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Sample records for dynamic renal study

  1. [Development of automatic analysis for dynamic renal function study using computed tomographic (CT) images].

    PubMed

    Ikematsu, Ryuuji; Kawata, Hidemichi; Kawamura, Seiji; Miura, Hisao; Miyagawa, Teruo; Ishibashi, Masatoshi; Hayabuchi, Naofumi

    2007-12-20

    Determination of the region of interest (ROI) for dynamic renal function has been highly discordant among operators because of the dependence on factors such as the rate of injection of radioactive medicines, constitution, and renal function. To simplify this problem, we developed a computer algorithm that provides automatic analysis for both localization of the kidney and automatic determination of ROIs using computed tomographic (CT) images. The bilateral kidneys were extracted from enhanced CT images, and the CT pixel size was adjusted to dynamic renal function images. The template-matching technique was used for these images, and the kidney renal location was analyzed on additional functional images constructed by dynamic renal function images. As a result, we were able to obtain time-activity curves of both renal function and quantified glomerular filtration rate (GFR). In conclusion, the computer algorithm we developed was considered to provide reliable results, apart from the variability among operators, because of its good reproducibility. PMID:18310998

  2. Quantitative renal scintillation camera studies in renal transplantation

    SciTech Connect

    Frentz, G.D.; Schlegel, J.U.; Hussey, J.L.; Prima, R.

    1981-12-01

    Renal transplant recipients and donors were studied serially with quantitative renal scintillation camera studies utilizing 131I-Hippuran and 99mTc-Iron ascorbate. This study allows for determination of effective renal plasma flow (ERPF), glomerular filtration rate (GFR), filtration fraction (FF), and predicted return in ten minutes. A drop in FF occurred with, or preceded clinical rejection; whereas, an increase in FF occurred with acute tubular necorsis (ATN) caused by preservation injury, aminoglycosides, and following acute rejection. Combined with the other parameters of renal function determined by this technique, FF alterations proved useful in the differentiation of ATN from rejection and in predicting the prognosis of renal homografts.

  3. Renal cyst puncture studies.

    PubMed

    Lang, E K

    1987-02-01

    The edict to contain costs and meet goals imposed by DRG remuneration policies mandates the work-up of asymptomatic renal mass lesions on an outpatient basis. This proved feasible in 98 per cent of patients. The vast majority of such mass lesions (82 to 90 per cent) is diagnosed with acceptable confidence by computed tomography and sonography alone. For a shrinking group of such patients, yet still 16 to 18 per cent, guided percutaneous aspiration biopsy is necessary to affirm the diagnosis. However, this technique has been refined during recent years to incorporate the use of thin needle equipment and can now be performed on an outpatient basis without significant risk of morbidity. For diagnosing hyperdense inflammatory and infected renal cysts, guided percutaneous aspiration is recommended as the most effective method. This procedure should take precedence over surgical exploration because it can diagnose and provide pertinent bacteriologic information that may determine the course of therapy. In many instances inflammatory cysts or even silent renal abscesses are diagnosed by a percutaneous aspiration technique that is then expanded to serve therapeutic purposes such as percutaneous drainage. Even these procedures can be performed safely on an outpatient basis provided the patient is followed closely. Because complications of percutaneous aspiration procedures are extremely rare, the procedure can be used safely on an outpatient basis. The impact of magnetic resonance imaging on the diagnosis of asymptomatic space-occupying lesions of the kidney is as yet not fully determined; however, this method appears promising for diagnosing some of the refractory lesions such as hemorrhagic cysts, aneurysms, or arteriovenous malformations. PMID:3101262

  4. The International Atomic Energy Agency software package for the analysis of scintigraphic renal dynamic studies: a tool for the clinician, teacher, and researcher.

    PubMed

    Zaknun, John J; Rajabi, Hossein; Piepsz, Amy; Roca, Isabel; Dondi, Maurizio

    2011-01-01

    Under the auspices of the International Atomic Energy Agency, a new-generation, platform-independent, and x86-compatible software package was developed for the analysis of scintigraphic renal dynamic imaging studies. It provides nuclear medicine professionals cost-free access to the most recent developments in the field. The software package is a step forward towards harmonization and standardization. Embedded functionalities render it a suitable tool for education, research, and for receiving distant expert's opinions. Another objective of this effort is to allow introducing clinically useful parameters of drainage, including normalized residual activity and outflow efficiency. Furthermore, it provides an effective teaching tool for young professionals who are being introduced to dynamic kidney studies by selected teaching case studies. The software facilitates a better understanding through practically approaching different variables and settings and their effect on the numerical results. An effort was made to introduce instruments of quality assurance at the various levels of the program's execution, including visual inspection and automatic detection and correction of patient's motion, automatic placement of regions of interest around the kidneys, cortical regions, and placement of reproducible background region on both primary dynamic and on postmicturition studies. The user can calculate the differential renal function through 2 independent methods, the integral or the Rutland-Patlak approaches. Standardized digital reports, storage and retrieval of regions of interest, and built-in database operations allow the generation and tracing of full image reports and of numerical outputs. The software package is undergoing quality assurance procedures to verify the accuracy and the interuser reproducibility with the final aim of launching the program for use by professionals and teaching institutions worldwide. PMID:21111861

  5. A biphasic parameter estimation method for quantitative analysis of dynamic renal scintigraphic data

    NASA Astrophysics Data System (ADS)

    Koh, T. S.; Zhang, Jeff L.; Ong, C. K.; Shuter, B.

    2006-06-01

    Dynamic renal scintigraphy is an established method in nuclear medicine, commonly used for the assessment of renal function. In this paper, a biphasic model fitting method is proposed for simultaneous estimation of both vascular and parenchymal parameters from renal scintigraphic data. These parameters include the renal plasma flow, vascular and parenchymal mean transit times, and the glomerular extraction rate. Monte Carlo simulation was used to evaluate the stability and confidence of the parameter estimates obtained by the proposed biphasic method, before applying the method on actual patient study cases to compare with the conventional fitting approach and other established renal indices. The various parameter estimates obtained using the proposed method were found to be consistent with the respective pathologies of the study cases. The renal plasma flow and extraction rate estimated by the proposed method were in good agreement with those previously obtained using dynamic computed tomography and magnetic resonance imaging.

  6. Effects of Renal Denervation on Renal Artery Function in Humans: Preliminary Study

    PubMed Central

    Doltra, Adelina; Hartmann, Arthur; Stawowy, Philipp; Goubergrits, Leonid; Kuehne, Titus; Wellnhofer, Ernst; Gebker, Rolf; Schneeweis, Christopher; Schnackenburg, Bernhard; Esler, Murray; Fleck, Eckart; Kelle, Sebastian

    2016-01-01

    Aim To study the effects of RD on renal artery wall function non-invasively using magnetic resonance. Methods and Results 32 patients undergoing RD were included. A 3.0 Tesla magnetic resonance of the renal arteries was performed before RD and after 6-month. We quantified the vessel sharpness of both renal arteries using a quantitative analysis tool (Soap-Bubble®). In 17 patients we assessed the maximal and minimal cross-sectional area of both arteries, peak velocity, mean flow, and renal artery distensibility. In a subset of patients wall shear stress was assessed with computational flow dynamics. Neither renal artery sharpness nor renal artery distensibility differed significantly. A significant increase in minimal and maximal areas (by 25.3%, p = 0.008, and 24.6%, p = 0.007, respectively), peak velocity (by 16.9%, p = 0.021), and mean flow (by 22.4%, p = 0.007) was observed after RD. Wall shear stress significantly decreased (by 25%, p = 0.029). These effects were observed in blood pressure responders and non-responders. Conclusions RD is not associated with adverse effects at renal artery level, and leads to an increase in cross-sectional areas, velocity and flow and a decrease in wall shear stress. PMID:27003912

  7. Dynamics of Urinary Calprotectin after Renal Ischaemia

    PubMed Central

    Ebbing, Jan; Seibert, Felix S.; Pagonas, Nikolaos; Bauer, Frederic; Miller, Kurt; Kempkensteffen, Carsten; Günzel, Karsten; Bachmann, Alexander; Seifert, Hans H.; Rentsch, Cyrill A.; Ardelt, Peter; Wetterauer, Christian; Amico, Patrizia; Babel, Nina; Westhoff, Timm H.

    2016-01-01

    Background: Urinary calprotectin has been identified as a promising biomarker for acute kidney injury. To date, however, the time-dependent changes of this parameter during acute kidney injury remain elusive. The aim of the present work was to define the time-course of urinary calprotectin secretion after ischaemia/reperfusion-induced kidney injury in comparison to neutrophil gelatinase—associated lipocalin, thereby monitoring the extent of tubular damage in nephron sparing surgery for kidney tumours. Methods: The study population consisted of 42 patients. Thirty-two patients underwent either open or endoscopic nephron sparing surgery for kidney tumours. During the surgery, the renal arterial pedicle was clamped with a median ischaemic time of 13 minutes (interquartile range, 4.5–20.3 minutes) in 26 patients. Ten retro-peritoneoscopic living donor nephrectomy patients and 6 nephron sparing surgery patients in whom the renal artery was not clamped served as controls. Urinary calprotectin and neutrophil gelatinase—associated lipocalin concentrations were repeatedly measured by enzyme-linked immunosorbent assay and assessed according to renal function parameters. Results: Urinary concentrations of calprotectin and neutrophil gelatinase—associated lipocalin increased significantly after ischaemia/reperfusion injury, whereas concentrations remained unchanged after nephron sparing surgery without ischaemia/reperfusion injury and after kidney donation. Calprotectin and neutrophil gelatinase—associated lipocalin levels were significantly increased 2 and 8 hours, respectively, post-ischaemia. Both proteins reached maximal concentrations after 48 hours, followed by a subsequent persistent decrease. Maximal neutrophil gelatinase—associated lipocalin and calprotectin concentrations were 9-fold and 69-fold higher than their respective baseline values. The glomerular filtration rate was only transiently impaired at the first post-operative day after ischaemia/reperfusion injury (p = 0.049). Conclusion: Calprotectin and neutrophil gelatinase—associated lipocalin can be used to monitor clinical and sub-clinical tubular damage after nephron sparing surgery for kidney tumours. Urinary calprotectin concentrations start rising within 2 hours after ischaemia/reperfusion-induced kidney injury. PMID:26745147

  8. Automated patient motion detection and correction in dynamic renal scintigraphy

    PubMed Central

    Folks, Russell D.; Manatunga, Daya; Garcia, Ernest V.; Taylor, Andrew T.

    2010-01-01

    Kidney motion during dynamic renal scintigraphy can cause errors in calculated renal function parameters. Our goal was to develop and validate algorithms to detect and correct patient motion. Methods We retrospectively collected dynamic images from 86 clinical renal studies (42 females, 44 males), acquired using the following protocol for 99m Tc Mertiatide (MAG3) imaging: 80 128128 image frames (24 2-second frames, 16 15-second frames, 40 30-second frames, 128128, 3.2 mm/pixel). We simulated ten types of vertical motion in each patient study, resulting in 860 image sets. Motion consisted of up or down shifts of magnitude 0.25 pixels to 4 pixels per frame, and were either A) gradual shift additive over multiple frames or B) abrupt shift of one or more consecutive frames, with a later return to the start position. Additional horizontal motion was added to test its effect on detection of vertical motion. Original and shifted files were submitted to a motion detection algorithm. Corrective shifts were applied, and corrected and original, unshifted images were compared on a pixel by pixel basis. Motion detected in the shifted data was also tabulated before and after correcting for motion detected in the original unshifted data. A detected shift was considered correct if it was within 0.25 pixel of the simulated magnitude. Software was developed to facilitate visual review of all images, and to summarize kidney motion and motion correction using linograms. Results Overall detection of simulated shifts was 99% (3068/3096 frames) when the existing motion in the original images was first corrected. When the original motion was not corrected, overall shift detection was 76% (2345/3096 frames). For image frames in which no shift was added, (and original motion was not corrected) 87% (27142/31132 frames) were correctly detected as having no shift. When corrected images were compared to original, calculated count recovery was 100% for all shifts that were whole pixel magnitudes. For fractional pixel shifts, percent count recovery varied from 5273%. Visual review suggested that some original, unshifted frames exhibited true patient motion. Conclusions The algorithm accurately detected motion as small as 0.25 pixels. Whole pixel motion can be detected and corrected with high accuracy. Fractional pixel motion can be detected and corrected but with less accuracy. Importantly, the algorithm accurately identified unshifted frames, which helps to prevent the introduction of errors during motion correction. PMID:21565959

  9. Mitochondrial dynamics: regulatory mechanisms and emerging role in renal pathophysiology

    PubMed Central

    Zhan, Ming; Brooks, Craig; Liu, Fuyou; Sun, Lin; Dong, Zheng

    2012-01-01

    Mitochondria are a class of dynamic organelles that constantly undergo fission and fusion. Mitochondrial dynamics is governed by a complex molecular machinery and finely tuned by regulatory proteins. During cell injury or stress, the dynamics is shifted to fission, resulting in mitochondrial fragmentation, which contributes to mitochondrial damage and consequent cell injury and death. Emerging evidence has suggested a role of mitochondrial fragmentation in the pathogenesis of renal diseases including acute kidney injury and diabetic nephropathy. A better understanding of the regulation of mitochondrial dynamics and its pathogenic changes may unveil novel therapeutic strategies. PMID:23325082

  10. Renal

    MedlinePLUS

    ... term "renal" refers to the kidney. For example, renal failure means kidney failure. Related topics: Kidney disease Kidney disease - diet Kidney failure Kidney function tests Renal scan Kidney transplant

  11. Effects of apelin and leptin on renal functions following renal ischemia/reperfusion: An experimental study

    PubMed Central

    SAGIROGLU, TAMER; TORUN, NESE; YAGCI, MEHMET; YALTA, TLIN; SAGIROGLU, GNL; OGUZ, SERHAT

    2012-01-01

    The present study aimed to investigate the effects of apelin and leptin on renal functions following renal ischemia/reperfusion (I/R). A total of 32 rats were divided into four groups. The control group was not induced with ischemia, but was administered normal saline intraperitoneally. Normal saline, apelin and leptin were administered intraperitoneally to the I/R, ischemia/reperfusion and apelin (I/R+A) and ischemia/reperfusion and leptin (I/R+L) groups, in turn for three days prior to the surgical procedure. Blood and urine samples were obtained after 24 h of reperfusion, and scintigraphic examination was performed. Renal damage was evaluated histopathologically. Urea levels of the I/R+L and I/R+A groups were comparable, but were higher compared to that of the control group. The I/R group had the highest urea levels (control, 272; I/R, 12015; I/R+A, 7510; I/R+L, 8011; p<0.001). Creatinine levels were higher in all three ischemic groups compared to the control group. Glomerular filtration rate values of the I/R+A and I/R+L groups were not significantly, but numerically higher compared to that of the I/R group. No pathological damage was observed in any of the animals in the control group. In the I/R group, two animals had moderate and six had severe renal damage, while three had moderate and one had severe renal damage in the I/R+L group. In the I/R+A group, moderate renal damage was found in one animal, while none had severe renal damage. This study demonstrates the functional and histopathological protective effects of leptin and apelin against renal I/R injury. PMID:22969992

  12. Effects of apelin and leptin on renal functions following renal ischemia/reperfusion: An experimental study.

    PubMed

    Sagiroglu, Tamer; Torun, Nese; Yagci, Mehmet; Yalta, Tlin; Sagiroglu, Gnl; Oguz, Serhat

    2012-05-01

    The present study aimed to investigate the effects of apelin and leptin on renal functions following renal ischemia/reperfusion (I/R). A total of 32 rats were divided into four groups. The control group was not induced with ischemia, but was administered normal saline intraperitoneally. Normal saline, apelin and leptin were administered intraperitoneally to the I/R, ischemia/reperfusion and apelin (I/R+A) and ischemia/reperfusion and leptin (I/R+L) groups, in turn for three days prior to the surgical procedure. Blood and urine samples were obtained after 24 h of reperfusion, and scintigraphic examination was performed. Renal damage was evaluated histopathologically. Urea levels of the I/R+L and I/R+A groups were comparable, but were higher compared to that of the control group. The I/R group had the highest urea levels (control, 272; I/R, 12015; I/R+A, 7510; I/R+L, 8011; p<0.001). Creatinine levels were higher in all three ischemic groups compared to the control group. Glomerular filtration rate values of the I/R+A and I/R+L groups were not significantly, but numerically higher compared to that of the I/R group. No pathological damage was observed in any of the animals in the control group. In the I/R group, two animals had moderate and six had severe renal damage, while three had moderate and one had severe renal damage in the I/R+L group. In the I/R+A group, moderate renal damage was found in one animal, while none had severe renal damage. This study demonstrates the functional and histopathological protective effects of leptin and apelin against renal I/R injury. PMID:22969992

  13. Renal nerves dynamically regulate renal blood flow in conscious, healthy rabbits.

    PubMed

    Schiller, Alicia M; Pellegrino, Peter R; Zucker, Irving H

    2016-01-15

    Despite significant clinical interest in renal denervation as a therapy, the role of the renal nerves in the physiological regulation of renal blood flow (RBF) remains debated. We hypothesized that the renal nerves physiologically regulate beat-to-beat RBF variability (RBFV). This was tested in chronically instrumented, healthy rabbits that underwent either bilateral surgical renal denervation (DDNx) or a sham denervation procedure (INV). Artifact-free segments of RBF and arterial pressure (AP) from calmly resting, conscious rabbits were used to extract RBFV and AP variability for time-domain, frequency-domain, and nonlinear analysis. Whereas steady-state measures of RBF, AP, and heart rate did not statistically differ between groups, DDNx rabbits had greater RBFV than INV rabbits. AP-RBF transfer function analysis showed greater admittance gain in DDNx rabbits than in INV rabbits, particularly in the low-frequency (LF) range where systemic sympathetic vasomotion gives rise to AP oscillations. In the LF range, INV rabbits exhibited a negative AP-RBF phase shift and low coherence, consistent with the presence of an active control system. Neither of these features were present in the LF range of DDNx rabbits, which showed no phase shift and high coherence, consistent with a passive, Ohm's law pressure-flow relationship. Renal denervation did not significantly affect nonlinear RBFV measures of chaos, self-affinity, or complexity, nor did it significantly affect glomerular filtration rate or extracellular fluid volume. Cumulatively, these data suggest that the renal nerves mediate LF renal sympathetic vasomotion, which buffers RBF from LF AP oscillations in conscious, healthy rabbits. PMID:26538235

  14. Dynamic relationship between sympathetic nerve activity and renal blood flow: a frequency domain approach.

    PubMed

    Guild, S J; Austin, P C; Navakatikyan, M; Ringwood, J V; Malpas, S C

    2001-07-01

    Blood pressure displays an oscillation at 0.1 Hz in humans that is well established to be due to oscillations in sympathetic nerve activity (SNA). However, the mechanisms that control the strength or frequency of this oscillation are poorly understood. The aim of the present study was to define the dynamic relationship between SNA and the vasculature. The sympathetic nerves to the kidney were electrically stimulated in six pentobarbital-sodium anesthetized rabbits, and the renal blood flow response was recorded. A pseudo-random binary sequence (PRBS) was applied to the renal nerves, which contains equal spectral power at frequencies in the range of interest (<1 Hz). Transfer function analysis revealed a complex system composed of low-pass filter characteristics but also with regions of constant gain. A model was developed that accounted for this relationship composed of a 2 zero/4 pole transfer function. Although the position of the poles and zeros varied among animals, the model structure was consistent. We also found the time delay between the stimulus and the RBF responses to be consistent among animals (mean 672 +/- 22 ms). We propose that the identification of the precise relationship between SNA and renal blood flow (RBF) is a fundamental and necessary step toward understanding the interaction between SNA and other physiological mediators of RBF. PMID:11404295

  15. Dynamic contrast-enhanced quantitative susceptibility mapping with ultrashort echo time MRI for evaluating renal function.

    PubMed

    Xie, Luke; Layton, Anita T; Wang, Nian; Larson, Peder E Z; Zhang, Jeff L; Lee, Vivian S; Liu, Chunlei; Johnson, G Allan

    2016-01-15

    Dynamic contrast-enhanced (DCE) MRI can provide key insight into renal function. DCE MRI is typically achieved through an injection of a gadolinium (Gd)-based contrast agent, which has desirable T1 quenching and tracer kinetics. However, significant T2* blooming effects and signal voids can arise when Gd becomes very concentrated, especially in the renal medulla and pelvis. One MRI sequence designed to alleviate T2* effects is the ultrashort echo time (UTE) sequence. In the present study, we observed T2* blooming in the inner medulla of the mouse kidney, despite using UTE at an echo time of 20 microseconds and a low dose of 0.03 mmol/kg Gd. We applied quantitative susceptibility mapping (QSM) and resolved the signal void into a positive susceptibility signal. The susceptibility values [in parts per million (ppm)] were converted into molar concentrations of Gd using a calibration curve. We determined the concentrating mechanism (referred to as the concentrating index) as a ratio of maximum Gd concentration in the inner medulla to the renal artery. The concentrating index was assessed longitudinally over a 17-wk course (3, 5, 7, 9, 13, 17 wk of age). We conclude that the UTE-based DCE method is limited in resolving extreme T2* content caused by the kidney's strong concentrating mechanism. QSM was able to resolve and confirm the source of the blooming effect to be the large positive susceptibility of concentrated Gd. UTE with QSM can complement traditional magnitude UTE and offer a powerful tool to study renal pathophysiology. PMID:26447222

  16. Renal denervation by intravascular ultrasound: Preliminary in vivo study

    NASA Astrophysics Data System (ADS)

    Sinelnikov, Yegor; McClain, Steve; Zou, Yong; Smith, David; Warnking, Reinhard

    2012-10-01

    Ultrasound denervation has recently become a subject of intense research in connection with the treatment of complex medical conditions including neurological conditions, development of pain management, reproduction of skin sensation, neuropathic pain and spasticity. The objective of this study is to investigate the use of intravascular ultrasound to produce nerve damage in renal sympathetic nerves without significant injury to the renal artery. This technique may potentially be used to treat various medical conditions, such as hypertension. The study was approved by the Institutional Animal Care and Use Committee. Ultrasound was applied to renal nerves of the swine model for histopathological evaluation. Therapeutic ultrasound energy was delivered circumferentially by an intravascular catheter maneuvered into the renal arteries. Fluoroscopic imaging was conducted pre-and post-ultrasound treatment. Animals were recovered and euthanized up to 30 hours post procedure, followed by necropsy and tissue sample collection. Histopathological examination showed evidence of extensive damage to renal nerves, characterized by nuclear pyknosis, hyalinization of stroma and multifocal hemorrhages, with little or no damage to renal arteries. This study demonstrates the feasibility of intravascular ultrasound as a minimally invasive renal denervation technique. Further studies are necessary to evaluate the long-term safety and efficacy of this technique and its related clinical significance.

  17. Assessment of renal function in mice with unilateral ureteral obstruction using 99mTc-MAG3 dynamic scintigraphy

    PubMed Central

    2012-01-01

    Background Renal scintigraphy using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) is widely used for the assessment of renal function in humans. However, the application of this method to animal models of renal disease is currently limited, especially in rodents. Here, we have applied 99mTc-MAG3 renal scintigraphy to a mouse model of unilateral ureteral obstruction (UUO) and evaluated its utility in studying obstructive renal disease. Methods UUO mice were generated by complete ligation of the left ureter. Sham-operated mice were used as a control. Renal function was investigated on days 0, 1, 3, and 6 post-surgery using dynamic planar imaging of 99mTc-MAG3 activity following retro-orbital injection. Time-activity curves (TACs) were produced for individual kidneys and renal function was assessed by 1) the slope of initial 99mTc-MAG3 uptake (SIU), which is related to renal perfusion; 2) peak activity; and 3) the time-to-peak (TTP). The parameters of tubular excretion were not evaluated in this study as 99mTc-MAG3 is not excreted from UUO kidneys. Results Compared to sham-operated mice, SIU was remarkably (>60%) reduced in UUO kidneys at day 1 post surgery and the TACs plateaued, indicating that 99mTc-MAG3 is not excreted in these kidneys. The plateau activity in UUO kidneys was relatively low (~40% of sham kidneys peak activity) as early as day1 post surgery, demonstrating that uptake of 99mTc-MAG3 is rapidly reduced in UUO kidneys. The time to plateau in UUO kidneys exceeded 200 sec, suggesting that 99mTc-MAG3 is slowly up-taken in these kidneys. These changes advanced as the disease progressed. SIU, peak activity and TTPs were minimally changed in contra-lateral kidneys during the study period. Conclusions Our data demonstrate that renal uptake of 99mTc-MAG3 is remarkably and rapidly reduced in UUO kidneys, while the changes are minimal in contra-lateral kidneys. The parametric analysis of TACs suggested that renal perfusion as well as tubular uptake is reduced in UUO kidneys. This imaging technique should allow non-invasive assessments of UUO renal injury and enable a more rapid interrogation of novel therapeutic agents and protocols. PMID:23228112

  18. RENAL CANCER STUDIES OF DRINKING WATER MIXTURES

    EPA Science Inventory

    Current default risk assessments for chemical mixtures assume additivity of carcinogenic effects but this may under or over represent the actual biological response. A rodent model of hereditary renal cancer (Eker rat) was used to evaluate the carcinogenicity of a mixture of DBPs...

  19. Angio-computed tomography and dynamic computed tomography in staging of renal cell carcinoma

    SciTech Connect

    Lang, E.K.

    1984-04-01

    Dynamic computed tomography and angio-tomography combine criteria generated by CT with those of angiography and are advocated by the author to improve staging of renal cell carcinoma. Dynamic CT was performed in 29 patients and angio-CT in 12 patients in this group. Rapid acquisition of data permits generation of a CT section in intervals of 1 to 6 seconds, which in turn reflects arterial capillary, and venous transit of contrast medium through tissue. The propensity for dense enhancement of renal cell carcinoma makes possible positive identification of tumor elements. This feature proved accurate for the assessment of local extension of renal neoplasms in all 29 patients, involvement of the renal vein by tumor in 9/10, involvement of the inferior vena cava by tumor in 6/6, and involvement of regional nodes by tumor in 6/8.

  20. Pharmacokinetics and dynamics of famotidine in patients with renal failure.

    PubMed Central

    Gladziwa, U; Klotz, U; Krishna, D R; Schmitt, H; Glckner, W M; Mann, H

    1988-01-01

    1. Famotidine, a new histamine H2-receptor antagonist was administered intravenously (20 mg) to 22 patients with end stage renal disease during a dialysis free interval (n = 6) and during different blood purification processes including haemodialysis (HD; n = 4), intermittent haemofiltration (HF; n = 4), continuous haemofiltration (CHF; n = 4) and continuous ambulatory peritoneal dialysis (CAPD; n = 4). The plasma, the dialysate/filtrate and the urine concentrations of famotidine were analysed by h.p.l.c. 2. In addition, intra-gastric pH was measured by a long-term-pH probe in seven patients with renal failure and in six patients with normal renal function (control group) following 20 mg famotidine. 3. A 7 to 10 fold prolongation of famotidine's elimination half-life (27.2 +/- 8.5 h; mean +/- s.d.) was observed in patients with renal failure as compared with the half-life (2.6-3.6 h) in subjects with normal renal function. 4. Total body clearance (CL) and volume of distribution (V) were found to be 33.5 +/- 10.1 ml min-1 and 1.3 +/- 0.7 l kg-1, respectively in patients with end-stage renal failure. 5. Blood purification processes have shown considerable variation in clearing famotidine from the body: 16.4 +/- 8.9 and 6.0 +/- 2.9% of the administered dose in HD with polysulphone and cuprophan membranes respectively, 7.7 +/- 5.2% in HF with a polyacrylonitrile membrane (each for 5 h), 4.5 +/- 1.1% in CAPD and 16.2 +/- 4.9% in CHF with a polysulphone membrane within 24 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2902874

  1. Renal blood flow transit time in the study of renal transplants

    SciTech Connect

    Sfakianakis, G.; Ihmeidan, I.; Kyriakides, G.; Martinez, B.; Hourani, M.; Miller, J.; Serafini, A.

    1985-05-01

    Radio-hippurate scintigraphy has been used to study renal transplant function because of its unique advantages over other noninvasive methods. Despite a great sensitivity in diagnosing the existence of a functional problem the test lacks in specificity. In an effort to differentiate between acute tubular necrosis (ATN) and graft rejection (RJ) the authors preceded hippurate scintigraphy by measurements of renal flow transit time (TT). After an intravenous injection of 8 mCi of Tc-99m-sulfur-colloid flow curves from the kidney and the abdominal aorta in 1 sec intervals for 1 min were obtained. Renal transit time was mathematically calculated and corrected for bolus and circulatory differences by dividing it with the corresponding Aortic TT (corrected Renal TT(cRTT). Radiohippuran (O-I-131-Hippurate), 150 ..mu..Ci was injected subsequently and of the different computer generated parameters the 30 min net cortical residual (% of the peak) activity (Hippuran Residual Activity, HRA) was found more sensitive and reproducible for comparisons. Results of documented cases showed a statistically significant difference. Uncomplicated cases (usually on antirejection therapy) showed a tendency to increasing the cRTTs with time (not significantly) but their HRAs were significantly lower than in ATN and RJ (p< 0.001).

  2. Labeled lectin studies of renal tubular dysgenesis and renal tubular atrophy of postnatal renal ischemia and end-stage kidney disease.

