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Stærk K, Langhorn L, Halle B, Andersen TE. Urinary bladder catheterisation of female pigs: Influence of bladder content and Escherichia coli urinary tract infection on procedural outcome. Lab Anim 2024; 58:252-260. [PMID: 38334709 DOI: 10.1177/00236772231169344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Catheterisation of the urinary bladder is needed in many types of human disease models in pigs. Based on our extensive experience with the pig as an infection model, we here demonstrate an approach of catheterising domestic pigs (40 attempts) and Göttingen minipigs (10 attempts) using a blinded method, that is, without speculums or videoscopes to visualise the urethral opening. The procedure was tested on control animals and pigs with experimental Escherichia coli urinary tract infection (UTI) to assess the potential influence of this condition on procedural outcome. Lastly, we performed cystoscopy in three animals to visualise the route to the urethra and to localise potential anatomical obstacles. All domestic pigs were catheterised successfully in an average of 2 minutes and 23 seconds, and this was not influenced by UTI (p = 0.06) or bladder urine content at the time of catheterisation (p = 0.32). All Göttingen minipigs were successfully catheterised in an average of 4 minutes and 27 seconds. We conclude that blinded catheterisation is a fast and reliable approach that can be performed in pigs with or without UTI with minimal risk of trauma or contamination.
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Affiliation(s)
- Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Denmark
| | - Louise Langhorn
- Biomedical laboratory, University of Southern Denmark, Denmark
| | - Bo Halle
- Department of Neurosurgery, Odense University Hospital, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Denmark
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Hayashi K, Shigemura K, Tanimoto H, Kumagai K, Gonzales RR, Yang YM, Maeda K, Matsuyama H, Fujisawa M. Establishment of an artificial urine model in vitro and rat or pig model in vivo to evaluate urinary crystal adherence. Sci Rep 2024; 14:12001. [PMID: 38796538 PMCID: PMC11127959 DOI: 10.1038/s41598-024-62766-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 05/21/2024] [Indexed: 05/28/2024] Open
Abstract
The current study aimed to establish an experimental model in vitro and in vivo of urinary crystal deposition on the surface of ureteral stents, to evaluate the ability to prevent crystal adhesion. Non-treated ureteral stents were placed in artificial urine under various conditions in vitro. In vivo, ethylene glycol and hydroxyproline were administered orally to rats and pigs, and urinary crystals and urinary Ca were investigated by Inductively Coupled Plasma-Optical Emission Spectrometer. in vitro, during the 3- and 4-week immersion periods, more crystals adhered to the ureteral stent in artificial urine model 1 than the other artificial urine models (p < 0.01). Comparing the presence or absence of urea in the composition of the artificial urine, the artificial urine without urea showed less variability in pH change and more crystal adhesion (p < 0.05). Starting the experiment at pH 6.3 resulted in the highest amount of crystal adhesion to the ureteral stent (p < 0.05). In vivo, urinary crystals and urinary Ca increased in rat and pig experimental models. This experimental model in vitro and in vivo can be used to evaluate the ability to prevent crystal adhesion and deposition in the development of new ureteral stents to reduce ureteral stent-related side effects in patients.
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Affiliation(s)
- Kana Hayashi
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-Ku, Kobe, 654-0142, Japan
| | - Katsumi Shigemura
- Department of Urology, Teikyo University Graduate School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan.
| | - Hiroshi Tanimoto
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-Ku, Kobe, 654-0142, Japan
| | - Kazuo Kumagai
- Research Center for Membrane and Film Technology, Kobe University, 1-1 Rokkodaicho, Nada-Ku, Kobe, 657-8501, Japan
- Department of Chemical Science and Engineering, Kobe University, 1-1 Rokkodaicho, Nada-Ku, Kobe, 657-8501, Japan
| | - Ralph Rolly Gonzales
- Research Center for Membrane and Film Technology, Kobe University, 1-1 Rokkodaicho, Nada-Ku, Kobe, 657-8501, Japan
| | - Young-Min Yang
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Koki Maeda
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Hideto Matsuyama
- Research Center for Membrane and Film Technology, Kobe University, 1-1 Rokkodaicho, Nada-Ku, Kobe, 657-8501, Japan
- Department of Chemical Science and Engineering, Kobe University, 1-1 Rokkodaicho, Nada-Ku, Kobe, 657-8501, Japan
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
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Pang J, Huang Y, Liu Y, Huang W. Applications of ion chromatography in urine analysis: A review. J Chromatogr A 2023; 1706:464231. [PMID: 37517316 DOI: 10.1016/j.chroma.2023.464231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Ion chromatography (IC) plays a crucial role in urine analysis for diverse medical diagnoses. This paper reviews a comprehensive investigation into urine pretreatment techniques, as well as the design and development of IC systems for the measurement of various chemicals. Prior to analysis, urine samples commonly undergo pretreatment procedures such as dilution, filtration, purification, and concentration. These steps effectively eliminate interfering factors and facilitate the accurate and sensitive analysis of ultra-trace components. To separate and quantify different chemical elements or ions present in urine, a range of homemade or commercially available columns coupled with various detectors were employed. This study focuses on the analysis of chemicals such as heavy metals, halogens, pesticides, drugs, and other essential or toxic substances by IC methods.
