T2-weighted sequences. Results: The various appearances of circumcaval ureter on IVU and MRU were studied and compared. The circumcaval portion of the ureter was especially well seen on axial MRU sections, though this portion was routinely not visualized on IVU. In one case with a ureteric calculus, MRU also depicted a circumcaval course of the ureter, thus providing a complete diagnosis. In yet another case, where a circumcaval ureter was suspected on IVU, MRU proved the actual cause of ureteric obstruction to be a crossing vessel. Conclusion: Static MRU using heavily T2-weighted coronal and axial sequences can make or exclude the diagnosis of circumcaval ureter unequivocally.

TECHNIQUE OF EXTRACORPOREAL PARTIAL NEPHRECTOMY IN TERMS OF PHARMACO-COLD ISCHEMIA WITHOUT CROSSING THE URETER WITH RENAL VESSELS ORTHOTOPIC REPLANTATION IN PATIENTS WITH RENAL CELL CARCINOMA

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Alexander Gritskevitch

2015-01-01

Full Text Available Background. The most difficult is to determine medical tactics in patients with renal cell carcinoma (RCC with intraparenchimal and central localization in the single, the only functioning kidney, as well as with a combination of tumor and other illnesses in contralateral kidney. Partial nephrectomy leading to renal replacement therapy results in life-threatening complications and poor prognosis. The priority is to develop organ-preserving treatment: from minimally invasive endoscopic surgery to ex vivo kidney resection. Aim: to develop a technique of extracorporeal partial nephrectomy in terms of pharmaco-cold ischemia without crossing the ureter with renal vessels orthotopic replantation in patients with RCC. Materials and methods. The study included 37 patients with pT1a-T3vN0M0-1G1-3 RCC with intraparenchymal and central tumor location. The average age of the patients was 55.32 ± 13.1 years. The ratio of men and women - 2.7:1. Bilateral renal tumors were observed in 3 (8.1% patients, and the RCC of the single functioning kidney in 6 (16.2% patients. One patient (2.7% was diagnosed RCC of a single kidney with intraluminal invasion (cava-renal form. Results. The mean operation time was 413.97 ± 89.14 minutes. The mean warm ischemia time – 8.39 ± 4.75 minutes. Cold ischemia lasted from 70 to 240 minutes, on the average 151.41 ± 41.29 min. The amount of blood loss made up 729.03 ± 481.4 ml. Perioperative complications were detected in 3 (8.1% patients. In two cases after starting the renal blood flow the kidney was found to be nonviable and had to be removed. And in one case the recurrent prosthetic thrombosis of the renal artery resulted in a renal scarring. Postoperative complications were observed in 18 (48.6% patients. According to Clavien-Dindo classification there were 8 low grade (I-II degree complications (44.4%, 8 other of III degree, and one IV degree complication, and there was one lethal case (V degree. Conclusion

The most common cause of non-functioning kidney nephrectomy: Urolithiasis

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Şenol Adanur

2014-09-01

Full Text Available Objective: Our aim is to evaluate and present the characteristics of patients underwent nephrectomy due to nonfunctional kidney secondary to urolithiasis in our clinic. Methods:Totally 696 patients were anlyzed retrospectively who underwent nephrectomy in our clinic between January 2000 and December 2012. Etiologies and characteristics of nephrectomy applied patients due to nontumoral non-functional kidney related with urinary tract stones are evaluated. Diagnoses of the patients were confirmed by using urinary system ultrasonography, ab dominal computed tomography, intravenous urography and renal scintigraphy. Results:Nephrectomy was performed for 280 (40.2% patients due to tumor formation and for 416 (59.8% patients due to non-functional kidney of totally 696 patients.43.8% (182 of non-funtional kidney cases were resulted by upper urinary tract stones. Mean age of nephrectomy performed urolithiasis patients were 43.7±16.9 years. 53.3% (97 of patients were male and 46.7% (85 patients were female. Preoperative mean creatinine value of patients were detected 2.98±0.47 mg/dl. Renal stone local izatian was ureteropelvic junction in 81.3% (148, ureter in 14.3% (26 and renal+ureter in 4.4% (8 of the patients. 66.8% of reteropelvic junction stones were 10-30 mm in size. Conclusion: Upper urinary tract stones are primer responsible of non-functional kidney development besides forming most of the non-tumor related nephrectomies. Routine urinary system examination should be suggested to patients with a history of urolithiasis in order to prevent later probable organ losses.

A SHH-FOXF1-BMP4 signaling axis regulating growth and differentiation of epithelial and mesenchymal tissues in ureter development.

Science.gov (United States)

Bohnenpoll, Tobias; Wittern, Anna B; Mamo, Tamrat M; Weiss, Anna-Carina; Rudat, Carsten; Kleppa, Marc-Jens; Schuster-Gossler, Karin; Wojahn, Irina; Lüdtke, Timo H-W; Trowe, Mark-Oliver; Kispert, Andreas

2017-08-01

The differentiated cell types of the epithelial and mesenchymal tissue compartments of the mature ureter of the mouse arise in a precise temporal and spatial sequence from uncommitted precursor cells of the distal ureteric bud epithelium and its surrounding mesenchyme. Previous genetic efforts identified a member of the Hedgehog (HH) family of secreted proteins, Sonic hedgehog (SHH) as a crucial epithelial signal for growth and differentiation of the ureteric mesenchyme. Here, we used conditional loss- and gain-of-function experiments of the unique HH signal transducer Smoothened (SMO) to further characterize the cellular functions and unravel the effector genes of HH signaling in ureter development. We showed that HH signaling is not only required for proliferation and SMC differentiation of cells of the inner mesenchymal region but also for survival of cells of the outer mesenchymal region, and for epithelial proliferation and differentiation. We identified the Forkhead transcription factor gene Foxf1 as a target of HH signaling in the ureteric mesenchyme. Expression of a repressor version of FOXF1 in this tissue completely recapitulated the mesenchymal and epithelial proliferation and differentiation defects associated with loss of HH signaling while re-expression of a wildtype version of FOXF1 in the inner mesenchymal layer restored these cellular programs when HH signaling was inhibited. We further showed that expression of Bmp4 in the ureteric mesenchyme depends on HH signaling and Foxf1, and that exogenous BMP4 rescued cell proliferation and epithelial differentiation in ureters with abrogated HH signaling or FOXF1 function. We conclude that SHH uses a FOXF1-BMP4 module to coordinate the cellular programs for ureter elongation and differentiation, and suggest that deregulation of this signaling axis occurs in human congenital anomalies of the kidney and urinary tract (CAKUT).

A SHH-FOXF1-BMP4 signaling axis regulating growth and differentiation of epithelial and mesenchymal tissues in ureter development.

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Tobias Bohnenpoll

2017-08-01

Full Text Available The differentiated cell types of the epithelial and mesenchymal tissue compartments of the mature ureter of the mouse arise in a precise temporal and spatial sequence from uncommitted precursor cells of the distal ureteric bud epithelium and its surrounding mesenchyme. Previous genetic efforts identified a member of the Hedgehog (HH family of secreted proteins, Sonic hedgehog (SHH as a crucial epithelial signal for growth and differentiation of the ureteric mesenchyme. Here, we used conditional loss- and gain-of-function experiments of the unique HH signal transducer Smoothened (SMO to further characterize the cellular functions and unravel the effector genes of HH signaling in ureter development. We showed that HH signaling is not only required for proliferation and SMC differentiation of cells of the inner mesenchymal region but also for survival of cells of the outer mesenchymal region, and for epithelial proliferation and differentiation. We identified the Forkhead transcription factor gene Foxf1 as a target of HH signaling in the ureteric mesenchyme. Expression of a repressor version of FOXF1 in this tissue completely recapitulated the mesenchymal and epithelial proliferation and differentiation defects associated with loss of HH signaling while re-expression of a wildtype version of FOXF1 in the inner mesenchymal layer restored these cellular programs when HH signaling was inhibited. We further showed that expression of Bmp4 in the ureteric mesenchyme depends on HH signaling and Foxf1, and that exogenous BMP4 rescued cell proliferation and epithelial differentiation in ureters with abrogated HH signaling or FOXF1 function. We conclude that SHH uses a FOXF1-BMP4 module to coordinate the cellular programs for ureter elongation and differentiation, and suggest that deregulation of this signaling axis occurs in human congenital anomalies of the kidney and urinary tract (CAKUT.

Bilateral complete ureteral duplication with calculi obstructing both limbs of left double ureter.

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Aiken, William D; Johnson, Peter B; Mayhew, Richard G

2015-01-01

A woman with bilateral complete ureteral duplication with stones simultaneously obstructing both limbs of the left double ureter is presented. A search of the English medical literature suggests that this is the first reported case. Based on the initial difficulty accessing the stones via ureteroscopy we make recommendations regarding how this rare problem should be approached if encountered. A 37-year old woman with left-sided flank pain was discovered on CT scan to have bilateral complete ureteral duplication and three stones obstructing both limbs of the left double ureter. Ureteroscopy was initially unsuccessful due to the very small calibre and unyielding nature of the ureters and both ureteral limbs were stented. Repeat ureteroscopy was easily achieved after pre-stenting and the impacted stones were completely cleared with intracorporeal laser lithotripsy. The smaller calibre of both double ureters and their presence in a common adventitial sheath distally, made initial attempts at ureteroscopy difficult. Stenting both limbs increased ureteral compliance, passively dilated both ureters and allowed for improved manoeuvrability and retrograde passage of the ureteroscope. Based on the experience with this first reported case it is recommended that pre-stenting should be routinely performed prior to any attempt at ureteroscopy in cases of stones complicating completely duplicated ureters. We report the first recorded case of bilateral complete ureteral duplication with stones simultaneously obstructing both limbs of the double ureter and recommend that routine pre-stenting be done prior to ureteroscopy to allow easy uncomplicated retrograde passage of the ureteroscope. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Duplicated collecting system of a kidney complicated with hydronephrosis - diagnostic methods review: A case report

International Nuclear Information System (INIS)

Osmanski, P.; Plucinska, I.; Calka, K.; Kedzierski, B.; Jazwiec, P.

2008-01-01

Duplicated collecting system of a kidney occurs in 1.7-4.2% of the population. It is a complex, unilateral or bilateral, congenital abnormality of the pyelocalyceal system and the ureter. The 2 ureters fuse to form a single ureteral orifice or empty separately into the bladder (ureter duplex). Duplicated collecting systems with complete ureteric duplication may lead to developing vesicoureteral reflux, hydronephrosis, and urinary infection. This article presents a case of a 49-year-old woman with duplicated collecting system and hydronephrosis in the upper pole. The anomaly was diagnosed using urography, ultrasonography and computed tomography examination.The best method for diagnostics of the duplicated pyelocalyceal system complicated by hydronephrosis is computed tomography examination, especially multislice computed tomography. The authors present also the options for therapy (author)

Villous Adenoma of the Ureter with Manifestation of Mucus Hydroureteronephrosis

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Chi-Min Shih

2007-01-01

Full Text Available Ureteral tumor is prone to result in lumen obstruction. Villous adenoma is most frequently found in the colon and rectum, seldom in the urinary tract and even more rarely in the ureter or pelvis. Herein, we present a case of bilateral renal stones of more than 10 years' duration with the chief complaint of right flank pain. Obstruction of the right upper ureter with hydroureteronephrosis was observed on sonography, computed tomography and retrograde pyelography. Ureteroscopy revealed papillary tumor obstructing the upper third of the ureter and inducing hydroureteronephrosis with abundant mucoid content. The ureteral tumor proved to be villous adenoma by pathologic examination. It should be noted that ureteral villous adenoma may be related to previous enteric-type metaplastic mucosa or ureteritis glandularis, demonstrates profuse production of mucus, and may eventually undergo malignant transformation.

Anatomy and ultrasonography of the normal kidney in brown lemurs: Eulemur fulvus.

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Raharison, Fidiniaina; Mogicato, Giovanni; Sautet, Jean

2009-08-01

The purpose of this study is to describe the anatomy and obtain echographic measurements of normal kidneys in brown lemurs (Eulemur fulvus). The anatomical findings show that brown lemur kidneys are comparable to those of rats except for an elongated papilla. The kidneys of 16 (7 females and 9 males) lemurs were examined with two-dimensional and power Doppler ultrasonography under general anesthesia. Morphometrically, the left and right kidney surface areas are comparable (3.29 and 3.51 cm(2)). Kidney area has a significant linear correlation with body weight. Echo-Doppler findings show that the mean renal arterial blood flow speeds for the left and right kidneys are comparable (0.70 and 0.73 m/s). However, flow speed is higher in the male (0.79 m/s) than in the female (0.60 m/s). The renal arterial diameters are between 1.0 and 1.8 mm. The fact that anesthesia can have hemodynamic effects on renal vasculature should be taken into consideration when assessing these echographic results.

[Ectopic ureter in pediatrics. A change in the way of presentation].

Science.gov (United States)

Escala, José Manuel; Cadena González, Yair; López, Pedro J; Retamal, Gabriela; Letelier, Nelly; Zubieta, Ricardo

2008-05-01

Classically, the diagnosis of ectopic ureter was done in grown up girls due to urinary incontinence, today the diagnoses are more precocious, which has partially changed treatment. The objective of this paper is to perform a review of our experience over the last years and to correlate it with the current type of presentation. We studied all patients with the diagnosis of ectopic ureter in a period of 10 years, between 1997 and December 2006. Demographic characteristics, type of presentation, diagnostic tests performed, age at the time of diagnosis and treatment were all analyzed, altogether with the different techniques employed for treatment. We found 19 patients with this disease, 15 of them females. Type of presentation was febrile urinary tract infection in 13 patients, urinary incontinence in two, and prenatal diagnosis of hydronephrosis in 4. Sixteen children had double pyeloureteral systems and only three had single systems. In all cases the diagnosis was performed with renal-bladder ultrasound, urethrocystogram and endoscopic studies. Additional studies such as excretion pyelograms were performed in 8 patients at the start of the series and nuclear medicine tests in 17. Median age at the time of diagnosis was eight months. All patients underwent surgical treatment. In patients with double systems superior heminephroureterectomy was performed in 8 patients, vesicoureteral reimplantation in three and pyelopyelic anastomosis in three cases with upper pole remnant function. In another two cases nephroureterectomy was performed due to the presence of reflux to the lower or system and severe renal compromise. In all three cases with single systems ureter reimplantation was performed. Currently prenatal suspicion and adequate study of urinary tract infections enable confirmation of ectopic ureter. Few children debut with urinary incontinence currently, due to the precocity of diagnosis. Treatment is always surgical, and basically depends on renal function, and

Peristomal pagetoid spread of urothelial carcinoma of the ureter

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Fumio Ito

2013-09-01

Full Text Available Patients with ostomy including urinary stoma often develop peristomal complications, especially skin damage. The patient in this case was a 69-year old female with a history of urothelial carcinoma of the bladder and left ureter who underwent transurethral resection of a bladder tumor, nephroureterectomy and cystectomy combined with ureterocutaneostomy. Later, she had recurrence of urothelial carcinoma in the remaining ureter that spread to the peristomal epidermis, with a skin appearance resembling Paget’s disease. We report this case based on its clinical significance since we believe it is the first description of this condition in the literature.

Diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) determination in normal and pathological fetal kidneys.

Science.gov (United States)

Chaumoitre, K; Colavolpe, N; Shojai, R; Sarran, A; D' Ercole, C; Panuel, M

2007-01-01

To assess the use of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of the fetal kidney and to estimate age-dependent changes in the apparent diffusion coefficient (ADC) of normal and pathological fetal kidneys. DW-MRI was performed on a 1.5-T machine at 23-38 gestational weeks in 51 pregnant women in whom the fetal kidneys were normal and in 10 whose fetuses had renal pathology (three with suspected nephropathy, three with renal tract dilatation, one with unilateral renal venous thrombosis, and three with twin-twin transfusion syndrome (TTTS)). The ADC was measured in an approximately 1-cm2 region of interest within the renal parenchyma. ADC values in normal renal parenchyma ranged from 1.1 to 1.8 10(-3) mm2 s-1. There was no significant age-dependent change in the ADC of normal kidneys. In cases of nephropathy, the ADC value was not always pathological but an ADC map could show abnormal findings. In cases of dilatation, the ADC value was difficult to determine when the dilatation was huge. In cases of TTTS, the ADC of the donor twin was higher than that of the recipient twin and the difference seemed to be related to the severity of the syndrome. Evaluation of the ADC for fetal kidneys is feasible. Fetal measurement of the ADC value and ADC maps may be useful tools with which to explore the fetal kidney when used in conjunction with current methods. DW-MR images, ADC value and ADC map seem to be useful in cases of suspected nephropathy (hyperechoic kidneys), dilated kidney and vascular pathology (renal venous thrombosis, TTTS). Copyright (c) 2006 ISUOG.

Effects of Short Term Exposure of Atrazine on the Liver and Kidney of Normal and Diabetic Rats

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Dinesh Babu Jestadi

2014-01-01

Full Text Available The present study evaluates the effects of short term (15 days exposure of low dose (300 μg kg−1 of atrazine (2-chloro-4-ethylamino-6-isopropylamino-1,3,5-triazine on antioxidant status and markers of liver and kidney damage in normal (nondiabetic and diabetic male Wistar rats. Rats were divided into four groups: Group I as normal control, Group II as atrazine treated, Group III as diabetic control, and Group IV as atrazine treated diabetic rats. Atrazine administration resulted in increased MDA concentration as well as increased activities of SOD, CAT, and GPx in both liver and kidney of atrazine treated and atrazine treated diabetic rats. However, GSH level was decreased in both liver and kidney of atrazine treated and atrazine treated diabetic rats. Atrazine administration led to significant increase in liver damage biomarkers such as AST, ALT, and ALP as well as kidney damage biomarkers such as creatinine and urea in both normal and diabetic rats, but this increase was more pronounced in diabetic rats when compared to normal rats. In conclusion, the results of the present study demonstrate that short term exposure of atrazine at a dose of 300 μg kg−1 could potentially induce oxidative damage in liver and kidney of both normal and diabetic rats.

Cell-Type-Specific Gene Programs of the Normal Human Nephron Define Kidney Cancer Subtypes.

Science.gov (United States)

Lindgren, David; Eriksson, Pontus; Krawczyk, Krzysztof; Nilsson, Helén; Hansson, Jennifer; Veerla, Srinivas; Sjölund, Jonas; Höglund, Mattias; Johansson, Martin E; Axelson, Håkan

2017-08-08

Comprehensive transcriptome studies of cancers often rely on corresponding normal tissue samples to serve as a transcriptional reference. In this study, we performed in-depth analyses of normal kidney tissue transcriptomes from the TCGA and demonstrate that the histological variability in cellularity, inherent in the kidney architecture, lead to considerable transcriptional differences between samples. This should be considered when comparing expression profiles of normal and cancerous kidney tissues. We exploited these differences to define renal-cell-specific gene signatures and used these as a framework to analyze renal cell carcinoma (RCC) ontogeny. Chromophobe RCCs express FOXI1-driven genes that define collecting duct intercalated cells, whereas HNF-regulated genes, specific for proximal tubule cells, are an integral part of clear cell and papillary RCC transcriptomes. These networks may be used as a framework for understanding the interplay between genomic changes in RCC subtypes and the lineage-defining regulatory machinery of their non-neoplastic counterparts. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Urothelial carcinoma of the allograft kidney developed in a renal transplant patient.

Science.gov (United States)

Gökçe, Mehmet İlker; Kocaay, Akın Fırat; Aktürk, Serkan; Tüzüner, Acar

2016-09-01

Renal transplantation is the best option in the treatment of end-stage renal disease However these patients are under the risk of developing malignancies particularly due to effects of immune supression. These malignancies tend to be more agressive compared to the general population. Here, we present a case of urothelial carcinoma develoing in the ureter of allograft kidney.

Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

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Andre Berger

2009-01-01

Full Text Available Introduction. Laparoscopic radical nephroureterectomy (LNU is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC. Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU or hand-assisted (HALNU. The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU. Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context.

Kidney, Ureteral, and Bladder Cancer: A Primer for the Internist.

Science.gov (United States)

Arora, Hans C; Fascelli, Michele; Zhang, Jj H; Isharwal, Sudhir; Campbell, Steven C

2018-03-01

Malignancies of the urinary tract (kidney, ureter, and bladder) are distinct clinical entities. Hematuria is a unifying common presenting symptom for these malignancies. Surgical management of localized disease continues to be the mainstay of treatment, and early detection is important in the prognosis of disease. Patients often require life-long follow-up and assessment for recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.

Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase.

Science.gov (United States)

Kamal, Faisal; Snook, Lindsay; Saikumar, Jagannath H

2018-01-01

Rhabdomyolysis is a syndrome characterized by the breakdown of skeletal muscle and leakage of intracellular myocyte contents, such as creatine phosphokinase (CPK) and myoglobin, into the interstitial space and plasma resulting in acute kidney injury (AKI). Elevated CPK of at least 5 times the upper limit of normal is an important diagnostic marker of Rhabdomyolysis. We present a case of rhabdomyolysis with severe AKI with a normal CPK at presentation. A 32-year-old man presented with acute respiratory failure and AKI after an overdose of recreational drugs. Urinalysis at presentation showed trace amounts of blood, identified as rare red blood cells under microscopy. CPK was 156 U/L at presentation. Workup for glomerulonephritis and vasculitis was negative. He was initiated on renal replacement therapy, and a kidney biopsy showed severe acute tubular injury with positive myoglobin casts. Supportive management and renal replacement therapy was provided, and renal function spontaneously improved after a few weeks. This is an uncommon clinical presentation of severe rhabdomyolysis complicated by AKI. This suggests that CPK alone may not be a sensitive marker for rhabdomyolysis-induced AKI in some cases. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Biochemical and Clinical Variables of Normal Parathyroid and Hyperparathyroid Diabetic Chronic Kidney Disease Patients

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Syed Abdul Kader

2016-09-01

Full Text Available Background: In chronic kidney disease (CKD intact parathyroid hormone (iPTH level is often increased before clinical hyperphosphatemia occurs. Despite its importance very few studies evaluated parathyroid status in CKD. Objective: The study was undertaken to estimate level of parathormone in diabetic CKD patients at a tertiary level hospital and assessing its relationship with different parameters like hemoglobin, calcium etc. and comparing biochemical and clinical variables between normal parathyroid and hyperparathyroid groups. Materials and Methods: It was a hospital based cross-sectional study involving purposively selected chronic kidney disease patients attending nephrology and endocrinology outdoor and indoor services of BIRDEM hospital, Dhaka, Bangladesh. Study was conducted during the period of April to October 2010. All the subjects were divided into two groups based on serum parathormone level and different parameters were compared between groups. Results: The mean duration of chronic kidney disease was significantly higher in hyperparathyroid group than that in the normal group (<0.001. Retinopathy and hypertension were more common in hyperparathyroid group than that in patients with normal serum parathormone (p<0.001 and p=0.012. Neuropathy was solely present in hyperparathyroid group (p<0.001. Mean fasting blood glucose, serum creatinine and serum phosphate were significantly higher in the hyperparathyroid group compared to normal group (p<0.001 in all cases while the mean serum calcium and haemoglobin were lower in hyperparathyroid group than those in the normal group (p<0.001 in both cases. Serum creatinine and serum parathormone bears a significantly linear relationship (r=0.986, p<0.001, while serum parathormone and serum calcium bears a significantly negative relationship (r=−0.892 and p<0.001. Conclusion: Earlier intervention on the basis of iPTH in addition to other biochemical parameters of chronic kidney disease is

Role of CD56 in Normal Kidney Development and Wilms Tumorigenesis

DEFF Research Database (Denmark)

Yap, Li-Wei; Brok, Jesper; Pritchard-Jones, Kathy

2017-01-01

The cell-surface glycoprotein CD56 has three major isoforms that play important roles in cell adhesion and signaling, which may promote cell proliferation, differentiation, survival, or migration. It is an important molecule in normal kidney development and acts as a key marker in Wilms tumor stem...

Metabolic abnormalities associated with renal calculi in patients with horseshoe kidneys.

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Raj, Ganesh V; Auge, Brian K; Assimos, Dean; Preminger, Glenn M

2004-03-01

Horseshoe kidneys are a complex anatomic variant of fused kidneys, with a 20% reported incidence of associated calculi. Anatomic causes such as high insertion of the ureter on the renal pelvis and obstruction of the ureteropelvic junction are thought to contribute to stone formation via impaired drainage, with urinary stasis, and an increased incidence of infection. In this multi-institutional study, we evaluated whether metabolic factors contributed to stone development in patients with horseshoe kidneys. A retrospective review of 37 patients with horseshoe kidneys was performed to determine if these patients had metabolic derangements that might have contributed to calculus formation. Stone compositions as well as 24-hour urine collections were examined. Specific data points of interest were total urine volume; urine pH; urine concentrations of calcium, sodium, uric acid, oxalate, and citrate; and number of abnormalities per patient per 24-hour urine collection. These data were compared with those of a group of 13 patients with stones in caliceal diverticula as well as 24 age-, race-, and sex-matched controls with stones in anatomically normal kidneys. Eleven (9 men and 2 women) of the 37 patients (30%) with renal calculi in horseshoe kidneys had complete metabolic evaluations available for review. All patients were noted to have at least one abnormality, with an average of 2.68 abnormalities per 24-hour urine collection (range 1-4). One patient had primary hyperparathyroidism and underwent a parathyroidectomy. Low urine volumes were noted in eight patients on at least one of the two specimens (range 350-1640 mL/day). Hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia were noted in seven, three, six, and six patients, respectively. No patients were found to have gouty diathesis or developed cystine stones. Comparative metabolic analyses of patients with renal calculi in caliceal diverticula or normal kidneys revealed a distinct profile in patients

Pure Ethiodized Oil-based Transcatheter Ablative Therapy in Normal Rabbit Kidneys and Kidneys Inoculated with VX-2 Carcinoma

International Nuclear Information System (INIS)

Kónya, András; Stephens, L. Clifton; Wright, Kenneth C.

2011-01-01

Purpose: To evaluate the efficacy of ablation with selective arterial injection of pure ethiodized oil followed by arterial occlusion with 9:1 ethanol–Ethiodol mixture (EEM) and coil placement in normal rabbit kidneys and kidneys inoculated with VX-2 carcinoma. Materials and Methods: All experiments were conducted with Animal Care and Use Committee approval. In six rabbits (group 1), one kidney was embolized with pure Ethiodol until capillary stasis, followed by injection of 9:1 EEM until arterial stasis and then coil placement into the main renal artery. In 12 other rabbits, one kidney was inoculated with VX-2 tumor. Ethiodol and EEM embolization and coil placement followed 7 days later (group 2, n = 6) or 11–14 days later (group 3, n = 6). Kidneys were evaluated (angiography, computed tomography, macro- and microscopy) 7 days after treatment. Results: Capillary stasis was achieved in groups 1, 2, and 3 with (mean ± standard deviation) 0.47 ± 0.03, 0.53 ± 0.02, and 0.56 ± 0.04 ml of pure Ethiodol, followed by 0.47 ± 0.05, 0.42 ± 0.03, and 0.38 ± 0.04 ml of EEM, respectively, which caused complete arterial occlusion in 17 of 18 kidneys. In group 1, all but one kidney showed at least 95% generalized coagulative necrosis. In group 2, all six kidneys exhibited 100% coagulative necrosis, with no viable tumor present. In group 3, 100% coagulative necrosis was present in all kidneys, with a small viable tumor in one. Conclusion: In the rabbit, selective arterial injection of pure Ethiodol can cause complete renal parenchyma and tumor ablation when it is followed by prompt, contiguous, and permanent occlusion of the arterial compartment.

Laparoscopic resection aided by preoperative 3-D CT angiography for rectosigmoid colon cancer associated with a horseshoe kidney: A case report.

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Maeda, Yoshiaki; Shinohara, Toshiki; Nagatsu, Akihisa; Futakawa, Noriaki; Hamada, Tomonori

2014-11-01

We herein report a case of laparoscopic high anterior resection with D3 lymph node dissection for rectosigmoid colon cancer with a horseshoe kidney. A 65-year-old Japanese man referred to our hospital for rectosigmoid colon cancer was found to have a horseshoe kidney on a CT scan. On 3-D CT angiography, an aberrant renal artery was visualized feeding the renal isthmus that arises from the aorta just below the root of the inferior mesenteric artery (IMA). Laparoscopic anterior rectal resection with D3 lymph node dissection was performed. During the operation, the IMA, left ureter, left gonadal vessels and hypogastric nerve plexus could be seen passing over the horseshoe kidney isthmus. With the aid of preoperative 3-D CT angiography, the root of the IMA was identified on the temporal side of the isthmus and divided safely just above the hypogastric nerve. As a horseshoe kidney is often accompanied by aberrant renal arteries and/or abnormal running of the ureter, 3-D CT angiography is useful for determining the location of these structures and avoiding intraoperative injury. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Normal differential renal function does not indicate a normal kidney after partial ureteropelvic obstruction and subsequent relief in 2-week-old piglets

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Dissing, Thomas H.; Mikkelsen, Mette Marie; Pedersen, Michael; Froekiaer, Joergen; Djurhuus, Jens Christian [University of Aarhus, Institute of Clinical Medicine, Aarhus (Denmark); Eskild-Jensen, Anni [Aarhus University Hospital, Department of Nuclear Medicine, Aarhus Sygehus, Aarhus (Denmark); Gordon, Isky [University College London, Institute of Child Health, London (United Kingdom); University College London, Radiology and Physics Unit, Institute of Child Health, London (United Kingdom)

2008-09-15

We investigated the functional consequences of relieving ureteric obstruction in young pigs with experimental hydronephrosis (HN) induced by partial unilateral ureteropelvic obstruction. Three groups of animals were followed from the age of 2 weeks to the age of 14 weeks: Eight animals had severe or grades 3-4 HN throughout the study. Six animals had relief of the obstruction after 4 weeks. Six animals received sham operations at both ages. Morphological and functional examinations were performed at age 6 weeks and again at age 14 weeks and consisted of magnetic resonance imaging (MRI), technetium-diethylenetriaminepentaaceticacid ({sup 99m}Tc-DTPA) renography, renal technetium-dimercaptosuccinicacid ({sup 99m}Tc-DMSA) scintigraphy, and glomerular filtration rate (GFR) measurement. After relief of the partial obstruction, there was reduction of the pelvic diameter and improvement of urinary drainage. Global and relative kidney function was not significantly affected by either obstruction or its relief. Renal {sup 99m}Tc-DMSA scintigraphy showed a change in both the appearance of the kidney and a change in the distribution within kidneys even after relief of obstruction. This study shows that partial ureteric obstruction in young pigs may be associated with little effect on global and differential kidney function. However, even after relief of HN, the distribution of {sup 99m}Tc-DMSA in the kidney remains abnormal suggesting that a normal differential renal function may not represent a normal kidney. (orig.)

Circumcaval ureter with synchronous ipsilateral transitional cell ...

African Journals Online (AJOL)

We report a case of concomitant transitional cell carcinoma (TCC) in a circumcaval ureter and invasive bladder cancer. The diagnosis was based on the findings of excretory urography (IVU) and contrast-enhanced computed tomography (CT). IVU showed a typical J-shaped deformity in the dilated right proximal ureteric ...

Functional evaluation of transplanted kidneys in normal function and acute rejection using BOLD MR imaging

International Nuclear Information System (INIS)

Xiao Wenbo; Xu Jingjing; Wang Qindong; Xu Ying; Zhang Minming

2012-01-01

In this study, we evaluated a large number of subjects using BOLD MRI to provide more information about oxygen metabolism in the normal function of transplanted kidneys and to distinguish acute graft rejection from normal function kidneys. This study included 122 subjects (20 volunteers, 72 patients with normal functioning transplants, and 21 patients with acute rejection), and 9 patients had normal function grafts received examination while grafts dysfunction occurred within 6 months during the follow-up. The R2* (1/s) values in the cortex and medulla as well as the R2* ratio of the medulla to cortex (R2* ratio of M/C) were recorded. The R2* values of the medulla were higher than those of the cortex in the normal function group and the volunteers which have a steep R2* ratio of M/C. All the R2* values in the acute rejection group were lower than those in the normal function grafts group (P 1.1) is an important reason for keeping clinical normal function.

Retrocaval ureter: a report on two neonates

African Journals Online (AJOL)

Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or the fourth decade of life. Its symptoms are because of ureteric obstruction, caused extrinsically by an abnormal inferior vena cava, intrinsically by ureteric hypoplasia, or both. Surgery is needed for symptomatic patients and involves transection ...

Retroperitoneal Malignant Peripheral Nerve Sheath Tumor Replacing an Absent Kidney in a Child

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Samin Alavi

2013-01-01

Full Text Available Malignant peripheral nerve sheath tumors (MPNSTs are nonrhabdomyosarcoma soft tissue sarcomas with rare occurrence in children specially in the retroperitoneum. We describe a young child who presented with an abdominal mass. Both ultrasound and computed tomography revealed a large right-sided abdominal mass in the anatomic place of right kidney, while no kidney or ureter was observed at that side. He underwent surgical resection of the tumor with a primary impression of Wilms tumor. To the authors’ knowledge, this is the first case of retroperitoneal malignant peripheral nerve sheath tumor and absent kidney. This case suggests the very rare probability of association of MPNSTs in children with genitourinary tract anomalies such as renal agenesis.

Percutaneous Nephrolithotomy in Horseshoe Kidney: Our First Experience

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Ercan Baş

2015-03-01

Full Text Available Objective To share our experience in percutaneous nephrolithotomy (PCNL procedures in patients with horseshoe kidney. Materials and Methods The data of 7 patients undergoing PCNL were analyzed retrospectively. Preoperative clinical and laboratory data of patients (including complete urinalysis, complete blood count, serum biochemistry, and coagulation tests were recorded. The stone surface area (mm2 was calculated by graph paper tracing of two dimensional projection of the stone on a plain film of the kidneys, ureters and bladder (KUB in the anteroposterior view by investigators. In addition, per-operative and post-operative findings were evaluated. Success and complication rates (according to the classification of Clavien were also determined. Results The mean stone surface area was 1234 (range 250-2460 mm2 mm2. Six patients were treated through a single tract, and one patient required additional access. Access was directed to the middle calyx (n=2, superior calyx (n=4, middle and inferior calyx (n=1 through the supracostal (n=2 and subcostal (n=5 areas. Mean operative time was 131 (range 70-215 minutes minutes. Stone-free rate after single session PCNL was 71% (n=5 and increased to 86% (n=6 with a post-operative secondary ureterorenoscopy procedure. Complications including bleeding necessitating blood transfusion (Clavien grade 2 and prolonged drainage (Clavien degree 3a were occurred in only 2 patients (24%. Conclusion PCNL is a safe and successful procedure in patients with horseshoe kidney and comparable with PNL procedures in patients with normal renal anatomy

Association between chronic kidney disease and urinary calculus by stone location: a population-based study.

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Keller, Joseph J; Chen, Yi-Kuang; Lin, Herng-Ching

2012-12-01

Study Type--Disease prevalence study (cohort design) Level of Evidence 2a. What's known on the subject? and What does the study add? Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified calculus (OR 1.89, 95% CI 1.74-2.06). We concluded that there was an association between CKD and UC regardless of stone location. • To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population-based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. • We identified 21,474 patients who received their first-time diagnosis of CKD between 2001 and 2009. • The 21,474 controls were frequency-matched with cases for sex, age group, and index year. • We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC. • The results show that compared with controls, the OR of prior UC for cases was 1

Circumcaval Ureter with Synchronous Ipsilateral Transitional Cell ...

African Journals Online (AJOL)

mn

flank pain and gross hematuria of one year's duration. Clinical examination was unremarkable apart from ... ry tract stasis and a J- or fish-hook deformity of the ureter as it passes behind the inferior vena cava (IVC). ... Patients usually present with right flank pain and discomfort, which can be intermittent, dull or aching6.

Mapping of Carboxypeptidase M in Normal Human Kidney and Renal Cell Carcinoma

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Denis, Catherine J.; Van Acker, Nathalie; De Schepper, Stefanie; De Bie, Martine; Andries, Luc; Fransen, Erik; Hendriks, Dirk; Kockx, Mark M.

2013-01-01

Although the kidney generally has been regarded as an excellent source of carboxypeptidase M (CPM), little is known about its renal-specific expression level and distribution. This study provides a detailed localization of CPM in healthy and diseased human kidneys. The results indicate a broad distribution of CPM along the renal tubular structures in the healthy kidney. CPM was identified at the parietal epithelium beneath the Bowman’s basement membrane and in glomerular mesangial cells. Capillaries, podocytes, and most interstitial cells were CPM negative. Tumor cells of renal cell carcinoma subtypes lose CPM expression upon dedifferentiation. Tissue microarray analysis demonstrated a correlation between low CPM expression and tumor cell type. CPM staining was intense on phagocytotic tumor-associated macrophages. Immunoreactive CPM was also detected in the tumor-associated vasculature. The absence of CPM in normal renal blood vessels points toward a role for CPM in angiogenesis. Coexistence of CPM and the epidermal growth factor receptor (EGFR) was detected in papillary renal cell carcinoma. However, the different subcellular localization of CPM and EGFR argues against an interaction between these h proteins. The description of the distribution of CPM in human kidney forms the foundation for further study of the (patho)physiological activities of CPM in the kidney. PMID:23172796

Kidney function and size in normal subjects before and during growth hormone administration for one week

DEFF Research Database (Denmark)

Gammelgaard, Jens; Orskov, H; Andersen, A R

1981-01-01

Kidney function and size were studied in seven normal male subjects before and after administration of highly purified human growth hormone for 1 week. Glomerular filtration rate, renal plasma flow (steady-state infusion technique with urinary collections using 125I-iothalamate and 131I-hippuran)......Kidney function and size were studied in seven normal male subjects before and after administration of highly purified human growth hormone for 1 week. Glomerular filtration rate, renal plasma flow (steady-state infusion technique with urinary collections using 125I-iothalamate and 131I...

Efficacy Quotient Tindakan ESWL Piezolith Richard Wolf 3000 pada Penderita Batu Ureter di RSUPN Dr. Cipto Mangunkusumo, 2008–2011

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Vinny Verdini

2017-01-01

Full Text Available Extracorporeal shockwave lithotripsy (ESWL saat ini telah menjadi metode yang paling umum dalam tatalaksana aktif batu ureter. Sejak Maret 2008, RSCM telah menggunakan mesin ESWL piezolith 3000 richard wolf dan belum diketahui nilai efficacy quotient (EQ. Penelitian ini bertujuan untuk menentukan nilai EQ dari tindakan ESWL menggunakan mesin piezolith richard wolf 3000 pada batu ureter dan hubungan angka bebas batu dengan lokasi batu, jumlah batu, beban batu, opasitas batu, obstruksi, dan fungsi ginjal. Studi cross sectional ini dilakukan pada bulan Januari 2008-Desember 2011 dan data dianalisis dengan statistik multivariat. Terdapat 113 (95 % dari 119 pasien yang dinyatakan bebas batu setelah tindakan ESWL pertama. Didapatkan nilai EQ 0,89. Hanya ukuran batu yang mempengaruhi angka bebas batu dalam penelitian ini (p<0,05. Disimpulkan bahwa prosedur ESWL menggunakan mesin richard wolf piezolith 3000 memiliki nilai EQ dan angka bebas batu yang lebih baik daripada mesin-mesin sebelumnya dan mesin lain yang sejenis. Faktor yang mempengaruhi keberhasilan adalah ukuran batu ureter yang ditatalaksana.Kata Kunci: batu ureter, ESWL, efficacy quotient, angka bebas batu. Efficacy Quotient of ESWL Piezolith Richard Wolf 3000 Machine in Patientswith Ureteral Stones in Dr. Cipto MangunkusumoNational Hospital 2008 - 2011AbstractExtracorporeal shockwave lithotripsy (ESWL is the most common method of ureteral stone management. Since 2008, RSCM has ben using ESWL piezolith 3000 richard wolf and efficacy quotient (EQ value have not yet studied. The study aims was to determine the efficacy quotient (EQ of ESWL using piezolith richard wolf 3000 machine for ureteral stone by analyzing free-stone rate with location of stones, number of stones, stone burden, stone opacity, obstruction and kidney function. This cross sectional study was carried out in January 2008-December 2011, with multivariate analytical study. Ninety five percent (n=113 of 119 patients were

Progesterone--specific binding sites in the kidney of the female baboon

International Nuclear Information System (INIS)

Weaker, F.J.; Herbert, D.C.; Sheridan, P.J.

1984-01-01

The uptake and retention of a radiolabeled synthetic progestin, ORG 2058, was studied in the urinary tract of the female baboon. Four estrogen-primed baboons were injected intravenously with 2.5 micrograms./kg. body weight of 3H-ORG 2058. One animal, which served as a control, received an additional injection of 2.5 mg./kg. body weight of unlabeled progesterone. One hour after the injections, the animals were killed and the kidneys, ureters and urinary bladder were removed and processed for autoradiography. Localization of progestin was observed in the nuclei of the convoluted and straight segments of the distal tubule, the ascending thick limb of the loop of Henle and both cortical and medullary collecting tubules. Connective tissue cells were also labeled in the medulla and cortex of the kidney. An absence of silver grains was noted in the renal corpuscle, all segments of the proximal tubule and the thin loop of Henle. Concentration of the tritiated steroid was not observed in either the ureter or bladder or in any portions of the urinary tract of the control animal. This study suggests that progesterone has a direct effect via a progesterone specific receptor on the various target cells that sequestered the 3H-ORG 2058

Evidence suggesting a genetic contribution to kidney stone in northeastern Thai population.

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Sritippayawan, Suchai; Borvornpadungkitti, Sombat; Paemanee, Atchara; Predanon, Chagkrapan; Susaengrat, Wattanachai; Chuawattana, Duangporn; Sawasdee, Nunghathai; Nakjang, Sirintra; Pongtepaditep, Suttikarn; Nettuwakul, Choochai; Rungroj, Nanyawan; Vasuvattakul, Somkiat; Malasit, Prida; Yenchitsomanus, Pa-thai

2009-06-01

Genetic factor may play a role in the pathogenesis of kidney stone that is found in the northeastern (NE) Thai population. Herein, we report initial evidence suggesting genetic contribution to the disease in this population. We examined 1,034 subjects including 135 patients with kidney stone, 551 family members, and 348 villagers by radiography of kidney-ureter-bladder (KUB) and other methods, and also analyzed stones removed by surgical operations. One hundred and sixteen of 551 family members (21.05%) and 23 of the 348 villagers (6.61%) were affected with kidney stone. The relative risk (lambda(R)) of the disease among family members was 3.18. Calcium stones (whewellite, dahllite, and weddellite) were observed in about 88% of stones analyzed. Our data indicate familial aggregation of kidney stone in this population supporting that genetic factor should play some role in its pathogenesis. Genetic and genomic studies will be conducted to identify the genes associated with the disease.

Evaluation of the normal fetal kidney length and its correlation with gestational age.

Science.gov (United States)

Seilanian Toosi, Farrokh; Rezaie-Delui, Hossein

2013-05-30

A true estimation of gestational age (GA) plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL) and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive equation to estimate GA on the KL and fetobiometry parameters. A significant correlation was found between GA and KL (r=0.83, P<0.002). The best GA predictor was obtained by combining head circumference, fetal biparietal diameter, femur length and KL with a standard error (SE) about 14.2 days. Our findings showed that KL measurements combination with other fetal biometric parameters could predict age of pregnancy with a better precision.

Endoscopic Urinary Diversion As Initial Management of Symptomatic Obstructive Ectopic Ureter in Infants

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Ruben Ortiz

2017-09-01

Full Text Available AimDefinitive surgery of ectopic ureter in infants is challenging. We propose an endoscopic urinary diversion (EUD as a novel surgical technique in the initial management of symptomatic obstructive ectopic ureter.Patients and methodsSixteen obstructive ectopic ureters (14 patients were initially treated by EUD between 2006 and 2015. All patients had urinary tract dilatation worsening at preoperative US scans and at least two febrile urinary tract infection (UTI or urinary sepsis despite antibiotic prophylaxis. Ectopic ureter was confirmed by cystoscopy. When ectopic meatus was not found, EUD consisted in the creation of a transurethral neo-orifice (TUNO performed by needle puncturing of the ureterovesical wall, under fluoroscopic and ultrasound control. If ectopic meatus was identified in the posterior urethra, “intravesicalization procedure” was done opening the urethral–ureteral wall to create a new ureteral outlet into the bladder.ResultsEUD was done at a median age of 3.5 months (0.5–7 with median follow-up of 48 months (24–136. TUNO was performed in six patients and “intravesicalization” in eight patients. Significant differences were observed in ureteral diameter and anteroposterior pelvis diameter before and after endoscopic treatment (p < 0.005. Initial renal function was preserved in all cases. Postoperative complications were UTI in four patients and TUNO stenosis in one patient, treated by endoscopic balloon dilation. Definitive treatment was further individualized in each patient after 1 year of life.ConclusionEUD is a feasible and safe less-invasive technique in the initial management of symptomatic obstructive ectopic ureter. It allows an adequate ureteral drainage preserving renal function until definitive repair if necessary and does not invalidate other surgical options in case of failure or future definitive treatments.

Crossing Anatomic Barriers-Transplantation of a Kidney with 5 Arteries, Duplication of the Pyelocalyceal System, and Double Ureter.

Science.gov (United States)

Bachul, Piotr J; Osuch, Czesław; Chang, Ea-Sle; Bętkowska-Prokop, Alina; Pasternak, Artur; Szura, Mirosław; Matyja, Andrzej; Walocha, Jerzy A

2017-10-01

During the time of organ harvest, it is crucial for the kidney procurement team to consider significant vascular anatomical variations. Multiple renal arteries are not uncommon, and unintentional injury can result in an irreversibly damaged kidney graft that needs to be discarded. We present a kidney graft with 5 renal arteries and a single vein that was successfully procured and implanted with good graft function at discharge and at 4-yr follow-up. According to the literature, additional renal arteries can be found in about 33% of kidneys. This is the first study on a kidney with 5 arteries in the published literature, especially in the context of transplantation.

Evaluation of the Normal Fetal Kidney Length and Its Correlation with Gestational Age

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Farrokh Seilanian Toosi

2013-05-01

Full Text Available A true estimation of gestational age (GA plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive equation to estimate GA on the KL and fetobiometry parameters. A significant correlation was found between GA and KL (r=0.83, P<0.002. The best GA predictor was obtained by combining head circumference, fetal biparietal diameter, femur length and KL with a standard error (SE about 14.2 days. Our findings showed that KL measurements combination with other fetal biometric parameters could predict age of pregnancy with a better precision.

Retrocaval ureter with vesicoureteric reflux, a very rare entity

African Journals Online (AJOL)

M.C. Arya

2016-12-26

Dec 26, 2016 ... side vesicoureteric reflux). Intravenous urogram (IVU) showed diagnostic dilemma between pelviureteric junction obstruction and retrocaval ureter (Fig. 2 – IVU suggestive of pelviureteric junction obstruction). For confirmation of the diagnosis magnetic resonance urography (MRU) (T2 weighted) was done ...