    PubMed

    Landing, B H; Ang, S M; Herta, N; Larson, E F; Turner, M

    1994-01-01

    Renal tubular dysgenesis (RTD), with hypoplasia especially of renal proximal convoluted tubules and clinical neonatal anuria or oliguria, has been reported as a congenital familial (autosomal recessive) disease, variably with features of oligohydramnios, Potter syndrome, or pulmonary hypoplasia. A similar tubular lesion due to antenatal tubular atrophy has been reported for conjoined twins with twin-twin transfusion syndrome or acardia and in infants of mothers given antihypertensive agents, including angiotensin-converting enzyme (ACE) inhibitors, during pregnancy, and it has been seen as a unilateral lesion in young infants with renal artery stenosis due to arteritis or medial arterial calcinosis. The renal tubular changes in RTD are very like those of the "endocrine kidney" in experimental animals and resemble those of the renal tubular atrophy of end-stage kidney diseases such as glomerulonephritis, tubulointerstitial kidney disease, obstructive uropathy/pyelonephritis, graft rejection of transplanted kidneys, or the renal parenchymal changes seen with protracted dialysis therapy. Labeled lectins that differentially mark proximal convoluted, distal convoluted and connecting, and collecting tubules showed no distinctive differences in staining patterns of the hypoplastic renal tubules of infants and children with RTD, postnatal renal artery obstruction, or the various types of end-stage renal disease with the lectins used (PNA, GSLI, UEA, and LTA). The findings suggest that the renal tubular changes in some if not all the conditions studied are the result of renal ischemia. The reported familial RTD with hypernephronic nephromegaly may be a specific disorder, but other forms could reflect renal ischemia acquired in utero or in early or later postnatal life. PMID:8159624

  3. Variations in renal morphometry: A hospital-based Indian study

    PubMed Central

    Rathore, Ranjeet S.; Mehta, Nisarg; Pillai, Biju S.; Sam, Mohan P.; Upendran, Binu; Krishnamoorthy, H.

    2016-01-01

    Introduction: The currently available standard renal nomograms for comparison of renal dimensions in India are based on the measurements made in the Western population. The objectives of our study were to identify variations in renal morphometric parameters in subjects with no known renal disease in a hospital-based Indian population and to find out any correlation between renal volumes with split renal functions and body mass index (BMI). Materials and Methods: One hundred and fifty-one subjects undergoing contrast-enhanced computerized tomography (CT) scan for various purposes, including donor nephrectomy, from June 2012 to August 2014 were included in the study. The renal and ureteral dimensions were assessed from the contrast-enhanced CT scan images of these patients. Results: The mean length, width, thickness and volume of the left kidney were 11.02 ± 1.13 cm, 5.21 ± 0.75 cm, 4.65 ± 0.84 cm and 138.22 ± 29.81 mL, respectively, and those for the right kidney were 10.86 ± 1.12 cm, 5.13 ± 0.77 cm, 4.73 ± 0.95 cm and 137.54 ± 34.48 mL, respectively. The mean length of the left ureter was 23.51 ± 1.48 cm and that of the right ureter was 23.24 ± 1.93 cm. The mean volume of the kidneys in males and females was also different. The volume of the kidney did not statically correlate with the split glomerular filtration rate ((P = 0.12) and BMI (P = 0.52)). Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature. PMID:26941497

  4. New tides: using zebrafish to study renal regeneration.

    PubMed

    McCampbell, Kristen K; Wingert, Rebecca A

    2014-02-01

    Over the past several decades, the zebrafish has become one of the major vertebrate model organisms used in biomedical research. In this arena, the zebrafish has emerged as an applicable system for the study of kidney diseases and renal regeneration. The relevance of the zebrafish model for nephrology research has been increasingly appreciated as the understanding of zebrafish kidney structure, ontogeny, and the response to damage has steadily expanded. Recent studies have documented the amazing regenerative characteristics of the zebrafish kidney, which include the ability to replace epithelial populations after acute injury and to grow new renal functional units, termed nephrons. Here we discuss how nephron composition is conserved between zebrafish and mammals, and highlight how recent findings from zebrafish studies utilizing transgenic technologies and chemical genetics can complement traditional murine approaches in the effort to dissect how the kidney responds to acute damage and identify therapeutics that enhance human renal regeneration. PMID:24183931

  5. Dynamic noninvasive monitoring of renal function in vivo by fluorescence lifetime imaging

    NASA Astrophysics Data System (ADS)

    Goiffon, Reece J.; Akers, Walter J.; Berezin, Mikhail Y.; Lee, Hyeran; Achilefu, Samuel

    2009-03-01

    Kidneys normally filter the blood of excess salts and metabolic products, such as urea, while retaining plasma proteins. In diseases such as multiple myeloma and diabetes mellitus, the renal function is compromised and protein escapes into the urine. In this study, we present the use of fluorescence lifetime imaging (FLI) to image excess serum protein in urine (proteinuria). The near-infrared fluorescent dye LS-288 has distinct lifetimes when bound to protein versus free in solution, providing contrast between the protein-rich viscera and the mostly protein-free bladder. FLI with LS-288 in mice revealed that fluorescence lifetime (FLT) differences in the bladder relative to surrounding tissues was due to the fractional contributions of the bound and unbound dye molecules. The FLT of LS-288 decreased in the case of proteinuria while fluorescence intensity was unchanged. The results show that FLI can be useful for the dynamic imaging of protein-losing nephropathy due to diabetes mellitus and other renal diseases and suggest the potential use of the FLI to distinguish tumors from fluid-filled cysts in the body.

  6. Spatiotemporal Dynamics of Hemorrhagic Fever with Renal Syndrome, Beijing, Peoples Republic of China

    PubMed Central

    2009-01-01

    We used geographic information systems to characterize the dynamic change in spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Beijing, Peoples Republic of China. The seasonal variation in its incidence was observed by creating an epidemic curve. HFRS was associated with developed land, orchards, and rice paddies. PMID:19961697

  7. Spatiotemporal dynamics of hemorrhagic fever with renal syndrome, Beijing, People's Republic of China.

    PubMed

    Fang, Li Qun; Zhao, Wen Juan; de Vlas, Sake J; Zhang, Wen Yi; Liang, Song; Looma, Caspar W N; Yan, Lei; Wang, Li Ping; Ma, Jia Qi; Feng, Dan; Yang, Hong; Cao, Wu Chun

    2009-12-01

    We used geographic information systems to characterize the dynamic change in spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Beijing, People's Republic of China. The seasonal variation in its incidence was observed by creating an epidemic curve. HFRS was associated with developed land, orchards, and rice paddies. PMID:19961697

  8. Synchronized Renal Blood Flow Dynamics Mapped with Wavelet Analysis of Laser Speckle Flowmetry Data

    PubMed Central

    Brazhe, Alexey R.; Marsh, Donald J.; Holstein-Rathlou, Niels-Henrik; Sosnovtseva, Olga

    2014-01-01

    Full-field laser speckle microscopy provides real-time imaging of superficial blood flow rate. Here we apply continuous wavelet transform to time series of speckle-estimated blood flow from each pixel of the images to map synchronous patterns in instantaneous frequency and phase on the surface of rat kidneys. The regulatory mechanism in the renal microcirculation generates oscillations in arterial blood flow at several characteristic frequencies. Our approach to laser speckle image processing allows detection of frequency and phase entrainments, visualization of their patterns, and estimation of the extent of synchronization in renal cortex dynamics. PMID:25216274

  9. A comparative study of renal scintigraphy and clearance with technetium-99m-MAG3 and iodine-123-hippurate in patients with renal disorders

    SciTech Connect

    Mueller-Suur, R.B.; Bois-Svensson, I.; Mesko, L. )

    1990-11-01

    The aim of this study was to compare kit prepared technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) with our routine radiopharmaceutical, iodine-123-hippurate our routine radiopharmaceutical, iodine-123-hippurate ((123I)OIH) for renal dynamic scintigraphy. Seventeen patients with different nephrologic disorders or hypertension were first studied with OIH and then reinvestigated with MAG3 2-8 days later. Renal MAG3 gamma camera images were almost identical with those of OIH except for higher (p less than 0.01) liver-to-background ratios at 20 min postinjection, irrespective of kidney function. Urinary peristalsis was visible longer and more clearly in the MAG3 studies. MAG3 and OIH renograms showed identical relative kidney uptake (r = 0.99), but elimination of MAG3 from the kidneys was slower (p less than 0.01). The plasma clearance of MAG3 was lower than that of OIH, but correlated (r = 0.92) significantly. The plasma distribution volume and content in blood cells was lower (p less than 0.01), but the binding of MAG3 to plasma proteins was higher, 90%, as compared with 74% for OIH, p less than 0.01. Urinary excretion expressed as a percent of the given dose 60 min after injection was the same for the two substances. Thus, there are some significant differences in the renal handling, plasma distribution, and cell penetration between MAG3 and (123I)OIH. MAG3, however, seems to have particular qualifications as a radionuclide for dynamic renal scintigraphy, especially in patients who require acute investigations or in those with low renal function.

  10. Hyaluronan and rat renal fibroblasts: in vitro studies.

    PubMed

    Pedagogos, E; Hewitson, T D; Nicholls, K M; Becker, G J

    2001-08-01

    Hyaluronic acid (HA) is a ubiquitous component of extracellular matrix. After tissue injury, HA appears in greater abundance during the inflammatory response and the phase of clearance of cell and matrix debris, before collagen production and matrix degradation. The aim of this study was to examine whether normal rat renal fibroblasts were capable of HA synthesis and to determine the effect of HA on in vitro collagen production in a series of normal rat cortical fibroblast cultures. Fibroblast cultures from both renal cortex and medulla were established from adult Sprague-Dawley rats. HA synthesis was measured by radioimmunoassay, and incorporation of (3)H-proline into collagen was used to determine collagen synthesis. Fibroblasts were defined on the basis of morphology and alpha smooth muscle actin immunohistochemistry. HA synthesis was measured in both renal cortical and medullary fibroblasts at passage 3 for both 24 and 48 h in 5 animals and expressed as a fraction of protein content. HA was synthesized by both cortical and medullary fibroblasts; however, cortical fibroblasts produced less HA than medullary fibroblasts at both 24 h (p = 0.05) and 48 h (p = 0.02). In normal cortical fibroblasts, exogenous HA suppressed overall total (cell and media) collagen production after a 22-hour labelling period (p = 0.002 compared to controls). Decreased collagen production was also found individually in cell (p = 0.02) and media fractions (p = 0.01). Both cortical and medullary fibroblasts are capable of synthesizing HA in vitro. Furthermore, the findings in this study suggest that HA may be an important mediator in reducing renal cortical fibroblast collagen production and may play an important role in limiting renal interstitial scarring. PMID:11474230

  11. Etiologies and outcome of acute renal insufficiency in older adults: a renal biopsy study of 259 cases.

    PubMed

    Haas, M; Spargo, B H; Wit, E J; Meehan, S M

    2000-03-01

    Acute renal insufficiency is a common problem, yet one that is frequently reversible with proper diagnosis and treatment. Although it has been argued that a renal biopsy is not needed for diagnosis in most cases of acute renal failure in the elderly, other studies have shown frequent disagreements between clinical and renal biopsy diagnoses in such cases. To investigate the causes of acute renal insufficiency in patients aged at least 60 years who underwent a renal biopsy and possible correlations between biopsy findings and renal survival, we first identified all native renal biopsy specimens from patients aged 60 years or older processed at The University of Chicago Medical Center (Chicago, IL) from 1991 through 1998 and reviewed the clinical records to determine the indication for the biopsy. We then reviewed again the records of those patients who underwent biopsy because of acute renal insufficiency, recorded the primary renal biopsy diagnosis in each of these cases, and obtained follow-up information for patients who underwent biopsy before July 1996. During the study period, 1,065 of 4,264 biopsy specimens (25.0%) received were obtained from patients aged 60 years or older, and acute renal insufficiency was the indication for biopsy in 259 of these patients (24.3%). The most frequent primary diagnoses on these latter biopsy specimens were pauci-immune crescentic glomerulonephritis (GN) with or without arteritis, 31.2% of biopsy specimens; acute interstitial nephritis, 18.6%; acute tubular necrosis (ATN) with nephrotic syndrome, 7.5%; atheroemboli, 7.1%; ATN alone, 6.7%; light chain cast nephropathy (LCCN), 5.9%; postinfectious GN, 5.5%; anti-glomerular basement membrane antibody nephritis, 4.0%; and immunoglobulin A (IgA) nephropathy and/or Henoch-Schnlein nephritis, 3.6%. Eight biopsy specimens (3.2%) showed only benign nephrosclerosis without an apparent cause of acute renal insufficiency, and another six specimens were inadequate. The renal biopsy diagnosis was in agreement with the prebiopsy clinical diagnosis (or differential diagnosis) in 107 of the 161 cases (67%) in which such information was provided. The distribution of diagnoses was similar in patients in the age groups of 60 to 69, 70 to 79, and 80 years or older, although younger age correlated significantly with improved renal and patient survival. The relative risk for progression to end-stage renal disease (ESRD) also increased according to diagnostic categories: LCCN (greatest risk) > GN other than pauci-immune > atheroemboli congruent with pauci-immune crescentic GN > tubulointerstitial diseases other than LCCN (the latter category including ATN with nephrotic syndrome). Development of ESRD correlated significantly with decreased patient survival. In summary, renal biopsy in patients aged 60 years or older with acute renal insufficiency uncovered the cause in greater than 90% of the cases and provided clinically useful information with respect to expectation for renal survival and potential treatment options. PMID:10692269

  12. A cross sectional study of renal involvement in tuberous sclerosis.

    PubMed Central

    Cook, J A; Oliver, K; Mueller, R F; Sampson, J

    1996-01-01

    Renal disease is a frequent manifestation of tuberous sclerosis (TSC) and yet little is known about its true prevalence or natural history. We reviewed the notes of 139 people with TSC, who had presented without renal symptoms, but who had been investigated by renal ultrasound. Information on the frequency, type, and symptomatology of renal involvement was retrieved. The prevalence of renal involvement was 61%. Angiomyolipomas were detected in 49%, renal cysts in 32%, and renal carcinoma in 2.2%. The prevalence of angiomyolipoma was positively correlated with age, compatible with a two hit aetiology. Renal cysts were the commoner lesion in young children, and their prevalence did not appear to be age related. Renal investigation in people with TSC had been inconsistent and limited. We suggest guidelines for renal investigation in those with TSC. Images PMID:8782048

  13. Study of factors that affect complications after renal transplantation.

    PubMed

    De Jess-Gmez, G; Santiago-Delpn, E A; Gonzlez-Caraballo, Z; Morales-Otero, L

    2006-04-01

    There are no multifactorial studies of complications after renal transplant in the Hispanic population. The objective of this study was to identify which factors are associated with the development of complications after renal transplantation. This retrospective study was performed on all patients transplanted in the Puerto Rico Transplant Program during 2002. Independent variables included preoperative albumin, white blood cell (WBC) count, hemoglobin, creatinine, weight, height, body mass index (BMI), type of dialysis, time on dialysis, and urine production after transplant. Dependent parameters included posttransplant diuresis, wound infection, wound dehiscence, lymphoceles, acute tubular necrosis, length of stay, postoperative weight, graft survival, and patient survival. Data were analyzed with parametric and nonparametric techniques using STAT 200 software. Sixty-four patients were included in the study: 37 male, 27 female. No significant differences in complication rate or length of stay were found with age, preoperative albumin, WBC count, hemoglobin, creatinine, weight, height, dialysis modality, and donor type. Significant factors included type of dialysis, time on dialysis, and BMI. Preoperative albumin if > 3 was not a prognostic indicator for the development of surgical complications following renal transplantation. Only preoperative weight, BMI, and dialysis duration were significant factors in the development of postoperative complications and prolonged hospital stay in this sample Hispanic transplant population. These data are important in formulating selection, education, and transplant management policy. PMID:16647507

  14. Cutaneous fungal infection following renal transplantation: a case control study.

    PubMed

    Shuttleworth, D; Philpot, C M; Salaman, J R

    1987-11-01

    The prevalence of cutaneous fungal infection was studied in 72 patients who had undergone renal transplantation and compared with a group of age and sex matched controls. Samples were obtained from toe nails, toe webs, and the upper back; clinically suspicious lesions from other areas were also examined. A total of 576 sites were sampled (288 in each group). Pathogenic fungi were identified from 44 sites (15%) in the renal transplant (RT) group compared with 26 sites (9%) in the control group, (P less than 0.05). However, site-specific differences were less marked; no difference was found between the RT group and controls when the results from the toe nails and toe webs were analysed separately. Trichophyton mentagrophytes was the most common species isolated from both groups. Colonization of the back with Pityrosporum yeasts was significantly more common in the RT group, but few patients in either group had tinea versicolor. 'Mixed infections', with more than one species of fungus isolated in an individual, were only found in the RT group. We also examined the relationship between the presence of fungal infection and the presence or absence of cutaneous malignancy in the renal transplant group. No increase in the prevalence of fungal colonization was found in those patients who had developed cutaneous malignancy compared with those who had not. PMID:3318908

  15. Immunofluorescent Studies in Renal Biopsies in Pre-eclampsia

    PubMed Central

    Petrucco, O. M.; Thomson, N. M.; Lawrence, J. R.; Weldon, M. W.

    1974-01-01

    Renal biopsies were performed on 11 patients considered clinically and histologically to have pre-eclampsia. Immunofluorescent studies with fluorescein-labelled anti-IgG, IgA, IgM, and IgE complement, albumin, fibrin, and fibrinogen were carried out on the tissue obtained. Significant correlation was obtained between the clinical severity of the disease and the density and pattern of IgM and IgG deposition. Complement was found in glomeruli in severe cases, while complement deposition in the walls of afferent and efferent arterioles was a constant finding. These findings support the concept that an immunological mechanism may be responsible for the renal lesions in pre-eclampsia. If immunity does play a part in the pathogenesis of pre-eclampsia, possible mechanisms include the involvement of histocompatibility antigens and cross-reactivity of fetal and maternal tissues. Renal fibrin deposition in pre-eclampsia may be secondary to an immune process, an occurrence well-described in other forms of glomerulonephritis in man and other species. ImagesFIG. 1FIG. 2FIG. 3FIG. 4 PMID:4593706

  16. Spatiotemporal Transmission Dynamics of Hemorrhagic Fever with Renal Syndrome in China, 20052012

    PubMed Central

    Sun, Hai-Long; Zhou, Hang; Li, Shen-Long; Haque, Ubydul; Tong, Shi-Lu; Glass, Gregory E.; Bi, Peng; Clements, Archie C. A.; Liu, Qi-Yong; Li, Cheng-Yi

    2014-01-01

    Background Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by many serotypes of hantaviruses. In China, HFRS has been recognized as a severe public health problem with 90% of the total reported cases in the world. This study describes the spatiotemporal dynamics of HFRS cases in China and identifies the regions, time, and populations at highest risk, which could help the planning and implementation of key preventative measures. Methods Data on all reported HFRS cases at the county level from January 2005 to December 2012 were collected from Chinese Center for Disease Control and Prevention. Geographic Information System-based spatiotemporal analyses including Local Indicators of Spatial Association and Kulldorff's space-time scan statistic were performed to detect local high-risk space-time clusters of HFRS in China. In addition, cases from high-risk and low-risk counties were compared to identify significant demographic differences. Results A total of 100,868 cases were reported during 20052012 in mainland China. There were significant variations in the spatiotemporal dynamics of HFRS. HFRS cases occurred most frequently in June, November, and December. There was a significant positive spatial autocorrelation of HFRS incidence during the study periods, with Moran's I values ranging from 0.46 to 0.56 (P<0.05). Several distinct HFRS cluster areas were identified, mainly concentrated in northeastern, central, and eastern of China. Compared with cases from low-risk areas, a higher proportion of cases were younger, non-farmer, and floating residents in high-risk counties. Conclusions This study identified significant space-time clusters of HFRS in China during 20052012 indicating that preventative strategies for HFRS should be particularly focused on the northeastern, central, and eastern of China to achieve the most cost-effective outcomes. PMID:25412324

  17. ELECTRON MICROSCOPIC STUDIES OF RENAL DISEASE

    PubMed Central

    Latta, Harrison

    1960-01-01

    The nephrotic syndrome, glomerulonephritis, disseminated lupus erythematosus and the Fanconi syndrome show characteristic changes with electron microscopy. Experimental studies of animals were carried out to determine the significance of such changes by observing reactions that occur under carefully controlled conditions. A lesion with collagen deposition that was found in the centrolobular region of glomeruli sheds new light on the function of this region. This evidence must be considered in developing an understanding of how the production of urine is controlled. Fluid-filled compartments and various bodies associated with the ultrastructure of tubule cells can be produced under conditions which suggest that these structures play a role in tubular resorption. ImagesFigure 1, 2.Figure 3.Figure 4, 5.Figure 6, 7.Figure 8, 9.Figure 10.Figure 11, 12.Figure 13, 14.Figure 15, 16.Figure 17. PMID:13759386

  18. Organ entrapment and renal morcellation: permeability studies.

    PubMed

    Urban, D A; Kerbl, K; McDougall, E M; Stone, A M; Fadden, P T; Clayman, R V

    1993-12-01

    We collected 24 intact LapSacs* during a laparoscopy course at our institution. Following laparoscopic nephrectomy or nephroureterectomy in a pig using high speed electrical tissue morcellation, the sacks were examined for perforation. When filled with water, 4 of the 24 LapSacs (16%) were found to have small perforations. The 20 remaining sacks were randomly divided into 3 groups of 6 and 2 sacks, although intact, were kept as substitutes to use if a trial with the study sacks could not be completed. Each group of 6 sacks was tested for permeability using 10 mg./ml. bovine serum albumin, 8 mg./ml. indigo carmine or 1 x 10(5)/ml. mouse bladder tumor cells. The results in the 18 tested sacks showed no dialysis of bovine serum albumin in the dialysate at 1, 3 and 18 hours, and no dialysis of indigo carmine at 0, 1, 2 and 3 hours. In 1 of 6 sacks tested with a mouse bladder tumor cell line a single cell was noted on the hemocytometer at 1 and 3 hours. The lack of an increasing concentration of cells at the 3-hour interval likely indicates that this represented contamination of the dialysate rather than ongoing leakage from a perforated sack in this case. We conclude that the LapSac, when properly used, remains impermeable throughout the morcellation process. PMID:8230506

  19. Tip Cells Act as Dynamic Cellular Anchors in the Morphogenesis of Looped Renal Tubules in Drosophila

    PubMed Central

    Weavers, Helen; Skaer, Helen

    2013-01-01

    Summary Tissue morphogenesis involves both the sculpting of tissue shape and the positioning of tissues relative toone another in the body. Using the renal tubules of Drosophila, we show that a specific distal tubule cell regulates both tissue architecture and position in the body cavity. Focusing on the anterior tubules, we demonstrate that tip cells make transient contacts with alary muscles at abdominal segment boundaries, moving progressively forward as convergentextension movements lengthen the tubule. Tip cellanchorage antagonizes forward-directed, TGF-?-guided tubule elongation, thereby ensuring the looped morphology characteristic of renal tubules from worms to humans. Distinctive tip cell exploratory behavior, adhesion, and basement membrane clearing underlie target recognition and dynamic interactions. Defects in these features obliterate tip cell anchorage, producing misshapen and misplaced tubules with impaired physiological function. PMID:24229645

  20. Calcium dynamics underlying the myogenic response of the renal afferent arteriole

    PubMed Central

    Edwards, Aurlie

    2013-01-01

    The renal afferent arteriole reacts to an elevation in blood pressure with an increase in muscle tone and a decrease in luminal diameter. This effect, known as the myogenic response, is believed to stabilize glomerular filtration and to protect the glomerulus from systolic blood pressure increases, especially in hypertension. To study the mechanisms underlying the myogenic response, we developed a mathematical model of intracellular Ca2+ signaling in an afferent arteriole smooth muscle cell. The model represents detailed transmembrane ionic transport, intracellular Ca2+ dynamics, the kinetics of myosin light chain phosphorylation, and the mechanical behavior of the cell. It assumes that the myogenic response is initiated by pressure-induced changes in the activity of nonselective cation channels. Our model predicts spontaneous vasomotion at physiological luminal pressures and KCl- and diltiazem-induced diameter changes comparable to experimental findings. The time-periodic oscillations stem from the dynamic exchange of Ca2+ between the cytosol and the sarcoplasmic reticulum, coupled to the stimulation of Ca2+-activated potassium (KCa) and chloride (ClCa) channels, and the modulation of voltage-activated L-type channels; blocking sarco/endoplasmic reticulum Ca2+ pumps, ryanodine receptors (RyR), KCa, ClCa, or L-type channels abolishes these oscillations. Our results indicate that the profile of the myogenic response is also strongly dependent on the conductance of ClCa and L-type channels, as well as the activity of plasmalemmal Ca2+ pumps. Furthermore, inhibition of KCa is not necessary to induce myogenic contraction. Lastly, our model suggests that the kinetic behavior of L-type channels results in myogenic kinetics that are substantially faster during constriction than during dilation, consistent with in vitro observations (Loutzenhiser R, Bidani A, Chilton L. Circ. Res. 90: 13161324, 2002). PMID:24173354

  1. Dynamic EKG Study

    NASA Technical Reports Server (NTRS)

    Fleck, R. L.

    1970-01-01

    The use of the dynamic EKG study as a part of periodic health examination is considered to be a valuable complement to other forms of stress testing with its ability to detect abnormal heart responses to stress stimuli. It is believed that statistical correlations of dynamic EKG findings with physical examination results contribute greatly to the understanding of cardiac abnormalities.

  2. sup 31 Phosphorus NMR studies of renal membrane phospholipids

    SciTech Connect

    Boylan, J.G.

    1988-01-01

    A research program was undertaken in order to study the effects of toxin-induced acute renal failure and streptozotozin-induced diabetes mellitus on the organization and motion of phospholipids in kidney membranes. The method of study included {sup 31}P NMR and computer simulated lineshape analyses and apparent lipid diffusion rate measurements. These were performed with selected tissue samples and disease models, and the results were compared with those of healthy renal tissues in order to identify changes associated with the diseased state. A new selective-excitation NMR pulse sequence was developed in which a portion of the lipid molecules were excited with a series of short equally-spaced RF pulses. As the position of the molecules changed on the membrane by lateral diffusion, the shape of the hole was seen to change. Experimental spectra were compared with calculated lineshapes in order to obtain estimates of useful molecular parameters including relation times and lateral lipid diffusion rates. The lineshape calculations were based on a solution to the Bloch equations for complex magnetization components with exchange terms added for diffusion.

  3. Evidence of Uncoupling between Renal Dysfunction and Injury in Cardiorenal Syndrome: Insights from the BIONICS Study

    PubMed Central

    Legrand, Matthieu; De Berardinis, Benedetta; Gaggin, Hanna K.; Magrini, Laura; Belcher, Arianna; Zancla, Benedetta; Femia, Alexandra; Simon, Mandy; Motiwala, Shweta; Sambhare, Rasika; Di Somma, Salvatore; Mebazaa, Alexandre; Vaidya, Vishal S.; Januzzi, James L.; (GREAT), from the Global Research on Acute Conditions Team

    2014-01-01

    Objective The objective of the study was to assess urinary biomarkers of renal injury for their individual or collective ability to predict Worsening renal function (WRF) in patients with acutely decompensated heart failure (ADHF). Methods In a prospective, blinded international study, 87 emergency department (ED) patients with ADHF were evaluated with biomarkers of cardiac stretch (B type natriuretic peptide [BNP] and its amino terminal equivalent [NT-proBNP], ST2), biomarkers of renal function (creatinine, estimated glomerular filtration rate [eGFR]) and biomarkers of renal injury (plasma neutrophil gelatinase associated lipocalin [pNGAL], urine kidney injury molecule-1 [KIM-1], urine N-acetyl-beta-D-glucosaminidase [NAG], urine Cystatin C, urine fibrinogen). The primary endpoint was WRF. Results 26% developed WRF; baseline characteristics of subjects who developed WRF were generally comparable to those who did not. Biomarkers of renal function and urine biomarkers of renal injury were not correlated, while urine biomarkers of renal injury correlated between each other. Biomarker concentrations were similar between patients with and without WRF except for baseline BNP. Although plasma NGAL was associated with the combined endpoint, none of the biomarker showed predictive accuracy for WRF. Conclusions In ED patients with ADHF, urine biomarkers of renal injury did not predict WRF. Our data suggest that a weak association exists between renal dysfunction and renal injury in this setting (Clinicaltrials.gov NCT#0150153). PMID:25386851

  4. Retrospective morphometric study of the suitability of renal arteries for renal denervation according to the Symplicity HTN2 trial criteria

    PubMed Central

    Schönherr, Elisabeth; Rehwald, Rafael; Nasseri, Parinaz; Luger, Anna K; Grams, Astrid E; Kerschbaum, Julia; Rehder, Peter; Petersen, Johannes; Glodny, Bernhard

    2016-01-01

    Objective The aim of this study was to describe the renal arteries of humans in vivo, as precisely as possible, and to formulate an expected value for the exclusion of renal denervation due to the anatomical situation based on the criteria of the Symplicity HTN trials. Design and setting In a retrospective cohort study, the renal arteries of 126 patients (57 women, 69 men, mean age 60±17.2 years (CI 57.7 to 63.6)) were segmented semiautomatically from high-contrast CT angiographies. Results Among the 300 renal arteries, there were three arteries with fibromuscular dysplasia and one with ostial renal artery stenosis. The first left renal artery was shorter than the right (34±11.4 mm (CI 32 to 36) vs 45.9±15 mm (CI 43.2 to 48.6); p<0.0001), but had a slightly larger diameter (5.2±1.4 mm (CI 4.9 to 5.4) vs 4.9±1.2 mm (CI 4.6 to 5.1); p>0.05). The first left renal arteries were 1.1±0.4 mm (CI 0.9 to 1.3), and the first right renal arteries were 0.3±0.6 mm (CI 0.1 to 0.5) thinner in women than in men (p<0.05). Ostial funnels were up to 14 mm long. The cross-sections were elliptical, more pronounced on the right side (p<0.05). In 23 cases (18.3%), the main artery was shorter than 2 cm; in 43 cases (34.1%), the diameter was not >4 mm. Some 46% of the patients, or 58.7% when variants and diseases were taken into consideration, were theoretically not suitable for denervation. Conclusions Based on these precise measurements, the anatomical situation as a reason for ruling out denervation appears to be significantly more common than previously suspected. Since this can be the cause of the failure of treatment in some cases, further development of catheters or direct percutaneous approaches may improve success rates. PMID:26729385

  5. Dynamically Applied B1+ Shimming Solutions for Non-Contrast Enhanced Renal Angiography at 7.0 Tesla

    PubMed Central

    Metzger, Gregory J.; Auerbach, Edward J.; Akgun, Can; Simonson, Josh; Bi, Xiaoming; Ugurbil, Kamil; van de Moortele, Pierre-Francois

    2012-01-01

    The purpose of this study was to detail a strategy for performing non-contrast enhanced renal angiography (rMRA) studies at 7.0 Tesla. It is demonstrated that with proper B1+ management, these studies can be successfully performed at ultrahigh fields within local specific absorption rate (SAR) constraints. An inversion prepared gradient echo acquisition, standard for non-contrast rMRA studies, required RF pulse specific B1+ shimming solutions to be dynamically applied to address the field dependent increases in both B0 and B1+ inhomogeneity as well as to accommodate limitation in available power. By using more efficient B1+ shimming solutions for the inversion preparation and more homogeneous solutions for the excitation, high quality images of the the renal arteries were obtained without venous and background signal artifacts while working within hardware and safety constraints. Finite difference time domain simulations confirmed in vivo measurements with respect to B1+ distributions and homogeneity for the range of shimming strategies employed, and allowed the calculation of peak local SAR values normalized by input power and B1+. Increasing B1+ homogeneity was accompanied by decreasing local SAR per Watt and increasing local SAR per [B1+]2, which must be considered, along with body size and respiratory rate, when finalizing acquisition parameters for a given individual. PMID:22442056

  6. Study of atmospheric dynamics

    NASA Technical Reports Server (NTRS)

    Mcnider, Richard T.; Christy, John R.; Cox, Gregory N.

