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Fatahajjad HH, Ompusunggu RA, Laksita TB, Soebadi MA. Multiple lower urinary tract calculi induced by foreign bodies insertion: A case report. Radiol Case Rep 2024; 19:2443-2447. [PMID: 38585402 PMCID: PMC10997869 DOI: 10.1016/j.radcr.2024.02.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Lower urinary tract foreign bodies are often reported but the underlying causes remain intriguing, ranging from unconventional practices to medical interventions. This condition predominantly affects young males and presentations are varied from asymptomatic, lower urinary tract symptoms to acute obstructive renal failure. We report a case of a 48-year-old male presented with lower urinary tract symptoms and obstructive renal failure. Imaging revealed multiple foreign bodies in the pelvic cavity, suggestive of vesical, and urethral lithiasis. Urethrocystoscopy removed an 8-cm needle with rubber band and a 10-cm encrusted cable, forming a urethral stone. Vesicolithotomy removed a 5 × 3 cm bladder stone with a SIM card inserter as its core. The patient's condition improved after surgery. Notably, the patient's history prompted a psychiatric evaluation, leading to the diagnosis of and treatment for an adjustment disorder. While endourology procedure is effective in most cases, some cases necessitate open surgery. Identification and treatment of underlying psychiatric disorders is needed to for long term care.
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Affiliation(s)
- Haykal Hermatyar Fatahajjad
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Ricky Agave Ompusunggu
- Department of Urology, Abdoel Wahab Sjahranie Hospital, Samarinda, East Kalimantan, Indonesia
| | - Tetuka Bagus Laksita
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Mohammad Ayodhia Soebadi
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Universitas Airlangga Teaching Hospital, Surabaya, East Java, Indonesia
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Zheng Q, Ni X, Yang R, Jiao P, Wu J, Yang S, Chen Z, Liu X, Wang L. UroAngel: a single-kidney function prediction system based on computed tomography urography using deep learning. World J Urol 2024; 42:238. [PMID: 38627315 DOI: 10.1007/s00345-024-04921-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 01/16/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Accurate estimation of the glomerular filtration rate (GFR) is clinically crucial for determining the status of obstruction, developing treatment strategies, and predicting prognosis in obstructive nephropathy (ON). We aimed to develop a deep learning-based system, named UroAngel, for non-invasive and convenient prediction of single-kidney function level. METHODS We retrospectively collected computed tomography urography (CTU) images and emission computed tomography diagnostic reports of 520 ON patients. A 3D U-Net model was used to segment the renal parenchyma, and a logistic regression multi-classification model was used to predict renal function level. We compared the predictive performance of UroAngel with the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, and two expert radiologists in an additional 40 ON patients to validate clinical effectiveness. RESULTS UroAngel based on 3D U-Net convolutional neural network could segment the renal cortex accurately, with a Dice similarity coefficient of 0.861. Using the segmented renal cortex to predict renal function stage had high performance with an accuracy of 0.918, outperforming MDRD and CKD-EPI and two radiologists. CONCLUSIONS We proposed an automated 3D U-Net-based analysis system for direct prediction of single-kidney function stage from CTU images. UroAngel could accurately predict single-kidney function in ON patients, providing a novel, reliable, convenient, and non-invasive method.
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Affiliation(s)
- Qingyuan Zheng
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Xinmiao Ni
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Rui Yang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Panpan Jiao
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Jiejun Wu
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Song Yang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Zhiyuan Chen
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Xiuheng Liu
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China.
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China.
| | - Lei Wang
- Department of Urology, Renmin Hospital of Wuhan University, 99 Zhang Zhi-Dong Road, Wuhan, 430060, Hubei, People's Republic of China.
- Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China.
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Wang K, Liao Q, Chen X. Research progress on the mechanism of renal interstitial fibrosis in obstructive nephropathy. Heliyon 2023; 9:e18723. [PMID: 37593609 PMCID: PMC10428074 DOI: 10.1016/j.heliyon.2023.e18723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
Renal fibrosis is a common result for various chronic kidney diseases developing to the end stage. It is a pathological process characterized by the destruction of normal kidney structure and the subsequent replacement with fibrous tissue, which primarily involves fibroblast proliferation and extracellular matrix deposition. Obstruction is a common cause of renal fibrosis, and obstructive renal fibrosis is a common disease in urology. Obstructive renal fibrosis, characterized by its insidious onset, is the result of a complex interplay of multiple factors. These factors encompass renal tubular epithelial cell injury, the presence of a hypoxic microenvironment in affected kidney tissue, inflammatory cell infiltration, release of inflammatory mediators, and the release of renal fibrosis growth factors, among others. This paper reviews the research progress on the mechanism and treatment of renal interstitial fibrosis.
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Affiliation(s)
- Kangning Wang
- Department of Urology Surgery, Xiangya Hospital Central South University, Changsha City, Hunan Province, 410008, China
| | - Qiuling Liao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province, 410011, China
| | - Xiang Chen
- Department of Urology Surgery, Xiangya Hospital Central South University, Changsha City, Hunan Province, 410008, China
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Jensen MS, de Araujo IBBA, Mutsaers HAM, Nørregaard R. Transcutaneous measurement of renal function in two rodent models of obstructive nephropathy. BMC Res Notes 2023; 16:119. [PMID: 37365638 DOI: 10.1186/s13104-023-06387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE Glomerular filtration rate (GFR) is a key indicator of renal function. In both clinical practice and pre-clinical research, serum levels of endogenous filtration markers, such as creatinine, are often used to estimate GFR. However, these markers often do not reflect minor changes in renal function. In this study, we therefore set out to evaluate the applicability of transcutaneous GFR (tGFR) measurements to monitor the changes in renal function, as compared to plasma creatinine (pCreatinine), in two models of obstructive nephropathy, namely unilateral ureteral obstruction (UUO) or bilateral ureteral obstruction followed by release (BUO-R) in male Wistar rats. RESULTS UUO animals showed a significant reduction in tGFR compared to baseline; whereas pCreatinine levels were not significantly changed. In BUO animals, tGFR drops 24 h post BUO and remains lower upon release of the obstruction until day 11. Concomitantly, pCreatinine levels were also increased 24 h after obstruction and 24 h post release, however after 4 days, pCreatinine returned to baseline levels. In conclusion, this study revealed that the tGFR method is superior at detecting minor changes in renal function as compared to pCreatinine measurements.
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Affiliation(s)
- Michael Schou Jensen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark
| | | | - Henricus A M Mutsaers
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark
| | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark.
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Mao Y, Yu J, Da J, Yu F, Zha Y. Acteoside alleviates UUO-induced inflammation and fibrosis by regulating the HMGN1/TLR4/TREM1 signaling pathway. PeerJ 2023; 11:e14765. [PMID: 36691481 PMCID: PMC9864189 DOI: 10.7717/peerj.14765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Acteoside (Act), a phenylethanoid compound that was first isolated from mullein, has been widely used for the investigation of anti-inflammatory and anti-fibrotic effect. However, the mechanism of Act against unilateral ureteral obstruction (UUO)-mediated renal injury is largely unknown. Therefore, this study aimed to explore the effects of Act on UUO rats and possible mechanisms. METHODS A total of 20 Sprague-Dawley (SD) rats were divided randomly into three groups (n ≥ 6): (i) sham-operated group (Sham); (ii) UUO group (UUO+Saline); and (iii) UUO + Act 40 mg/kg/day, (UUO+Act); Continuous gavage administration for 2 weeks postoperatively, while the rats in Sham and UUO+saline groups were given equal amounts of saline. All rats were sacrificed after 14 days, the urine and blood samples were collected for biochemical analysis, the renal tissues were collected for pathological staining and immunohistochemistry. Correlations between individual proteins were analyzed by Pearson correlation analysis. RESULTS The results of renal function indexes and histopathological staining showed that Act could improve renal function by reducing serum creatinine, blood urea nitrogen and urine protein at the same time, Act could alleviate renal inflammation and fibrosis. In addition, the results of immunohistochemistry showed that Act could reduce the expression of inflammation and kidney injury-related proteins F4/80, Mcp-1, KIM-1 proteins, as well as the expression of fibrosis-related protein α-SMA and β-catenin. More importantly, Act can also reduce the expression of HMGN1, TLR4 and TREM-1 proteins. CONCLUSION These data demonstrate that Act can ameliorate UUO-induced renal inflammation and fibrosis in rats probably through triggering HMGN1/TLR4/TREM-1 pathway.