Anatomy of the collecting system of lower pole of the kidney in patients with a single renal stone: a comparative study with individuals with normal kidneys.

Science.gov (United States)

Zomorrodi, Afshar; Buhluli, Abulfazel; Fathi, Samad

2010-07-01

At least 5% of women and 12% of men during their lives will experience renal colic, at least once. Many theories have been suggested for the etiology of renal stones and variations in the anatomy of the collecting system have been suggested to have a role in stone formation. This study was conducted to examine the role of variation of lower pole collecting system in patients with lower pole kidney stone and compared the same in normal persons (kidney donors). Investigation for the anatomy of the lower pole of the kidney (angle between lower infundibulum and pelvis, length and diameter of the infundibulum and number and pattern distribution of calyces) was carried out using intravenous pyelogram (IVP) in 100 cases with urinary stone (study cases) and 400 persons with normal kidneys (control subjects). The study was a retrospective cross-sectional case control study. Results were analyzed by Mann-Whitney and independent sample chi square tests. The mean infundibulum-pelvic angle (IPA) in control subjects and in patients was 112.5 +/- 10.7 and 96.6 +/- 28.8, respectively. There was significant correlation between reduced angle and stone formation (P= kidney (IPIL) in controls and study patients was 22.5 +/- 4.1 and 27.5 +/- 7.7, respectively, which was statistically significant (Pkidney (LPCN) in controls and study patients was 2.6 +/- 0.6 and 3 +/- 0.9, respectively, which was statistically significant (P = or anatomy was more common in patients with lower pole kidney stone and should be considered a risk factor for forming lower pole kidney stone.

Medline Plus

Full Text Available ... kidneys, ureters, bladder and urethra. Within each kidney, urine flows from the outer cortex to the inner ... The renal pelvis is the funnel through which urine exits the kidney and enters the ureter. As ...

[Lithiasis of the distal ureter: ESWL or URS].

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González Enguita, C; Sánchez Gómez, J; Rodríguez-Miñon Cifuentes, J L; Cabrera Pérez, J; Calahorra Fernández, F J; García Cardoso, J; García de la Peña, E; Vela Navarrete, R

1998-10-01

A nephritic colic is the clinical picture that evidences the presence of ureteral stones, the natural evolution being their spontaneous passing. Stones in the distal ureter are self-eliminated in about 71-80% cases. The adoption of a "watchful wait" involves an uncertain occupational and medical evolution since, although in some cases the stones will pass with no problems, in other instances they can result in severe, life threatening situations for the patient's health (intractable pain, anuria or sepsis). When a decision is made to treat the condition, there are two choices available: "in situ" SWEL (extracorporeal lithotrity), or URS (ureterorenoscopy), long-standing conflicting techniques each with its own advantages and disadvantages, which should now be considered complementary. SWEL's major disadvantage is the number of repetitions required and the long wait, sometimes even months, until the last fragment is passed. The greater strength of URS is that it can be resolutive in just one episode (95% cases), thus avoiding the obstruction problems that can arise after SWEL. In the Lithiasis-Lithotrity Unit of FJD, SWEL is the first therapeutical option for the treatment of stones in the distal ureter. SWEL and URS are equally likely to be performed although SWEL is the initial choice for efficiency reasons that are explained. We achieve 93.6% positive results with a 1.82% re-SWEL rate (retreatment), 0.60 coefficient of efficiency (EQ) and 0.69 modified coefficient of efficiency (EQM) (Chart). No serious complications were recorded. Morbidity is variable with little clinical significance. Distal ureter lithiasis can be treated with either URS and SWEL, both considered "different and complementary". The choice in each particular case and within each hospital will depend on availability of means to perform one or the other, equipment's efficiency, skill of the urologist, patient's preference and cost of each treatment.

Urology and nephrology update: bladder and kidney cancer.

Science.gov (United States)

Fiore, David C; Fox, Cara-Louise

2014-01-01

It has been estimated that bladder and kidney cancers would be diagnosed in approximately 140,000 Americans in 2013, with approximately 30,000 dying from these cancers. Urinary tract cancers affect men more commonly than they do women, and the median age at diagnosis is 65 years. Major risk factors for these cancers include tobacco smoking, certain chemical exposures, family history, age, and obesity. Unexplained hematuria in adults should be evaluated to exclude bladder and kidney cancer. Staging of bladder and kidney cancer should be based on the TNM staging system, which, along with tumor grade, provides important treatment and prognostic information. Urothelial cell carcinoma is the most common type of bladder cancer; it also can occur in the kidneys or ureters. Renal cell carcinoma is the most common type of kidney cancer. Treatment options for bladder cancer vary widely, depending on the grade of the cancer. Early non-muscle-invasive bladder cancer may be removed cystoscopically and/or treated with intravesical immunotherapy or chemotherapy, whereas patients with muscle-invasive bladder tumors typically require surgery. Management of kidney cancer is almost always surgical, unless the patient is too ill to undergo surgery or chooses palliative care. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model.

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Francesco Clavica

Full Text Available Double-J stenting is the most common clinical method employed to restore the upper urinary tract drainage, in the presence of a ureteric obstruction. After implant, stents provide an immediate pain relief by decreasing the pressure in the renal pelvis (P. However, their long-term usage can cause infections and encrustations, due to bacterial colonization and crystal deposition on the stent surface, respectively. The performance of double-J stents - and in general of all ureteric stents - is thought to depend significantly on urine flow field within the stented ureter. However very little fundamental research about the role played by fluid dynamic parameters on stent functionality has been conducted so far. These parameters are often difficult to assess in-vivo, requiring the implementation of laborious and expensive experimental protocols. The aim of the present work was therefore to develop an artificial model of the ureter (i.e. ureter model, UM to mimic the fluid dynamic environment in a stented ureter. The UM was designed to reflect the geometry of pig ureters, and to investigate the values of fluid dynamic viscosity (μ, volumetric flow rate (Q and severity of ureteric obstruction (OB% which may cause critical pressures in the renal pelvis. The distributed obstruction derived by the sole stent insertion was also quantified. In addition, flow visualisation experiments and computational simulations were performed in order to further characterise the flow field in the UM. Unique characteristics of the flow dynamics in the obstructed and stented ureter have been revealed with using the developed UM.

Retroperitoneal Sarcoma Involving Unilateral Double Ureter: Management, Treatment and Psychological Implications

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Vito Leanza

2014-05-01

Full Text Available The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed.

Comparison of a New Polytetrafluoroethylene-Covered Metallic Stent to a Noncovered Stent in Canine Ureters

International Nuclear Information System (INIS)

Chung, Hwan-Hoon; Lee, Seung Hwa; Cho, Sung Bum; Park, Hong Suk; Kim, Young Sik; Kang, Byung Chul; Frisoli, Joan K.; Razavi, Mahmood K.

2008-01-01

The aim of this study was to determine the feasibility of using a newly designed polytetrafluoroethylene (PTFE)-covered metallic stent in the ureter by comparing its effectiveness with that of the noncovered stent in a canine model. We placed 14 stents in the ureters of seven mongrel dogs that weighed 30-40 kg each. The covered and noncovered stents were deployed in the right and left ureters, respectively, of six dogs. In the seventh dog, a covered stent and a double-J catheter were inserted in the right ureter, and a covered stent only was inserted in the left ureter. The first six dogs were sacrificed at 5, 10, and 15 weeks after deployment of the stents (two for each follow-up period), and the seventh dog was sacrificed at 30 weeks. There was no migration or poor expansion of any of the stents observed on plain radiography. On intravenous pyelogram and retrograde pyelogram, all of the covered stents at each follow-up period had patent lumens at the stented segments without hydronephrosis, and the passage of contrast material through it was well preserved. The noncovered stents in the dogs sacrificed at 5 and 10 weeks and one of the two dogs sacrificed at 15 weeks showed near-complete occlusion of the stent lumen due to ingrowth of the soft tissue, and severe hydronephrosis was also noted. The noncovered stent in the other dog sacrificed at 15 weeks showed the passage of contrast material without hydronephrosis, but the lumen of the stent was still nearly occluded by the soft tissue. There was no evidence of hydronephrosis or passage disturbance of the contrast material in both ureters of the dog sacrificed at 30 weeks. We conclude that the newly designed PTFE-covered stent effectively prevented the luminal occlusion caused by urothelial hyperplasia compared to the near-total occlusion of the noncovered stents, and no migration of the covered stents was noted

Kidney spiral CT, indications, realization, results

International Nuclear Information System (INIS)

Braunschweig, R.; Beilicke, M.; Hundt, W.; Breiteneder, T.; Reiser, M.

1999-01-01

The introduction of spiral computed tomography (spiral CT) has vastly enriched the methodologically diversity of computer-tomographic scans. It allows for the recording of different perfusion or excretion stages of the kidney parenchyma of the urine draining paths by carrying out long-distance, phase-identical multiple examinations of the retroperitoneum. The description of the findings which are characterized by their local and contrasts behavior is possible. The following report describes the indications and technological process of kidney spiral CT using kidney-typical intravenous contrast media. Special emphasis is put on the advantages and limits of multiple phase spiral CT. Decisive preconditions are: 1. Specific clinical query, 2. selection of the corresponding phase contrasts of the kidneys and uretra or bladder, 3. exact technical and temporal adjustment of the acquisition parameters. Scanning times are in the range of seconds. The overall examination can be carried out quick and without any major strain on the part of the patient. A sound proof and a general differentiation of focal kideny lesions can be derived from the acquired data. This is also true for kidneys and ureters findings. Bladder findings can be localized and differentiated according to stage. More than two 'spiral acquisitions' should be carried out with restraint taking exposure to radiation into account. Due to the sound registration of focal lesions, its capability of reproduction and its short-time examination, the spiral CT of the kidneys can be said to be the most effective current scanning method of the retroperitoneum following clinical examinations and sonography. (orig.) [de

Laparoscopic Transvesical Resection of an En Bloc Bladder Cuff and Distal Ureter during Nephroureterectomy

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Stilianos Giannakopoulos

2012-01-01

Full Text Available Objective. The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach. Materials and Methods. Seven men and three women diagnosed with upper tract transitional cell carcinoma were treated with this procedure. Three intravesical ports were inserted, and pneumovesicum was established at 12 mmHg. Transvesical laparoscopic circumferential detachment of the bladder cuff and en bloc mobilization of the last centimeters of the distal ureter were performed, followed by the closure of the bladder defect. Subsequently, a nephrectomy was performed either laparoscopically or using an open flank approach. Results. The median age was 68.5 years. The procedure was completed uneventfully in all cases. The median operating time for distal ureter excision was 82.5 minutes (range 55–120. No complications directly related to the pneumovesicum method were recorded. The median follow-up period was 31 months (range 12–55. During the follow-up period, two patients (20% died from the disease, and a bladder tumor developed in three cases (30%. Conclusion. The laparoscopic transvesical resection of the en bloc bladder cuff and distal ureter is a reliable, effective, and oncologically safe technique, at least in the midterm.

Primary antegrade ureteric stenting: Prospective experience and cost-effectiveness analysis in 50 ureters

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Watson, Gillian M.T.; Patel, Uday

2001-07-01

AIM: To evaluate the success rate and cost efficiency of primary antegrade ureteric stenting (antegrade ureteric stent insertion as a single procedure without preliminary drainage). MATERIALS AND METHODS: A policy of primary stenting was tested in 38 patients (50 ureters) with obstructive hydronephrosis, of acute or chronic onset and of benign or malignant origin. Patients with suspected pyonephrosis were excluded. Patients successfully primarily stented (group 1) were compared to a group stented as a traditional two-stage procedure (group 2). End point assessments were screening time, equipment used, procedure-related costs, bed occupancy and technical and clinical success rate. Using these cost and outcome measures, a cost-efficiency analysis was performed comparing the two strategies. RESULTS: 40/50 (80%) ureters were considered primary stent successes. The average procedure-related bed occupancy was 2 days (range 1-2 days). Simple equipment alone was successful in 16 cases. Van Andel dilatation catheters and peel-away sheaths were frequently used (23 ureters). Expensive equipment was rarely necessary (four cases) and average extra equipment cost was small (46 pounds/case). The mean screening time was similar for the two groups (13.5 min vs 15.3 min;P {>=} 0.05). There was a minimum saving of 800 pounds per successful primary stent. The cost-effectiveness of a primary antegrade stenting strategy was 1229 pounds vs 2093 pounds for secondary stenting. CONCLUSION: In carefully selected patients, the majority of obstructed ureters can be primarily stented using simple equipment. The reduced hospital stay and overall success rate significantly improves the cost competitiveness of antegrade ureteric stenting. Watson, G.M.T. and Patel, U. (2001)

Robotic repair of retrocaval ureter: A case series | Nayak | African ...

African Journals Online (AJOL)

Subjects and methods: This is a prospective case series of five consecutive patients who underwent robotic retrocaval ureter repair at our institute from August 2006 to September 2009. Pre-operative imaging included intravenous urogram, contrast enhanced CT scan and diuretic renography. All cases were done through a ...

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... up of these main parts: two kidneys two ureters (say: YUR-uh-turz) bladder urethra (say: yoo- ... waste becomes urine (pee), which drips into the ureters (long, thin tubes, one connected to each kidney). ...

[EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IN PATIENTS WITH UROLITHIASIS OF A SOLITARY KIDNEY].

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Parshenkova, I G; Dutov, V V; Rumjancev, A A; Mamedov, E A

2015-01-01

The article presents results of extracorporeal shock wave lithotripsy (ESWL) in 62 patients with urolithiasis of a solitary kidney. In 50 (80.6%) patients calculi were located in the kidney and in 12 (19.4%) patients in the ureter. Effectiveness of ESWL at 3 month follow-up was 85.5%, which is somewhat lower than in patients with two healthy kidneys due to the choice of sparing low-energy modes of lithotripsy. The effectiveness of ESWL depended on the size of the original calculi (ppre-drainage of the kidney before a session of ESWL in patients with large and multiple calculi. There was no correlation between the occurrence of complications during treatment and the clinical form of a solitary kidney (p>0.05). In patients with stones larger than 1 cm and a moderate baseline abnormalities of the upper urinary tract urodynamics ESWL was less effective (pcalculus (p=0.504). Extracorporeal shock wave lithotripsy is a highly effective and safe treatment of stones of a solitary kidney. Rational choice of indications and contraindications for the use of ESWL in a specific clinical situation is of great importance.

Role of oxidants/inflammation in declining renal function in chronic kidney disease and normal aging.

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Vlassara, Helen; Torreggiani, Massimo; Post, James B; Zheng, Feng; Uribarri, Jaime; Striker, Gary E

2009-12-01

Oxidant stress (OS) and inflammation increase in normal aging and in chronic kidney disease (CKD), as observed in human and animal studies. In cross-sectional studies of the US population, these changes are associated with a decrease in renal function, which is exhibited by a significant proportion of the population. However, since many normal adults have intact renal function, and longitudinal studies show that some persons maintain normal renal function with age, the link between OS, inflammation, and renal decline is not clear. In aging mice, greater oxidant intake is associated with increased age-related CKD and mortality, which suggests that interventions that reduce OS and inflammation may be beneficial for older individuals. Both OS and inflammation can be readily lowered in normal subjects and patients with CKD stage 3-4 by a simple dietary modification that lowers intake and results in reduced serum and tissue levels of advanced glycation end products. Diabetic patients, including those with microalbuminuria, have a decreased ability to metabolize and excrete oxidants prior to observable changes in serum creatinine. Thus, OS and inflammation may occur in the diabetic kidney at an early time. We review the evidence that oxidants in the diet directly lead to increased serum levels of OS and inflammatory mediators in normal aging and in CKD. We also discuss a simple dietary intervention that helps reduce OS and inflammation, an important and achievable therapeutic goal for patients with CKD and aging individuals with reduced renal function.

Retrocaval ureter: a report on two neonates | Bassiouny | Annals of ...

African Journals Online (AJOL)

Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or the fourth decade of life. Its symptoms are because of ureteric obstruction, caused extrinsically by an abnormal inferior vena cava, intrinsically by ureteric hypoplasia, or both. Surgery is needed for symptomatic patients and involves transection ...

Bilateral Double Ureters with Bladder Neck Diverticulum in a Nigerian Woman Masquerading as an Obstetric Fistula

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Imran O. Morhason-Bello

2014-01-01

Full Text Available A 43-year-old woman presented with 20-year history of leakage of urine per vaginam. She had one failed repair attempt. Pelvic examination with dye test showed leakage of clear urine suggestive of ureterovaginal fistula. The preoperative intravenous urogram revealed duplex ureter and cystoscopy showed normally cited ureteric orifices with two other ectopic ureteric openings and bladder diverticula. The definitive surgery performed was ureteric reimplantation (ureteroneocystostomy of the two distal ureteric to 2 cm superiolateral to the two normal orifices and diverticuloplasty. There was resolution of urinary incontinence after surgery. Three months after surgery, she had urodynamic testing done (cystometry, which showed 220 mLs with no signs of instability or leakage during filling phase but leaked on coughing at maximal bladder capacity. This is to showcase some diagnostic dilemma that could arise with obstetric fistula, which is generally diagnosed by clinical assessment.

Tc-99m MAG3 SPECT on transplanted kidney

International Nuclear Information System (INIS)

Ryu, Jong Gul; Kim, Soon; Zeon, Seok Kil

1999-01-01

This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 paints with renal arterial variation showed focally decreased radioactivity and SPECT helped guide further studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings

Prognostic factors in urothelial renal pelvis and ureter tumors: a multicenter rare cancer network study

International Nuclear Information System (INIS)

Ozsahin, M.; Zouhair, A.; Villa, S.; Storme, G.; Chauvet, B.; Taussky, D.; Houtte, P. van; Ries, G.; Bontemps, P.; Coucke, P.; Mirimanoff, R.O.

1997-01-01

Purpose: To assess the prognostic factors and the outcome in patients with transitional-cell carcinoma of the renal pelvis and/or ureter. Materials and Methods: A series of 138 patients treated between 1971 and 1996 for transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicenter study of the Rare Cancer Network. Twelve patients with distant metastases were excluded from the statistical evaluation. In the remaining 126 patients, median age was 66 years (range: 41-87). The male to female ratio was 2.5 ((90(36))). All but 3 patients underwent a radical surgery: nephroureterectomy (n = 71), nephroureterectomy and lymphadenectomy (n = 20), nephroureterectomy and partial bladder resection or transurethral resection (n = 20), nephrectomy (n = 8), and ureterectomy (n = 4). There were 6 stage pTa, 22 pT1, 17 pT2, 37 pT3, 37 pT4, and 7 pTx tumors. The pN-stage distribution was as follows: 69 pN0, 8 pN1, 14 pN2, 4 pN3, and 31 pNx. Sixty-one percent (n = 77) of the tumors were located in the renal pelvis, and 21% (n = 27) in the ureter. Renal pelvis and ureter localization was present together in 22 (17%) patients. There were 4 grade 1, 37 grade 2, 42 grade 3 tumors (grade was not registered in 43). Following surgery, microscopic (n = 16) or macroscopic (n = 17) tumor rest was detected in 33 patients. Postoperative radiotherapy was given in 45 (36%) patients with a median total dose of 50 Gy (range: 20-66) in median 25 fractions (range: 4-33). Adjuvant systemic chemotherapy was administered in 12 (10%) patients. The median follow-up period was 39 months (range: 5-220). Results: In a median period of 9 months (range: 1-141), 66% (n = 81) of the patients relapsed (local in 34, locoregional in 7, regional in 16, and distant in 24). The 5- and 10-year overall survival (Kaplan-Meier product-limit estimates) was respectively 29% (± 5) and 19% (± 5) in all patients. In univariate analyses (logrank test), statistically significant

Early postnatal gentamicin and ceftazidime treatment in normal and food restricted neonatal wistar rats: Implications for kidney development.

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Bueters, Ruud R G; Jeronimus-Klaasen, Annelies; Brüggemann, Roger J M; van den Heuvel, Lambertus P; Schreuder, Michiel F

2017-09-01

Up to two-thirds of premature born neonates are treated for infections with aminoglycosides such as gentamicin. Although acute toxicities are well described, there is uncertainty on developmental changes after treatment of premature born neonates. We studied the effect of gentamicin and ceftazidime on kidney development in the rat. Additionally, we evaluated the modulating effect of extrauterine growth restriction. On postnatal day (PND) 2, Wistar rats were cross-fostered into normal sized litters (12 pups) or large litters (20 pups) to create normal food (NF) or food restricted (FR) litters to simulate growth restriction and dosed daily intraperitoneally with placebo, 4 mg/kg of gentamicin or 50 mg/kg ceftazidime until PND 8. Gentamicin pharmacokinetics were studied in a separate group of animals. Kidneys were weighed. Renal expression of 18 developmental genes was evaluated by quantitative PCR on PND 8. On PND 35, glomerular number was assessed by stereology and glomerular generations were counted. Food restricted litters showed 22% less body weight compared with controls by day 35 (p kidney development, ceftazidime can affect Renin expression, and extrauterine growth restriction impairs kidney development, but did not modulate potential drug toxicity. Birth Defects Research 109:1228-1235, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Carcinosarcoma of the Ureter with a Small Cell Component: Report of a Rare Pathologic Entity and Potential for Diagnostic Error on Biopsy

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Kent Newsom

2014-01-01

Full Text Available Carcinosarcomas of the ureter are rare biphasic neoplasms, composed of both malignant epithelial (carcinomatous and malignant mesenchymal (sarcomatous components. Carcinosarcomas of the urinary tract are exceedingly rare. We report a unique case of a carcinosarcoma of the ureter with a chondrosarcoma and small cell tumor component arising in a 68-year-old male who presented with microscopic hematuria. CT intravenous pyelogram revealed right-sided hydroureter and hydronephrosis with thickening and narrowing of the right ureter. The patient underwent robot-assisted ureterectomy with bladder cuff excision and subsequent adjuvant chemotherapy. The patient is disease-free at 32 months after treatment. We provide a brief synoptic review of carcinosarcoma of the ureter and bladder with utilization of immunohistochemical (IHC stains and potential diagnostic pitfalls.

Kidney Length in Normal Korean Children

International Nuclear Information System (INIS)

Kim, In One; Cheon, Jung Eun; Lee, Young Seok; Lee, Sun Wha; Kim, Ok Hwa; Kim, Ji Hye; Kim, Hong Dae; Sim, Jung Suk

2010-01-01

Renal length offers important information to detect or follow-up various renal diseases. The purpose of this study was to determine the kidney length of normal Korean children in relation to age, height, weight, body surface area (BSA), and body mass index (BMI). Children between 1 month and 15 years of age without urological abnormality were recruited. Children below 3rd percentile and over 97th percentile for height or weight were excluded. Both renal lengths were measured in the prone position three times and then averaged by experienced radiologists. The mean length and standard deviation for each age group was obtained, and regression equation was calculated between renal length and age, weight, height, BSA, and BMI, respectively. Renal length was measured in 550 children. Renal length grows rapidly until 24 month, while the growth rate is reduced thereafter. The regression equation for age is: renal length (mm) = 45.953 + 1.064 x age (month, ≤ 24 months) (R2 = 0.720) or 62.173 + 0.203 x age (months, > 24 months) (R2 = 0.711). The regression equation for height is: renal length (mm) = 24.494 + 0.457 x height (cm) (R2 = 0.894). The regression equation for weight is: renal length (mm) = 38.342 + 2.117 x weight (kg, ≤18 kg) (R2 = 0.852) or 64.498 + 0.646 x weight (kg, > 18 kg) (R2 = 0.651). The regression equation for BSA is: renal length (mm) = 31.622 + 61.363 x BSA (m2, ≤ 0.7) (R2 = 0.857) or 52.717 + 29.959 x BSA (m2, > 0.7) (R2 = 0.715). The regression equation for BMI is: renal length (mm) = 44.474 + 1.163 x BMI (R2 = 0.079). This study provides data on the normal renal length and its association with age, weight, height, BSA and BMI. The results of this study will guide the detection and follow-up of renal diseases in Korean children

Interkinetic nuclear migration in the mouse embryonic ureteric epithelium: Possible implication for congenital anomalies of the kidney and urinary tract.

Science.gov (United States)

Motoya, Tomoyuki; Ogawa, Noriko; Nitta, Tetsuya; Rafiq, Ashiq Mahmood; Jahan, Esrat; Furuya, Motohide; Matsumoto, Akihiro; Udagawa, Jun; Otani, Hiroki

2016-05-01

Interkinetic nuclear migration (INM) is a phenomenon in which progenitor cell nuclei migrate along the apico-basal axis of the pseudostratified epithelium, which is characterized by the presence of apical primary cilia, in synchrony with the cell cycle in a manner of apical mitosis. INM is suggested to regulate not only stem/progenitor cell proliferation/differentiation but also organ size and shape. INM has been reported in epithelia of both ectoderm and endoderm origin. We examined whether INM exists in the mesoderm-derived ureteric epithelium. At embryonic day (E) 11.5, E12.5 and E13.5, C57BL/6J mouse dams were injected with 5-bromo-2'-deoxyuridine (BrdU) and embryos were killed 1, 2, 4, 6, 8, 10 and 12 h later. We immunostained transverse sections of the ureter for BrdU, and measured the position of BrdU (+) nuclei in the ureteric epithelia along the apico-basal axis at each time point. We analyzed the distribution patterns of BrdU (+) nuclei in histograms using the multidimensional scaling. Changes in the nucleus distribution patterns suggested nucleus movement characteristic of INM in the ureteric epithelia, and the mode of INM varied throughout the ureter development. While apical primary cilia are related with INM by providing a centrosome for the apical mitosis, congenital anomalies of the kidney and urinary tract (CAKUT) include syndromes linked to primary ciliary dysfunction affecting epithelial tubular organs such as kidney, ureter, and brain. The present study showed that INM exists in the ureteric epithelium and suggests that INM may be related with the CAKUT etiology via primary ciliary protein function. © 2015 Japanese Teratology Society.

Pelvicalyceal system duplication with ectopic ureter – diagnostic difficulties associated with the imaging procedure. Two cases report

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Agnieszka Pukajło-Marczyk

2014-09-01

Full Text Available Urinary tract abnormalities are the most frequently occurring developmental anomaly in children. Pelvicalyceal system duplication is one of them and signifies the existence of two urine diverting separate systems. This anomaly occurs in 10% of population, usually in girls, and is associated with complete or partial ureter duplication. The frequency of total ureter duplication, which in 20–40% of patients is found as bilateral, is 1:125 children (0.8% of the population. The most frequent malformation is asymptomatic, diagnosed coincidentally casually and does not require any treatment. In some patients with pelvicalyceal system duplication, vesicoureteral reflux (VUR and ectopic ureter may coexist. Malposition of ureter’s orifice into the bladder predispose to urinary retention, development of hydronephrosis and urinary tract infection (UTI. Ectopic ureterocele is recognized in 6–20% of children with recurrent UTI. The reason why children are referred to the hospital is UTI or hydronephrosis revealed by ultrasound imaging. When the ultrasound image of pelvicalyceal system duplication is ambiguous, micturating cystourethrography (MCU and scintigraphy become the primary diagnostic procedure, or urography – in more complicated cases. In the case of ectopic ureter, the danger of inappropriate catheterization, i.e. directly into its lumen, may occur. Though very rare, this may cause some diagnostic difficulties and lead to injury of the urinary tract. For this reason, we want to further discuss this complication following a diagnostic procedure on the example of two cases of pelvicalyceal system duplication with ectopic ureter.

Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection.

Science.gov (United States)

Yun, Kangsun

2017-10-12

Urinary tract junction obstruction defects are congenital anomalies inducing hydronephrosis and hydroureter. Murine urinary tract junction obstruction defects can be assessed by tracking methylene blue dye flow within the urinary system. Methylene blue dye is injected into the renal pelvis of perinatal embryonic kidneys and dye flow is monitored from the renal pelvis of the kidney through the ureter and into the bladder lumen after applying hydrostatic pressure. Dye accumulation will be evident in the bladder lumen of the normal perinatal urinary tract, but will be constrained between the renal pelvis and the end point of an abnormal ureter, if urinary tract obstructions occur. This method facilitates the confirmation of urinary tract junction obstructions and visualization of hydronephrosis and hydroureter. This manuscript describes a protocol for methylene blue dye injection into the renal pelvis to confirm urinary tract junction obstructions.

Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys.

Science.gov (United States)

Kurihara, Osamu; Takano, Masamichi; Uchiyama, Saori; Fukuizumi, Isamu; Shimura, Tetsuro; Matsushita, Masato; Komiyama, Hidenori; Inami, Toru; Murakami, Daisuke; Munakata, Ryo; Ohba, Takayoshi; Hata, Noritake; Seino, Yoshihiko; Shimizu, Wataru

2015-12-01

Contrast-induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty-six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = -0.627, P contrast media administration in the non-CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media. © 2015 The Authors. Clinical and Experimental Pharmacology and Physiology Published by Wiley Publishing Asia Pty Ltd.

As in Real Estate, Location Is What Matters: A Case Report of Transplant Ureteral Obstruction Due to an Inguinal Hernia.

Science.gov (United States)

Bugeja, Ann; Clark, Edward G; Sood, Manish M; Ali, Sohrab N

2018-01-01

Kidney allograft dysfunction is common and often reversible but can lead to allograft loss if not promptly evaluated. Transplant ureteral obstruction in an inguinal hernia is a rare cause of allograft dysfunction, but early recognition may prevent allograft loss. We present a case of a man with acute kidney allograft dysfunction who received a deceased donor kidney transplant 6 years earlier for end-stage kidney disease secondary to polycystic kidney disease. Abdominal ultrasounds revealed hydronephrosis without full visualization of the transplant ureter. Abdominal computed tomography revealed moderate hydronephrosis of the transplant kidney due to obstructed herniation of the transplant ureter in a right inguinal hernia. A stent was inserted into the transplant ureter to prevent further allograft dysfunction and facilitate hernia repair. Transplant ureteral obstruction is a rare cause of acute kidney allograft dysfunction, and its detection can be challenging. The recognition of transplant ureteral obstruction is vital to timely management for preventing allograft loss.

Ultrasonic propulsion of kidney stones.

Science.gov (United States)

May, Philip C; Bailey, Michael R; Harper, Jonathan D

2016-05-01

Ultrasonic propulsion is a novel technique that uses short bursts of focused ultrasonic pulses to reposition stones transcutaneously within the renal collecting system and ureter. The purpose of this review is to discuss the initial testing of effectiveness and safety, directions for refinement of technique and technology, and opinions on clinical application. Preclinical studies with a range of probes, interfaces, and outputs have demonstrated feasibility and consistent safety of ultrasonic propulsion with room for increased outputs and refinement toward specific applications. Ultrasonic propulsion was used painlessly and without adverse events to reposition stones in 14 of 15 human study participants without restrictions on patient size, stone size, or stone location. The initial feasibility study showed applicability in a range of clinically relevant situations, including facilitating passage of residual fragments following ureteroscopy or shock wave lithotripsy, moving a large stone at the ureteropelvic junction with relief of pain, and differentiating large stones from a collection of small fragments. Ultrasonic propulsion shows promise as an office-based system for transcutaneously repositioning kidney stones. Potential applications include facilitating expulsion of residual fragments following ureteroscopy or shock wave lithotripsy, repositioning stones prior to treatment, and repositioning obstructing ureteropelvic junction stones into the kidney to alleviate acute renal colic.

Insights into cellular and molecular basis for urinary tract infection in autosomal-dominant polycystic kidney disease.

Science.gov (United States)

Gao, Chao; Zhang, Long; Zhang, Ye; Wallace, Darren P; Lopez-Soler, Reynold I; Higgins, Paul J; Zhang, Wenzheng

2017-11-01

Urinary tract infection (UTI) is a broad term referring to an infection of the kidneys, ureters, bladder, and/or urethra. Because of its prevalence, frequent recurrence, and rising resistance to antibiotics, UTI has become a challenge in clinical practice. Autosomal-dominant polycystic kidney disease (ADPKD) is the most common monogenic disorder of the kidney and is characterized by the growth of fluid-filled cysts in both kidneys. Progressive cystic enlargement, inflammation, and interstitial fibrosis result in nephron loss with subsequent decline in kidney function. ADPKD patients frequently develop UTI; however, the cellular and molecular mechanisms responsible for the high UTI incidence in ADPKD patients remain virtually unaddressed. Emerging evidence suggests that α-intercalated cells (α-ICs) of the collecting ducts function in the innate immune defense against UTI. α-ICs inhibit bacterial growth by acidifying urine and secreting neutrophil gelatinase-associated lipocalin (NGAL) that chelates siderophore-containing iron. It is necessary to determine, therefore, if ADPKD patients with recurrent UTI have a reduced number and/or impaired function of α-ICs. Identification of the underlying cellular and molecular mechanisms may lead to the development of novel strategies to reduce UTI in ADPKD. Copyright © 2017 the American Physiological Society.

Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: an animal model.

Science.gov (United States)

Panda, Shasanka Shekhar; Bajpai, Minu; Mallick, Saumyaranjan; Sharma, Mehar C

2014-01-01

The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks) and were the late parameters to be reversed after reversal of obstruction. Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

ULTRASONOGRAPHIC ELASTOGRAPHY OF THE LIVER, SPLEEN, KIDNEYS, AND PROSTATE IN CLINICALLY NOR-MAL BEAGLE DOGS [corrected].

Science.gov (United States)

Jeon, Sunghoon; Lee, Gahyun; Lee, Sang-Kwon; Kim, Hyunwoo; Yu, Dohyeon; Choi, Jihye

2015-01-01

Standard ultrasonography is often insensitive for distinguishing normal vs. diseased states for canine abdominal organs. Ultrasonographic elastography is a new technique that is becoming increasingly available and may help to improve sensitivity. This study evaluated the feasibility, repeatability, and reproducibility of strain elastography of the liver, spleen, kidneys, and prostate in healthy dogs and described the elasticity of each organ using strain values and strain ratios. The reproducibility of strain elastography was excellent, and intraobserver repeatability was moderate to excellent. The strain value of each organ was not significantly different among dogs (liver = 143.38 ± 7.41, spleen = 141.04 ± 9.03, left renal cortex = 141.26 ± 7.50, right renal cortex = 145.80 ± 7.79, and prostate = 135.46 ± 5.80), except for the renal medulla (left = 51.19 ± 4.54 and right = 51.93 ± 5.09) (P spleen, renal cortex, and prostate were similar with no significant difference (liver = 10.20 ± 1.47, spleen = 8.40 ± 1.53, left renal cortex = 9.62 ± 1.56, right renal cortex = 8.29 ± 1.63, and prostate = 8.20 ± 1.21), except for the renal medulla (left = 3.48 ± 0.68 and right = 2.95 ± 0.63) (P spleen, kidneys, and prostate. This study provides basic information for strain values and strain ratios for the liver, spleen, kidneys, and prostate in clinically normal dogs. © 2015 American College of Veterinary Radiology.

Ureterocystoplasty using the lower pole ureter of a duplex kidney with preservation of ipsilateral renal function

OpenAIRE

John Lazarus

2012-01-01

We describe the case of a 9 year old boy with neurogenic bladder dysfunction who co-incidentally had a unilateral duplex kidney with Grade 5 vesico-ureteric reflux into a poorly functioning lower moiety allowing heminephrectomy and ureterocystoplasty with preservation of ipsilateral renal function.

The effect of short-term glucagon infusion on kidney function in normal man

DEFF Research Database (Denmark)

Parving, H H; Noer, J; Kehlet, H

1977-01-01

Kidney function was studied in six normal males before and during a 2 h glucagon (10 ng/kg/min) infusion. The following variables were determined during each 20 min clearance period; glomerular filtration rate (GFR), renal plasma-flow (RPF) , filtration fraction (FF), urinary albumin and beta2......-microglobulin-excretion rates. Glucagon infusion resulted in a fourfold increase in plasma glucagon concentration. The infusion induced a significant increase in GFR (+9%), FF (+9%) and urinary beta2-microglobulin excretion rate (+32%), (p less than 0.01). RPF and urinary albumin excretion rates were...

Peroxynitrite induced mitochondrial biogenesis following MnSOD knockdown in normal rat kidney (NRK cells

Directory of Open Access Journals (Sweden)

Akira Marine

2014-01-01

Full Text Available Superoxide is widely regarded as the primary reactive oxygen species (ROS which initiates downstream oxidative stress. Increased oxidative stress contributes, in part, to many disease conditions such as cancer, atherosclerosis, ischemia/reperfusion, diabetes, aging, and neurodegeneration. Manganese superoxide dismutase (MnSOD catalyzes the dismutation of superoxide into hydrogen peroxide which can then be further detoxified by other antioxidant enzymes. MnSOD is critical in maintaining the normal function of mitochondria, thus its inactivation is thought to lead to compromised mitochondria. Previously, our laboratory observed increased mitochondrial biogenesis in a novel kidney-specific MnSOD knockout mouse. The current study used transient siRNA mediated MnSOD knockdown of normal rat kidney (NRK cells as the in vitro model, and confirmed functional mitochondrial biogenesis evidenced by increased PGC1α expression, mitochondrial DNA copy numbers and integrity, electron transport chain protein CORE II, mitochondrial mass, oxygen consumption rate, and overall ATP production. Further mechanistic studies using mitoquinone (MitoQ, a mitochondria-targeted antioxidant and L-NAME, a nitric oxide synthase (NOS inhibitor demonstrated that peroxynitrite (at low micromolar levels induced mitochondrial biogenesis. These findings provide the first evidence that low levels of peroxynitrite can initiate a protective signaling cascade involving mitochondrial biogenesis which may help to restore mitochondrial function following transient MnSOD inactivation.

Normal kidney size and renal cortical thickness of the Korean adults

International Nuclear Information System (INIS)

Chung, Hee Kyung; Hahm, Chang Kok

1974-01-01

1. The kidney size and cortical thickness were measured from intravenous pyelograms of healthy Korean adults of 250 males and 250 females. 2. The measured size and cortical thickness of kidney were following figure (mm). 3. The size of kidney of male is a little larger than female both in vertical length and horizontal width. 4. The renal cortical thickness were not significant in differences between male and female, right and left, in each poles. 5. In the study of distribution of length differences between pairs of kidneys in our series, the length of right kidney is larger in 18.6%, and width in 27.2%. 6. Comparative study is carried out measuring the length of first lumbar vertebral bodies including 4 intervertebral spaces. 7. The site of kidney is larger in the group of greater length of vertebral height. 8. The renal cortical thickness have no significant differences in according to the differences of length of vertebral height, in each poles. 9. Comparing with the western authors, the kidney size of the Korean adult is not smaller than western

Rictor/mammalian target of rapamycin complex 2 promotes macrophage activation and kidney fibrosis.

Science.gov (United States)

Ren, Jiafa; Li, Jianzhong; Feng, Ye; Shu, Bingyan; Gui, Yuan; Wei, Wei; He, Weichun; Yang, Junwei; Dai, Chunsun

2017-08-01

Mammalian target of rapamycin (mTOR) signalling controls many essential cellular functions. However, the role of Rictor/mTOR complex 2 (mTORC2) in regulating macrophage activation and kidney fibrosis remains largely unknown. We report here that Rictor/mTORC2 was activated in macrophages from the fibrotic kidneys of mice. Ablation of Rictor in macrophages reduced kidney fibrosis, inflammatory cell accumulation, macrophage proliferation and polarization after unilateral ureter obstruction or ischaemia/reperfusion injury. In bone marrow-derived macrophages (BMMs), deletion of Rictor or blockade of protein kinase Cα inhibited cell migration. Additionally, deletion of Rictor or blockade of Akt abolished interleukin-4-stimulated or transforming growth factor (TGF)-β1-stimulated macrophage M2 polarization. Furthermore, deletion of Rictor downregulated TGF-β1-stimulated upregulation of multiple profibrotic cytokines, including platelet-derived growth factor, vascular endothelial growth factor and connective tissue growth factor, in BMMs. Conditioned medium from TGF-β1-pretreated Rictor -/- macrophages stimulated fibroblast activation less efficiently than that from TGF-β1-pretreated Rictor +/+ macrophages. These results demonstrate that Rictor/mTORC2 signalling can promote macrophage activation and kidney fibrosis. Targeting this signalling pathway in macrophages may shine light on ways to protect against kidney fibrosis in patients with chronic kidney diseases. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Epidermal growth factor receptor-induced activato protein 1 activity controls density-dependent growht inhibition in normal rat kidney fibroblasts.

NARCIS (Netherlands)

Hornberg, J.J.; Dekker, H.; Peters, P.H.J.; Langerak, P.; Westerhoff, H.V.; Lankelma, J.; Zoelen, E.J.J.

2006-01-01

Density-dependent growth inhibition secures tissue homeostasis. Dysfunction of the mechanisms, which regulate this type of growth control is a major cause of neoplasia. In confluent normal rat kidney (NRK) fibroblasts, epidermal growth factor (EGF) receptor levels decline, ultimately rendering these

Use of computed tomography scout film and Hounsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter and bladder radiographs.

Science.gov (United States)

Chua, Michael E; Gomez, Odina R; Sapno, Lorelei D; Lim, Steve L; Morales, Marcelino L

2014-07-01

The objective of this study is to determine the diagnostic utility of computed tomography (CT)- scout film with an optimal non-contrast helical CT scan Hounsfield unit (HU) in predicting the appearance of urinary calculus in the plain kidneys, ureter, urinary bladder (KUB)-radiograph. A prospective cross-sectional study was executed and data were collected from June 2007 to June 2012 at a tertiary hospital. The included subjects were diagnosed to have value, CT-scout film and KUB radiograph appearance were recorded independently by two observers. Univariate logistic analysis with receiver operating characteristic curve was generated to determine the best cut-off HU value of urolithiases not identified in CT-scout film, but determined radio-opaque in KUB X-ray. Subsequently, its sensitivity, specificity, predictive values and likelihood ratios were calculated. Statistical significance was set at P value of 0.05 or less. Two hundred and three valid cases were included. 73 out of 75 CT-scout film detected urolithiasis were identified on plain radiograph and determined as radio-opaque. The determined best cut off value of HU utilized for prediction of radiographic characteristics was 630HU at which urinary calculi were not seen at CT-scout film and were KUB X-ray radio-opaque. The set HU cut-off was established of ideal accuracy with an overall sensitivity of 82.2%, specificity of 96.9% and a positive predictive value of 96.5% and negative predictive value of 83.5%. Urolithiases identified on the CT-scout film were also seen as radiopaque on the KUB radiograph while those stones not visible on the CT-scout film, but above the optimal HU cut-off value of 630 are also likely to be radiopaque.

Functional characterization of the vertebrate primary ureter: Structure and ion transport mechanisms of the pronephric duct in axolotl larvae (Amphibia

Directory of Open Access Journals (Sweden)

Prehn Lea R

2010-05-01

Full Text Available Abstract Background Three kidney systems appear during vertebrate development: the pronephroi, mesonephroi and metanephroi. The pronephric duct is the first or primary ureter of these kidney systems. Its role as a key player in the induction of nephrogenic mesenchyme is well established. Here we investigate whether the duct is involved in urine modification using larvae of the freshwater amphibian Ambystoma mexicanum (axolotl as model. Results We investigated structural as well as physiological properties of the pronephric duct. The key elements of our methodology were: using histology, light and transmission electron microscopy as well as confocal laser scanning microscopy on fixed tissue and applying the microperfusion technique on isolated pronephric ducts in combination with single cell microelectrode impalements. Our data show that the fully differentiated pronephric duct is composed of a single layered epithelium consisting of one cell type comparable to the principal cell of the renal collecting duct system. The cells are characterized by a prominent basolateral labyrinth and a relatively smooth apical surface with one central cilium. Cellular impalements demonstrate the presence of apical Na+ and K+ conductances, as well as a large K+ conductance in the basolateral cell membrane. Immunolabeling experiments indicate heavy expression of Na+/K+-ATPase in the basolateral labyrinth. Conclusions We propose that the pronephric duct is important for the subsequent modification of urine produced by the pronephros. Our results indicate that it reabsorbs sodium and secretes potassium via channels present in the apical cell membrane with the driving force for ion movement provided by the Na+/K+ pump. This is to our knowledge the first characterization of the pronephric duct, the precursor of the collecting duct system, which provides a model of cell structure and basic mechanisms for ion transport. Such information may be important in understanding

Influence of kidney function on risk of supratherapeutic international normalized ratio-related hemorrhage in warfarin users: a prospective cohort study

Science.gov (United States)

Background: Anticoagulation management is difficult in chronic kidney disease, with frequent supratherapeutic international normalized ratios (INRs >/= 4) increasing hemorrhagic risk. We evaluated whether the interaction of INR and lower estimated glomerular filtration rate (eGFR) increases hemorrha...

Comparison of different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters: An animal model

Directory of Open Access Journals (Sweden)

Shasanka Shekhar Panda

2014-01-01

Full Text Available Background: The objective of the following study is to determine and to compare the different morphological parameters with duration of obstruction created experimentally in unilateral upper ureters of rats. Materials and Methods: Unilateral upper ureteric obstruction was created in 60 adult Wistar rats that were reversed after predetermined intervals. Rats were sacrificed and ipsilateral kidneys were subjected for analysis of morphological parameters such as renal height, cranio-caudal diameter, antero-posterior diameter, lateral diameter, volume of the pelvis and average cortical thickness: Renal height. Results: Renal height and cranio-caudal diameter of renal pelvis after ipsilateral upper ureteric obstruction started rising as early as 7 days of creating obstruction and were affected earlier than antero-posterior and lateral diameter and also were reversed earlier than other parameters after reversal of obstruction. Renal cortical thickness and volume of the pelvis were affected after prolonged obstruction (> 3 weeks and were the late parameters to be reversed after reversal of obstruction. Conclusions: Cranio-caudal diameter and renal height were the early morphological parameters to be affected and reversed after reversal of obstruction in experimentally created ipsilateral upper ureteric obstruction.

ACUTE RENAL FAILURE WITH NORMAL PLASMA UREA LEVEL SECONDARY TO ACUTE PYELONEPHITIS IN A SINGLE KIDNEY PATIENT

Directory of Open Access Journals (Sweden)

Imperiali N

2006-03-01

Full Text Available SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels. RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.

ACUTE RENAL FAILURE WITH NORMAL PLASMA UREA LEVEL SECONDARY TO ACUTE PYELONEPHITIS IN A SINGLE KIDNEY PATIENT

Directory of Open Access Journals (Sweden)

Algranati L

2007-04-01

Full Text Available SUMMARY: Acute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.RESUMEN: La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.