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Affiliation(s)
- Jiafeng Pang
- Hubei Key Laboratory of Yangtze Catchment Environmental Aquatic Science, School of Environmental Studies, China University of Geosciences, Wuhan 430078, Hubei, China
| | - Yongming Huang
- Hubei Key Laboratory of Yangtze Catchment Environmental Aquatic Science, School of Environmental Studies, China University of Geosciences, Wuhan 430078, Hubei, China
| | - Yanli Liu
- Hubei Key Laboratory of Yangtze Catchment Environmental Aquatic Science, School of Environmental Studies, China University of Geosciences, Wuhan 430078, Hubei, China
| | - Weixiong Huang
- Hubei Key Laboratory of Yangtze Catchment Environmental Aquatic Science, School of Environmental Studies, China University of Geosciences, Wuhan 430078, Hubei, China.
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Chen SJ, Chiu KY, Chen HY, Lin WY, Chen YH, Chen WC. Animal Models for Studying Stone Disease. Diagnostics (Basel) 2020; 10:diagnostics10070490. [PMID: 32708380 PMCID: PMC7400259 DOI: 10.3390/diagnostics10070490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022] Open
Abstract
Animals have stone disease too. There are several animal models for the research of human stone disease. Rodents are the most frequently used for stone research, although they are not prone to forming crystals in the kidneys. Ethylene glycol (EG), sodium oxalate and l-hydroxyproline are common lithogenic agents. Dogs and pigs were also reported as a study animal for stone disease. However, the breeding costs and body size are too high. The most-used genetic study animal for stone disease was the mouse, but it was high-cost. Calcium oxalate (CaOx) crystals can also be light microscopically observed in the Malphigian tubules of Drosophila melanogaster, induced by adding EG to the food. Genetic studies of flies can be done by cross-breeding, and this has a lower cost than using mice. The fly model also has several advantages, including minimal breeding equipment, the fact that it is easier to reach larger numbers in a short time with flies, that crystals can be observed under microscopy, and that they allow genetic study. We suggest the fly will be an ideal animal model for stone research in the future.
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Affiliation(s)
- Szu-Ju Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407204, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Kun-Yuan Chiu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407204, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Huey-Yi Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
| | - Wei-Yong Lin
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
| | - Yung-Hsiang Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan
- Correspondence: (Y.-H.C.); (W.-C.C.)
| | - Wen-Chi Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
- Correspondence: (Y.-H.C.); (W.-C.C.)
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Fargue S, Milliner DS, Knight J, Olson JB, Lowther WT, Holmes RP. Hydroxyproline Metabolism and Oxalate Synthesis in Primary Hyperoxaluria. J Am Soc Nephrol 2018; 29:1615-1623. [PMID: 29588429 PMCID: PMC6054332 DOI: 10.1681/asn.2017040390] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 03/06/2018] [Indexed: 12/24/2022] Open
Abstract
Background Endogenous oxalate synthesis contributes to calcium oxalate stone disease and is markedly increased in the inherited primary hyperoxaluria (PH) disorders. The incomplete knowledge regarding oxalate synthesis complicates discovery of new treatments. Hydroxyproline (Hyp) metabolism results in the formation of oxalate and glycolate. However, the relative contribution of Hyp metabolism to endogenous oxalate and glycolate synthesis is not known.Methods To define this contribution, we performed primed, continuous, intravenous infusions of the stable isotope [15N,13C5]-Hyp in nine healthy subjects and 19 individuals with PH and quantified the levels of urinary 13C2-oxalate and 13C2-glycolate formed using ion chromatography coupled to mass detection.Results The total urinary oxalate-to-creatinine ratio during the infusion was 73.1, 70.8, 47.0, and 10.6 mg oxalate/g creatinine in subjects with PH1, PH2, and PH3 and controls, respectively. Hyp metabolism accounted for 12.8, 32.9, and 14.8 mg oxalate/g creatinine in subjects with PH1, PH2, and PH3, respectively, compared with 1.6 mg oxalate/g creatinine in controls. The contribution of Hyp to urinary oxalate was 15% in controls and 18%, 47%, and 33% in subjects with PH1, PH2, and PH3, respectively. The contribution of Hyp to urinary glycolate was 57% in controls, 30% in subjects with PH1, and <13% in subjects with PH2 or PH3.Conclusions Hyp metabolism differs among PH types and is a major source of oxalate synthesis in individuals with PH2 and PH3. In patients with PH1, who have the highest urinary excretion of oxalate, the major sources of oxalate remain to be identified.