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Affiliation(s)
- Yan Mao
- School of Medicine, Guizhou University, Guiyang, Guizhou, China
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Jiali Yu
- School of Medicine, Guizhou University, Guiyang, Guizhou, China
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Jingjing Da
- School of Medicine, Guizhou University, Guiyang, Guizhou, China
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Fuxun Yu
- School of Medicine, Guizhou University, Guiyang, Guizhou, China
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Yan Zha
- School of Medicine, Guizhou University, Guiyang, Guizhou, China
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
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Wang F, Wang W, Peng S, Wang HY, Chen R, Wang J, Yang C, Li P, Wang Y, Zhang L. Effects of ambient temperature on hospital admissions for obstructive nephropathy in Wuhan, China: A time-series analysis. Ecotoxicol Environ Saf 2022; 242:113876. [PMID: 35841652 DOI: 10.1016/j.ecoenv.2022.113876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Under the background of global warming, it has been confirmed that heat exposure has a huge impact on human health. The current study aimed to evaluate the effects of daily mean ambient temperature on hospital admissions for obstructive nephropathy (ON) at the population level. A total of 19,494 hospitalization cases for ON in Wuhan, China from January 1, 2015 to December 31, 2018 were extracted from a nationwide inpatient database in tertiary hospitals according to the International Classification of Diseases (ICD)- 10 codes. Daily ambient meteorological and pollution data during the same period were also collected. A quasi-Poisson Generalized Linear Model (GLM) combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between daily mean temperature and daily hospital admissions for ON. Results showed that there were significantly positive associations between the daily mean temperature and ON hospital admissions. Relative to the minimum-risk temperature (-3.4 ℃), the risk of hospital admissions for ON at moderate hot temperature (25 ℃, 75th percentile) occurred from lag day 4 and stayed to lag day 12 (cumulative relative risk [RR] was 1.846, 95 % confidence interval [CI]: 1.135-3.005, over lag 0-12 days). Moreover, the risk of extreme hot temperature (32 ℃, 99th percentile) appeared immediately and lasted for 8 days (RR = 2.019, 95 % CI: 1.308-3.118, over lag 0-8 days). Subgroup analyses indicated that the middle-aged and elderly (≥45 years) patients might be more susceptible to the negative effects of high temperature, especially at moderate hot conditions. Our findings suggest that temperature may have a significant impact on the acute progression and onset of ON. Higher temperature is associated with increased risks of hospital admissions for ON, which indicates that early interventions should be taken in geographical settings with relatively high temperatures, particularly for the middle-aged and elderly.
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Affiliation(s)
- Fulin Wang
- Peking University First Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Suyuan Peng
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Huai-Yu Wang
- National Institute of Health Data Science at Peking University, Beijing, China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou, China
| | - Yang Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University, Beijing, China; Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
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Overstreet JM, Gifford CC, Tang J, Higgins PJ, Samarakoon R. Emerging role of tumor suppressor p53 in acute and chronic kidney diseases. Cell Mol Life Sci 2022; 79:474. [PMID: 35941392 DOI: 10.1007/s00018-022-04505-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/06/2023]
Abstract
p53 is a major regulator of cell cycle arrest, apoptosis, and senescence. While involvement of p53 in tumorigenesis is well established, recent studies implicate p53 in the initiation and progression of several renal diseases, which is the focus of this review. Ischemic-, aristolochic acid (AA) -, diabetic-, HIV-associated-, obstructive- and podocyte-induced nephropathies are accompanied by activation and/or elevated expression of p53. Studies utilizing chemical or renal-specific inhibition of p53 in mice confirm the pathogenic role of this transcription factor in acute kidney injury and chronic kidney disease. TGF-β1, NOX, ATM/ATR kinases, Cyclin G, HIPK, MDM2 and certain micro-RNAs are important determinants of renal p53 function in response to trauma. AA, cisplatin or TGF-β1-mediated ROS generation via NOXs promotes p53 phosphorylation and subsequent tubular dysfunction. p53-SMAD3 transcriptional cooperation downstream of TGF-β1 orchestrates induction of fibrotic factors, extracellular matrix accumulation and pathogenic renal cell communication. TGF-β1-induced micro-RNAs (such as mir-192) could facilitate p53 activation, leading to renal hypertrophy and matrix expansion in response to diabetic insults while AA-mediated mir-192 induction regulates p53 dependent epithelial G2/M arrest. The widespread involvement of p53 in tubular maladaptive repair, interstitial fibrosis, and podocyte injury indicate that p53 clinical targeting may hold promise as a novel therapeutic strategy for halting progression of certain acute and chronic renal diseases, which affect hundreds of million people worldwide.
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Zhang G, Yu F, Dong R, Yu J, Luo M, Zha Y. Verbascoside alleviates renal fibrosis in unilateral ureteral obstruction rats by inhibiting macrophage infiltration. Iran J Basic Med Sci 2021; 24:752-759. [PMID: 34630952 PMCID: PMC8487594 DOI: 10.22038/ijbms.2021.52759.11903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/19/2021] [Indexed: 12/29/2022]
Abstract
Objective(s): To explore the effect of verbascoside on renal fibrosis in unilateral ureteral obstruction (UUO) rats. Materials and Methods: Twenty Sprague-Dawley rats were randomly distributed into sham-operated, UUO, and UUO+Verbascoside groups. After two weeks of rat model construction, urine and blood samples were collected for biochemical analysis while kidney tissues were harvested for hematoxylin and eosin (H&E), Masson’s Trichrome, and immunohistochemistry staining. Pearson coefficient was used to analyze the correlation between the two proteins. Results: Verbascoside improved UUO-induced renal dysfunction as detected by decreased serum creatinine, urea nitrogen, and urinary protein excretion rate. In UUO rats, H&E staining result revealed increased total nucleated cell number, and Masson’s Trichrome staining results showed tubular interstitial fibrosis with the deposition of collagen fibrils. Besides, expressions of fibrosis-related proteins including collagen type I (COL-I), α-smooth muscle actin (a-SMA), and tissue inhibitor of metalloproteinase 2 (TIMP2) expressed higher in the UUO group. Moreover, macrophage infiltration-related factors such as CD68+, F4/80+ cells, and suppressor of cytokine signaling-3 (SOCS3) were significantly higher in the UUO group than in sham-operated rats. However, after administration with verbascoside, the accumulation of collagen fibrils and total nucleated cell numbers were mitigated. Likewise, macrophage infiltration was extenuated and fibrosis-related proteins were down-regulated in the UUO+Verbascoside rats. Correlation analysis indicated that macrophage infiltration-related markers were related to fibrosis-related factors. Conclusion: Verbascoside could alleviate renal fibrosis in UUO rats probably through ameliorating macrophage infiltration.
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Affiliation(s)
- Guihua Zhang
- Guizhou University School of Medicine, Guizhou University, Gui Yang, Gui Zhou, China
| | - Fuxun Yu
- The NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Gui Yang, Gui Zhou, China
| | - Rong Dong
- Guizhou University School of Medicine, Guizhou University, Gui Yang, Gui Zhou, China.,Department of Nephrology, Guizhou Provincial People's Hospital, Gui Yang, Gui Zhou, China
| | - Jiali Yu
- Guizhou University School of Medicine, Guizhou University, Gui Yang, Gui Zhou, China.,Department of Nephrology, Guizhou Provincial People's Hospital, Gui Yang, Gui Zhou, China
| | - Meng Luo
- Guizhou University School of Medicine, Guizhou University, Gui Yang, Gui Zhou, China.,Department of Thoracic Surgery, Guizhou Provincial People's Hospital, Gui Yang, Gui Zhou, China
| | - Yan Zha
- Guizhou University School of Medicine, Guizhou University, Gui Yang, Gui Zhou, China.,Department of Nephrology, Guizhou Provincial People's Hospital, Gui Yang, Gui Zhou, China
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Zhang CL, Xie DQ, Ao LN, Zhu L. A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation. Pak J Med Sci 2021; 37:1014-1019. [PMID: 34290775 PMCID: PMC8281144 DOI: 10.12669/pjms.37.4.3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/17/2020] [Accepted: 03/05/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation. Methods: This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People’s Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., β2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy. Results: Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, β2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant. Conclusions: High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate.