    1993-01-01

    In order to better understand the dynamics of the global atmosphere, a data set of precision temperature measurements was developed using the NASA built Microwave Sounding Unit. Modeling research was carried out to validate global model outputs using various satellite data. Idealized flows in a rotating annulus were studied and applied to the general circulation of the atmosphere. Dynamic stratospheric ozone fluctuations were investigated. An extensive bibliography and several reprints are appended.

  7. Myxoid renal cell carcinoma: histological, immunocytochemical and ultrastructural study.

    PubMed

    Birch, H A; Glass, J M; Vale, J; Walker, M M

    1996-12-01

    Renal cell carcinomas show a variety of histological features. A case of a renal tumour arising in a 44 year old African man is reported. The tumour was composed of a cobweb-like pattern of narrow anastomising tubules lined by cuboidal cells separated by a hypocellular myxoid stroma. Immunohistochemical stains were consistent with a renal cell origin. The differential diagnosis in these cases includes sarcoma. PMID:9038743

  8. Renal Manifestations in Scleroderma: Evidence for Subclinical Renal Disease as a Marker of Vasculopathy

    PubMed Central

    Shanmugam, Victoria K.; Steen, Virginia D.

    2010-01-01

    Scleroderma is a disease characterized by immune activation, vasculopathy, fibroblast stimulation, and connective tissue fibrosis. End-organ damage occurs due to progressive tissue fibrosis and vasculopathy. Markers of incipient vasculopathy have not been well studied in scleroderma. However, reduced renal functional reserve and proteinuria are common indicators of progressive vasculopathy in diabetic and hypertensive vasculopathy. Recent studies suggest a strong association between renal involvement and outcomes in scleroderma, with a threefold increased risk of mortality from pulmonary hypertension if renal insufficiency is present. We review the types of renal involvement seen in scleroderma and the data to support the use of renal parameters including proteinuria, glomerular filtration rate, and renal vascular dynamics measured with Doppler ultrasound to identify subclinical renal insufficiency. Further studies are warranted to investigate the use of renal parameters as prognostic indicators in scleroderma. PMID:20827302

  9. Quantitative Estimation of Renal Function with Dynamic Contrast-Enhanced MRI Using a Modified Two-Compartment Model

    PubMed Central

    Chen, Bin; Zhang, Yudong; Song, Xiaojian; Wang, Xiaoying; Zhang, Jue; Fang, Jing

    2014-01-01

    Objective To establish a simple two-compartment model for glomerular filtration rate (GFR) and renal plasma flow (RPF) estimations by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Materials and Methods A total of eight New Zealand white rabbits were included in DCE-MRI. The two-compartment model was modified with the impulse residue function in this study. First, the reliability of GFR measurement of the proposed model was compared with other published models in Monte Carlo simulation at different noise levels. Then, functional parameters were estimated in six healthy rabbits to test the feasibility of the new model. Moreover, in order to investigate its validity of GFR estimation, two rabbits underwent acute ischemia surgical procedure in unilateral kidney before DCE-MRI, and pixel-wise measurements were implemented to detect the cortical GFR alterations between normal and abnormal kidneys. Results The lowest variability of GFR and RPF measurements were found in the proposed model in the comparison. Mean GFR was 3.031.1 ml/min and mean RPF was 2.640.5 ml/g/min in normal animals, which were in good agreement with the published values. Moreover, large GFR decline was found in dysfunction kidneys comparing to the contralateral control group. Conclusion Results in our study demonstrate that measurement of renal kinetic parameters based on the proposed model is feasible and it has the ability to discriminate GFR changes in healthy and diseased kidneys. PMID:25141138

  10. RADAR – A randomised, multi-centre, prospective study comparing best medical treatment versus best medical treatment plus renal artery stenting in patients with haemodynamically relevant atherosclerotic renal artery stenosis

    PubMed Central

    Schwarzwälder, Uwe; Hauk, Michael; Zeller, Thomas

    2009-01-01

    Background Prospective, international, multi-centre, randomised (1:1) trial to evaluate the clinical impact of percutaneous transluminal renal artery stenting (PTRAS) on the impaired renal function measured by the estimated glomerular filtration rate (eGFR) in patients with haemodynamically significant atherosclerotic renal artery stenosis. Methods Patients will be randomised to receive either PTRAS using the Dynamic Renal Stent system plus best medical treatment or best medical treatment. Renal stenting will be performed under angiographic imaging. For patients randomised to best medical treatment the degree of stenosis measured by renal duplex sonography (RDS) will be confirmed by MR angio or multi-slice CT where possible. Best medical treatment will be initiated at randomisation or post procedure (for PTRAS arm only), and adjusted as needed at all visits. Best medical treatment is defined as optimal drug therapy for control of the major risk factors (blood pressure ≤ 125/80 mmHg, LDL cholesterol ≤ 100 mg/dL, HbA1c ≤ 6.5%). Data recordings include serum creatinine values, eGFR, brain natriuretic peptide, patients' medical history and concomitant medication, clinical events, quality of life questionnaire (SF-12v2™), 24 hour ambulatory blood pressure measurement, renal artery duplex ultrasound and echocardiography. Follow-up intervals are at 2, 6, 12 and 36 months following randomisation. The primary endpoint is the difference between treatments in change of eGFR over 12 months. Major secondary endpoints are technical success, change of renal function based on the eGFR slope change between pre-treatment and post-treatment (i.e. improvement, stabilisation, failure), clinical events overall such as renal or cardiac death, stroke, myocardial infarction, hospitalisation for congestive heart failure, progressive renal insufficiency (i.e. need for dialysis), need of target vessel revascularisation or target lesion revascularisation, change in average systolic and diastolic blood pressure, change in left ventricular mass index calculated from echocardiography, difference in the size of kidney (pole to pole length) measured by renal duplex sonography, total number, drug name, drug class, daily dose, regimen and Defined Daily Dose (DDD), of anti-hypertensive drugs, and change in New York Heart Association (NYHA) classification. Approximately 30 centres in Europe and South America will enrol patients. Duration of enrolment is expected to be 12 months resulting in study duration of 48 months. Trial registration Trial registration number: NCT00640406 PMID:19635148

  11. [Feasibility study of the Doppler exploration of the renal artery].

    PubMed

    Milon, P; Clavier, E; Genevois, A; Benozio, M

    1990-03-01

    Using arteriography as a reference, the authors investigate the feasibility of pulsed doppler exploration of the normal or pathological renal arteries in 46 successive patients. The poor sensitivity of pulsed doppler, mainly due to the considerable anatomical variations of the renal pedicle, does not currently allow using this technique for the detection of renal arterial stenosis. When combined with angiography, pulsed doppler becomes a definite asset in therapeutic radiology to help in the choice of a treatment and in follow-up. PMID:2191123

  12. The Diagnosis of Yo-Yo Reflux with Dynamic Renal Scintigraphy in a Patient with Incomplete Ureteral Duplication

    PubMed Central

    zdo?an, zhan; Ate?, O?uz; Kart, Yeliz; Aras, Feray; Olguner, Mustafa; Akgr, Feza; Durak, Hatice

    2012-01-01

    The diagnosis of yo-yo reflux in patients with incomplete upper collecting system duplications is difficult. We report a case with recurrent urinary tract infections and ultrasonographically detected duplication in the left collecting system in which the presence of yo-yo reflux is demonstrated with dynamic renal scintigraphy. Conflict of interest:None declared. PMID:23486254

  13. Reproducibility of Dynamic Contrast-Enhanced MRI in Renal Cell Carcinoma

    PubMed Central

    Wang, Haiyi; Su, Zihua; Ye, Huiyi; Xu, Xiao; Sun, Zhipeng; Li, Lu; Duan, Feixue; Song, Yuanyuan; Lambrou, Tryphon; Ma, Lin

    2015-01-01

    Abstract The objective of this study was to investigate the intra- and interobserver as well as scanrescan reproducibility of quantitative parameters of renal cell carcinomas (RCCs) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). A total of 21 patients with clear cell RCCs (17 men, 4 woman; age 3769 years, mean age 54.6 years, mean size, 5.0??2.2?cm) were prospectively recruited from September 2012 to November 2012. Patients underwent paired DCE-MRI studies on a 3.0 T MR system with an interval of 48 to 72 hours. The extended-Tofts model and population-based arterial input function were used to calculate kinetic parameters. Three observers defined the 2-dimensional whole-tumor region of interest at the slice with the maximum diameter of the RCC. Intraobserver and scanrescan differences were assessed using paired t tests, whereas interobserver differences using two-way analysis of variance. Intra- and interobserver reproducibility and scanrescan reproducibility were evaluated using within-subject coefficient of variation (wCoV) and intraclass correlation coefficient (ICC). There were no significant intra-, interobserver, or scanrescan differences in parameters (all P?>?0.05). All ICCs for intra- and interobserver agreements were >0.75 (P?30%). DCE-MRI demonstrated good intra- and interobserver reproducibility and moderate to good scanrescan performance in the assessment of RCC using Ktrans, Kep, and Ve as parameters under noncontinuous scanning mode. Vp showed poor reproducibility, and thus may not be suitable for this scanning protocol. PMID:26376399

  14. Impact on creatinine renal clearance by the interplay of multiple renal transporters: a case study with INCB039110.

    PubMed

    Zhang, Yan; Warren, Mark S; Zhang, Xuexiang; Diamond, Sharon; Williams, Bill; Punwani, Naresh; Huang, Jane; Huang, Yong; Yeleswaram, Swamy

    2015-04-01

    Serum creatinine is commonly used as a marker of renal function, but increases in serum creatinine might not represent changes in glomerular filtration rate (GFR). INCB039110 (2-(3-(4-(7H-pyrrolo[2,3-day]pyrimidin-4-yl)-1H-pyrazol-1-yl)-1-(1-(3-fluoro-2-(trifluoromethyl)isonicotinoyl)piperidin-4-yl)azetidin-3-yl)acetonitrile) is an inhibitor of the Janus kinases (JAKs) with selectivity for JAK1. In a phase 1 study, a modest and reversible increase in serum creatinine was observed after treatment with INCB039110. However, a dedicated renal function study with INCB039110, assessed by iohexol plasma clearance, conducted in healthy volunteers indicated no change in GFR. In vitro studies were therefore conducted to investigate the interaction of INCB039110 with five transporters that are likely involved in the renal clearance of creatinine. Cell systems expressing individual or multiple transporters were used, including a novel quintuple-transporter model OAT2/OCT2/OCT3/MATE1/MATE2-K. INCB039110 potently inhibited OCT2-mediated uptake of creatinine as well as MATE1-/MATE2-K-mediated efflux of creatinine. Given the interactions of INCB039110 with multiple transporters affecting creatinine uptake and efflux, an integrated system expressing all five transporters was sought; in that system, INCB039110 caused a dose-dependent decrease in transcellular transport of creatinine with weaker net inhibition compared with the effects on individual transporters. In summary, a molecular mechanism for the increase in serum creatinine by INCB039110 has been established. These studies also underline the limitations of using serum creatinine as a marker of renal function. PMID:25605813

  15. Transient impairment of dynamic renal autoregulation in early diabetes mellitus in rats.

    PubMed

    Mitrou, Nicholas; Morrison, Sidney; Mousavi, Paymon; Braam, Branko; Cupples, William A

    2015-10-15

    Renal autoregulation is impaired in early (1 wk) diabetes mellitus (DM) induced by streptozotocin, but effective in established DM (4 wk). Furthermore nitric oxide synthesis (NOS) inhibition with N(G)-nitro-L-arginine methyl ester (L-NAME) significantly improved autoregulation in early DM but not in established DM. We hypothesized that autoregulation is transiently impaired in early DM because of increased NO availability in the kidney. Because of the conflicting evidence available for a role of NO in DM, we tested the hypothesis that DM reduces autoregulation effectiveness by reducing the spatial similarity of autoregulation. Male Long-Evans rats were divided into control (CON) and diabetic (DM; streptozotocin) groups and followed for either 1 wk (CON1, n = 6; DM1, n = 5) or 4 wk (CON4, n = 7; DM4, n = 7). At the end of the experiment, dynamic autoregulation was assessed in isoflurane-anesthetized rats by whole kidney RBF during baseline, NOS1 inhibition, and nonselective NOS inhibition. Kidney surface perfusion, monitored with laser speckle contrast imaging, was used to assess spatial heterogeneity of autoregulation. Autoregulation was significantly impaired in DM1 rats and not impaired in DM4 rats. L-NAME caused strong renal vasoconstriction in all rats, but did not significantly affect autoregulation dynamics. Autoregulation was more spatially heterogeneous in DM1, but not DM4. Therefore, our results, which are consistent with transient impairment of autoregulation in DM, argue against the hypothesis that this impairment is NO-dependent, and suggest that spatial properties of autoregulation may also contribute to reduced autoregulatory effectiveness in DM1. PMID:26246507

  16. Renal Interstitial Arteriosclerotic Lesions in Lupus Nephritis Patients: A Cohort Study from China

    PubMed Central

    Qin, Dan-dan; Wu, Li-hua; Song, Yan; Yu, Feng; Wang, Su-xia; Liu, Gang; Zhao, Ming-hui

    2015-01-01

    Objective The aim of this study was to evaluate renal arteriosclerotic lesions in patients with lupus nephritis and investigate their associations with clinical and pathological characteristics, especially cardio-vascular features. Design A retrospective cohort study. Participants Seventy-nine patients with renal biopsy-proven lupus nephritis, diagnosed between January 2000 and June 2008 from Peking University First Hospital. Results In clinico-pathological data, patients with arteriosclerosis had higher ratio of hypertension and more severe renal injury indices compared with patients with no renal vascular lesions. More importantly, patients with renal arteriosclerosis had worse cardiac structure and function under transthoracic echocardiographic examination. Patients with renal arteriosclerosis tend to have higher ratios of combined endpoints compared with those of no renal vascular lesions, although the difference didn’t reach statistical meanings (P = 0.104). Conclusion Renal arteriosclerotic lesion was common and associated with vascular immune complex deposits in lupus nephritis. It might have a certain degree of association with poor outcomes and cardiovascular events, which needs further explorations. PMID:26544865

  17. Underestimation of chronic renal dysfunction after liver transplantation: ICEBERG study

    PubMed Central

    Varo, Evaristo; Bañares, Rafael; Guilera, Magda

    2015-01-01

    AIM: To compare prevalence of chronic renal dysfunction (CRD) according to serum creatinine (sCr) vs estimated glomerular filtration rate (eGFR) among maintenance liver transplant patients. METHODS: The ICEBERG study was an observational, retrospective, cross-sectional, and multicenter study. Consecutive adult patients (aged 18 years or older) with liver transplantation (LT) performed at least two years previously were recruited. Multi-organ transplant recipients were excluded. Chronic renal dysfunction was defined according to sCr based criteria in routine clinical practice (≥ 2 mg/dL) and eGFR using MDRD-4 equation (< 60 mL/min per 1.73 m2). Agreement between sCr definition and eGFR assessment was evaluated using the Kappa index. Cox regression analysis was applied to identify predictive factors for developing CRD after LT. RESULTS: A total of 402 patients were analyzed (71.6% males). Mean ± SD age at transplant was 52.4 ± 9.8 years. Alcoholic cirrhosis without hepatocellular carcinoma was the most common reason for LT (32.8%). Mean time since LT was 6.9 ± 3.9 years. Based on sCr assessment, 35.3% of patients (95%CI: 30.6-40.0) had CRD; 50.2% (95%CI: 45.3-55.1) according to eGFR. In 32.2% of cases, sCr assessment had underestimated CRD. Multivariate analysis showed the following factors associated with developing CRD: eGFR < 60 mL/min per 1.73 m2 at three months post-transplant [hazard ratio (HR) = 4.76; 95%CI: 2.78-8.33; P < 0.0001]; calcineurin inhibitor use (HR = 2.31; 95%CI: 1.05-5.07; P = 0.0371); male gender (HR = 1.98; 95%CI: 1.09-3.60; P = 0.0260); and ≥ 10 years post-transplantation (HR = 1.95; 95%CI: 1.08-3.54; P = 0.0279). CONCLUSION: Seven years after LT, CRD affected half our patients, which was underestimated by sCr. An eGFR < 60 mL/min per 1.73 m2 three months post-LT was predictive of subsequent CRD. PMID:25815269

  18. Histochemical Study of the Progenetic Trematode Alloglossidium renale

    PubMed Central

    Schimmer, Craig A.; Landers, Stephen C.

    2014-01-01

    A histochemical study of the progenetic trematode Alloglossidium renale has demonstrated the absence of any secreted material between the adult worm and the host (freshwater shrimp) antennal gland tubules. Host tissue is affected only by the compression, abrasion, and ingestion by the parasite, and host tubule cells near the worm have the same staining patterns as those distant from the parasite. The trematode sometimes dies within the host, leaving a necrotic mass whose histochemical staining differs significantly from the living organism. In the necrotic mass, the only recognizable features were the ova and the vitellarium, which atrophied and resulted in tyrosine-positive staining within the mass. A melanin reaction was not observed in the host using a specialized ferro-ferricyanide stain. The only apparent host response to infection was a layer of damaged squamous host cells adhering to the necrotic worm. The results confirm benign host-parasite effects and a highly evolved relationship between the host and parasite, perhaps bordering on commensalism. PMID:25295179

  19. Cystic Renal Oncocytoma and Tubulocystic Renal Cell Carcinoma: Morphologic and Immunohistochemical Comparative Study.

    PubMed

    Skenderi, Faruk; Ulamec, Monika; Vranic, Semir; Bilalovic, Nurija; Peckova, Kvetoslava; Rotterova, Pavla; Kokoskova, Bohuslava; Trpkov, Kiril; Vesela, Pavla; Hora, Milan; Kalusova, Kristyna; Sperga, Maris; Perez Montiel, Delia; Alvarado Cabrero, Isabel; Bulimbasic, Stela; Branzovsky, Jindrich; Michal, Michal; Hes, Ondrej

    2016-02-01

    Renal oncocytoma (RO) may present with a tubulocystic growth in 3% to 7% of cases, and in such cases its morphology may significantly overlap with tubulocystic renal cell carcinoma (TCRCC). We compared the morphologic and immunohistochemical characteristics of these tumors, aiming to clarify the differential diagnostic criteria, which facilitate the discrimination of RO from TCRCC. Twenty-four cystic ROs and 15 TCRCCs were selected and analyzed for: architectural growth patterns, stromal features, cytomorphology, ISUP nucleolar grade, necrosis, and mitotic activity. Immunohistochemical panel included various cytokeratins (AE1-AE3, OSCAR, CAM5.2, CK7), vimentin, CD10, CD117, AMACR, CA-IX, antimitochondrial antigen (MIA), EMA, and Ki-67. The presence of at least focal solid growth and islands of tumor cells interspersed with loose stroma, lower ISUP nucleolar grade, absence of necrosis, and absence of mitotic figures were strongly suggestive of a cystic RO. In contrast, the absence of solid and island growth patterns and presence of more compact, fibrous stroma, accompanied by higher ISUP nucleolar grade, focal necrosis, and mitotic figures were all associated with TCRCC. TCRCC marked more frequently for vimentin, CD10, AMACR, and CK7 and had a higher proliferative index by Ki-67 (>15%). CD117 was negative in 14/15 cases. One case was weakly CD117 reactive with cytoplasmic positivity. All cystic RO cases were strongly positive for CD117. The remaining markers (AE1-AE3, CAM5.2, OSCAR, CA-IX, MIA, EMA) were of limited utility. Presence of tumor cell islands and solid growth areas and the type of stroma may be major morphologic criteria in differentiating cystic RO from TCRCC. In difficult cases, or when a limited tissue precludes full morphologic assessment, immunohistochemical pattern of vimentin, CD10, CD117, AMACR, CK7, and Ki-67 could help in establishing the correct diagnosis. PMID:26180933

  20. Atypical Renal Cysts: A Morphologic, Immunohistochemical, and Molecular Study.

    PubMed

    Matoso, Andres; Chen, Ying-Bei; Rao, Vishal; Wang, Lu; Cheng, Liang; Epstein, Jonathan I

    2016-02-01

    There is a lack of standardized nomenclature for renal cysts lined by multiple cell layers or with short papillary projections but without nests of epithelial cells within the stroma. We retrieved 29 cases (15 nephrectomies, 14 partial nephrectomies) from the surgical pathology files of Johns Hopkins Hospital from 1993 to 2014 and performed immunohistochemistry for CK7, alpha-methylacyl-CoA racemase (AMACR), CAIX, and CD10 and fluorescence in situ hybridization for trisomy 7 and 17 and 3p deletion. The mean age at excision was 58 years (range, 29 to 80 y) with 16 men and 13 women. Mean size was 2.9 cm (range, 0.3 to 10 cm). The cysts were grouped by their morphology into (1) clear cell, (2) eosinophilic stratified, and (3) eosinophilic papillary. By immunohistochemistry, 7/9 (78%) of the clear cell cases were diffusely positive for both CK7 and CAIX resembling the pattern seen in clear cell papillary renal cell carcinoma. The majority of eosinophilic stratified (4/6; 67%) and eosinophilic papillary (12/14; 86%) cases were positive for CK7 and had variable staining for AMACR, CD10, or CAIX, suggesting a differentiation more aligned with papillary renal cell carcinoma. The most common molecular alterations detected were trisomy 17 (n=6) and trisomy 7 (n=4). One case showed deletion of chromosome 3p. Clinical follow-up information was available in 23 patients; 20 were alive with no evidence of disease after a median follow-up of 20 months (range, 3 to 120 mo), 1 patient was dead due to metastatic lung cancer, 1 of sepsis, and 1 of unknown reason. Atypical renal cysts present as complex radiologic lesions, as secondary lesions in patients with a renal mass, or in a background of chronic renal disease. These atypical cysts appear heterogenous, and some follow in their morphology and immunoprofile with well-established renal tumors. The presence of 3p deletion and trisomy 7/17 suggests that in some cases they may be precursors of renal cell carcinoma. Longer follow-up with more cases is needed, but on the basis of our data, these lesions should not be diagnosed as carcinoma. PMID:26574846

  1. Assessment of Semiquantitative Parameters of Dynamic Contrast-Enhanced Perfusion MR Imaging in Differentiation of Subtypes of Renal Cell Carcinoma

    PubMed Central

    Abdel Razek, Ahmed Abdel Khalek; Mousa, Amani; Farouk, Ahmed; Nabil, Nancy

    2016-01-01

    Summary Background To assess semiquantitative parameters of dynamic contrast-enhanced perfusion MR imaging (DCE) in differentiation of subtypes of renal cell carcinoma (RCC). Material/Methods Prospective study conducted upon 34 patients (27 M, 7 F, aged 25–72 ys: mean 45 ys) with RCC. Abdominal dynamic contrast-enhanced gradient-recalled echo MR sequence after administration of gadopentetate dimeglumine was obtained. The time signal intensity curve (TIC) of the lesion was created with calculation of enhancement ratio (ER), and washout ratio (WR). Results The subtypes of RCC were as follows: clear cell carcinomas (n=23), papillary carcinomas (n=6), and chromophobe carcinomas (n=5). The mean ER of clear cell, papillary and chromophobe RCC were 188±49.7, 35±8.9, and 120±41.6 respectively. The mean WR of clear cell, papillary and chromophobe RCCs were 28.6±6.8, 47.6±5.7 and 42.7±10, respectively. There was a significant difference in ER (P=0.001) and WR (P=0.001) between clear cell RCC and other subtypes of RCC. The threshold values of ER and WR used for differentiating clear cell RCC from other subtypes of RCC were 142 and 38 with areas under the curve of 0.937 and 0.895, respectively. Conclusions We concluded that ER and WR are semiquantitative perfusion parameters useful in differentiation of clear cell RCC from chromophobe and papillary RCCs.

  2. Case-control study of renal cell carcinoma in relation to occupation, smoking, and alcohol consumption

    SciTech Connect

    Brownson, R.C.

    1988-05-01

    A case-control study based on data from a cancer registry was conducted to evaluate the effects of smoking, alcohol use, and occupation on renal cell cancer risk. Information was obtained for 326 male and female cases and 978 age- and sex-matched controls. Elevated risks were identified for cigarette smokers and for men employed as truck drivers. No relationship between alcohol consumption and renal cancer was observed.

  3. Association between cadmium exposure and renal cancer risk: a meta-analysis of observational studies

    PubMed Central

    Song, Ju kun; Luo, Hong; Yin, Xin hai; Huang, Guang lei; Luo, Si yang; Lin, Du ren; Yuan, Dong Bo; Zhang, Wei; Zhu, Jian guo

    2015-01-01

    Cadmium (Cd) is a widespread environmental pollutant and has been a recognized carcinogen for several decades. Many observational studies reported Cd exposure might be one cause of renal cancer. However, these findings are inconsistent. We conducted a meta-analysis to evaluate the relationship between cadmium exposure and renal cancer risk. A comprehensive PubMed and Embase search was conducted to retrieve observational studies meeting our meta-analysis criteria. A combined odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to assess the association between Cd exposure and renal cancer risk. The meta-analysis showed that a high Cd exposure significantly increased renal cancer 1.47 times (OR = 1.47; 95% CI = 1.27 to 1.71, for highest versus lowest category of cadmium categories). The significant association remained consistent when stratified by geographic region and gender, however mixed results were produced when stratified by sample size, study design, NOS score, adjustment for covariates, effects measure, and exposure type. Our results indicated that a high Cd exposure was associated with increased renal cancer risk and the association was higher for occupational exposure compared with non-occupational exposure. This meta-analysis suggests that a high Cd exposure may be a risk factor for renal cancer in occupational population. PMID:26656678

  4. Association between cadmium exposure and renal cancer risk: a meta-analysis of observational studies.

    PubMed

    Song, Ju Kun; Luo, Hong; Yin, Xin Hai; Huang, Guang Lei; Luo, Si Yang; Lin, Du Ren; Yuan, Dong Bo; Zhang, Wei; Zhu, Jian Guo

    2015-01-01

    Cadmium (Cd) is a widespread environmental pollutant and has been a recognized carcinogen for several decades. Many observational studies reported Cd exposure might be one cause of renal cancer. However, these findings are inconsistent. We conducted a meta-analysis to evaluate the relationship between cadmium exposure and renal cancer risk. A comprehensive PubMed and Embase search was conducted to retrieve observational studies meeting our meta-analysis criteria. A combined odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to assess the association between Cd exposure and renal cancer risk. The meta-analysis showed that a high Cd exposure significantly increased renal cancer 1.47 times (OR?=?1.47; 95% CI?=?1.27 to 1.71, for highest versus lowest category of cadmium categories). The significant association remained consistent when stratified by geographic region and gender, however mixed results were produced when stratified by sample size, study design, NOS score, adjustment for covariates, effects measure, and exposure type. Our results indicated that a high Cd exposure was associated with increased renal cancer risk and the association was higher for occupational exposure compared with non-occupational exposure. This meta-analysis suggests that a high Cd exposure may be a risk factor for renal cancer in occupational population. PMID:26656678

  5. Prevalence of and relationship between pulp and renal stones: A radiographic study

    PubMed Central

    Patil, Santosh R.