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Affiliation(s)
- Sonia Fargue
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dawn S Milliner
- Mayo Clinic Hyperoxaluria Center, Division of Nephrology and Hypertension, Rochester, Minnesota; and
| | - John Knight
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Julie B Olson
- Mayo Clinic Hyperoxaluria Center, Division of Nephrology and Hypertension, Rochester, Minnesota; and
| | - W Todd Lowther
- Center for Structural Biology, Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ross P Holmes
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama;
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Studies using a porcine model: what insights into human calcium oxalate stone formation mechanisms has this model facilitated? Urolithiasis 2016; 45:109-125. [PMID: 27904915 DOI: 10.1007/s00240-016-0947-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
Animal models are useful in the study of many human diseases. Our current understanding of the biological, physiological, and biochemical aspects of hyperoxaluria and calcium oxalate urolithiasis has been greatly informed by studies using animals. Recently, limitations in the extrapolation to humans of research results derived from laboratory rodents have been identified. The use in biomedical research of a variety of organisms, including large animals, is increasingly encouraged. The purpose of this article is to review the use of pigs in biomedical and stone research, to provide a rationale for using pigs in metabolic stone research, and to describe our 8-year experience in developing a porcine platform for studying hyperoxaluria and calcium oxalate urolithiasis. In this article, we share and review some of the highlights of our findings. We also report results from a recent feeding swine study that demonstrated oxalate-induced renal nephropathy. Finally, we offer ideas for future directions in urolithiasis research using swine.
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Tzou DT, Taguchi K, Chi T, Stoller ML. Animal models of urinary stone disease. Int J Surg 2016; 36:596-606. [PMID: 27840313 DOI: 10.1016/j.ijsu.2016.11.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 01/29/2023]
Abstract
The etiology of stone disease remains unknown despite the major technological advances in the treatment of urinary calculi. Clinically, urologists have relied on 24-h urine collections for the last 30-40 years to help direct medical therapy in hopes of reducing stone recurrence; yet little progress has been made in preventing stone disease. As such, there is an urgent need to develop reliable animal models to study the pathogenesis of stone formation and to assess novel interventions. A variety of vertebrate and invertebrate models have been used to help understand stone pathogenesis. Genetic knockout and exogenous induction models are described. Surrogates for an endpoint of stone formation have been urinary crystals on histologic examination and/or urinalyses. Other models are able to actually develop true stones. It is through these animal models that real breakthroughs in the management of urinary stone disease will become a reality.
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Affiliation(s)
- David T Tzou
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite Box 0738, San Francisco, CA 94143, USA.
| | - Kazumi Taguchi
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite Box 0738, San Francisco, CA 94143, USA; Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Japan.
| | - Thomas Chi
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite Box 0738, San Francisco, CA 94143, USA.
| | - Marshall L Stoller
- Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite Box 0738, San Francisco, CA 94143, USA.
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8
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Abstract
Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow diverticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed.
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Affiliation(s)
- G C Musk
- School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia Animal Care Services, University of Western Australia, Perth, Western Australia
| | - M Zwierzchoniewska
- Western Australia Liver Kidney Transplant Surgery Service, Sir Charles Gairdner Hospital, Perth, Western Australia School of Surgery, University of Western Australia, Perth, Western Australia
| | - B He
- Western Australia Liver Kidney Transplant Surgery Service, Sir Charles Gairdner Hospital, Perth, Western Australia School of Surgery, University of Western Australia, Perth, Western Australia
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Harper JD, Dunmire B, Wang YN, Simon JC, Liggitt D, Paun M, Cunitz BW, Starr F, Bailey MR, Penniston KL, Lee FC, Hsi RS, Sorensen MD. Preclinical safety and effectiveness studies of ultrasonic propulsion of kidney stones. Urology 2014; 84:484-9. [PMID: 24975708 DOI: 10.1016/j.urology.2014.04.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/20/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To provide an update on a research device to ultrasonically reposition kidney stones transcutaneously. This article reports preclinical safety and effectiveness studies, survival data, modifications of the system, and testing in a stone-forming porcine model. These data formed the basis for regulatory approval to test the device in humans. MATERIALS AND METHODS The ultrasound burst was shortened to 50 ms from previous investigations with 1-s bursts. Focused ultrasound was used to expel 2- to 5-mm calcium oxalate monohydrate stones placed ureteroscopically in 5 pigs. Additionally, de novo stones were imaged and repositioned in a stone-forming porcine model. Acute safety studies were performed targeting 2 kidneys (6 sites) and 3 pancreases (8 sites). Survival studies followed 10 animals for 1 week after simulated treatment. Serum and urine analyses were performed, and tissues were evaluated histologically. RESULTS All ureteroscopically implanted stones (6/6) were repositioned out of the kidney in 14 ± 8 minutes with 13 ± 6 bursts. On average, 3 bursts moved a stone more than 4 mm and collectively accounted for the majority of relocation. Stones (3 mm) were detected and repositioned in the 200-kg stone-forming model. No injury was detected in the acute or survival studies. CONCLUSION Ultrasonic propulsion is safe and effective in the porcine model. Stones were expelled from the kidney. De novo stones formed in a large porcine model were repositioned. No adverse effects were identified with the acute studies directly targeting kidney or pancreatic tissue or during the survival studies indicating no evidence of delayed tissue injury.