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Affiliation(s)
- Chen-Li Zhang
- Chen-li Zhang, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China
| | - De-Qiong Xie
- De-qiong Xie, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China
| | - Li-Na Ao
- Li-na Ao, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China
| | - Lei Zhu
- Lei Zhu, Department of Nephrology, The Second People's Hospital of Yibin City, Yibin, Sichuan, 644000, P.R. China
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Song J, Gong YH, Yan X, Liu Y, Zhang M, Luo J, Jiang CM, Zhang M, Shi GP, Zhu W. Regulatory T Cells Accelerate the Repair Process of Renal Fibrosis by Regulating Mononuclear Macrophages. Am J Med Sci 2021; 361:776-785. [PMID: 33667434 DOI: 10.1016/j.amjms.2021.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 11/18/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND We aimed to investigate the mechanisms of renal fibrosis and explore the effect of CD4+CD25+Foxp3+ regulatory T cells (Treg) on renal fibrosis after the obstruction was removed. METHODS Fifty-five C57BL/6 mice were randomly divided into three groups: the unilateral ureteral obstruction (UUO) group, the relief for unilateral ureteral obstruction (RUUO) group, and the RUUO+Treg group. Renal fibrosis indexes of RUUO mice were evaluated using hematoxylin and eosin (HE) and, Masson staining and immunohistochemistry after CD4+CD25+Treg cells were injected into the tail vein at the moment of recanalization. We detected the levels of Treg, M1, and M2 markers by flow cytometry, and the levels of transforming growth factor (TGF)-β1, interleukin (IL)-1β, IL-6 and IL-10 using ELISA. RESULTS The tubular necrosis score, AO value of α-SMA (smooth muscle actin), and collagen area on the 3rd and 14th days post RUUO were up-regulated compared with the 7th day post RUUO (P<0.05). After injection of Treg via tail vein, the tubular necrosis score, AO value of α-SMA, TGF-β1 level, and collagen area in the RUUO+Treg group on the 14th day were down-regulated compared with the RUUO group (P<0.05). Moreover, Treg could transform M1 macrophages into M2 macrophages, manifesting as up-regulated expression of CD206 compared with the RUUO group (P<0.05). Treg could also down-regulate the secretion of IL-6 and IL-1β while up-regulating the secretion of IL-10 in vitro compared with the M1 group (P<0.05). CONCLUSIONS The kidney could deteriorate into a state of injury and fibrosis after the obstruction was removed, and Treg could effectively protect the kidney function.
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Affiliation(s)
- Jie Song
- Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China; The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yu-Hang Gong
- Department of Pharmacology, China Pharmaceutical University, Nanjing, China
| | - Xiang Yan
- Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Ying Liu
- Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Mingzhuo Zhang
- Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jia Luo
- Department of Nephrology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Chun-Ming Jiang
- Department of Nephrology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Miao Zhang
- Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China; Department of Nephrology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Guo-Ping Shi
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Wei Zhu
- Department of Nephrology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China; Department of Nephrology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
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11
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Ruiz-Alejos A, Caplin B, Miranda JJ, Pearce N, Bernabé-Ortiz A. CKD and CKDu in northern Peru: a cross-sectional analysis under the DEGREE protocol. BMC Nephrol 2021; 22:37. [PMID: 33478431 PMCID: PMC7818732 DOI: 10.1186/s12882-021-02239-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/11/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This study estimated the prevalence and risk factors for decreased estimated glomerular filtration rate (eGFR) in those without known hypertension, type 2 diabetes mellitus, or heavy proteinuria as a surrogate marker for chronic kidney disease of unknown cause (CKDu) among adults in the North of Peru. METHODS A cross-sectional study was conducted following the Disadvantaged Populations eGFR Epidemiology (DEGREE) Study protocol. Low eGFR was defined based on a single eGFR ≤60 mL/min/1.7m2 estimated using the CKD-EPI equation. Environmental conditions related to CKDu (i.e., work in agriculture or sugarcane, water source, heat intolerance, and pesticide exposure) were evaluated, in addition to traditional risk factors for CKD (i.e., smoking, heavy drinking, physical activity, hypertension, type 2 diabetes mellitus, urolithiasis, among others). RESULTS A total of 1514 subjects were included in the study, mean age 45.1 (SD: 16.4), and 55.2% were females. Overall, only 26 cases (1.7%; 95%CI: 1.1-2.5%) had an eGFR < 60 mL/min/1.7m2 compatible with CKD definition; when those with hypertension and type-2 diabetes or heavy proteinuria were excluded, according to the DEGREE protocol, the estimate fell to 0.9% (95%CI: 0.4-1.5%). Low physical activity levels (OR = 1.99; 95%CI: 1.18-3.34), hypertension (OR = 2.07; 1.26-3.41), and urolithiasis (OR = 1.97; 95%CI: 1.18-3.27) were factors associated with low eGFR. CONCLUSIONS A low population-based prevalence of low eGFR (as a surrogate for CKDu), both in rural and urban settings areas, in the Northern Peru, was found. Low physical activity levels, hypertension and urolithiasis were factors associated with low eGFR. Interventions to prevent CKD cases may be focused on well-known CV risk factors and urolithiasis.
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Affiliation(s)
- Andrea Ruiz-Alejos
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Miraflores, Lima, Peru
| | - Ben Caplin
- grid.11100.310000 0001 0673 9488Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J. Jaime Miranda
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Miraflores, Lima, Peru ,grid.83440.3b0000000121901201Centre for Nephrology, University College London, London, UK
| | - Neil Pearce
- grid.8991.90000 0004 0425 469XDepartment of Medical Statistics and Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.8991.90000 0004 0425 469XCentre for Global Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Miraflores, Lima, Peru.
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12
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Matsell DG, Catapang M. Predicting outcomes and improving care in children with congenital kidney anomalies. Pediatr Nephrol 2020; 35:1811-1814. [PMID: 32638086 DOI: 10.1007/s00467-020-04677-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Douglas G Matsell
- Division of Nephrology, British Columbia Children's Hospital, University of British Columbia, 4480 Oak Street, Room K4-150, Vancouver, British Columbia, V6H 2V2, Canada.
| | - Marisa Catapang
- Division of Nephrology, British Columbia Children's Hospital, University of British Columbia, 4480 Oak Street, Room K4-150, Vancouver, British Columbia, V6H 2V2, Canada
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13
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Iida T, Miura K, Hattori M. Pathological findings of initial-phase postrenal acute kidney injury. Clin Exp Nephrol 2020; 24:974-5. [PMID: 32621074 DOI: 10.1007/s10157-020-01916-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
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14
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Liu L, Mao L, Xu Y, Wu X. Endothelial-specific deletion of Brahma-related gene 1 (BRG1) assuages unilateral ureteral obstruction induced renal injury in mice. Biochem Biophys Res Commun 2019; 517:244-252. [PMID: 31349970 DOI: 10.1016/j.bbrc.2019.07.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 07/20/2019] [Indexed: 02/07/2023]
Abstract
Renal homeostasis is regulated by the interplay among different cell types in the kidneys including endothelial cells. In the present study we investigated the phenotypic regulation of endothelial cells by BRG1, a chromatin remodeling protein, in a mouse model of obstructive nephropathy (ON). We report that endothelial-specific deletion of BRG1 attenuated renal inflammation induced by unilateral ureteral tract obstruction (UUO) in mice, as evidenced by down-regulation of pro-inflammatory cytokines and diminished infiltration of immune cells. Moreover, endothelial BRG1 deficiency suppressed UUO-induced renal fibrosis in mice as measured by expression of pro-fibrogenic genes, picrosirius red staining of collagenous tissues, and quantification of hydroxylproline levels. Mechanistically, BRG1 activated the transcription of adhesion molecules and chemokines in endothelial cells by recruiting histone modifying enzymes leading to macrophage adhesion and chemotaxis. In conclusion, we propose that epigenetic regulation of endothelial function by BRG1 may play an active role in ON pathogenesis.