    2015-01-01

    Aim The aim of the present study was to determine the prevalence of and the relationship between pulp and renal in affected patients and in healthy adults. Materials and methods A total of 240 patients participated in the study. Group A consisted of 120 patients who had renal calculi and Group B had 120 randomly selected controls for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The radiographs were also evaluated to determine the presence or absence of pulp stones. The results were compared and analyzed using the Chi-square test (p < 0.001). Results A total of 164 patients had pulp narrowing and 112 patients had pulp stones, which included 55 controls and 57 renal calculi patients. There was no statistical correlation between pulp narrowing and renal stones (p > 0.001) and also between pulp stones and renal stones (p > 0.001). Conclusion However, there was no significant correlation between the presence of pulp stones and renal stones, and the incidental findings of pulp stones on periapical radiographs can provide useful information in the early diagnosis of the systemic calcifications. PMID:26605145

  6. Short-Term Effects of Ankaferd Hemostat for Renal Artery Embolization: An Experimental Study

    SciTech Connect

    Ozbek, Orhan; Acar, Kadir; Koc, Osman; Saritas, Kadir; Toy, Hatice; Solak, Yalcin; Ozbek, Seda; Kucukapan, Ahmet; Guler, Ibrahim; Gaipov, Abduzhappar; Turk, Suleyman; Haznedaroglu, Ibrahim Celaleddin

    2013-04-15

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  7. Renal function tests in lithium treated patients - a controlled study.

    PubMed

    Kuruvilla, M; Kuruvilla, K; Jacob, C K

    1988-01-01

    Results of renal function tests done on 36 patients on prophylactic lithium treatment are compared with those of 28 age matched individuals, also being treated for affective disorders but exposed only to neuroleptics and/or tricyclic antidepressants. 25% of the lithium treated patients had A.D.H. resistant concentration dysfunction resulting in polyuria and polydypsia. Serum lithium levels had a significant positive correlation with the daily urine volume and a significant negative correlation with the 12 hour urine specific gravity. No relationship was found between the total amount of lithium consumed or the duration of lithium treatment and the urine volume. Though a higher proportion of the lithium treated patients had proteinuria, it was only of a mild degree. Glomerular Filteration Rate and renal tubular hydrogen ion excretion were normal in both the test and control groups. PMID:21927280

  8. Atheromatous emboli in renal biopsies. An ultrastructural study.

    PubMed Central

    Jones, D. B.; Iannaccone, P. M.

    1975-01-01

    In a series of 755 renal biopsies atheromatous emboli were found in biopsies of 8 men from 49 to 72 years of age. Unexplained recent deterioration of renal function was present in each. This previously unreported incidence of 8/755 biopsies is ascribed to the selection for biopsy of patients with unexplained decrease in renal function. Hypertension was a major feature in 6, hyperlipidemia in 2, a leaking aortic aneurysm in 1, carcinoma of the pancreas in 1, and chronic glomerulonephritis in 1 patient. Toluidine-blue-stained epoxy sections proved to be more effective in recognizing small emboli than paraffin sections. Ultrastructural observation concerned a) early lesions (eg, fresh emboli with endothelial distortion or injury), b) intermediate lesions (eg, histiocytic or giant cell reaction and intimal proliferation), and c) later lesions (eg, extraluminalization of the crystals eventually resulting in inert location in intimal stroma). Osmiophilic deposits on the crystal surfaces were myelin-form in structure and were felt to result from lysosomal action. Images Fig 4 Fig 5 Fig 6 Fig 7 Fig 8 Fig 9 Fig 10 Fig 11 Fig 1 Fig 2 Fig 3 PMID:1115220

  9. Renal papillary calcification and the development of calcium oxalate monohydrate papillary renal calculi: a case series study

    PubMed Central

    2013-01-01

    Background The objective of this study is to determine in a case series (four patients) how calcified deposits in renal papillae are associated with the development of calcium oxalate monohydrate (COM) papillary calculi. Methods From the recently collected papillary calculi, we evaluated retrospectively patients, subjected to retrograde ureteroscopy, with COM papillary lithiasis. Results The COM papillary calculi were found to result from subepithelial injury. Many of these lesions underwent calcification by hydroxyapatite (HAP), with calculus morphology and the amount of HAP in the concave zone dependent on the location of the calcified injury. Most of these HAP deposits grew, eroding the epithelium covering the renal papillae, coming into contact with urine and starting the development of COM calculi. Subepithelial HAP plaques may alter the epithelium covering the papillae, resulting in the deposit of COM crystals directly onto the epithelium. Tissue calcification depends on a pre-existing injury, the continuation of this process is due to modulators and/or crystallization inhibitors deficiency. Conclusions Since calculus morphology and the amount of detected HAP are dependent on the location and widespread of calcified injury, all types of papillary COM calculi can be found in the same patient. All patients had subepithelial calcifications, with fewer papillary calculi, demonstrating that some subepithelial calcifications did not further evolve and were reabsorbed. A high number of subepithelial calcifications increases the likelihood that some will be transformed into COM papillary calculi. PMID:23497010

  10. Do Renal Cysts Affect the Success of Extracorporeal Shockwave Lithotripsy? A Retrospective Comparative Study

    PubMed Central

    Gck, Adnan; ztrk, Ufuk; yetrk, U?ur; Kemahl?, Eray; Ak?n, Gven; ?mamo?lu, M. Abdurrahim; Metin, Ahmet

    2013-01-01

    The aim of this study was to assess the effect of simple renal cysts on extracorporeal shockwave lithotripsy (SWL) in patients with calyceal renal calculi. Patients with simple renal cysts >35?mm and ipsilateral renal calculi <20?mm that were treated with SWL constituted group 1 (cyst + calculi). The control group included patients aged >40 years that had renal calculi <20?mm and no cysts that were treated with SWL. The 2 groups were compared according to age, gender, body mass index, calculi size, localization, and density, the calculi fragmentation rate, and the percentage of stone-free patients. Mean cyst size in group 1 was 44.04 9.08?mm. Mean age in group 1 was 61.4 10.2 years versus 56.9 8.2 years in the control group; the difference was significant (P = 0.045). There were not any other significant differences between the 2 groups, except for the stone-free rate (P > 0.05), which was 33.3% in group 1 and 68.2% in the control group (P = 0.017). The presence of renal cysts in a patient with calculi requires that an individualized treatment plan be devised, so as to provide the patient with the most effective treatment. PMID:23840202

  11. Acute pyelonephritis resulting in intense vascular blush during dynamic renal scintigraphy.

    PubMed

    Joshi, Prathamesh; Deshpande, Sushil; Kulkarni, Mukta; Shetkar, Shubhangi

    2016-01-01

    A thirty-year-old male underwent Tc-99m diethylenetriaminepentaacetic acid renal scintigraphy for evaluation of gross hydronephrosis of left kidney. The perfusion phase revealed an intense vascular blush in left renal fossa. The uptake phase of scintigraphy revealed the absence of tracer uptake in left kidney. Contrast-enhanced computed tomography (CECT) was performed for evaluating the cause of vascular blush. CECT demonstrated features suggestive of acute pyelonephritis (APN) involving lower pole of the hydronephrotic left kidney, corresponding to the site of vascular blush seen on renal scintigraphy. The postnephrectomy specimen confirmed the diagnosis of APN suggested on CECT. PMID:26917903

  12. Acute pyelonephritis resulting in intense vascular blush during dynamic renal scintigraphy

    PubMed Central

    Joshi, Prathamesh; Deshpande, Sushil; Kulkarni, Mukta; Shetkar, Shubhangi

    2016-01-01

    A thirty-year-old male underwent Tc-99m diethylenetriaminepentaacetic acid renal scintigraphy for evaluation of gross hydronephrosis of left kidney. The perfusion phase revealed an intense vascular blush in left renal fossa. The uptake phase of scintigraphy revealed the absence of tracer uptake in left kidney. Contrast-enhanced computed tomography (CECT) was performed for evaluating the cause of vascular blush. CECT demonstrated features suggestive of acute pyelonephritis (APN) involving lower pole of the hydronephrotic left kidney, corresponding to the site of vascular blush seen on renal scintigraphy. The postnephrectomy specimen confirmed the diagnosis of APN suggested on CECT. PMID:26917903

  13. Clinical and Renal Biopsy Findings Predicting Outcome in Renal Thrombotic Microangiopathy: A Large Cohort Study from a Single Institute in China

    PubMed Central

    Song, Di; Wang, Su-Xia; Song, Yan; Liu, Gang

    2014-01-01

    Objective. The current study aimed to investigate the spectrum of etiologies and associated disorders of renal biopsy-proven thrombotic microangiopathy (TMA) patients. Methods. The clinical, laboratory, and renal histopathological data of patients with renal TMA from 2000 to 2012 in our institute were collected and reviewed. Results. One hundred and nine TMA patients were enrolled in this study. The mean age was 34.0 11.1 years. Seventy patients (64.2%) were male and thirty-nine patients (35.8%) were female. There were eight patients (7.3%) with hemolytic uremic syndrome (HUS). Sixty-one patients (56.0%) were secondary to malignant hypertension. Fourteen patients (12.8%) were pregnancy-associated TMA. Other associated disorders included 17 patients with connective tissue disorders, 2 patients with hematopoietic stem cell transplantation, 4 patients with Castleman's disease, 1 patient with cryoglobulinemia, and 2 patients with glomerulopathy. During followup, 8 patients died due to severe infection, 17 patients had doubling of serum creatinine, and 44 had end-stage renal disease. In multivariate analysis, male, elevated serum creatinine, and decreased hemoglobin were independently associated with poor renal outcomes. Conclusions. Renal TMA changes consisted of different disorders with various etiologies. aHUS, pregnancy-associated TMA, and malignant hypertension accounted for the majority of patients in our cohort. PMID:25184151

  14. Structural dynamics verification facility study

    NASA Technical Reports Server (NTRS)

    Kiraly, L. J.; Hirchbein, M. S.; Mcaleese, J. M.; Fleming, D. P.

    1981-01-01

    The need for a structural dynamics verification facility to support structures programs was studied. Most of the industry operated facilities are used for highly focused research, component development, and problem solving, and are not used for the generic understanding of the coupled dynamic response of major engine subsystems. Capabilities for the proposed facility include: the ability to both excite and measure coupled structural dynamic response of elastic blades on elastic shafting, the mechanical simulation of various dynamical loadings representative of those seen in operating engines, and the measurement of engine dynamic deflections and interface forces caused by alternative engine mounting configurations and compliances.

  15. Morphological variability of the renal artery branching pattern: a brief review and an anatomical study.

    PubMed

    D?escu, Ecaterina; Z?hoi, Delia Elena; Motoc, A; Alexa, Aurora; Baderca, Flavia; Enache, Alexandra

    2012-01-01

    The segmental branches of the renal artery vary in number and origin. The 1998, Terminologia Anatomica homologates two branches of the renal artery (anterior, posterior) and five segmental arteries: four from the anterior branch and one from the posterior one. The purpose of this study is to evaluate the renal artery branching pattern, the number and origin of the segmental arteries, as well as to review data from similar studies. The study material consisted of 60 formalin-fixed adult kidneys. Dissections and microdissections were performed on the renal arteries and their branches. The branching of the renal artery was prehilar in 81.67% of cases, hilar in 10% and intra-sinusal in 8.33%. The number branches varied as follows: two branches in 42 cases (70%), three branches in 14 cases (23.33%) and four branches in four cases (6.67%). We subsequently analyzed the origin of the segmental arteries and found that in 53% of the cases the segmental arteries arose independently from the renal artery's branches, while in 47% of the cases they derived from common trunks of type I (85%) or II (15%). Type I trunks are those that originate directly from the main renal artery. They divide either into 2-3 segmental branches, or into just 1-2 branches and a smaller trunk (type II). The type II trunks further divide into 2-3 other segmental branches. These common trunks must be taken into account to avoid confusion with the segmental arteries. Knowledge of these variations is useful not only morphologically, but also clinically. PMID:22732797

  16. The Renal Effects of Vanadate Exposure: Potential Biomarkers and Oxidative Stress as a Mechanism of Functional Renal DisordersPreliminary Studies

    PubMed Central

    ?cibior, Agnieszka; Go??biowska, Dorota; Adamczyk, Agnieszka; Nied?wiecka, Irmina; Fornal, Emilia

    2014-01-01

    The alterations in the levels/activities of selected biomarkers for detecting kidney toxicity and in the levels of some oxidative stress (OS) markers and elements were studied in male rats to evaluate biochemically the degree of kidney damage, investigate the role of OS in the mechanism of functional renal disorders, reveal potential biomarkers of renal function, and assess the renal mineral changes in the conditions of a 12-week sodium metavanadate (SMV, 0.125?mg?V/mL) exposure. The results showed that OS is involved in the mechanism underlying the development of SMV-induced functional renal disturbances. They also suggest that the urinary cystatin C (CysCu) and kidney injury molecule-1 (KIM-1u) could be the most appropriate to evaluate renal function at the conditions of SMV intoxication when the fluid intake, excreted urinary volume (EUV), body weight (BW), and the urinary creatinine excretion (Creu) decreased. The use of such tests as the urinary lactate dehydrogenase, alkaline phosphatase, ?-glutamyltranspeptidase, and N-acetyl-?-D-glucosaminidase (LDHu, ALPu, GGTPu, and NAGu) seems not to be valid given their reduced activities. The use of only traditional biomarkers of renal function in these conditions may, in turn, be insufficient because their alterations are greatly influenced by the changes in the fluid intake and/or BW. PMID:24605335

  17. Renal teratogens.

    PubMed

    Morgan, Thomas M; Jones, Deborah P; Cooper, William O

    2014-09-01

    In utero exposure to certain drugs early in pregnancy may adversely affect nephrogenesis. Exposure to drugs later in pregnancy may affect the renin-angiotensin system, which could have an impact on fetal or neonatal renal function. Reduction in nephron number and renal function could have adverse consequences for the child several years later. Data are limited on the information needed to guide decisions for patients and providers regarding the use of certain drugs in pregnancy. The study of drug nephroteratogenicity has not been systematized, a large, standardized, global approach is needed to evaluate the renal risks of in utero drug exposures. PMID:25155731

  18. Extrarenal abnormalities in Tc-99m-DTPA renal blood flow studies

    SciTech Connect

    Shih, W.J.; Domstad, P.A.; DeLand, F.H.

    1985-01-01

    The authors observed extrarenal abnormalities during renal flow scintigraphy and retrospectively reviewed 90 patient studies to determine the types and frequencies of such abnormal findings. For each routine Tc-99m-DTPA renal flow study, they obtained nine 2-second sequential images, which included the heart, abdominal aorta, spleen and kidneys. Eighty abnormalities, observed in 62 patients, were divided into three categories: aortic, 37 cases; splenic, 40 cases; and miscellaneous, 3 cases. Other correlative studies including Tc-99m sulfur colloid-spleen scintigraphy, ultrasonography (US), CT, aortography, and surgical and/or autopsy findings were available for corroboration in 56 of 80 lesions.

  19. A population approach to renal replacement therapy epidemiology: lessons from the EVEREST study.

    PubMed

    Caskey, Fergus J; Jager, Kitty J

    2014-08-01

    The marked variation that exists in renal replacement therapy (RRT) epidemiology between countries and within countries requires careful systematic examination if the root causes are to be understood. While individual patient-level studies are undoubtedly important, there is a complementary role for more population-level, area-based studies--an aetiological approach. The EVEREST Study adopted such an approach, bringing RRT incidence rates, survival and modality mix together with macroeconomic factors, general population factors and renal service organizational factors for up to 46 countries. This review considers the background to EVEREST, its key results and then the main methodological lessons and their potential application to ongoing work. PMID:24166464

  20. The internist and the renal resistive index: truths and doubts.

    PubMed

    Boddi, Maria; Natucci, Fabrizia; Ciani, Elisa

    2015-12-01

    The renal resistive index (RRI) is measured by Doppler sonography in an intrarenal artery, and is the difference between the peak systolic and end-diastolic blood velocities divided by the peak systolic velocity. The RRI is used for the study of vascular and renal parenchymal renal abnormalities, but growing evidence indicates that it is also a dynamic marker of systemic vascular properties. Renal vascular resistance is only one of several renal (vascular compliance, interstitial and venous pressure), and extrarenal (heart rate, aortic stiffness, pulse pressure) determinants that combine to determine the RRI values, and not the most important one. RRI cannot always be considered a specific marker of renal disease. To summarize from the literature: (1) hydronephrosis, abdominal hypertension, renal vein thrombosis and acute kidney injury are all associated with an acute increase in interstitial and venous pressure that determine RRI values. In all these conditions, RRI is a reliable marker of the severity of renal damage. (2) The hemodynamic impact of renal artery stenosis can be assayed by the RRI decrease in the homolateral kidney by virtue of decreasing pulse pressure. However, renal diseases that often coexist, increase renal vascular stiffness and hide the hemodynamic effect of renal stenosis. (3) In transplant kidney and in chronic renal disease, high RRI values (>0.80) can independently predict renal and clinical outcomes, but systemic (pulse pressure) rather than renal hemodynamic determinants sustain the predictive role of RRI. (4) Higher RRI detects target renal organ damage in hypertension and diabetes when renal function is still preserved, as a marker of systemic atherosclerotic burden. Is this the fact? We attempt to answer. PMID:26337967

  1. Baseline Predictors of Renal Disease Progression in the African American Study of Hypertension and Kidney Disease

    PubMed Central

    Norris, Keith C.; Greene, Tom; Kopple, Joel; Lea, Janice; Lewis, Julia; Lipkowitz, Mike; Miller, Pete; Richardson, Annie; Rostand, Stephen; Wang, Xuelei; Appel, Lawrence J.

    2013-01-01

    Patients with chronic kidney disease have an increased risk for progression to ESRD. The purpose of this study was to examine factors that predict increased risk for adverse renal outcomes. Cox regression was performed to assess the potential of 38 baseline risk factors to predict the clinical renal composite outcome of 50% or 25-ml/min per 1.73 m2 GFR decline or ESRD among 1094 black patients with hypertensive nephrosclerosis (GFR 20 to 65 ml/min per 1.73 m2). Patients were trial participants who had been randomly assigned to one of two BP goals and to one of three antihypertensive regimens and followed for a range of 3 to 6.4 yr. In unadjusted and adjusted analyses, baseline proteinuria was consistently associated with an increased risk for adverse renal outcomes, even at low levels of proteinuria. The relationship of proteinuria with adverse renal outcomes also was evident in analyses that were stratified by level of GFR, which itself was associated with adverse renal outcomes but only at levels <40 ml/min. Other factors that were significantly associated with increased renal events after adjustment for baseline GFR, age, and gender, both with and without adjustment for baseline proteinuria, included serum creatinine, urea nitrogen, and phosphorus. In black patients with hypertensive nephrosclerosis, increased proteinuria, reduced GFR, and elevated levels of serum creatinine, urea nitrogen and phosphorus were directly associated with adverse clinical renal events. These findings identify a subset of this high-risk population that might benefit from even more aggressive treatment. PMID:16959828

  2. The effects of tadalafil on renal ischemia reperfusion injury: an experimental study

    PubMed Central

    Gasanov, Feyzul; Aytac, Berna; Vuruskan, Hakan

    2011-01-01

    Many pharmacological agents were investigated for the prevention of renal ischemic reperfusion (I/R) injury as well as the phosphodiesterase (PDE) inhibitors. The aim of the study was to examine the possible renoprotective effect of a member in this family, tadalafil (Td) on I/R injury. Thirty-six Spraque Dawley rats were allocated to six groups as; control, sham, ischemia (I), ischemia/reperfusion (I/R), Td pretreatment ischemia (Td/I) and Td pretreatment ischemia/reperfusion (Td/IR) groups. Right nephrectomy was performed in all groups. Td was dissolved in saline solution and given as a single dose (1mg/kg) through an orogastrictube 60 min before the operation in the Td pretreatment groups. In ischemia group the left renal pedicle was occluded for 45 minutes and after than underwent left nephrectomy. In I/R group left renal pedicle was occluded for 45 minutes, reperfused for 1 hour and after then underwent nephrectomy. The left kidneys were evaluated after standard laboratory procedures with regard to tubular morphology, and leukocyte infiltration. The data were analyzed by using KruskalWallis test to determine differences among the groups. A p value of < 0.05 was considered significant. Renal tubular damage was significant increased in the ischemia and I/R group (Groups III and IV) when compared to those in the sham group (Group II), (p = 0.004, 0.004, respectively). Tubular damage, in the Td pretreatment ischemia (Td/I) (Group V) and Td pretreatment ischemia/reperfusion (Td/IR) (Group VI) were less than that in the ischemia group (Group III) (p= 0.010, p= 0.025, respectively). Td administration prior to the renal I/R injury attenuated these morphological disarrangements, which were observed in renal I/R. Tubular necrosis, which may be considered as an important issue of the developing renal injury, was also completely prevented with Td administration. PMID:21875417

  3. High-grade Neuroendocrine Carcinoma With Focal Squamous Metaplasia of Renal Pelvis Associated With Renal Calculus: Study of a Case

    PubMed Central

    Huang, Yan-Ping; Chen, Bin; Sun, Xiang-Zhou; Guo, Yan; Yang, Shi-Cong; Deng, Chun-Hua; Huang, Yi-Ran

    2014-01-01

    Mixed neuroendocrine and non-neuroendocrine type of tumor in renal pelvis is rare and presents a high-grade malignancy. We present a case report that a 57-year-old man had no history of small cell cancer but presented a high-grade neuroendocrine carcinoma with focal squamous metaplasia and multiple stones simultaneously in the right renal pelvis. The patient underwent nephroureterocystectomy 9 months before this presentation, with evidence of multiple metastatic tumors in various parts of the body. The case of mixed neuroendocrine tumor with stones in the renal pelvis carries a poor prognosis and poses a therapeutic challenge to urologists. PMID:26952913

  4. High-grade Neuroendocrine Carcinoma With Focal Squamous Metaplasia of Renal Pelvis Associated With Renal Calculus: Study of a Case.

    PubMed

    Huang, Yan-Ping; Chen, Bin; Sun, Xiang-Zhou; Guo, Yan; Yang, Shi-Cong; Deng, Chun-Hua; Huang, Yi-Ran

    2014-05-01

    Mixed neuroendocrine and non-neuroendocrine type of tumor in renal pelvis is rare and presents a high-grade malignancy. We present a case report that a 57-year-old man had no history of small cell cancer but presented a high-grade neuroendocrine carcinoma with focal squamous metaplasia and multiple stones simultaneously in the right renal pelvis. The patient underwent nephroureterocystectomy 9 months before this presentation, with evidence of multiple metastatic tumors in various parts of the body. The case of mixed neuroendocrine tumor with stones in the renal pelvis carries a poor prognosis and poses a therapeutic challenge to urologists. PMID:26952913

  5. A Population- and Hospital-based Cross-sectional Study of Renal Function in Hidradenitis Suppurativa.

    PubMed

    Miller, Iben M; Carlson, Nicholas; Mogensen, Ulla B; Ellervik, Christina; Jemec, Gregor B E

    2016-01-20

    The chronic inflammatory skin diseases hidradenitis suppurativa (HS) and psoriasis have been linked to cardiovascular risk factors and the latter has also been linked to possible renal dysfunction. Since basement membrane thinning in the skin of HS patients has been described, we speculated whether similar basement membrane defects might occur in renal tissue. Our objective was to investigate a possible association between HS and renal dysfunction. We performed a hospital and population-based cross-sectional study using estimated Glomerular-Filtration-Rate (eGFR) to assess renal function. Thirty-two hospital individuals with HS, 430 population individuals with HS, and 20,780 population individuals without HS were (controls) identified. The age-, sex-, smoking-, BMI-, hypertension- and diabetes-adjusted analysis revealed a statistically significant higher eGFR for the hospital group with HS and a mean difference in eGFR of 6.81 (1.27-12.35) ml/min/1.73 m2 between the hospital group with HS and the population group without HS. The observed higher eGFR in the hospital group with HS indicates a possible association of HS and renal dysfunction. PMID:25710874

  6. Effects of exercise and excitement on mesenteric and renal dynamics in conscious, unrestrained baboons

    NASA Technical Reports Server (NTRS)

    Vatner, S. F.

    1978-01-01

    Radiotelemetry was used to measure arterial pressure and mesenteric and renal blood flows from nine unrestrained, conscious baboons during periods of rest, moderate exercise, and extreme excitement. A description of the experiments hardware is presented, including artificial depressants phenylcyclidine hydrochloride, 0.5-1.0 mg/kg, and pentobarbital sodium, 15 mg/kg, and an ultrasonic telemetry flow meter. Results showed rising heart rate and arterial pressure coupled with a reduction of mesenteric and renal flows as the level of exercise was increased. These findings are compared with mesenteric and renal flows somewhat above control level, but relatively stable heart rate and arterial pressure, postprandially. Attention is given to a quantitative analysis of the experimental results.

  7. Renal excretory sectors.

    PubMed

    Burykh, M P

    2002-01-01

    One thousand and ninety-four normal human kidneys and 18 abnormal (with duplication of the ureter) were studied by the corrosion method and pyelography followed by topometric and mathematics analyses. It was found that the renal pelvis is a calicopelvic complex built up of renal calices, urine ducts and renal pelvis. Before opening into the renal pelvis, renal calices join together forming urine ducts (superior and inferior; or superior, middle and inferior; or superior, middle anterior, middle posterior and inferior) which transport urine to the container, the renal pelvis. It can be seen that groups of renal calices with pyramids and their surrounding cortical substance form the renal excretory sectors of the kidneys where the processes of uropoiesis and transportation of urine through elements of the nephron and calicopelvic complex take place. These are two (superior and inferior), three (superior, middle and inferior) or four (superior, middle anterior, middle posterior and inferior) renal excretory sectors. The existence of renal excretory sectors is proved by congenital anomalies of the calicopelvic complex such as duplication of the ureter, where urine ducts of the superior and inferior renal excretory sectors do not form a renal pelvis but run separately to the urinary bladder. On the basis of anatomical data obtained, renal excretory sectors may be distinguished, analogous to bronchopulmonary segments in lungs. These data about renal excretory sectors will contribute to further improvement in the operative technique of renal partial resections as well as to anatomical nomenclature. PMID:12375073

  8. Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study

    PubMed Central

    Ahlstrm, Magnus Glindvad; Feldt-Rasmussen, Bo; Legarth, Rebecca; Kronborg, Gitte; Pedersen, Court; Larsen, Carsten Schade; Gerstoft, Jan; Obel, Niels

    2015-01-01

    Introduction Smoking is a main risk factor for morbidity and mortality in people living with human immunodeficiency virus (PLHIV), but its potential association with renal impairment remains to be established. Methods We did a nationwide population-based cohort study in Danish PLHIV to evaluate the association between smoking status and 1) overall renal function and risk of chronic kidney disease (CKD), 2) risk of any renal replacement therapy (aRRT), and 3) mortality following aRRT. We calculated estimated creatinine clearance using the CockcroftGault equation (CG-CrCl), and evaluated renal function graphically. We calculated cumulative incidence of CKD (defined as two consecutive CG-CrCls of ?60 mL/min, ?3 months apart) and aRRT and used Cox regression models to calculate incidence rate ratios (IRRs) for risk of CKD, aRRT, and mortality rate ratios (MRRs) following aRRT. Results From the Danish HIV Cohort Study, we identified 1,475 never smokers, 768 previous smokers, and 2,272 current smokers. During study period, we observed no association of smoking status with overall renal function. Previous and current smoking was not associated with increased risk of CKD (adjusted IRR: 1.1, 95% confidence interval [CI]: 0.71.7; adjusted IRR: 1.3, 95% CI: 0.91.8) or aRRT (adjusted IRR: 0.8, 95% CI: 0.41.7; adjusted IRR: 0.9, 95% CI: 0.51.7). Mortality following aRRT was high in PLHIV and increased in smokers vs never smokers (adjusted MRR: 3.8, 95% CI: 1.311.2). Conclusion In Danish PLHIV, we observed no strong association between smoking status and renal function, risk of CKD, or risk of aRRT, but mortality was increased in smokers following aRRT. PMID:26357490

  9. Renal grafts from elderly donors: histological studies and long-term results.

    PubMed

    Rossetti, O; Soldano, S; Aseni, P; Colombo, V; Roselli, E; De Gasperi, A; Sansalone, C V

    2007-01-01

    To satisfy the increasing requests for renal grafts, elderly donors are increasingly accepted for kidney transplant at many centers. The main unresolved question is the long-term effect on graft survival of potential histological lesions due to donor age. We present a prospective histological study performed from January 1997 to December 2001 on 184 consecutively transplanted renal grafts in which the only criterion for graft acceptance was a normal value of serum creatinine upon admission to the intensive care unit independent of donor age. At the end of the study, 57 recipients (31%) of mean age 55 years (range 39 to 67 years) received a renal graft from donors aged more than 60 years (mean age 66 years; range 60 to 75 years), this cohort denoted as older donor kidney transplant group (ODKTG) and 127 recipients (69%) with a mean age of 49 years (range 21 to 63 years) received a renal graft from donors whose age was lower than 60 years (mean age 49 years; range 16 to 59 years), a cohort denoted as the younger donor kidney transplant group (YDKTG). The two groups were comparable for time of dialysis, cold ischemia time, immunosuppression therapy, grading of histological damage. At the end of the study with a mean follow-up of 5.6 years (range 3.5 to 7.5 years), primary graft nonfunction and delayed graft function were significantly more represented in the ODKTG than the YDKTG. Cumulative patient and graft survival was 84.3% and 79.4% in the ODKTG, respectively, and 93.8% and 85.9% in the YDKTG, respectively (P = NS). Cumulative serum creatinine values were 1.98 mg/100 mL in ODKTG and 1.65 mg/100 mL in YDKTG (P = NS). In conclusion, renal grafts from older donors presented histological damage comparable to that seen among renal grafts from younger donors. PMID:17692621

  10. Structural and functional studies of ligandin, a major renal organic anion-binding protein.

    PubMed Central

    Kirsch, R; Fleischner, G; Kamisaka, K; Arias, I M

    1975-01-01

    Sephadex gel filtration of the 1000,000 g supernate of homogenates of rat kidney revealed binding of various organic anions (penicillin, Bromsulphalein [BSP], bilirubin, phenolsulfonphthalein [PSP], phlorizin, glutathione [GSH], p-amino hippurate (PAH), probenecid, conjugated bilirubin, and BSP-GSH) to a nonalbumin-containing protein fraction (Y), which precipated on addition of monospecific anti-rat liver ligandin (Y protein)-IgG, but not control IgG. Quantitatively similar organic anion binding was observed in vivo after injection of BSP, BSP-GSH, phlorizin, probenecid, conjugated bilirubin, PAH, or penicillin. The binding protein was purified to apparent homogeneity and is a basic protein (pI 8.9) of 44,000 daltons with two apparently identical subunits of 22,000 daltons. Monospecific antibody was produced against the renal protein. The results of binding studies in vivo and in vitro and phsicochemical, immunologic, structural, and binding site investigations indicate that the renal protein is identical to hepatic ligandin. Immunofluorescent studies utilizing anti-ligandin IgG previously localized ligandin in the kidney to all proximal tubular cells. By quantitative radial immunodiffusion, the concentration of renal ligandin was 31.2 plus or minus 2.2 mug/mg supernatant protein and was increased 160% above basal values by pretreatment of rats with tetrachloro-dibenzo-p-dioxin. Pretreatment with phenobarbital, DDT, or pregnene-16alpha-carbonitrile did not increase renal ligandin concentration but doubled hepatic ligandin concentration. Circular dichroism studies of renal ligandin revealed percent helical structure similar to hepatic ligandin and primary association contrasts were derived for BSP (10-6 M-1) and PAH, probenecid, and penicillin (10-3 M-1). Administration of BSP or probenecid simultaneously with [C14] penicillin resulted in increased plasma retention and reduced kidney and urinary bladder content of [14C] penicillin and a correlation coefficient of -0.8 between total kidney/plasma radioactivity and percent of protein-bound radioactivity bound to ligandin in the kidney. These studies indicate that renal and hepatic ligandin are identical. Their response to drugs and chemicals varies. Competitive binding between several organic anions for ligandin correlated with their renal uptake from plasma, which suggests that ligandin may function in the proximal tubular cell as a component of the renal organic anion transport system. Images PMID:804493

  11. Development and Prospective Evaluation of an Automated Software System for Quality Control of Quantitative 99mTc-MAG3 Renal Studies

    PubMed Central

    Folks, Russell D.; Garcia, Ernest V.; Taylor, Andrew T.