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Affiliation(s)
- Jonathan D Harper
- Department of Urology, University of Washington School of Medicine, Seattle, WA.
| | - Barbrina Dunmire
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Yak-Nam Wang
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Julianna C Simon
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Denny Liggitt
- Department of Comparative Medicine, University of Washington School of Medicine, Seattle, WA
| | - Marla Paun
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Bryan W Cunitz
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Frank Starr
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Michael R Bailey
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, WA
| | - Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Franklin C Lee
- Department of Urology, University of Washington School of Medicine, Seattle, WA
| | - Ryan S Hsi
- Department of Urology, University of Washington School of Medicine, Seattle, WA
| | - Mathew D Sorensen
- Department of Urology, University of Washington School of Medicine, Seattle, WA; Division of Urology, Department of Veteran Affairs Medical Center, Seattle, WA
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Sivalingam S, Nakada SY, Sehgal PD, Crenshaw TD, Penniston KL. Dietary hydroxyproline induced calcium oxalate lithiasis and associated renal injury in the porcine model. J Endourol 2013; 27:1493-8. [PMID: 24219634 DOI: 10.1089/end.2013.0185] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND PURPOSE We previously reported hyperoxaluria and calcium oxalate calculi in adult pigs (sows) fed hydroxyproline (HP). The purpose of this study was to grossly and histopathologically characterize intrarenal effects in this model. METHODS In the swine facility at our campus, we maintained 21 gestating sows, of which 15 received daily treatment (5% HP mixed with dry feed) and 6 received no treatment (controls). Nine were sacrificed at 21 d (three control, six HP). All kidneys were extracted and examined grossly and for radiographic evidence of stones (GE CT scanner, 80kV, 400MA, 1 sec rotation, 0.625 mm slices). Papillary and cortical samples were processed for histologic analysis. RESULTS Kidneys from treated sows showed significant calculi distributed within the renal papilla on CT, appeared mottled in the renal cortex and papillary areas, and had less distinct corticomedullary borders. Tiny crystals and mucinous debris lined the papillary tips, calices, and pelvis in kidneys from four of six treated sows, and multiple stones were noted at the papillary tips. Hematoxylin and eosin stain revealed crystals in collecting tubules and papillary tips in treated kidneys and none in controls. Yasue staining confirmed crystals in proximal periglomerular tubules of treated but not control animals. Tubular dilation and inflammatory/fibrotic changes were identified in kidneys from treated animals; none of these changes were evident in control kidneys. CONCLUSIONS We report renal damage as a result of dietary-induced hyperoxaluria in adult sows. Specifically, we found crystalluria in proximal periglomerular tubules and collecting ducts, with tubular damage at all segments.
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Affiliation(s)
- Sri Sivalingam
- 1 Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
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Ritz E. Bariatric surgery and the kidney-much benefit, but also potential harm. Clin Kidney J 2012; 6:368-72. [PMID: 27293562 PMCID: PMC4898330 DOI: 10.1093/ckj/sfs161] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 10/19/2012] [Indexed: 12/14/2022] Open
Abstract
Bariatric surgery is increasingly performed on overweight individuals. A significant benefit with respect to cardiovascular (CV) events and survival has been documented. After weight loss, reduction of albuminuria/proteinuria is almost consistently seen; small studies documented retardation of the glomerular filtration rate (GFR) loss after bariatric surgery; reduction of blood pressure (BP) is less consistent. It has been known for a long time that the frequency of oxalate stones is increased after bariatric surgery. The main renal threat of hyperoxaluria is renal oxalosis, often irreversible, causing persisting renal failure. The causes are reduced oxalate binding by calcium due to saponification of calcium causing fat malabsorption, increased permeability for oxalate because of increased permeability of colon mucosa triggered by increased bile salts and reduced colonization of the colon by oxalobacter formigenes. These mechanisms are susceptible to treatment.
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Affiliation(s)
- Eberhard Ritz
- Nierenzentrum , University of Heidelberg , Heidelberg , Germany
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