Kidney function in normal man during short-term growth hormone infusion

DEFF Research Database (Denmark)

Parving, H H; Noer, I; Mogensen, C E

1978-01-01

Kidney function was studied in 9 normal males before and during a 2 h growth hormone (GH) infusion of 50 ng/kg/min. The following variables were measured during each 20 min clearance period: glomerular filtration rate, GFR, effective renal plasma flow, RPF (steady state infusion technique...... with urinary collections using [125I]iothalamate and [131I]iodohippurate), and urinary albumin and beta2-microglobulin excretion rates (radioimmunoassays). The GH infusion resulted in a 10-fold increase in plasma GH concentration. All the above mentioned variables remained practically unchanged during...... the infusion except for a small (-5%) but significant decrease in renal plasma flow (P less than 0.01). Our negative results contrast to the findings of increased GFR and RPF during prolonged GH administration and suggest that GH requires several hours or days for its renal effects to become manifest....

Reestablishment of radiographic kidney size in Miniature Schnauzer dogs.

Science.gov (United States)

Sohn, Jungmin; Yun, Sookyung; Lee, Jeosoon; Chang, Dongwoo; Choi, Mincheol; Yoon, Junghee

2017-01-10

Kidney size may be altered in renal diseases, and the detection of kidney size alteration has diagnostic and prognostic values. We hypothesized that radiographic kidney size, the kidney length to the second lumbar vertebra (L2) length ratio, in normal Miniature Schnauzer dogs may be overestimated due to their shorter vertebral length. This study was conducted to evaluate radiographic and ultrasonographic kidney size and L2 length in clinically normal Miniature Schnauzers and other dog breeds to evaluate the effect of vertebral length on radiographic kidney size and to reestablish radiographic kidney size in normal Miniature Schnauzers. Abdominal radiographs and ultrasonograms from 49 Miniature Schnauzers and 54 other breeds without clinical evidence of renal disease and lumbar vertebral abnormality were retrospectively evaluated. Radiographic kidney size, in the Miniature Schnauzer (3.31 ± 0.26) was significantly larger than that in other breeds (2.94 ± 0.27). Relative L2 length, the L2 length to width ratio, in the Miniature Schnauzer (1.11 ± 0.06) was significantly shorter than that in other breeds (1.21 ± 0.09). However, ultrasonographic kidney sizes, kidney length to aorta diameter ratios, were within or very close to normal range both in the Miniature Schnauzer (6.75 ± 0.67) and other breeds (7.16 ± 1.01). Thus, Miniature Schnauzer dogs have breed-specific short vertebrae and consequently a larger radiographic kidney size, which was greater than standard reference in normal adult dogs. Care should be taken when evaluating radiographic kidney size in Miniature Schnauzers to prevent falsely diagnosed renomegaly.

Preliminary results of laser tissue welding in extravesical reimplantation of the ureters.

Science.gov (United States)

Kirsch, A J; Dean, G E; Oz, M C; Libutti, S K; Treat, M R; Nowygrod, R; Hensle, T W

1994-02-01

One exciting potential use of laparoscopic technology is the extravesical reimplantation of the ureters. We have assessed the efficacy of laser-activated fibrinogen solder to close vesical muscle flaps over submucosal ureters (Lich-Gregoir technique) in a canine model. Four dogs were subjected to unilateral flap closures via a protein solder (indocyanine green and fibrinogen) applied to the bladder serosa and exposed to 808 nm. continuous wave diode laser energy. Contralateral reimplantation was performed using 4-zero vicryl muscle flap closures (controls). At 7, 14 and 28 days postoperatively, intravenous pyelograms confirmed bilateral ureteral patency. At intravesical pressures above 100 cm. H2O, there was no evidence of wound disruption in either group. Nondisrupted wound closures were sectioned and strained until ultimate breakage to determine tensile strength. At each study interval the laser-welded closures withstood greater stress than the controls. Although these data represent single tissue samples and are not amenable to statistical analysis, laser-welded closures appeared to be stronger at each study interval. In conclusion, laser-welded vesical wound closures appear at least as strong as suture closures in the canine model.

Kidney volume in type 1 (insulin-dependent) diabetic patients with normal or increased urinary albumin excretion

DEFF Research Database (Denmark)

Feldt-Rasmussen, B; Hegedüs, L; Mathiesen, E R

1991-01-01

Forty-seven patients with type 1 (insulin-dependent) diabetes mellitus and 14 normal subjects had renal volume determined by an ultrasonic technique. Renal volume of 299 +/- 49 ml/1.73 m2 (mean +/- SD) in type 1 diabetic patients with normal urinary albumin excretion exceeded that in the normal...... subjects (245 +/- 53 ml/1.73 m2, p less than 0.05). Compared with diabetic patients with normal urinary albumin excretion, renal volume was significantly higher in patients with microalbuminuria (372 +/- 24 ml/1.73 m2, p less than 0.05) and patients with clinical nephropathy (352 +/- 48 ml/1.73 m2, p less...... than 0.05). In a multiple linear regression with HbA1c, urinary albumin excretion, age, diabetes duration and mean blood pressure as independent variables, variations in HbA1c could account for 33% of the variations in kidney volume (n = 47, r = 0.57, p less than 0.01). The other variables played...

Acute Renal Failure In Infancy and Childhood

African Journals Online (AJOL)

1974-10-19

Oct 19, 1974 ... Single kidney + calculus in ureter ... Calculus in one ureter + acute glomeru- lonephritis ... Ureteric ... A careful history and physical examination will often provide clues to ..... variation in response and tolerance occurs; frequent.

In vivo imaging of oxidative stress in the kidney of diabetic mice and its normalization by angiotensin II type 1 receptor blocker

International Nuclear Information System (INIS)

Sonta, Toshiyo; Inoguchi, Toyoshi; Matsumoto, Shingo; Yasukawa, Keiji; Inuo, Mieko; Tsubouchi, Hirotaka; Sonoda, Noriyuki; Kobayashi, Kunihisa; Utsumi, Hideo; Nawata, Hajime

2005-01-01

This study was undertaken to evaluate oxidative stress in the kidney of diabetic mice by electron spin resonance (ESR) imaging technique. Oxidative stress in the kidney was evaluated as organ-specific reducing activity with the signal decay rates of carbamoyl-PROXYL probe using ESR imaging. The signal decay rates were significantly faster in corresponding image pixels of the kidneys of streptozotocin-induced diabetic mice than in those of controls. This technique further demonstrated that administration of angiotensin II type 1 receptor blocker (ARB), olmesartan (5 mg/kg), completely restored the signal decay rates in the diabetic kidneys to control values. In conclusion, this study provided for the first time the in vivo evidence for increased oxidative stress in the kidneys of diabetic mice and its normalization by ARB as evaluated by ESR imaging. This technique would be useful as a means of further elucidating the role of oxidative stress in diabetic nephropathy

Length and volume of morphologically normal kidneys in Korean Children: Ultrasound measurement and estimation using body size

International Nuclear Information System (INIS)

Kim, Jun Hwee; Kim, Myung Joon; Lim, Sok Hwan; Lee, Mi Jung; Kim, Ji Eun

2013-01-01

To evaluate the relationship between anthropometric measurements and renal length and volume measured with ultrasound in Korean children who have morphologically normal kidneys, and to create simple equations to estimate the renal sizes using the anthropometric measurements. We examined 794 Korean children under 18 years of age including a total of 394 boys and 400 girls without renal problems. The maximum renal length (L) (cm), orthogonal anterior-posterior diameter (D) (cm) and width (W) (cm) of each kidney were measured on ultrasound. Kidney volume was calculated as 0.523 x L x D x W (cm 3 ). Anthropometric indices including height (cm), weight (kg) and body mass index (m 2 /kg) were collected through a medical record review. We used linear regression analysis to create simple equations to estimate the renal length and the volume with those anthropometric indices that were mostly correlated with the US-measured renal sizes. Renal length showed the strongest significant correlation with patient height (R2, 0.874 and 0.875 for the right and left kidneys, respectively, p < 0.001). Renal volume showed the strongest significant correlation with patient weight (R2, 0.842 and 0.854 for the right and left kidneys, respectively, p < 0.001). The following equations were developed to describe these relationships with an estimated 95% range of renal length and volume (R2, 0.826-0.884, p < 0.001): renal length = 2.383 + 0.045 x Height (± 1.135) and = 2.374 + 0.047 x Height (± 1.173) for the right and left kidneys, respectively; and renal volume 7.941 + 1.246 x Weight (± 15.920) and = 7.303 + 1.532 x Weight (± 18.704) for the right and left kidneys, respectively. Scatter plots between height and renal length and between weight and renal volume have been established from Korean children and simple equations between them have been developed for use in clinical practice.

Length and volume of morphologically normal kidneys in Korean Children: Ultrasound measurement and estimation using body size

Energy Technology Data Exchange (ETDEWEB)

Kim, Jun Hwee; Kim, Myung Joon; Lim, Sok Hwan; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Ji Eun [Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2013-08-15

To evaluate the relationship between anthropometric measurements and renal length and volume measured with ultrasound in Korean children who have morphologically normal kidneys, and to create simple equations to estimate the renal sizes using the anthropometric measurements. We examined 794 Korean children under 18 years of age including a total of 394 boys and 400 girls without renal problems. The maximum renal length (L) (cm), orthogonal anterior-posterior diameter (D) (cm) and width (W) (cm) of each kidney were measured on ultrasound. Kidney volume was calculated as 0.523 x L x D x W (cm{sup 3}). Anthropometric indices including height (cm), weight (kg) and body mass index (m{sup 2}/kg) were collected through a medical record review. We used linear regression analysis to create simple equations to estimate the renal length and the volume with those anthropometric indices that were mostly correlated with the US-measured renal sizes. Renal length showed the strongest significant correlation with patient height (R2, 0.874 and 0.875 for the right and left kidneys, respectively, p < 0.001). Renal volume showed the strongest significant correlation with patient weight (R2, 0.842 and 0.854 for the right and left kidneys, respectively, p < 0.001). The following equations were developed to describe these relationships with an estimated 95% range of renal length and volume (R2, 0.826-0.884, p < 0.001): renal length = 2.383 + 0.045 x Height (± 1.135) and = 2.374 + 0.047 x Height (± 1.173) for the right and left kidneys, respectively; and renal volume 7.941 + 1.246 x Weight (± 15.920) and = 7.303 + 1.532 x Weight (± 18.704) for the right and left kidneys, respectively. Scatter plots between height and renal length and between weight and renal volume have been established from Korean children and simple equations between them have been developed for use in clinical practice.

Clinical evaluation of diuretic renography in infants and children with congenital urinary abnormality

International Nuclear Information System (INIS)

Li Jingsong; Li Jianing; Fu Hongliang; Zou Renjian; Wu Jingchuan

2006-01-01

Objective: The clinical application of furosemide plus 15-minute diuretic renography (F+15 DR) was evaluated in infants and children with congenital urinary abnormalities. Methods: In 163 patients with different congenital urinary abnormalities undergoing F+15 DR, 97 were operated and followed by F+15 DR reexamination. The DR imaging characteristics were analyzed and, based on those analyses, hydronephrosis was classified into five degrees. Follow-up data were analyzed both quantitatively and qualitatively. Results: Each renal abnormality (kidney duplication 60, horseshoe kidney 6, multiple cysts of kidney 5, hypoplasia 35, ureterocele 20, displacement of ureter opening 13, megaloureter 20, valve of ureter 26) exhibited its unique characteristics on DR imaging. Renal functions of those patients were improved dur- ing the follow-up after surgical operations. Patients with duplex kidney and ureter abnormalities had better prognosis than those with urethral valve. Conclusion: F + 15 DR imaging may reveal characteristic changes of congenital urinary abnormalities and helps in the qualitative or quantitative evaluation of the treatments. (authors)

A Giant Pedunculated Urothelial Polyp Mimicking Bladder Mass in a Child: A Rare Case

Directory of Open Access Journals (Sweden)

Mehmet Kaba

2014-01-01

Full Text Available Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter.

Uptake of indium-111 labelled platelets by normal, nephrotic and transplanted kidneys

International Nuclear Information System (INIS)

Desir, G.; Lange, R.; Smith, E.; Bia, M.; Flye, M.; Kashgarian, M.; Canganelli, A.; Ezekowitz

1984-01-01

To determine the role of platelets in the genesis of renal transplant (T) rejection, the authors studied 3 groups of adult patients. Group I, n=8, had normal renal function (Cr=1 +- 0.1 mg%, Mean +- SD). Group II, n=9, had nephrotic syndrome (Cr=2.4 +- 1). Group III, n=7, consisted of 5 cadaveric (C) and 2 living related donor (LRD) T. In Group II, 1 patient had received a T 4 years prior to study. Group I and II received 448 +- 101 μCi and Group III 236 +- 51 μCi of Indium-111. In Groups I and II the first image was obtained 18 +- 6 hrs after injection. In Group II the first was obtained 6 +- 2 hr after injection and 1-3 times/day thereafter for a maximum of 7 days. Renal biopsies were obtained in all patients in Group III during imaging (n=5) or within 2 - 5 days of the last image. One patient was studied twice. In Group III, 5 patients received prednisone and azothiaprine and 2 prednisone and cyclosporine. Platelet uptake index (PUI) was calculated as the ratio of uptake over the T against a reference area. Rejection was diagnosed by biopsy. In groups I and II platelet uptake was seen only in the T patient. In Group III the PUI was 1.54 +- .13 in the rejecting T (n=5), 1.42 +- .2 in the non-rejecting T (n=3), 1.62 in a LRD non-rejecting T and 1.31 (n=2) in C non-rejecting T. In the four patients studied within 5 days of T the PUI was elevated at 1.47 +- .1. The authors conclude that: 1) platelets do not accumulate in normal or nephrotic native kidneys, 2) significant uptake occurs in the first week after C and LRD whether or not rejection is present, and 3) uptake in non-rejecting kidneys cannot be ascribed to perfusion induced endothelial injury since it was present in LRD transplants

Imaging of a supernumerary kidney

International Nuclear Information System (INIS)

Koureas, A.P.; Panourgias, E.C.; Gouliamos, A.D.; Trakadas, S.J.; Vlahos, L.J.

2000-01-01

A 33-year-old female patient was investigated for a right lower quadrant pain. The investigation, which included an excretory urography and a computed tomography examination, revealed a normal kidney on the right side and another two normal sized, complete kidneys on the left side, which appeared to have a small parenchymal bridge. The patient was treated surgically for a cyst of the right ovary. (orig.)

Imaging of a supernumerary kidney

Energy Technology Data Exchange (ETDEWEB)

Koureas, A.P.; Panourgias, E.C.; Gouliamos, A.D.; Trakadas, S.J.; Vlahos, L.J. [Dept. of Radiology, Areteion Hospital, Athens (Greece)

2000-11-01

A 33-year-old female patient was investigated for a right lower quadrant pain. The investigation, which included an excretory urography and a computed tomography examination, revealed a normal kidney on the right side and another two normal sized, complete kidneys on the left side, which appeared to have a small parenchymal bridge. The patient was treated surgically for a cyst of the right ovary. (orig.)

Experimental investigations of radiological and nuclear functional diagnosis of the ureter

International Nuclear Information System (INIS)

Wolf, M.

1980-01-01

A new nuclear method for reflux and motility investigations of the ureter is described, and its diagnostic potential is determined in model experiments. Thresholds of visualisation of a urine spindle are considered. The following results were obtained in animal experiments: 1) If investigations are repeated under identical conditions, there are considerable variations of refluxivity. 2) With IMCU (Isotope Micturition Cystoureterogram), the number of refluxes detected is about the same as with MCU (Micturition Cystoureterogram); this applies in particular to refluxes of the 3rd and 4th degree. 3) UKG is equal to AUR in judging the direction, time, velocity and frequency of discharge of a spindle while thickness and initial conus lenght of a spindle are better seen in AUR. 4) Inconstant depots of residual urine can be detected by UKG an AUR alike. The radiological observations made in the animal experiment are compared with the relevant literature, and possible error sources in the evaluation are indicated. Finally, the application of IMCU and UKG in humans is described. IMCU is recommended especially for pardiatric applications as the observation time is long and radiation exposure low. In renal function studies, the UKG supplies extensive information on functional data of the ureter which until now could be obtained only with the aid of contrast media. (orig./MG) [de

Phosphorus Regulation in Chronic Kidney Disease.

Science.gov (United States)

Suki, Wadi N; Moore, Linda W

2016-01-01

Serum phosphorus levels stay relatively constant through the influence of multiple factors-such as parathyroid hormone, fibroblast growth factor 23, and vitamin D-on the kidney, bone, and digestive system. Whereas normal serum phosphorus ranges between 3 mg/dL to 4.5 mg/dL, large cross-sectional studies have shown that even people with normal kidney function are sometimes found to have levels ranging between 1.6 mg/dL and 6.2 mg/dL. While this may partially be due to diet and the factors mentioned above, total understanding of these atypical ranges of serum phosphorus remains uncertain. Risks for bone disease are high in people aged 50 and older, and this group comprises a large proportion of people who also have chronic kidney disease. Consuming diets low in calcium and high in phosphorus, especially foods with phosphate additives, further exacerbates bone turnover. Existing bone disease increases the risk for high serum phosphorus, and higher serum phosphorus has been associated with increased adverse events and cardiovascular-related mortality both in people with chronic kidney disease and in those with no evidence of disease. Once kidney function has deteriorated to end-stage disease (Stage 5), maintaining normal serum phosphorus requires dietary restrictions, phosphate-binding medications, and dialysis. Even so, normal serum phosphorus remains elusive in many patients with Stage 5 kidney disease, and researchers are testing novel targets that may inhibit intestinal transport of phosphorus to achieve better phosphate control. Protecting and monitoring bone health should also aid in controlling serum phosphorus as kidney disease advances.

Cutaneous tube ureterostomy: a fast and effective method of urinary diversion in emergency situations

Directory of Open Access Journals (Sweden)

Abdin T

2015-06-01

Full Text Available Tamer Abdin,1 Gideon Zamir,2 Alon Pikarsky,2 Ran Katz,1 Ezekiel H Landau,1 Ofer N Gofrit1 1Department of Urology, 2Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel Aim: To report on a simple and rapid method of urinary diversion. This method was applied successfully in different clinical scenarios when primary reconstruction of the ureters was not possible. Materials and methods: The disconnected ureter is catheterized by a feeding tube. The tube is secured with sutures and brought out to the lateral abdominal wall as cutaneous tube ureterostomy (CTU. Results: This method was applied in three different clinical scenarios: a 40-year-old man who sustained multiple high-velocity gunshots to the pelvis with combined rectal and bladder trigone injuries and massive bleeding from a comminuted pubic fracture. Damage control included colostomy and bilateral CTUs. A 26-year-old woman had transection of the right lower ureter during abdominal hysterectomy. Diagnosis was delayed for 3 weeks when the patient developed sepsis. The right kidney was diverted with a CTU. A 37-year-old male suffered from bladder perforation and hemorrhagic shock. Emergency cystectomy was done and urinary diversion was accomplished with bilateral CTUs. In all cases, effective drainage of the urinary system was achieved with normalization of kidney function. Conclusion: When local or systemic conditions preclude definitive repair and damage control surgery is needed, CTU provides fast and effective urinary diversion. Keywords: Ureter, trauma, tube cutenuous ureterostomy 

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... waste products from your blood. The waste becomes urine (pee), which drips into the ureters (long, thin ... one connected to each kidney). From there, the urine travels through the ureters down to the bladder. ...

Kidney removal - slideshow

Science.gov (United States)

... this page: //medlineplus.gov/ency/presentations/100069.htm Kidney removal (nephrectomy) - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 5 Go to slide 2 out of ... to slide 5 out of 5 Overview The kidneys are paired organs that lie posterior to the ...

The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

Energy Technology Data Exchange (ETDEWEB)

Kriegshauser, J. Scott, E-mail: skriegshauser@mayo.edu; Naidu, Sailen G. [Mayo Clinic Hospital, Department of Radiology (United States); Chang, Yu-Hui H. [Mayo Clinic, Department of Biostatistics (United States); Huettl, Eric A. [Mayo Clinic Hospital, Department of Radiology (United States)

2015-04-15

PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks were categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.

Pengaruh Pemberian Valsartan Dan Kurkumin Terhadap Pembentukan Fibrosis Di Tubulus Proksimal Ginjal Akibat Obstruksi Ureter Unilateral pada Tikus Wistar.

Directory of Open Access Journals (Sweden)

Lubis M

2013-01-01

Full Text Available AbstrakPendahuluan: Obstruksi ureter adalah kondisi terhalangnya aliran urin dari ginjal ke buli-buli, adanya obstruksi pada ureter memperlambat laju filtrasi glomerulus dan dapat menyebabkan kerusakan parenkim ginjal. Fibrosis pada ginjal yang obstruksi timbul melalui dua mediator yaitu tumor nekrotik factor (TNF-α dan angiotensin II. Penghambatan kedua mediator ini akan menurunkan tingkat fibrosis di tubulus proksimal ginjal akibat obstruksi. Zat yang bisa menghambat TNF-α salah satunya adalah kurkumin sedangkan Angitensin II dapat dihambat dengan valsatran. Metode: Penelitian ini merupakan penelitian eksperimental, tikus wistar dibagi dalam dua kelompok dengan jumlah tiap kelompok adalah 15 ekor. Proksimal ureter kanan diikat dan kelompok perlakuan 1 sebagai kontrol diberi valsatran, kelompok perlakuan2 diberi valsartan dan kurkumin. Pemberian oral, dimana obat dilakukan pengenceran. Hari ke lima belas dilakukan pengambilan ginjal tikus wistar, diperiksa histologi. Pembentukan fibrosis di tubulus proksimal dianalisa dengan uji statistik chisquare dengan koreksi Yates dan t test, sedang terbentuknya degenerasi hidrofik dan terbentuknya atrofi pada tubulus proksimal dianalisa dengan uji statistik t test. Hasil: Adanya perbedaan bermakna perubahan pembentukan fibrosis di tubulus proksimal ginjal antara kelompok perlakuan dan kontrol ( Chi Squqre didapat nilai p ≤ 0,001 dan dengan t test didapat nilai p ≤ 0,000. Terbentuknya degenerasi hidrofilik di tubulus proksimal ginjal terdapat perbedaan bermakna terbentuknya degenerasi hidrofilik kelompok perlakuan dan kelompok kontrol ( t test didapatkan nilai p ≤ 0,000. Terbentuknya atrofi di tubulus proksimal terdapatt perbedaan bermakna terbentuknya atrofi di tubulus proksimal ginjal kelompok perlakuan dan kelompok kontrol ( t test didapat nilai p ≤ 0,000. Kesimpulan: Ada perbedaan pengaruh pemberian valsartan dan valsartan + kurkumin terhadap pembentukan fibrosis di tubulus proksimal ginjal

9. The Contribution of Animal Experiments to Kidney Transplantation

OpenAIRE

Botting, Jack Howard

2016-01-01

Haemodialysis is life-saving and curative in acute renal failure. By reversing the build-up of metabolic products normally excreted by a functioning kidney, dialysis enables the temporarily affected kidneys to heal and resume normal function. In chronic renal failure however, the burden of regular dialysis is necessary unless a healthy kidney from a donor can be grafted. Chronic Renal Failure Chronic renal failure (CRF) due to glomerulonephritis, pyelonephritis or polycystic kidney disease is...

Overexpression of Robo2 causes defects in the recruitment of metanephric mesenchymal cells and ureteric bud branching morphogenesis

International Nuclear Information System (INIS)

Ji, Jiayao; Li, Qinggang; Xie, Yuansheng; Zhang, Xueguang; Cui, Shaoyuan; Shi, Suozhu; Chen, Xiangmei

2012-01-01

Highlights: ► Overexpression of Robo2 caused reduced UB branching and glomerular number. ► Fewer MM cells surrounding the UB after overexpression of Robo2 in vitro. ► No abnormal Epithelial Morphology of UB or apoptosis of mm cells in the kidney. ► Overexpression of Robo2 affected MM cells migration and caused UB deficit. ► The reduced glomerular number can also be caused by fewer MM cells. -- Abstract: Roundabout 2 (Robo2) is a member of the membrane protein receptor family. The chemorepulsive effect of Slit2–Robo2 signaling plays vital roles in nervous system development and neuron migration. Slit2–Robo2 signaling is also important for maintaining the normal morphogenesis of the kidney and urinary collecting system, especially for the branching of the ureteric bud (UB) at the proper site. Slit2 or Robo2 mouse mutants exhibit multilobular kidneys, multiple ureters, and dilatation of the ureter, renal pelvis, and collecting duct system, which lead to vesicoureteral reflux. To understand the effect of Robo2 on kidney development, we used microinjection and electroporation to overexpress GFP-Robo2 in an in vitro embryonic kidney model. Our results show reduced UB branching and decreased glomerular number after in vitro Robo2 overexpression in the embryonic kidneys. We found fewer metanephric mesenchymal (MM) cells surrounding the UB but no abnormal morphology in the branching epithelial UB. Meanwhile, no significant change in MM proliferation or apoptosis was observed. These findings indicate that Robo2 is involved in the development of embryonic kidneys and that the normal expression of Robo2 can help maintain proper UB branching and glomerular morphogenesis. Overexpression of Robo2 leads to reduced UB branching caused by fewer surrounding MM cells, but MM cell apoptosis is not involved in this effect. Our study demonstrates that overexpression of Robo2 by microinjection in embryonic kidneys is an effective approach to study the function of Robo2.

Overexpression of Robo2 causes defects in the recruitment of metanephric mesenchymal cells and ureteric bud branching morphogenesis

Energy Technology Data Exchange (ETDEWEB)

Ji, Jiayao [Institute of Nephrology, State Key Laboratory of Kidney Disease (2011DAV00088), The Chinese PLA General Hospital, Beijing 100853 (China); Medical College of NanKai University, Tianjin (China); Li, Qinggang; Xie, Yuansheng; Zhang, Xueguang; Cui, Shaoyuan; Shi, Suozhu [Institute of Nephrology, State Key Laboratory of Kidney Disease (2011DAV00088), The Chinese PLA General Hospital, Beijing 100853 (China); Chen, Xiangmei, E-mail: xmchen301@126.com [Institute of Nephrology, State Key Laboratory of Kidney Disease (2011DAV00088), The Chinese PLA General Hospital, Beijing 100853 (China); Medical College of NanKai University, Tianjin (China)

2012-05-11

Highlights: Black-Right-Pointing-Pointer Overexpression of Robo2 caused reduced UB branching and glomerular number. Black-Right-Pointing-Pointer Fewer MM cells surrounding the UB after overexpression of Robo2 in vitro. Black-Right-Pointing-Pointer No abnormal Epithelial Morphology of UB or apoptosis of mm cells in the kidney. Black-Right-Pointing-Pointer Overexpression of Robo2 affected MM cells migration and caused UB deficit. Black-Right-Pointing-Pointer The reduced glomerular number can also be caused by fewer MM cells. -- Abstract: Roundabout 2 (Robo2) is a member of the membrane protein receptor family. The chemorepulsive effect of Slit2-Robo2 signaling plays vital roles in nervous system development and neuron migration. Slit2-Robo2 signaling is also important for maintaining the normal morphogenesis of the kidney and urinary collecting system, especially for the branching of the ureteric bud (UB) at the proper site. Slit2 or Robo2 mouse mutants exhibit multilobular kidneys, multiple ureters, and dilatation of the ureter, renal pelvis, and collecting duct system, which lead to vesicoureteral reflux. To understand the effect of Robo2 on kidney development, we used microinjection and electroporation to overexpress GFP-Robo2 in an in vitro embryonic kidney model. Our results show reduced UB branching and decreased glomerular number after in vitro Robo2 overexpression in the embryonic kidneys. We found fewer metanephric mesenchymal (MM) cells surrounding the UB but no abnormal morphology in the branching epithelial UB. Meanwhile, no significant change in MM proliferation or apoptosis was observed. These findings indicate that Robo2 is involved in the development of embryonic kidneys and that the normal expression of Robo2 can help maintain proper UB branching and glomerular morphogenesis. Overexpression of Robo2 leads to reduced UB branching caused by fewer surrounding MM cells, but MM cell apoptosis is not involved in this effect. Our study demonstrates that

Standardised Outcomes in Nephrology-Polycystic Kidney Disease (SONG-PKD) : Study protocol for establishing a core outcome set in polycystic kidney disease

NARCIS (Netherlands)

Cho, Yeoungjee; Sautenet, Benedicte; Rangan, Gopala; Craig, Jonathan C.; Ong, Albert C. M.; Chapman, Arlene; Ahn, Curie; Chen, Dongping; Coolican, Helen; Kao, Juliana Tze-Wah; Gansevoort, Ron; Perrone, Ronald; Harris, Tess; Torres, Vicente; Pei, York; Kerr, Peter G.; Ryan, Jessica; Gutman, Talia; Howell, Martin; Ju, Angela; Manera, Karine E.; Teixeira-Pinto, Armando; Hamiwka, Lorraine A.; Tong, Allison

2017-01-01

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common potentially life threatening inherited kidney disease and is responsible for 5-10% of cases of end-stage kidney disease (ESKD). Cystic kidneys may enlarge up to 20 times the weight of a normal kidney due to the

Normal ureteral diameter in infancy and childhood

International Nuclear Information System (INIS)

Hellstroem, M.; Hjaelmaas, K.; Jacobsson, B.; Jodal, U.; Oden, A.; Oestra Sjukhuset, Goeteborg; Oestra Sjukhuset, Goeteborg; Goeteborg Univ.

1985-01-01

Ureteral diameters were estimated on films from intravenous urography in 194 children (100 boys and 94 girls) aged 0-16 years. Children with signs of urinary tract infection, calculi, obstruction, duplication or malformation were excluded. Films obtained without abdominal compression were used for measurements, including only ureters visualized over 50 per cent of their lengths. A good correlation was demonstrated between ureteral diameter and age and between ureteral diameter and the length of a segment of the lumbar spine. The widest part of the ureter was most often located just above the crossing of the iliac vessels. The right ureter was slightly wider than the left one. No difference between boys and girls was noted. The results are in good agreement with those of others obtained at autopsy. Bearing in mind the possible physiologic variations, it would seem that measuring the ureteral diameter can be of value for a more objective differentiation between dilated and non-dilated ureters. (orig.)

Assessment of Hydroureteronephrosis in Children Using Diuretic Radionuclide Ureterography

International Nuclear Information System (INIS)

Kim, Jong Ho; Lee, Dong Soo; Kwark, Cheol Eun

1994-01-01

The need for assessment of ureteric function in the patient with an obviously dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydronephrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during 99m Tc-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Ktl/2) and ureteral (Utl/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Ktl/2 (> 20 min), no patient with an abnormal ureter underwent therapy at the ureteropeivic junction because (he hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

Experimental irradiation of the rat ureter: The effects of field size and the presence of contrast medium on incidence and latency of hydronephrosis

International Nuclear Information System (INIS)

Knowles, J.F.; Trott, K.R.

1987-01-01

Following X-irradiation of a 1.5 cm length of rat ureter, hydronephrosis developed after doses down to 10 Gy. The estimated ED 50 was 11.8 Gy. In the dose range 37.4 Gy to 17.5 Gy there was a significant increase in latency with decreasing dose, but at lower doses the latency did not increase further. Reducing the length of ureter irradiated to 0.5 cm or 0.8 cm caused a decrease in incidence of hydronephrosis and longer latency periods. The ED 50 for rats iradiated to 0.5 cm of ureter was 29.6 Gy. The possibility that secondary radiation produced as a result of interaction between X-radiation and iodinated contrast medium might affect the radiation induction of hydronephrosis was investigated. No difference was found between groups of rats irradiated with or without injection of contrast media. 39 refs.; 4 figs

Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate

DEFF Research Database (Denmark)

Mocroft, Amanda; Lundgren, Jens D; Ross, Michael

2016-01-01

BACKGROUND: Whether or not the association between some antiretrovirals used in HIV infection and chronic kidney disease is cumulative is a controversial topic, especially in patients with initially normal renal function. In this study, we aimed to investigate the association between duration...... of exposure to antiretrovirals and the development of chronic kidney disease in people with initially normal renal function, as measured by estimated glomerular filtration rate (eGFR). METHODS: In this prospective international cohort study, HIV-positive adult participants (aged ≥16 years) from the D......:A:D study (based in Europe, the USA, and Australia) with first eGFR greater than 90 mL/min per 1·73 m(2) were followed from baseline (first eGFR measurement after Jan 1, 2004) until the occurrence of one of the following: chronic kidney disease; last eGFR measurement; Feb 1, 2014; or final visit plus 6...

Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy.

Science.gov (United States)

Kaynar, Mehmet; Tekinarslan, Erdem; Keskin, Suat; Buldu, İbrahim; Sönmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa Okan

2015-01-01

To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.

[Ultrasound and color Doppler applications in nephrology. The normal kidney: anatomy, vessels and congenital anomalies].

Science.gov (United States)

Meola, Mario; Petrucci, Ilaria; Giovannini, Lisa; Samoni, Sara; Dellafiore, Carolina

2012-01-01

Gray-scale ultrasound is the diagnostic technique of choice in patients with suspected or known renal disease. Knowledge of the normal and abnormal sonographic morphology of the kidney and urinary tract is essential for a successful diagnosis. Conventional sonography must always be complemented by Doppler sampling of the principal arterial and venous vessels. B-mode scanning is performed with the patient in supine, prone or side position. The kidney can be imaged by the anterior, lateral or posterior approach using coronal, transverse and oblique scanning planes. Morphological parameters that must be evaluated are the coronal diameter, the parenchymal thickness and echogenicity, the structure and state of the urinary tract, and the presence of congenital anomalies that may mimic a pseudomass. The main renal artery and the hilar-intraparenchymal branches of the arterial and venous vessels should be accurately evaluated using color Doppler. Measurement of intraparenchymal resistance indices (IP, IR) provides an indirect and quantitative parameter of the stiffness and eutrophic or dystrophic remodeling of the intrarenal microvasculature. These parameters differ depending on age, diabetic and hypertensive disease, chronic renal glomerular disease, and interstitial, vascular and obstructive nephropathy.

Impact of tamsulosin and nifedipine on contractility of pregnant rat ureters in vitro.

Science.gov (United States)

Haddad, Lisette; Corriveau, Stéphanie; Rousseau, Eric; Blouin, Simon; Pasquier, Jean-Charles; Ponsot, Yves; Roy-Lacroix, Marie-Ève

2018-01-01

To evaluate the in vitro effect of tamsulosin and nifedipine on the contractility of pregnant rat ureters and to perform quantitative analysis of the pharmacological effects. Medical expulsive therapy (MET) is commonly used to treat urolithiasis. However, this treatment is seldom used in pregnant women since no studies support this practice. This was an in vitro study on animal tissue derived from pregnant Sprague-Dawley rats. A total of 124 ureteral segments were mounted in an organ bath system and contractile response to methacholine (MCh) was assessed. Tamsulosin or nifedipine were added at cumulative concentrations (0.001-1 μM). The area under the curve (AUC) from isometric tension measurements was calculated. The effect of pharmacological agents and the respective controls were assessed by calculating the AUC for each 5-min interval. Statistical analyses were performed using the Mann-Whitney-Wilcoxon nonparametric test. Both drugs displayed statistically significant inhibitory activity at concentrations of 0.1 and 1 μM for tamsulosin and 1 μM for nifedipine when calculated as the AUC as compared to DMSO controls. Tamsulosin and nifedipine directly inhibit MCh-induced contractility of pregnant rat ureters. Further work is needed to determine the clinical efficacy of these medications for MET in pregnancy.

Radiological imaging of the kidney

Energy Technology Data Exchange (ETDEWEB)

Quaia, Emilio (ed.) [Trieste Univ. Ospedale di Cattinara (Italy). Ist. Radiologia

2011-07-01

This book provides a unique and comprehensive analysis of the normal anatomy and pathology of the kidney and upper urinary tract from the modern diagnostic imaging point of view. The first part is dedicated to the embryology and normal radiological anatomy of the kidney and anatomic variants. The second part presents in detail all of the imaging modalities which can be employed to assess the kidney and the upper urinary tract, including ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Patient preparation and investigation protocols are accurately described, and the principal fields of application of each imaging modality are clearly highlighted. The entire spectrum of kidney pathologies is then presented in a series of detailed chapters. Each pathology is illustrated by high-quality images obtained with state of the art equipment and the most advanced imaging modalities, as well as by figures showing macroscopic and microscopic specimens. The latest innovations in interventional radiology, biopsy procedures, and parametric and molecular imaging are also described, as is the relationship between contrast media and kidney function. This book will be of great interest to all radiologists, oncologists, and urologists who are involved in the management of kidney pathologies in their daily clinical practice. (orig.)

Radiological imaging of the kidney

International Nuclear Information System (INIS)

Quaia, Emilio

2011-01-01

This book provides a unique and comprehensive analysis of the normal anatomy and pathology of the kidney and upper urinary tract from the modern diagnostic imaging point of view. The first part is dedicated to the embryology and normal radiological anatomy of the kidney and anatomic variants. The second part presents in detail all of the imaging modalities which can be employed to assess the kidney and the upper urinary tract, including ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Patient preparation and investigation protocols are accurately described, and the principal fields of application of each imaging modality are clearly highlighted. The entire spectrum of kidney pathologies is then presented in a series of detailed chapters. Each pathology is illustrated by high-quality images obtained with state of the art equipment and the most advanced imaging modalities, as well as by figures showing macroscopic and microscopic specimens. The latest innovations in interventional radiology, biopsy procedures, and parametric and molecular imaging are also described, as is the relationship between contrast media and kidney function. This book will be of great interest to all radiologists, oncologists, and urologists who are involved in the management of kidney pathologies in their daily clinical practice. (orig.)

Potential Deleterious Effects of Vasopressin in Chronic Kidney Disease and Particularly Autosomal Dominant Polycystic Kidney Disease

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Meijer, E.; Boertien, W. E.; Zietse, R.; Gansevoort, R. T.

2011-01-01

The antidiuretic hormone vasopressin is crucial for regulating free water clearance in normal physiology. However, it has also been hypothesized that vasopressin has deleterious effects on the kidney. Vasopressin is elevated in animals and patients with chronic kidney disease. Suppression of

Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter

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Yu Miyama

2015-11-01

Full Text Available We report on a case of urothelial carcinoma (UC with lipid cell and micropapillary variants in the ureter. A 64-year-old man presented with gross hematuria. Urinary cytology revealed the presence of atypical urothelial cells. Computed tomography and drip infusion/retrograde pyelography identified a mass-occupying lesion in the left mid-ureter, as well as left hydronephrosis. A clinical diagnosis of left ureteral cancer was given and the patient underwent left nephroureterectomy. Microscopically, the major component of the tumor was a conventional high-grade UC. In the invasive region, however, lipid cell and micropapillary variants of UC were also observed. Upon immunohistochemical analysis, all of the components were diffusely positive for cytokeratin 7 and p53. Intense membranous expression of human epidermal growth factor receptor 2 (HER2 was also observed in both the lipid cell and micropapillary variants of UC, whereas weak and incomplete staining was observed in most regions of the conventional UC. The pathological stage was pT3 N2. Multiple times, the patient experienced recurrence of the UC in the urinary bladder and urethra. Although the patient underwent total cystectomy and urethrectomy, 52 months following the initial surgery, signs of local recurrence developed, as well as multiple lymph node and bone metastases. The patient died 75 months following the initial surgery. To the best of our knowledge, this is the first reported case of a lipid cell variant of ureteral UC. The overexpression of HER2 may be associated with both the lipid cell and micropapillary variants of UC.

Prenatal ultrasonographic findings of multicystic dysplastic kidney: Emphasis on cyst distribution

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Moon, Min Hoan; Cho, Jeong Yeon [Samsung Cheil Hospital, Sungkunkwan University school of Medicine, Seoul (Korea, Republic of)

2003-09-15

To characterize the ultrasonographic findings of multicystic dysplastic kidney on prenatal ultrasonography (US) with a special emphasis on the distribution of cysts. From January 1998 to March 2003, medical records of sixty two subjects with multicystic dysplastic kidney diagnosed on prenatal US examination were retrospectively reviewed, and forty three patients confirmed either by pathology or postnatal follow-up US were selected for this study. US assessment included the time of diagnosis, laterality, size of the multicystic dysplastic and contralateral normal kidneys, distribution of cysts and associated anomalies. The distribution of cysts was categorized as subcapsular and random distribution, and interobserver agreement was determined using the cross table analysis. The largest multicystic and contralateral normal longitudinal diameters were measured, and the data were plotted on the normal reference chart. Multicystic dysplastic kidney was left sided in 55.8%, right sided in 34.8% and bilateral in 9.3%. Subcapsular distribution of cysts was observed in 68.2% (n=15) for radiologist 1 while 59.1% (n=13) for radiologist 2, showing an excellent interobserver agreement (k=0.697). The longitudinal diameter of the multicystic dysplastic kidney was above 95 percentile in 68%. Meanwhile, the diameter of the contralateral normal kidney was more commonly normal, 70%. Fetal karyotyping was done in 18 cases including 2 cases with associated major anomalies, but karyotyping was all normal. On prenatal US, subcapsular distribution of cysts in multicystic dysplastic kidney is more common than random distribution. This characteristic distribution of cysts may be helpful in the prenatal diagnosis of multicystic dysplastic kidney.

Prenatal ultrasonographic findings of multicystic dysplastic kidney: Emphasis on cyst distribution

International Nuclear Information System (INIS)

Moon, Min Hoan; Cho, Jeong Yeon

2003-01-01

To characterize the ultrasonographic findings of multicystic dysplastic kidney on prenatal ultrasonography (US) with a special emphasis on the distribution of cysts. From January 1998 to March 2003, medical records of sixty two subjects with multicystic dysplastic kidney diagnosed on prenatal US examination were retrospectively reviewed, and forty three patients confirmed either by pathology or postnatal follow-up US were selected for this study. US assessment included the time of diagnosis, laterality, size of the multicystic dysplastic and contralateral normal kidneys, distribution of cysts and associated anomalies. The distribution of cysts was categorized as subcapsular and random distribution, and interobserver agreement was determined using the cross table analysis. The largest multicystic and contralateral normal longitudinal diameters were measured, and the data were plotted on the normal reference chart. Multicystic dysplastic kidney was left sided in 55.8%, right sided in 34.8% and bilateral in 9.3%. Subcapsular distribution of cysts was observed in 68.2% (n=15) for radiologist 1 while 59.1% (n=13) for radiologist 2, showing an excellent interobserver agreement (k=0.697). The longitudinal diameter of the multicystic dysplastic kidney was above 95 percentile in 68%. Meanwhile, the diameter of the contralateral normal kidney was more commonly normal, 70%. Fetal karyotyping was done in 18 cases including 2 cases with associated major anomalies, but karyotyping was all normal. On prenatal US, subcapsular distribution of cysts in multicystic dysplastic kidney is more common than random distribution. This characteristic distribution of cysts may be helpful in the prenatal diagnosis of multicystic dysplastic kidney.

Adenosine contribution to normal renal physiology and chronic kidney disease.

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Oyarzún, Carlos; Garrido, Wallys; Alarcón, Sebastián; Yáñez, Alejandro; Sobrevia, Luis; Quezada, Claudia; San Martín, Rody

2017-06-01

Adenosine is a nucleoside that is particularly interesting to many scientific and clinical communities as it has important physiological and pathophysiological roles in the kidney. The distribution of adenosine receptors has only recently been elucidated; therefore it is likely that more biological roles of this nucleoside will be unveiled in the near future. Since the discovery of the involvement of adenosine in renal vasoconstriction and regulation of local renin production, further evidence has shown that adenosine signaling is also involved in the tubuloglomerular feedback mechanism, sodium reabsorption and the adaptive response to acute insults, such as ischemia. However, the most interesting finding was the increased adenosine levels in chronic kidney diseases such as diabetic nephropathy and also in non-diabetic animal models of renal fibrosis. When adenosine is chronically increased its signaling via the adenosine receptors may change, switching to a state that induces renal damage and produces phenotypic changes in resident cells. This review discusses the physiological and pathophysiological roles of adenosine and pays special attention to the mechanisms associated with switching homeostatic nucleoside levels to increased adenosine production in kidneys affected by CKD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Detection of recurrent transmission of 17q12 microdeletion by array comparative genomic hybridization in a fetus with prenatally diagnosed hydronephrosis, hydroureter, and multicystic kidney, and variable clinical spectrum in the family.

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Chen, Chih-Ping; Chang, Shuenn-Dyh; Wang, Tzu-Hao; Wang, Liang-Kai; Tsai, Jeng-Daw; Liu, Yu-Peng; Chern, Schu-Rern; Wu, Peih-Shan; Su, Jun-Wei; Chen, Yu-Ting; Wang, Wayseen

2013-12-01

This study was aimed at detection of recurrent transmission of the 17q12 microdeletion in a fetus with congenital anomalies of the kidney and urinary tract. A 35-year-old woman was referred to the hospital at 20 weeks' gestation because of hydronephrosis in the fetus. The mother was normal and healthy. Her second child was a girl who had bilateral dysplastic kidneys that required hemodialysis, and died at the age of 5 years. During this pregnancy, the woman underwent amniocentesis at 18 weeks' gestation because of advanced maternal age. Cytogenetic analysis revealed a karyotype of 46,XY. Prenatal ultrasound showed left hydronephrosis with a tortuous ureter, right hydronephrosis, and increased echogenicity of the kidneys. Fetal magnetic resonance imaging showed right dilated renal calyces, left hydronephrosis, hydroureter, and multicystic kidney. The pregnancy was subsequently terminated. Array comparative genomic hybridization (aCGH) and fluorescence in situ hybridization were applied for genetic analysis using umbilical cord, maternal blood, and cultured amniocytes. aCGH analysis on umbilical cord detected a 1.75-Mb deletion at 17q12 including haploinsufficiency of LHX1 and HNF1B. aCGH analysis on maternal blood detected a 1.54-Mb deletion at 17q12 including haploinsufficiency of LHX1 and HNF1B. Metaphase fluorescence in situ hybridization analysis on cultured amniocytes and maternal blood lymphocytes using 17q12-specific bacterial artificial chromosome probe showed 17q12 microdeletion in the fetus and the mother. Prenatal diagnosis of recurrent renal and urinary tract abnormalities in the fetus should include a differential diagnosis of familial 17q12 microdeletion. Copyright © 2013. Published by Elsevier B.V.

The first report of 3 forgotten encrusted double J stents in the same ureter: An endourology nightmare!

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Ahmed Adam

2017-09-01

Conclusion: The first report of 3 encrusted stents within the same ureter is presented. The prevention of JJ stent encrustation is crucial via adequate and appropriate patient counselling. In most patients with forgotten encrusted stents who qualify for endoscopic management, a multi-modality approach is required.

Bilateral s-shaped kidneys: A rare congenital malformation

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Nikhil Ranjan

2015-01-01

Full Text Available A bilateral S-shaped kidney is a rare anomaly in which both the kidneys are in their normal position, in contrast to the commonly reported S-shaped fusion anomaly, in which the contralateral kidney crosses the midline to fuse with opposite kidney leaving the ipsilateral renal fossa empty. Here we present the diagnosis and management of a case of bilateral S-shaped renal anomaly with associated left pelviureteric junction obstruction and nonfunctioning kidney and right renal stones. Left kidney was managed by open nephrectomy and right kidney by PNL.