    2011-01-01

    Quantitative nuclear renography has numerous potential sources of error. We previously reported the initial development of a computer software module for comprehensively addressing the issue of quality control (QC) in the analysis of radionuclide renal images. The objective of this study was to prospectively test the QC software. Methods The QC software works in conjunction with standard quantitative renal image analysis using a renal quantification program. The software saves a text file that summarizes QC findings as possible errors in user-entered values, calculated values that may be unreliable because of the patients clinical condition, and problems relating to acquisition or processing. To test the QC software, a technologist not involved in software development processed 83 consecutive nontransplant clinical studies. The QC findings of the software were then tabulated. QC events were defined as technical (study descriptors that were out of range or were entered and then changed, unusually sized or positioned regions of interest, or missing frames in the dynamic image set) or clinical (calculated functional values judged to be erroneous or unreliable). Results Technical QC events were identified in 36 (43%) of 83 studies. Clinical QC events were identified in 37 (45%) of 83 studies. Specific QC events included starting the camera after the bolus had reached the kidney, dose infiltration, oversubtraction of background activity, and missing frames in the dynamic image set. Conclusion QC software has been developed to automatically verify user input, monitor calculation of renal functional parameters, summarize QC findings, and flag potentially unreliable values for the nuclear medicine physician. Incorporation of automated QC features into commercial or local renal software can reduce errors and improve technologist performance and should improve the efficiency and accuracy of image interpretation. PMID:17337654

  12. Epidemiologic study of renal function in copper smelter workers

    SciTech Connect

    Lilis, R.; Valciukas, J.A.; Weber, J.P.; Malkin, J.; Selikoff, I.J.

    1984-03-01

    A medical cross-sectional examination of a copper smelter work force was undertaken after environmental contamination with lead, cadmium and arsenic had been documented. A total of 920 subjects was examined, including active smelter employees, retired workers and copper mine employees who had never worked in the smelter. Slight to moderate absorption of lead and cadmium was definitely present in the active copper smelter employees, who had significantly higher levels of Pb-B, ZPP and Cd-B than retired employees and miners. Cd-U levels were higher in retired workers, who were also older and had, as a group, longer duration of exposure in the smelter. Cd-U did not exceed 10 ..mu..g/g creatinine, the level considered critical for nephrotoxicity, in any of the subjects. Median Cd-B level for active workers was 2.75 ..mu..g/L. Lead absorption was characterized by a relatively small proportion (16.7%) of active employees with Pb-B levels 40 ..mu..g/dL or higher. That kidney function could be impaired by long-term exposure in the smelter was only indirectly suggested. Effects on renal function at the low levels of cadmium and lead absorption that were observed in this smelter population are minimal. 21 references, 8 figures, 21 tables.

  13. Three new renal simulators for use in nuclear medicine

    NASA Astrophysics Data System (ADS)

    Dullius, Marcos; Fonseca, Mateus; Botelho, Marcelo; Cunha, Clêdison; Souza, Divanízia

    2014-03-01

    Renal scintigraphy is useful to provide both functional and anatomic information of renal flow of cortical functions and evaluation of pathological collecting system. The objective of this study was develop and evaluate the performance of three renal phantoms: Two anthropomorphic static and another dynamic. The static images of the anthropomorphic phantoms were used for comparison with static renal scintigraphy with 99mTc-DMSA in different concentrations. These static phantoms were manufactured in two ways: one was made of acrylic using as mold a human kidney preserved in formaldehyde and the second was built with ABS (acrylonitrile butadiene styrene) in a 3D printer. The dynamic renal phantom was constructed of acrylic to simulate renal dynamics in scintigraphy with 99mTc-DTPA. These phantoms were scanned with static and dynamic protocols and compared with clinical data. Using these phantoms it is possible to acquire similar renal images as in the clinical scintigraphy. Therefore, these new renal phantoms can be very effective for use in the quality control of renal scintigraphy, and image processing systems.

  14. A Cadaveric Study about the Anomolous Origin of Testicular Arteries Arising from the Accessory Renal Arteries.

    PubMed

    H, Mamatha; D'Souza, Antony Sylvan; P, Vinodhini; Ray, Biswabina; Suhani; Pallavi

    2015-04-01

    Testicular arteries are paired vessels, arising from the abdominal aorta, at the level of second lumbar vertebra. Variations in the origin of these vessels highlight a potential importance regarding the vascular supply to the gonads and kidneys. This study was designed to assess the variations in the origin, course, and distance about the point of origin of the testicular arteries. The posterior abdominal walls of 40 male cadavers were studied on either side, during routine dissection in the Department of Anatomy, Kasturba Medical College, Manipal. A majority had a normal course and the variations were reported as: a) Bilateral origin of gonadal arteries from accessory renal arteries, b) Unilateral origin of the gonadal artery from the left accessory renal artery, and c) Unique origin of the right testicular artery from the right inferior epigastric artery and left testicular artery from descending thoracic aorta above the aortic opening of the diaphragm. Due to the embryological attribution, these variations in the testicular arteries indicate an alarming threat to the radiologists and surgeons during renal transplants and nephrectomies, as these vessels monopolize the vascular supply to the gonads. This study was undertaken to document the incidence of testicular arteries originating from accessory renal arteries. PMID:26139964

  15. Evolution of renal segmental atrophy (Ask-Upmark kidney) in children with vesicoureteric reflux: radiographic and morphologic studies.

    PubMed

    Shindo, S; Bernstein, J; Arant, B S

    1983-06-01

    A radiographic and morphologic study of nine patients with renal segmental "hypoplasia," whose kidneys were radiographically normal when first examined, showed the lesion to be a form of localized, progressive renal atrophy. The renal abnormality bears a strong relationship to vesicoureteric reflux, which could be demonstrated in every patient. No evidence of renal scarring or atrophy was observed in initial roentgenographic examinations at a mean age of 2.9 years (range 0.1 to 10 years); however, serial studies during five to 14 years after discovery of vesicoureteral reflux demonstrated both a lack of renal growth and a progressive loss of substance irrespective of infection. Radiographic lengths of scarred kidneys, as measures of renal growth, correlated poorly with the radiographic surface areas of the renal parenchymal outlines. The mean time from discovery of vesicoureteric reflux to appearance of a renal scar was 6.1 years, and to onset of hypertension in six patients was 7.8 years. The renal abnormality consisted of lobar atrophy with variable tubular atrophy and glomerular sclerosis and with parenchymal destruction that in some specimens had proceeded to a complete loss of nephronic elements. The occasional presence of relatively well-preserved glomeruli and tubules and of focal segmental sclerosis within persisting glomeruli was taken as evidence of a progressive renal abnormality, as opposed to a static developmental hypoplasia. These observations indicate that renal scarring, the injury presumably having been initiated by vesicoureteric reflux, can progress despite correction of the reflux and despite prevention of urinary tract infection. PMID:6854447

  16. Current Safety of Renal Allograft Biopsy With Indication in Adult Recipients: An Observational Study.

    PubMed

    Tsai, Shang-Feng; Chen, Cheng-Hsu; Shu, Kuo-Hsiung; Cheng, Chi-Hung; Yu, Tung-Min; Chuang, Ya-Wen; Huang, Shih-Ting; Tsai, Jun-Li; Wu, Ming-Ju

    2016-02-01

    Renal biopsy remains the golden standard diagnosis of renal function deterioration. The safety in native kidney biopsy is well defined. However, it is a different story in allograft kidney biopsy. We conduct this retrospective study to clarify the safety of allograft kidney biopsy with indication.All variables were grouped by the year of biopsy and they were compared by Mann-Whitney U test (for continuous variables) or Chi-square test (for categorical variables). We collected possible factors associated with complications, including age, gender, body weight, renal function, cause of uremia, status of coagulation, hepatitis, size of needle, and immunosuppressants.We recruited all renal transplant recipients undergoing allograft biopsy between January of 2009 and December of 2014. This is the largest database for allograft kidney biopsy with indication. Of all the 269 biopsies, there was no difference in occurrence among the total 14 complications (5.2%) over these 6 years. There were only 3 cases of hematomas (1.11%), 6 gross hematuria (2.23%), 1 hydronephrosis (0.37%), and 2 hemoglobin decline (0.74%). The outcome of this cohort is the best compared to all other studies, and it is even better than the allograft protocol kidney biopsy. Among all possible factors, patients with pathological report containing "medullary tissue only" were susceptible to complications (P < 0.001, 1.8 of relative risk).In modern era, this study demonstrates the safety of allograft kidney biopsy with indication. Identifying the renal capsule before biopsy to avoid puncture into medulla is the most important element to prevent complications. PMID:26871853

  17. Isolated Renal Hydatidosis Presenting as Renal Mass: A Diagnostic Dilemma

    PubMed Central

    Hota, Datteswar; Pujari, Sujata; Choudhuri, Sanjay; Panda, Sabyasachi

    2015-01-01

    Hydatid disease is a parasitic infestation by larval form of Echinococcus granulosus. Isolated renal involvement is extremely rare. There are no specific signs and symptoms of renal hydatidosis. However it may present as palpable mass, flank pain, hematuria, malaise, fever, and hydatiduria or as a complication of it such as infection, abscess, hemorrhage, necrosis and pelviureteric junction obstruction, renal failure etc. Except hydatiduria, none are pathognomonic for renal hydatidosis. There is no literature on renal hydatidosis presenting as renal mass we report 2 cases of isolated renal hydatidosis, which mimicked a renal mass on imaging study.

  18. Follow up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation.

    PubMed Central

    Geyskes, G G; Puylaert, C B; Oei, H Y; Mees, E J

    1983-01-01

    Between April 1978 and April 1981, 70 patients with hypertension and renal artery stenosis were treated by percutaneous transluminal arterial dilatation. Selection of the patients was based solely on arteriographic criteria. Arteriography after dilatation showed considerable widening of the stenosed area in all patients. In 65 patients the effect of treatment on the blood pressure was assessed during follow up periods of one to four years. In 14 of these patients the hypertension was cured, in 29 it was improved, and in 22 there was no change. Patients with fibromuscular lesions benefited distinctly more than did those with atheromatous stenosis, only one of the 21 patients with fibromuscular lesions showing no change as compared with 21 of the 44 patients with atheromatous lesions. The only serious complication encountered was microcholesterol emboli, which developed in two patients with severe atheromatous lesions of the aorta. In the atheromatous group age and overall renal function had no influence on the blood pressure response. In the subgroup of patients with a unilateral lesion the renal vein renin ratios and asymmetrical curves obtained by renography had only a very limited predictive value. In experienced hands percutaneous transluminal arterial dilatation is relatively safe, and this study suggests that it should be attempted in all patients with renal artery stenosis. Only in patients with severe atheromatosis of the aorta should the risk associated with the catheterisation be weighed against the 50% or so chance of benefit from the procedure. PMID:6223685

  19. A comparative evaluation of epidural and general anaesthetic technique for renal surgeries: A randomised prospective study

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Kaur, Jasleen; Singh, Amarjit

    2014-01-01

    Background and Aims: Neuraxial anaesthesia has become popular for the renal surgeries during the last few years. This study was aimed at comparing general anaesthesia (GA) with epidural anaesthesia in patients undergoing renal surgeries. Methods: One hundred American Society of Anaesthesiologists (ASA) physical status-I and II adult consenting patients of both gender in the age group of 25-55 years undergoing renal surgeries were randomly assigned to two groups of 50 patients each: Group G and Group E. Group G patients were administered conventional GA while Group E received epidural anaesthesia (EA) with 3 mg/kg of ropivacaine and 1 ?g/kg of dexmedetomidine. Besides cardio-respiratory parameters, surgeon's satisfaction, patient's satisfaction and side effects were observed. Parametric data were analysed by ANOVA while non-parametric data were compared with MannWhitney U-test and Wilcoxon test. Value of P < 0.05 was considered statistically significant. Results: The demographic profile, total anaesthesia time, surgical time and haemodynamic parameters and surgeon's satisfaction scores were comparable in both groups. Patient's satisfaction scores were better in Group E during the post-operative period. Incidence of side-effects such as nausea and vomiting and shivering were higher in Group G (P < 0.001) while the incidence of dry mouth was higher in Group E (P < 0.001). Conclusion: Epidural anaesthesia with ropivacaine and dexmedetomidine can be safely and effectively used in patients undergoing renal surgeries. PMID:25197108

  20. /sup 31/P nuclear magnetic resonance study of renal allograft rejection in the rat

    SciTech Connect

    Shapiro, J.I.; Haug, C.E.; Shanley, P.F.; Weil, R. III; Chan, L.

    1988-01-01

    Phosphorus (/sup 31/P) nuclear magnetic resonance (NMR) spectroscopy was used to serially evaluate heterotopic renal allograft rejection in the rat. Renal allografts transplanted to the groin of recipient animals were studied using a 1.89 Tesla horizontal bore magnet. The relative intracellular concentrations of phosphorus metabolites such as adenosine triphosphate and inorganic phosphate as well as intracellular pH were determined by /sup 31/P NMR on days 4, 7, 10, and 14 following transplantation across a major histocompatibility mismatch. Recipient rats chosen to be rejectors received no immunosuppression while animals chosen to be nonrejectors received cyclosporine during the first 7 days following transplantation. By day 7, all rejector rats could be distinguished from nonrejector rats by their higher relative concentration of inorganic phosphate and their lower relative concentration of adenosine triphosphate. These NMR findings correlated with histologic findings of renal infarction probably related to vascular rejection in the allografts. /sup 31/P NMR spectroscopy may have application as a noninvasive tool in the differential diagnosis of posttransplantation renal insufficiency.

  1. Reference values and factors associated with renal resistive index in a family-based population study.

    PubMed

    Ponte, Beln; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Eisenberger, Ute; Guessous, Idris; Rousson, Valentin; Mohaupt, Markus G; Alwan, Heba; Ehret, Georg; Pechere-Bertschi, Antoinette; Paccaud, Fred; Staessen, Jan A; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Bochud, Murielle

    2014-01-01

    Increased renal resistive index (RRI) has been recently associated with target organ damage and cardiovascular or renal outcomes in patients with hypertension and diabetes mellitus. However, reference values in the general population and information on familial aggregation are largely lacking. We determined the distribution of RRI, associated factors, and heritability in a population-based study. Families of European ancestry were randomly selected in 3 Swiss cities. Anthropometric parameters and cardiovascular risk factors were assessed. A renal Doppler ultrasound was performed, and RRI was measured in 3 segmental arteries of both kidneys. We used multilevel linear regression analysis to explore the factors associated with RRI, adjusting for center and family relationships. Sex-specific reference values for RRI were generated according to age. Heritability was estimated by variance components using the ASSOC program (SAGE software). Four hundred women (mean ageSD, 44.916.7 years) and 326 men (42.116.8 years) with normal renal ultrasound had mean RRI of 0.640.05 and 0.620.05, respectively (P<0.001). In multivariable analyses, RRI was positively associated with female sex, age, systolic blood pressure, and body mass index. We observed an inverse correlation with diastolic blood pressure and heart rate. Age had a nonlinear association with RRI. We found no independent association of RRI with diabetes mellitus, hypertension treatment, smoking, cholesterol levels, or estimated glomerular filtration rate. The adjusted heritability estimate was 428% (P<0.001). In a population-based sample with normal renal ultrasound, RRI normal values depend on sex, age, blood pressure, heart rate, and body mass index. The significant heritability of RRI suggests that genes influence this phenotype. PMID:24126174

  2. Renal Transplantation Is Not Associated with Regression of Left Ventricular Hypertrophy: A Magnetic Resonance Study

    PubMed Central

    Patel, Rajan K.; Mark, Patrick B.; Johnston, Nicola; McGregor, Ellon; Dargie, Henry J.; Jardine, Alan G.

    2008-01-01

    Background and objectives: Patients with end-stage renal failure (ESRD) have an increased risk of premature cardiovascular (CV) disease. Left ventricular hypertrophy is an independent risk factor for CV events and death in ESRD. Renal transplantation has been associated with reduction in CV risk and echocardiographic regression of left ventricular hypertrophy. However, echocardiography overestimates LV mass in ESRD patients. Cardiac magnetic resonance (CMR) provides more detailed, volume-independent, measures of cardiac structure. Changes in LV mass measured by CMR after renal transplantation were studied. Design, setting, participants, & measurements: Fifty patients underwent CMR on two occasions. Twenty-five were transplanted before the second scan. CMR was performed to measure LV mass index (LVMI), ejection fraction, end-diastolic and end-systolic volumes. Changes were expressed as percentage change over time. Patients with CV events between scans (e.g., acute coronary syndrome, myocardial infarction) were excluded. All transplant patients had serum creatinine <150 ?mol/L. Results: There was no significant change in LVMI between patients who underwent renal transplantation and those who remained on dialysis (transplanted mean, 2.75%/yr, 9.1 versus dialysis, ?3.6%/yr 16.7). In addition, there were no significant changes in end-diastolic volume (transplant, 0.1%/yr 19.5 versus not transplanted, ?3.4%/yr 31.5), end-systolic volume (transplanted mean, 15.2%/yr 65.2 versus not transplanted, 3.0%/yr 55.5), or ejection fraction (transplant, 2.1%/yr 11.9 versus not transplanted, ?0.4%/yr 5.3). Conclusions: Renal transplantation is not associated with significant regression of LVMI on CMR compared with patients who remain on the transplant waiting list. PMID:18650407

  3. Management of pediatric renal tumor: Past and future trials of the Japan Wilms Tumor Study Group.

    PubMed

    Oue, Takaharu; Fukuzawa, Masahiro; Koshinaga, Tsugumichi; Okita, Hajime; Nozaki, Miwako; Chin, Motoki; Kaneko, Yasuhiko; Tanaka, Yukichi; Haruta, Masayuki; Tsuchiya, Kunihiko; Kuwajima, Shigeko; Takimoto, Tetsuya

    2015-10-01

    The Japan Wilms Tumor Study group (JWiTS) was founded in 1996 to improve outcomes for children with renal tumor in Japan, and a nationwide multicenter cooperative study was initiated thereafter. JWiTS-1 (1996-2005) was analyzed, and JWiTS-2 (2005-2014) is now under analysis; the following problems have been identified and used to decide future study protocol: (i) there has been a decline in survival rate for patients with rhabdoid tumor of the kidney (RTK) and new treatment strategies are required; (ii) the survival rate for bilateral Wilms tumors (BWT) has improved, but results for renal preservation are unsatisfactory; (iii) the prognosis of stage IV favorable nephroblastoma is very good, suggesting that the current protocols provide overtreatment, particularly for patients with lung metastasis; and (iv) no effective biological risk factors exist for predicting the outcome of Wilms tumor, and a study of the genetic changes of these tumors is necessary to determine biological markers for use in risk classification. To solve these issues, the development of a new risk classification of pediatric renal tumors is required. In addition, different study protocols should be developed according to the risk-based classification of the patients. Further, a new study protocol for BWT began in 2015, and new study protocols are being prepared for RTK, and for Wilms tumor with lung metastasis. In addition, an analysis of biological markers with regard to risk classification is to be performed. Furthermore, to create new protocols for patients with rare renal tumors, international collaboration with Children's Oncology Group and International Society of Pediatric Oncology is necessary. PMID:26267611

  4. /sup 99m/Tc-DTPA renal studies for acute tubular necrosis: specificity of dissociation between perfusion and clearance

    SciTech Connect

    Shanahan, W.S.M.; Klingensmith, W.C. III; Weil, R. III

    1981-02-01

    In order to evaluate the usefulness of radionuclide renal studies in differentiating acute tubular necrosis from causes of decreased renal clearance (e.g., rejection) in renal transplant patients, we assumed that acute tubular necrosis would be common during the first 4 days after cadaveric transplantation (group 1) and uncommon 3 weeks or longer after transplantation (group 2). There were 38 renal studies in 34 patients in group 1 and 62 studies in 27 patients in group 2. Each renal study consisted of both a technetium-99m-DTPA and an iodine-131 hippuran study. Perfusion, clearance, and transit time in the /sup 99m/Tc-DTPA study, and clearance and transit time in the /sup 131/I-hippuran study were visually graded on a 5 point scale without knowledge of the time of study of clinical diagnosis. There were 19 studies in group 1 and 25 studies in group 2 with clearance decreased two or more gradations. Eleven /sup 99m/Tc-DTPA studies had perfusion 2 or more gradations better than clearance; all 11 were in group 1 (p < 0.01). Other dissociations within the /sup 99m/TcDTPA and /sup 131/I-hippuran studies, or between them, did not distinguish the two groups. Data support the hypothesis that decreased clearance with relatively well preserved perfusion in /sup 99m/Tc-DTPA studies is common in acute tubular necrosis and uncommon in other causes of decreased renal clearance.

  5. Carbon-11-acetate PET imaging in renal disease

    SciTech Connect

    Shreve, P.; Chiao, Ping-Chun; Humes, H.D.; Schwaiger, M.; Gross, M.D.

    1995-09-01

    The purpose of this study was to investigate the use of [1-{sup 11}C]acetate as a metabolic tracer for renal imaging in human subjects. Eighteen patients underwent dynamic PET imaging of the kidneys after intravenous bolus injection of 10-20 mCi [1-{sup 11}C]acetate. Time-activity curves of renal parenchyma tracer activity were fitted to a two-compartment model using direct arterial blood sampling for the arterial input function. Renal uptake of [1-{sup 11}C]acetate is prompt and high target-to-background ratios are achieved even in the presence of markedly reduced renal function. Carbon-11-acetate is cleared from the renal parenchyma without any urinary excretion and the rate of clearance is comparable to myocardial clearance rates. Among normal subjects, K{sub 1} ranged from 0.653 to 1.37 ml/min-g, and was reduced to as low as 0.363 ml/min-g in severe renal disease (serum creatinine greater than 5 mg/dl), while k{sub 2} ranged from 0.114 to 0.166 min{sup {minus}1} among normal subjects and was reduced to as low as 0.053 min{sup {minus}1} in severe renal disease. Kinetic parameters K{sub 1} and k{sub 2} were both reduced in the presence of intrinsic renal disease or significant renal artery stenosis. Renal cell carcinoma demonstrated similar uptake of [1-{sup 11}C]acetate, but substantially reduced the rate of clearance compared to normal and diseased non-neoplastic renal tissue, allowing for ready differentiation of renal cell carcinoma from non-neoplastic renal tissue on images acquired beyond 10 min of tracer administration. Carbon-11-acetate is a promising physiologic tracer for the study of renal disease. 26 refs., 6 figs., 1 tab.

  6. Theoretical studies of combustion dynamics

    SciTech Connect

    Bowman, J.M.

    1993-12-01

    The basic objectives of this research program are to develop and apply theoretical techniques to fundamental dynamical processes of importance in gas-phase combustion. There are two major areas currently supported by this grant. One is reactive scattering of diatom-diatom systems, and the other is the dynamics of complex formation and decay based on L{sup 2} methods. In all of these studies, the authors focus on systems that are of interest experimentally, and for which potential energy surfaces based, at least in part, on ab initio calculations are available.

  7. The complexon-renal stone interaction: solubility and electronic microscopy studies.

    PubMed

    Kustov, Andrey V; Berezin, Boris D; Trostin, Vyacheslav N

    2009-07-16

    We have studied how complex formation between calcium and ethylenediaminetetraacetate or citrate ions influences the surface texture and the size of passed oxalate-phosphate renal stones. The four hour concrement treatment by sodium citrate or ethylenediaminetetraacetate aqueous solutions strongly affects the stone texture and provides a mass loss of 6-15%. We have found a significant decrease of the calcium and phosphor content on a concrement surface and formation of appreciable cracks. Our results do indicate that the Ca-complexon interaction can be effectively applied for disrupting some types of renal stones and, especially, residual concrements, which frequently occurs after a surgical operation or an extracorporeal shock-wave lithotripsy. This study provides an additional quantitative physicochemical basis for this slightly invasive therapy. PMID:19537693

  8. Renal Neoplasms With Overlapping Features of Clear Cell Renal Cell Carcinoma and Clear Cell Papillary Renal Cell Carcinoma: A Clinicopathologic Study of 37 Cases From a Single Institution.