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Affiliation(s)
- Li Liu
- Key Laboratory of Targeted Intervention of Cardiovascular Disease and Collaborative Innovation Center for Cardiovascular Translational Medicine, Department of Pathophysiology, Nanjing Medical University, Nanjing, China
| | - Lei Mao
- Key Laboratory of Targeted Intervention of Cardiovascular Disease and Collaborative Innovation Center for Cardiovascular Translational Medicine, Department of Pathophysiology, Nanjing Medical University, Nanjing, China
| | - Yong Xu
- Key Laboratory of Targeted Intervention of Cardiovascular Disease and Collaborative Innovation Center for Cardiovascular Translational Medicine, Department of Pathophysiology, Nanjing Medical University, Nanjing, China; Institute of Biomedical Research, Liaocheng University, Liaocheng, China
| | - Xiaoyan Wu
- Key Laboratory of Targeted Intervention of Cardiovascular Disease and Collaborative Innovation Center for Cardiovascular Translational Medicine, Department of Pathophysiology, Nanjing Medical University, Nanjing, China; The Laboratory Center for Basic Medical Sciences, Nanjing Medical University, Nanjing, China.
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15
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Narváez Barros A, Guiteras R, Sola A, Manonelles A, Morote J, Cruzado JM. Reversal Unilateral Ureteral Obstruction: A Mice Experimental Model. Nephron Clin Pract 2019; 142:125-134. [PMID: 30783029 DOI: 10.1159/000497119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/20/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Reversible unilateral ureteral obstruction (R-UUO) is a model of renal injury used to study the structural and functional recovery of the kidneys after relief of the obstruction. This model has a prominent potential for the study of inflammatory and immune processes, cellular and tissue regeneration. Here we sought to describe a model of renal injury and repair R-UUO in mice. METHODS Eight week-old C57BL/6J male mice were divided into 5 groups (n = 5 each): UUO day 1, 2, 3, 4 and 5. R-UUO was performed with a microvascular clamp. At day 3, the ureteral clamp was removed and nephrectomy of the contralateral kidney was performed. Mice were sacrificed 48 h afterwards (day 5). An extra group with unilateral nephrectomy without UUO was added. Wild type mice were used as controls. Blood and tissue samples were collected for creatinine, immunohistochemistry and kidney mRNA gene expression analysis. RESULTS In the analysis of the obstructed kidney, we observed acute kidney injury with creatinine that doubled its baseline value; histological signs of tubular damage; increased inflammatory response evaluated by F4/80 macrophage; upregulation of pro-inflammatory and pro-fibrotic cytokines such as IL-2, MCP-1, CD40 and TGF-β1 and increased α-smooth muscle actin staining and mild fibrosis. Once the clamp was removed, we observed the amelioration of the kidney function, pathological lesions and the inflammatory response. CONCLUSION This R-UUO model is an easy, reproducible and reliable method to assess kidney recovery after obstructive uropathy. In this setting, the use of this model may help to a better understanding of the process of kidney repair.
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Affiliation(s)
- Alonso Narváez Barros
- Experimental Nephrology, Department of Ciències Clíniques, Universitat de Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain.,Department of Urology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Roser Guiteras
- Experimental Nephrology, Department of Ciències Clíniques, Universitat de Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sola
- Experimental Nephrology, Department of Ciències Clíniques, Universitat de Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Manonelles
- Experimental Nephrology, Department of Ciències Clíniques, Universitat de Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain.,Department of Nephrology, Bellvitge University Hospital, Barcelona, Spain
| | - Juan Morote
- Department of Urology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Josep M Cruzado
- Experimental Nephrology, Department of Ciències Clíniques, Universitat de Barcelona, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain, .,Department of Nephrology, Bellvitge University Hospital, Barcelona, Spain,
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16
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Huang M, Zhang J, Xu H, Ding T, Tang D, Yuan Q, Tao L, Ye Z. The TGFβ-ERK pathway contributes to Notch3 upregulation in the renal tubular epithelial cells of patients with obstructive nephropathy. Cell Signal 2018; 51:139-151. [PMID: 30081092 DOI: 10.1016/j.cellsig.2018.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/01/2023]
Abstract
Renal interstitial fibrosis is a common renal injury resulted from a variety of chronic kidney conditions and an array of factors. We report here that Notch3 is a potential contributor. In comparison to 6 healthy individuals, a robust elevation of Notch3 expression was observed in the renal tubular epithelial cells of 18 patients with obstructive nephropathy. In a rat unilateral ureteral obstruction (UUO) model which mimics the human disease, Notch3 upregulation closely followed the course of renal injury, renal fibrosis, TGFβ expression, and alpha-smooth muscle actin (α-SMA) expression, suggesting a role of Notch3 in promoting tubulointerstitial fibrosis. This possibility was supported by the observation that TGFβ, the major renal fibrogenic cytokine, stimulated Notch3 expression in human proximal tubule epithelial HK-2 cells. TGFβ enhanced the activation of ERK, p38, but not JNK MAP kinases in HK-2 cells. While inhibition of p38 activation using SB203580 did not affect TGFβ-induced Notch3 expression, inhibition of ERK activation with a MEK1 inhibitor PD98059 dramatically reduced the event. Furthermore, enforced ERK activation through overexpression of the constitutively active MEK1 mutant MEK1Q56P upregulated Notch3 expression in HK-2 cells, and PD98059 reduced ERK activation and Notch3 expression in HK-2 cells expressing MEK1Q56P. Collectively, we provide the first clinical evidence for Notch3 upregulation in patients with obstructive nephropathy; the upregulation is likely mediated through the TGFβ-ERK pathway. This study suggests that Notch3 upregulation contributes to renal injury caused by obstructive nephropathy, which could be prevented or delayed through ERK inhibition.
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Affiliation(s)
- Mei Huang
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jin Zhang
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, China
| | - Hui Xu
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| | - Ting Ding
- Department of Nephrology, The Second Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Damu Tang
- Division of Nephrology, Department of Medicine, McMaster University, Canada; The Hamilton Center for Kidney Research, St. Joseph's Hospital, Hamilton, Ontario, Canada
| | - Qiongjing Yuan
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Lijian Tao
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; State Key Laboratory of Medical Genetics of China, Central South University, Changsha, Hunan 410008, China
| | - Zunlong Ye
- 1717 Class, ChangJun High School of Changsha, Changsha, Hunan 410002, China
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17
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Stroo I, Emal D, Butter LM, Teske GJ, Claessen N, Dessing MC, Girardin SE, Florquin S, Leemans JC. No difference in renal injury and fibrosis between wild-type and NOD1/NOD2 double knockout mice with chronic kidney disease induced by ureteral obstruction. BMC Nephrol 2018; 19:78. [PMID: 29609537 PMCID: PMC5879837 DOI: 10.1186/s12882-018-0867-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 03/07/2018] [Indexed: 01/01/2023] Open
Abstract
Background Chronic kidney disease (CKD) is characterized by sustained tissue damage and ongoing tubulo-interstitial inflammation and fibrosis. Pattern recognition receptors (PRRs) including Toll-like receptors (TLRs) and NOD-like receptors (NLRs) can sense endogenous ligands released upon tissue damage, leading to sterile inflammation and eventually irreversible kidney disease. It is known that NOD1 and NOD2 contribute to the pathogenesis of various inflammatory diseases, including acute kidney injury. However their role in chronic kidney disease is largely unknown. The aim of this study was therefore to investigate the contribution of NOD1 and NOD2 in renal interstitial fibrosis and obstructive nephropathy. Methods To do so, we performed unilateral ureteral obstruction (UUO) in wild type (WT) and NOD1/NOD2 double deficient (DKO) mice and analysed renal damage, fibrosis and inflammation. Data were analysed using the non-parametric Mann-Whitney U-test. Results Minor changes in inflammatory response were observed in NOD1/2 DKO mice, while no effects were observed on renal injury and the development of fibrosis. Conclusion No difference in renal injury and fibrosis between WT and NOD1/NOD2 DKO mice following obstructive nephropathy induced by ureteral obstruction. Electronic supplementary material The online version of this article (10.1186/s12882-018-0867-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid Stroo
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
| | - Diba Emal
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands.