A decreased soluble Klotho level with normal eGFR, FGF23, serum phosphate, and FEP in an ADPKD patient with enlarged kidneys due to multiple cysts.

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Kanai, Takahiro; Shiizaki, Kazuhiro; Betsui, Hiroyuki; Aoyagi, Jun; Yamagata, Takanori

2018-05-16

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder. ADPKD is characterized clinically by the presence of multiple bilateral renal cysts that lead to chronic renal failure. The cysts evolve from renal tubular epithelial cells that express the Klotho gene. Notably, Klotho acts as a co-receptor for fibroblast growth factor 23 (FGF23); in this context, it induces phosphaturia and maintains serum phosphate at a normal level. Many reports have shown that decreases in the soluble Klotho level and increases in the FGF23 level are associated with glomerular filtration rate (GFR) decline, but a recent study observed these changes in patient with normal eGFR. It remains unclear whether the decrease in the Klotho level precedes the increase in FGF23. Here, we present an ADPKD patient with enlarged kidneys due to multiple cysts who had a decreased soluble Klotho level but a normal eGFR and a normal FGF23 level. The patient's serum phosphate level was normal, as was the fractional excretion of phosphate (FEP). This appears to be the first reported case to show a decreased soluble Klotho level plus normal eGFR, FGF23, and FEP. These results suggest that Klotho decreases before FGF23 increases and further suggest that Klotho is not required to maintain normal serum phosphate levels in ADPKD if the FEP and serum phosphate levels are normal.

Short-term Results of Retrograde Intrarenal Surgery in the Management of Kidney Stones in Children: A Safe and Efficacious Procedure

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Emrah Yürük

2015-03-01

Full Text Available Aim: To demonstrate the feasibility of retrograde intrarenal surgery (RIRS in pediatric age group. Methods: Data of patients who underwent RIRS for the treatment of kidney stones were retrospectively analyzed. The procedure was performed using 7.5 Fr FlexX™ 2 flexible ureterorenoscope in all patients. Ureteral access sheath was not used in any patients. A double-j stent was inserted and the procedure was delayed for 2 weeks whenever access to the ureter was not possible. The stones were fragmented using laser and fragments smaller than 2 mm were left for spontaneous passage. Postoperative success was evaluated using ultrasonography and kidney, ureter and bladder (KUB x-ray. Results: 14 patients with a mean age of 7.5±2.47 (range: 3-12 years were included. Male to female ratio was 8/6 and six patients had a stone on the right side. The mean stone size was 12.3±3.49 (range: 8-20 mm. Of the patients, 10 had a history of unsuccessful shock wave lithotripsy (SWL treatment. Mean operation and fluoroscopy screening times were 33.5±6.9 (range: 25-45 and 45.3±15.4 (range: 30-75 minutes, respectively. The median hospital stay was 1.07±0.2 (range: 1-2 days. No major complications were noticed during the operation. Double-J stents were removed on the 2nd postoperative week and all patients were stone-free during the follow-up. Conclusion: RIRS can be performed safely and efficaciously in pediatric patients. (The Medical Bulletin of Haseki 2015; 53:52-6

Tissue-specific expression of transgenic secreted ACE in vasculature can restore normal kidney functions, but not blood pressure, of Ace-/- mice.

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Saurabh Chattopadhyay

Full Text Available Angiotensin-converting enzyme (ACE regulates normal blood pressure and fluid homeostasis through its action in the renin-angiotensin-system (RAS. Ace-/- mice are smaller in size, have low blood pressure and defective kidney structure and functions. All of these defects are cured by transgenic expression of somatic ACE (sACE in vascular endothelial cells of Ace-/- mice. sACE is expressed on the surface of vascular endothelial cells and undergoes a natural cleavage secretion process to generate a soluble form in the body fluids. Both the tissue-bound and the soluble forms of ACE are enzymatically active, and generate the vasoactive octapeptide Angiotensin II (Ang II with equal efficiency. To assess the relative physiological roles of the secreted and the cell-bound forms of ACE, we expressed, in the vascular endothelial cells of Ace-/- mice, the ectodomain of sACE, which corresponded to only the secreted form of ACE. Our results demonstrated that the secreted form of ACE could normalize kidney functions and RAS integrity, growth and development of Ace-/- mice, but not their blood pressure. This study clearly demonstrates that the secreted form of ACE cannot replace the tissue-bound ACE for maintaining normal blood pressure; a suitable balance between the tissue-bound and the soluble forms of ACE is essential for maintaining all physiological functions of ACE.

Tissue-specific expression of transgenic secreted ACE in vasculature can restore normal kidney functions, but not blood pressure, of Ace-/- mice.

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Chattopadhyay, Saurabh; Kessler, Sean P; Colucci, Juliana Almada; Yamashita, Michifumi; Senanayake, Preenie deS; Sen, Ganes C

2014-01-01

Angiotensin-converting enzyme (ACE) regulates normal blood pressure and fluid homeostasis through its action in the renin-angiotensin-system (RAS). Ace-/- mice are smaller in size, have low blood pressure and defective kidney structure and functions. All of these defects are cured by transgenic expression of somatic ACE (sACE) in vascular endothelial cells of Ace-/- mice. sACE is expressed on the surface of vascular endothelial cells and undergoes a natural cleavage secretion process to generate a soluble form in the body fluids. Both the tissue-bound and the soluble forms of ACE are enzymatically active, and generate the vasoactive octapeptide Angiotensin II (Ang II) with equal efficiency. To assess the relative physiological roles of the secreted and the cell-bound forms of ACE, we expressed, in the vascular endothelial cells of Ace-/- mice, the ectodomain of sACE, which corresponded to only the secreted form of ACE. Our results demonstrated that the secreted form of ACE could normalize kidney functions and RAS integrity, growth and development of Ace-/- mice, but not their blood pressure. This study clearly demonstrates that the secreted form of ACE cannot replace the tissue-bound ACE for maintaining normal blood pressure; a suitable balance between the tissue-bound and the soluble forms of ACE is essential for maintaining all physiological functions of ACE.

Better recovery of kidney function in patients with de novo chronic kidney disease after partial nephrectomy compared with those with pre-existing chronic kidney disease.

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Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Hashimoto, Yasunobu; Yoshida, Kazuhiko; Tanabe, Kazunari

2014-06-01

We compared kidney functional recovery between patients with pre-existing chronic kidney disease, those with de novo chronic kidney disease and those with normal kidney function, after partial nephrectomy. A total of 311 patients who underwent partial nephrectomy at Tokyo Women's Medical University Hospital, Tokyo, Japan, between January 2004 and July 2011 with sufficient kidney functional data participated in the study. Patients with pre-existing chronic kidney disease (group1: 78 patients) were defined as those with estimated glomerular filtration rate under 60 mL/min/m(2) before partial nephrectomy. Patients with de novo chronic kidney disease (group 2: 49) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) before surgery and who developed estimated glomerular filtration rate under 60 mL/min/m(2) 3 months after partial nephrectomy. Normal patients (group 3: 184) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) both before and after partial nephrectomy. Group 1 was associated with older age and higher comorbidity, including hypertension and diabetes mellitus, compared with other groups. R.E.N.A.L. score was not significantly different between the groups. Although the percent change of estimated glomerular filtration rate between the preoperative period and 3 months after partial nephrectomy in group 2 was significantly decreased compared with that in other groups (group 1: -6.8%, group 2: -18%, group 3: -7.3%), the renal functional recovery between 3 and 12 months after partial nephrectomy in group 2 was better than that in other groups (group 1: -0.5%, group 2: 5.6%, group 3: -0.4%). Patients with de novo chronic kidney disease had better kidney functional recovery than the other two groups, which might suggest that they were surgically assaulted and developed chronic kidney disease in the early postoperative period, and were essentially different from those with pre-existing chronic kidney

Functional evaluation of the kidney by diffusion-weighted MR imaging

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Hasegawa, Taro; Hasegawa, Norio; Irie, Takeo; Fukuda, Kunihiko

2003-01-01

The purpose of this study was to determine the relationship between the apparent diffusion coefficient (ADC) and diffuse renal disease by diffusion-weighted echo planar magnetic resonance (MR) imaging (EPI). Ten volunteers, seven patients with chronic renal failure and eighteen recipients of renal transplants were examined with diffusion-weighted EPI. We compared renal function (serum creatinine level) with provided ADC value. The average ADC values were 2.63 x 10 -3 mm 2 /sec for the whole kidney, 2.67 x 10 -3 mm 2 /sec for the cortex and 2.61 x 10 -3 mm 2 /sec for the medulla in normal kidneys. ADC values in the whole kidney, the cortex and the medulla in chronic renal failure were significantly lower than those for normal kidneys. In renal transplantation kidneys, the ADC values in the cortex were significantly lower than those for normal kidney. There was a linear correlation between ADC value and serum creatinine level. Our results show that diffusion-weighted MR imaging may be useful to identify renal dysfunction. (author)

Parietal podocytes in normal human glomeruli.

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Bariety, Jean; Mandet, Chantal; Hill, Gary S; Bruneval, Patrick

2006-10-01

Although parietal podocytes along the Bowman's capsule have been described by electron microscopy in the normal human kidney, their molecular composition remains unknown. Ten human normal kidneys that were removed for cancer were assessed for the presence and the extent of parietal podocytes along the Bowman's capsule. The expression of podocyte-specific proteins (podocalyxin, glomerular epithelial protein-1, podocin, nephrin, synaptopodin, and alpha-actinin-4), podocyte synthesized proteins (vascular endothelial growth factor and novH), transcription factors (WT1 and PAX2), cyclin-dependent kinase inhibitor p57, and intermediate filaments (cytokeratins and vimentin) was tested. In addition, six normal fetal kidneys were studied to track the ontogeny of parietal podocytes. The podocyte protein labeling detected parietal podocytes in all of the kidneys, was found in 76.6% on average of Bowman's capsule sections, and was prominent at the vascular pole. WT1 and p57 were expressed in some parietal cells, whereas PAX2 was present in all or most of them, so some parietal cells coexpressed WT1 and PAX2. Furthermore, parietal podocytes coexpressed WT1 and podocyte proteins. Cytokeratin-positive cells covered a variable part of the capsule and did not express podocyte proteins. Tuft-capsular podocyte bridges were present in 15.5 +/- 3.7% of the glomerular sections. Parietal podocytes often covered the juxtaglomerular arterioles and were present within the extraglomerular mesangium. Parietal podocytes were present in fetal kidneys. Parietal podocytes that express the same epitopes as visceral podocytes do exist along Bowman's capsule in the normal adult kidney. They are a constitutive cell type of the Bowman's capsule. Therefore, their role in physiology and pathology should be investigated.

Immunocytochemical localization of estrogen receptors in the normal male and female canine urinary tract and prostate

International Nuclear Information System (INIS)

Schulze, H.; Barrack, E.R.

1987-01-01

We have used the monoclonal estrogen receptor (ER) antibody H222Sp gamma to localize ER by immunocytochemistry in frozen sections of the normal canine urinary tract of both sexes and of the normal prostate of the male. Striking regional heterogeneity of ER location was observed. In the urinary tract, specific ER staining was confined to nuclei of the transitional epithelium (mucosa) and subjacent stroma (submucosa) of the prostatic urethra in the male dog and of the proximal urethra in the female dog. In both sexes there was a gradient of ER staining intensity along these urethral segments. In the male, ER staining intensity was highest in the region of the verumontanum. The pattern and intensity of staining were similar in the male prostatic urethra and female proximal urethra, indicating a similar concentration of ER in these tissues, which have the same embryological origin. No specific staining was found in the kidney, ureter, bladder, or distal urethra of either sex. In the normal prostate, specific immunocytochemical ER staining was confined to nuclei of the prostatic stroma and prostatic ductal epithelium. Specific staining intensity appeared to be higher in the periurethral region of the prostate than in the periphery. No specific staining was found in the acinar epithelium of the prostate. Based on overall staining intensity there appeared to be a higher concentration of ER in the urethra than in the prostate. Scatchard analysis of [ 3 H]estradiol binding confirmed a similar ER content in the urethra of male and female dogs and a higher ER content in the prostatic urethra than in the prostate itself (P less than 0.001)

A case of retrocaval ureter diagnosed by CT scan combined with a ureteral catheter

International Nuclear Information System (INIS)

Matsumoto, Atsushi; Iio, Shozo; Toyama, Takashi; Mochizuki, Teruichi

1986-01-01

The patient was a 45-year-old male who was admitted for right flank pain, nausea and vomitting. IVP revealed right hydronephrosis and hydroureter with medial distortion at the level of the 3rd lumbar spine. The diagnosis of retrocaval ureter was made with CT scan combined with a ureteral catheter. End to end anastomosis after resection of the retrocaval segment was performed. IVP 21 days after the operation showed that the right hydroureteronephrosis had moderately improved. (author)

Medline Plus

Full Text Available ... the kidney and enters the ureter. As urine can become very concentrated as it passes through the ... salts and other chemicals dissolved in the urine can crystallize, forming a kidney stone (renal calculus). Usually ...

Urinary Tract Infections (For Kids)

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Full Text Available ... system made up of these main parts: two kidneys two ureters (say: YUR-uh-turz) bladder urethra (say: yoo-REE-thruh) All day long, the kidneys clean waste products from your blood. The waste ...

Residual kidney function after donor nephrectomy. Assessment by 99mTc-MAG3-Clearance

International Nuclear Information System (INIS)

Hamscho, N.; Doebert, N.; Menzel, C.; Berner, U.; Zaplatnikov, K.; Gruenwald, F.; Wilhelm, A.; Gossmann, J.; Scheuermann, E.H.

2005-01-01

Aim: We evaluated the long-term residual renal function after donor nephrectomy using 99m Tc-mercaptoacetyltriglycin (MAG3)-clearance. Donors, methods: Altogether 49 kidney donors were examined using 99m Tc-MAG3-clearance after nephrectomy for donation to a relative (m:f=11.38; age 55±27 years). The donors were examined 16±8 years postoperatively (1.5-26 years). 42 donors (86%) showed normal creatinine values, whereas the other seven (14%) exhibited slightly elevated levels. 20 donors were examined pre- and postoperatively and compared intraindividually. The kidney function was compared to the age adapted normal values of healthy persons with two kidneys (67-133% of age related mean). Results: After nephrectomy all donors showed a normal perfusion, good secretion, merely physiological intrarenal transit and a normal elimination from the kidneys. The 99m Tc-MAG3-clearance was 69±15% of the normal mean value of healthy carriers of two kidneys regardless of the gender. 20 donors with a preoperative examination showed a significantly reduced total renal function from 84±15% of the mean normal value preoperatively to 60±15% postoperatively (p 99m Tc-MAG3-clearance measured prior to nephrectomy and the clearance levels after nephrectomy. Also, no correlation between the preoperative 99m Tc-MAG3-clearance and the postoperative serum creatinine values could be observed. Althogether, 22% of the donors (11/49) developed arterial hypertension 10±8 years after donation (1-23 years). This corresponds to the normal age prevalence of hypertension in the carriers of two kidneys. Three donors suffered from arterial hypertension prior to the operation. Conclusion: Kidney donors with normal or slightly elevated creatinine values postoperatively show a 99m Tc-MAG3 clearance value of 69% of the mean value of healthy carriers of two kidneys. This may serve as a reference value for healthy carriers of one kidney. In our study we demonstrated a good compensation of the contralateral

Ureterocolonic anastomosis in clinically normal dogs

International Nuclear Information System (INIS)

Stone, E.A.; Walter, M.C.; Goldschmidt, M.H.; Biery, D.N.; Bovee, K.C.

1988-01-01

Ureterocolonic anastomosis was evaluated in 13 clinically normal dogs. Urinary continence was maintained after surgery, and the procedure was completed without technique errors in all but 2 dogs. Three dogs died within 5 weeks (2 of undetermined causes and 1 of aspiration pneumonia and neurologic disease), and 1 dog was euthanatized 4 months after surgery because of neurologic signs. Two healthy dogs were euthanatized 3 months after surgery for light microscopic evaluation of their kidneys. Five dogs were euthanatized 6 months after surgery for light microscopic evaluation of their kidneys. Gastrointestinal and neurologic disturbances developed in 4 dogs at various postoperative intervals. Plasma ammonia concentration measured in 2 dogs with neurologic signs was increased. Plasma ammonia concentration measured in 5 dogs without neurologic signs was within normal limits. All 5 dogs, in which metabolic acidosis was diagnosed, had high normal or above normal serum chloride concentration. Serum urea nitrogen values were increased after surgery because of colonic absorption of urea. Serum creatinine concentration was increased in 1 dog 6 months after surgery. Individual kidney glomerular filtration rate was reduced in 38% (3/8) of the kidneys from 4 other dogs at 6 months after surgery. Of 5 dogs euthanatized at 3 to 4 months after surgery, 4 had bilateral pyelitis, and 1 had unilateral pyelonephritis. Six months after surgery, pyelonephritis was diagnosed in 40% (4/10) of the kidneys from 5 dogs. The ureterocolonic anastomosis procedure is a salvage procedure that should allow complete cystectomy. However, variable degress of metabolic acidosis, hyperammonemia, and neurologic disease may result

Evaluation of the Cytotoxic Effects of CAM Therapies: An In Vitro Study in Normal Kidney Cell Lines

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Shagun Arora

2014-01-01

Full Text Available The purpose of this current study was to justify the incorporation of complementary and alternate medicine (CAM in current cancer treatments. The major drawback of anticancer drugs is their nonselective killing, which ultimately leads to attrition of normal cells. Keeping this as the foundation of our study, we made an effort to compare the cytotoxicity associated with a known chemotherapeutic drug 5-Fluorouracil (5-FU, with certain CAM therapies previously reported to have anticancer activity. The parameters chosen for the study were based on antiproliferative and cytotoxic effects on normal, kidney epithelial cells (NRK-52E. The MTT assay, colony formation assay, DNA fragmentation, and differential staining using AO/EB, following treatment with either 5-FU or CAM therapies, were performed. The CAM therapies under study were various extracts of wheatgrass, roots of Achyranthes aspera (AA, mushroom extracts (Pleurotus ostreatus, Macrolepiota procera, and Auricularia polytricha, and a homeopathic drug, Ruta graveolens (Ruta. The results showed that treatment of normal cells with the CAM therapies led to minimum cell damage in comparison to 5-FU. This evidence-based study will lead to greater acceptance of alternative therapies against cancer.

Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review

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Shashi Alok

2013-12-01

Full Text Available Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review

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Alok, Shashi; Jain, Sanjay Kumar; Verma, Amita; Kumar, Mayank; Sabharwal, Monika

2013-01-01

Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

Diffusion-weighted MR imaging of kidneys in renal artery stenosis

International Nuclear Information System (INIS)

Yildirim, Erkan; Kirbas, Ismail; Teksam, Mehmet; Karadeli, Elif; Gullu, Hakan; Ozer, Ismail

2008-01-01

Objective: The purpose of our study was to evaluate perfusion and diffusion of kidneys in renal artery stenosis (RAS) and any correlation between stenosis and ADC values and whether this imaging modality may be a noninvasive complementary assessment technique to MR angiography before interventional procedures. Materials and methods: Twenty consecutive patients suspected of having renal artery stenosis were evaluated with renal MR angiography to exclude stenosis and were then included in the study. Transverse DW multisection echo-planar MR imaging was performed. In the transverse ADC map, rectangular regions of interest were placed in the cortex on 3 parts (upper, middle, and lower poles) in each kidney. ADCs of the kidneys were calculated separately for the low, average, and high b-values to enable differentiation of the relative influence of the perfusion fraction and true diffusion. The ADC values of 39 kidneys (13 with renal artery stenosis and 26 normal renal arteries) were compared, and the relationship between stenosis degree and ADC values was calculated. Results: RAS was detected in 11 of 20 (55%) patients with MRA. Thirteen of 39 kidneys demonstrated RAS, and 26 were normal. The ADC low (1.9 ± 0.2 versus 2.1 ± 0.2; P = .020), ADC average (1.7 ± 0.2 versus 1.9 ± 0.1; P = .006), and ADC high (1.8 ± 0.2 versus 2.0 ± 0.1; P = .012) values were significantly lower in patients with kidneys with arterial stenosis than that in patients with kidneys with normal arteries. Statistical analysis revealed that stenosis degree correlated strongly with ADC low (r = -.819; P = .001), ADC average (r = -.754; P = .003), and ADC high (r = -.788; P = .001). The ADC low , ADC average , and ADC high values were significantly lower in patients with kidneys with arterial stenosis than that in patients with kidneys with normal arteries. Conclusion: We think that DW MR imaging of kidneys with RAS can help determine the functional status of a renal artery stenosis

PHOSPHATE METABOLISM IN KIDNEY DONORS: A CROSS-SECTIONAL STUDY

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Jayakumar Edathedathe

2016-05-01

Full Text Available AIM To study the changes in phosphate metabolism in kidney donors, to study the correlation of albuminuria, fractional excretion of phosphorus [FE Pi] and estimated glomerular filtration rate [eGFR] with fibroblast growth factor 23 [FGF 23] in kidney donors, to study the early tubule interstitial injury in the remnant kidney of donors by measuring urine transforming growth factor beta [TGF beta] levels. MATERIALS AND METHODS A cross-sectional study in which kidney donors with 1 year or more after donation were included. 69 kidney donors with a mean duration of 5.86 years after kidney donation were studied. Serum phosphate level, fractional excretion of phosphorus [FE Pi] and serum levels of parathyroid hormone were measured. Plasma levels of FGF 23 were measured by a second generation enzyme linked immune sorbent assay [ELISA]. Renal function was assessed by estimated glomerular filtration rate [eGFR] and degree of albuminuria. Urine levels of transforming growth factor beta [TGF beta] were measured by ELISA. A hypothesis that in kidney donors with reduced nephron number, the single nephron excretion of phosphorus will be increased to maintain normal phosphorus homeostasis and that this increase in single nephron phosphorus excretion may be mediated by FGF 23 was proposed. Testing of this hypothesis was done by studying the correlation between parameters of phosphorus metabolism, FGF 23 and the renal function of the donors. RESULTS The mean eGFR was 70.36 mL/min/1.73 m2 . 52.2% of donors had moderate increase in albuminuria [microalbuminuria], Serum phosphorus, fractional excretion of phosphorus and serum PTH levels were in the normal range. FGF 23 levels were in the normal reference range and showed no correlation with FE pi, eGFR or albuminuria, Urine TGF-beta levels were undetectable in all the donors. DISCUSSION Normal phosphorus homeostasis is maintained in kidney donors. There was no correlation between FE pi and FGF 23 levels. Kidney

Radiographic evaluation of experimentally induced nephrosis in goats

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Kumar, R.; Pandey, N. N.; Singh, G. R.; Setia, H. C. [Indian Veterinary Research Institute, Izatnagar (India)

1995-06-15

Intravenous pyelography (IVP) with pneumoperitoneum (PP) was undertaken in normal and induced nephrotic goats. In normal goats, the technique provided visualization of both the kidneys, renal pelvis, ureter and urinary bladder at 10 min post-administration of sodium iothalamate (70%). In mercuric chloride- and oxytetracycline-induced nephrosis in goats, the urinary tract could not be visualized even 60 min post-administration of dye indicating sever failure of renal excretory function. However, in gentamicin-abused goats, renal excretory function was not significantly altered owing to a very mild renal damage. It was concluded that IVP with PP could be a dependable diagnostic test for varied degree of renal insufficiency in ruminants.

Radiographic evaluation of experimentally induced nephrosis in goats

International Nuclear Information System (INIS)

Kumar, R.; Pandey, N.N.; Singh, G.R.; Setia, H.C.

1995-01-01

Intravenous pyelography (IVP) with pneumoperitoneum (PP) was undertaken in normal and induced nephrotic goats. In normal goats, the technique provided visualization of both the kidneys, renal pelvis, ureter and urinary bladder at 10 min post-administration of sodium iothalamate (70%). In mercuric chloride- and oxytetracycline-induced nephrosis in goats, the urinary tract could not be visualized even 60 min post-administration of dye indicating sever failure of renal excretory function. However, in gentamicin-abused goats, renal excretory function was not significantly altered owing to a very mild renal damage. It was concluded that IVP with PP could be a dependable diagnostic test for varied degree of renal insufficiency in ruminants

Renal morphology and function immediately after extracorporeal shock-wave lithotripsy

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Kaude, J.V.; Williams, C.M.; Millner, M.R.; Scott, K.N.; Finlayson, B.

1985-08-01

The acute effects of extracorporeal shock-wave lithotripsy (ESWL) on morphology and function of the kidney were evaluated by excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in 33 consecutive patients. Excretory urograms demonstrated an enlarged kidney in seven (18%) of 41 treatments and partial or complete obstruction of the ureter by stone fragments after 15 (37%) of 41 treatments. Total effective renal plasma flow (ERPF) was not changed after ESWL, but the percentage ERPF of the treated kidney was decreased by more than 5% in 10 (30%) of 33 cases. QRR images showed partial parenchymal obstruction in 10 (25%) of 41 teated kidneys and total parenchymal obstruction in 9 (22%). MRI disclosed one or more abnormalities in 24 (63%) of 38 treated kidneys. Treated kidneys were normal by all three imaging methods in 26% and abnormal by one or more tests in 74% of cases. The morphologic and functional changes are attributed to renal contusion resulting in edema and extravasation of urine and blood into the interstitial, subcapsular, and perirenal spaces.

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Full Text Available The urinary tract includes the kidneys, ureters, bladder and urethra. Within each kidney, urine flows from the outer cortex to ... from a stone being stuck anywhere along the urinary tract. Fortunately, small stones typically pass out of the ...

Expression of tumor necrosis factor receptor-associated protein 1 and its clinical significance in kidney cancer.

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Si, Tong; Yang, Guosheng; Qiu, Xiaofu; Luo, Youhua; Liu, Baichuan; Wang, Bingwei

2015-01-01

To investigate the expression and clinical significance of TRAP1 (tumor necrosis factor receptor-associated protein 1) in kidney cancer. TRAP1 expression was detected in kidney cancer and normal kidney tissues by qRT-PCR and immunohistochemistry (IHC), respectively. Then, the correlation of TRAP1 expression with clinicopathological characters and patients' prognosis was evaluated in kidney cancer. IHC results revealed that the high-expression rates of TRAP1 in kidney cancer tissues and normal kidney tissues were 51.3% (41/80), 23.3% (7/30), and the difference was statistically significant (P=0.01). Also, TRAP1 mRNA level in kidney cancer was found to be significantly greater compared with those in normal kidney by qRT-PCR. In addition, TRAP1 expression in kidney cancer significantly correlated with lymph node metastasis and clinical stage (Pkidney cancer and correlates with patients prognosis, which may be served as a potential marker for the diagnosis and treatment of kidney cancer.

[Fibroepithelial polyp of the ureter. Report of one case].

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Morales, Raúl; Manrique, Eduardo; Casanova, Rubén; Molina, Pedro; Falcón, Ramón

2004-05-01

To report the rare case of a patient with a ureteral polyp. We describe the case of a 55-year-old female patient receiving care at the Celia Sanchez Manduley University Hospital in Manzanillo, Cuba, who was fortuitously diagnosed of a fibroepithelial polyp of the right ureter during the work up and treatment of an ovarian tumor. This case is the first of its kind in this hospital after 22 years, which confirms the rarity of ureteral tumors, specifically those of benign etiology. The absence of symptoms, specifically hematuria and pain, does not correspond to the reviewed articles. The chosen treatment was exeresis of the polyp at its base and frozen biopsy, followed by re-establishment of the urinary passage, as various authors recommend. Currently the endoscopical approach is recommended for its multiple advantages. We conclude that this disease is very rare, may have a symptomatic course and the treatment of choice is surgery with very good results.

High serum bicarbonate level within the normal range prevents the progression of chronic kidney disease in elderly chronic kidney disease patients

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Kanda Eiichiro

2013-01-01

Full Text Available Abstract Background Metabolic acidosis leads to chronic kidney disease (CKD progression. The guidelines recommend a lower limit of serum bicarbonate level, but no upper limit. For serum bicarbonate level to be clinically useful as a therapeutic target marker, it is necessary to investigate the target serum bicarbonate level within the normal range to prevent CKD progression. Methods One hundred and thirteen elderly CKD patients, whose serum bicarbonate level was controlled within the normal range, were enrolled in this retrospective cohort study in Ibaraki, Japan. Outcome was defined as a decrease of 25% or more in estimated glomerular filtration rate (eGFR or starting dialysis. We used Cox proportional hazard models adjusted for patients’ characteristics to examine the association between serum bicarbonate level and the outcome. Results Female patients were 36.3%: average age (SD, 70.4 (6.6 years; eGFR, 25.7 (13.6 ml/min/1.73 m2; serum bicarbonate level, 27.4 (3.2 mEq/l. Patients with the lowest quartile of serum bicarbonate levels [23.4 (1.8 mEq/l] showed a high risk of CKD progression compared with patients with high serum bicarbonate levels [28.8 (2.3 mEq/l]: adjusted hazard ratio (HR, 3.511 (95% CI, 1.342-9.186. A 1 mEq/l increase in serum bicarbonate level was associated with a low risk of CKD progression: adjusted HR, 0.791 [95% confidence interval (CI, 0.684-0.914]. Conclusions In elderly CKD patients, our findings suggest that serum bicarbonate level is independently associated with CKD progression, and that a high serum bicarbonate level is associated with a low risk of CKD progression. A high target serum bicarbonate level within the normal range may be effective for preventing CKD progression.

Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

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Wang, Zhen J.; Daldrup-Link, Heike; Coakley, Fergus V.; Yeh, Benjamin M. [University of California, San Francisco (United States). Department of Radiology

2010-03-15

Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning. (orig.)

Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

International Nuclear Information System (INIS)

Wang, Zhen J.; Daldrup-Link, Heike; Coakley, Fergus V.; Yeh, Benjamin M.

2010-01-01

Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning. (orig.)

Bilateral Supernumerary Kidney: A Very Rare Presentation

International Nuclear Information System (INIS)

Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Firat Ozcan, Irfan

2014-01-01

To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys

The valuation of 99Tcm-DMSA renal cortical scintigraphy for prediction of renal scarring in children with acute pyelonephritis

International Nuclear Information System (INIS)

Zhao Ruifang; Ji Zhiying; Lv Xiaomei; Wu Ha; Li Yiwei; Gu Fanlei; Zhao Xiaofei

2009-01-01

Objective: Acute pyelonephritis (APN) is a common infectious disease in childhood. APN may result in ineversible renal scarring. 99 Tc m -dimercaptsuccinic (DMSA) renal cortical scintigraphy was reported to be highly sensitive and specific for detection APN and renal scarring. The aim of this study was to determine the incidence of renal scarring in a group of children with APN and to evaluate the relative factors at risk of scarring using 99 Tc m -DMSA renal cortical scintigraphy. Methods: One hundred and eighteen patients (44 males, 74 females, age range: 1 month to 14 years) with APN underwent DMSA renal cortical scan before treatment and six month after treatment to identify renal damage and renal scarring. The degree of renal damage was divided to grade I to IV. A directed radionuclide cystography (DRC) was performed in 72 cases to evaluate vesicoureteric reflux (VUR). Statistical analysis between all those relative factors was performed using Spearman grading relational analysis. The software was SPSS 11.5. Results: The follow-up renal cortical scan revealed that 79 normal kidneys on first scan remained normal; of 64 kidneys with grade I damage, 7.81% (5/64) developed renal scar; of 51 kidneys with grade II, 49.02% (25/51) developed renal scar; of 19 with grade III, 68.42% (13/19) developed renal scar; of 23 with grade IV, 100.00% (23/23) developed renal scar. There was a significant relationship between the incidence of renal scar on follow-up and the grade of renal damage on first scan (r=0.877, P<0.01). VUR was found in 54.17% (78/144) per renal unit. Only 4.55% (3/66) of those with non-refluxing ureters developed renal scars on follow-up. One of four patients with mild-refluxing ureters developed renal scars. 46.51% (20/43) of those with moderate-refluxing ureters developed renal scars. 87.10% (27/31) of those with severe-refluxing ureters developed renal scars. There was a significant relationship between the incidence of renal scarring in follow-up and

Renal dysplasia with single system ectopic ureter: Diagnosis using magnetic resonance urography and management with laparoscopic nephroureterectomy in pediatric age

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Milind Joshi

2009-01-01

Conclusion : Single system ectopic ureter associated with congenital renal dysplasia is exceedingly rare. MRU is definitely the better investigation for the diagnosis of this condition as compared to the conventional radiological investigations. Laparoscopic nephroureterectomy is a very good procedure for the management of these cases.

Validation of a novel cost effective easy to produce and durable in vitro model for kidney-puncture and PNL-Simulation.

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Klein, Jan Thorsten; Rassweiler, Jens; Rassweiler-Seyfried, Marie-Claire Charlotte

2018-03-29

Nephrolithiasis is one of the most common diseases in urology. According to the EAU Guidelines, a percutaneous nephrolitholapaxy (PNL) is recommended when treating a kidney stone >2 cm. Nowadays PNL is performed even for smaller stones (PNL is the puncture of the planned site. PNL-novice surgeons need to practice this step in a safe environment with an ideal training model. We developed and evaluated a new, easy to produce, in-vitro model for the training of the freehand puncture of the kidney. Porcine kidneys with ureters were embedded in ballistic gel. Food coloring and preservative agent were added. We used the standard imaging modalities of X-ray and ultrasound to validate the training model. An additional new technique, the iPAD guided puncture, was evaluated. Five novices and three experts conducted 12 punctures for each imaging technique. Puncture time, radiation dose, and number of attempts to a successful puncture were measured. Mann-Whitney-U, Kruskal-Wallis, and U-Tests were used for statistical analyses. The sonographic guided puncture is slightly but not significantly faster than the fluoroscopic guided puncture and the iPAD assisted puncture. Similarly, the most experienced surgeon's time for a successful puncture was slightly less than that of the residents, and the experienced surgeons needed the least attempts to perform a successful puncture. In terms of radiation exposure, the residents had a significant reduction of radiation exposure compared to the experienced surgeons. The newly developed ballistic gel kidney-puncture model is a good training tool for a variety of kidney puncture techniques, with good content, construct, and face validity.

Preoperative evaluation of hilar vessel anatomy with 3-D computerized tomography in living kidney donors.

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Tombul, S T; Aki, F T; Gunay, M; Inci, K; Hazirolan, T; Karcaaltincaba, M; Erkan, I; Bakkaloglu, A; Yasavul, U; Bakkaloglu, M

2008-01-01

Digital subtract angiography is the gold standard for anatomic assessment of renal vasculature for living renal donors. However, multidetector-row computerized tomography (MDCT) is less invasive than digital subtract angiography and provides information of kidney stones and other intra-abdominal organs. In this study, preoperative MDCT angiography results were compared with the peroperative findings to evaluate the accuracy of MDCT for the evaluation of renal anatomy. From December 2002 to May 2007, all 60 consecutive living kidney donors were evaluated with MDCT angiography preoperatively. We reported the number and origin of renal arteries, presence of early branching arteries, and any intrinsic renal artery disease. Renal venous anatomy was evaluated for the presence of accessory, retroaortic, and circumaortic veins using venous phase axial images. The calyces and ureters were assessed with delayed topograms. The results of the MDCT angiography were compared with the peroperative findings. A total of 67 renal arteries were seen peroperatively in 60 renal units. Preoperative MDCT angiography detected 64 of them. The two arteries not detected by MDCT had diameters less than 3 mm. Anatomic variations were present in nine veins, five of which were detected by CT angiography. Sensitivity of MDCT angiography for arteries and veins was 95% and 93%, respectively. Positive predictive values were 100% for both arteries and veins. MDCT angiography offers a less invasive, rapid, and accurate preoperative investigation modality for vascular anatomy in living kidney donors. It also provides sufficient information about extrarenal anatomy important for donor surgery.

Experience of extracorporeal shock wave lithotripsy for kidney and upper ureteric stones by electromagnetic lithotripter

International Nuclear Information System (INIS)

Wazir, B.G.; Haq, M.I.H.; Faheem-ul-Haq; Nawaz, A.; Nawaz, A.; Ikramullah; Jamil, M.

2010-01-01

Background: Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive treatment of urinary stones which breaks them, by using externally applied, focused, high intensity acoustic pulse, into smaller pieces so that they can pass easily through ureter. Shock wave generation, focusing, coupling and stone localisation by fluoroscope or ultrasound are the basic components of ESWL. ESWL has some complications and is contraindicated in certain situations. The aim of this study was to evaluate the effectiveness and safety of ESWL in kidney and upper ureteric stones by Electromagnetic Lithotriptor. Methods: All adult patients with renal and upper ureteric stones having a diameter of up to 1 Cm were included in the study. Basic evaluation such as history, examination, ultrasound and excretory urography were performed. Electromagnetic lithotripsy was done and data were collected on a printed proforma from January 1, 2008 to March 30, 2009 in Institute of Kidney Diseases, Peshawar. Results: Out of a total of 625 patients 463 were male and 162 were female; 67.36% of patients were having renal stones, 23.84% upper ureteric and 8.8% both renal and ureteric stones. Complications noted were renal colic in 9.76%, haematuria in 3.2%, stein strasse in 2.72%, and fever in 1.12% of patients. The stone free rate was 89% and 7% of patients were having stone fragments <4 mm. ESWL failed in 4% of patients. Conclusion: ESWL is a safe and effective way of treating kidney and upper ureteric stones. (author)

Stereotactic Body Radiotherapy for Localized Ureter Transitional Cell Carcinoma: Three Case Reports

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Yoshiyasu Maehata

2015-01-01

Full Text Available The gold standard management for ureter transitional cell carcinoma (UTCC is radical nephroureterectomy with excision of the bladder cuff. However, some patients cannot undergo this procedure for several reasons. In the case reports described herein, we performed stereotactic body radiotherapy (SBRT on three patients with inoperable or surgery-rejected localized UTCC. Two out of the three patients did not develop local recurrence or distant metastasis during the observation period. However, recurrence was detected in the bladder of one patient 22 months after the treatment. No acute or late adverse events occurred in any of the three patients. SBRT may become one of the treatment options for inoperable or surgery-rejected UTCC patients.

Predictors for kidney stones recurrence following extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL).

Science.gov (United States)

Chongruksut, Wilaiwan; Lojanapiwat, Bannakij; Tawichasri, Chamaiporn; Paichitvichean, Somboon; Euathrongchit, Jantima; Ayudhya, Vorvat Choomsai Na; Patumanond, Jayanton

2012-03-01

Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL) are common. Predictors for kidney stones vary among populations and areas. To determine predictors for kidney stones recurrence after ESWL or PCNL. A retrospective cohort study was conducted at a university hospital. The study cohort was patients aged more than 18 years, diagnosed with kidney stones, who were treated with ESWL or PCNL between 2006 and 2009. Medical files were reviewed for clinical profiles, stone characteristics, composition, type of treatment, presence of stone after treatment, stone reappearance, and related laboratory data. Predictors were determined by a multivariable poisson regression and presented as incidence rate ratios (IRRs) with 95% confidence interval. From a cohort of 252 patients, 240 who had at least one follow-up and with complete plain kidney ureters and bladder (KUB) film or intravenous pyelogram (IVP) were included in analysis. At three years, the total incidence rate of recurrence was 46 per 1,000 person-months. After a multivariable poisson regression clustering by type of stone composition, independent predictors for stone recurrence were age ESWL treatment (adjusted IRR = 2.1, 95% CI = 2.1-2.2, p < 0.001), stones located in lower calyx as compared to renal pelvis (adjusted IRR = 8.7, 95% CI = 2.9-25.9, p = 0.001), multiple stones (adjusted IRR = 5.9, 95% CI = 4.8-7.5, p < 0.001), and stone size larger than 20 mm (adjusted IRR = 1.4, 95% CI = 1.2-1.6, p < 0.001). After stone removals, patients with these predictors should closely be followed up for regular clinical evaluations.

Evaluating Sucralfate as a Phosphate Binder in Normal Cats and Cats with Chronic Kidney Disease.

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Quimby, Jessica; Lappin, Michael

2016-01-01

Control of hyperphosphatemia is an important part of the management of chronic kidney disease (CKD). The purpose of this study was to determine the efficacy of sucralfate as a phosphate binder in normal cats and normophosphatemic CKD cats. A 500 mg sucralfate slurry was administered orally q 8 hr for 2 wk, and serum phosphorus, urine fractional excretion of phosphorus, and fecal phosphorus concentrations were measured. In normal cats treated with sucralfate, significant changes in serum phosphorus concentration or urinary excretion of phosphorus were not detected, and vomiting occurred after 14.7% of administrations. Of the five normophosphatemic cats with CKD treated with sucralfate, three experienced clinical decompensation, including vomiting, anorexia, constipation, and increased azotemia. Administration of sucralfate did not result in significant changes in fecal phosphorus concentration in these cats. The effects of sucralfate administration on serum phosphorus concentration and urinary excretion of phosphorus in CKD cats was difficult to determine because of dehydration and worsening azotemia associated with decompensation. Due to side effects and the apparent lack of efficacy of the medication, the study was discontinued. This study was unable to confirm efficacy of this sucralfate formulation as a phosphate binder, and side effects were problematic during the study.

Ultrasound: Renal (Kidneys, Ureters, Bladder) (For Parents)

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[Skip to Content] for Parents Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family ...

Periodontitis associated with chronic kidney disease among Mexican Americans.

Science.gov (United States)

Ioannidou, Effie; Hall, Yoshio; Swede, Helen; Himmelfarb, Jonathan

2013-01-01

In comparison to non-Hispanic whites, a number of health-care disparities, including poor oral health, have been identified among Hispanics in general and Mexican Americans in particular. We hypothesized that Mexican Americans with chronic kidney disease (CKD) would have higher prevalence of chronic periodontitis compared with Mexican Americans with normal kidney function, and that the level of kidney function would be inversely related to the prevalence of periodontal disease. We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) data set. We followed the American Academy of Periodontology/Center for Disease Control and Prevention case definition for periodontitis. Glomerular filtration rate was estimated using the CKD-Epidemiology equation for Hispanic populations. The classification to CKD stages was based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Periodontitis prevalence increased across the kidney function groups showing a statistically significant dose-response association (Pperiodontitis compared with Mexican Americans with normal kidney function after adjusting for potential confounders such as smoking, diabetes, and socioeconomic status. Multivariate adjusted odds ratio for periodontitis significantly increased with 1, 5, and 10 mL/minute estimated glomerular filtration rate reduction from the mean. This is the first report, to the best our knowledge, that showed an increase of periodontitis prevalence with decreased kidney function in this population. © 2012 American Association of Public Health Dentistry.

Bilateral Supernumerary Kidney: A Very Rare Presentation

Science.gov (United States)

Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Firat Ozcan, Irfan

2014-01-01

To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys. PMID:25780543

Urinary Tract Infections (For Kids)

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Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys two ureters (say: ... Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more ... & Terms of Use Notice of Nondiscrimination Visit the Nemours Web ...

Aging and physiological changes of the kidneys including changes in glomerular filtration rate.

Science.gov (United States)

Musso, Carlos G; Oreopoulos, Dimitrios G

2011-01-01

In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water-soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease. Copyright © 2011 S. Karger AG, Basel.

Change in expression of cyclin G2 in kidney cancer cell and its significance.

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Cui, D W; Sun, G G; Cheng, Y J

2014-04-01

This study aims to analyze the expression and clinical significance of cyclin G2 (CCNG2) in kidney carcinoma, and the biological effect in its cell line by CCNG2 overexpression. Immunohistochemistry and western blot were used to analyze CCNG2 protein expression in 63 cases of kidney cancer and normal tissues to study the relationship between CCNG2 expression and clinical factors. CCNG2 lentiviral vector and empty vector were respectively transfected into kidney ACHN cell line. During immunohistochemistry, the level of CCNG2 protein expression was found to be significantly lower in kidney cancer tissue than normal tissues (P kidney cancer tissue was respectively found to be significantly lower than in normal tissues (P 0.05), but it was correlated with lymph node metastasis, clinic stage, and histological grade (P kidney cancer and correlated significantly with lymph node metastasis, clinical stage, histological grade, and poor overall survival, suggesting that CCNG2 may play important roles as a negative regulator to kidney cancer ACHN cell by promoting degradation of CDK2.

Attenuation changes of the normal and ischemic canine kidney

International Nuclear Information System (INIS)

Jaschke, W.; Lipton, M.J.; Boyd, D.P.; Cann, C.; Strauss, L.; Sievers, R.S.; California Univ., San Francisco

1985-01-01

The potential of CT scanning to explore total and regional renal blood flow was evaluated in a dog model with unilateral renal artery stenosis (n=7, reduction of renal blood flow: 32-75% of base line flow). Attenuation versus time curves were generated for the renal cortex and medulla, as well as for the aorta and renal vein. A fast CT scanner was used which allowed for up to 24 scans/minute at the same level (slice thickness: 10 mm). A total of 10 ml contrast medim was injected into a peripheral vein for each scan series taken. During baseline conditions, the curve of the renal cortex and medulla demonstrated 2 peaks. The first peak was mainly related to early vascular enhancement, whereas the second peak corresponded mainly to the appearance of contrast medium in the distal convolutes and collecting ducts. Ischemia of the kidney resulted in a reduction of the first peak and a flattening of the leading edge slope. Transport of contrast medium through the extravascular compartments of the kidney was delayed during ischemia. Relative renal blood flow was obtained from the CT data by dividing peak enhancement by rise-time as assessed from the cortical curve. All measurements were related to baseline flow and validated by flow measurements using radioactive labeled microspheres (n=5). Correlation was found to be r=0.97. (orig.)

Tumor, serum and urine carcinoembryonic antigen (CEA) in upper urinary tract urothelial cancer

International Nuclear Information System (INIS)

Stefanovic, V.; Ignjatovic, M.