    PubMed

    Dhakal, Hari P; McKenney, Jesse K; Khor, Li Yan; Reynolds, Jordan P; Magi-Galluzzi, Cristina; Przybycin, Christopher G

    2016-02-01

    Clear cell papillary renal cell carcinoma (CCPRCC) was recently included in the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia as a subtype of RCC that is morphologically, immunohistochemically, and genetically distinct from both clear cell renal cell carcinoma (CCRCC) and papillary renal cell carcinoma. In our clinical practice we have observed tumors with overlapping histologic features of CCPRCC and CCRCC; therefore, our aim was to describe the morphologic, immunohistochemical, and clinical characteristics of these tumors. We examined a large series of consecutive nephrectomies diagnosed as CCRCC and found 37 tumors with morphologic overlap between CCRCC and CCPRCC, identifying 2 patterns. Pattern 1 tumors (N=19) had areas diagnosable as CCRCC admixed with foci having a prominent linear arrangement of nuclei away from the basement membrane imparting a resemblance to CCPRCC; however, other morphologic features commonly seen in CCPRCC (such as branching acini and cystic spaces with papillary tufts) were not typical and, when present, were focal or poorly developed. Pattern 2 (N=18) tumors had 2 discrete areas, one area with an appearance strongly resembling CCPRCC and the other with higher grade nuclei and features diagnosable as CCRCC, sometimes including rhabdoid differentiation, sarcomatoid differentiation, necrosis, and high-stage disease. Four (21%) of the pattern 1 tumors had grade 3 nuclei in the CCRCC-like areas, and 4 were high stage (pT3a). Of the 16 immunostained pattern 1 tumors, all expressed cytokeratin 7 (CK7) at least focally in the CCPRCC-like areas, strongly and diffusely in 9 (56%) cases; 12 (75%) showed negative to focal and/or weak CK7 expression in the CCRCC-like areas. CD10, α-methylacyl-CoA-racemase, high-molecular-weight cytokeratin, and carbonic anhydrase IX (CA IX) had no significant differential expression between these foci. No cup-like staining pattern was seen with CA IX. Two (11%) patients with pattern 1 tumors developed metastases, and 1 (5%) subsequently died of disease. Eleven (61%) pattern 2 cases had the International Society of Urological Pathology grade 3 nuclei in the CCRCC-like areas, and 7 (39%) were grade 4 (4 of these cases had rhabdoid features; 1 was also sarcomatoid). Of the 16 immunostained pattern 2 tumors, 8 (50%) showed strong diffuse CK7 expression in the CCPRCC-like areas, and 9 (56%) showed complete lack of CK7 expression in the CCRCC-like areas. CD10, α-methylacyl-CoA-racemase, and high-molecular-weight cytokeratin did not have significant differential expression. Membranous expression of CA IX, typically strong and diffuse, was identified in both the CCPRCC-like and CCRCC-like areas in all cases tested (with a cup-like pattern at least focally in the CCPRCC-like areas of 10 [63%] pattern 2 cases). Five (28%) patients with pattern 2 tumors had distant metastases, 3 (17%) of whom subsequently died of disease. Renal cell carcinomas with areas resembling both CCRCC and CCPRCC occur. Some can have high-grade and high-stage foci, and aggressive clinical outcomes are seen. Given this malignant potential, we would presently diagnose such cases as CCRCC. These 2 patterns of renal neoplasia underscore the need for caution in diagnosing CCPRCC on limited sampling, reserving the diagnosis for those tumors that strictly fulfill both morphologic and immunohistochemical criteria. PMID:26752401

  9. Nanoscale Study of Polymer Dynamics.

    PubMed

    Keshavarz, Masoumeh; Engelkamp, Hans; Xu, Jialiang; Braeken, Els; Otten, Matthijs B J; Uji-I, Hiroshi; Schwartz, Erik; Koepf, Matthieu; Vananroye, Anja; Vermant, Jan; Nolte, Roeland J M; De Schryver, Frans; Maan, Jan C; Hofkens, Johan; Christianen, Peter C M; Rowan, Alan E

    2016-01-26

    The thermal motion of polymer chains in a crowded environment is anisotropic and highly confined. Whereas theoretical and experimental progress has been made, typically only indirect evidence of polymer dynamics is obtained either from scattering or mechanical response. Toward a complete understanding of the complicated polymer dynamics in crowded media such as biological cells, it is of great importance to unravel the role of heterogeneity and molecular individualism. In the present work, we investigate the dynamics of synthetic polymers and the tube-like motion of individual chains using time-resolved fluorescence microscopy. A single fluorescently labeled polymer molecule is observed in a sea of unlabeled polymers, giving access to not only the dynamics of the probe chain itself but also to that of the surrounding network. We demonstrate that it is possible to extract the characteristic time constants and length scales in one experiment, providing a detailed understanding of polymer dynamics at the single chain level. The quantitative agreement with bulk rheology measurements is promising for using local probes to study heterogeneity in complex, crowded systems. PMID:26688072

  10. Dynamic reprogramming of DNA methylation in SETD2-deregulated renal cell carcinoma.

    PubMed

    Tiedemann, Rochelle L; Hlady, Ryan A; Hanavan, Paul D; Lake, Douglas F; Tibes, Raoul; Lee, Jeong-Heon; Choi, Jeong-Hyeon; Ho, Thai H; Robertson, Keith D

    2016-01-12

    Clear cell renal cell carcinomas (ccRCCs) harbor frequent mutations in epigenetic modifiers including SETD2, the H3K36me3 writer. We profiled DNA methylation (5mC) across the genome in cell line-based models of SETD2 inactivation and SETD2 mutant primary tumors because 5mC has been linked to H3K36me3 and is therapeutically targetable. SETD2 depleted cell line models (long-term and acute) exhibited a DNA hypermethylation phenotype coinciding with ectopic gains in H3K36me3 centered across intergenic regions adjacent to low expressing genes, which became upregulated upon dysregulation of the epigenome. Poised enhancers of developmental genes were prominent hypermethylation targets. SETD2 mutant primary ccRCCs, papillary renal cell carcinomas, and lung adenocarcinomas all demonstrated a DNA hypermethylation phenotype that segregated tumors by SETD2 genotype and advanced grade. These findings collectively demonstrate that SETD2 mutations drive tumorigenesis by coordinated disruption of the epigenome and transcriptome,and they have important implications for future therapeutic strategies targeting chromatin regulator mutant tumors. PMID:26646321

  11. Preliminary study on tubuloglomerular dysfunction and evidence of renal inflammation in patients with visceral leishmaniasis.

    PubMed

    Oliveira, Michelle J C; Silva, Geraldo B; Sampaio, Aline M; Montenegro, Brbara L; Alves, Marlia P; Henn, Guilherme A L; Rocha, Hermano A L; Meneses, Gdayllon C; Martins, Alice M C; Daher, Elizabeth F

    2014-11-01

    Visceral leishmaniasis (VL) is a re-emerging zoonosis of worldwide distribution. Monocyte chemotactic protein-1 (MCP-1) and malondialdehyde (MDA) are inflammation biomarkers that have never been investigated in VL. The aim of this study is to investigate the association between renal abnormalities and inflammation biomarkers in VL. This study is a preliminary prospective study with 16 VL adult patients evaluated before treatment compared with a group of 13 healthy volunteers and 5 VL patients evaluated after treatment. Urinary concentration and acidification tests were performed. MCP-1 and MDA were quantified in urine. Urinary concentration deficit was found in all VL patients before (100%) and four VL patients after (80%) treatment. Urinary acidification deficit was found in nine cases before (56.2%) and two cases after (40%) treatment. Urinary MCP-1 (374 359 versus 42 29 pg/mg creatinine, P = 0.002) as well as urinary MDA (5.4 2.6 versus 2.0 0.8 ?mol/mL) showed significant differences between VL patients and controls. These data show that VL patients present urinary concentration and acidification deficit, which can persist even after specific treatment. Urinary MCP-1 and MDA are elevated in patients with VL, which suggests renal inflammation and incipient renal damage. PMID:25114011

  12. Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective observational study

    PubMed Central

    2012-01-01

    Background No studies on continuous renal replacement therapy (CRRT) have analyzed nutritional status in children. The objective of this study was to assess the association between mortality and nutritional status of children receiving CRRT. Methods Prospective observational study to analyze the nutritional status of children receiving CRRT and its association with mortality. The variables recorded were age, weight, sex, diagnosis, albumin, creatinine, urea, uric acid, severity of illness scores, CRRT-related complications, duration of admission to the pediatric intensive care unit, and mortality. Results The sample comprised 174 critically ill children on CRRT. The median weight of the patients was 10 kg, 35% were under percentile (P) 3, and 56% had a weight/P50 ratio of less than 0.85. Only two patients were above P95. The mean age for patients under P3 was significantly lower than that of the other patients (p = 0.03). The incidence of weight under P3 was greater in younger children (p = 0.007) and in cardiac patients and in those who had previous chronic renal insufficiency (p = 0.047). The mortality analysis did not include patients with pre-existing renal disease. Mortality was 38.9%. Mortality for patients with weight < P3 was greater than that of children with weight > P3 (51% vs 33%; p = 0.037). In the univariate and multivariate logistic regression analyses, the only factor associated with mortality was protein-energy wasting (malnutrition) (OR, 2.11; 95% CI, 1.067-4.173; p = 0.032). Conclusions The frequency of protein-energy wasting in children who require CRRT is high, and the frequency of obesity is low. Protein-energy wasting is more frequent in children with previous end-stage renal disease and heart disease. Underweight children present a higher mortality rate than patients with normal body weight. PMID:23016957

  13. Metformin initiation and renal impairment: a cohort study in Denmark and the UK

    PubMed Central

    Christiansen, Christian Fynbo; Ehrenstein, Vera; Heide-Jrgensen, Uffe; Skovbo, Stine; Nrrelund, Helene; Srensen, Henrik Toft; Li, Lin; Jick, Susan

    2015-01-01

    Objectives To estimate prevalence of renal impairment, rate of decline in kidney function and changes in metformin use after decline in kidney function, in metformin initiators. Design, setting and participants We conducted this 2-country cohort study using routine data from northern Denmark and the UK during 20002011. We included metformin initiators among patients aged ?30?years with medically treated diabetes. Main outcome measures We described patients demographics, comorbidity, co-medications and their estimated glomerular filtration rates (eGFR). Furthermore, we described the patients characteristics according to eGFR level. Finally, we examined the rate of any decline in eGFR and changes in metformin use within 90?days after first decline in eGFR during follow-up. Results We included 124?720 metformin initiators in the 2 countries. Prevalence of eGFR <60?mL/min/1.73?m2 among metformin initiators was 9.0% in Denmark and 25.2% in the UK. In contrast, prevalence of eGFR values <30?mL/min/1.73?m2 among metformin initiators was 0.3% in Denmark and 0.4% in the UK. Patients with renal impairment were older and more likely to have received cardiovascular drugs. Incidence rate of decline in renal function was 4.92 per 100 person-years (95% CI 4.76 to 5.09) in Denmark and 7.48 per 100 person-years (95% CI 7.39 to 7.57) in the UK. The proportion of patients continuing metformin use, even after a first decline brought the eGFR below 30?mL/min/1.73?m2, was 44% in Denmark and 62% in the UK. There was no clinically significant dose reduction with decreasing baseline eGFR level discernible from the data. Conclusions Mild to moderate renal impairment was common among metformin initiators, while severe renal impairment was uncommon. Patients with severe renal impairment frequently continued receiving/redeeming metformin prescriptions even 90?days after eGFR decline. PMID:26338686

  14. Contribution of large pig for renal ischemia-reperfusion and transplantation studies: the preclinical model.

    PubMed

    Giraud, S; Favreau, F; Chatauret, N; Thuillier, R; Maiga, S; Hauet, T

    2011-01-01

    Animal experimentation is necessary to characterize human diseases and design adequate therapeutic interventions. In renal transplantation research, the limited number of in vitro models involves a crucial role for in vivo models and particularly for the porcine model. Pig and human kidneys are anatomically similar (characterized by multilobular structure in contrast to rodent and dog kidneys unilobular). The human proximity of porcine physiology and immune systems provides a basic knowledge of graft recovery and inflammatory physiopathology through in vivo studies. In addition, pig large body size allows surgical procedures similar to humans, repeated collections of peripheral blood or renal biopsies making pigs ideal for medical training and for the assessment of preclinical technologies. However, its size is also its main drawback implying expensive housing. Nevertheless, pig models are relevant alternatives to primate models, offering promising perspectives with developments of transgenic modulation and marginal donor models facilitating data extrapolation to human conditions. PMID:21403881

  15. Renal biopsy frozen section: a fluorescent study of hematoxylin and eosin-stained sections.

    PubMed

    Bonsib, S M; Reznicek, M J

    1990-03-01

    When frozen sections of kidney are stained with hematoxylin and eosin (H&E) and viewed by standard fluorescence microscopy, crisp detail of nephron and vascular basement membranes is revealed. We studied by H&E fluorescence, control kidneys, and 85 renal biopsies which span a broad range of renal disease. We found that H&E fluorescence provides useful initial orientation by revealing the presence of cortex or medulla and number of glomeruli and vessels. It also reveals major structural alterations of nephron and vascular basement membranes (sclerosis, disruption, atrophy) and heavy deposition of abnormal material (fibrin, immune deposits, paraprotein). When coupled with direct immunofluorescence, a much greater understanding of the disease process is possible, prior to review of permanent sections. PMID:1691496

  16. Solvent effect in vitro of Anticolana Valley water on renal stones: analytical-instrumental study.

    PubMed

    De Angelis Curtis, S; Curini, R; Fraioli, A; Petronio, B M; Ricciuti, G; D'Ascenzo, G

    1999-01-01

    The presence of humic and fulvic acids in the Anticolana Valley (Fiuggi) water has been established. On the basis of this evidence we investigated the capacity of Anticolana Valley (Fiuggi) water to dissolve renal calculi in vitro. Crystals of calcium oxalate monohydrate to simulate a kidney stone were prepared. Human renal stones of calcium oxalate monohydrate were obtained by courtesy of the Division of Urology of 'La Sapienza' University (Rome), the Division of Urology of the University of Havana (Cuba) and the ASTIF of Fiuggi. The study was performed using the Anticolana Valley (Fiuggi) water, distilled water and tap water (ACEA, Rome), in a specially designed Perspex apparatus. Each calculus was subjected to a water flow of 2 liters/24 h. The capacity of the Anticolana Valley (Fiuggi) water to dissolve human and synthetic calculi was found to be much higher than that of distilled water which in turn was significantly more effective than tap (ACEA) water. PMID:9873221

  17. Prognostic factors of overall survival in renal cancer patients single oncological center study

    PubMed Central

    Sandheim, Marek; Jakubowski, Jacek; Juszczak, Kajetan; Stelmach, Andrzej Wojciech

    2013-01-01

    Introduction The clinical course of renal cancer remains difficult to predict. Attempts to appoint new independent prognostic factors (IPFs) and comparisons of already identified ones among populations are inevitable to develop more effective prognostic instruments. The aim of this study was to evaluate IPFs of overall survival in a given population of patients with renal cancer. Materials and methods Retrospective analysis of 148 patients with renal cancer treated at the Oncological Institute in Cracow from 2000 to 2007 was performed. Mean followup was 51 months. Using the lograng test, a group of clinicopathological and biochemical features was analyzed in respect to their influence on overall survival. Results were presented as KaplanMeier curves. Final identification of IPFs was made by multivariate Cox regression analysis. Results Overall survival rate at 1, 2, and 5year followup was 58.8%, 38.2%, and 21.4%, respectively. The set of identified IPFs consisted of performance status, smoking history, hemoglobin concentration, anatomical staging, tumor grade, and the presence of microvascular invasion. It was confirmed that only nephrectomy increases significantly overall survival. Conclusions Apart from smoking history, the role of all other IPFs identified in our study is well documented in the literature. Smoking history seems to be a new IPF with strong negative impact on survival in patients with RCC. PMID:24707365

  18. Pregnancy and risk of renal cell cancer: a population-based study in Sweden.

    PubMed

    Lambe, Mats; Lindblad, P; Wuu, J; Remler, R; Hsieh, C-c

    2002-05-01

    Epidemiological findings indicate that hormonal influences may play a role in the etiology of renal cell cancer (RCC). The possible effect of childbearing remains enigmatic; while some investigators have reported a positive association between number of births and renal cell cancer risk, others have not. A case-control study, nested within a nation-wide Fertility Register covering Swedish women born 1925 and later, was undertaken to explore possible associations between parity and age at first birth and the risk of renal cell cancer. Among these women a total of 1465 cases of RCC were identified in the Swedish Cancer Register between 1958 and 1992 and information on the number of live childbirths and age at each birth was obtained by linkage to the Fertility Database. For each case, five age-matched controls were randomly selected from the same register. Compared to nulliparous women, ever-parous women were at a 40% increased risk of RCC (Odds Ratio [OR]=1.42; 95% CI 1.19-1.69). The corresponding OR for women of high parity (five or more live births) was 1.91 (95% CI 1.40-2.62). After controlling for age at first birth among parous women, each additional birth was associated with a 15% increase in risk (OR=1.15; 95% CI 1.08-1.22). The observed positive association between parity and renal cell cancer risk is unlikely to be fully explained by uncontrolled confounding, but warrants further evaluation in large studies, with allowance for body mass index. PMID:11986775

  19. Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones

    PubMed Central

    Haggag, Yasser M.; Morsy, Gamal; Badr, Magdy M.; Al Emam, Abdel Baset A.; Farid, Mourad; Etafy, Mohamed

    2013-01-01

    Background The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL). Methods: This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm2 or greater were included. Group 1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed. Results: There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 12.25 [range: 52.7577.25] vs. 180 20.74 [range: 159.26200.74] mL, p ? 0001), mean hospital stay (2.3 0.64 [range: 1.662.94] vs. 3.7 1.4 [range: 2.35.1] days, p ? 0.006), rate of postoperative blood transfusion (0% vs. 4.8%, p ? 0.0024), and stone-free rate (80% vs. 78.6%, p ? 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 22.11 [range: 108.89153.11) vs. 51.19 24.39 [range: 26.875.58] min, p ? 0001), respectively. Conclusion: Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones. PMID:23589752

  20. Minimally invasive renal autotransplantation.

    PubMed

    Sood, Akshay; Jeong, Wooju; Ahlawat, Rajesh; Abdollah, Firas; Sammon, Jesse D; Bhandari, Mahendra; Menon, Mani

    2015-12-01

    Minimally invasive renal allotransplantation techniques have been recently described; reported benefits include reduced morbidity/complications. These benefits have been successfully adapted for minimally invasive renal autotransplantation, however, in a non-oncological setting. We, here, describe a novel alternative robot-assisted renal autotransplantation technique, utilizing GelPOINT, which by permitting ex vivo graft examination and surgery might allow further broadening of indications for minimally-invasive renal autotransplantation, to include complex oncological renal/ureteral lesions. Future studies are needed to evaluate the utility of these techniques. J. Surg. Oncol. 2015;112:717-722. 2015 Wiley Periodicals, Inc. PMID:25995142

  1. Is renal tissue oxygen desaturation during severe hypoxia underestimated? An observational study in term newborn piglets.

    PubMed

    Pichler, Gerhard; Cheung, Po-Yin; Tze-Fun, Lee; Li, Elliott S; Schmlzer, Georg M

    2015-02-01

    The kidney is an organ highly susceptible to injury by regional tissue oxygen desaturation during hypoxic episodes. Transcutaneous monitoring of renal tissue oxygen saturation is therefore of increasing interest. The aim of the present study was to compare renal tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) during acute hypoxia in neonates directly on the kidney and transcutaneously. We hypothesized that transcutaneous renal tissue oxygen saturation measurements would be influenced by superficial tissue. Five term newborn piglets were anesthetized, instrumented and exposed to normocapnic hypoxia at an inspired oxygen concentration of 0.14. Regional tissue oxygen saturation (rSO?) was simultaneously measured for comparison with the sensor of NIRS (Invos 5100, Somanetics Corp., Troy, MI, USA) applied directly on the left kidney (renaldirect rSO?) and on the skin of right flank above the right kidney (renalskin rSO?). Cerebral regional tissue oxygenation (cerebralskin rSO?), arterial oxygen saturation, heart rate (HR) and mean arterial pressure (MAP) were also monitored. NIRS parameters were analyzed in 5?s intervals during first 2?min of hypoxia. Hypoxia was achieved with an arterial oxygen desaturation from median (range) 95.3% (86.8-98.0) to 23.5% (13.0-41.0) after 2?min. HR and MAP did not change significantly during hypoxia. There were pronounced and lower renaldirect rSO? readings when compared with those of renalskin rSO? with significant differences from 25 to 55?s after initiation of hypoxia. Changes of cerebralskin rSO? and renalskin rSO? were similar. Transcutaneous monitoring of renal tissue oxygen saturation may underestimate acute oxygen desaturation of the kidney during hypoxia in neonates. PMID:25619650

  2. Progress in gene targeting: using mutant mice to study renal function and disease.

    PubMed

    Kohan, Donald E

    2008-08-01

    Genetic engineering in mice has provided much information about gene function in renal health and disease. This knowledge has largely come from conventional transgenic approaches. Recently, methods have been developed to control the cell type, timing and reversibility of target gene expression. Advances in identifying promoters conferring renal cell-specific gene regulation in vivo have greatly facilitated interpretation of gene targeting studies. Site-specific recombinases have permitted cell-specific knockout of genes; Cre is the preeminent recombinase, but recent progress with other recombinases, include Flp and PhiC31, will likely increase the usefulness of this class of enzymes. Temporally regulated gene expression, particularly using doxycycline- and tamoxifen-inducible systems, holds great promise for avoiding developmental effects of gene mutations as well as facilitating comparison of the same animal's phenotype before and after gene modification. RNA interference is undergoing tremendous growth and has great potential for achieving gene knockdown quickly and reversibly. To date, however, the utility of these systems in modifying renal function in transgenic mice remains unproven. Finally, new gene targeting tools are in development that may substantially simplify generation of transgenic animals. This review discusses the state-of-the-art in gene targeting in the kidney, reviewing function, indications and limitations of the molecular biologic tools. PMID:18418351

  3. Establishing an Association between Renal Failure and Periodontal Health: A Cross Sectional Study

    PubMed Central

    Chhokra, Mehak; Manocha, Srishti; Dodwad, Vidya; Gupta, Udayan; Vaish, Shubhra

    2013-01-01

    Periodontal infections can act as focus of infection, aggravating the immunocompromised state of End Stage Renal Disease patients (ESRD). Aim: Evaluation of the periodontal health status of ESRD patients undergoing haemodialysis and establishing the underlying association between renal failure and periodontal disease. Material and Methods: Eighty control and test subjects were included in the study, after matching age and sex. Creatinine and GFR were measured in each patient. Oral hygiene index- Simplified (OHI-S), Gingival Index (GI), Pocket Depth (PD) and Clinical Attachment Level (CAL) were recorded as periodontal parameters to assess the correlation between the subjects of the two groups. Further, the test group was divided into three subgroups, on basis of duration, as less than 6 months, from 6 months to one year and more than one year. Statistical Analysis: Students t test and ANOVA were used to analyze the intergroup and intragroup comparisons. Results: Statistical significant difference was observed for all periodontal parameters between the test and control group. However, difference amongst periodontal parameters on basis of duration of haemodialysis was seen between the subgroups of test subjects, it was not found to be statistically significant. Conclusion: Severity of periodontal diseases in ESRD patients undergoing haemodialysis majorly affected due to debilitating condition of the subjects. Dialysis vintage has only a small role to play in worsening of the condition. Further research is needed to potentiate the establishment of twoway relationship between renal disease and periodontal condition. PMID:24298526

  4. Case-control study of hydrocarbon exposures in patients with renal cell carcinoma.

    PubMed Central

    Sharpe, C R; Rochon, J E; Adam, J M; Suissa, S

    1989-01-01

    A retrospective case-control study tested the hypothesis that exposure to hydrocarbon combustion products is associated with the development of renal cell carcinoma. One control per case, matched for sex, date of birth (within 5 years) and urologist, was chosen. Controls were patients who presented with hematuria and were shown not to have a urinary tract tumour. A total of 164 cases and 161 controls responded to mailed questionnaires and telephone interviews. Smoking more than 20 cigarettes per day was associated with the presence of metastatic renal cell carcinoma (p less than 0.001). Exposure to burning coal was associated with an increased relative risk of the disease but only when the exposure occurred between the ages of 10 and 24 years (p less than 0.05). Dose-response relations were demonstrated for intensity of exposure (p less than 0.025) and duration of occupational exposure (p less than 0.05). The distribution of latent periods from first exposure to diagnosis was bimodal, with one mode at 21 to 30 years and another at 41 to 50 years. Occupational exposure to tar or pitch or both was also associated with an increased relative risk of renal cell carcinoma (p less than 0.05). PMID:2720514

  5. Prospective study of BKV nephropathy in 117 renal transplant recipients.

    PubMed

    Giraldi, Cristina; Noto, Alessandra; Tenuta, Robert; Greco, Francesca; Perugini, Daniela; Dodaro, Saveria; Spadafora, Mario; Lo Bianco, Anna Maria; Savino, Olga; Papalia, Teresa; Greco, Rosita; Bonofiglio, Renzo

    2007-04-01

    Nephropathy caused by poliomavirus (BKVAN) in transplant recipients is responsible for the loss of the transplanted organ. In this study we suggest a non-invasive diagnostic protocol for the early identification of BKVAN during follow-up treatments. In 117 kidney transplant recipients follow-up was performed every three months during a two year period after transplantation and a positive screening result was confirmed and assessed by quantitative assays (BKV DNA load in plasma and urine). The definitive diagnosis of BKV requires allograft biopsy. Of the 117 patients 4 had BKVAN (3.4%), and the consequential reduction of immunosuppression improved kidney function and plasma clearance of the virus was achieved. PMID:17619256

  6. Pharmacokinetics of serelaxin in patients with severe renal impairment or end-stage renal disease requiring hemodialysis: A single-dose, open-label, parallel-group study.

    PubMed

    Dahlke, Marion; Halabi, Atef; Canadi, Jasna; Tsubouchi, Chiaki; Machineni, Surendra; Pang, Yinuo

    2016-04-01

    Serelaxin, a recombinant human relaxin-2 hormone, is in clinical development for treating acute heart failure. This open-label, parallel-group study investigated serelaxin pharmacokinetics (PK) after a single 4-hour intravenous infusion (10 µg/kg) in patients with severe renal impairment (n = 6) or end-stage renal disease (ESRD) requiring hemodialysis (PK on the day of dialysis [n = 6] or during dialysis-free interval [n = 6]), compared with matched healthy subjects (n = 18). In all participants, serum serelaxin concentration peaked at the end of infusion and subsequently declined with mean terminal elimination half-life of 6.5-8.8 hours. Compared with healthy subjects, a moderate decrease in serelaxin systemic clearance (37%-52%) and increase in its exposure (30%-115%) were observed in all patients. During the 4-hour hemodialysis in ESRD patients, 30% serelaxin was removed, with hemodialysis clearance constituting approximately 52% of total systemic clearance. Serelaxin was well tolerated with no deaths, serious adverse events (AE), or AE-related discontinuations. Antiserelaxin antibodies were not detected in any participant. Given the shallow dose-response relationship observed with serelaxin in clinical studies and its wide therapeutic window, the observed PK differences in patients with severe renal impairment compared with healthy subjects are unlikely to pose a safety risk and do not warrant a predefined dosage adjustment in such patients. PMID:26239266

  7. Lower Incidence of End-Stage Renal Disease but Suboptimal Pre-Dialysis Renal Care in Schizophrenia: A 14-Year Nationwide Cohort Study

    PubMed Central

    Ouyang, Wen-Chen; Lin, Chen-Li; Huang, Chi-Ting; Hsu, Chih-Cheng

    2015-01-01

    Schizophrenia is closely associated with cardiovascular risk factors which are consequently attributable to the development of chronic kidney disease and end-stage renal disease (ESRD). However, no study has been conducted to examine ESRD-related epidemiology and quality of care before starting dialysis for patients with schizophrenia. By using nationwide health insurance databases, we identified 54,361 ESRD-free patients with schizophrenia and their age-/gender-matched subjects without schizophrenia for this retrospective cohort study (the schizophrenia cohort). We also identified a cohort of 1,244 adult dialysis patients with and without schizophrenia (1:3) to compare quality of renal care before dialysis and outcomes (the dialysis cohort). Cox proportional hazard models were used to estimate the hazard ratio (HR) for dialysis and death. Odds ratio (OR) derived from logistic regression models were used to delineate quality of pre-dialysis renal care. Compared to general population, patients with schizophrenia were less likely to develop ESRD (HR = 0.6; 95% CI 0.40.8), but had a higher risk for death (HR = 1.2; 95% CI, 1.11.3). Patients with schizophrenia at the pre-ESRD stage received suboptimal pre-dialysis renal care; for example, they were less likely to visit nephrologists (OR = 0.6; 95% CI, 0.40.8) and received fewer erythropoietin prescriptions (OR = 0.7; 95% CI, 0.60.9). But they had a higher risk of hospitalization in the first year after starting dialysis (OR = 1.4; 95% CI, 1.01.8, P < .05). Patients with schizophrenia undertaking dialysis had higher risk for mortality than the general ESRD patients. A closer collaboration between psychiatrists and nephrologists or internists to minimize the gaps in quality of general care is recommended. PMID:26469976

  8. Lower Incidence of End-Stage Renal Disease but Suboptimal Pre-Dialysis Renal Care in Schizophrenia: A 14-Year Nationwide Cohort Study.