| | - Loes M Butter
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
| | - Gwen J Teske
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
| | - Nike Claessen
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
| | - Mark C Dessing
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
| | - Stephen E Girardin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Sandrine Florquin
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands.,Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jaklien C Leemans
- Department of Pathology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, room L2-112, 1105, AZ, Amsterdam, The Netherlands
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18
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Stein J, Latz S, Ellinger J, Fechner G, Safi M, Krausewitz P, Müller S, Weyer K, Müller SC. Fungaemia caused by obstructive renal candida bezoars leads to bilateral chorioretinitis: a case report. BMC Urol 2018; 18:21. [PMID: 29548319 PMCID: PMC5857136 DOI: 10.1186/s12894-018-0335-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/12/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Renal fungal bezoars are remarkably rare and mostly occur in immunodeficient patients. Only a small number of cases with immunocompetent patients have been published so far. The published treatment approaches comprised systemic antimycotic therapy and surgical or minimal invasive removal of the fungal balls. In some cases irrigation of the renal duct system with amphotericin B was performed. By obstruction of the urinary tract bezoars can lead to infected hydronephrosis and severe urosepsis with high lethality. Fungaemia can cause fungal colonization in different distant organs. Fulminant chorioretinitis and irreversible visual impairment can be the consequence of ocular fundus colonization. The following report highlights that a co-operation between urologists and ophthalmologists is absolutely indispensible in case of fungaemia. CASE PRESENTATION Hereinafter we describe a case of an immunocompetent 56 years old woman, presenting with flank pain and shivering. The diagnosis turned out to be difficult due to initially negative urine culture. The fungaemia caused by obstructive nephropathy led to bilateral candida chorioretinitis. The patient was treated with intravenous amphotericin b and the bezoar was removed by percutaneous "nephrolitholapaxy". After two months, a follow up revealed the patient felt well, chorioretinal lesions regressed and urine culture did not show any fungal growth. CONCLUSION To the best of our knowledge, this is the first case reporting on obstructive renal bezoars, which lead to haematogenous fungus spread and bilateral chorioretinitis. It points out that extensive ophthalmologic examination should be performed in case of fungaemia even if the patient is not suffering from any visual impairment.
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Affiliation(s)
- Johannes Stein
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Stefan Latz
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Jörg Ellinger
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Guido Fechner
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Maher Safi
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Philipp Krausewitz
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Simone Müller
- Department of Ophthalmology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Karin Weyer
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | - Stefan C. Müller
- Department of Urology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
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Lin J, Zhuo Y, Zhang D. Nephrolithiasis and Osteomalacia associated with adefovir-induced Fanconi syndrome in a patient with hepatitis B. BMC Nephrol 2017; 18:275. [PMID: 28851305 PMCID: PMC5576285 DOI: 10.1186/s12882-017-0693-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 08/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background An increasing number of case reports suggest that acquired renal Fanconi syndrome may be associated with prolonged use of adefovir against hepatitis B virus. Renal Fanconi syndrome is an uncommon disease, and its complication with nephrolithiasis is quite rare. Herein, we report a rare coexistence of nephrolithiasis and acquired renal Fanconi syndrome in a chronic hepatitis B-positive patient with prolonged adefovir therapy. Case presentation The patient presented with osteomalacia and nephrolithiasis. Consequently, extracorporeal shock-wave lithotripsy and left double-J ureteral stent insertion were considered for obstructive nephropathy, which was caused by nephrolithiasis. However, osteomalacia had been misdiagnosed as osteoporosis before admission to our hospital. On admission, a complexity of multiple fractures, hypophosphataemia, glycosuria without hyperglycaemia and non–anion-gap metabolic acidosis indicated a diagnosis of acquired renal Fanconi syndrome induced by adefovir. After switching from adefovir to entecavir, the patient’s symptoms and laboratory findings improved significantly. Conclusions The mechanism responsible for nephrolithiasis in renal Fanconi syndrome is still unclear. We recommend regularly monitoring renal function and serum calcium and serum phosphate to prevent renal Fanconi syndrome during the prolonged use of adefovir for hepatitis B virus.
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Affiliation(s)
- Jueying Lin
- Department of Traditional Chinese Medicine, Zhong Shan Hospital Xiamen University, No. 201 Hubin nan Road, Xiamen, Fujian, 361004, China
| | - Yufeng Zhuo
- Department of Traditional Chinese Medicine, Zhong Shan Hospital Xiamen University, No. 201 Hubin nan Road, Xiamen, Fujian, 361004, China
| | - Dongdong Zhang
- Department of Traditional Chinese Medicine, Zhong Shan Hospital Xiamen University, No. 201 Hubin nan Road, Xiamen, Fujian, 361004, China.
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Mazzei L, Cuello-Carrión FD, Docherty N, Manucha W. Heat shock protein 70/nitric oxide effect on stretched tubular epithelial cells linked to WT-1 cytoprotection during neonatal obstructive nephropathy. Int Urol Nephrol 2017; 49:1875-1892. [PMID: 28711961 DOI: 10.1007/s11255-017-1658-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mechanical stress is a key pathogenic driver of apoptosis in the tubular epithelium in obstructive nephropathy. Heat shock protein 70 (Hsp70) and Wilms' tumor (WT-1) have been proposed to represent linked downstream effectors of the cytoprotective properties of NO. In the present study, we sought to evaluate whether the cytoprotective effects of L-arginine in neonatal obstructive nephropathy may be associated with NO-dependent increases in WT-1 and Hsp70 expression. METHODS Neonatal Wistar-Kyoto rats were submitted to complete unilateral ureteral obstruction (UUO) and treated thereafter with vehicle, L-NAME or L-arginine by daily gavage for 14 days to block or augment NO levels, respectively. Normal rat kidney epithelial cells by NRK-52E were exposed to mechanical stress in vitro in the presence or absence of L-NAME, L-arginine, sodium nitroprusside (SNP), L-arginine + SNP or L-arginine/L-NAME. Induction of apoptosis and the mRNA expression of WT-1 and Hsp70 genes were assessed. RESULTS WT-1 and Hsp70 genes expression decreased in the presence of L-NAME and following UUO coincident with increased tubular apoptosis. L-arginine treatment increased NO levels, reduced apoptosis and restored expression levels of WT-1 and Hsp70 to control levels. L-arginine treatment in vitro reduced basal apoptotic rates and prevented apoptosis in response to mechanical strain, an effect enhanced by SNP co-incubation. L-NAME increased apoptosis and prevented the anti-apoptotic action of L-arginine. CONCLUSIONS L-arginine treatment in experimental neonatal UUO reduces apoptosis coincident with restoration of WT-1 and Hsp70 expression levels and directly inhibits mechanical strain-induced apoptosis in an NO-dependent manner in vitro. This potentially implicates an NO-Hsp70-WT-1 axis in the cytoprotective effects of L-arginine.
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Affiliation(s)
- Luciana Mazzei
- Laboratorio de Farmacología Experimental Básica y Traslacional. IMBECU-CONICET (National Council of Scientific and Technical Research of Argentina), Buenos Aires, Argentina.,Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Fernando Darío Cuello-Carrión
- Laboratorio de Farmacología Experimental Básica y Traslacional. IMBECU-CONICET (National Council of Scientific and Technical Research of Argentina), Buenos Aires, Argentina
| | - Neil Docherty
- Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Dublin, Ireland
| | - Walter Manucha
- Laboratorio de Farmacología Experimental Básica y Traslacional. IMBECU-CONICET (National Council of Scientific and Technical Research of Argentina), Buenos Aires, Argentina. .,Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina. .,Pharmacology Area, Pathology Department, Medical Sciences College, National University of Cuyo, Mendoza, CP5500, Argentina.
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Abstract
Pelvic organ prolapse (POP) is the descent of pelvic organs through the vagina, and sometimes causes hydronephrosis. Although the association between POP and hydronephrosis has long been recognized, severe hydronephrosis and renal dysfunction are rarely seen. We report a case of 66-year-old woman who had a vaginal delivery presented with externalized uterine and bladder prolapse during the previous 2 years. She had a 3-day history of hypophagia and vomiting, and laboratory analysis resulted in serum creatinine of 5.75 mg/dL and blood urea of 78.1 mg/dL. The patient was treated urgently with vaginal pessary to return the uterine and bladder into the pelvis. After 2 weeks, her serum creatinine dropped to 3.66 mg/dL, but chronic renal failure persisted. Hydronephrosis caused by POP may lead to renal dysfunction and can advance to irreversible renal damage if left untreated. Important is early evaluation of renal function and images of the kidney and ureter.