1987-01-01

The aim of this investigation was to study the possible diagnostic value of a CEA test in cancer of the renal pelvis and ureter. Thirty-eight patients with upper urinary tract cancer, 15 patients with transitional cell carcinoma of the bladder, 6 kidney carcinoma patients and 25 healthy adults were studied. CEA was determined in tumor tissue, serum and urine, by using a monoclonal radioimmunoassay. Increased serum CEA level was found in 7 out of 27 patients (26%) with active cancer of the renal pelvis and ureter. None of 11 patients with inactive cancer had an increased serum CEA level. No significant correlation was found between the serum CEA level and the histological grading. The tumor CEA content varied markedly, from values obtainted in normal urothelium up to 840 ng/g wet weight. CEA content of tumor tissue did not correlate with the serum level. Our data suggest that serum and urine CEA have not diagnostic accuracy for clinical diagnosis of upper tract urothelial cancer. (orig.) [de

Frequency of Acute Kidney Injury in Patients Treated With Normal Saline after Off-Pump Coronary Artery Bypass Grafting

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Shima Sheybani

2017-03-01

Full Text Available Introduction: Acute kidney injury (AKI is a common postoperative complication of cardiac surgery, which is associated with an increased risk of morbidity and mortality. This study investigated the frequency of postoperative AKI in low risk adult patients undergoing off-pump coronary artery bypass grafting (CABG.Materials & Methods: All consecutive adult patients of American Society of Anesthesiologists (ASA class II and III, who were transferred to the post-operative cardiac surgery ICU after off-pump CABG and were low risk for AKI from October 2013 to September 2014 at Emam Reza Hospital, Mashhad, Iran were enrolled in this prospective cohort study at a teaching hospital. The patients were explored for AKI development, based on risk-injury-failure-loss- end stage kidney disease (RIFLE and acute kidney injury network (AKIN criteria, frequency of metabolic acidosis, hypernatremia, hyperchloremia, and length of stay in ICU.Results: According to the results of the present study, 479 patients with the mean age of 60.8±10.75 yrs were included. AKI occurred in 22 (4.4% and23 (4.8% patients, based on both the RIFLE and AKIN criteria, respectively with the highest rate of AKI, reported on the third and fourth post-operative days. Additionally, hyperchloremia and hypernatremia were observed in 71 (14.8% and 76 (15.9% patients, respectively. Only one case of mortality occurred during the study. Metabolic acidosis was reported in 112 (23.4% patients with a high anion gap in 60 (12.5% cases.Conclusion: The current study demonstrated that hypernatremia and metabolic acidosis but not AKI are frequently seen in patients receiving normal saline following off pump CABG with low risk for AKI.

Carcinoma of the renal pelvis and ureter

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Fernando Korkes

2006-12-01

Full Text Available OBJECTIVE: To assess the occurrence of upper urinary tract urothelial tumors (UUTT in Brazil. MATERIALS AND METHODS: We performed a clinical and histopathologic study of 33 patients who were diagnosed with a malignant neoplasm in the renal pelvis or ureter in the period of 1994 to 2004, in a single institution. RESULTS: Among the patients with upper urinary tract carcinoma, 70% were males and 30% females, with mean age of 65 ± 16 years (ranging from 31 to 91 years. Nineteen patients presented renal pelvis tumor (58%, 9 ureteral tumor (27% and 5 synchronic pelvic and ureteral tumors (15%. Renal pelvis tumors represented 2.8% of all the urothelial neoplasms, and 11.4% of all renal neoplasms treated in the same period. Ureteral tumors represented 1.6% of all the urothelial malignancies surgically managed in these 11 years. Tobacco smoking was the most common risk factor, and analgesic abuse was not reported by those patients. Most carcinomas were high-grade and muscle-invasive. Mean time to diagnosis was 7 months, being hematuria the most common symptom. CONCLUSIONS: A high association was also found between UUTT and bladder urothelial carcinoma. UUTT were mostly seen in men in their seventies and related to a high overall and cancer-related mortality rate. The overall disease-specific survival was 40%, much lower than found in most of the reported series.

[The clinical and experimental validation of the role of laser-magnetic therapy in the combined treatment of patients following plastic operations on the ureter].

Science.gov (United States)

Loran, O B; Kaprin, A D; Afanas'ev, M B

1994-01-01

The paper deals with clinical efficacy of laser magnetic therapy performed in patients following ureteroplasty on distal parts of the ureters. The results were estimated by clinical, biochemical and ultrasound monitoring.

Conditional ablation of glycogen synthase kinase 3β in postnatal mouse kidney.

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Ge, Yan; Si, Jin; Tian, Li; Zhuang, Shougang; Dworkin, Lance D; Gong, Rujun

2011-01-01

Glycogen synthase kinase (GSK)3 is a ubiquitously expressed serine/threonine kinase existing in two isoforms, namely GSK3α and GSK3β. Aside from the long-recognized role in insulin signal transduction and glycogen biosynthesis, GSK3β has been recently coined as a master control molecule in nuclear factor-κB activation and inflammatory kidney injury. Nevertheless, previous studies are less conclusive because they relied greatly on small molecule inhibitors, which lack selectivity and barely distinguish between the GSK3 isoforms. In addition, early embryonic lethality after global knockout of GSK3β precludes interrogation of the biological role of GSK3β in the adult kidney. To circumvent these issues, the Cre/loxP system was used to generate a conditional knockout mouse model in which the GSK3β gene was specifically deleted in kidney cortical tubules at postnatal mature stage. Kidney-specific ablation of GSK3β resulted in a phenotype no different from control littermates. Knockout mice (KO) were viable and exhibited normal development and normal kidney physiology in terms of kidney function, urine albumin excretion, and urine-concentrating ability. It is noteworthy that apart from normal glomerular and tubulointerstitial morphology, the kidneys from KO demonstrated more glycogen accumulation in the renal cortical tubules as assessed by both periodic acid-Schiff staining for light microscopy and direct biochemical assay, consistent with an elevated glycogen synthetic activity as evidenced by diminished inhibitory phosphorylation of glycogen synthase that occurred subsequent to GSK3β ablation. This finding was further validated by electron microscopic observations of increased deposition of glycogen particles in the renal tubules of KO, suggesting that GSK3α could not fully compensate for the loss of GSK3β in regulating glycogen metabolism in the kidney. Collectively, our study suggests that kidney-specific ablation of GSK3β barely affects kidney function

Urinary tract infection in children: Role of ultrasonography

International Nuclear Information System (INIS)

Lee, Hye Won; Lee, Sun Wha; Ko, Young Tae; Lim, Joo Won

1994-01-01

To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I and III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, altrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal sonogram had vesicoureteral reflux of grade I to IV on VCUG. Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection

Serum uric acid to creatinine ratio: A predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function.

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Gu, Liubao; Huang, Liji; Wu, Haidi; Lou, Qinglin; Bian, Rongwen

2017-05-01

Serum uric acid has shown to be a predictor of renal disease progression in most but not all studies. This study aims to test whether renal function-normalized serum uric acid is superior to serum uric acid as the predictor of incident chronic kidney disease in type 2 diabetes mellitus patients. In this study, 1339 type 2 diabetes mellitus patients with estimated glomerular filtration rate ⩾60 mL/min/1.73 m 2 and normouricemia were included. Renal function-normalized serum uric acid was calculated using serum uric acid/creatinine. Cox regression analysis was used to estimate the association between serum uric acid, renal function-normalized serum uric acid and incident chronic kidney disease. In total, 74 (5.53%) patients developed to chronic kidney disease 3 or greater during a median follow-up of 4 years, with older ages, longer diabetes duration and lower estimated glomerular filtration rate at baseline. The decline rate of estimated glomerular filtration rate was positively correlated with serum uric acid/creatinine ( r = 0.219, p uric acid ( r = 0.005, p = 0.858). Moreover, multivariate analysis revealed that serum uric acid was not an independent risk factor for incident chronic kidney disease ( p = 0.055), whereas serum uric acid to creatinine ratio was significantly associated with incident chronic kidney disease independently of potential confounders including baseline estimated glomerular filtration rate. serum uric acid to creatinine ratio might be a better predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.

Robotic Assisted Radical Cystoprostatectomy and Intracorporeal Ileal Conduit Urinary Diversion for a Kidney Transplant Recipient

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Peter A. Caputo

Full Text Available ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen; identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours. Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient

Urinary Tract Effects After Multifocal Nonthermal Irreversible Electroporation of the Kidney: Acute and Chronic Monitoring by Magnetic Resonance Imaging, Intravenous Urography and Urinary Cytology

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Wendler, Johann Jakob, E-mail: johann.wendler@med.ovgu.de [University of Magdeburg, Department of Urology (Germany); Pech, Maciej [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Porsch, Markus; Janitzky, Andreas [University of Magdeburg, Department of Urology (Germany); Fischbach, Frank [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Buhtz, Peter; Vogler, Klaus [University of Magdeburg, Institute of Pathology (Germany); Huehne, Sarah [University of Magdeburg, Department of Urology (Germany); Borucki, Katrin [University of Magdeburg, Institute of Clinical Chemistry (Germany); Strang, Christof [University of Magdeburg, Department of Anaesthesiology (Germany); Mahnkopf, Dirk [Institute of Medical Technology and Research (Germany); Ricke, Jens [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Liehr, Uwe-Bernd [University of Magdeburg, Department of Urology (Germany)

2012-08-15

Purpose: The nonthermal irreversible electroporation (NTIRE) is a novel potential ablation modality for renal masses. The aim of this study was the first evaluation of NTIRE's effects on the renal urine-collecting system using intravenous urography (IVU) and urinary cytology in addition to histology and magnetic resonance imaging (MRI). Methods: Eight percutaneous NTIRE ablations of the renal parenchyma, including the calyxes or pelvis, were performed in three male swine. MRI, IVU, histology, and urinary cytology follow-ups were performed within the first 28 days after treatment. Results: MRI and histological analysis demonstrated a localized necrosis 7 days and a localized scarification of the renal parenchyma with complete destruction 28 days after NTIRE. The urine-collecting system was preserved and showed urothelial regeneration. IVU and MRI showed an unaltered normal morphology of the renal calyxes, pelvis, and ureter. A new urinary cytology phenomenon featured a temporary degeneration by individual vacuolization of detached transitional epithelium cells within the first 3 days after NTIRE. Conclusions: This first urographical, urine-cytological, and MRI evaluation after porcine kidney NTIRE shows multifocal parenchyma destruction while protecting the involved urine-collecting system with regenerated urothelial tissue. NTIRE could be used as a targeted ablation method of centrally located renal masses.

Use of spiral CT and the contrast medium iohexol to determine in one session aortorenal morphology and the relative glomerular filtration rate of each kidney

International Nuclear Information System (INIS)

Frennby, B.; Almen, T.

2001-01-01

The aim of this study was to determine the relative glomerular filtration rate (GFR), i.e. the GFR of each kidney in percent of total GFR, by spiral CT. In 41 patients, who were part of a follow-up program after endoluminal stent grafting of aortic aneurysm, spiral CT with the contrast medium iohexol was used to evaluate the morphology of the aorta and kidneys. The opportunity was taken to utilize the already injected iohexol to determine the relative GFR with an extra CT sequence. In each patient two determinations were made, 6 or 12 months apart. The amount of a GFR marker accumulating in Bowman's space, tubuli, and renal pelvis within 2-3 min after i.v. injection, before any marker had left the kidney via the ureter, was defined as proportional to the GFR of that kidney. The renal accumulation of iohexol was obtained by spiral CT using 10-mm collimation and a table speed of 10 mm/s (pitch ratio 1:1) from the upper to the lower poles. The correlation coefficient between the relative GFR of each kidney determined at the first and second examination was excellent (r=0.99) with a median (range) difference of 1% (0-6%) of total GFR. The radiation dose calculated as the mean absorbed dose to the kidneys was 50 mGy and the effective dose 5 mSv. The morphology of aorta and kidneys and the relative GFR of each kidney can be determined in one session with spiral CT using iohexol as both angiographic contrast medium and as a GFR marker. It is also possible to take some plasma samples in the same session to determine iohexol concentration to calculate the body clearance of iohexol (or take plasma and urine samples to calculate the renal clearance of iohexol). (orig.)

Chronic kidney disease, severe arterial and arteriolar sclerosis and kidney neoplasia: on the spectrum of kidney involvement in MELAS syndrome.

Science.gov (United States)

Piccoli, Giorgina Barbara; Bonino, Laura Davico; Campisi, Paola; Vigotti, Federica Neve; Ferraresi, Martina; Fassio, Federica; Brocheriou, Isabelle; Porpiglia, Francesco; Restagno, Gabriella

2012-02-21

MELAS syndrome (MIM ID#540000), an acronym for Mitochondrial Encephalopathy, Lactic Acidosis and Stroke-like episodes, is a genetically heterogeneous mitochondrial disorder with protean manifestations and occasional kidney involvement. Interest in the latter is rising due to the identification of cases with predominant kidney involvement and to the hypothesis of a link between mitochondrial DNA and kidney neoplasia. We report the case of a 41-year-old male with full blown MELAS syndrome, with lactic acidosis and neurological impairment, affected by the "classic" 3243A > G mutation of mitochondrial DNA, with kidney cancer. After unilateral nephrectomy, he rapidly developed severe kidney functional impairment, with nephrotic proteinuria. Analysis of the kidney tissue at a distance from the two tumor lesions, sampled at the time of nephrectomy was performed in the context of normal blood pressure, recent onset of diabetes and before the appearance of proteinuria. The morphological examination revealed a widespread interstitial fibrosis with dense inflammatory infiltrate and tubular atrophy, mostly with thyroidization pattern. Vascular lesions were prominent: large vessels displayed marked intimal fibrosis and arterioles had hyaline deposits typical of hyaline arteriolosclerosis. These severe vascular lesions explained the different glomerular alterations including ischemic and obsolescent glomeruli, as is commonly observed in the so-called "benign" arteriolonephrosclerosis. Some rare glomeruli showed focal segmental glomerulosclerosis; as the patient subsequently developed nephrotic syndrome, these lesions suggest that silent ischemic changes may result in the development of focal segmental glomerulosclerosis secondary to nephron loss. Nephron loss may trigger glomerular sclerosis, at least in some cases of MELAS-related nephropathy. Thus the incidence of kidney disease in the "survivors" of MELAS syndrome may increase as the support therapy of these patients improves.

Renal transplant scintigraphy (Part 1)

International Nuclear Information System (INIS)

Chew, Ghee

2005-01-01

Renal transplantation is the most effective mode of renal replacement therapy for correction of renal failure. Renal donors can either be: a. a deceased person - the kidneys being removed when brain death or absence of cerebral cortical function / perfusion is confirmed - the cadaveric kidney is packed in ice and nutrient solution and transplanted within 24 hours of removal ('cold ischemia') ob. a living donor - the donor may or may not be related to the recipient. Due to the limited length of the renal vessels and ureter of the donor kidney, it is implanted close to the bladder of the recipient. The donor vessels are anastomosed to the iliac artery and vein of the recipient. Transplant variants: a. 2 kidneys maybe transplanted because: - an old donor with less kidney reserve from atrophy due to age or disease (e.g. hypertension) - an infant donor when both kidneys are removed en bloc, b. Donor kidneys with more than 1 artery, vein or ureter. c. Donor horse shoe kidney d. Combined renal and pancreas transplant for type I diabetics -a short segment of duodenum transplanted with the pancreas maybe implanted into the bladder. Copyright (2005) The Australian and New Zealand Society of Nuclear Medicine

Urinary carbonic anhydrase VI as a biomarker for kidney disease in pigs.

Science.gov (United States)

Nishita, Toshiho; Yatsu, Juro; Watanabe, Kazuo; Ochiai, Hideharu; Ichihara, Nobutsune; Orito, Kensuke; Arishima, Kazuyoshi

2014-11-01

This study investigated whether carbonic anhydrase (CA)-VI has utility as a biomarker in swine kidney disease. Serum chemistry, histopathology, immunohistochemical staining and enzyme-linked immunosorbent assay (ELISA) analyses were performed. In the kidney of normal healthy pigs, CA-VI was localized in the epithelial cells of the renal distal straight tubules. CA-VI levels were 16 ± 35 ng/g wet tissue and 50 ± 66 ng/mL in normal pig kidney and urine, respectively, and 136 ± 173 ng/mL in the urine of pigs with kidney disease. CA-VI urinary concentration was not correlated with urinary urea nitrogen (UUN), urinary creatinine (Cre), or urinary albumin levels in pigs with kidney disease. However, UUN and Cre levels were positively correlated in the urine of pigs with kidney disease. These data suggest that urinary CA-VI may represent a biomarker for kidney disease in pigs, particularly for disorders affecting distal straight tubules. Copyright © 2014 Elsevier Ltd. All rights reserved.

Histopathologic Findings of Potential Kidney Donors With Asymptomatic Microscopic Hematuria: Impact on Donation.

Science.gov (United States)

Hassan, E A; Ali, T Z; Abdulbaki, A; Ibrahim, I A; Almanae, H M; Aleid, H A

2017-10-01

Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors. The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation. In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016. Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation. IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality. Copyright © 2017 Elsevier Inc. All rights reserved.

XYLITOL IMPROVES ANTI-OXIDATIVE DEFENSE SYSTEM IN SERUM, LIVER, HEART, KIDNEY AND PANCREAS OF NORMAL AND TYPE 2 DIABETES MODEL OF RATS.

Science.gov (United States)

Chukwuma, Chika Ifeanyi; Islam, Shahidul

2017-05-01

The present study investigated the anti-oxidative effects of xylitol both in vitro and in vivo in normal and type 2 diabetes (T2D) rat model. Free radical scavenging and ferric reducing potentials of different concentrations of xylitol were investigated in vitro. For in vivo study, six weeks old male Sprague-Dawley rats were divided into four groups, namely: Normal Control (NC), Diabetic Control (DBC), Normal Xylitol (NXYL) and Diabetic Xylitol (DXYL). T2D was induced in the DBC and DXYL groups. After the confirmation of diabetes, a 10% xylitol solution was supplied instead of drinking water to NXYL and DXYL, while normal drinking water was supplied to NC and DBC ad libitum. After five weeks intervention period, the animals were sacri- ficed and thiobarbituric acid reactive substances (TBARS) and reduced glutathione (GSH) concentrations as well as superoxide dismutase, catalase glutathione reductase and glutathione peroxidase activities were determined in the liver, heart, kidney, pancreatic tissues and serum samples. Xylitol exhibited significant (p foods and food products.

Improved Structure and Function in Autosomal Recessive Polycystic Rat Kidneys with Renal Tubular Cell Therapy.

Science.gov (United States)

Kelly, K J; Zhang, Jizhong; Han, Ling; Kamocka, Malgorzata; Miller, Caroline; Gattone, Vincent H; Dominguez, Jesus H

2015-01-01

Autosomal recessive polycystic kidney disease is a truly catastrophic monogenetic disease, causing death and end stage renal disease in neonates and children. Using PCK female rats, an orthologous model of autosomal recessive polycystic kidney disease harboring mutant Pkhd1, we tested the hypothesis that intravenous renal cell transplantation with normal Sprague Dawley male kidney cells would improve the polycystic kidney disease phenotype. Cytotherapy with renal cells expressing wild type Pkhd1 and tubulogenic serum amyloid A1 had powerful and sustained beneficial effects on renal function and structure in the polycystic kidney disease model. Donor cell engraftment and both mutant and wild type Pkhd1 were found in treated but not control PCK kidneys 15 weeks after the final cell infusion. To examine the mechanisms of global protection with a small number of transplanted cells, we tested the hypothesis that exosomes derived from normal Sprague Dawley cells can limit the cystic phenotype of PCK recipient cells. We found that renal exosomes originating from normal Sprague Dawley cells carried and transferred wild type Pkhd1 mRNA to PCK cells in vivo and in vitro and restricted cyst formation by cultured PCK cells. The results indicate that transplantation with renal cells containing wild type Pkhd1 improves renal structure and function in autosomal recessive polycystic kidney disease and may provide an intra-renal supply of normal Pkhd1 mRNA.

Prevalence of chronic kidney disease after preeclampsia.

Science.gov (United States)

Lopes van Balen, Veronica Agatha; Spaan, Julia Jeltje; Cornelis, Tom; Spaanderman, Marc Erich August

2017-06-01

Preeclampsia (PE), an endothelial disease that affects kidney function during pregnancy, is correlated to an increased future risk of cardiovascular and chronic kidney disease. The Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline emphasizes the combined role of glomerular filtration rate (GFR) and albuminuria in determining the frequency of monitoring of kidney function. In this study we evaluated the prevalence of CKD in women with a history of PE. We investigated how many seemingly healthy women required monitoring of kidney function according to the KDIGO guideline. We included 775 primiparous women with a history of PE. They were at least 4 months postpartum, and had no pre-existing hypertension, diabetes or kidney disease. We estimated GFR by the CKD-Epidemiology equation and urinary albumin loss by albumin creatinine ratio in a 24-h urine collection. Most women, 669 (86.3 %), had a normal GFR and absent albuminuria. Based on the KDIGO guideline, 13.7 % would require at least yearly monitoring of kidney function. Only 1.4 % were classified to be at high risk for kidney function deterioration. Monitoring of kidney function seems relevant for about one in seven women with a history of PE, mainly due to albuminuria. Albuminuria should be evaluated postpartum to identify those women that need further monitoring of kidney function.

Computational analysis of kidney scintigrams

Energy Technology Data Exchange (ETDEWEB)

Vrincianu, D.; Puscasu, E.; Creanga, D. [University Al. I. Cuza, Faculty of Physics, 11 Blvd. Carol I, 700506, Iasi (Romania); Stefanescu, C. [University of Medicine and Pharmacy Gr. T. Popa, Iasi (Romania)

2013-11-13

The scintigraphic investigation of normal and pathological kidneys was carried out using specialized gamma-camera device from nuclear medicine hospital department. Technetium 90m isotope with gamma radiation emission, coupled with vector molecules for kidney tissues was introduced into the subject body, its dynamics being recorded as data source for kidney clearance capacity. Two representative data series were investigated, corresponding to healthy and pathological organs respectively. The semi-quantitative tests applied for the comparison of the two distinct medical situations were: the shape of probability distribution histogram, the power spectrum, the auto-correlation function and the Lyapunov exponent. While power spectrum led to similar results in both cases, significant differences were revealed by means of distribution probability, Lyapunov exponent and correlation time, recommending these numerical tests as possible complementary tools in clinical diagnosis.

Reconstructive surgery in eight children with solitary kidneys

DEFF Research Database (Denmark)

Thorup, Jørgen Mogens

1989-01-01

Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two of t...... months of age. Postoperatively, the renal function was subnormal (although improved) in two children; in six it was normal. The most important prognostic factors in solitary kidneys with urinary tract obstruction are infection and developmental injury.......Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...

Kidney Rehabilitation Technology by Improving Blood Flow and Nerve Activation

International Nuclear Information System (INIS)

Mohd Jamil Hashim

2016-01-01

The rehabilitation of kidney is impossible from doctors point of view. Kidney failure happens when nephron in kidney fail to filter blood and water. Two major causes of kidney failure. First is the shrinkage of kidney and the second is the blockage of kidney medulla. Kidney shrinkage is because nephron damage due to long term diabetes (Nephrology expert point of view). Whereas blockage of kidney is due to food consume which in turn build up deposit at the blood duct connecting to the medulla. Experiment specimen own body. The rehabilitation methodology is to build up your blood flow system and nerve activation. Result from the study is through analyzing blood components such as creatinine, hemoglobin, urea and potassium. Conclusion, creatinine value has lowered and kidney shrinkage has normalize to its original size. It is hopeful I regain my health 100 % when my GFR reading achieved below 100. (author)

Photoacoustic cystography using handheld dual modal clinical ultrasound photoacoustic imaging system

Science.gov (United States)

Sivasubramanian, Kathyayini; Periyasamy, Vijitha; Austria, Dienzo Rhonnie; Pramanik, Manojit

2018-02-01

Vesicoureteral reflux is the abnormal flow of urine from your bladder back up the tubes (ureters) that connect your kidneys to your bladder. Normally, urine flows only down from your kidneys to your bladder. Vesicoureteral reflux is usually diagnosed in infants and children. The disorder increases the risk of urinary tract infections, which, if left untreated, can lead to kidney damage. X-Ray cystography is used currently to diagnose this condition which uses ionising radiation, making it harmful for patients. In this work we demonstrate the feasibility of imaging the urinary bladder using a handheld clinical ultrasound and photoacoustic dual modal imaging system in small animals (rats). Additionally, we demonstrate imaging vesicoureteral reflux using bladder mimicking phantoms. Urinary bladder imaging is done with the help of contrast agents like black ink and gold nanoparticles which have high optical absorption at 1064 nm. Imaging up to 2 cm was demonstrated with this system. Imaging was done at a framerate of 5 frames per second.

Nuclear magnetic resonance imaging of the kidney

International Nuclear Information System (INIS)

Hricak, H.; Crooks, L.; Sheldon, P.; Kaufman, L.

1983-01-01

The role of nuclear magnetic resonance (NMR) imaging of the kidney was analyzed in 18 persons (6 normal volunteers, 3 patients with pelvocaliectasis, 2 with peripelvic cysts, 1 with renal sinus lipomatosis, 3 with renal failure, 1 with glycogen storage disease, and 2 with polycystic kidney disease). Ultrasound and/or computed tomography (CT) studies were available for comparison in every case. In the normal kidney distinct anatomical structures were clearly differentiated by NMR. The best anatomical detail ws obtained with spin echo (SE) imaging, using a pulse sequence interval of 1,000 msec and an echo delay time of 28 msec. However, in the evaluation of normal and pathological conditions, all four intensity images (SE 500/28, SE 500/56, SE 1,000/28, and SE 1,000/56) have to be analyzed. No definite advantage was found in using SE imaging with a pulse sequence interval of 1,500 msec. Inversion recovery imaging enhanced the differences between the cortex and medulla, but it had a low signal-to-noise level and, therefore, a suboptimal overall resolution. The advantages of NMR compared with CT and ultrasound are discussed, and it is concluded that NMR imaging will prove to be a useful modality in the evaluation of renal disease

Normal anatomy of the female pelvis in axial, coronal, and sagittal planes demonstrated with reformatted CT

International Nuclear Information System (INIS)

Constant, O.C.; Cooke, J.C.; Parsons, C.A.

1987-01-01

Axial CT is used in assessing gynecologic malignancies. Accurate delineation of local tumor extent in carcinoma of the cervix is important in initial staging and in planning subsequent management. A modified scanning technique produces reformatted coronal and sagittal images, which demonstrate additional valuable information about the cardinal ligaments, parametria, ureters, boundaries between the cervix, bladder, and rectum, and extension to vagina and uterus. This information is illustrated by representative axial, coronal, and sagittal scans. Familiarity with normal appearances is essential to allow correct interpretation of pathology

When Your Child Needs a Kidney Transplant

Science.gov (United States)

... ureter tubes (tubes that carry urine) will be connected to the bladder. In most cases, children's failed ... person's immune system is programmed to sense foreign objects, such as bacteria, and help the body get ...

Nitrite-induced acute kidney injury with secondary hyperparathyroidism: Case report and literature review.

Science.gov (United States)

Peng, Tao; Hu, Zhao; Yang, Xiangdong; Gao, Yanxia; Ma, Chengjun

2018-02-01

Acute kidney injury (AKI) with hyperparathyroidism caused by nitrite was rare, and renal function and parathyroid hormone (PTH) decreased to normal range after therapy. Acute kidney injury was diagnosed in a 40-year-old male with hyperparathyroidism and cyanosis of his hands and both forearms. The patient ate some recently pickled vegetables, and he experienced nausea, vomiting and diarrhoea without oliguria or anuria; Additionally, his hands and both forearms had a typical blue ash appearance. After admission, the laboratory findings indicated theincreasing serum creatinine (Scr) and parathyroid hormone (PTH). He was diagnosed as acute kidney injury with hyperparathyroidism caused by nitrite. The patient stopped eating the pickled vegetables and was given rehydration, added calories and other supportive therapy without any glucocorticoids. According to his clinical manifestations, laboratory findings and imaging results, the patient was diagnosed with acute kidney injury with secondary hyperparathyroidism. He was given symptomatic supportive care therapy. After one week, the serum creatinine, parathyroid hormone (PTH), hypercalcemia, hyperphosphatemia, proteinuria, and urine red blood cell values decreased to normal range. Nitrite-induced acute kidney injury with secondary hyperparathyroidism was relatively rare. After therapy, the function of the kidney and parathyroid returned to normal. This case suggests that detailed collection of medical history, physical examination and correct symptomatic treatment is very important.

An experimental microangiographic study on radiation injury: Microangiography in radiation-injured rabbit kidney

International Nuclear Information System (INIS)

Han, Man Chung; Chang, Kee Hyun; Yoo, Seong Yul; Yeon, Kyung Mo; Kim, Chu Wan

1980-01-01

Microangiography may be defined as a branch of radiology which deals with the production and study of roentgenograms of thin sections of tissue for evaluation of microvasculatures. Its main advantage is that it permits study of a vascular system in continuity so that the pattern and overall architecture can be appreciated. Authors performed the microangiography to study the irradiation changes of kidney in 30 rabbits. Following local irradiation of 2,000 rads to one kidney of each rabbit, both normal and irradiated kidneys of each rabbit were studied. The results are as follows; 1. In the normal kidneys there is good filling of interiobular arteries, afferent arterioies, glomeruli and efferent arterioies. 2. In the early stage 91 month) after irradiation there appears to be no identifiable abnormal findings except slightly poor filling of glomeruli in the irradiated kidneys. 3. 5 months after irradiation the radiation-injured kidneys reveal intense curling and spralling of interlobular arterials and afferent arterioles with poor filling of glomeruli. 4. Microangiography, as expected, proved to be of good value in evaluation of the microvasculature of the kidney.

Serum erythropoietin level in anemic and non-anemic nephrotic children with normal kidney functions

International Nuclear Information System (INIS)

Moustafa, A.M.E.; Moawad, A.T.; Gad, A.A.; Ahmed, S.M.

2005-01-01

Nephrotic syndrome (NS) is associated with a significant alteration in protein metabolism. While lowering the concentration of certain proteins, the disease often raises the level of certain other proteins. The current study aimed to investigate the serum erythropoietin (EPO) levels in children with NS either anemic or non-anemic and to compare them to children with iron deficiency anemia (IDA) and healthy controls with normal hemoglobin level (NHB). Sixteen nephrotic children with anemia (NS-A) and 15 nephrotic children with normal hemoglobin level (NS-NHB) were examined and compared with 10 children with iron deficiency anemia (IDA) and 10 healthy controls (NHB). Circulating serum EPO levels, blood indices and iron status were measured in nephrotic patients with anemia (NS-A) and compared to those nephrotic patients with normal HE (NS-NHB). Most NS-A children were steroid resistant. The NS-A children showed greater EPO levels than those without anemia (21.01 ±4.02 mlU/ml versus 9.18 ± 0.79 mlU/ml; P < 0.001) but their response to treatment of anemia was inappropriately low when compared to IDA (EPO 96.9 ±4.9 mlU/ml) despite similar HB concentration. A significant positive correlation was observed between serum EPO and serum albumin in NS-A (r = 0.84, P < 0.001) and in NS-NHB group (r = 0.89, P < 0.001). Moreover, a significant positive correlation was observed between serum EPO and HB in the nephrotic groups indicating a blunted EPO response to anemia in NS-A (r 0.63, P < 0.05) and in NS-NHB group (r = 0.80, P < 0.001). In conclusion, anemia is a common feature of NS and is present even before the worsening of kidney function. Depletion of the iron stores due to loss of iron and transferrin in urine due to massive proteinurea may contribute to the development of anemia, but it was found that iron replacement was ineffective alone

The normal and pathologic renal medulla: a comprehensive overview.

Science.gov (United States)

López, José I; Larrinaga, Gorka; Kuroda, Naoto; Angulo, Javier C

2015-04-01

The renal medulla comprises an intricate system of tubules, blood vessels and interstitium that is not well understood by most general pathologists. We conducted an extensive review of the literature on the renal medulla, in both normal and pathologic conditions. We set out in detail the points of key interest to pathologists: normal and pathological development, physiology, microscopic anatomy, histology and immunohistochemistry; and the specific and most common other types of disease associated with this part of the kidney: developmental abnormalities, (multicystic dysplastic kidney, autosomal dominant and recessive polycystic kidney diseases, medullary cystic kidney disease), inflammatory conditions (xanthogranulomatous pyelonephritis, malakoplakia), hyperplasia and dysplasia, and neoplastic processes (oncocytoma, atypical oncocytic tumors, chromophobe cell carcinoma, collecting duct carcinoma, urothelial carcinoma, other carcinomas, renal medullary fibroma and metastatic tumors). This condensed overview of the origin, function and pathology of the renal medulla, both in terms of development, inflammation and neoplastic processes, should help focus the interest of clinical pathologists on this widely overlooked part of the kidney. Copyright © 2014 Elsevier GmbH. All rights reserved.

Ultrasound features of kidneys in the rabbit (Oryctolagus cuniculus

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R S Dimitrov

2012-10-01

Full Text Available Purpose: To determine the normal sonographic features of rabbit kidneys with regard to their use in diagnostic imaging of renal lesions in this species. Materials: Twelve sexually mature clinically healthy New Zealand White rabbits weighing 2.8 kg to 3.2 kg were examined after anaesthesia. Methods: A diagnostic ultrasound system with microconvex multifrequency 6.5 MHz probe was used. The animals were positioned in dorsal recumbency. The transabdominal paravertebral imaging approach was used. Longitudinal and transverse scans of the kidneys were obtained. Six rabbits were sacrificed, their kidneys removed and studied in isotonic liquid medium. Results: The shape of kidneys was elliptical. The fibrous capsule was visualized as a straight hyperechoic band. The fatty capsule was hyperechoic and with irregular borders. The cortex exhibited a heterogeneous echogenicity. The acoustic density of the cortex was lower than that of the liver. The echoicity of the medulla was lower as compared to the cortex and the structures of the kidney pelvis. The latter appeared as a centrally located hyperechoic structure. The post mortem examination showed that kidneys were oval and hyperechoic. The kidney pelvis was seen as a centrally located longitudinal finding, and the renal hilum – as a centrally located hyperechoic finding. Conclusions: The transabdominal paravertebral approach was a good method for visualization of rabbit kidneys. The dorsal recumbency of the subjects allowed the visualization. The in vivo results corresponded to those from the post mortem study. The rabbit kidney was oval in shape. The hypoechoic peripheral zone is occupied by the cortex and the medulla, while the hyperechoic central zone – by the kidney pelvis. The cortex was less echoic than the liver parenchyma. The kidney pelvic cavity had a lower acoustic density than its walls, due to the presence of peripelvic adipose tissue. The present results could be used in the interpretation

MR imaging of adult glomerulocystic kidney disease

International Nuclear Information System (INIS)

Egashira, K.; Nakata, H.; Hashimoto, O.; Kaizu, K.; University of Occupational and Environmental Health School of Medicine, Kitakyushu

1991-01-01

A 59-year-old man with hypertension and severe renal dysfunction was diagnosed as having adult glomerulocystic kidney disease. MR imaging of the kidney showed a diffuse reduction of the intensity of the renal cortex with a loss of normal cortico-medullary differentiation of T1-weighted images. Numerous small cortical cysts were also demonstrated. These MR findings complemented the results of the biopsy and were useful for making a definitive diagnosis. (orig.)

Deletion of the miR-143/145 Cluster Leads to Hydronephrosis in Mice

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Medrano, Silvia; Sequeira-Lopez, Maria Luisa S.; Gomez, R. Ariel

2015-01-01

Obstructive nephropathy, the leading cause of kidney failure in children, can be anatomic or functional. The underlying causes of functional hydronephrosis are not well understood. miRNAs, which are small noncoding RNAs, regulate gene expression at the post-transcriptional level. We found that miR-145-5p, a member of the miR-143/145 cluster that is highly expressed in smooth muscle cells of the renal vasculature, was present in the pelvicalyceal system and the ureter. To evaluate whether the miR-143/145 cluster is involved in urinary tract function we performed morphologic, functional, and gene expression studies in mice carrying a whole-body deletion of miR-143/145. miR-143/145–deficient mice developed hydronephrosis, characterized by severe papillary atrophy and dilatation of the pelvicalyceal system without obvious physical obstruction. Moreover, mutant mice showed abnormal ureteral peristalsis. The number of ureter contractions was significantly higher in miR-143/145–deficient mice. Peristalsis was replaced by incomplete, short, and more frequent contractions that failed to completely propagate in a proximal-distal direction. Microarray analysis showed 108 differentially expressed genes in ureters of miR-143/145–deficient mice. Ninety genes were up-regulated and 18 genes were down-regulated, including genes with potential regulatory roles in smooth muscle contraction and extracellular matrix-receptor interaction. We show that miR-143/145 are important for the normal peristalsis of the ureter and report an association between the expression of these miRNAs and hydronephrosis. PMID:25307343

Kidney growth in 717 healthy children aged 0-18 months

DEFF Research Database (Denmark)

Schmidt, Ida M; Main, Katharina M; Damgaard, Ida N

2004-01-01

Kidney size is an important parameter in the evaluation of children with renal disease. However, reference materials for kidney size in healthy children have been limited beyond the neonatal period. We performed a longitudinal cohort study of 717 healthy children born at term with normal birth...... weight. Kidney size and shape were determined by ultrasonography and related to gender, age, and body size (weight, length, body surface area, skinfold thickness) at 0, 3, and 18 months of age. Gender-differentiated reference charts were established. Boys had significantly larger kidney volumes than...... girls ( Page. The best single predictor of gender-differentiated kidney volume was weight. Relative kidney volume changed with increasing age and height in a two-phase pattern: an initial...

Bilateral uric acid nephrolithiasis and ureteral hypertrophy in a free-ranging river otter (Lontra canadensis)

Science.gov (United States)

Grove, Robert A.; Bildfell, Rob; Henny, Charles J.; Buhler, D.R.

2003-01-01

We report the first case of uric acid nephrolithiasis in a free-ranging river otter (Lontra canadensis). A 7 yr old male river otter collected from the Skagit River of western Washington (USA) had bilateral nephrolithiasis and severely enlarged ureters (one of 305 examined [0.33%]). The uroliths were 97% uric acid and 3% protein. Microscopic changes in the kidney were confined to expansion of renal calyces, minor loss of medullary tissue, and multifocal atrophy of the cortical tubules. No inflammation was observed in either kidney or the ureters. The ureters were enlarged due to marked hypertrophy of smooth muscle plus dilation of the lumen. Fusion of the major calyces into a single ureteral lumen was several cm distal to that of two adult male otters used as histopathologic control specimens. This case report is part of a large contaminant study of river otters collected from Oregon and Washington. It is important to understand diseases and lesions of the otter as part of our overall evaluation of this population.

Demonstration of Adaptive Functional Differences Seen in Kidneys Accompanying a Nonfunctioning/Hypofunctioning Partner, using Camera Based Tc 99m MAG3 Clearance Measurement Technique

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Burcu Esen Akkaş

2012-08-01

Full Text Available Objective: The aim of this study was to demonstrate the functional compensation that occurs in kidneys which accompany a partner with total or partial loss of renal functioning mass, using camera-based Tc 99m MAG3 clearance technique. Material and Methods: Eighty five patients (43M, 42F, age: 44.8±12.6, range: 18-77 years with normal serum creatinine levels and normal (normal kidney (unilateral atrophied/agenetic (n=23, group 2: normal kidney with contralateral hypoplasic/hypofunctioning kidney (split renal function<30%, (n=24, group 3: bilateral normal kidneys (n=38. The measured camera based Tc 99m MAG3 clearances of normal kidneys in each group were compared. Results: Total Tc 99m MAG3 clearances (mL/min/1.73m 2 were significantly lower in group 1 and group 2 compared to group 3 (281.5±46, 260.5±61.7 and 316.1±84, respectively. Highest isolated Tc 99m MAG3 clearances among normal functioning kidneys were observed in group 1 (281.5±45.6 followed by group 2 (204.4±55 and group 3 (157.5±44. Moderate negative correlation was detected between the Tc99m MAG3 clearances of normal kidneys and contralateral renal function (r=-0.5, p<0.001. Conclusion: Normal kidneys can compensate for the loss of contralateral kidney function via increasing their clearances, which seems to be dependent on the residual function of their partner. Camera based Tc 99m MAG3 clearance measurement is an objective method to demonstrate compensatory differences in renal function seen between kidneys with contralateral normofunctioning, hypofunctioning and nonfunctioning partner. (MIRT 2012;21:56-62

CA V is present in rat kidney mitochondria

International Nuclear Information System (INIS)

Dodgson, S.J.; Contino, L.C.

1987-01-01

Guinea pig liver mitochondria contain the unique carbonic anhydrase isozyme, CA V. Prior to sacrifice, 15 rats and 15 guinea pigs were either fed normal lab chow (group 1), starved 48 hours (group 2) or fed normal lab chow and given to drink only water with added HCl, pH 2.5 (group 3). Mitochondria were prepared from excised livers and kidneys. CA V activity of disrupted mitochondria was measured by 18 O-mass spectrometric technique at pH 7.4, 37 0 C, 25 mM NaHCO 3 . Mass spectrometric CA assays with intact kidney mitochondria localize CA V activity to the matrix, as was found for liver mitochondria. It has been shown in hepatocytes prepared from starved guinea pigs and rats that inhibition of CA V results in decreased rate of gluconeogenesis from pyruvate. These present results are in line with the published observation that rat kidneys are much more gluconeogenic than guinea pig, and that this is increased by starvation and acidosis

Evaluation of regenerative capacity after kidney ischemic/reperfustion injury using 99mTc-DMSA

International Nuclear Information System (INIS)

Kwak, W. J.; Kim, J. W.; Park, K. M.; Lee, S. W.; Ahn, B. C.; Lee, J. T.; Yoo, J. S.

2007-01-01

Acute renal failure can be caused by a reduced renal blood flow induced because of ischemic injury. The damaged kidney can be completely restored in structure and function. 99m Tc-DMSA binds to cortical tubules in kidney and its uptake has been suggested to indicate function of cortical mass. Herein, the generative capacity of kidney after bilateral or unilateral ischemia/reperfusion (I/R) injury was evaluated non-invasively by scintigraphic imaging. Three different animal models were used. One or both kidneys of mice were subjected ischemic for 30 min for unilateral or bilateral I/R model, respectively. In third model, one kidney was excised and the other kidney was subjected ischemic for 30 min to give nephrectomy model. At 1 hr, 1 d, 3 d, 1 w, 2 w, 3 w after reperfusion, 99m Tc-DMSA (27.7 MBq) was injected via tail vein. After 3 hr, the mice were scanned for 30 min with pinhole equipped gamma camera. The ratio of ROI counts of kidney to total counts was calculated. In unilateral I/R mouse, the 99m Tc-DMSA uptake of injured kidney was decreased continuously up to 3 w (13.9 to 7.7%), while uptake in normal kidney is slowly increased. In case of nephrectomy model, 99m Tc-DMSA uptake of injured kidney was rapidly restored within 1 w after I/R operation (8.5 to 30%). Bilateral model showed reduced 99m Tc-DMSA uptake at 1 d, but total uptake in both I/R kidney was also increase up to 30% after 1 w and the uptake was maintained up to 3 w. In unilateral model, the 99m Tc-DMSA uptake of injured kidney kept decreasing up to 3 w while normal kidney showed increased 99m Tc-DMSA uptake. The restoration of I/R kidney was not observed within 3 w. However, in case of animal models which have only I/R kidneys such as bilateral and nephrectomy models, the 99m Tc-DMSA uptake was restored within 1 w and the excised kidney size was also normal in contrast to much smaller I/R kidney of unilateral model

Ectopia renal cruzada con fusión, reflujo vesicoureteral y riñón ectópico afuncional:: informe de un caso Crossed renal ectopia with fusion, vesicoureteral reflux and dysfunctional ectopic kidney:: A case report

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Sandalio Durán Álvarez

2010-03-01

Full Text Available Se presenta el caso de un niño cuyo ultrasonido materno-fetal de la semana 20 de la gestación no detectó alteraciones, pero el de la semana 23,6 mostró un riñón pélvico derecho. A los 22 días de nacido el ultrasonido renal mostró un riñón derecho de tamaño y posición normal y dilatación pélvica moderada, e inmediatamente por debajo del polo inferior de éste, un bolsón hidronefrótico que parecía corresponder a una ectopia renal cruzada con hidronefrosis grave. El padre padeció reflujo vesicoureteral derecho que desapareció espontáneamente. A pesar de la profilaxis con cefalexina, hubo una infección urinaria que se trató satisfactoriamente con ceftriaxona. Investigaciones ultrasonográficas y radioisotópicas arrojaron la existencia de una anomalía congénita dada por dilatación pélvica no obstructiva del riñón derecho, ectopia renal cruzada con fusión del riñón izquierdo afuncional y reflujo vesicoureteral bilateral, de grado II del riñón derecho y de grado V del izquierdo ectópico cruzado. A los 11 meses de edad se le realizó una lumbotomía y se comprobó la fusión del bolsón hidronefrótico con el polo inferior del riñón derecho. Se resecó el bolsón y se realizó una ligadura baja del uréter.This is the case of a child whose maternal-fetus ultrasound (US at twenty weeks pregnancy not detected alterations, but at the 23, 6 weeks it showed the presence of a right pelvic kidney. At twenty two days the renal US showed a right kidney with a normal size and location as well as a moderate pelvic dilation and immediately beneath its lower pole a hydronephrosis big sac in correspondence with a crossed renal ectopia with severe hydronephrosis. His father had right vesiculorectal reflux disappeared spontaneously. Despite the prophylaxis with Cephalexin there was a urinary infection adequately treated with Cephtriaxone. Ultrasonography and radioisotope researches demonstrated the presence of a congenital anomaly

Vesicoureteral reflux in children: comparison of contrast - enhanced voiding ultrasonography with radiographic voiding cystourethrography - preliminary report

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Yoon, Chong Hyun; Kim, Hyun Joo; Goo, Hyun Woo; Kim, Hungy; Lee, Jung Joo; Kim, Ellen Ai-Rhan; Kim, Ki Soo; Park, Young Seo; Pi, Soo Young [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

2001-01-01

To compared the usefullness of contrst-enhanced voiding ultrasonogrphy (US) with that of radiogrphic voiding cystourethrography (VCUG) for the diagnosis of vesicoureteral reflux (VUR) in children. Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast -enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinaru tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravityfilled at a height of 1 m with normal saline. A galactose-based, microbubble-containning echo-enhancing agent (Lvovist; Dchering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bldder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvocalyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrst-enhanced voiding US detected VUR was calcilated. In 87 of 95 kidney-ureter units (91.6%), the two methods showed similiar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occcur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was was not demostarted by radiographic VCUG; in six units, the resverse was true. In the detection of VUR, contrast-enhanced voiding us showed a sensitivity of 66.7%, a sprcificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. Contrst-enhanced voiding US is highly specific and has high positive and nagative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use its first required.

Vesicoureteral reflux in children: comparison of contrast - enhanced voiding ultrasonography with radiographic voiding cystourethrography - preliminary report

International Nuclear Information System (INIS)

Yoon, Chong Hyun; Kim, Hyun Joo; Goo, Hyun Woo; Kim, Hungy; Lee, Jung Joo; Kim, Ellen Ai-Rhan; Kim, Ki Soo; Park, Young Seo; Pi, Soo Young

2001-01-01

To compared the usefullness of contrst-enhanced voiding ultrasonogrphy (US) with that of radiogrphic voiding cystourethrography (VCUG) for the diagnosis of vesicoureteral reflux (VUR) in children. Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast -enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinaru tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravityfilled at a height of 1 m with normal saline. A galactose-based, microbubble-containning echo-enhancing agent (Lvovist; Dchering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bldder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvocalyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrst-enhanced voiding US detected VUR was calcilated. In 87 of 95 kidney-ureter units (91.6%), the two methods showed similiar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occcur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was was not demostarted by radiographic VCUG; in six units, the resverse was true. In the detection of VUR, contrast-enhanced voiding us showed a sensitivity of 66.7%, a sprcificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. Contrst-enhanced voiding US is highly specific and has high positive and nagative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use its first required

Spontaneous adrenal hemorrhage during pregnancy: a case with horseshoe kidney

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Mohadeseh Amini

2017-11-01

Full Text Available Spontaneous adrenal hemorrhage is an acute hemorrhage during pregnancy, which can be tragic for the mother and the baby. We report a unique spontaneous hemorrhage during pregnancy in a case with horseshoe kidney with separated adrenal, presented for the first time in the world. Computed tomography scan showed a horseshoe kidney fused with left normal kidney. Interestingly the adrenal gland was remained in right flank and separated from the horseshoe kidney, which prepares a probable physical stress for the hemorrhage. Diagnosis and surgery were done successfully and the case was fully recovered after several days.

Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

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Xu, Xueqin; Fang, Wenqiang; Ling, Huawei; Chai, Weimin; Chen, Kemin [Ruijin Hospital Shanghai, Jiaotong University School of Medicine, Department of Radiology, Shanghai (China)

2010-04-15

To prospectively evaluate the feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in the assessment of renal function in patients with chronic kidney disease (CKD). Seventy-two healthy volunteers and 43 patients underwent coronal echo-planar DW MR imaging of the kidneys with a single breath-hold time of 16 s. The patients were grouped according to five stages as indicated by the K/DOQI CKD (kidney disease outcome quality initiative). The apparent diffusion coefficient (ADC) value of the kidneys was calculated with high b values (b = 500 s/mm{sup 2}). The ADC values were compared between patients and healthy volunteers, and among different stages. For statistical analysis, Student's t tests, ANOVA, Pearson's correlation tests, and Spearman's correlation tests were used. No difference between the cortex and medulla could be observed on DW images of all volunteers. Patients with CKD had significantly lower renal ADC (t = -4.383, P = 0.000) than volunteers. The ADC values of kidneys were significantly lower than normal at most stages of CKD, except CKD1. There was a negative correlation between the ADCs and serum creatinine (sCr) level (P = 0.000) amongst the patients. Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD. (orig.)

Diffusion-weighted MR imaging of kidneys in patients with chronic kidney disease: initial study

International Nuclear Information System (INIS)

Xu, Xueqin; Fang, Wenqiang; Ling, Huawei; Chai, Weimin; Chen, Kemin

2010-01-01

To prospectively evaluate the feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in the assessment of renal function in patients with chronic kidney disease (CKD). Seventy-two healthy volunteers and 43 patients underwent coronal echo-planar DW MR imaging of the kidneys with a single breath-hold time of 16 s. The patients were grouped according to five stages as indicated by the K/DOQI CKD (kidney disease outcome quality initiative). The apparent diffusion coefficient (ADC) value of the kidneys was calculated with high b values (b = 500 s/mm 2 ). The ADC values were compared between patients and healthy volunteers, and among different stages. For statistical analysis, Student's t tests, ANOVA, Pearson's correlation tests, and Spearman's correlation tests were used. No difference between the cortex and medulla could be observed on DW images of all volunteers. Patients with CKD had significantly lower renal ADC (t = -4.383, P = 0.000) than volunteers. The ADC values of kidneys were significantly lower than normal at most stages of CKD, except CKD1. There was a negative correlation between the ADCs and serum creatinine (sCr) level (P = 0.000) amongst the patients. Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD. (orig.)

Quantitative MRI of kidneys in renal disease.

Science.gov (United States)

Kline, Timothy L; Edwards, Marie E; Garg, Ishan; Irazabal, Maria V; Korfiatis, Panagiotis; Harris, Peter C; King, Bernard F; Torres, Vicente E; Venkatesh, Sudhakar K; Erickson, Bradley J

2018-03-01

To evaluate the reproducibility and utility of quantitative magnetic resonance imaging (MRI) sequences for the assessment of kidneys in young adults with normal renal function (eGFR ranged from 90 to 130 mL/min/1.73 m 2 ) and patients with early renal disease (autosomal dominant polycystic kidney disease). This prospective case-control study was performed on ten normal young adults (18-30 years old) and ten age- and sex-matched patients with early renal parenchymal disease (autosomal dominant polycystic kidney disease). All subjects underwent a comprehensive kidney MRI protocol, including qualitative imaging: T1w, T2w, FIESTA, and quantitative imaging: 2D cine phase contrast of the renal arteries, and parenchymal diffusion weighted imaging (DWI), magnetization transfer imaging (MTI), blood oxygen level dependent (BOLD) imaging, and magnetic resonance elastography (MRE). The normal controls were imaged on two separate occasions ≥24 h apart (range 24-210 h) to assess reproducibility of the measurements. Quantitative MR imaging sequences were found to be reproducible. The mean ± SD absolute percent difference between quantitative parameters measured ≥24 h apart were: MTI-derived ratio = 4.5 ± 3.6%, DWI-derived apparent diffusion coefficient (ADC) = 6.5 ± 3.4%, BOLD-derived R2* = 7.4 ± 5.9%, and MRE-derived tissue stiffness = 7.6 ± 3.3%. Compared with controls, the ADPKD patient's non-cystic renal parenchyma (NCRP) had statistically significant differences with regard to quantitative parenchymal measures: lower MTI percent ratios (16.3 ± 4.4 vs. 23.8 ± 1.2, p quantitative measurements was obtained in all cases. Significantly different quantitative MR parenchymal measurement parameters between ADPKD patients and normal controls were obtained by MT, DWI, BOLD, and MRE indicating the potential for detecting and following renal disease at an earlier stage than the conventional qualitative imaging techniques.

Thioacetamide-induced changes in the body weight, kidney weight and the total nucleic acids content of kidney of mouse

International Nuclear Information System (INIS)

Shakoori, Abdul Rauf; Ashraf, Fauzia.

1976-01-01

Effects of thioacetamide (TAA) on the body weight, kidney weight and the total nucleic acids content of kidney of mouse were studied. TAA 1% and 2% solutions were injected intraperitoneally, twice with an interval of 24 hours in two different batches of male mice. In this way one batch received a total dose of 100 mg TAA/Kg body wt. while the other got a total dose of 200 mg TAA/Kg. Both the body as well as kidney weights decrease after TAA treatment. A total dose of 200 mg/Kg is a stronger inhibitor of growth as compared with that of 100 mg/Kg. The nucleic acids content show an increase after the drug treatment. The ribonucleic acid content of kidney increased from an average value of 4.30+0.14 mg/g kidney to 4.60+-0.22 mg/g kidney after 1% TAA treatment. The increase in 2% TAA treated mice is slightly more prominent. The deoxyribonucleic acid (DNA) content of kidney are likewise affected. After an initial increase in 1% TAA-treated animals, the DNA content gradually fall down to normal control values. Administration of 2% TAA solution causes an average increase of 21% i.e. from 1.93+-0.19 mg/g kidney wt to 2.26+-0.23 mg/g kidney wt. The size of cell, nucleus and nucleolus also increased after drug treatment, which mainly occurred during the first 24 hours of the post-treatment period

Primary congenital bladder diverticula: Where does the ureter drain?

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Antonio Macedo

2015-01-01

Full Text Available Background: Primary congenital bladder diverticulum (PCBD is related to a deficient detrusor layer allowing out-pouching of the bladder mucosa through the inadequate muscularis wall. We aimed to review our experience with symptomatic PCBD in order to correlate clinical findings with anatomical aspects and to present late outcome. Materials and Methods: We reviewed all patients operated in our institution since 2004. We evaluated the charts for complaints, radiological exams, method of treatment, complications and length of follow-up. Results: We treated 10 cases (11 renal units - [RU], predominantly males (9/10, mean age at surgery of 5.3 years. All patients had significant urological complaints presenting either with antenatal hydronephrosis (4 or febrile urinary tract infection (5 and urinary retention in one. The ureter was found implanted inside the diverticulum in 8/11 RU. An extravesical psoas-hitch ureteroneocystostomy and diverticulum resection was performed in 10/11 cases, whereas 1 case was treated intravesically based on surgeon′s preference without performing cystoscopy. Mean follow-up was 34.1 months (1-120 without complications. Conclusions: PCBD is an uncommon diagnosis and has a high probability of drainage inside the diverticulum (72.7%. We recommend the extravesical approach associated with diverticulectomy and ureteroneocystostomy as the preferred technique to treat this abnormality.

A Giant Ureteral Stone without Underlying Anatomic or Metabolic Abnormalities: A Case Report

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Selcuk Sarikaya

2013-01-01

Full Text Available A 28-year old man presented with left flank pain and dysuria. Plain abdominal film and computed tomography showed a left giant ureteral stone measuring 11.5 cm causing ureteral obstruction and other stones 2.5 cm in size in the lower pole of ipsilateral kidney and 7 mm in size in distal part of right ureter. A left ureterolithotomy was performed and then a double J stent was inserted into the ureter. The patient was discharged from the hospital 4 days postoperatively with no complications. Stone analysis was consistent with magnesium ammonium phosphate and calcium oxalate. Underlying anatomic or metabolic abnormalities were not detected. One month after surgery, right ureteral stone passed spontaneously, left renal stone moved to distal ureter, and it was removed by ureterolithotomy. Control intravenous urography and cystography demonstrated unobstructed bilateral ureter and the absence of vesicoureteral reflux.

Renal Structural And Physiological Alterations Subsequent To Unilateral Ureteral Obstruction

OpenAIRE

El Gohary, Z. M. A. [زينب محمود احمد الجوهري

1992-01-01

Complete obstruction of the right ureter of male rabbits for eight weeks resulted in filling of the obstructed kidney with clear urine, no precipitation or stone formation. The calyces and pelvis were distinctly dilated with parenchymal atrophy, the medulla was almost completely destroyed and the cortex was reduced to a thin extensively sclerotic rim. When compared with the contralateral control kidney, the parenchymal weight and water content of the obstructed kidney were distinctly greater....

Radiotherapy may improve overall survival of patients with T3/T4 transitional cell carcinoma of the renal pelvis or ureter and delay bladder tumour relapse

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Wu Li-Li

2011-07-01

Full Text Available Abstract Background Since transitional cell carcinoma (TCC of the upper urinary tract is a relatively uncommon malignancy, the role of adjuvant radiotherapy is unknown. Methods We treated 133 patients with TCC of the renal pelvis or ureter at our institution between 1998 and 2008. The 67 patients who received external beam radiotherapy (EBRT following surgery were assigned to the radiation group (RT. The clinical target volume included the renal fossa, the course of the ureter to the entire bladder, and the paracaval and para-aortic lymph nodes, which were at risk of harbouring metastatic disease in 53 patients. The tumour bed or residual tumour was targeted in 14 patients. The median radiation dose administered was 50 Gy. The 66 patients who received intravesical chemotherapy were assigned to the non-radiation group (non-RT. Results The overall survival rates for the RT and non-RT groups were not significantly different (p = 0.198. However, there was a significant difference between the survival rates for these groups based on patients with T3/T4 stage cancer. A significant difference was observed in the bladder tumour relapse rate between the irradiated and non-irradiated bladder groups (p = 0.004. Multivariate analysis indicated that improved overall survival was associated with age grade 3 hematologic symptoms also occurred. Conclusion EBRT may improve overall survival for patients with T3/T4 cancer of the renal pelvis or ureter and delay bladder tumour recurrence in all patients.

Screening for Bladder and Other Urothelial Cancers

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... cancer is the focus of this summary. Enlarge Anatomy of the male urinary system (left panel) and female urinary system (right panel) showing the kidneys, ureters, bladder, and urethra. Urine is made in ...

Comparison of hematocrit/hemoglobin ratios in subjects with alpha-thalassemia, with subjects having chronic kidney disease and normal subjects.

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Insiripong, Somchai; Supattarobol, Tanarat; Jetsrisuparb, Arunee

2013-07-04

The ratio of hematocrit (Hct) to hemoglobin (Hb) in the people with normal red blood cell (RBC) morphology is generally three to one. We studied Hct/Hb ratios among patients with alpha-thalassemias (Hb H, H-CS, AEBart, AEBart-CS, EFBart and EFBart-CS diseases) diagnosed by high performance liquid chromatography, and compared them with normal subjects and with patients having anemia due to chronic kidney disease (CKD). The Hct and Hb levels were derived by automated analyzer. The means +/- SD of the Hct/Hb ratios were 3.5 +/- 0.2 (range 3.3 - 4.1), 3.0 +/- 0.1 (range 2.9 - 3.2) and 3.0 +/- 0.1 (range 2.8 - 3.2) in the alpha-thalassemia, normal and CKD groups, respectively. The mean Hct/Hb ratio in subjects with alpha-thalassemia was higher than the mean in normal subjects and in those with CKD. The Hct/Hb ratios for each genotype of the alpha-thalassemia were not different from each other. The underlying mechanisms for the higher Hct/Hb ratio among those with alpha-thalassemia are theorized to be less density and/or more hydration of a-thalassemia RBCs, more entrapment of plasma in the spun RBC, the high percent of nucleated RBC and WBC interference. A ratio of 3.5 +/- 0.2 may be helpful in cases of moderate anemia when typing only shows Hb A and E, to consider investigation for alpha-thalassemia, or in cases of alpha-thalassemia with acute blood loss, if the Hct is less than 35%, in the decision to transfuse.

Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

International Nuclear Information System (INIS)

Ng, Cheuk Fan; Chan, L.W.; Cheng, C.W.; Yu, S.C.H.; Wong, W.S.; Wong, K.T.

2004-01-01

Purpose: We investigate the use of non-contrast helical computerized tomography (NCHCT) in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (Cr Cl) for unilateral chronically obstructed kidney. Materials And Methods: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG) of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN) was inserted to the obstructed kidney, and Cr Cl of both the obstructed kidney (PCN urine) and the normal side (voided urine) were measured two 2 after the relief of obstruction. Results: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential Cr Cl of the obstructed kidney (%CrCl) was defined as the percentage of Cr Cl of the obstructed kidney as of the total Cr Cl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol) was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort) was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r) between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00) x %CTvol - 14.27. The %CTvol

Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

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Ng C.F.

2004-01-01

Full Text Available PURPOSE: We investigate the use of non-contrast helical computerized tomography (NCHCT in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (CrCl for unilateral chronically obstructed kidney. MATERIALS AND METHODS: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN was inserted to the obstructed kidney, and CrCl of both the obstructed kidney (PCN urine and the normal side (voided urine were measured two 2 after the relief of obstruction. RESULTS: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential CrCl of the obstructed kidney (%CrCl was defined as the percentage of CrCl of the obstructed kidney as of the total CrCl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00 x %CTvol - 14.27. The %CTvol

Changes in serum cystatin C, creatinine, and C-reactive protein after cardiopulmonary bypass in patients with normal preoperative kidney function.

Science.gov (United States)

Svensson, Anders S; Kvitting, John-Peder Escobar; Kovesdy, Csaba P; Cederholm, Ingemar; Szabó, Zoltán

2016-06-01

The use of cardiopulmonary bypass (CPB) can cause changes in serum creatinine and cystatin C independent of glomerular filtration rate. We aimed to quantify the temporal changes of these biomarkers and C-reactive protein (CRP) after CPB. This was a prospective study at an academic medical centre between April and October 2013. We compared postoperative changes in serum creatinine and cystatin C in 38 patients with normal preoperative kidney function who underwent cardiac surgery using CPB and did not develop perioperative acute kidney injury (AKI). The effect of inflammation on intra-individual changes was examined in mixed effects regressions, using measurements of pre- and postoperative CRP. Both serum creatinine (79.9 ± 22.7 vs. 92.6 ± 21.4 µmol/L, P = 0.001) and cystatin C (1.16 ± 0.39 vs. 1.33 ± 0.37 mg/L, P = 0.012) decreased significantly in the first 8 h postoperatively compared to preoperatively, as a result of haemodilution. Thereafter serum creatinine returned to preoperative levels, whereas serum cystatin C continued to rise and was significantly elevated at 72 h post-CPB compared to preoperative levels (1.53 ± 0.48 vs. 1.33 ± 0.37 mg/L, P = 0.003). CRP levels increased significantly post-CPB and were significantly associated with increases in both serum creatinine and cystatin C. Serum creatinine and cystatin C appear not to be interchangeable biomarkers during and immediately after CPB. Processes unrelated to kidney function such as acute inflammation have a significant effect on post-CPB changes in these biomarkers, and may result in significant increases in serum cystatin C that could erroneously be interpreted as AKI. © 2015 Asian Pacific Society of Nephrology.

Heart Failure Increases the Risk of Adverse Renal Outcomes in Patients With Normal Kidney Function.

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George, Lekha K; Koshy, Santhosh K G; Molnar, Miklos Z; Thomas, Fridtjof; Lu, Jun L; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

2017-08-01

Heart failure (HF) is associated with poor cardiac outcomes and mortality. It is not known whether HF leads to poor renal outcomes in patients with normal kidney function. We hypothesized that HF is associated with worse long-term renal outcomes. Among 3 570 865 US veterans with estimated glomerular filtration rate (eGFR) ≥60 mL min -1 1.73 m -2 during October 1, 2004 to September 30, 2006, we identified 156 743 with an International Classification of Diseases , Ninth Revision , diagnosis of HF. We examined the association of HF with incident chronic kidney disease (CKD), the composite of incident CKD or mortality, and rapid rate of eGFR decline (slopes steeper than -5 mL min -1 1.73 m -2 y -1 ) using Cox proportional hazard analyses and logistic regression. Adjustments were made for various confounders. The mean±standard deviation baseline age and eGFR of HF patients were 68±11 years and 78±14 mL min -1 1.73 m -2 and in patients without HF were 59±14 years and 84±16 mL min -1 1.73 m -2 , respectively. HF patients had higher prevalence of hypertension, diabetes mellitus, cardiac, peripheral vascular and chronic lung diseases, stroke, and dementia. Incidence of CKD was 69.0/1000 patient-years in HF patients versus 14.5/1000 patient-years in patients without HF, and 22% of patients with HF had rapid decline in eGFR compared with 8.5% in patients without HF. HF patients had a 2.12-, 2.06-, and 2.13-fold higher multivariable-adjusted risk of incident CKD, composite of CKD or mortality, and rapid eGFR decline, respectively. HF is associated with significantly higher risk of incident CKD, incident CKD or mortality, and rapid eGFR decline. Early diagnosis and management of HF could help reduce the risk of long-term renal complications. © 2017 American Heart Association, Inc.

Hereditary renal adysplasia, pulmonary hypoplasia and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a case report

Science.gov (United States)

2010-01-01

Background Hereditary renal adysplasia is an autosomal dominant trait with incomplete penetrance and variable expression that is usually associated with malformative combinations (including Müllerian anomalies) affecting different mesodermal organs such as the heart, lung, and urogenital system. Case report A case showing pulmonary hypoplasia, hip dysplasia, hereditary renal adysplasia, and Mayer-Rokitansky-Kuster-Hauser syndrome in adulthood is reported here. The i.v. pyelography showed right renal agenesis with a normal left kidney and ureter. Ultrasound and Magnetic Resonance Imaging also showed right renal agenesis with multicystic embryonary remnants in the right hemipelvis probably corresponding to a dysgenetic kidney. An uretrocystoscopy showed absence of ectopic ureter and of the right hemitrigone. She was scheduled for a diagnostic laparoscopy and creation of a neovagina according to the McIndoe technique with a prosthesis and skin graft. Laparoscopy confirmed the absence of the uterus. On both sides, an elongated, solid, rudimentary uterine horn could be observed. Both ovaries were also elongated, located high in both abdominal flanks and somewhat dysgenetics. A conventional cytogenetic study revealed a normal female karyotype 46, XX at a level of 550 GTG bands. A CGH analysis was performed using a 244K oligoarray CGH detecting 11 copy number variants described as normal variants in the databases. The 17q12 and 22q11.21 microdeletions described in other MRKH patients were not present in this case. Four years after operation her evolution is normal, without symptoms and the neovagina is adequately functional. The geneticists have studied her family history and the pedigree of the family is shown. Conclusions We suggest that primary damage to the mesoderm (paraaxil, intermediate, and lateral) caused by mutations in a yet unidentified gene is responsible for: 1) skeletal dysplasia, 2) inappropriate interactions between the bronchial mesoderm and endodermal

Heterozygosity for fibrinogen results in efficient resolution of kidney ischemia reperfusion injury.

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Amrendra Kumar Ajay

Full Text Available Fibrinogen (Fg has been recognized to play a central role in coagulation, inflammation and tissue regeneration. Several studies have used Fg deficient mice (Fg(-/- in comparison with heterozygous mice (Fg(+/- to point the proinflammatory role of Fg in diverse pathological conditions and disease states. Although Fg(+/- mice are considered 'normal', plasma Fg is reduced to ~75% of the normal circulating levels present in wild type mice (Fg(+/+. We report that this reduction in Fg protein production in the Fg(+/- mice is enough to protect them from kidney ischemia reperfusion injury (IRI as assessed by tubular injury, kidney dysfunction, necrosis, apoptosis and inflammatory immune cell infiltration. Mechanistically, we observed binding of Fg to ICAM-1 in kidney tissues of Fg(+/+ mice at 24 h following IRI as compared to a complete absence of binding observed in the Fg(+/- and Fg(-/- mice. Raf-1 and ERK were highly activated as evident by significantly higher phosphorylation in the Fg(+/+ kidneys at 24 h following IRI as compared to Fg(+/- and Fg(-/- mice kidneys. On the other hand Cyclin D1 and pRb, indicating higher cell proliferation, were significantly increased in the Fg(+/- and Fg(-/- as compared to Fg(+/+ kidneys. These data suggest that Fg heterozygosity allows maintenance of a critical balance of Fg that enables regression of initial injury and promotes faster resolution of kidney damage.

Medullary sponge kidney on axial computed tomography

International Nuclear Information System (INIS)

Ginalski, J.-M.; Schnyder, Pierre; Portmann, Luc; Jaeger, Philippe

1991-01-01

To evaluate features of medullary sponge kidney (MSK) on computed tomography (CT), 4-mm-thick axial slices without intravenous contrast material were 1st made in 13 patients through 24 kidneys which showed images of MSK on excretory urograms. On CT, papillary calcifications were found in 11 kidneys. In 5 of these, the calcifications were not detectable on plain films. Some hyperdense papillae (attenuation value 55-70 Hounsfield units) without calcification were found in 4 other kidneys. 9 kidneys appeared normal. 10 of the 14 kidneys were reexamined by a 2nd series of 4-mm-thick axial slices, 5 min after intravenous injection of 50 ml of Urografin. Images suggesting possible ectasia of precaliceal tubules were found in only 4 kidneys. These images appear much less obvious and characteristic on CT than on excretory urogram and do nothing more than suggest the possibility of MSK. In conclusion, the sensitivity of CT in the detection of MSK is markedly lower than that of excretory urography. In the most florid cases of the disease, CT can only show images suggesting the possibility of MSK. On the other hand, CT appears much more sensitive than plain films and tomograms of excretory in the detection of papillary calcifications, the most frequent complication of MSK. (author). 13 refs.; 3 figs

Lesions in mink (Mustela vison) infected with giant kidney worm (Dioctophyma renale).

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Mace, T F

1976-01-01

Adult Dioctophyma renale occupied the enlarged renal pelvis of the right kidney of naturally infected mink. Lesions in the kidney parenchyma consisted of connective tissue proliferation in the interstitial tissue, tubular atrophy and fibrosis, and periglomerular fibrosis. The luminal surface of the renal pelvis wall was formed of numerous papillae covered with transitional epithelium. The nematodes in the lumen were bathed in an albuminous fluid containing red blood cells, epithelial cells and D. renale eggs. The left (uninfected) kidney was 60% larger than the left kidney of normal mink.

Plasma Neutrophil Gelatinase-Associated Lipocalin Reflects Both Inflammation and Kidney Function in Patients with Myocardial Infarction

DEFF Research Database (Denmark)

Lindberg, Søren; Jensen, Jan S; Hoffmann, Søren

2016-01-01

BACKGROUND/AIMS: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a marker for acute kidney injury and cardiovascular outcome. However, the relative importance of inflammation versus kidney function on plasma NGAL levels is uncertain, making the interpretation of plasma NGAL unclear....... Accordingly, we investigated the relationship between plasma NGAL, inflammation and kidney function in patients with myocardial infarction (MI). METHODS: We prospectively included 584 patients with acute ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (PCI) from 2006.......001). Leukocyte count and C-reactive protein were the main determinants of plasma NGAL in patients with normal eGFR, whereas eGFR was the main determinant at reduced kidney function. CONCLUSIONS: eGFR determines the association of NGAL with either inflammation or kidney function; in patients with normal e...

Complete renal fusion in a child with recurrent urinary tract infection

International Nuclear Information System (INIS)

Gun, Saul; Ciantelli, Guilherme Lippi; Takahashi, Marilia Akemi Uzuelle; Brabo, Alexandre Mineto; Morais, Livea Athayde de; Figueiredo, Caio Barros

2012-01-01

Cake kidney, a rare anomaly of the urinary tract, may be diagnosed at any age range. During the investigation of recurrent urinary tract infection in a 12-year-old child, contrast-enhanced computed tomography demonstrated the presence of a right-sided ectopic kidney, with renal fusion, drained by two ureters. Prophylactic treatment with nitrofurantoin was instituted, and the patient currently remains asymptomatic. (author)

Complete renal fusion in a child with recurrent urinary tract infection

Energy Technology Data Exchange (ETDEWEB)

Gun, Saul [Department of Surgery, Faculdade de Medicina de Sorocaba, SP (Brazil); Conjunto Hospitalar de Sorocaba, SP (Brazil); Ciantelli, Guilherme Lippi; Takahashi, Marilia Akemi Uzuelle; Brabo, Alexandre Mineto; Morais, Livea Athayde de; Figueiredo, Caio Barros, E-mail: gui_lippi@hotmail.com [Faculdade de Ciencias Medicas e da Saude da Pontificia Universidade Catolica de Sao Paulo (FCMS/PUC-SP), Sorocaba, SP (Brazil)

2012-07-15

Cake kidney, a rare anomaly of the urinary tract, may be diagnosed at any age range. During the investigation of recurrent urinary tract infection in a 12-year-old child, contrast-enhanced computed tomography demonstrated the presence of a right-sided ectopic kidney, with renal fusion, drained by two ureters. Prophylactic treatment with nitrofurantoin was instituted, and the patient currently remains asymptomatic. (author)

Urine Blockage in Newborns

Science.gov (United States)

... the ureter joins the kidney. Bladder outlet obstruction (BOO). BOO describes any blockage in the urethra or at ... urethral valves (PUV), the most common form of BOO seen in newborns and during prenatal ultrasound exams, ...

Combined heart-kidney transplantation after total artificial heart insertion.

Science.gov (United States)

Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-01-01

We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Localized Cystic Disease of the Kidney: A Rare Cause of Hypertension in a Young Adult

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Aynur Solak

2013-01-01

Full Text Available Localized cystic disease of kidney (LCDK is a rare, non-familial, non-progressive renal disorder that is not associated with cysts or disorders in other organs. Only a few cases have been reported in the literature. While this condition is morphologically identical to the autosomal dominant form of polycystic kidney disease, it is not inherited and is not associated with significant deterioration of renal function. We present a case of a 16-year-old male patient who suffered from hypertension for over two years. On imaging we found several, variable-sized cysts in the upper half of the right kidney. The left kidney and lower segment of the right kidney were normal. Selective renal vein catheterization and sampling showed markedly elevated renin level in the right upper segmental vein (92 pg/ml, normal value: 11-33 pg/ml. The patient underwent a right upper heminephrectomy and histopathology was suggestive of LCDK. After surgery, the patient′s blood pressure returned to normal levels without any need of antihypertensive medication and he is under follow-up on outpatient basis for the past two years.

Cell cycle arrest and the evolution of chronic kidney disease from acute kidney injury.

Science.gov (United States)

Canaud, Guillaume; Bonventre, Joseph V

2015-04-01

For several decades, acute kidney injury (AKI) was generally considered a reversible process leading to complete kidney recovery if the individual survived the acute illness. Recent evidence from epidemiologic studies and animal models, however, have highlighted that AKI can lead to the development of fibrosis and facilitate the progression of chronic renal failure. When kidney injury is mild and baseline function is normal, the repair process can be adaptive with few long-term consequences. When the injury is more severe, repeated, or to a kidney with underlying disease, the repair can be maladaptive and epithelial cell cycle arrest may play an important role in the development of fibrosis. Indeed, during the maladaptive repair after a renal insult, many tubular cells that are undergoing cell division spend a prolonged period in the G2/M phase of the cell cycle. These tubular cells recruit intracellular pathways leading to the synthesis and the secretion of profibrotic factors, which then act in a paracrine fashion on interstitial pericytes/fibroblasts to accelerate proliferation of these cells and production of interstitial matrix. Thus, the tubule cells assume a senescent secretory phenotype. Characteristic features of these cells may represent new biomarkers of fibrosis progression and the G2/M-arrested cells may represent a new therapeutic target to prevent, delay or arrest progression of chronic kidney disease. Here, we summarize recent advances in our understanding of the biology of the cell cycle and how cell cycle arrest links AKI to chronic kidney disease. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Measurement of kidney by computed tomography

International Nuclear Information System (INIS)

Hamada, Tatsumi; Nakagawa, Kenichi; Tamura, Kenji; Yoshida, Akio; Fujii, Koichi

1983-01-01

Several measurements of normal kidney in vivo were obtained from computed tomography and were correlated with age, sex and body dimensions. Forty four males and 21 females without a history of renal disease were studied. 1. Angle between renal coronal section and body frontal (degree): The mean value (+- SD) of the angle was 44.0 +- 11.1 for right kidney and 42.3 +- 11.2 for left, with a low correlation coefficient. The angle had no significant correlation with age nor sex. 2. The largest width of kidney (cm): The mean value of the width was 4.6 +- 0.6 for male right kidney, 5.1 +- 0.6 for male left, 4.6 +- 0.7 for female right and 4.7 +- 1.0 for female left. The values correlated with age under 40 positively and over 40 negatively. 3. Renal volume (cm 3 ): Renal volume was calculated by adding together the area measurements obtained from successive 1 cm thick scans, excluding renal sinus. The mean volume was 107 +- 27 for male right kidney, 114 +- 24 for male left, 101 +- 33 for female right and 111 +- 41 for female left. The correlation coefficient of right versus left renal volume was significantly high. Total renal volume, i. e. left + right renal volume, had significant negative correlation with age over 40. 4. CT numbers of kidney: Average value of right kidney was 31.4 +- 6.0 and that of left was 30.7 +- 5.9. Though the correlation coefficient between right and left was nearly 1, no significant correlation was found with other values. (author)

MR urography (MRU) of non-dilated ureter with diuretic administration: Static fluid 2D FSE T2-weighted versus 3D gadolinium T1-weighted GE excretory MR

International Nuclear Information System (INIS)

Roy, C.; Ohana, M.; Host, Ph.; Alemann, G.; Labani, A.; Wattiez, A.; Lang, H.

2014-01-01

•T2w-MRU with multiple orientations and diuretic is sufficient to identify non-dilated ureter.•T2w-MRU offers information on ureteral contractions and could be proposed to detect initial obstruction before hydronephrosis occurs (for instance in cases of endometriosis).•T2w-MRU could also be used to evaluate potential renal donors or in patients unable to receive gadolinium.•CE-MRU rapidly produces an overdistended bladder with a risk of false positive diagnosis of mild obstruction.•CE-MRU is less convenient for patients. T2w-MRU with multiple orientations and diuretic is sufficient to identify non-dilated ureter. T2w-MRU offers information on ureteral contractions and could be proposed to detect initial obstruction before hydronephrosis occurs (for instance in cases of endometriosis). T2w-MRU could also be used to evaluate potential renal donors or in patients unable to receive gadolinium. CE-MRU rapidly produces an overdistended bladder with a risk of false positive diagnosis of mild obstruction. CE-MRU is less convenient for patients. The goal of this prospective study was to compare the efficiency of two types of MRU after diuretic administration to identify the non-dilated ureter. MR pelvic examinations were performed in 126 patients after receiving furosemide. Each patient underwent in addition to their protocol for context, two types of MRU: 2D T2-weighted FSE (T2w-MRU) and 3D Gd T1-weighted GE (CE-MRU). Four segments were checked for each ureter. For the first part of the analysis, readers evaluated the whole image quality using a four points subjective scale and for the second part, they were asked to score separately each ureteral segment as present or absent. 1008 ureteral segments were checked. For the image quality, readers did not find any significant difference (3.8 ± 0.5 vs 3.6 ± 0.7, p value: 0.13) between MRU methods. The interobserver agreement was excellent with a κ correlation coefficient as high as 0.89 for T2w-MRU and 0.92 for CE

Physical rehabilitation in complex therapy of the ureter stones patients in the Truskavets health resort area

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Shologon R.P.

2010-05-01

Full Text Available Efficiency of rehabilitation measures is considered in complex therapy with the use of differentiated methods of medical physical education for patients with stones of ureter. Under a supervision there was 143 patients. 93 patients were made basic group, 50 patients - control. From them 51 (56 % are men and 42 (54% are women. Age of patients made from 20 to 60 years. A sanatorium-resort rehabilitation is recommended with the use of the differentiated methods of medical gymnastics. Application of method improved the indexes of the functional state of buds and overhead urinary ways. Frequency of advancement and output of concrements is also megascopic.

The Effects of Early Postnatal Diuretics Treatment on Kidney Development and Long-Term Kidney Function in Wistar Rats

NARCIS (Netherlands)

Bueters, Ruud R. G.; Jeronimus-Klaasen, Annelies; Maicas, Nuria; Florquin, Sandrine; van den Heuvel, Lambertus P.; Schreuder, Michiel F.

2016-01-01

Diuretics are administered to neonates to control fluid balance. We studied whether clinical doses affected kidney development and function and whether extrauterine growth retardation (EUGR) could be a modulator. Wistar rats were cross-fostered in normal food or food restricted litters at postnatal

Intra-operative on-line discrimination of kidney cancer from normal tissue by IR ATR spectroscopy of extracellular fluid

Science.gov (United States)

Urboniene, V.; Velicka, M.; Ceponkus, J.; Pucetaite, M.; Jankevicius, F.; Sablinskas, V.; Steiner, G.

2016-03-01

Determination of cancerous and normal kidney tissues during partial, simple or radical nephrectomy surgery was performed by using differences in the IR absorption spectra of extracellular fluid taken from the corresponding tissue areas. The samples were prepared by stamping of the kidney tissue on ATR diamond crystal. The spectral measurements were performed directly in the OR during surgery for 58 patients. It was found that intensities of characteristic spectral bands of glycogen (880-1200 cm-1) in extracellular fluid are sensitive to the type of the tissue and can be used as spectral markers of tumours. Characteristic spectral band of lactic acid (1730 cm-1) - product of the anaerobic glycolysis, taking place in the cancer cells is not suitable for use as a spectral marker of cancerous tissue, since it overlaps with the band of carbonyl stretch in phospholipids and fatty acids. Results of hierarchical cluster analysis of the spectra show that the spectra of healthy and tumour tissue films can be reliably separated into two groups. On the other hand, possibility to differentiate between tumours of different types and grades remains in question. While the fluid from highly malignant G3 tumour tissue contains highly pronounced glycogen spectral bands and can be well separated from benign and G1 tumours by principal component analysis, the variations between spectra from sample to sample prevent from obtaining conclusive results about the grouping between different tumour types and grades. The proposed method is instant and can be used in situ and even in vivo.

Intravenous Pyelogram (IVP)

Science.gov (United States)

... the kidney, ureters or urinary bladder scarring from urinary tract infection surgery on the urinary tract congenital anomalies of ... Gallery Radiography procedure View full size with caption Pediatric Content Some imaging tests and treatments have special ...

Aging and the Kidneys: Anatomy, Physiology and Consequences for Defining Chronic Kidney Disease.

Science.gov (United States)

Glassock, Richard J; Rule, Andrew D

2016-01-01

The varied functions of the kidneys are influenced by the complex process of aging. The glomerular filtration rate (GFR) steadily declines with normal aging, and the progress of this process can be influenced by superimposed diseases. Microscopically, nephron numbers decrease as global glomerulosclerosis becomes more evident. The precise mechanisms underlying nephron loss with aging are not well understood, but derangements in podocyte biology appear to be involved. Classifications of chronic kidney disease (CKD) incorporate GFR values and attendant risk of adverse events. Arbitrary and fixed thresholds of GFR for defining CKD have led to an overdiagnosis of CKD in the elderly. An age-sensitive definition of CKD could offer a solution to this problem and more meaningfully capture the prognostic implications of CKD. © 2016 S. Karger AG, Basel.

Kidney transplant

Science.gov (United States)

... always take your medicine as directed. Alternative Names Renal transplant; Transplant - kidney Patient Instructions Kidney removal - discharge Images Kidney anatomy Kidney - blood and urine flow Kidneys Kidney transplant - ...

ECAJS 2009 VOL 14 No 1 FINAL EDIT doc

African Journals Online (AJOL)

user

The per rectal examination was normal. A complete laboratory evaluation was done. His haematological profile was within normal limits; the ... side vein, the ureter is trapped dorsal to it.1 Variations of this include duplication of vena cava with the ureter lying beside or behind the vascular limbs. There is a report of a case.

A Clinical and Radiological Observation on Urolithiasis

International Nuclear Information System (INIS)

Chung, Young Sun; Byun, Moung Ho; Yoon, I Ho

1983-01-01

A clinical and radiological observation was made on 167 cases of urolithiasis among the number of 150 patients during 1 year and 6 months from June, 1981 to November, 1982. The results were summarized as follows. 1. There were 101 man and 49 women, a ratio of 2:1. The ages of the patients ranged from 2 to 74 years, showing the highest incidence in 31 to 60 years (68.1%). 2. Locational distributions of urolithiasis were 80 cases (47.9%) in the ureter, 66 cases (39.5%) in the kidney, 11 cases (6.5%) in the urethra and 10 cases (5.9%) in the bladder. 3. Among the 66 cases of renal stone, pelvis stone was 55 cases (83.3%) with staghorn types in 23 cases (34.8%), and calyceal stone was 11 cases (16.6%). 4. The location of ureteral stone was 47.5% in lower, 40% in upper ureter and 12.5% in mid-ureter. 5. The location of urethra stone was 82% in the anterior urethra and 18% in the posterior urethra. 6. The chief complain of urolithiasis was flank pain in 59.2%, gross hematuria in 20.3%, renal colic in 13.1%, dysuria in 8.3%, nausea and vomiting in 4.7%, and sudden stoppage of urine stream in 3.5%. 7. On urinalysis, gross hematuria was found in 54.4%, pyuria in 28.7%, bacteriuria in 23.3%, microscopic hematuria in 18.5% and normal in 7.1%. 8. The size of urinary stone was 0.6-2.0 cm in length in 105 cases (62.8%). 9. On I.V.P. study of renal stones (66 cases), mild and moderate hydro nephrotic changes were detected in 38 kidneys (57.5%), and the relationship between the urinary stasis and renal stone size was relatively good. 10. On I.V.P. study of ureteral stones (80 cases), mild to severe hydro nephrotic changes were detected in 64 kidneys (80%). 11. On K.U.B. film, paralytic ileus was found in 25 cases (14.9%). 12. Among the urinary stones, the radiolucent stones were detected in 8 cases (4.7%). 13. Urinary stones disappeared in 11 cases (6.5%) spontaneously or medical treatment.

A Clinical and Radiological Observation on Urolithiasis

Energy Technology Data Exchange (ETDEWEB)

Chung, Young Sun; Byun, Moung Ho; Yoon, I Ho [Chonnam National University Hospital, Gwangju (Korea, Republic of)

1983-09-15

A clinical and radiological observation was made on 167 cases of urolithiasis among the number of 150 patients during 1 year and 6 months from June, 1981 to November, 1982. The results were summarized as follows. 1. There were 101 man and 49 women, a ratio of 2:1. The ages of the patients ranged from 2 to 74 years, showing the highest incidence in 31 to 60 years (68.1%). 2. Locational distributions of urolithiasis were 80 cases (47.9%) in the ureter, 66 cases (39.5%) in the kidney, 11 cases (6.5%) in the urethra and 10 cases (5.9%) in the bladder. 3. Among the 66 cases of renal stone, pelvis stone was 55 cases (83.3%) with staghorn types in 23 cases (34.8%), and calyceal stone was 11 cases (16.6%). 4. The location of ureteral stone was 47.5% in lower, 40% in upper ureter and 12.5% in mid-ureter. 5. The location of urethra stone was 82% in the anterior urethra and 18% in the posterior urethra. 6. The chief complain of urolithiasis was flank pain in 59.2%, gross hematuria in 20.3%, renal colic in 13.1%, dysuria in 8.3%, nausea and vomiting in 4.7%, and sudden stoppage of urine stream in 3.5%. 7. On urinalysis, gross hematuria was found in 54.4%, pyuria in 28.7%, bacteriuria in 23.3%, microscopic hematuria in 18.5% and normal in 7.1%. 8. The size of urinary stone was 0.6-2.0 cm in length in 105 cases (62.8%). 9. On I.V.P. study of renal stones (66 cases), mild and moderate hydro nephrotic changes were detected in 38 kidneys (57.5%), and the relationship between the urinary stasis and renal stone size was relatively good. 10. On I.V.P. study of ureteral stones (80 cases), mild to severe hydro nephrotic changes were detected in 64 kidneys (80%). 11. On K.U.B. film, paralytic ileus was found in 25 cases (14.9%). 12. Among the urinary stones, the radiolucent stones were detected in 8 cases (4.7%). 13. Urinary stones disappeared in 11 cases (6.5%) spontaneously or medical treatment.

Epidemiology of RBC Transfusions in Patients With Severe Acute Kidney Injury: Analysis From the Randomized Evaluation of Normal Versus Augmented Level Study.

Science.gov (United States)

Bellomo, Rinaldo; Mårtensson, Johan; Kaukonen, Kirsi-Maija; Lo, Serigne; Gallagher, Martin; Cass, Alan; Myburgh, John; Finfer, Simon

2016-05-01

To assess the epidemiology and outcomes associated with RBC transfusion in patients with severe acute kidney injury requiring continuous renal replacement therapy. Post hoc analysis of data from a multicenter, randomized, controlled trial. Thirty-five ICUs in Australia and New Zealand. Cohort of 1,465 patients enrolled in the Randomized Evaluation of Normal versus Augmented Level replacement therapy study. Daily information on morning hemoglobin level and amount of RBC transfused were prospectively collected in the Randomized Evaluation of Normal versus Augmented Level study. We analyzed the epidemiology of such transfusions and their association with clinical outcomes. Overall, 977 patients(66.7%) received a total of 1,192 RBC units. By day 5, 785 of 977 transfused patients (80.4%) had received at least one RBC transfusion. Hemoglobin at randomization was lower in transfused than in nontransfused patients (94 vs 111 g/L; p regression analysis, RBC transfusion was independently associated with lower 90-day mortality (hazard ratio, 0.55; 95% CI, 0.38-0.79). However, we found no independent association between RBC transfusions and mortality when the analyses were restricted to patients surviving at least 5 days (hazard ratio, 1.29; 95% CI, 0.90-1.85). We found no independent association between RBC transfusion and renal replacement therapy-free days, mechanical ventilator-free days, or length of stay in ICU or hospital. In patients with severe acute kidney injury treated with continuous renal replacement therapy, we found no association of RBC transfusion with 90-day mortality or other patient-centered outcomes. The optimal hemoglobin threshold for RBC transfusion in such patients needs to be determined in future randomized controlled trials.

A case of acute kidney injury by near-drowning.

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Amir, A; Lee, Y L

2013-01-01

Acute kidney injury following immersion or near-drowning is rarely described and no data from Malaysia have been found. We report a case of acute kidney injury following a near-drowning event. A 20-year-old man who recovered from near-drowning in a swimming pool 5 days earlier presented to our clinic with abdominal pain, anorexia, nausea and polyuria. Dipstick urinalysis showed a trace of blood. The serum creatinine level was 10-fold higher than the normal range. A bedside ultrasound showed features suggestive of acute tubular necrosis. He is then referred to the hospital with the diagnosis of acute kidney injury with the possibility of acute tubular necrosis secondary to near-drowning. We suggest that any patient presenting after immersion or near-drowning to be should assessed for potential acute kidney injury.

[Can man live with a pig kidney?].

Science.gov (United States)

Valentin, J F; Lebranchu, Y; Nivet, H

1999-01-01

The transplantation of organs from one species to another introduces a question of compatibility not seen in allotransplantation, the ability of a kidney to perform its physiological function in the new host environment. It has been assumed that an allotransplanted organ will function normally if is not rejected; ample experience supports this assumption. This luxury will not exist in the field of xenotransplantation, where the issues of comparative physiology will assume great importance. From many standpoints, the pig kidney seems an ideal donor for xenotransplantation. They are of similar size and have remarkably similar internal anatomy. Even if the immunological problems could be overcome, there is almost no direct experimental evidence to answer the question of whether or not a pig kidney can function in a human body.

Endoglin haploinsufficiency attenuates radiation-induced deterioration of kidney function in mice

International Nuclear Information System (INIS)

Scharpfenecker, Marion; Floot, Ben; Russell, Nicola S.; Coppes, Rob P.; Stewart, Fiona A.

2013-01-01

Background and Purpose: Endoglin is a transforming growth receptor beta (TGF-β) co-receptor, which plays a crucial role in the development of late normal tissue damage. Mice with halved endoglin levels (Eng +/- mice) develop less inflammation, vascular damage and fibrosis after kidney irradiation compared to their wild type littermates (Eng +/+ mice). This study was aimed at investigating whether reduced tissue damage in Eng +/- mice also results in superior kidney function. Material and Methods: Kidneys of Eng +/+ and Eng +/- mice were irradiated with a single dose of 14 Gy. Functional kidney parameters and kidney histology were analysed at 20, 30 and 40 weeks after irradiation. Results: Eng +/- mice displayed improved kidney parameters (haematocrit, BUN) compared to Eng +/+ mice at 40 weeks after irradiation. Irradiation of Eng +/+ kidneys damaged the vascular network and led to an increase in PDGFR-β positive cells, indicative of fibrosis-promoting myofibroblasts. Compared to Eng +/+ kidneys, vascular perfusion and number of PDGFR-β positive cells were reduced in Eng +/- control mice; however, this did not further deteriorate after irradiation. Conclusions: Taken together, we show that not only kidney morphology, but also kidney function is improved after irradiation in Eng +/- compared to Eng +/+ mice

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... when you do, phew! Your pee smells bad. These things happen because bacteria have caused an infection ... tract is actually a system made up of these main parts: two kidneys two ureters (say: YUR- ...

Medline Plus

Full Text Available ... Usually the calculus is the size of a small pebble. But ureters are very sensitive to being ... being stuck anywhere along the urinary tract. Fortunately, small stones typically pass out of the kidneys and ...