    PubMed

    Hsu, Yueh-Han; Cheng, Jur-Shan; Ouyang, Wen-Chen; Lin, Chen-Li; Huang, Chi-Ting; Hsu, Chih-Cheng

    2015-01-01

    Schizophrenia is closely associated with cardiovascular risk factors which are consequently attributable to the development of chronic kidney disease and end-stage renal disease (ESRD). However, no study has been conducted to examine ESRD-related epidemiology and quality of care before starting dialysis for patients with schizophrenia. By using nationwide health insurance databases, we identified 54,361 ESRD-free patients with schizophrenia and their age-/gender-matched subjects without schizophrenia for this retrospective cohort study (the schizophrenia cohort). We also identified a cohort of 1,244 adult dialysis patients with and without schizophrenia (1:3) to compare quality of renal care before dialysis and outcomes (the dialysis cohort). Cox proportional hazard models were used to estimate the hazard ratio (HR) for dialysis and death. Odds ratio (OR) derived from logistic regression models were used to delineate quality of pre-dialysis renal care. Compared to general population, patients with schizophrenia were less likely to develop ESRD (HR = 0.6; 95% CI 0.4-0.8), but had a higher risk for death (HR = 1.2; 95% CI, 1.1-1.3). Patients with schizophrenia at the pre-ESRD stage received suboptimal pre-dialysis renal care; for example, they were less likely to visit nephrologists (OR = 0.6; 95% CI, 0.4-0.8) and received fewer erythropoietin prescriptions (OR = 0.7; 95% CI, 0.6-0.9). But they had a higher risk of hospitalization in the first year after starting dialysis (OR = 1.4; 95% CI, 1.0-1.8, P < .05). Patients with schizophrenia undertaking dialysis had higher risk for mortality than the general ESRD patients. A closer collaboration between psychiatrists and nephrologists or internists to minimize the gaps in quality of general care is recommended. PMID:26469976

  9. Monoanion inhibition and 35Cl nuclear magnetic resonance studies of renal dipeptidase.

    PubMed

    Ferren, L G; Ward, R L; Campbell, B J

    1975-12-01

    Kinetic analyses of monoanion inhibition and 15Cl nuclear magnetic resonance at 5.88 MHz were employed to study monoanion interactions with the zinc metalloenzyme, renal dipeptidase. The enzyme-catalyzed hydrolysis of glycyldehydrophenylalanine exhibited competitive inhibition when the reaction rate was determined in the presence of the monovalent anions fluoride, chloride, bromide, iodide, azide, nitrate, or thiocyanate or upon the addition of the divalent anion, sulfate. Competitive inhibition was produced by these anions. One anion was bound per enzyme molecule, and except in the case of fluoride all of the anions appeared to bind at the same site. Cyanide ion produced a much more effective inhibition of renal dipeptidase than the other monoanions, and it was shown that two cyanide ions were bound per enzyme molecule. An investigation of the effect of pH upon monoanion inhibition suggested that the anion inhibitors bind to the group with a pK of approximately 7.8. Complete dissociation of this group (approximately pH 8.4) eliminates the inhibitory effect of anions. The 35Cl line broadening produced by renal dipeptidase in 0.5 M NaCl solutions was 100 times more effective than that produced by equivalent concentrations of aquozinc(II). The line broadening was dependent upon the concentration of the metalloenzyme and independent of the frequency of the exciting radiation. When zinc ion was removed from the metalloenzyme by dialysis or when chloride was titrated from the metalloenzyme by cyanide, line broadening was decreased. Treatment of renal dipeptidase with saturating concentrations of the competitive inhibitor, guanosine triphosphate, in the presence of 0.5 M NaCl also produced a significant decrease in the 35Cl line width. The 35Cl line broadening produced by renal dipeptidase was shown to decrease with increasing pH through the range pH 5.8-10.8. This line-width variation with pH appeared to result from the titration of a site on the metalloprotein with an approximate pK of 7.4. Temperature studies of 35Cl line broadening by the metalloenzyme in the presence of chloride and cyanide inhibitors suggest that the fast exchange process pertains and that the dominant relaxation mechanism is quadrupolar in nature. PMID:48

  10. Intakes of coffee, tea, milk, soda and juice and renal cell cancer in a pooled analysis of 13 prospective studies.

    PubMed

    Lee, Jung Eun; Hunter, David J; Spiegelman, Donna; Adami, Hans-Olov; Bernstein, Leslie; van den Brandt, Piet A; Buring, Julie E; Cho, Eunyoung; English, Dallas; Folsom, Aaron R; Freudenheim, Jo L; Gile, Graham G; Giovannucci, Edward; Horn-Ross, Pamela L; Leitzmann, Michael; Marshall, James R; Mnnist, Satu; McCullough, Marjorie L; Miller, Anthony B; Parker, Alexander S; Pietinen, Pirjo; Rodriguez, Carmen; Rohan, Thomas E; Schatzkin, Arthur; Schouten, Leo J; Willett, Walter C; Wolk, Alicja; Zhang, Shumin M; Smith-Warner, Stephanie A

    2007-11-15

    Specific beverage intake may be associated with the risk of renal cell cancer through a diluting effect of carcinogens, alterations of hormone levels, or other changes in the renal tubular environment, but few prospective studies have examined these associations. We evaluated the associations between coffee, tea, milk, soda and fruit and vegetable juice intakes and renal cell cancer risk in a pooled analysis of 13 prospective studies (530,469 women and 244,483 men). Participants completed a validated food-frequency questionnaire at baseline. Using the primary data, the study-specific relative risks (RRs) were calculated and then pooled using a random effects model. A total of 1,478 incident renal cell cancer cases were identified during a follow-up of 7-20 years across studies. Coffee consumption was associated with a modestly lower risk of renal cell cancer (pooled multivariate RR for 3 or more 8 oz (237 ml) cups/day versus less than one 8 oz (237 ml) cup/day = 0.84; 95% CI = 0.67-1.05; p value, test for trend = 0.22). Tea consumption was also inversely associated with renal cell cancer risk (pooled multivariate RR for 1 or more 8 oz (237 ml) cups/day versus nondrinkers = 0.85; 95% CI = 0.71-1.02; pvalue, test for trend = 0.04). No clear associations were observed for milk, soda or juice. Our findings provide strong evidence that neither coffee nor tea consumption increases renal cell cancer risk. Instead, greater consumption of coffee and tea may be associated with a lower risk of renal cell cancer. (c) 2007 Wiley-Liss, Inc. PMID:17583573

  11. Retinopathy and Chronic Kidney Disease in the Chronic Renal Insufficiency Cohort Study (CRIC)

    PubMed Central

    Grunwald, Juan E.; Alexander, Judith; Ying, Gui-Shuang; Maguire, Maureen; Daniel, Ebenezer; Whittock-Martin, Revell; Parker, Candace; McWilliams, Kathleen; Lo, Joan C.; Go, Alan; Townsend, Raymond; Gadegbeku, Crystal A.; Lash, James P.; Fink, Jeffrey C.; Rahman, Mahboob; Feldman, Harold; Kusek, John W.; Xie, Dawei; Jaar, Bernard G.

    2013-01-01

    Objectives Retinal vascular and anatomic abnormalities caused by diabetes, hypertension, and other conditions can be observed directly in the ocular fundus and may reflect severity of chronic renal insufficiency. The purpose of this study was to investigate the association between retinopathy and chronic kidney disease (CKD). Methods In this observational, cross-sectional study, 2605 participants of the Chronic Renal Insufficiency Cohort (CRIC) study, a multi-center study of CKD, were offered participation. Non-mydriatic fundus photographs of the disc and macula in both eyes were obtained in 1936 of these subjects. Photographs were reviewed in a masked fashion at a central photograph reading center using standard protocols. Presence and severity of retinopathy (diabetic, hypertensive or other) and vessel diameter caliber were assessed by trained graders and a retinal specialist using protocols developed for large epidemiologic studies. Kidney function measurements and information on traditional and non-traditional risk factors for decreased kidney function were obtained from the CRIC study. Results Greater severity of retinopathy was associated with lower estimated glomerular filtration rate (eGFR) after adjustment for traditional and non-traditional risk factors. Presence of vascular abnormalities usually associated with hypertension was also associated with lower eGFR. We found no strong direct relationship between eGFR and average arteriolar or venular calibers. Conclusions Our findings show a strong association between severity of retinopathy and its features and level of kidney function after adjustment for traditional and non-traditional risk factors for CKD, suggesting that retinovascular pathology reflects renal disease. PMID:22965589

  12. Renal function improvement in liver transplant recipients after early everolimus conversion: A clinical practice cohort study in Spain.

    PubMed

    Bilbao, Itxarone; Salcedo, Magdalena; Gómez, Miguel Angel; Jimenez, Carlos; Castroagudín, Javier; Fabregat, Joan; Almohalla, Carolina; Herrero, Ignacio; Cuervas-Mons, Valentín; Otero, Alejandra; Rubín, Angel; Miras, Manuel; Rodrigo, Juan; Serrano, Trinidad; Crespo, Gonzalo; De la Mata, Manuel; Bustamante, Javier; Gonzalez-Dieguez, M Luisa; Moreno, Antonia; Narvaez, Isidoro; Guilera, Magda

    2015-08-01

    A national, multicenter, retrospective study was conducted to assess the results obtained for liver transplant recipients with conversion to everolimus in daily practice. The study included 477 recipients (481 transplantations). Indications for conversion to everolimus were renal dysfunction (32.6% of cases), hepatocellular carcinoma (HCC; 30.2%; prophylactic treatment for 68.9%), and de novo malignancy (29.7%). The median time from transplantation to conversion to everolimus was 68.7 months for de novo malignancy, 23.8 months for renal dysfunction, and 7.1 months for HCC and other indications. During the first year of treatment, mean everolimus trough levels were 5.4 (standard deviation [SD], 2.7) ng/mL and doses remained stable (1.5 mg/day) from the first month after conversion. An everolimus monotherapy regimen was followed by 28.5% of patients at 12 months. Patients with renal dysfunction showed a glomerular filtration rate (4-variable Modification of Diet in Renal Disease) increase of 10.9 mL (baseline mean, 45.8 [SD, 25.3] versus 57.6 [SD, 27.6] mL/minute/1.73 m(2) ) at 3 months after everolimus initiation (P < 0.001), and 6.8 mL at 12 months. Improvement in renal function was higher in patients with early conversion (<1 year). Adverse events were the primary reason for discontinuation in 11.2% of cases. The probability of survival at 3 years after conversion to everolimus was 83.0%, 71.1%, and 59.5% for the renal dysfunction, de novo malignancy, and HCC groups, respectively. Everolimus is a viable option for the treatment of renal dysfunction, and earlier conversion is associated with better recovery of renal function. Prospective studies are needed to confirm advantages in patients with malignancy. PMID:25990257

  13. pH-responsive, gluconeogenic renal epithelial LLC-PK1-FBPase+cells: a versatile in vitro model to study renal proximal tubule metabolism and function

    PubMed Central

    Curthoys, Norman P.

    2014-01-01

    Ammoniagenesis and gluconeogenesis are prominent metabolic features of the renal proximal convoluted tubule that contribute to maintenance of systemic acid-base homeostasis. Molecular analysis of the mechanisms that mediate the coordinate regulation of the two pathways required development of a cell line that recapitulates these features in vitro. By adapting porcine renal epithelial LLC-PK1 cells to essentially glucose-free medium, a gluconeogenic subline, termed LLC-PK1-FBPase+ cells, was isolated. LLC-PK1-FBPase+ cells grow in the absence of hexoses and pentoses and exhibit enhanced oxidative metabolism and increased levels of phosphate-dependent glutaminase. The cells also express significant levels of the key gluconeogenic enzymes, fructose-1,6-bisphosphatase (FBPase) and phosphoenolpyruvate carboxykinase (PEPCK). Thus the altered phenotype of LLC-PK1-FBPase+ cells is pleiotropic. Most importantly, when transferred to medium that mimics a pronounced metabolic acidosis (9 mM HCO3−, pH 6.9), the LLC-PK1-FBPase+ cells exhibit a gradual increase in NH4+ ion production, accompanied by increases in glutaminase and cytosolic PEPCK mRNA levels and proteins. Therefore, the LLC-PK1-FBPase+ cells retained in culture many of the metabolic pathways and pH-responsive adaptations characteristic of renal proximal tubules. The molecular mechanisms that mediate enhanced expression of the glutaminase and PEPCK in LLC-PK1-FBPase+ cells have been extensively reviewed. The present review describes novel properties of this unique cell line and summarizes the molecular mechanisms that have been defined more recently using LLC-PK1-FBPase+ cells to model the renal proximal tubule. It also identifies future studies that could be performed using these cells. PMID:24808535

  14. Biodistribution and radioimmunoscintigraphy studies of renal cell carcinoma using tumor-preferential monoclonal antibodies and F(ab')2 fragments

    SciTech Connect

    Chiou, R.K. )

    1989-12-01

    The in vivo localization of renal cell carcinoma-preferential monoclonal antibodies A6H, D5D, and C5H was evaluated and the biodistribution of F(ab')2 antibody fragments of A6H and the intact Mab were compared in over 100 nude mice. A6H localized well to most renal cell carcinoma xenografts studied; the median tumor to blood ratios ranged from 6.4 to 11.5 for various xenografts. C5H also localized well to most renal cell carcinoma xenografts tested. However, D5D did not localize well to renal cell carcinoma xenografts in vivo despite its highly restrictive in vitro reactivity. The F(ab')2 fragments of A6H produced higher tumor to blood ratios, which probably resulted from fast clearance of the fragments from the circulation. Preliminary results showed that indium-111 labeling may further improve imaging.

  15. Waist Circumference, Not Body Mass Index, Is Associated with Renal Function Decline in Korean Population: Hallym Aging Study

    PubMed Central

    Oh, Hyunju; Quan, Shan Ai; Jeong, Jin-Young; Jang, Soong-Nang; Lee, Jung Eun; Kim, Dong-Hyun

    2013-01-01

    Background Prospective investigation of obesity and renal function decline in Asia is sparse. We examined the associations of body mass index (BMI) and waist circumference (WC) with renal function decline in a prospective study of Korean population. Methods A total of 454 participants who had baseline estimated glomerular filtration rate (eGFR) levels of more than 60 mL/min/1.73 m2 in Hallym Aging Study (HAS) were included and followed for 6 years. Renal function decline was defined as follows: (1) an eGFR decline ?3 mL/min/1.73 m2/year (n?=?82 cases); (2) an eGFR decrease of 20% or greater (n?=?87 cases) at follow-up; (3) an eGFR decrease of 20% greater at follow-up or eGFR decline ?3 mL/min/1.73 m2/year (n?=?91 cases); and (4) an eGFR <60 mL/min/1.73 m2 at follow-up (n?=?54 cases). eGFR was determined based on the Modification of Diet in Renal Disease (MDRD) Study equation. Multivariate logistic regression model was used to determine the association between obesity and renal function decline. Results We found that central obesity was associated with faster renal function decline. Comparing WC of >95 cm in men or >90 cm in women with ?90 cm in men or ?85 cm in women, ORs (95% CIs) ranged from 2.31 (1.144.69) to 2.78 (1.196.50) for the 4 definitions of renal function decline (all p-values for trend <0.05). Waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) also was associated with renal function decline. There was no significant association of BMI with renal function decline. Conclusions Central obesity, but not BMI, is associated with faster renal function decline in Korean population. Our results provide important evidence that simple measurement of central fat deposition rather than BMI could predict decline in renal function in Korean population. PMID:23536858

  16. Active video gaming in patients with renal transplant: a pilot study

    PubMed Central

    2014-01-01

    Background Patients with renal transplant are at higher risk of mortality from cardiovascular disease (CVD) compared with the general population. Physical activity has been shown to reduce the risk of CVD mortality in these patients. Unfortunately, barriers such as the harsh Canadian climate prevent patients from engaging in and harvesting the health benefits of physical activity. This pilot study explored active video gaming (AVG) as a way for patients with renal transplant to obtain physical activity and examined its effect on their functional status and quality of life (QOL). Main text We recruited nine patients for an 8-week prospective pilot study. All patients received a Microsoft Xbox 360 video gaming console, a Microsoft Kinect sensor, and the video game Your Shape Fitness Evolved 2012. Assessment of each participant before and after the intervention included blood pressure measures, a 6-minute walk test, and the Godin Leisure Time Questionnaire (GLTQ). We analyzed all nine patients at the end of the 8-week study period, and found no changes in blood pressure or GLTQ scores. However, there was a significant increase in the 6-minute walk distance (P?=?0.022), which represented a consistent increase for most patients (correlation?=?0.977). In addition, participants over the age of 45years (n?=?4) were more likely to use the AVG system (P?=?0.042). Conclusion AVG has the potential to improve the functional status in patients with renal transplant. Further research is required to corroborate the full health benefits of AVG in this patient population. PMID:25114788

  17. Effect of renal impairment on the pharmacokinetics of prucalopride: a single- dose open-label Phase I study

    PubMed Central

    Smith, William B; Mannaert, Erik; Verhaeghe, Tom; Kerstens, Ren; Vandeplassche, Lieve; Van de Velde, Vera

    2012-01-01

    Objective To evaluate the pharmacokinetics of prucalopride in individuals with renal impairment (RI). Methods This open-label Phase I study (ClinicalTrials.gov identifier: NCT01674192) enrolled men and women aged 1875 years who were classified by renal function: normal renal function (creatinine clearance ? 80 mL/min/1.73 m2), mild RI (5079 mL/min/1.73 m2), moderate RI (2549 mL/min/1.73 m2), and severe RI (?24 mL/min/1.73 m2). All received a single oral dose of prucalopride 2 mg. Results Thirty-four individuals (normal renal function: 10; mild RI: 8; moderate RI: 7; severe RI: 9) received prucalopride. In all groups, maximum plasma concentration was reached within 24 hours. There was no significant difference in exposure (area under the plasma concentrationtime curve from time zero to infinity) between participants with mild RI and those with normal renal function. However, area under the plasma concentrationtime curve from time zero to infinity values were 1.5- and 2.3-fold higher (P = 0.002 and P < 0.001) in patients with moderate RI and severe RI, respectively, than in those with normal renal function. The proportion of total body clearance accounted for by renal clearance was significantly reduced in those with RI. Conclusion Clinically meaningful reductions in renal clearance were seen in participants with severe RI, which supports a decrease from the standard dose of prucalopride 2 mg daily to 1 mg daily in these individuals. PMID:23269861

  18. Functional MRI of the kidney: tools for translational studies of pathophysiology of renal disease

    PubMed Central

    Prasad, Pottumarthi V.

    2010-01-01

    Magnetic resonance imaging (MRI) provides exquisite anatomic detail of various organs and is capable of providing additional functional information. This combination allows for comprehensive diagnostic evaluation of pathologies such as ischemic renal disease. Noninvasive MRI techniques could facilitate translation of many studies performed in controlled animal models using technologies that are invasive to humans. Such a translation is being recognized as essential because many proposed interventions and drugs that prove efficacious in animal models fail to do so in humans. In this article, we review the state-of-the-art functional MRI technique as applied to the kidneys. PMID:16601297

  19. Meat intake, 'mate' drinking and renal cell cancer in Uruguay: a case-control study.

    PubMed Central

    De Stefani, E.; Fierro, L.; Mendilaharsu, M.; Ronco, A.; Larrinaga, M. T.; Balbi, J. C.; Alonso, S.; Deneo-Pellegrini, H.

    1998-01-01

    In the period January 1988-December 1995, a case-control study of diet and renal cell carcinoma (RCC) risk involving 121 cases and 243 hospitalized controls was carried out in Montevideo, Uruguay. After adjusting for major covariates, red meat intake was associated with a 3.4 increase in risk for the highest category of intake, with a significant dose-response pattern. Also, barbecued meat, protein and heterocyclic amine intakes were associated with significant increases in risk of RCC. The consumption of the beverage known as 'mate' (a ocal tea derived from the herb Ilex paraguariensis) was associated with an increased risk of 3.0 for heavy drinkers. PMID:9820187

  20. Genomics of chromophobe renal cell carcinoma: implications from a rare tumor for pan-cancer studies

    PubMed Central

    Rathmell, Kimryn W.; Chen, Fengju; Creighton, Chad J.

    2015-01-01

    Chromophobe Renal Cell Carcinoma (ChRCC) is a rare subtype of the renal cell carcinomas, a heterogenous group of cancers arising from the nephron. Recently, The Cancer Genome Atlas (TCGA) profiled this understudied disease using multiple data platforms, including whole exome sequencing, whole genome sequencing (WGS), and mitochondrial DNA (mtDNA) sequencing. The insights gained from this study would have implications for other types of kidney cancer as well as for cancer biology in general. Global molecular patterns in ChRCC provided clues as to this cancer's cell of origin, which is distinct from that of the other renal cell carcinomas, illustrating an approach that might be applied towards elucidating the cell of origin of other cancer types. MtDNA sequencing revealed loss-of-function mutations in NADH dehydrogenase subunits, highlighting the role of deregulated metabolism in this and other cancers. Analysis of WGS data led to the discovery of recurrent genomic rearrangements involving TERT promoter region, which were associated with very high expression levels of TERT, pointing to a potential mechanism for TERT deregulation that might be found in other cancers. WGS data, generated by large scale efforts such as TCGA and the International Cancer Genomics Consortium (ICGC), could be more extensively mined across various cancer types, to uncover structural variants, mtDNA mutations, themes of tumor metabolic properties, as well as noncoding point mutations. TCGA's data on ChRCC should continue to serve as a resource for future pan-cancer as well as kidney cancer studies, and highlight the value of investigations into rare tumor types to globally inform principals of cancer biology. PMID:25859550

  1. Multicenter Prospective Cohort Study of Renal Failure in Patients Treated with Colistin versus Polymyxin B.

    PubMed

    Rigatto, Maria Helena; Oliveira, Maura S; Perdigão-Neto, Lauro V; Levin, Anna S; Carrilho, Claudia M; Tanita, Marcos Toshiyuki; Tuon, Felipe F; Cardoso, Douglas E; Lopes, Natane T; Falci, Diego R; Zavascki, Alexandre P

    2016-04-01

    Nephrotoxicity is the main adverse effect of colistin and polymyxin B (PMB). It is not clear whether these two antibiotics are associated with different nephrotoxicity rates. We compared the incidences of renal failure (RF) in patients treated with colistimethate sodium (CMS) or PMB for ≥48 h. A multicenter prospective cohort study was performed that included patients aged ≥18 years. The primary outcome was renal failure (RF) according to Risk, Injury, Failure, Loss, and End-stage renal disease (RIFLE) criteria. Multivariate analysis with a Cox regression model was performed. A total of 491 patients were included: 81 in the CMS group and 410 in the PMB group. The mean daily doses in milligrams per kilogram of body weight were 4.2 ± 1.3 and 2.4 ± 0.73 of colistin base activity and PMB, respectively. The overall incidence of RF was 16.9% (83 patients): 38.3% and 12.7% in the CMS and PMB groups, respectively (P< 0.001). In multivariate analysis, CMS therapy was an independent risk factor for RF (hazard ratio, 3.35; 95% confidence interval, 2.05 to 5.48;P< 0.001) along with intensive care unit admission, higher weight, older age, and bloodstream and intraabdominal infections. CMS was also independently associated with a higher risk of RF in various subgroup analyses. The incidence of RF was higher in the CMS group regardless of the patient baseline creatinine clearance. The development of RF during therapy was not associated with 30-day mortality in multivariate analysis. CMS was associated with significantly higher rates of RF than those of PMB. Further studies are required to confirm our findings in other patient populations. PMID:26856846

  2. The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study

    PubMed Central

    Stengel, Bndicte; Combe, Christian; Jacquelinet, Christian; Brianon, Serge; Fouque, Denis; Laville, Maurice; Frimat, Luc; Pascal, Christophe; Herpe, Yves-Edouard; Deleuze, Jean-Franois; Schanstra, Joost; Pisoni, Ron L.; Robinson, Bruce M.; Massy, Ziad A.

    2014-01-01

    Background While much has been learned about the epidemiology and treatment of end-stage renal disease (ESRD) in the last 30 years, chronic kidney disease (CKD) before the end-stage has been less investigated. Not enough is known about factors associated with CKD progression and complications, as well as its transition to ESRD. We designed the CKD-renal epidemiology and information network (REIN) cohort to provide a research platform to address these key questions and to assess clinical practices and costs in patients with moderate or advanced CKD. Methods A total of 46 clinic sites and 4 renal care networks participate in the cohort. A stratified selection of clinic sites yields a sample that represents a diversity of settings, e.g. geographic region, and public versus for-profit and non-for-profit private clinics. In each site, 6090 patients with CKD are enrolled at a routine clinic visit during a 12-month enrolment phase: 3600 total, including 1800 with Stage 3 and 1800 with Stage 4 CKD. Follow-up will continue for 5 years, including after initiation of renal replacement therapy. Data will be collected from medical records at inclusion and at yearly intervals, as well as from self-administered patient questionnaires and provider-level questionnaires. Patients will also be interviewed at baseline, and at 1, 3 and 5 years. Healthcare costs will also be determined. Blood and urine samples will be collected and stored for future studies on all patients at enrolment and at study end, and at 1 and 3 years in a subsample of 1200. Conclusions The CKD-REIN cohort will serve to improve our understanding of the biological, clinical and healthcare system determinants associated with CKD progression and adverse outcomes as well as of international variations in collaboration with the CKD Outcome and Practice Pattern Study (CKDopps). It will foster CKD epidemiology and outcomes research and provide evidence to improve the health and quality of life of patients with CKD and the performances of the healthcare system in this field. PMID:24064325

  3. Graft irradiation in the treatment of acute rejection of renal transplants: a randomized study

    SciTech Connect

    Pilepich, M.V.; Anderson, C.B.; Etheredge, E.E.; Sicard, G.A.; Melzer, J.S.; Blum, J.

    1982-05-01

    A randomized study of graft irradiation in the treatment of acute rejection of renal transplants was conducted from 1978 to 1981. Patients developing clinical signs of an acute graft rejection received customary antirejection treatment in the form of intravenous administration of high-dose (1 gm per day) of methylprednisolone. They were at the same time randomized to either receive therapeutic irradiation (175 rad every other day to a total of 525 rad) or sham irradiation. Neither the patient nor the Transplant Service surgeons knew at any time whether the radiation treatment had been given. Eighty-three rejection episodes occurring in 64 grafts were entered into the study. Acute rejection was reversed in 84.5% of grafts in the control and 75% in the treated group. The incidence of recurrent rejection was higher in the treated group (66 vs. 46%) and graft survival was lower (22% vs. 54%). The study failed to demonstrate a beneficial effect of graft irradiation in the treatment of acute renal allograft rejection, when used in conjunction with high dose steriods.

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

    PubMed

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

    2015-05-01

    Although subjects with chronic kidney disease (CKD) are at markedly increased risk for cardiovascular mortality, the relation between CKD and aortic valve calcification has not been fully elucidated. Also, few data are available on the relation of aortic valve calcification and earlier stages of CKD. We sought to assess the relation of aortic valve calcium (AVC) with estimated glomerular filtration rate (eGFR), traditional and novel cardiovascular risk factors, and markers of bone metabolism in the Chronic Renal Insufficiency Cohort (CRIC) Study. All patients who underwent aortic valve scanning in the CRIC study were included. The relation between AVC and eGFR, traditional and novel cardiovascular risk factors, and markers of calcium metabolism were analyzed using both unadjusted and adjusted regression models. A total of 1,964 CRIC participants underwent computed tomography for AVC quantification. Decreased renal function was independently associated with increased levels of AVC (eGFR 47.11, 44.17, and 39 ml/min/1.73 m2, respectively, p<0.001). This association persisted after adjusting for traditional, but not novel, AVC risk factors. Adjusted regression models identified several traditional and novel risk factors for AVC in patients with CKD. There was a difference in AVC risk factors between black and nonblack patients. In conclusion, our study shows that eGFR is associated in a dose-dependent manner with AVC in patients with CKD, and this association is independent of traditional cardiovascular risk factors. PMID:25791240

  5. Renal cancer.

    PubMed

    Capitanio, Umberto; Montorsi, Francesco

    2016-02-27

    The diagnosis and management of renal cell carcinoma have changed remarkably rapidly. Although the incidence of renal cell carcinoma has been increasing, survival has improved substantially. As incidental diagnosis of small indolent cancers has become more frequent, active surveillance, robot-assisted nephron-sparing surgical techniques, and minimally invasive procedures, such as thermal ablation, have gained popularity. Despite progression in cancer control and survival, locally advanced disease and distant metastases are still diagnosed in a notable proportion of patients. An integrated management strategy that includes surgical debulking and systemic treatment with well established targeted biological drugs has improved the care of patients. Nevertheless, uncertainties, controversies, and research questions remain. Further advances are expected from translational and clinical studies. PMID:26318520

  6. The course and outcome of renal failure due to human leptospirosis referred to a hospital in North of Iran; A follow-up study

    PubMed Central

    Ghasemian, Roya; Shokri, Mehran; Makhlough, Atieh; Suraki-Azad, Mohammad Amin

    2016-01-01

    Background: Renal complication of leptospirosis is common and its clinical manifestations vary from urinary sediment changes to acute renal failure. The aim of this study was to determine the final outcome of renal involvement in leptospirosis. Methods: This longitudinal prospective study included all serologically confirmed cases of leptospirosis with evidence of renal failure. All patients were followed for three months while all patients with renal failure were followed-up for one year. Results: Fifty-one patients, 53.5±14.8 years (82.4% males) with acute renal failure were studied. Over the hospitalization period, 28 patients recovered, and seven (13.72%) patients died of multiple organ failure. At the time of discharge, 16 patients had mild renal failure. Over the follow-up period, all patients recovered but in two patients renal failure persisted at creatinine level of 1.5 mg/dl. Conclusion: Development of renal failure in leptospirosis is not rare. Recovery of renal function may last several months. However, most patients recover completely at least after one year.

  7. Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults.