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22
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Papadopoulos T, Casemayou A, Neau E, Breuil B, Caubet C, Calise D, Thornhill BA, Bachvarova M, Belliere J, Chevalier RL, Moulos P, Bachvarov D, Buffin-Meyer B, Decramer S, Auriol FC, Bascands JL, Schanstra JP, Klein J. Systems biology combining human- and animal-data miRNA and mRNA data identifies new targets in ureteropelvic junction obstruction. BMC Syst Biol 2017; 11:31. [PMID: 28249581 PMCID: PMC5333413 DOI: 10.1186/s12918-017-0411-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/22/2017] [Indexed: 12/13/2022]
Abstract
Background Although renal fibrosis and inflammation have shown to be involved in the pathophysiology of obstructive nephropathies, molecular mechanisms underlying evolution of these processes remain undetermined. In an attempt towards improved understanding of obstructive nephropathy and improved translatability of the results to clinical practice we have developed a systems biology approach combining omics data of both human and mouse obstructive nephropathy. Results We have studied in parallel the urinary miRNome of infants with ureteropelvic junction obstruction and the kidney tissue miRNome and transcriptome of the corresponding neonatal partial unilateral ureteral obstruction (UUO) mouse model. Several hundreds of miRNAs and mRNAs displayed changed abundance during disease. Combination of miRNAs in both species and associated mRNAs let to the prioritization of five miRNAs and 35 mRNAs associated to disease. In vitro and in vivo validation identified consistent dysregulation of let-7a-5p and miR-29-3p and new potential targets, E3 ubiquitin-protein ligase (DTX4) and neuron navigator 1 (NAV1), potentially involved in fibrotic processes, in obstructive nephropathy in both human and mice that would not be identified otherwise. Conclusions Our study is the first to correlate a mouse model of neonatal partial UUO with human UPJ obstruction in a comprehensive systems biology analysis. Our data revealed let-7a and miR-29b as molecules potentially involved in the development of fibrosis in UPJ obstruction via the control of DTX4 in both man and mice that would not be identified otherwise. Electronic supplementary material The online version of this article (doi:10.1186/s12918-017-0411-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Theofilos Papadopoulos
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Audrey Casemayou
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Eric Neau
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Benjamin Breuil
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Cécile Caubet
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Denis Calise
- Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Barbara A Thornhill
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA.,Department of Molecular Medicine, Université Laval, Québec, Canada
| | - Magdalena Bachvarova
- Department of Molecular Medicine, Université Laval, Québec, Canada.,Centre de recherche du CHU de Québec, L'Hôtel-Dieu de Québec, Québec, Canada
| | - Julie Belliere
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Robert L Chevalier
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA.,Department of Molecular Medicine, Université Laval, Québec, Canada
| | - Panagiotis Moulos
- HybridStat Predictive Analytics, Aiolou 19, 10551, Athens, Greece.,Institute of Molecular Biology and Genetics, Biomedical Sciences Research Center 'Alexander Fleming', Fleming 34, 16672, Vari, Greece
| | - Dimcho Bachvarov
- Department of Molecular Medicine, Université Laval, Québec, Canada.,Centre de recherche du CHU de Québec, L'Hôtel-Dieu de Québec, Québec, Canada
| | - Benedicte Buffin-Meyer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Stéphane Decramer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France.,Université Toulouse III Paul-Sabatier, Toulouse, France.,Service de Néphrologie-Médecine Interne-Hypertension Pédiatrique, CHU Toulouse, Hôpital des Enfants, 31059, Toulouse, France.,Centre De Référence des Maladies Rénales Rares du Sud Ouest (SORARE), 31059, Toulouse, France
| | - Françoise Conte Auriol
- Unité de recherche clinique pédiatrique, Module plurithémathique pédiatrique du Centre d'Investigation Clinique Toulouse 1436 Hôpital des enfants 330 avenue de grande bretagne, 31059, Toulouse, France
| | - Jean-Loup Bascands
- DéTROI-Inserm U1188-Université de La Réunion, Diabète athérothrombose Thérapies Réunion Océan Indien, CYROI, 2, rue Maxime Rivière, 97490, Sainte Clotilde, La Réunion, France
| | - Joost P Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France. .,Université Toulouse III Paul-Sabatier, Toulouse, France.
| | - Julie Klein
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institute of Metabolic and Cardiovascular Diseases-I2MC, 1 avenue Jean Poulhès, B.P. 84225, 31432, Toulouse Cedex 4, France. .,Université Toulouse III Paul-Sabatier, Toulouse, France.
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23
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Chen M, Xia J, Pei G, Zhang Y, Wu S, Qin Y, Deng Y, Guo S, Guo Y, Xu G, Han M. A more accurate method acquirement by a comparison of the prediction equations for estimating glomerular filtration rate in Chinese patients with obstructive nephropathy. BMC Nephrol 2016; 17:150. [PMID: 27756243 PMCID: PMC5070157 DOI: 10.1186/s12882-016-0345-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/05/2016] [Indexed: 02/03/2023] Open
Abstract
Background Researchers have developed several equations to predict glomerular filtration rate (GFR) in patients with chronic kidney diseases (CKD). However, there are scarcely any studies performed to discern the best equation to estimate GFR in patients with pure obstructive nephropathy. In present study, we assessed the suitability of six prediction equations and compared their performance in eGFR evaluation for Chinese patients with obstructive nephropathy. Methods A total of 245 adult patients with obstructive nephropathy were enrolled. We evaluated the performance of the 3 Modification of Diet in Renal Disease equations (MDRD) (the original MDRD7, 7MDRD; the abbreviated MDRD, aMDRD; and re-expressed abbreviated MDRD, re-aMDRD) and 3 Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI) (CKD-EPI equation based on creatinine alone, CKD-EPIcr; CKD-EPI equation based on cystatin C alone, CKD-EPIcys; CKD-EPI equation based on combined creatinine-cystatin, CKD-EPIcr-cys). The measured GFR (mGFR) by 99mTc-DTPA renal dynamic imaging method was used as the reference GFR. Results The mean age of the study population was 51.61 ± 14.17 and 131 were male (53.47 %). The mean measured GFR was 66.54 ± 23.99 ml/min/1.73 m2. Overall, the CKD-EPIcr-cys equation gave the best performance with the best correlation (R = 0.72) and agreement (−34.87, 40.83). CKD-EPIcr-cys equation also exhibited the highest accuracy (69.39 %, P < 0.01) and diagnostic efficacy (ROCAUC = 0.874) with the smallest bias (2.98, P < 0.01). In the subgroup of the lowest GFR, CKD-EPIcys equation exhibited the highest accuracy (52.69 %) and the smallest bias (0.27). In the youngest age subgroup, CKD-EPIcys equation had the highest accuracy (71.64 %) and the smallest bias (−1.24). In other subgroups stratified by GFR, age and gender, CKD-EPIcr-cys equation remained the best performance. Conclusion The 3 CKD-EPI equations performed better than the 3 MDRD equations in estimating GFR in Chinese obstructive nephropathy patients; while the CKD-EPI equation based on combined creatinine-cystatin C provided the best estimation of GFR.
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Affiliation(s)
- Meixue Chen
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Jumei Xia
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Guangchang Pei
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Ying Zhang
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Shuting Wu
- Division of nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yushuang Qin
- Division of nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuanjun Deng
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Shuiming Guo
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Yanyan Guo
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Gang Xu
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.
| | - Min Han
- Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.
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24
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Chevalier RL. Prognostic factors and biomarkers of congenital obstructive nephropathy. Pediatr Nephrol 2016; 31:1411-20. [PMID: 26667236 DOI: 10.1007/s00467-015-3291-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/03/2015] [Accepted: 12/03/2015] [Indexed: 12/14/2022]
Abstract
Congenital obstructive nephropathy (CON) is the leading cause of chronic kidney disease (CKD) in children. Anomalies of the urinary tract are often associated with abnormal nephrogenesis, which is compounded by obstructive injury and by maternal risk factors associated with low birth weight. Currently available fetal and postnatal imaging and analytes of amniotic fluid, urine, or blood lack predictive value. For ureteropelvic junction obstruction, biomarkers are needed for optimal timing of pyeloplasty; for posterior urethral valves, biomarkers of long-term prognosis and CKD are needed. The initial nephron number may be a major determinant of progression of CKD, and most patients with CON who progress to renal failure reach this point in adulthood, presumably compounded by episodes of acute kidney injury. Biomarkers of tubular injury may be of particular value in predicting the need for surgical intervention or in tracking progression of CKD, and must be adjusted for patient age. Discovery of new biomarkers may depend on "unbiased" proteomics, whereby patterns of urinary peptide fragments from patients with CON are analyzed in comparison to controls. Most promising are the analysis of urinary exosomes (restricting biomarkers to relevant tubular cells) and quantitative magnetic resonance imaging techniques allowing precise determination of nephron number and tubular mass. The greatest need is for large prospective multicenter studies with centralized biomarker sample repositories to follow patients with CON from fetal life through adulthood.