Stages of Wilms Tumor

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... through the urethra and leaves the body. Enlarge Anatomy of the female urinary system showing the kidneys, adrenal glands, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of ...

Multiple Primary and Histology Coding Rules - SEER

Science.gov (United States)

Download the coding manual and training resources for cases diagnosed from 2007 to 2017. Sites included are lung, breast, colon, melanoma of the skin, head and neck, kidney, renal pelvis/ureter/bladder, benign brain, and malignant brain.

Medline Plus

Full Text Available ... ureter. As urine can become very concentrated as it passes through the kidneys. When the urine becomes ... being stretched, and when stones form and distend it, the stretching can be very painful. Often, people ...

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... connected to each kidney). From there, the urine travels through the ureters down to the bladder. When ... You'll also want to stay away from foods and drinks that contain caffeine , such as cola ...

RLIP76 Targeted Therapy for Kidney Cancer.

Science.gov (United States)

Singhal, Sharad S; Singhal, Jyotsana; Figarola, James; Horne, David; Awasthi, Sanjay

2015-10-01

Despite recent improvements in chemotherapeutic approaches to treating kidney cancer, this malignancy remains deadly if not found and removed at an early stage of the disease. Kidney cancer is highly drug-resistant, which may at least partially result from high expression of transporter proteins in the cell membranes of kidney cells. Although these transporter proteins can contribute to drug-resistance, targeting proteins from the ATP-binding cassette transporter family has not been effective in reversing drug-resistance in kidney cancer. Recent studies have identified RLIP76 as a key stress-defense protein that protects normal cells from damage caused by stress conditions, including heat, ultra-violet light, X-irradiation, and oxidant/electrophilic toxic chemicals, and is crucial for protecting cancer cells from apoptosis. RLIP76 is the predominant glutathione-electrophile-conjugate (GS-E) transporter in cells, and inhibiting it with antibodies or through siRNA or antisense causes apoptosis in many cancer cell types. To date, blocking of RLIP76, either alone or in combination with chemotherapeutic drugs, as a therapeutic strategy for kidney cancer has not yet been evaluated in human clinical trials, although there is considerable potential for RLIP76 to be developed as a therapeutic agent for kidney cancer. In the present review, we discuss the mechanisms underlying apoptosis caused by RLIP76 depletion, the role of RLIP76 in clathrin-dependent endocytosis deficiency, and the feasibility of RLIP76-targeted therapy for kidney cancer.

Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function

Science.gov (United States)

Akin, Yigit; Yucel, Selcuk

2014-01-01

Introduction Extracorporeal shock wave lithotripsy (ESWL) is a well-known and successful treatment modality. In addition, it can be used in premature infants. ESWL is used to treat kidney and ureter stones in children. However, although it is a preferred noninvasive treatment in that setting, there is debate about its long-term effects on growing kidneys in children. Objectives To investigate the long-term effects of pediatric ESWL on renal function in light of updated literature. Methods PubMed and Medline were searched for studies on ESWL in a pediatric population with keywords including efficacy, child, kidney calculi, ureter calculi, lithotripsy, injury, vascular trauma, and shock waves. The research was limited to the English literature during a period from 1980 to 2014. In total, 3,000 articles were evaluated, but only 151 papers were considered. Only the manuscripts directly related to the reviewed subjects were included in the current study. Results However, the acute effects of ESWL in kidney are well-described. Although there are limited studies on the long-term effects of ESWL in children, there is a widespread opinion that ESWL is not affecting renal functions in the long-term. Conclusion ESWL is a safe, effective, and noninvasive treatment option in children. Although ESWL can cause some acute effects in the kidney, there is no long-term effect on the growing kidneys of children. PMID:24892029

Evaluation of {sup 123}I-orthoiodohippurate single kidney clearance rate by renal sequential scintigraphy in a large cohort of likely normal subjects aged between 0 and 18 years

Energy Technology Data Exchange (ETDEWEB)

Imperiale, Alessio; Olianti, Catia; Comis, Giannetto; Cava, Giuseppe la [University of Florence, Nuclear Medicine Unit, Department of Clinical Pathophysiology, Florence (Italy)

2006-12-15

Age-related values of{sup 123}I-orthoiodohippurate (OIH) single kidney clearance rate (Cl) were estimated in a large cohort of likely normal children aged between 0 and 18 years. Among 4,111 children examined in the past 10 years, 917 were selected with the following inclusion criteria: (a) mild ultrasonographic hydronephrosis with right differential renal function (DRF) <53% and >47% (498 pts), (b) known or suspected urinary tract infection with normal ultrasound, serum creatinine and DMSA and DRF <53% and >47% (419 pts).{sup 123}I-OIH-Cl was assessed using a validated gamma camera method. Children were divided into 21 age classes: from 0 to 2 years, eight 3-month classes; from 2 to 14 years, twelve 1-year classes; from 14 to 18 years, one 4-year class. Cl, plotted against age, was fitted using an increasing function (y = a - be - cx). Mean{sup 123}I-OIH-Cl of 1,834 kidneys was 306{+-}22 ml/min/1.73 m{sup 2} BSA. Mean{sup 123}I-OIH-Cl of the right and left kidneys was 307{+-}23 and 305{+-}22 ml/min/1.73 m{sup 2} BSA, respectively (p<0.002). The best-fitting{sup 123}I-OIH-Cl growing function was: Cl=311-230e-0.69 x Age (months).{sup 123}I-OIH-Cl improved progressively starting from birth, reaching 96% and 98% of the mature value at 1 and 1.5 years, respectively.{sup 123}I-OIH-Cl at birth (age=0) was 81 ml/min/1.73 m{sup 2} BSA. After 18.6 days of life, the renal function had doubled its starting value, and it reached a plateau of 311 ml/min/1.73 m{sup 2} BSA at 2 years. This work represents a systematic evaluation of ERPF by a gamma camera method in a large cohort of selected likely normal paediatric subjects. (orig.)

CT and MR imaging of the kidney and adrenal glands: MR imaging of the kidney and adrenal glands

International Nuclear Information System (INIS)

Lee, J.K.T.

1987-01-01

The normal anatomy of the kidney is clearly demonstrated with MR imaging. The renal cortex can be differentiated from the renal medulla; renal vessels can also be identified. MR imaging can differentiate cystic from solid lesions. The signal intensity of a renal cell carcinoma varies and overlaps with the signal intensities of renal neoplasms of other etiologies. MR imaging is superior to CT in distinguishing vascular from nonvascular structures. It can distinguish collateral vessels from lymph nodes and can disclose tumoral thrombi. MR imaging can also aid in the differentiation of acute rejection from acute tubular necrosis in renal transplant recipients. Both normal and abnormal adrenal glands can be seen on MR imaging. A normal adrenal gland has a signal intensity higher than or equal to that of muscle but lower than that of fat. T1-weighted images offer excellent antomic resolution; T2-weighted images provide additional information about internal characteristics of adrenal neoplasms. Preliminary data indicate that MR imaging is useful in distinguishing nonfunctioning adenomas from adrenal metastases. The role of MR imaging of the kidney and adrenal gland is discussed

Two cases of combined liver-kidney transplantation

Institute of Scientific and Technical Information of China (English)

无

2000-01-01

Objectives To report the clinical experiences of srmultaneous hepatorenal transplantation. Methods We performed simultaneous hepatorenal transplantation in one patient with liver cirrhosis of hepatitis B and uremia of chronic nephritis on February 1,1999 and one patient with liver cirrhosis of hepatitis B complicated by hepatorenal syndrome on March 12, 1999.The donors were heart arrest cases. Rapid multiple organ harvesting techniques and UW solution infusion in situ were used. Liver and kidney transplantation were orthotopic and ordinary methods, respectively. Immunosuppressive drugs consisted of cyclosporine, Cellcept, ALG and sortstso steroids. Lamividine was used os day 50 and day 40 postoparation, respectively. Results Both transplanted organs rapidly achieved normal function postoperation and the patients recovered well but suffered mild kidney rejection day 110 postopemtion in No 1 patient. In No 2 patient, acute renal function failure, mental symptoms, muscle spasm,cerebral artery thrombosis, inhalation poeumonia and chronic liver graft rejection ensured sequentially but were controlled.The patients have survived for more than nine and eight months, respectively, with normal life quality. Conclusions Combined hepatorenal transplant is a radical treatment method for liver and kidney function failure and requires more comprehensive techniques than isolated single organ transplantation.Preventing the recurrence of hepatitis B by oral lamividine may be a kdy to long-term survival.

Increased circulating miR-21 levels are associated with kidney fibrosis.

Directory of Open Access Journals (Sweden)

François Glowacki

Full Text Available MicroRNAs (miRNAs are a class of noncoding RNA acting at a post-transcriptional level to control the expression of large sets of target mRNAs. While there is evidence that miRNAs deregulation plays a causative role in various complex disorders, their role in fibrotic kidney diseases is largely unexplored. Here, we found a strong up-regulation of miR-21 in the kidneys of mice with unilateral ureteral obstruction and also in the kidneys of patients with severe kidney fibrosis. In addition, mouse primary fibroblasts derived from fibrotic kidneys exhibited higher miR-21 expression level compared to those derived from normal kidneys. Expression of miR-21 in normal primary kidney fibroblasts was induced upon TGFβ exposure, a key growth factor involved in fibrogenesis. Finally, ectopic expression of miR-21 in primary kidney fibroblasts was sufficient to promote myofibroblast differentiation. As circulating miRNAs have been suggested as promising non-invasive biomarkers, we further assess whether circulating miR-21 levels are associated with renal fibrosis using sera from 42 renal transplant recipients, categorized according to their renal fibrosis severity, evaluated on allograft biopsies (Interstitial Fibrosis/Tubular Atrophy (IF/TA. Circulating miR-21 levels are significantly increased in patients with severe IF/TA grade (IF/TA grade 3: 3.0±1.0 vs lower grade of fibrosis: 1.5±1.2; p = 0.001. By contrast, circulating miR-21 levels were not correlated with other renal histological lesions. In a multivariate linear regression model including IF/TA grade and estimated GFR, independent associations were found between circulating miR-21 levels and IF/TA score (ß = 0.307, p = 0.03, and between miR-21 levels and aMDRD (ß = -0.398, p = 0.006. Altogether, these data suggest miR-21 has a key pathogenic role in kidney fibrosis and may represent a novel, predictive and reliable blood marker of kidney fibrosis.

Choice of fluids in the perioperative period of kidney transplantation

Directory of Open Access Journals (Sweden)

Alejandro Gonzalez-Castro

2017-11-01

Full Text Available Normal saline has traditionally been the resuscitation fluid of choice in the perioperative period of kidney transplantation over balanced potassium solutions. However, the problems arising from hyperchloraemia triggered by the infusion of normal saline have led to studies being conducted that compare this solution with balanced solutions. From this narrative review it can be concluded that the use of balanced crystalloids containing potassium in the perioperative period of kidney transplantation can be considered safe. These solutions do not affect serum potassium levels any more than normal saline, whilst maintaining a better acid–base balance in these patients. Resumen: El suero salino normal (SSN ha sido clásicamente el fluido de resucitación elegido en el periodo perioperatorio del trasplante renal frente a aquellas soluciones balanceadas con potasio. Sin embargo, los problemas derivados de la hipercloremia desencadenada por la infusión de SSN han llevado a la realización de estudios que comparaban esta solución con los fluidos equilibrados. Mediante la presente revisión narrativa se deduce que el uso de cristaloides balanceados con contenido de potasio en su formulación, en el perioperatorio de trasplante renal, puede considerarse seguro. Estas soluciones no provocan una alteración del potasio sérico mayor que la provocada por el SSN y mantienen mejor el equilibrio ácido-base en estos enfermos. Keywords: Kidney transplantation, Normal saline, Balanced solutions, Hyperchloraemia, Hyperkalaemia, Palabras clave: Trasplante renal, Suero salino normal, Soluciones balanceadas, Hipercloremia, Hiperpotasemia

Dietary protein effects on irradiated rat kidney function

International Nuclear Information System (INIS)

Mahler, P.A.; Yatuin, M.B.

1984-01-01

The authors have previously reported that unilaterally nephrectomized, kidney irradiated young male S-D rats have an increased median survival when placed on a low (4%) protein diet, as compared to a normal (20%) or high (50%) protein diet (200, 103, and 59 days respectively for 14 Gy irradiation). They have expanded these studies to examine the effects of irradiation and dietary protein levels on kidney function, by examining the parameters of blood urea nitrogen, serum creatinine, urine urea nitrogen, urine creatinine, urine osmolarity, urine volume, and water consumption. Irradiated 20% protein diet animals show an increase in water consumption and urine production and also a decrease in urine osmolarity, urine urea concentration and urine creatinine concentration. These changes all support the hypothesis the kidney irradiated rats fed a normal protein diet have a reduced capability to concentrate urine compared to nonirradiated control rats. Evaluation of the same parameters in irradiated rats fed a 4% protein diet does not indicate a similar loss of concentrating capability. Whether this protection is due to the growth inhibition of the 4% protein diet or some other phenomena remains to be determined

Variations in renal morphometry: A hospital-based Indian study

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Ranjeet S Rathore

2016-01-01

Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature.

Adult and pediatric urology

International Nuclear Information System (INIS)

Gillenwater, J.Y.; Howards, S.S.; Grayhack, J.T.; Ducket, J.W.

1987-01-01

This book contains 32 chapters. Come of the chapter titles are: Imaging; Urinary tract infections; Calculus formation; Perioperative care; Renal injuries; Kidney stone surgery; Trauma to the lower urinary tract; renel cystic disease; Bladder cancer; and The ureter

End Stage and Chronic Kidney Disease: Associations with Renal Cancer

International Nuclear Information System (INIS)

Russo, Paul

2012-01-01

There is a well known association between end stage renal disease and the development of kidney cancer in the native kidney of patients requiring renal replacement therapy. There is now emerging evidence that lesser degrees of renal insufficiency (chronic kidney disease, CKD) are also associated with an increased likelihood of cancer in general and kidney cancer in particular. Nephropathological changes are commonly observed in the non-tumor bearing portions of kidney resected at the time of partial and radical nephrectomy (RN). In addition, patients with renal cancer are more likely to have CKD at the time of diagnosis and treatment than the general population. The exact mechanism by which renal insufficiency transforms normal kidney cells into tumor cells is not known. Possible mechanisms include uremic immune inhibition or increased exposure to circulating toxins not adequately cleared by the kidneys. Surgeons managing kidney tumors must have an increased awareness of their patient’s renal functional status as they plan their resection. Kidney sparing approaches, including partial nephrectomy (PN) or active surveillance in older and morbidly ill patients, can prevent CKD or delay the further decline in renal function which is well documented with RN. Despite emerging evidence that PN provides equivalent local tumor control to RN while at the same time preventing CKD, this operation remains under utilized in the United States and abroad. Increased awareness of the bi directional relationship between kidney function and kidney cancer is essential in the contemporary management of kidney cancer.

Urinary endotrophin predicts disease progression in patients with chronic kidney disease

DEFF Research Database (Denmark)

Rasmussen, Daniel Guldager Kring; Fenton, Anthony; Jesky, Mark

2017-01-01

Renal fibrosis is the central pathogenic process in progression of chronic kidney disease (CKD). Collagen type VI (COL VI) is upregulated in renal fibrosis. Endotrophin is released from COL VI and promotes pleiotropic pro-fibrotic effects. Kidney disease severity varies considerably and accurate...... information regarding CKD progression may improve clinical decisions. We tested the hypothesis that urinary endotrophin derived during COL VI deposition in fibrotic human kidneys is a marker for progression of CKD in the Renal Impairment in Secondary Care (RIISC) cohort, a prospective observational study...... of 499 CKD patients. Endotrophin localised to areas of increased COL VI deposition in fibrotic kidneys but was not present in histologically normal kidneys. The third and fourth quartiles of urinary endotrophin:creatinine ratio (ECR) were independently associated with one-year disease progression after...

Detection of cancerous kidney tissue areas by means of infrared spectroscopy of intercellular fluid

Science.gov (United States)

Urboniene, V.; Jankevicius, F.; Zelvys, A.; Steiner, G.; Sablinskas, V.

2014-03-01

In this work the infrared absorption spectra of intercellular fluid of normal and tumor kidney tissue were recorded and analyzed. The samples were prepared by stamping freshly resected tissue onto a CaF2 substrate. FT-IR spectra obtained from intracellular fluid of tumor tissue exhibit stronger absorption bands in the spectral region from 1000-1200 cm-1 and around 1750 cm-1 than those obtained from normal tissue. It is likely the spectra of extracellular matrix of kidney tumor tissue with large increases in the intensities of these bands represent a higher concentration of fatty acids and glycerol. Amide I and amide II bands are stronger in spectra of normal tissue indicating a higher level of proteins. The results demonstrate that FT-IR spectroscopy of intercellular fluids is a novel approach for a quick diagnosis during surgical resection, which can improve the therapy of kidney tumors.

Robot-assisted pyeloplasty for pelvi-ureteric junction obstruction of lower moiety in partial duplex system: A technical challenge

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Girdhar S Bora

2016-01-01

Full Text Available Management of pelvi-ureteric junction obstruction (PUJO in a duplex system is technically challenging as dissection at the pelvis may jeopardize the vascularity of the normal moiety ureter. Anastomosing the pelvis to the one single ureter will have a risk of future development of stricture which then will risk both the moieties. Robotic assistance enables appropriate tissue dissection; minimal handling of normal ureter and precision in suturing, overcoming the potential challenges involved in the minimally invasive management of such complex cases. We report the feasibility and efficacy of robot-assisted laparoscopic pyeloplasty in such case.

Aging has small effects on initial ischemic acute kidney injury development despite changing intrarenal immunologic micromilieu in mice.

Science.gov (United States)

Jang, Hye Ryoun; Park, Ji Hyeon; Kwon, Ghee Young; Park, Jae Berm; Lee, Jung Eun; Kim, Dae Joong; Kim, Yoon-Goo; Kim, Sung Joo; Oh, Ha Young; Huh, Wooseong

2016-02-15

Inflammatory process mediated by innate and adaptive immune systems is a major pathogenic mechanism of renal ischemia-reperfusion injury (IRI). There are concerns that organ recipients may be at increased risk of developing IRI after receiving kidneys from elder donors. To reveal the effects of aging on the development of renal IRI, we compared the immunologic micromilieu of normal and postischemic kidneys from mice of three different ages (9 wk, 6 mo, and 12 mo). There was a higher number of total T cells, especially effector memory CD4/CD8 T cells, and regulatory T cells in the normal kidneys of old mice. On day 2 after IRI, the proportion of necrotic tubules and renal functional changes were comparable between groups although old mice had a higher proportion of damaged tubule compared with young mice. More T cells, but less B cells, trafficked into the postischemic kidneys of old mice. The infiltration of NK T cells was similar across the groups. Macrophages and neutrophils were comparable between groups in both normal kidneys and postischemic kidneys. The intrarenal expressions of TNF-α and VEGF were decreased in normal and postischemic kidneys of aged mice. These mixed effects of aging on lymphocytes and cytokines/chemokines were not different between the two groups of old mice. Our study demonstrates that aging alters the intrarenal micromilieu but has small effects on the development of initial renal injury after IRI. Further study investigating aging-dependent differences in the repair process of renal IRI may be required. Copyright © 2016 the American Physiological Society.

A case of acute kidney injury by near-drowning

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Amirah Amir

2013-12-01

Full Text Available Acute kidney injury following immersion or near-drowning is rarely described and no data from Malaysia have been found. We report a case of acute kidney injury following a near-drowning event. A 20-yearold man who recovered from near-drowning in a swimming pool 5 days earlier presented to our clinic with abdominal pain, anorexia, nausea and polyuria. Dipstick urinalysis showed a trace of blood. The serum creatinine level was 10-fold higher than the normal range. A bedside ultrasound showed features suggestive of acute tubular necrosis. He is then referred to the hospital with the diagnosis of acute kidney injury with the possibility of acute tubular necrosis secondary to near-drowning. We suggest that any patient presenting after immersion or near-drowning to be should assessed for potential acute kidney injury

Calciphylaxis following kidney transplantation: a case report

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Hanvesakul Rajesh

2009-11-01

Full Text Available Abstract Introduction Calciphylaxis occurring after kidney transplantation is rare and rarely reported. It results in chronic non-healing wounds and is associated with a poor prognosis and is often fatal. We present a case of proximal lower limb calciphylaxis that occurred early after kidney transplantation. The patient had no classic associated risk factors. He had previously had a total parathyroidectomy but had normal serum calcium-phosphate product and parathyroid hormone levels. The clinical outcome of this case was favorable and highlights some fundamental issues relating to management. Case presentation A 70-year-old British Caucasian man with end-stage renal failure secondary to IgA nephropathy presented six months post kidney transplantation with cutaneous calciphylaxis lesions involving the medial aspect of the thigh bilaterally. Conclusion To the best of our knowledge, this is the first reported case of rapid onset cutaneous calciphylaxis occurring soon after kidney transplantation that was associated with a favorable outcome. Cutaneous calciphylaxis lesions should be promptly managed with meticulous wound care, antimicrobial therapy and the correction of calcium-phosphate product where indicated.

Analysis of renal blood flow and renal volume in normal fetuses and in fetuses with a solitary functioning kidney.

Science.gov (United States)

Hindryckx, An; Raaijmakers, Anke; Levtchenko, Elena; Allegaert, Karel; De Catte, Luc

2017-12-01

To evaluate renal blood flow and renal volume for the prediction of postnatal renal function in fetuses with solitary functioning kidney (SFK). Seventy-four SFK fetuses (unilateral renal agenesis [12], multicystic dysplastic kidney [36], and severe renal dysplasia [26]) were compared with 58 healthy fetuses. Peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the renal artery (RA) were measured; 2D and 3D (VOCAL) volumes were calculated. Renal length and glomerular filtration rate (GFR) were obtained in SFK children (2 years). Compared with the control group, the PSV RA was significantly lower in nonfunctioning kidneys and significantly higher in SFK. Volume measurements indicated a significantly larger volume of SFK compared with healthy kidneys. All but 4 children had GFR above 70 mL/min/1.73 m 2 , and compensatory hypertrophy was present in 69% at 2 years. PSV RA and SFK volume correlated with postnatal renal hypertrophy. No correlation between prenatal and postnatal SFK volume and GFR at 2 years was demonstrated. Low PSV RA might have a predictive value for diagnosing a nonfunctioning kidney in fetuses with a SFK. We demonstrated a higher PSV RA and larger renal volume in the SFK compared with healthy kidneys. © 2017 John Wiley & Sons, Ltd.

Kidney Modelling for FDG Excretion with PET

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Huiting Qiao

2007-01-01

Full Text Available The purpose of this study was to detect the physiological process of FDG's filtration from blood to urine and to establish a mathematical model to describe the process. Dynamic positron emission tomography scan for FDG was performed on seven normal volunteers. The filtration process in kidney can be seen in the sequential images of each study. Variational distribution of FDG in kidney can be detected in dynamic data. According to the structure and function, kidney is divided into parenchyma and pelvis. A unidirectional three-compartment model is proposed to describe the renal function in FDG excretion. The time-activity curves that were picked up from the parenchyma, pelvis, and abdominal aorta were used to estimate the parameter of the model. The output of the model has fitted well with the original curve from dynamic data.

ALK1 heterozygosity delays development of late normal tissue damage in the irradiated mouse kidney

International Nuclear Information System (INIS)

Scharpfenecker, Marion; Floot, Ben; Korlaar, Regina; Russell, Nicola S.; Stewart, Fiona A.

2011-01-01

Background and Purpose: Activin receptor-like kinase 1 (ALK1) is a transforming growth factor β (TGF-β) receptor, which is mainly expressed in endothelial cells regulating proliferation and migration in vitro and angiogenesis in vivo. Endothelial cells also express the co-receptor endoglin, which modulates ALK1 effects on endothelial cells. Our previous studies showed that mice with reduced endoglin levels develop less irradiation-induced vascular damage and fibrosis, caused by an impaired inflammatory response. This study was aimed at investigating the role of ALK1 in late radiation toxicity. Material and Methods: Kidneys of ALK +/+ and ALK1 +/- mice were irradiated with 14 Gy. Mice were sacrificed at 10, 20, and 30 weeks after irradiation and gene expression and protein levels were analyzed. Results: Compared to wild type littermates, ALK1 +/- mice developed less inflammation and fibrosis at 20 weeks after irradiation, but displayed an increase in pro-inflammatory and pro-fibrotic gene expression at 30 weeks. In addition, ALK1 +/- mice showed superior vascular integrity at 10 and 20 weeks after irradiation which deteriorated at 30 weeks coinciding with changes in the VEGF pathway. Conclusions: ALK1 +/- mice develop a delayed normal tissue response by modulating the inflammatory response and growth factor expression after irradiation.

Gender-dependent effects of aging on the kidney

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A.L. Gava

2011-09-01

Full Text Available It is well known that the kidney plays an important role in the development of cardiovascular diseases such as hypertension. The normal aging process leads to changes in kidney morphology, hemodynamics and function, which increase the incidence of cardiovascular events in the elderly population. These disturbances are influenced by several factors, including gender. In general, females are protected by the effects of estrogens on the cardiorenal system. Several studies have demonstrated the beneficial effects of estrogens on renal function in the elderly; however, the relationships between androgens and kidney health during one’s lifetime are not well understood. Sex steroids have many complex actions, and the decline in their levels during aging clearly influences kidney function, decreases the renal reserve and facilitates the development of cardiovascular disorders. Therefore, in this review, we discuss the cellular, biochemical, and molecular mechanisms by which sex hormones may influence renal function during the aging process.

MR urography (MRU of non-dilated ureter with diuretic administration: Static fluid 2D FSE T2-weighted versus 3D gadolinium T1-weighted GE excretory MR

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C. Roy

2014-01-01

Conclusion: T2-weighted MRU with multiple orientations and diuretic is sufficient to identify the non-dilated ureter. It offers information on ureteral peristaltism. It can be suggested that this sequence is able to detect an initial obstruction before hydronephrosis occurs.

A case of tacrolimus-induced encephalopathy after kidney transplantation

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Myoung Uk Kim

2011-01-01

Full Text Available We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI showed acute infarction of the middle cerebral artery (MCA territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI and diffusion tensor tractography (DTT of white matter tract, visualization was possible.

Calcium Balance in Chronic Kidney Disease.

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Hill Gallant, Kathleen M; Spiegel, David M

2017-06-01

The kidneys play a critical role in the balance between the internal milieu and external environment. Kidney failure is known to disrupt a number of homeostatic mechanisms that control serum calcium and normal bone metabolism. However, our understanding of calcium balance throughout the stages of chronic kidney disease is limited and the concept of balance itself, especially with a cation as complex as calcium, is often misunderstood. Both negative and positive calcium balance have important implications in patients with chronic kidney disease, where negative balance may increase risk of osteoporosis and fracture and positive balance may increase risk of vascular calcification and cardiovascular events. Here, we examine the state of current knowledge about calcium balance in adults throughout the stages of chronic kidney disease and discuss recommendations for clinical strategies to maintain balance as well as future research needs in this area. Recent calcium balance studies in adult patients with chronic kidney disease show that neutral calcium balance is achieved with calcium intake near the recommended daily allowance. Increases in calcium through diet or supplements cause high positive calcium balance, which may put patients at risk for vascular calcification. However, heterogeneity in calcium balance exists among these patients. Given the available calcium balance data in this population, it appears clinically prudent to aim for recommended calcium intakes around 1000 mg/day to achieve neutral calcium balance and avoid adverse effects of either negative or positive calcium balance. Assessment of patients' dietary calcium intake could further equip clinicians to make individualized recommendations for meeting recommended intakes.

Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach.

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Kang Su Cho

Full Text Available To investigate whether skin-to-stone distance (SSD, which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL in patients with upper ureter stones.We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4-20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU, and SSD were determined on pretreatment non-contrast computed tomography (NCCT. For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile.In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032. The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL.Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL.

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis.

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Tiong, Ho Yee; Goh, Benjamin Yen Seow; Chiong, Edmund; Tan, Lincoln Guan Lim; Vathsala, Anatharaman

2018-03-31

Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirements and steps developed for the above training purpose. Over a series of four animal ethics' approved experiments, the technique of robotic-assisted laparoscopic autotransplantation of the kidney was developed in Amsterdam live pigs (60-70 kg). The surgery was based around the vascular anastomosis technique described by Menon et al. This non-survival porcine training model is targeted at transplant surgeons with robotic surgery experience. Under general anesthesia, each pig was placed in lateral decubitus position with the placement of one robotic camera port, two robotic 8 mm ports and one assistant port. Robotic docking over the pig posteriorly was performed. The training platform involved the following procedural steps. First, ipsilateral iliac vessel dissection was performed. Second, robotic-assisted laparoscopic donor nephrectomy was performed with in situ perfusion of the kidney with cold Hartmann's solution prior to complete division of the hilar vessels, ureter and kidney mobilization. Thirdly, the kidney was either kept in situ for orthotopic autotransplantation or mobilized to the pelvis and orientated for the vascular anastomosis, which was performed end to end or end to side after vessel loop clamping of the iliac vessels, respectively, using 6/0 Gore-Tex sutures. Following autotransplantation and release of vessel loops, perfusion of the

Familial Peters Plus syndrome with absent anal canal, sacral ...

African Journals Online (AJOL)

Rabah M. Shawky

2013-07-23

Jul 23, 2013 ... developmental delay, characteristic craniofacial features, and ... malities except for colostomy at the left iliac region. Neurolog- ... Visual evoked potential showed bilateral functioning ... Echocardiography, electroencephalogram and MRI brain ... kidney with the right ureter passing across the midline to the.

End Stage and Chronic Kidney Disease:Associations with Renal Cancer

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Paul eRusso

2012-04-01

Full Text Available There is a well known association between end stage renal disease and the development of kidney cancer in the native kidney of patients requiring renal replacement therapy. There is now emerging evidence that lesser degrees of renal insufficiency (chronic kidney disease, CKD are also associated with an increased likelihood of cancer in general and kidney cancer in particular. Nephro pathological changes are commonly observed in the non tumor bearing portions of kidney resected at the time of partial and radical nephrectomy. In addition, patients with renal cancer are more likely to have CKD at the time of diagnosis and treatment than the general population. The exact mechanism by which renal insufficiency transforms normal kidney cells into tumor cells is not known. Possible mechanisms include uremic immune inhibition or increased exposure to circulating toxins not adequately cleared by the kidneys. Surgeons managing kidney tumors must have an increased awareness of their patient’s renal functional status as they plan their resection. Kidney sparing approaches, including partial nephrectomy or active surveillance in older and morbidly ill patients, can prevent CKD or delay the further decline in renal function which is well documented with radical nephrectomy. Despite emerging evidence that partial nephrectomy provides equivalent local tumor control to radical nephrectomy while at the same time preventing CKD, this operation remains under utilized in the United States and abroad. Increased awareness of the bi directional relationship between kidney function and kidney cancer is essential in the contemporary management of kidney cancer.

Simple Kidney Cysts

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... Solitary Kidney Your Kidneys & How They Work Simple Kidney Cysts What are simple kidney cysts? Simple kidney cysts are abnormal, fluid-filled ... that form in the kidneys. What are the kidneys and what do they do? The kidneys are ...

Study of cloisonne kidney lesion frequency in slaughtered sheeps of Tabriz and Rashta slaughterhouse

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A Khaki

2016-07-01

Full Text Available Cloisonne kidney is an accidental finding of the kidneys observed in abattoir. The lesion caused by the thickening of the proximal and sometimes distal convoluted tubules basement membranes due to iron pigmentation is so far reported in goats, sheep and horses. Renal cortex is brown but the condition does not involve the medulla. The lesion brings about no impairment of the renal normal function and affected animals are clinically normal. Although the exact cause of this condition remains unknown but intravascular hemolysis is considered to have a role. The following study was undertaken to determine sheep cloisonne kidney frequency rate in Tabriz and Rasht abattoir. A number of 10000 sheep carcasses in Rasht slaughterhouse and 8600 carcasses in Tabriz slaughterhouse were randomly examined and tissue samples were stained with H&E. Only eleven cases were diagnosed with the cloisonne kidney lesion. Thus the frequency rate of the lesion was estimated at 0.059% in sheep of these cities.

Cyclodextrin Protects Podocytes in Diabetic Kidney Disease

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Merscher-Gomez, Sandra; Guzman, Johanna; Pedigo, Christopher E.; Lehto, Markku; Aguillon-Prada, Robier; Mendez, Armando; Lassenius, Mariann I.; Forsblom, Carol; Yoo, TaeHyun; Villarreal, Rodrigo; Maiguel, Dony; Johnson, Kevin; Goldberg, Ronald; Nair, Viji; Randolph, Ann; Kretzler, Matthias; Nelson, Robert G.; Burke, George W.; Groop, Per-Henrik; Fornoni, Alessia

2013-01-01

Diabetic kidney disease (DKD) remains the most common cause of end-stage kidney disease despite multifactorial intervention. We demonstrated that increased cholesterol in association with downregulation of ATP-binding cassette transporter ABCA1 occurs in normal human podocytes exposed to the sera of patients with type 1 diabetes and albuminuria (DKD+) when compared with diabetic patients with normoalbuminuria (DKD−) and similar duration of diabetes and lipid profile. Glomerular downregulation of ABCA1 was confirmed in biopsies from patients with early DKD (n = 70) when compared with normal living donors (n = 32). Induction of cholesterol efflux with cyclodextrin (CD) but not inhibition of cholesterol synthesis with simvastatin prevented podocyte injury observed in vitro after exposure to patient sera. Subcutaneous administration of CD to diabetic BTBR (black and tan, brachiuric) ob/ob mice was safe and reduced albuminuria, mesangial expansion, kidney weight, and cortical cholesterol content. This was followed by an improvement of fasting insulin, blood glucose, body weight, and glucose tolerance in vivo and improved glucose-stimulated insulin release in human islets in vitro. Our data suggest that impaired reverse cholesterol transport characterizes clinical and experimental DKD and negatively influences podocyte function. Treatment with CD is safe and effective in preserving podocyte function in vitro and in vivo and may improve the metabolic control of diabetes. PMID:23835338

Abnormal bone and mineral metabolism in kidney transplant patients--a review

DEFF Research Database (Denmark)

Sprague, S.M.; Belozeroff, V.; Danese, M.D.

2008-01-01

BACKGROUND/AIMS: Abnormal bone and mineral metabolism is common in patients with kidney failure and often persists after successful kidney transplant. METHODS: To better understand the natural history of this disease in transplant patients, we reviewed the literature by searching MEDLINE...... within 2 months. Low levels of 1,25(OH)2 vitamin D typically did not reach normal values until almost 18 months after transplant. CONCLUSION: This review provides evidence demonstrating that abnormal bone and mineral metabolism exists in patients after kidney transplant and suggests the need...... for English language articles published between January 1990 and October 2006 that contained Medical Subject Headings and key words related to secondary or persistent hyperparathyroidism and kidney transplant. RESULTS: Parathyroid hormone levels decreased significantly during the first 3 months after...

CT and MR imaging of the kidney and adrenal glands: CT of the kidney

International Nuclear Information System (INIS)

Levine, E.

1987-01-01

Because of its high diagnostic yield, safety, and cost-effectiveness, CT has become a major imaging technique for evaluating the kidney. CT is highly accurate for determining the nature and extent of renal masses, and this has become the main indication for renal CT. However, CT is also valuable in assessing patients with renal cystic disease, trauma, inflammatory disease, infarction, hemorrhage and hydronephrosis of unknown cause. This presentation reviews the normal CT anatomy of the kidneys and the usefulness of CT in the diagnosis of all these conditions. Examination techniques are discussed with particular emphasis on avoiding diagnostic pitfalls and tailoring the examination to the nature of the clinical problem. CT findings in various renal disorders are compared with those of other imaging techniques, particularly US and angiography, and the place of CT in the diagnostic approach to these disorders is considered

Evaluation of kidney repair capacity using 99mTc-DMSA in ischemia/reperfusion injury models.

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Kwak, Wonjung; Jang, Hee-Seong; Belay, Takele; Kim, Jinu; Ha, Yeong Su; Lee, Sang Woo; Ahn, Byeong-Cheol; Lee, Jaetae; Park, Kwon Moo; Yoo, Jeongsoo

2011-03-04

Quantitative (99m)Tc-DMSA renal uptake was studied in different renal ischemia/reperfusion (I/R) mice models for the assessment of renal repair capacity. Mice models of nephrectomy, uni- and bi-lateral I/R together with sham-operated mice were established. At 1h, 1d, 4d, 1, 2 and 3 wk after I/R, (99m)Tc-DMSA (27.7 ± 1.3 MBq) was injected via tail vein and after 3h post-injection, the mice were scanned for 30 min with pinhole equipped gamma camera. Higher uptake of (99m)Tc-DMSA was measured in normal kidneys of uni-lateral I/R model and nephrectomized kidney I/R model at 3 wk post-surgery. Comparing the restoration capacities of the affected kidneys of nephrectomy, uni- and bi-lateral I/R models, higher repair capacity was observed in the nephrectomized model followed by bi-lateral then uni-lateral models. The normal kidney may retard the restoration of damaged kidney in uni-lateral I/R model. Moreover, 3 wk after Uni-I/R, the size of injured kidney was significantly smaller than non-ischemic contralateral and sham operated kidneys, while nephrectomy I/R kidneys were significantly enlarged compared to all others at 3 wk post-surgery. Very strong correlation between (99m)Tc-DMSA uptake and weight of dissected kidneys in I/R models was observed. Consistent with (99m)Tc-DMSA uptake results, all histological results indicate that kidney recovery after injury is correlated with the amount of intact tubules and kidney sizes. In summary, our study showed good potentials of (99m)Tc-DMSA scan as a promising non-invasive method for evaluation of kidney restoration after I/R injuries. Interestingly, mice with Bi-I/R injury showed faster repair capacity than those with uni-I/R. Copyright © 2011 Elsevier Inc. All rights reserved.

A trifid pelvis in a patient with a solitary kidney with LUTS: An unusual presentation

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Guntaka Ajay Kumar

2013-01-01

Full Text Available Trifid pelvis is one of the rarest congenital malformations of the upper urinary tract. Trifid pelvis in a solitary kidney is a very rare presentation. A young male adult presented to us with dysuria and white discharge per urethra since 1 year on and off. Urine examination showed few pus cells and white blood cells. Initial imaging by ultrasonography revealed a solitary right kidney. A computed tomography urogram showed a normal right kidney with a trifid pelvis and left ectopic hypoplastic kidney with focal thickening at the right posterolateral aspect of the vesicoureteric junction. Cystoscopy revealed normal anterior and posterior urethra, verumontanum extending until bladder neck, no ejaculatory duct openings noted, and right ureteric orifice placed slightly laterally, with the left ureteric orifice not visualized. Right RGP confirmed a trifid pelvis. A high index of suspicion is needed for the identification of this rare condition.

Urinary System Birth Defects in Surgically Treated Infants in Sarajevo Region of Bosnia and Herzegovina

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Selma Aličelebić

2008-05-01

Full Text Available Congenital anomalies of the urinary system are relatively common anomalies. In Bosnia and Herzegovina there is no existent unique evidence of congenital anomalies and registries. The aim of this study was to obtain the frequency of different urinary tract anomalies types and their sex distribution among cases hospitalized in the Department of Pediatric Surgery of the University of Sarajevo Clinics Centre, Bosnia and Herzegovina, during the period from January 2002 to December 2006. Retrospective study was carried out on the basis of clinical records. Standard methods of descriptive statistics were performed for the data analysis. Among 289 patients that were surgically treated 62,37% of the patients were male patients, while 37,63% were female patients. Twenty nine different urinary system anomalies types were found in this study. These were: vesicoureteral reflux (99 cases or 30,75%, hypospadias (62 cases or 19,26%, pelviureteric junction obstruction (42 cases or 13,04%, megaureter (35 cases or 10,87%, duplex pelvis and ureter (16 cases or 4,97%, bladder diverticulum (8 cases or 2,48%, ureterocoele (7 cases or 2,17%, stenosis of the external urethral opening (6 cases or 1,86%, ectopic kidney, duplex kidney and pelvis (each 5 cases or 1,55%, polycystic kidneys and urethral stricture (each 4 cases or 1,24%, multicystic kidney (3 cases or 0,93%, kidney agenesis, ureter agenesis, urethral diverticulum, ectopic ureter, horseshoe kidney and fetal kidney (each 2 cases or 0,62%, renal aplasia, urethral atresia, renal cyst, urachal cyst, epispadias, bladder exstrophy, renal hypoplasia, renal malrotation and Prune-Belly syndrome (each 1 case or 0,31%. According to this study, urinary tract anomalies were more common in male than in female patients (62,37%, Generally, the most frequent anomaly type was vesicoureteral reflux in total number of 99 cases, and in females (66 cases, but hypospadias was the most common anomaly in males (62 cases. The anomalies

Retrograde Intrarenal Surgery for Complex Stones in a Toddler with Congenital Renal Anomalies: Technical Details

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Murat Can Kiremit

2015-07-01

Full Text Available We report herein the management of a challenging case due to anatomic and stone-related complications in a 37-month-old Caucasian toddler with megacalycosis and complex stone in the left kidney and duplicated ureter on the right side.

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... REE-thruh) All day long, the kidneys clean waste products from your blood. The waste becomes urine (pee), which drips into the ureters ( ... a plastic cup. Your doctor will give you special wipes to clean yourself off before you collect ...

Urinary Tract Infections (For Kids)

Medline Plus

Full Text Available ... REE-thruh) All day long, the kidneys clean waste products from your blood. The waste becomes urine (pee), which drips into the ureters ( ... drink something, no matter how busy you are. Water and cranberry juice are two good choices. Those ...

Endoplasmic Reticulum Stress in the Diabetic Kidney, the Good, the Bad and the Ugly.

Science.gov (United States)

Cunard, Robyn

2015-04-20

Diabetic kidney disease is the leading worldwide cause of end stage kidney disease and a growing public health challenge. The diabetic kidney is exposed to many environmental stressors and each cell type has developed intricate signaling systems designed to restore optimal cellular function. The unfolded protein response (UPR) is a homeostatic pathway that regulates endoplasmic reticulum (ER) membrane structure and secretory function. Studies suggest that the UPR is activated in the diabetic kidney to restore normal ER function and viability. However, when the cell is continuously stressed in an environment that lies outside of its normal physiological range, then the UPR is known as the ER stress response. The UPR reduces protein synthesis, augments the ER folding capacity and downregulates mRNA expression of genes by multiple pathways. Aberrant activation of ER stress can also induce inflammation and cellular apoptosis, and modify signaling of protective processes such as autophagy and mTORC activation. The following review will discuss our current understanding of ER stress in the diabetic kidney and explore novel means of modulating ER stress and its interacting signaling cascades with the overall goal of identifying therapeutic strategies that will improve outcomes in diabetic nephropathy.

Renal function maturation in children: is normalization to surface area valid?

International Nuclear Information System (INIS)

Rutland, M.D.; Hassan, I.M.; Que, L.

1999-01-01

Full text: Gamma camera DTPA renograms were analysed to measure renal function by the rate at which the kidneys took up tracer from the blood. This was expressed either directly as the fractional uptake rate (FUR), which is not related to body size, or it was converted to a camera-based GFR by the formula GFR blood volume x FUR, and this GFR was normalized to a body surface area of 1.73 m2. Most of the patients studied had one completely normal kidney, and one kidney with reflux but normal function and no large scars. The completely normal kidneys contributed, on average, 50% of the total renal function. The results were considered in age bands, to display the effect of age on renal function. The camera-GFR measurements showed the conventional results of poor renal function in early childhood, with a slow rise to near-adult values by the age of 2 years, and somewhat low values throughout childhood. The uptake values showed a different pattern, with renal function rising to adult equivalent values by the age of 4 months, and with children having better renal function than adults throughout most of their childhood. The standard deviations expressed as coefficients of variation (CV) were smaller for the FUR technique than the GFR (Wilcoxon rank test, P < 0.01). These results resemble recent published measurements of absolute DMSA uptake, which are also unrelated to body size and show early renal maturation. The results also suggest that the reason children have lower serum creatinine levels than adults is that they have better renal function. If this were confirmed, it would raise doubts about the usefulness of normalizing renal function to body surface area in children

Somatic mutations in stilbene estrogen-induced Syrian hamster kidney tumors identified by DNA fingerprinting

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Roy Deodutta

2004-01-01

Full Text Available Abstract Kidney tumors from stilbene estrogen (diethylstilbestrol-treated Syrian hamsters were screened for somatic genetic alterations by Random Amplified Polymorphic DNA-polymerase chain-reaction (RAPD-PCR fingerprinting. Fingerprints from tumor tissue were generated by single arbitrary primers and compared with fingerprints for normal tissue from the same animal, as well as normal and tumor tissues from different animals. Sixty one of the arbitrary primers amplified 365 loci that contain approximately 476 kbp of the hamster genome. Among these amplified DNA fragments, 44 loci exhibited either qualitative or quantitative differences between the tumor tissues and normal kidney tissues. RAPD-PCR loci showing decreased and increased intensities in tumor tissue DNA relative to control DNA indicate that loci have undergone allelic losses and gains, respectively, in the stilbene estrogen-induced tumor cell genome. The presence or absence of the amplified DNA fragments indicate homozygous insertions or deletions in the kidney tumor DNA compared to the age-matched normal kidney tissue DNA. Seven of 44 mutated loci also were present in the kidney tissues adjacent to tumors (free of macroscopic tumors. The presence of mutated loci in uninvolved (non-tumor surrounding tissue adjacent to tumors from stilbene estrogen-treated hamsters suggests that these mutations occurred in the early stages of carcinogenesis. The cloning and sequencing of RAPD amplified loci revealed that one mutated locus had significant sequence similarity with the hamster Cyp1A1 gene. The results show the ability of RAPD-PCR to detect and isolate, in a single step, DNA sequences representing genetic alterations in stilbene estrogen-induced cancer cells, including losses of heterozygosity, and homozygous deletion and insertion mutations. RAPD-PCR provides an alternative molecular approach for studying cancer cytogenetics in stilbene estrogen-induced tumors in humans and experimental

Laparascopic-assisted nephroureterectomy for shaped urolithiasis and xanthogranulomatous pyelonephritis: Case report and review of literature

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Valentina Pastore

2013-01-01

Full Text Available We report a case of xanthogranulomatous pyelonephritis (XGP complicated by shaped urolithiasis, severe hydroureteronephrosis and kidney exclusion treated by laparoscopic-assisted nephroureterectomy. A 9 year-old boy was referred to us for recurrent episodes of urinary tract infection, abdominal pain and severe hydronephrosis. Abdominal CT and a Tc-99m MAG3 scan showed a non-functioning obstructed kidney with shaped urolithiasis of the distal ureter. XGP was suspected, and nephroureterectomy was performed by laparoscopic distal ureterectomy and open extraperitoneal nephrectomy. This technique avoided the need for a more extended nephrectomy incision or even a second iliac incision. It also ensured complete excision of the distal ureter with minimal risk of developing the ureteral stump syndrome, which sometimes follows nephroureterectomy. We believe that laparoscopic-assisted nephroureterectomy may be a suitable technique in those cases of difficult nephrectomy where a ureteral stump syndrome is likely to develop.