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25
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Muñoz-Félix JM, Pérez-Roque L, Núñez-Gómez E, Oujo B, Arévalo M, Ruiz-Remolina L, Cuesta C, Langa C, Pérez-Barriocanal F, Bernabeu C, Lopez-Novoa JM. Overexpression of the short endoglin isoform reduces renal fibrosis and inflammation after unilateral ureteral obstruction. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1801-14. [PMID: 27321931 DOI: 10.1016/j.bbadis.2016.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 06/08/2016] [Accepted: 06/13/2016] [Indexed: 02/07/2023]
Abstract
Transforming growth factor beta 1 (TGF-β1) is one of the most studied cytokines involved in renal tubulo-interstitial fibrosis, which is characterized by myofibroblast abundance and proliferation, and high buildup of extracellular matrix in the tubular interstitium leading to organ failure. Endoglin (Eng) is a 180-kDa homodimeric transmembrane protein that regulates a great number of TGF-β1 actions in different biological processes, including ECM synthesis. High levels of Eng have been observed in experimental models of renal fibrosis or in biopsies from patients with chronic kidney disease. In humans and mice, two Eng isoforms are generated by alternative splicing, L-Eng and S-Eng that differ in the length and composition of their cytoplasmic domains. We have previously described that L-Eng overexpression promotes renal fibrosis after unilateral ureteral obstruction (UUO). However, the role of S-Eng in renal fibrosis is unknown and its study would let us analyze the possible function of the cytoplasmic domain of Eng in this process. For this purpose, we have generated a mice strain that overexpresses S-Eng (S-ENG(+)) and we have performed an UUO in S-ENG(+) and their wild type (WT) control mice. Our results indicate that obstructed kidney of S-ENG(+) mice shows lower levels of tubulo-interstitial fibrosis, less inflammation and less interstitial cell proliferation than WT littermates. Moreover, S-ENG(+) mice show less activation of Smad1 and Smad2/3 pathways. Thus, S-Eng overexpression reduces UUO-induced renal fibrosis and some associated mechanisms. As L-Eng overexpression provokes renal fibrosis we conclude that Eng-mediated induction of renal fibrosis in this model is dependent on its cytoplasmic domain.
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26
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Chen WY, Chang YJ, Su CH, Tsai TH, Chen SD, Hsing CH, Yang JL. Upregulation of Interleukin-33 in obstructive renal injury. Biochem Biophys Res Commun 2016; 473:1026-32. [PMID: 27067050 DOI: 10.1016/j.bbrc.2016.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 04/03/2016] [Indexed: 12/11/2022]
Abstract
Interstitial fibrosis and loss of parenchymal tubular cells are the common outcomes of progressive renal diseases. Pro-inflammatory cytokines have been known contributing to the damage of tubular cells and fibrosis responses after renal injury. Interleukin (IL)-33 is a tissue-derived nucleus alarmin that drives inflammatory responses. The regulation and function of IL-33 in renal injury, however, is not well understood. To investigate the involvement of cytokines in the pathogenesis of renal injury and fibrosis, we performed the mouse renal injury model induced by unilateral urinary obstruction (UUO) and analyze the differentially upregulated genes between the obstructed and the contralateral unobstructed kidneys using RNA sequencing (RNAseq). Our RNAseq data identified IL33 and its receptor ST2 were upregulated in the UUO kidney. Quantitative analysis confirmed that transcripts of IL33 and ST2 were upregulated in the obstructed kidneys. Immunofluorescent staining revealed that IL-33 was upregulated in Vimentin- and alpha-SMA-positive interstitial cells. By using genetically knockout mice, deletion of IL33 reduced UUO-induced renal fibrosis. Moreover, in combination with BrdU labeling technique, we observed that the numbers of proliferating tubular epithelial cells were increased in the UUO kidneys from IL33-or ST2-deficient mice compared to wild type mice. Collectively, our study demonstrated the upregulation of IL-33/ST2 signaling in the obstructed kidney may promote tubular cell injury and interstitial fibrosis. IL-33 may serve as a biomarker to detect renal injury and that IL-33/ST2 signaling may represent a novel target for treating renal diseases.
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27
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Nørregaard R, Kwon TH, Frøkiær J. Physiology and pathophysiology of cyclooxygenase-2 and prostaglandin E2 in the kidney. Kidney Res Clin Pract 2015; 34:194-200. [PMID: 26779421 PMCID: PMC4688592 DOI: 10.1016/j.krcp.2015.10.004] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 10/13/2015] [Indexed: 01/12/2023] Open
Abstract
The cyclooxygenase (COX) enzyme system is the major pathway catalyzing the conversion of arachidonic acid into prostaglandins (PGs). PGs are lipid mediators implicated in a variety of physiological and pathophysiological processes in the kidney, including renal hemodynamics, body water and sodium balance, and the inflammatory injury characteristic in multiple renal diseases. Since the beginning of 1990s, it has been confirmed that COX exists in 2 isoforms, referred to as COX-1 and COX-2. Even though the 2 enzymes are similar in size and structure, COX-1 and COX-2 are regulated by different systems and have different functional roles. This review summarizes the current data on renal expression of the 2 COX isoforms and highlights mainly the role of COX-2 and PGE2 in several physiological and pathophysiological processes in the kidney.
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Affiliation(s)
- Rikke Nørregaard
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tae-Hwan Kwon
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Korea
| | - Jørgen Frøkiær
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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28
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Mazzei L, Docherty NG, Manucha W. Mediators and mechanisms of heat shock protein 70 based cytoprotection in obstructive nephropathy. Cell Stress Chaperones 2015; 20:893-906. [PMID: 26228633 PMCID: PMC4595437 DOI: 10.1007/s12192-015-0622-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/24/2015] [Accepted: 07/09/2015] [Indexed: 12/19/2022] Open
Abstract
Urinary heat shock protein 70 (Hsp70) is rapidly increased in patients with clinical acute kidney injury, indicating that it constitutes a component of the endogenous stress response to renal injury. Moreover, experimental models have demonstrated that Hsp70 activation is associated with the cytoprotective actions of several drugs following obstruction, including nitric oxide (NO) donors, geranylgeranylacetone, vitamin D, and rosuvastatin. Discrete and synergistic effects of the biological activities of Hsp70 may explain its cytoprotective role in obstructive nephropathy. Basic studies point to a combination of effects including inhibition of apoptosis and inflammation, repair of damaged proteins, prevention of unfolded protein aggregation, targeting of damaged protein for degradation, and cytoskeletal stabilization as primary effectors of Hsp70 action. This review summarizes our understanding of how the biological actions of Hsp70 may affect renal cytoprotection in the context of obstructive injury. The potential of Hsp70 to be of central importance to the mechanism of action of various drugs that modify the genesis of experimental obstructive nephropathy is considered.
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Affiliation(s)
- Luciana Mazzei
- Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina.
- IMBECU-CONICET (National Council of Scientific and Technical Research of Argentina), Buenos Aires, Argentina.
| | - Neil G Docherty
- Conway Institute of Biomolecular and Biomedical Research, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Walter Manucha
- Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
- IMBECU-CONICET (National Council of Scientific and Technical Research of Argentina), Buenos Aires, Argentina
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29
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Zhao Q, Yang Y, Wang CL, Hou Y, Chen H. Screening and identification of the differential proteins in kidney with complete unilateral ureteral obstruction. Int J Clin Exp Pathol 2015; 8:2615-2626. [PMID: 26045767 PMCID: PMC4440076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 11/29/2014] [Indexed: 06/04/2023]
Abstract
Obstructive nephropathy is a major cause of renal failure, particularly in infants and children, and indications for therapeutic intervention remain highly controversial. There is a great need for the development of new methods to monitor patients, and the biomarker research field is a promising approach for this purpose to be used as prognostic tools for early disease detection and the choice of the optimal treatment and monitoring. Here, we presented our comparative proteomics study of rat kidney with complete unilateral ureteral obstruction (CUUO). Proteins from the groups of CUUO and corresponding sham rat kidney tissues were subjected to 2-D gel electrophoresis, and then protein identification by mass spectrometry. We identified 39 proteins with differential expression between kidney tissues from sham operated group and those with CUUO. These identified proteins were reported to be involved in cell apoptosis, energy metabolism and injuries of mitochondrion and oxidative stress, and so on. We confirmed 3 identified proteins by immunoblot analysis and immunofluorescence staining and assessed their mRNA levels in renal tissues. Our results demonstrate protein alterations that reflect the pathological situation of the obstructed kidneys, which may help understand the relationship between oxidative stress and obstructive nephropathy.
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Affiliation(s)
- Qi Zhao
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University Shenyang 110004, China
| | - Yi Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University Shenyang 110004, China
| | - Chang-Lin Wang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University Shenyang 110004, China
| | - Ying Hou
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University Shenyang 110004, China
| | - Hui Chen
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University Shenyang 110004, China
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30
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Chuang ST, Kuo YH, Su MJ. KS370G, a caffeamide derivative, attenuates unilateral ureteral obstruction-induced renal fibrosis by the reduction of inflammation and oxidative stress in mice. Eur J Pharmacol 2015; 750:1-7. [PMID: 25620133 DOI: 10.1016/j.ejphar.2015.01.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/14/2015] [Accepted: 01/15/2015] [Indexed: 12/19/2022]
Abstract
Unilateral ureteral obstruction (UUO) is an established animal model used to study renal nephropathy. Caffeic acid phenethyl ester, a natural phenolic compound, possesses antifibrotic, anti-inflammation and anti-oxidative stress effects; however, rapid decomposition by esterases substantially decreases its bioavailability. The goal of this study was to investigate the beneficial effects of KS370G, a synthetic caffeamide derivative, on UUO-induced renal injury. Following the UUO, KS370G (10mg/kg) was administered by oral gavage once a day. Renal injury was analyzed at 14 days post-operation. Our results show that KS370G significantly attenuated collagen deposition in the obstructed kidney and inhibited UUO-induced renal fibrosis markers expression, including fibronectin, type I collagen, vimentin, and α-smooth muscle actin (α-SMA). KS370G significantly lowered the expression of renal inflammatory chemokines/adhesion molecules and monocyte cells marker (MCP-1, VCAM-1, ICAM-1 and CD11b). KS370G also reduced renal malondialdehyde levels and reversed the expression of renal antioxidant enzymes (SOD and catalase) after UUO. Furthermore, KS370G significantly inhibited UUO-induced elevated plasma AngII and TGF-β1 levels, TGF-β1 protein expression and Smad3 phosphorylation. These findings demonstrate that KS370G reduces renal obstructive nephropathy by possibly inhibiting AngII, TGF-β and Smad3 signaling pathways.
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Affiliation(s)
- Sung-Ting Chuang
- Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
| | - Yueh-Hsiung Kuo
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, Taichung 40402, Taiwan; Department of Biotechnology, Asia University, Taichung 41354, Taiwan
| | - Ming-Jai Su
- Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
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31
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Abstract
This review discusses the pathology of non-neoplastic kidney disease that pathologists may encounter as nephrectomy specimens. The spectrum of pediatric disease is emphasized. Histopathologic assessment of non-neoplastic nephrectomy specimens must be interpreted in the clinical context for accurate diagnosis. Although molecular pathology is not the primary focus of this review, the genetics underlying several of these diseases are also touched on.
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Affiliation(s)
- Joseph P Gaut
- Nephropathology Associates, 10810 Executive Center Drive, Suite 100, Little Rock, AR 72211, USA.
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32
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Kotb S, ElSheemy MS, Morsi HA, Zakaria T, Salah M, Eissa MA. Renal recoverability in infants with obstructive calcular anuria: is it better than in older children? J Pediatr Urol 2013; 9:1178-82. [PMID: 23769201 DOI: 10.1016/j.jpurol.2013.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 05/01/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Urolithiasis in infants can cause considerable morbidity. The literature regarding calcular anuria in this age group is very defective. Our aim was to evaluate impact of intervention on renal recoverability in these infants. PATIENTS AND METHODS A series of 24 patients presenting with obstructive calcular anuria were included in this study. Mean age was 16.5 ± 6.2 months. They were treated either by initial urinary diversion or definitive endoscopic (ureteroscopy or JJ stenting with medical alkalinization) or open surgical (ureterolithotomy or pyelolithotomy) treatment. RESULTS Mean serum creatinine was 5.8 ± 2.6 mg/dl. Initial peritoneal dialysis and/or urinary diversion was needed in 11 patients (45.8%). Open surgical treatment was applied in 5 (20.8%), endoscopic treatment was applied in 15 (62.5%), while combined treatment was applied in 4 (16.6%) patients. All patients had normal serum creatinine on discharge. Three (12.5%) had residual stones which were cleared by 2ry ureteroscopic intervention at 6 months. The overall complication rate in this study was 12.5% in the form of postoperative leakage (1) and postoperative fever (2). No mortality or development of chronic renal failure was reported at 6 months follow up. In comparison with these results, a previous study carried out in our centre on an older age group had a higher complication rate (28%) with higher mortalities and lower renal function recoverability rate (94%). CONCLUSIONS Appropriate and timely medical and surgical management of calcular anuria will mostly lead to full recovery of renal functions. In comparison with older children, renal prognosis in those less than 2 years seems more favorable.
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Affiliation(s)
- Sameh Kotb
- Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt
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Samarakoon R, Dobberfuhl AD, Cooley C, Overstreet JM, Patel S, Goldschmeding R, Meldrum KK, Higgins PJ. Induction of renal fibrotic genes by TGF-β1 requires EGFR activation, p53 and reactive oxygen species. Cell Signal 2013; 25:2198-209. [PMID: 23872073 DOI: 10.1016/j.cellsig.2013.07.007] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 07/10/2013] [Indexed: 12/14/2022]
Abstract
While transforming growth factor-β (TGF-β1)-induced SMAD2/3 signaling is a critical event in the progression of chronic kidney disease, the role of non-SMAD mechanisms in the orchestration of fibrotic gene changes remains largely unexplored. TGF-β1/SMAD3 pathway activation in renal fibrosis (induced by ureteral ligation) correlated with epidermal growth factor receptor(Y845) (EGFR(Y845)) and p53(Ser15) phosphorylation and induction of disease causative target genes plasminogen activator inhibitor-1 (PAI-1) and connective tissue growth factor (CTGF) prompting an investigation of the mechanistic involvement of EGFR and tumor suppressor p53 in profibrotic signaling. TGF-β1, PAI-1, CTGF, p53 and EGFR were co-expressed in the obstructed kidney localizing predominantly to the tubular and interstitial compartments. Indeed, TGF-β1 activated EGFR and p53 as well as SMAD2/3. Genetic deficiency of either EGFR or p53 or functional blockade with AG1478 or Pifithrin-α, respectively, effectively inhibited PAI-1and CTGF induction and morphological transformation of renal fibroblasts as did SMAD3 knockdown or pretreatment with the SMAD3 inhibitor SIS3. Reactive oxygen species (ROS)-dependent mechanisms initiated by TGF-β1 were critical for EGFR(Y845) and p53(Ser15) phosphorylation and target gene expression. The p22(Phox) subunit of NADPH oxidase was also elevated in the fibrotic kidney with an expression pattern similar to p53 and EGFR. EGF stimulation alone initiated, albeit delayed, c-terminal SMAD3 phosphorylation (that required the TGF-β1 receptor) and rapid ERK2 activation both of which are necessary for PAI-1 and CTGF induction in renal fibroblasts. These data highlight the extensive cross-talk among SMAD2/3, EGFR and p53 pathways essential for expression of TGF-β1-induced fibrotic target genes.
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Affiliation(s)
- Rohan Samarakoon
- Center for Cell Biology & Cancer Research, Albany Medical College, Albany, NY 12208, USA
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