Kidney Problems

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... our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & Information The kidneys are two ... kidney (renal) diseases are called nephrologists . What are Kidney Diseases? For about one-third of older people, ...

Bladder urine oxygen tension for assessing renal medullary oxygenation in rabbits: experimental and modeling studies

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Sgouralis, Ioannis; Kett, Michelle M.; Ow, Connie P. C.; Abdelkader, Amany; Layton, Anita T.; Gardiner, Bruce S.; Smith, David W.; Lankadeva, Yugeesh R.

2016-01-01

Oxygen tension (Po2) of urine in the bladder could be used to monitor risk of acute kidney injury if it varies with medullary Po2. Therefore, we examined this relationship and characterized oxygen diffusion across walls of the ureter and bladder in anesthetized rabbits. A computational model was then developed to predict medullary Po2 from bladder urine Po2. Both intravenous infusion of [Phe2,Ile3,Orn8]-vasopressin and infusion of NG-nitro-l-arginine reduced urinary Po2 and medullary Po2 (8–17%), yet had opposite effects on renal blood flow and urine flow. Changes in bladder urine Po2 during these stimuli correlated strongly with changes in medullary Po2 (within-rabbit r2 = 0.87–0.90). Differences in the Po2 of saline infused into the ureter close to the kidney could be detected in the bladder, although this was diminished at lesser ureteric flow. Diffusion of oxygen across the wall of the bladder was very slow, so it was not considered in the computational model. The model predicts Po2 in the pelvic ureter (presumed to reflect medullary Po2) from known values of bladder urine Po2, urine flow, and arterial Po2. Simulations suggest that, across a physiological range of urine flow in anesthetized rabbits (0.1–0.5 ml/min for a single kidney), a change in bladder urine Po2 explains 10–50% of the change in pelvic urine/medullary Po2. Thus, it is possible to infer changes in medullary Po2 from changes in urinary Po2, so urinary Po2 may have utility as a real-time biomarker of risk of acute kidney injury. PMID:27385734

Kidney recipients experiences before during and after kidney transplantation

DEFF Research Database (Denmark)

Nielsen, Charlotte

Background Kidney transplantation is considered to be the best treatment for terminal renal insufficiency. Kidney transplant patients report higher quality of life because they avoid regular dialysis treatment that causes side effects, complications, restrictions and limitations in their daily...... and after the kidney transplant, through outpatient visits and during possible hospitalization, which can occur due to complications or disease progression. Objective To explore the coherence of the kidney transplant process in order to explain the lived experiences of kidney recipients before, during...... and after kidney transplantation. Method Participant observation and semi-structured individual interviews was conducted with kidney recipients before, during and after kidney transplantation. Data analysis is inspired by Ricoeur's interpretation theory on three levels: Naive reading; structural analysis...

Association of periodontitis and chronic kidney disease in dogs

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S. U. Nabi

2014-06-01

Full Text Available Aim: The purpose of our study is to study the etiopathogenesis of periodontitis in chronic kidney disease and to identify a correlation between periodontitis and chronic kidney disease, with the help of periodontal exaamination, ultrasonographic and hematobiochemical analysis. Materials and Methods: 46 dogs with renal failure were studied and classified as presenting a slight (56.52%, moderate (36.95% and severe (47.8% degree of periodontal disease. Results: Marked gingival recession involving whole maxillary dental arcade, Oral mucosa ulcers and tissue necrosis and mobility of mandibular incisors was observed in dogs with chronic kidney disease. Dogs with normal renal function were observed to have minimal gingival recession of the mandibular teeth only. Conclusion: In view of the causative association between periodontal infection, generalized inflammation and important systemic diseases like chronic kidney disease, we hypothesize that targeted prophylaxis and careful treatment of oral diseases can prevent the progression of renal failure

Kidney Disease

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... Staying Safe Videos for Educators Search English Español Kidney Disease KidsHealth / For Teens / Kidney Disease What's in ... Coping With Kidney Conditions Print What Do the Kidneys Do? You might never think much about some ...

Pediatric excretory MR urography: comparative study of enhanced and non-enhanced techniques

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Borthne, Arne S. [Department of Pediatric Radiology, Kirkeveien 166, Ullevaal University Hospital, 0407 Oslo (Norway); Pierre-Jerome, Claude [Department of Central Radiology, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway); Gjesdal, Kjell I.; Storaas, Tryggve; Courivaud, Frederic [Department of Medical Physics, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway); Eriksen, Morten [Institute of Experimental Research, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway)

2003-06-01

Our purpose was to compare the quality of ureteral imaging in pediatric patients using two different MR sequences: the non-enhanced heavily T2-weighted (W) turbo spin-echo sequence (TSE) and the gadolinium-enhanced T1W fast-field-echo sequence (T1 FFE). An experimental study on three pigs was first performed. The TSE, before and after furosemide injection, was followed by the T1 FFE sequence. The clinical study included 11 infants and 10 children. With some modifications the same MR parameters and techniques were used as in the animal study. The TSE with TR 8000 ms and TE 650 ms implied 6 radial stacks each of 40 mm thickness. The T1 FFE included TR 18 ms, TE 2.9 ms, flip angle 60, and 50 slices with thickness 0.7 mm. After post-processing, image reconstructions qualitative and quantitative analysis were performed. Complete visualization of the ureters was achieved in 35 of 42 (83%) cases. Seventy-four percent of the ureters were completely visualized with T1 FFE compared with only 19% with TSE. Sixty-nine percent of the ureters were better imaged with T1 FFE than TSE and 21% equally well imaged. Four ureters (10%), either obstructed or due to poor renal function, were better imaged with TSE. The two sequences are complementary. Visualization of non-obstructed ureters is excellent with T1 FFE and the sequence is superior to TSE. The TSE, however, may be equal to or even better than T1 FFE in visualizing obstructed ureters or ureters draining malfunctioning kidneys. (orig.)

Ureteral stents increase risk of postoperative acute kidney injury following colorectal surgery.

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Hassinger, Taryn E; Mehaffey, J Hunter; Mullen, Matthew G; Michaels, Alex D; Elwood, Nathan R; Levi, Shoshana T; Hedrick, Traci L; Friel, Charles M

2018-07-01

Ureteral stents are commonly placed before colorectal resection to assist in identification of ureters and prevent injury. Acute kidney injury (AKI) is a common cause of morbidity and increased cost following colorectal surgery. Although previously associated with reflex anuria, prophylactic stents have not been found to increase AKI. We sought to determine the impact of ureteral stents on the incidence of AKI following colorectal surgery. All patients undergoing colon or rectal resection at a single institution between 2005 and 2015 were reviewed using American College of Surgeons National Surgical Quality Improvement Program dataset. AKI was defined as a rise in serum creatinine to ≥ 1.5 times the preoperative value. Univariate and multivariate regression analyses were performed to identify independent predictors of AKI. 2910 patients underwent colorectal resection. Prophylactic ureteral stents were placed in 129 patients (4.6%). Postoperative AKI occurred in 335 (11.5%) patients during their hospitalization. The stent group demonstrated increased AKI incidence (32.6% vs. 10.5%; p colorectal surgery including age, procedure duration, and ureteral stent placement. Prophylactic ureteral stents independently increased AKI risk when placed prior to colorectal surgery. These data demonstrate increased morbidity and hospital costs related to usage of stents in colorectal surgery, indicating that placement should be limited to patients with highest potential benefit.

Different techniques of vessel reconstruction during kidney transplantation

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Tomić Aleksandar

2015-01-01

Full Text Available Background/Aim. Multiple renal arteries (MRAs represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs must be reconstructed and prepared for safe anastomosis. The paper decribed the different techniques of vessel reconstruction during kidney transplantation including important steps within recovery of organs, preparation and implantation. Methods. In a 16-year period (1996-2012 of kidney transplantation in the Military Medical Academy, Belgrade, a total of 310 living donors and 44 human cadaver kidney transplantations were performed, of which 28 (8% kidneys had two or more RAs. Results. All the transplanted kidneys had immediate function. We repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs, one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one case with 3 arteries and additional polytetrafluoroethylene (PTFE graft reconstruction, one case with transected renal artery and reconstruction with 5 cm long deceased donor external iliac artery. There were no major complications and graft failure. At a minimum of 1-year follow-up, all the patients showed normal renal function. Conclusion. Donor kidney transplantation on a contralateral side and “end-to-end” anastomosis of the renal artery to the internal iliac artery (IIA is our standard procedure with satisfactory results. Renal artery reconstruction and anastomosis with IIA is a safe and highly efficient procedure and kidneys with MRAs are not contraindicated for transplantation. A surgical team should be fully competent to remove cadaveric abdominal organs to avoid accidental injuries of organs vessels.

The gut-kidney axis in chronic renal failure: A new potential target for therapy.

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Khoury, Tawfik; Tzukert, Keren; Abel, Roy; Abu Rmeileh, Ayman; Levi, Ronen; Ilan, Yaron

2017-07-01

Evidence is accumulating to consider the gut microbiome as a central player in the gut-kidney axis. Microbiome products, such as advanced glycation end products, phenols, and indoles, are absorbed into the circulation but are cleared by normal-functioning kidneys. These products then become toxic and contribute to the uremic load and to the progression of chronic kidney failure. In this review, we discuss the gut-kidney interaction under the state of chronic kidney failure as well as the potential mechanisms by which a change in the gut flora (termed gut dysbiosis) in chronic kidney disease (CKD) exacerbates uremia and leads to further progression of CKD and inflammation. Finally, the potential therapeutic interventions to target the gut microbiome in CKD are discussed. © 2016 International Society for Hemodialysis.

ORIGINAL ARTICLE ORIGINAL ARTICLE Normal variance in renal ...

African Journals Online (AJOL)

It is therefore imperative to have accurate data regarding normal renal sizes. Numerous ... deciding whether larger kidney sizes may be acceptable for a big patient ... between renal length and different body habitus indices, including weight ...

To evaluate vascular complications of transplant kidney examined by multislice spiral CT angiograph

International Nuclear Information System (INIS)

Peng Qian; Fan Miao; Luo Xiaomei

2008-01-01

Objective: To evaluate the value of multislice CT angiography (MSCTA) in vascular complications of transplant kidney. Methods: Six transplant kidneys were undergone enhanced MSCT scanning postoperation. MPR, CPR, VR and VP reformation were performed to observe transplant kidney's parenchyma, renal artery, and renal vein. To analysis all the reconstruction technique and find the advantage and shortage of them. Results: One case showed enhanced function of transplant kidney decreased. Vascular stenosis was found in one case and false aneurysm was found in another transplant kidney. Transplant kidney were enhanced normal in the left three cases. MPR couldn't reconstruct all the tortuous vessel of renal hilus in one plane. But all six cases could expose the vessel of renal hilus very clearly in coronal section and sagittal plane of CPR. Six cases of VR could observe the vessel direction and lesions outside vessel through rotate the reconstruction image. VP could see through inside the vessel of transplant kidney. Conclusion: MSCTA has an important role as an imaging technique to evaluate vascular complications of transplant kidney, it can replace DSA. (authors)

Urinary acylcarnitines are altered in human kidney cancer.

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Ganti, Sheila; Taylor, Sandra L; Kim, Kyoungmi; Hoppel, Charles L; Guo, Lining; Yang, Joy; Evans, Christopher; Weiss, Robert H

2012-06-15

Kidney cancer often diagnosed at late stages when treatment options are severely limited. Thus, greater understanding of tumor metabolism leading ultimately to novel approaches to diagnosis is needed. Our laboratory has been utilizing metabolomics to evaluate compounds appearing in kidney cancer patients' biofluids at concentrations different from control patients. Here, we collected urine samples from kidney cancer patients and analyzed them by chromatography coupled to mass spectrometry. Once normalized to control for urinary concentration, samples were analyzed by two independent laboratories. After technical validation, we now show differential urinary concentrations of several acylcarnitines as a function of both cancer status and kidney cancer grade, with most acylcarnitines being increased in the urine of cancer patients and in those patients with high cancer grades. This finding was validated in a mouse xenograft model of human kidney cancer. Biological validation shows carbon chain length-dependent effects of the acylcarnitines on cytotoxicity in vitro, and higher chain length acylcarnitines demonstrated inhibitory effects on NF-κB activation, suggesting an immune modulatory effect of these compounds. Thus, acylcarnitines in the kidney cancer urine may reflect alterations in metabolism, cell component synthesis and/or immune surveillance, and may help explain the profound chemotherapy resistance seen with this cancer. This study shows for the first time the value of a novel class of metabolites which may lead to new therapeutic approaches for cancer and may prove useful in cancer biomarker studies. Furthermore, these findings open up a new area of investigation into the metabolic basis of kidney cancer. Copyright © 2011 UICC.

Kidney pain (image)

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A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size of sand or ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the ...

Incidentally Detected Primary Giant Renal Cystic Enchinococcosis in a Young Patient: An Underestimated Entity?

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Emre Urer

2015-01-01

Full Text Available Echinococcosis is a parasitic infestation caused by Echinococcus granulosus and is an endemic disease in many parts of world. The symptoms and signs depend on the location and size of the cyst. Renal cystic echinococcosis or hydatid cyst (HC disease of the kidney is extremely rare and constitutes only 2-4% of all cases of hydatid disease (HD. We present a 39-year-old male patient who was referred to our outpatient clinic with cystic right kidney mass that was incidentally diagnosed during hepatobiliary ultrasound for chronic hepatitis B evaluation. Routine blood tests were normal without eosinophilia. Indirect haemagglutination test was negative. Abdominal kidneys, ureters, and bladder X-ray showed an 83×95 mm sized curvilinear calcification in the right upper abdominal quadrant. Abdominal computed tomography scan and magnetic resonance imaging demonstrated a 10x9x10 cm sized cystic mass arising from the middle pole of the right kidney, destructing the whole upper pole and extending into the liver. Daughter vesicles were present in the cystic lesion suggesting renal HD. Right retroperitoneal exploration with flank approach and right radical nephrectomy was performed without any complications. Pathology confirmed HC lesion. Following surgery, albendazole 400 mg per os twice daily for 4 weeks was suggested.

Diffusion-weighted MRI of kidneys in healthy volunteers and living kidney donors

International Nuclear Information System (INIS)

Sulkowska, K.; Palczewski, P.; Duda-Zysk, A.; Szeszkowski, W.; Wojcik, D.; Kownacka-Piotrowska, D.; Gołebiowski, M.

2015-01-01

Aim: To establish the normal apparent diffusion coefficient (ADC) values in healthy kidneys, comparing them with the literature, and assessing the correlation between ADC values, creatinine blood level, and glomerular filtration rate (GFR). Materials and methods: Twenty-four healthy volunteers and 26 living kidney donors were examined on a 1.5 T magnetic resonance imaging (MRI) unit. Two diffusion-weighted imaging (DWI) sequences were included in the study protocol (protocol 1 with 16 b-values, protocol 2 with 10 b-values) before the examination blood and urine samples were collected. The GFR was calculated using Cockcroft & Gault and MDRD (Modification of Diet In Renal Disease) formulas and the ADC values were measured separately for the cortex and medulla of each kidney by two independent observers. All statistical analyses were performed using the STATISTICA (version 10.0) software package. Data were analysed using an unpaired t-test; p<0.05 indicated a statistically significant difference. Results: The average ADC value for protocol 1 for the cortex was 2.26×10 −3  mm 2 /s, for the medulla 2.21×10 −3  mm 2 /s. In protocol 2, the respective values were 2.13×10 −3  mm 2 /s and 2.06×10 −3  mm 2 /s. Neither statistically significant interobserver differences nor correlation between ADC values, GFR, and creatinine serum level were observed. Conclusion: The reference ADC values were established. The measurements show high interobserver consistency. The differences in ADC values reported in the literature suggest dependence on the equipment and methodology and point to the necessity of obtaining ADC norms for each MRI unit. -- Highlights: •Magnetic resonance diffusion-weighted imaging of kidneys. •Apparent diffusion coefficient in healthy individuals. •Monoexponential model of diffusion

Studies on kidney function in workers exposed to uranium contamination

International Nuclear Information System (INIS)

Bugueno, M.C.; Suarez, J.

1983-01-01

The values of some kidney function tests in our workers were studied through the media, range and statistical spread, compared with those used abroad and also in our main hospitals. With that purpose, thirty three personas were selected among those without kidney pathology history of uranium internal contamination as revealed by the permanent control of our clinical and radiotoxicological service. Kidney function was explored through the measurement of uremia, ureic nitrogen, albuminuria, endogenous creatinine clearance and the Addis test. Values determined were normal with respect to those used in the international literature, with the exception of the creatinine clearance test. Also a 6% of our workers were abnormal in at least one or two of the five tests employed. (Author)

Chronic Kidney Diseases

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... Safe Videos for Educators Search English Español Chronic Kidney Diseases KidsHealth / For Kids / Chronic Kidney Diseases What's ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

AFJU OFC 18(4).indd

African Journals Online (AJOL)

imac-1

www.ees.elsevier.com/afju www.sciencedirect.com. Short communication. Ureterocystoplasty using the lower pole ureter of a duplex kidney with preservation of ipsilateral renal function. John Lazarus. Division of Paediatric Urology, Red Cross Children's Hospital, University of Cape Town, South Africa. Received 4 July 2012 ...

Trace elemental analysis of carcinoma kidney and stomach by PIXE method

International Nuclear Information System (INIS)

Reddy, S. Bhuloka; John Charles, M.; Naga Raju, G.J.; Vijayan, V.; Seetharami Reddy, B.; Ravi Kumar, M.; Sundareswar, B.

2003-01-01

Trace elemental analysis was carried out in the biological samples of carcinoma kidney and stomach using particle induced X-ray emission technique. A 2 MeV proton beam was employed to excite the samples. From the present results, the levels of elements K, Ca, Fe, Ni and Se are lower and those of the elements Ti, Co, Zn, As and Cd are higher in the cancer tissue of kidney than those observed in the normal tissue. In the case of stomach, the concentrations of elements Cl, K, Ca, Ti, Mn, Fe, Co, Cu and Zn are lower while concentrations of elements Cr, Ni, As and Br are higher in the cancer tissue of stomach than those observed in the normal tissue. The observed deficiency or excess of certain elements is correlated to carcinogenesis of that organ. The present results of carcinoma stomach support the previous observations that nickel and chromium are carcinogenic agents. The low levels of selenium observed in the carcinoma tissue of kidney and the low levels of manganese observed in the carcinoma tissue of stomach support the view that selenium and manganese inhibit the growth of cancer in kidney and stomach respectively. The observed high levels of zinc in the cancer tissue of kidney suggest that zinc is involved in the tumor growth and development of neoplastic transformation in kidney while the observed low levels of zinc in the carcinoma tissue of stomach suggest that zinc inhibits the growth of cancer in this organ. For correctly assessing the role played by the trace elements in initiating, promoting or inhibiting cancer in various organs, there is a need for acquisition of more data by trace elemental analysis from several investigations of this type undertaken in different regions

Overexpression of esterase D in kidney from trisomy 13 fetuses

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Loughna, S.; Moore, G. (Institute of Obstetrics and Gynaecology, London (United Kingdom)); Gau, G.; Blunt, S. (Cytogenetics Lab., London (United Kingdom)); Nicolaides, K. (King' s College School of Medicine and Dentistry, London (United Kingdom))

1993-10-01

Human trisomy 13 (Patau syndrome) occurs in approximately 1 in 5,000 live births. It is compatible with life, but prolonged survival is rare. Anomalies often involve the urogenital, cardiac, craniofacial, and central nervous systems. It is possible that these abnormalities may be due to the overexpression of developmentally important genes on chromosome 13. The expression of esterase D (localized to chromosome 13q14.11) has been investigated in both muscle and kidney from trisomy 13 fetuses and has been compared with normal age- and sex-matched fetal tissues, by using northern analysis. More than a twofold increase in expression of esterase D was found in the kidney of two trisomy 13 fetuses, with normal levels in a third. Overexpression was not seen in the muscle tissues from these fetuses. 34 refs., 3 figs., 2 tabs.

Kidney biopsy

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... the kidney (in rare cases, may require a blood transfusion) Bleeding into the muscle, which might cause soreness Infection (small risk) Alternative Names Renal biopsy; Biopsy - kidney Images Kidney anatomy ...

Automatic detection of kidney in 3D pediatric ultrasound images using deep neural networks

Science.gov (United States)

Tabrizi, Pooneh R.; Mansoor, Awais; Biggs, Elijah; Jago, James; Linguraru, Marius George

2018-02-01

Ultrasound (US) imaging is the routine and safe diagnostic modality for detecting pediatric urology problems, such as hydronephrosis in the kidney. Hydronephrosis is the swelling of one or both kidneys because of the build-up of urine. Early detection of hydronephrosis can lead to a substantial improvement in kidney health outcomes. Generally, US imaging is a challenging modality for the evaluation of pediatric kidneys with different shape, size, and texture characteristics. The aim of this study is to present an automatic detection method to help kidney analysis in pediatric 3DUS images. The method localizes the kidney based on its minimum volume oriented bounding box) using deep neural networks. Separate deep neural networks are trained to estimate the kidney position, orientation, and scale, making the method computationally efficient by avoiding full parameter training. The performance of the method was evaluated using a dataset of 45 kidneys (18 normal and 27 diseased kidneys diagnosed with hydronephrosis) through the leave-one-out cross validation method. Quantitative results show the proposed detection method could extract the kidney position, orientation, and scale ratio with root mean square values of 1.3 +/- 0.9 mm, 6.34 +/- 4.32 degrees, and 1.73 +/- 0.04, respectively. This method could be helpful in automating kidney segmentation for routine clinical evaluation.

Xenon-computed tomography of kidney transplants

International Nuclear Information System (INIS)

Mutze, S.; Reichmuth, B.; Suess, C.; Lippert, J.; Ewert, R.

1994-01-01

Xenon-CT is an established method for determining cerebral perfusion, while applications in other organs are rare. We evaluated the diagnostic potential of measuring the regional Renal Blood Flow (rRBF) in 10 patients with transplanted kidneys by xenon-CT. We found significant differences in the rRBF between the renal medulla and the cortex. There were no differences between normal renal transplants and transplants with chronic rejection. (orig.) [de

The construction of a panel of serum amino acids for the identification of early chronic kidney disease patients.

Science.gov (United States)

Li, Rui; Dai, Jinna; Kang, Hui

2018-03-01

Serum creatinine, urea, and cystatin-c are standardly used for the evaluation of renal function in the clinic. However, some patients have chronic kidney disease but still retain kidney function; a conventional serum index in these patients can be completely normal. Serum amino acid levels can reflect subtle changes in metabolism and are closely related to renal function. Here, we investigated how amino acids change as renal impairment increases. Subjects were divided into three groups by renal function glomerular filtration rate: healthy controls, patients with chronic kidney disease with normal kidney function, and patients with chronic kidney disease with decreased kidney function group. We identified 11 amino acids of interest using LC-MS/MS on MRM (+) mode. Statistical analysis indicated that alanine (ALA), valine (VAL), and tyrosine (TYR) decrease with renal function impairment, whereas phenylalanine (PHE) and citrulline (CIT) increase. We tried to construct a diagnostic model utilizing a combination of amino acids capable of identifying early chronic kidney disease patients. The accuracy, specificity, and sensitivity of the combining predictors were 86.9%, 84.6%, and 90.9%, respectively, which is superior to the reported values for serum creatinine, urea, and cystatin-c. Our data suggest that serum amino acid levels may supply important information for the early detection of chronic kidney disease. We are the first to establish a diagnostic model utilizing serum levels of multiple amino acids for the diagnosis of patients with early-stage chronic kidney disease. © 2017 Wiley Periodicals, Inc.

Does hypertension remain after kidney transplantation?

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Gholamreza Pourmand

2015-05-01

Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

Tubular kidney injury molecule-1 in protein-overload nephropathy

NARCIS (Netherlands)

van Timmeren, Mirjan M.; Bakker, Stephan J. L.; Vaidya, Vishal S.; Bailly, Veronique; Schuurs, Theo A.; Damman, Jeffrey; Stegeman, Coen A.; Bonventre, Joseph V.; van Goor, Harry

Kim-1, a recently discovered membrane protein, is undetectable in normal kidneys but markedly induced in proximal tubules after ischemic and toxic injury. The function of Kim-1 is unclear, but it is implicated in damage/repair processes. The Kim-1 ectodomain is cleaved by metalloproteinases and

Kidney fibroblast growth factor 23 does not contribute to elevation of its circulating levels in uremia.

Science.gov (United States)

Mace, Maria L; Gravesen, Eva; Nordholm, Anders; Hofman-Bang, Jacob; Secher, Thomas; Olgaard, Klaus; Lewin, Ewa

2017-07-01

Fibroblast growth factor 23 (FGF23) secreted by osteocytes is a circulating factor essential for phosphate homeostasis. High plasma FGF23 levels are associated with cardiovascular complications and mortality. Increases of plasma FGF23 in uremia antedate high levels of phosphate, suggesting a disrupted feedback regulatory loop or an extra-skeletal source of this phosphatonin. Since induction of FGF23 expression in injured organs has been reported we decided to examine the regulation of FGF23 gene and protein expressions in the kidney and whether kidney-derived FGF23 contributes to the high plasma levels of FGF23 in uremia. FGF23 mRNA was not detected in normal kidneys, but was clearly demonstrated in injured kidneys, already after four hours in obstructive nephropathy and at 8 weeks in the remnant kidney of 5/6 nephrectomized rats. No renal extraction was found in uremic rats in contrast to normal rats. Removal of the remnant kidney had no effect on plasma FGF23 levels. Well-known regulators of FGF23 expression in bone, such as parathyroid hormone, calcitriol, and inhibition of the FGF receptor by PD173074, had no impact on kidney expression of FGF23. Thus, the only direct contribution of the injured kidney to circulating FGF23 levels in uremia appears to be reduced renal extraction of bone-derived FGF23. Kidney-derived FGF23 does not generate high plasma FGF23 levels in uremia and is regulated differently than the corresponding regulation of FGF23 gene expression in bone. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Cycloxygenase-2 is expressed in vasculature of normal and ischemic adult human kidney and is colocalized with vascular prostaglandin E2 EP4 receptors

DEFF Research Database (Denmark)

Therland, Karina L; Stubbe, Jane; Thiesson, Helle C

2004-01-01

The study was performed to elucidate the distribution and cellular localization of cyclooxygenase (COX)-2 in human kidney and to address localization of downstream targets for COX-derived prostanoids. Cortex and outer and inner medulla tissue were obtained from control kidneys (cancer specimens),...... feature encountered in human kidneys at all ages, whereas COX-2 was seen in macula densa only in fetal kidney. Vascular COX-2 activity in human kidney and extrarenal tissues may support blood flow and affect vascular wall-blood interaction....

Hymenoptera Stings and the Acute Kidney Injury

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Yashad Dongol

2013-07-01

Full Text Available Hymenoptera stings are a health concern. Apidae (bees, Vespidae (hornets, yellow jackets and wasps and Formicidae (ants are medically-important stinging insects under the order Hymenoptera. Clinical features from simple skin manifestations to severe and fatal organ injury are due to the hypersensitivity reactions and/ or the toxic effects of the venom inoculated. Here we discuss on Hymenoptera stings involving apids (honey bees and vespids (wasps, hornets and yellow jackets and their effect on renal function and associated morphological changes in the kidney. Despite the differences in venom composition and quantity released per sting in two insect groups, both lead to similar medical consequences, such as localised normal allergic reactions, mild to severe anaphylaxis and shock and multiple organ and tissue injury leading to multiple organ failure. Acute kidney injury (AKI is one of the unusual complications of Hymenoptera stings and has the basis of both immune-mediated and toxic effects. Evidence has proven that supportive therapy along with the standard medication is very efficient in completely restoring the kidney function without any recurrence.

Chronic Kidney Disease and Kidney Failure

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... death rates limited life expectancy. Some patients were lucky enough to get a kidney transplant, which greatly ... epidemic rates. Through the 1980s and 1990s, the number of patients developing end-stage kidney failure nearly ...

Changes in Pre- and Post-Exercise Gene Expression among Patients with Chronic Kidney Disease and Kidney Transplant Recipients.

Directory of Open Access Journals (Sweden)

Dawn K Coletta

Full Text Available Decreased insulin sensitivity blunts the normal increase in gene expression from skeletal muscle after exercise. In addition, chronic inflammation decreases insulin sensitivity. Chronic kidney disease (CKD is an inflammatory state. How CKD and, subsequently, kidney transplantation affects skeletal muscle gene expression after exercise are unknown.Study cohort: non-diabetic male/female 4/1, age 52±2 years, with end-stage CKD who underwent successful kidney transplantation. The following were measured both pre-transplant and post-transplant and compared to normals: Inflammatory markers, euglycemic insulin clamp studies determine insulin sensitivity, and skeletal muscle biopsies performed before and within 30 minutes after an acute exercise protocol. Microarray analyses were performed on the skeletal muscle using the 4x44K Whole Human Genome Microarrays. Since nuclear factor of activated T cells (NFAT plays an important role in T cell activation and calcineurin inhibitors are mainstay immunosuppression, calcineurin/NFAT pathway gene expression was compared at rest and after exercise. Log transformation was performed to prevent skewing of data and regression analyses comparing measures pre- and post-transplant performed.Markers of inflammation significantly improved post-transplantation. Insulin infusion raised glucose disposal slightly lower post-transplant compared to pre-transplant, but not significantly, thus concluding differences in insulin sensitivity were similar. The overall pattern of gene expression in response to exercise was reduced both pre-and post-transplant compared to healthy volunteers. Although significant changes were observed among NFAT/Calcineurin gene at rest and after exercise in normal cohort, there were no significant differences comparing NFAT/calcineurin pathway gene expression pre- and post-transplant.Despite an improvement in serum inflammatory markers, no significant differences in glucose disposal were observed post

Results of simultaneous and sequential pediatric liver and kidney transplantation.

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Rogers, J; Bueno, J; Shapiro, R; Scantlebury, V; Mazariegos, G; Fung, J; Reyes, J

2001-11-27

The indications for simultaneous and sequential pediatric liver (LTx) and kidney (KTx) transplantation have not been well defined. We herein report the results of our experience with these procedures in children with end-stage liver disease and/or subsequent end-stage renal disease. Between 1984 and 1995, 12 LTx recipients received 15 kidney allografts. Eight simultaneous and seven sequential LTx/KTx were performed. There were six males and six females, with a mean age of 10.9 years (1.5-23.7). One of the eight simultaneous LTx/KTx was part of a multivisceral allograft. Five KTx were performed at varied intervals after successful LTx, one KTx was performed after a previous simultaneous LTx/KTx, and one KTx was performed after previous sequential LTx/KTx. Immunosuppression was with tacrolimus or cyclosporine and steroids. Indications for LTx were oxalosis (four), congenital hepatic fibrosis (two), cystinosis (one), polycystic liver disease (one), A-1-A deficiency (one), Total Parenteral Nutrition (TPN)-related (one), cryptogenic cirrhosis (one), and hepatoblastoma (one). Indications for KTx were oxalosis (four), drug-induced (four), polycystic kidney disease (three), cystinosis (one), and glomerulonephritis (1). With a mean follow-up of 58 months (0.9-130), the overall patient survival rate was 58% (7/12). One-year and 5-year actuarial patient survival rates were 66% and 58%, respectively. Patient survival rates at 1 year after KTx according to United Network of Organ Sharing (liver) status were 100% for status 3, 50% for status 2, and 0% for status 1. The overall renal allograft survival rate was 47%. Actuarial renal allograft survival rates were 53% at 1 and 5 years. The overall hepatic allograft survival rate was equivalent to the overall patient survival rate (58%). Six of seven surviving patients have normal renal allograft function, and one patient has moderate chronic allograft nephropathy. All surviving patients have normal hepatic allograft function. Six

Evaluation of cyclooxygenase protein expression in traumatized versus normal tissues from eastern box turtles (Terrapene carolina carolina).

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Royal, Lillian W; Lascelles, B Duncan X; Lewbart, Gregory A; Correa, Maria T; Jones, Samuel L

2012-06-01

This pilot study was designed to determine whether cyclooxygenase (COX)-1, COX-2, or both are expressed in normal turtle tissues and whether level of expression changes when tissue becomes inflamed. Five eastern box turtles, Terrapene carolina carolina, that either died or were euthanatized due to disease or injuries were used for this work. Tissues were obtained from the five turtles. Western blot analysis was used to evaluate tissues for COX-1 and COX-2 proteins. Densiometric analysis was used to compare Western blot bands within each turtle. COX-1 and COX-2 were found in the liver, kidney, grossly normal muscle, and grossly traumatized (inflamed) muscle of all study turtles. In all cases, COX-1 and COX-2 proteins were increased in traumatized muscle over grossly normal nontraumatized muscle. The highest levels of COX-1 and COX-2 proteins were found in kidney and liver. There was no statistical difference between the amount of COX-1 protein in liver and kidney, but traumatized muscle compared with grossly normal muscle had significantly greater COX-1 but not COX 2 protein concentrations. There was no statistical difference between the amount of COX-2 protein in liver and kidney. Traumatized muscle expressed nonstatistically significant greater amounts of COX-2 compared with grossly normal muscle. COX-1 and COX-2 proteins are expressed in turtle tissues, and both isoforms are upregulated during inflammation of muscle tissue. Traditional nonsteroidal anti-inflammatory drugs (NSAIDs) that block both COX isoforms might be more efficacious than COX-2-selective drugs. This work suggests that NSAIDs should be evaluated for potential liver and kidney toxicity in turtles.

Transplantation of Kidneys From Donors With Acute Kidney Injury: Friend or Foe?

NARCIS (Netherlands)

Boffa, C.; van de Leemkolk, F.; Curnow, E.; Homan van der Heide, J.; Gilbert, J.; Sharples, E.; Ploeg, R. J.

2017-01-01

The gap between supply and demand in kidney transplantation has led to increased use of marginal kidneys; however, kidneys with acute kidney injury are often declined/discarded. To determine whether this policy is justified, we analyzed outcomes of donor kidneys with acute kidney injury (AKI) in a

Shockwave lithotripsy with music: Less painful and more satisfactory treatment.

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Ordaz Jurado, D G; Budia Alba, A; Bahilo Mateu, P; Trassierra Villa, M; López-Acón, D; Boronat Tormo, F

2017-11-01

The objective of this study was to determine whether listening to music during a session of extracorporeal shockwave lithotripsy (ESWL) improves patients' pain. A simple, blind randomisation was undertaken of patients with kidney and ureter stones attending an ESWL session of 7,000 waves for the first time, between September and December 2014. One group was given music and the other was not. The age, gender, location of stones (kidney/ureter) were recorded and 2questionnaires: pre ESWL (questionnaire A) and postESWL (questionnaire B). Each questionnaire contained a question about anxiety and another question on pain on the Likert scale (0-10). Questionnaire B also had a question on satisfaction and comfort (Likert 0-10). Other variables included heart rate, respiratory rate, systolic and diastolic blood pressure on wave 2,000, 5,000 and 7,000, reason for halting the procedure, total pethidine (mg), secondary analgesia, energy (J) and frequency (Hz). Bivariate analysis using the Student's t-test, X 2 /Fisher test and a multiple linear regression model. The sample comprised 95 patients, with a mean age of 52 (±13) years, 35 (36.84%) females, 60 (63.2%) males. A total of 25 (26.3%) ureter stones and 70 (73.7%) kidney stones. A number of 42 (44.2%) patients were given music. There were no differences between the demographic variables or questionnaire A scores. Satisfaction and pain were better on questionnaire B with music. Music can reduce pain and improve patient satisfaction in ESWL treatment. More studies are required to confirm this effect. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Effect of laser wavelength and protein solder concentration on acute tissue repair using laser welding: initial results in a canine ureter model.

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Wright, E J; Poppas, D P

1997-01-01

Successful tissue approximation can be performed using low power laser energy combined with human albumin solder. In vitro studies were undertaken to investigate the acute repair strengths achieved using different laser wavelengths. Furthermore, we evaluated the change in repair strength with that resulted from changes in protein solder concentration. Intraluminal bursting pressure following ureterotomy repair was measured for the following laser wavelengths: 532, 808, 1,320, 2,100, and 10,600 nm. The tissue absorption characteristics of the 808-nm diode and the KTP-532-nm lasers required the addition of the exogenous chromophores indocyanine green and fluorescein, respectively. A 40% human albumin solder was incorporated in the repair of a 1.0-cm longitudinal defect in the canine ureter. Following determination of an optimal welding wavelength, human albumin solder of varying concentrations (25%, 38%, 45%, and 50%) were prepared and tested. The 1,320-nm YAG laser achieved the highest acute bursting pressure and was the most effective in this model. Of the concentrations of albumin tested, 50% human albumin yielded the greatest bursting pressures. We conclude that of the laser wavelengths evaluated, the 1,320-nm YAG achieves the strongest tissue weld in the acute ex vivo dog ureter model. In addition, when this laser system is used, the acute strength of a photothermal weld appears to be directly proportional to the concentration of human albumin solder in the range of 25 to 50%.

Functionally induced changes in water transport in the proximal tubule segment of rat kidneys

DEFF Research Database (Denmark)

Faarup, Poul; von Holstein-Rathlou, Niels-Henrik; Nørgaard, Tove

2011-01-01

To eliminate freezing artifacts in the proximal tubule cells, two cryotechniques were applied to normal rat kidneys, ie, freeze substitution and special freeze drying. In addition, salt depletion and salt loading were applied to groups of rats to evaluate whether the segmental structure of the pr......To eliminate freezing artifacts in the proximal tubule cells, two cryotechniques were applied to normal rat kidneys, ie, freeze substitution and special freeze drying. In addition, salt depletion and salt loading were applied to groups of rats to evaluate whether the segmental structure...... segment, representing a structural background for the essential transport of water from the proximal tubules to the peritubular capillaries....

Histologic features of harvested canine kidneys preserved in four ...

African Journals Online (AJOL)

Endless efforts are required in the investigation of the best organ preservative. Normal Saline, 5% dextrose, Darrows and Ringers' Lactate were used as preservatives with the view to investigate the prospect of kidney survival in these solutions post harvest at the Veterinary Teaching Hospital, Ahmadu Bello University-Zaria.

Nephrectomy (Kidney Removal)

Science.gov (United States)

... nephrectomy is needed because of other kidney diseases. Kidney function Most people have two kidneys — fist-sized ... and the disease that prompted the surgery? Monitoring kidney function Most people can function well with only ...

Drug induced acute kidney injury: an experimental animal study

International Nuclear Information System (INIS)

Khan, M.W.A.; Khan, B.T.; Qazi, R.A.; Ashraf, M.; Waqar, M.

2017-01-01

Objective: To assess the extent of drug induced nephrotoxicity in laboratory animals for determining the role and extent of iatrogenic kidney damage in patients exposed to nephrotoxic drugs in various clinical setups. Study Design: Randomized control trail. Place and Duration of study: Pharmacology department and animal house of Army Medical College from Jan 2011 to Aug 2011. Material and Methods: Thirty six mixed breed rabbits were used in this study. Animals were randomly divided into six groups consisting of six rabbits in each. Groups were named A, B, C, D, E and F. Group A was control group. Group B was given 0.9% normal saline. Group C rabbits were given acute nephrotoxic single dose of amphotericin B deoxycholate. Group D received 0.9% normal saline 10ml/kg followed by amphotericin B infusion. Group E was injected acute nephrotoxic regimen of cyclosporine and amphotericin B infusion. Group F received saline loading along with acute nephrotoxic regimen of cyclosporine and amphotericin B infusion. Results: Biochemical and histopathological analysis showed significant kidney injury in rabbits exposed to acute nephrotoxic doses of amphotericin B and cyclosporine. Toxicity was additive when the two drugs were administered simultaneously. Group of rabbits with saline loading had significantly lesser kidney damage. Conclusion: Iatrogenic acute kidney damage is a major cause of morbidity in experimental animals exposed to such nephrotoxic drugs like amphotericin B and cyclosporine, used either alone or in combination. Clinical studies are recommended to assess the extent of iatrogenic renal damage in patients and its economic burden. Efficient and cost effective protective measure may be adopted in clinical setups against such adverse effects. (author)

Perfusion of tumor-bearing kidneys as a model for scintigraphic screening of monoclonal antibodies

International Nuclear Information System (INIS)

van Dijk, J.; Oosterwijk, E.; van Kroonenburgh, M.J.; Jonas, U.; Fleuren, G.J.; Pauwels, E.K.; Warnaar, S.O.

1988-01-01

Tumor-bearing human kidneys were used in an ex vivo perfusion model to screen monoclonal antibodies, recognizing renal cell carcinoma-associated antigens for diagnostic potential in vivo. Perfusion of tumor-bearing kidneys with /sup 99m/Tc-labeled G250 and RC38 antibody resulted in visualization of the tumor, whereas perfusion with two other monoclonal antibodies, RC2 and RC4, did not lead to tumor visualization. Uptake of radiolabel in normal kidney tissue was low for G250 and RC38 antibody. Tumor-to-kidney tissue ratios after perfusion with G250 and RC38 antibody were 2.7 and 2.2, respectively. After rinsing for 3 hr with unlabeled perfusion fluid the tumor-to-kidney tissue ratios increased to 8.6 for G250 antibody and to 2.7 for RC38 antibody. We conclude that perfusion of tumor-bearing human kidneys with radiolabeled monoclonal antibodies is a relatively simple way to evaluate renal cell carcinoma associated monoclonal antibodies as diagnostic agents in vivo

APOPTOSIS DURING HUMAN FETAL KIDNEY DEVELOPMENT

Directory of Open Access Journals (Sweden)

Rade Čukuranović

2005-01-01

Full Text Available Kidney morphogenesis is a complex and stepwise process. The formation of mature kidney in mammals is preceded by two primitive embryonic kidneys known as pronephros and mesonephros. Metanephros develops as a result of reciprocal inductive interactions between two primordial mesodermal derivates: ureteric bud, an epithelial outgrowth of the Wolffian duct, and metanephric blastema, a group of mesenchymal cells. The ureteric bud induces the metanephric mesenchyme to differentiate and form nephrons, whilst the metanephric mesenchyme induces the ureteric bud to grow and branch to form collecting ducts. The nephron goes through four developmental stages, which are described as: 1 vesicle, 2 comma-shaped and S-shaped stages, 3 developing capillary loop, and finally 4 maturing glomerulus. Apoptosis (programmed cell death is a predominant form of physiological cell death, by which organism eliminate unwanted or damaged cells. It is the major component of normal development and disease. Apoptosis is the result of series of biochemical processes happening in certain order in a dying cell, among which the most important is activation of enzyme families called caspases which influence different cell components. Apoptosis is characterized by membrane blebbing, shrinkage of the cell, nuclear fragmentation and chromatin condensation. Organelles are preserved almost intact. Cell surface molecules change. A variety of physiological and pathological stimuli can initiate apoptosis. They act via receptor mechanisms, through biochemical agents, or cause DNA and cell membrane damage. Apoptosis is an important component of fetal development. It is thought that apoptosis is the one of the main regulatory events involved in kidney morphogenesis, considering that among great number of developed cells, only a few of them are involved in the developing program by escaping apoptosis. In any period during kidney development about 3 to 5%of cells are apoptotic. Thorough

Analysis of 64-row multidetector CT images for preoperative angiographic evaluation of potential living kidney donors; Analyse der mehrphasigen 64-Zeilen-Multidetektor-Computertomographie zur praeoperativen angiographischen Evaluation potenzieller Lebendnierenspender

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Blondin, D.; Andersen, K.; Kroepil, P.; Cohnen, M.; Moedder, U.; Jung, G. [Universitaetsklinikum Duesseldorf, Institut fuer Diagnostische Radiologie, Duesseldorf (Germany); Sandmann, W. [Universitaetsklinikum Duesseldorf, Klinik fuer Gefaesschirurgie und Nierentransplantation, Duesseldorf (Germany); Ivens, K. [Universitaetsklinikum Duesseldorf, Klinik fuer Nephrologie, Duesseldorf (Germany)

2008-07-15

Anatomical imaging and the ascertainment of any anomalies in the renal vessels and the ureters are essential in the planning of a kidney donation. The aim of the present study was to assess the value of 64-row multidetector CT in noninvasive examination of the renal vessels and ureters of potential living kidney donors. The evaluation embraced 63 living renal donors (LNS) who underwent preoperative CT examination from December 2004 to January 2007. The examinations were all carried out using a Somatom Sensation -Cardiac 64 (Siemens Medical Solutions, Germany). As well as CT angiography (CTA), a venous phase of the abdomen and a late phase after 15 min using low-dose technique were performed for CT urography (CTU). The radiological findings were compared with the surgical results, or with the angiograms in 2 cases. Sensitivity, specificity and both negative and positive predictive value were calculated. In the 63 (31 female, 32 male) donors CTA had a sensitivity of 100% in examination of the main and accessory renal arteries and of 98.3% when the venous and ureteric anatomy were assessed. The sensitivity of low-dose CTU was also 100%. The findings recorded in this study indicate that noninvasive preoperative planning with 64-row multidetector CTA and CTU is a reliable 'one-stop shopping' method of examination for potential living kidney donors. (orig.) [German] Die anatomische Darstellung und Erfassung moeglicher Anomalien der Nierengefaesse und Ureteren ist fuer die Planung einer Lebendnierenspende von essenzieller Bedeutung. Die vorliegende Untersuchung soll die Wertigkeit der nichtinvasiven Evaluation mit der 64-Zeilen-Multidetektor-CT untersuchen. In die Auswertung wurden 63 Lebendnierenspender (LNS) eingeschlossen, die im Zeitraum 12.2004 bis 01.2007 mit der CT praeoperativ untersucht wurden. Die Untersuchungen erfolgten mit einem Somatom-Sensation-Cardiac-64 (Siemens Medical Solutions, Deutschland). Neben einer CT-Angiographie (CTA) wurden eine

A Case Report of Successful Kidney Donation After Brain Death Following Nicotine Intoxication.

Science.gov (United States)

Räsänen, M; Helanterä, I; Kalliomäki, J; Savikko, J; Parry, M; Lempinen, M

Nicotine intoxication is a rare cause of death and can lead to brain death after respiratory arrest and hypoxic-ischemic encephalopathy. To our knowledge, no previous reports regarding organ donation after nicotine intoxication have been described. We present a successful case of kidney donation after brain death caused by subcutaneous nicotine overdose from liquid nicotine from an e-cigarette cartridge in an attempted suicide. Both kidneys were transplanted successfully with immediate graft function, and both recipients were discharged at postoperative day 9 with normal plasma creatinine levels. Graft function has remained excellent in follow-up. This case suggests that kidneys from a donor with fatal nicotine intoxication may be successfully used for kidney transplantation in the absence of other contraindications for donation. Copyright © 2016 Elsevier Inc. All rights reserved.