    PubMed

    Xie, Di; Yuan, Yan; Guo, Jiangnan; Yang, Shenglin; Xu, Xin; Wang, Qin; Li, Youbao; Qin, Xianhui; Tang, Genfu; Huo, Yong; Deng, Guangpu; Wu, Shengjie; Wang, Binyan; Zhang, Qin; Wang, Xiaobin; Fang, Pu; Wang, Hong; Xu, Xiping; Hou, Fanfan

    2015-01-01

    Hyper-homocysteinemia (HHcy) is associated with microalbuminuria and glomerular injury in general and diabetic populations. However, HHcy's role in hypertensive patients was not studied. We investigated whether HHcy is an independent risk factor for renal function decline and development of chronic kidney disease (CKD) in hypertensive men and women. This was a community-based prospective cohort study of 2,387 hypertensive adults without CKD at baseline, with a mean follow-up of 4.4 years. Baseline and follow-up levels of plasma Hcy, folate, vitamin B12, blood pressure and other pertinent covariables were obtained. CKD was defined as an estimated glomerular filtration rate (eGFR) <60?ml/min/per 1.73?m(2) and an eGFR decline rate >1?ml/min/per 1.73?m(2)/year. There was a graded association between Hcy tertiles and eGFR decline. Subjects in the 3(rd) tertile of Hcy levels had an accelerated rate of eGFR decline and an increased risk of incident CKD, as compared with those in the 1st tertile, after adjusting for age, gender, baseline diabetes, SBP, BMI, smoking, dyslipidemia, eGFR, folate and vitamin B12 levels. In conclusion, in this prospective cohort of Chinese hypertensive adults, elevated baseline plasma Hcy can serve as an independent biomarker to predict renal function decline and incident CKD. PMID:26553372

  8. Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults

    PubMed Central

    Xie, Di; Yuan, Yan; Guo, Jiangnan; Yang, Shenglin; Xu, Xin; Wang, Qin; Li, Youbao; Qin, Xianhui; Tang, Genfu; Huo, Yong; Deng, Guangpu; Wu, Shengjie; Wang, Binyan; Zhang, Qin; Wang, Xiaobin; Fang, Pu; Wang, Hong; Xu, Xiping; Hou, Fanfan

    2015-01-01

    Hyper-homocysteinemia (HHcy) is associated with microalbuminuria and glomerular injury in general and diabetic populations. However, HHcys role in hypertensive patients was not studied. We investigated whether HHcy is an independent risk factor for renal function decline and development of chronic kidney disease (CKD) in hypertensive men and women. This was a community-based prospective cohort study of 2,387 hypertensive adults without CKD at baseline, with a mean follow-up of 4.4 years. Baseline and follow-up levels of plasma Hcy, folate, vitamin B12, blood pressure and other pertinent covariables were obtained. CKD was defined as an estimated glomerular filtration rate (eGFR) <60?ml/min/per 1.73?m2 and an eGFR decline rate >1?ml/min/per 1.73?m2/year. There was a graded association between Hcy tertiles and eGFR decline. Subjects in the 3rd tertile of Hcy levels had an accelerated rate of eGFR decline and an increased risk of incident CKD, as compared with those in the 1st tertile, after adjusting for age, gender, baseline diabetes, SBP, BMI, smoking, dyslipidemia, eGFR, folate and vitamin B12 levels. In conclusion, in this prospective cohort of Chinese hypertensive adults, elevated baseline plasma Hcy can serve as an independent biomarker to predict renal function decline and incident CKD. PMID:26553372

  9. Renal angiomyolipoma. DNA content and immunohistochemical study of classic and multicentric variants.

    PubMed

    Abdulla, M; Bui, H X; del Rosario, A D; Wolf, B C; Ross, J S

    1994-07-01

    Angiomyolipomas (AMLs) are polymorphic renal tumors that are composed of mature tissues and frequently associated with tuberous sclerosis; AMLs have long been considered hamartomatous in nature. We report the routine histologic and immunohistochemical features and DNA content analysis of two fatal cases of renal giant multicentric AML with distant organ involvement, and we contrast the findings with those of four similarly studied cases of classic solitary AML. Severe nuclear pleomorphism, significant mitotic activity, and necrosis, which are all characteristics of multicentric AML, were not seen in the cases of classic AML. Quantitation of DNA by image analysis of Feulgen-stained slides from paraffin-embedded blocks revealed an aneuploid pattern in the two cases of multicentric AML and an aneuploid pattern in one of the four cases of classic AML. Tumors in the liver, spleen, and lungs in one of the cases of multicentric AML were diploid. Immunohistochemical analysis revealed positive staining reaction of vascular and adipose tissue components with HMB-45 antibody in three of the six cases of AML. We conclude that AMLs may occur in a sarcomatous, infiltrating multicentric form involving multiple organs, that aneuploidy may be seen in lesions of both the multicentric AML and classic AML variants, that AMLs may feature DNA ploidy heterogeneity in multiple-organ sites, that HMB-45 immunoreactivity may be encountered in AMLs without evidence of nevomelanocytic differentiation, and that continued study of AMLs is needed to clarify further the histogenesis, lineage, clonality, and malignant potential of these tumors. PMID:8024411

  10. Renal Calculi

    PubMed Central

    Yendt, E. R.

    1970-01-01

    The pathogenesis of renal calculi is reviewed in general terms followed by the results of investigation of 439 patients with renal calculi studied by the author at Toronto General Hospital over a 13-year period. Abnormalities of probable pathogenetic significance were encountered in 76% of patients. Idiopathic hypercalciuria was encountered in 42% of patients, primary hyperparathyroidism in 11%, urinary infection in 8% and miscellaneous disorders in 8%. The incidence of uric acid stones and cystinuria was 5% and 2% respectively. In the remaining 24% of patients in whom no definite abnormalities were encountered the mean urinary magnesium excretion was less than normal. Of 180 patients with idiopathic hypercalciuria, only 24 were females. In the diagnosis of hyperparathyroidism, the importance of detecting minimal degrees of hypercalcemia is stressed; attention is also drawn to the new observation that the upper limit of normal for serum calcium is slightly lower in females than in males. The efficacy of various measures advocated for the prevention of renal calculi is also reviewed. In the author's experience the administration of thiazides has been particularly effective in the prevention of calcium stones. Thiazides cause a sustained reduction in urinary calcium excretion and increase in urinary magnesium excretion. These agents also appear to affect the skeleton by diminishing bone resorption and slowing down bone turnover. PMID:5438766

  11. Preventing renal and cardiovascular risk by renal function assessment: insights from a cross-sectional study in low-income countries and the USA

    PubMed Central

    Cravedi, Paolo; Sharma, Sanjib Kumar; Bravo, Rodolfo Flores; Islam, Nazmul; Tchokhonelidze, Irma; Ghimire, Madhav; Pahari, Bishnu; Thapa, Sanjeev; Basnet, Anil; Tataradze, Avtandil; Tinatin, Davitaia; Beglarishvili, Lela; Fwu, Chyng-Wen; Kopp, Jeffrey B; Eggers, Paul; Ene-Iordache, Bogdan; Carminati, Sergio; Perna, Annalisa; Chianca, Antonietta; Couser, William G; Remuzzi, Giuseppe; Perico, Norberto

    2012-01-01

    Objective To assess the prevalence of microalbuminuria and kidney dysfunction in low-income countries and in the USA. Design Cross-sectional study of screening programmes in five countries. Setting Screening programmes in Nepal, Bolivia, the USA (National Health and Nutrition Examination Survey (NHANES) 20052008) Bangladesh and Georgia. Participants General population in Nepal (n=20?811), Bolivia (n=3436) and in the USA (n=4299) and high-risk subjects in Bangladesh (n=1518) and Georgia (n=1549). Primary and secondary outcome measures Estimated glomerular filtration rate (eGFR)<60ml/min/1.73?m2 and microalbuminuria (defined as urinary albumin creatinine ratio values of 30300?mg/g) were the main outcome measures. The cardiovascular (CV) risk was also evaluated on the basis of demographic, clinical and blood data. Results The prevalence of eGFR<60ml/min/1.73?m2 was 19%, 3.2% and 7% in Nepal, Bolivia and the USA, respectively. In Nepal, 7% of subjects were microalbuminuric compared to 8.6% in the USA. The prevalence of participants with predicted 10-year CV disease (CVD) risk ?10% was 16.9%, 9.4% and 17% in Nepal, Bolivia and in the USA, respectively. In Bangladesh and Georgia, subjects with eGFR<60?ml/min/1.73?m2 were 8.6% and 4.9%, whereas those with microalbuminuria were 45.4% and 56.5%, respectively. Predicted 10-year CVD risk ?10% was 25.4% and 25% in Bangladesh and Georgia, respectively. Conclusions Renal abnormalities are common among low-income countries and in the USA. Prevention programmes, particularly focused on those with renal abnormalities, should be established worldwide to prevent CVD and progression to end-stage renal disease. PMID:23002161

  12. NMR studies of renal phosphate metabolites in vivo: Effects of hydration and dehydration

    SciTech Connect

    Wolff, S.D.; Eng, C.; Balaban, R.S. )

    1988-10-01

    The present study characterizes the {sup 31}P-nuclear magnetic resonance (NMR) spectrum of rabbit kidneys in vivo and evaluates the effect of hydration on phosphorous metabolites including the organic solute glycerophosphorylcholine (GPC). Cortical phosphorylethanolamine is the predominant component of the phosphomonoester region of the {sup 31}P spectrum. The contribution of blood to the spectrum is mainly from 2,3 diphosphoglycerate, which comprises {approximately}30% of the inorganic phosphate region. Acute infusion of 0.9% saline decreases the sodium content of the inner medulla by >50% in 15 min as shown by {sup 23}Na imaging. Despite this medullary Na dilution, no change in renal GPC content was observed for >1 h even with the addition of furosemide or furosemide and antidiuretic hormone. However, 20 h of chronic dehydration with 0.45% saline did result in a 30% decrease in renal GPC content when compared with dehydrated animals. These findings are consistent with GPC not playing a role in the short-term regulation of the medullary intracellular milieu in response to acute reductions in medullary Na content.

  13. Causes of death in renal transplant recipients: a study of 102 autopsies from 1968 to 1991.

    PubMed Central

    Reis, M A; Costa, R S; Ferraz, A S

    1995-01-01

    A study was conducted on 102 patients submitted to renal transplant who died and were autopsied at the University Hospital, Faculty of Medicine of Ribeirão Preto, Brazil, from 1968 to 1991. The cause of death, based on a review of medical records and autopsy reports, was assigned to one of the following categories: infectious (69.6%); cardiovascular (12.7%); gastrointestinal (7.8%); graft rejection (6.9%); tumoral (2.0%); and undetermined (1.0%). Among the 71 cases of death caused by infection, 28 (39.4%) showed disseminated agents involving two or more organs. Isolated pneumonia involved 17 patients (23.9%), followed by acute pyelonephritis in the transplanted kidney in 10 patients (14.1%). The most frequent agents were: bacteria (58.0%), divided into 'non-classified' (83.0%), Nocardia (10.6%) and Mycobacterium (6.4%); fungi (27.5%) represented by Cryptococcus (22.7%), Aspergillus, Candida and Pneumocystis carinii (18.1% each), Histoplasma (13.6%), Mucor and Paracoccidioides brasiliensis (4.5% each); viruses (6.2%) represented by Herpes simplex (60.0%); metazoa (5.0%, S. stercoralis), and protozoa (2.5%, T. cruzi). Cytomegalovirus (CMV) was identified in the lungs of 12 patients and was not directly correlated with death but was associated with other agents. In conclusion, immunodepressed patients such as renal transplant recipients should be carefully monitored for infection due to the high mortality rate. PMID:7884765

  14. A clinical comparative study of the management of chronic renal failure with Punarnavadi compound

    PubMed Central

    Prashanth, G. S.; Baghel, M. S.; Ravishankar, B.; Gupta, S. N.; Mehta, Miten P.

    2010-01-01

    India like any other country is facing a silent epidemic of chronic renal failure (CRF)- a facet of the health transition associated with industrialization partly fuelled by increase in sedentary lifestyle, low birth weight and malnutrition. Increasing figures by many folds seen is posing a difficult situation to overcome with respect to economy and health of the working and earning population of the nation. There is an urgent need to explore, highlight new interventions and modify modifiable risk factors as a basis for treatment strategies to prevent the development and progression of CRF. The present study was taken up to evaluate the role of trial formulation tab. Punarnavadi compound in the management of chronic renal failure. This was an open clinical comparative study in controlled circumstances wherein 67 patients were studied for two months in three groups- Group A (allopathic control), Group B (ayurvedic control) and Group C (ayurvedic test). It was a multi-centric study; patients were registered from Anandababa charitable dialysis centre, Jamnagar, Kayachikitsa O.P.D. of I.P.G.T. and R.A. Jamnagar and P. D. Patel Ayurveda hospital, Nadiad. Results were assessed on 15 parameters using Students (paired) ‘t’ test. Group A patients showed comparatively better results in eight parameters- weight, platelet count, serum urea, serum uric acid, serum sodium, potassium, chloride and total proteins. Parameter Hemoglobin% showed better results in Group B patients and in Group C patients comparatively better results in six parameters viz.- quality of life (breathlessness, weakness, general functional capacity), total count, serum creatinine and serum calcium - were observed. Throughout the study, trial drug tab. Punarnavadi compound did not show any adverse drug reaction. The results of this study will help in developing a cheap and safe treatment for the management of CRF. PMID:22131708

  15. Theoretical studies of quantum dynamics

    NASA Astrophysics Data System (ADS)

    Sim, Eunji

    1997-12-01

    Quantum mechanical methods have been developed for the study of dynamical processes in polyatomic systems and condensed matter. First, we developed an exact scheme for wavefunction propagation with a few degrees of freedom based on time-dependent discrete variable representations (TD-DVR) of the evolution operator. The TD-DVR evolves under appropriate reference Hamiltonians and leads to an efficient scheme for studying intramolecular or collision dynamics, allowing significant reduction of grid size and large time steps while requiring numerical effort that scales almost linearly with the total number of grid points. The method is readily applicable to systems described by time-dependent Hamiltonians. The filtered propagator functional (FPF) method, based on Feynman's path integral formulation of time-dependent quantum mechanics, has been introduced to propagate the reduced density matrix of a one-dimensional quantum mechanical system coupled to a harmonic dissipative environment. An adiabatic reference is employed to obtain accurate propagators and the harmonic bath is replaced by an influence functional which is discretized by optimal discrete variable representations. A functional of statistically important path segments selected by a Monte Carlo procedure is propagated forward in time via multiplication with a propagator functional which included finite-length nonlocal interaction arising from the dissipative bath. High efficiency and dramatic reduction of the required storage are achieved with the aid of sorting and filtering criteria, allowing iterative evaluation of the path integral over long time periods even for processes involving long-memory kernels characteristic of low-frequency solvents. Using the FPF method, we have carried out accurate path integral simulations of the primary charge separation in bacterial photosynthesis. The process is modeled in terms of three coupled electronic states corresponding to the photoexcited special pair, the reduced accessory bacteriochlorophyll and the reduced bacteriopheophytin of the L branch which interact with a dissipative medium of protein and solvent degrees of freedom. We found that a free energy of the reduced bacteriochlorophyll state about 400 cm-1 lower than that of the excited special pair, which is associated with a two-step electron transfer mechanism, yields state populations in agreement with experimental results on wild-type and modified reaction centers including the observed temperature dependence. The results are found to be rather stable with respect to reasonable changes of the medium spectral density and the specifics of the nonequilibrium configuration of the photoexcited donor state.

  16. A dynamic paracellular pathway serves diuresis in mosquito Malpighian (renal) tubules

    PubMed Central

    Beyenbach, Klaus W.

    2012-01-01

    Female mosquitoes gorge on vertebrate blood, a rich nutrient source for developing eggs. But gorging meals increase the risk of predation. Mosquitoes are quick to reduce the flight payload with a potent diuresis. Diuretic peptides of the insect kinin family induce a tenfold-reduction in the paracellular resistance of Malpighian tubules and increase the paracellular permeation of Cl−, the counterion of the transepithelial secretion of Na+ and K+. As a result, the transepithelial secretion of NaCl and KCl and water increases. Insect kinins signal to the opening of the paracellular pathway via G protein-coupled receptors and the elevation of intracellular [Ca2+], which leads to the reorganization of the cytoskeleton associated with the septate junction. The reorganization may affect the septate junctional proteins that control the barrier and permselectivity properties of the paracellular pathway. The proteins involved in the embryonic formation of the septate junction and in epithelial polarization are largely known for ectodermal epithelia, but the proteins that form and mediate the dynamic functions of the septate junction in Malpighian tubules remain to be determined. PMID:22731730

  17. Studies in Chaotic adiabatic dynamics

    SciTech Connect

    Jarzynski, C.

    1994-01-01

    Chaotic adiabatic dynamics refers to the study of systems exhibiting chaotic evolution under slowly time-dependent equations of motion. In this dissertation the author restricts his attention to Hamiltonian chaotic adiabatic systems. The results presented are organized around a central theme, namely, that the energies of such systems evolve diffusively. He begins with a general analysis, in which he motivates and derives a Fokker-Planck equation governing this process of energy diffusion. He applies this equation to study the {open_quotes}goodness{close_quotes} of an adiabatic invariant associated with chaotic motion. This formalism is then applied to two specific examples. The first is that of a gas of noninteracting point particles inside a hard container that deforms slowly with time. Both the two- and three-dimensional cases are considered. The results are discussed in the context of the Wall Formula for one-body dissipation in nuclear physics, and it is shown that such a gas approaches, asymptotically with time, an exponential velocity distribution. The second example involves the Fermi mechanism for the acceleration of cosmic rays. Explicit evolution equations are obtained for the distribution of cosmic ray energies within this model, and the steady-state energy distribution that arises when this equation is modified to account for the injection and removal of cosmic rays is discussed. Finally, the author re-examines the multiple-time-scale approach as applied to the study of phase space evolution under a chaotic adiabatic Hamiltonian. This leads to a more rigorous derivation of the above-mentioned Fokker-Planck equation, and also to a new term which has relevance to the problem of chaotic adiabatic reaction forces (the forces acting on slow, heavy degrees of freedom due to their coupling to light, fast chaotic degrees).

  18. Grandma's TUM-my Trouble: A Case Study in Renal Physiology and Acid-Base Balance

    ERIC Educational Resources Information Center

    Massey, Ann T.

    2015-01-01

    This case study involves the role of the kidneys in regulating blood pH and electrolytes. The case was used near the end of a two-semester Human Anatomy and Physiology course sequence, during the time when renal physiology was under study. Groups of two to three students were given the case and associated information (lab values, etc.). Students…

  19. Grandma's TUM-my Trouble: A Case Study in Renal Physiology and Acid-Base Balance

    ERIC Educational Resources Information Center

    Massey, Ann T.

    2015-01-01

    This case study involves the role of the kidneys in regulating blood pH and electrolytes. The case was used near the end of a two-semester Human Anatomy and Physiology course sequence, during the time when renal physiology was under study. Groups of two to three students were given the case and associated information (lab values, etc.). Students

  20. Arterial stenosis complicating renal allotransplantation in man: a study of 38 cases.

    PubMed Central

    Lacombe, M

    1975-01-01

    Of 306 renal transplantations, stenosis of the artery supplying the grafted kidney was found in 38 patients three months to two years after they had undergone renal transplantation. The diagnosis was made by arteriography done because of refractory hypertension with or without impaired renal function in 36 patients and as a routine investigation in two normotensive patients. The stenosis was corrected surgically in 14 patients, with resultant lasting relief of hypertension in ten patients and improvement of renal function in five out of six patients with impaired renal function. Different types of stenosis were recognized: stenosis of the recipient artery, stenosis of the suture line, stenosis of the donor renal artery (segmental or diffuse) and multiple forms. The most frequent site of stenosis was the donor artery. There seems to be no single cause of stenosis: atheroma of the recipient vessels, faulty suture technique, hemodynamic disturbances, trauma to donor or recipient arteries account for some cases, whereas in other cases the evidence points to an immune mechanism. This complication of renal transplantation may be more frequent than is thought at present; therefore, routine renal arteriography should be performed at repeated intervals in all transplanted patients. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. PMID:1093485

  1. Studies on the Release of Renin by Direct and Reflex Activation of Renal Sympathetic Nerves.

    ERIC Educational Resources Information Center

    Donald, David E.

    1979-01-01

    Presents data on release of renin during direct and indirect stimulation of renal nerves. Conclusions show that renin release is influenced by change in activity of carotid and cardiopulmonary baroreceptor systems, and excitation of discrete areas of brain and hypothalamus by changes in renal sympathetic nerve. (Author/SA)

  2. Polar solvation dynamics of lysozyme from molecular dynamics studies

    NASA Astrophysics Data System (ADS)

    Sinha, Sudipta Kumar; Bandyopadhyay, Sanjoy

    2012-05-01

    The solvation dynamics of a protein are believed to be sensitive to its secondary structures. We have explored such sensitivity in this article by performing room temperature molecular dynamics simulation of an aqueous solution of lysozyme. Nonuniform long-time relaxation patterns of the solvation time correlation function for different segments of the protein have been observed. It is found that relatively slower long-time solvation components of the α-helices and β-sheets of the protein are correlated with lower exposure of their polar probe residues to bulk solvent and hence stronger interactions with the dynamically restricted surface water molecules. These findings can be verified by appropriate experimental studies.

  3. Overhauser Dynamic Nuclear Polarization Studies on Local Water Dynamics.

    PubMed

    Kaminker, Ilia; Barnes, Ryan; Han, Songi

    2015-01-01

    Overhauser dynamic nuclear polarization (ODNP) is an emerging technique for quantifying translational water dynamics in the vicinity (<1 nm) of stable radicals that can be chemically attached to macromolecules of interest. This has led to many in-depth and enlightening studies of hydration water of biomolecules, revolving around the role of solvent dynamics in the structure and function of proteins, nucleic acids, and lipid bilayer membranes. Still to date, a complete and fully automated ODNP instrument is not commercialized. The purpose of this chapter is to share the technical know-how of the hardware, theory, measurement, and data analysis method needed to successfully utilize and disseminate the ODNP technique. PMID:26477261

  4. Ultrasmall superparamagnetic iron oxide to enhance MRA of the renal and coronary arteries: Studies in human patients

    SciTech Connect

    Stillman, A.E.; Wilke, N.; Li, D.; Haacke, E.M.; McLachlan, S.

    1996-01-01

    Our goal was to determine the feasibility of using an intravascular MR contrast agent to improve 3D MRA. Three-dimensional TOF MRA was performed in nine patients both prior to and following the administration of an ultrasmall particle superparamagnetic iron oxide contrast agent (AMI 227). The lengths of both renal arteries were measured from the maximum intensity projection (MIP) images as well as the individual partitions. Seven of these patients also were studied by a 3D coronary artery MRA sequence. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements of the right coronary artery were determined both prior to and following the administration of AMI 227. Statistical analysis of both renal artery lengths and right coronary SNR and CNR was performed using a one tailed paired t test comparing pre- and postcontrast images. The renal artery lengths significantly increased (right renal artery: 30%, p = 0.001; left renal artery: 25%, p < 0.008) when measured from the individual axial slice partitions. No significant increase in length was observed on the MIP images following contrast. In the right coronary artery, the SNR increased by an average of 80% (p = 0.008) and CNR increased by an average of 109% (p = 0.007). Increased background signal and superimposed venous structures reduced the measurable lengths of the renal arteries from the MIP images. These studies support the hypothesis that 3D MRA in the body will benefit from the use of intravascular contrast agents. Nevertheless, conventional MIP processing is unable to reveal the full advantage of the contrast improvement. 14 refs., 6 figs., 2 tabs.

  5. A retrospective study of end-stage renal disease in captive polar bears (Ursus maritimus).

    PubMed

    LaDouceur, Elise E B; Davis, Barbara; Tseng, Flo

    2014-03-01

    This retrospective study summarizes 11 cases of end-stage renal disease (ESRD) in captive polar bears (Ursus maritimus) from eight zoologic institutions across the United States and Canada. Ten bears were female, one was male, and the mean age at the time of death was 24 yr old. The most common clinical signs were lethargy, inappetence, and polyuria-polydipsia. Biochemical findings included azotemia, anemia, hyperphosphatemia, and isosthenuria. Histologic examination commonly showed glomerulonephropathies and interstitial fibrosis. Based on submissions to a private diagnostic institution over a 16-yr period, ESRD was the most commonly diagnosed cause of death or euthanasia in captive polar bears in the United States, with an estimated prevalence of over 20%. Further research is needed to discern the etiology of this apparently common disease of captive polar bears. PMID:24712164

  6. Study of molecule variations in renal tumor based on confocal micro-Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Zhuang, Zhengfei; Li, Ning; Guo, Zhouyi; Zhu, Meifang; Xiong, Ke; Chen, Sijin

    2013-03-01

    Confocal micro-Raman spectroscopy-a valuable analytical tool in biological and medical field of research-allows probing molecular vibrations of samples without external labels or extensive preparation. We employ confocal micro-Raman spectroscopy to characterize renal tumors and normal tissue. Results show that Raman peaks of the renal tumor at 788 and 1087 cm-1, which belong to νs and νas stretching, respectively, have an obvious increase. At the same time, the ratio of I855/I831 in renal tumor tissue is 1.39±0.08, while that in normal renal tissue is 2.44±0.05 (p<0.01). This means that more tyrosine conformation transform from "buried" to "exposed" in the presence of cancer. Principal component analysis is used to classify the Raman spectra of renal tumor tissue and normal tissue.

  7. A retrospective study of renal cancer with special reference to coffee and animal protein consumption.

    PubMed Central

    Armstrong, B.; Garrod, A.; Doll, R.

    1976-01-01

    Interviews were obtained with 106 patients with adenocarcinoma of the renal parenchyma, 33 patients with carcinoma of the renal pelvis and 139 individually matched control patients. Comparison of the cancer patients with the control patients showed no evidence of a positive association between either type of renal cancer and coffee or animal protein consumption. Carcinoma of the renal pelvis was associated positively with cigareete consumption (relative risk estimate 1-8) and the daily consumption of analgesic tablets was more frequent in patients with cancer of the renal parenchyma than in their matched controls (14-2% compared with 1-9%,P less than 0.005). It appeared likely that the latter relationship was non-causal. PMID:944046

  8. Antiphospholipid syndrome nephropathy (APSN) in patients with lupus nephritis: a retrospective clinical and renal pathology study.

    PubMed

    Erre, Gian Luca; Bosincu, Luisanna; Faedda, Rossana; Fenu, Patrizia; Masala, Antonio; Sanna, Marcella; Taras, Loredana; Longu, Maria Giovanna; Piras, Marco; Soro, Giovanni; Satta, Andrea Ercole; Passiu, Giuseppe

    2014-04-01

    Data about clinical-laboratory features and outcome of antiphospholipid syndrome nephropathy (APSN) in the course of lupus nephritis (LN) are scarce. To determine prevalence, clinical correlations and outcome of APSN in patients with LN, retrospective analysis of renal specimens and review of medical records from 48 LN patients were performed. APSN was found in 12/48 (25 %) of LN. Positivity for lupus anticoagulant (LAC) and double antiphospholipids positivity [LAC plus anticardiolipin (aCL)] were significantly more frequent in APSN-LN (p = 0.02 and p = 0.01, respectively) than in LN, while single aCL positivity was not. Overt antiphospholipid syndrome appeared more frequent in patients with APSN-LN (p = 0.05). There were no statistically significant differences between APSN-LN and LN in the proportion of each World Health Organization class of LN (with the exception of a trend toward fewer Class III LN in APS-LN) and in the systemic lupus erythematosus (SLE) disease duration and severity. At the time of renal biopsy, patients with APSN-LN had median serum creatinine levels significantly higher than patients with LN [1.45 (0.6-6.6) vs. 1.00 (0.7-3.0), p = 0.02]. Double antiphospholipid positivity was the only variable significantly associated with APSN-LN at multivariate regression analysis (OR 8, 95 % CI 1.7-37, p = 0,008). APSN-LN and LN did not differ significantly as regards the rate of complete (25 vs. 19.4 %, p = 0.72) and partial treatment response (25 vs. 29 %, p = 0.82) at 6 months and the progression to end-stage renal disease after a median follow-up of 8.1 3.6 years (16.6 vs. 13.8 %, p = 0.82). APSN was demonstrated in a quart of LN, appeared to be independent from underlying LN class and SLE severity, and did not seem to confer a worse prognosis to LN. The findings of higher creatinine and more interstitial fibrosis in APSN should be confirmed in future prospective larger studies. PMID:24232504

  9. Hijama improves overall quality of life in chronic renal failure patients: A pilot study.

    PubMed

    Bilal, Muhammad; Khan, Rafeeq Alam; Danial, Khurram

    2015-09-01

    Present study assesses the therapeutic effectiveness of Hijama (blood letting) inpatients of chronic renal failure undergoing hemodialysis for past several years with almost no urinary output.24 patients from Sindh Government Qatar Hospital Karachi were selected randomly under going dialysis 2-3 times/week for an average of 3 years under supervision of Dr. Khurram Danial, in-charge nephrologist at dialysis Centre Sindh Government Qatar Hospital Karachi after the written consent from patients. Each patient was subjected to Hijama session once a week after dialysis for a period of one year in a nearby hospital Aligarh Shifa with the consent of the ethical committee of the hospital. Serum urea, creatinine, complete blood count and electrolytes were determined prior to Hijama as baseline values and were again recorded on monthly basis for twelve months of Hijama sessions. The patient's feedback regarding quality of life after each Hijama session shows that almost all the patients reported a significant recovery from severe fatigue which they used to face during the interval between the dialysis sessions. There was significant recovery in all patients from anorexia and insomnia with the improvement in quality of life as compared to patients not undergoing Hijama. Both systolic and diastolic blood pressures were shifted towards normal in almost all patients after Hijama. Serum Creatinine level was declined significantly, while electrolyte and hematological parameters were also improved significantly. The hemoglobin of all patients undergoing Hijama was maintained near normal without any blood transfusion, which was frequently needed in patients not undergoing Hijama sessions. There was insignificant improvement in Urinary output in 2 out of 24 patients. Results of the present study suggest that Hijama may be performed safely in patients of chronic renal failure on dialysis with overall improvement in quality of life, since there was reduction in fatigue, improvement in appetite, quality of sleep and platelet count. PMID:26408893

  10. Study of ambulatory blood pressure in diabetic children: prediction of early renal insult

    PubMed Central

    Shalaby, Nehad Mohamed; Shalaby, Naglaa M

    2015-01-01

    Background Hypertension is a highly prevalent risk factor for cardiovascular disease in patients with type 1 diabetes mellitus. Elevated blood pressure (BP) promotes the development and progression of microvascular complications, eg, nephropathy and retinopathy. The purpose of this study was to identify and detect early BP changes in diabetic children and adolescents, aiming for the early prediction of future renal and cardiovascular disease risk during childhood. Methods and materials Ambulatory BP monitoring was undertaken for 40 normotensive type 1 diabetic children with mean age of 11.56±2.82 years, and 24 healthy children as control group with matched age and sex. Albumin/creatinine ratio and glycated hemoglobin were tested. BP indices and standard deviation scores were calculated using reference standards. The data were analyzed by SPSS software version 20 using mean and standard deviations for descriptive data. Correlation and regression analysis tests were used to study relations between BP indices and diabetic parameters. Results All parameters of BP z-scores were highly significantly increased in diabetic patients compared with controlled group (P<0.0001). The frequency of non-dipping was greater and highly significant in microalbuminuric diabetic patients (P<0.0001). Regression analysis revealed that BP parameters were significantly related to albumin/creatinine ratio, glycated hemoglobin, insulin dose, and body mass index. Conclusion Our observation revealed a clear link between the nocturnal BP and microalbuminuria which mandates BP follow-up via ambulatory BP monitoring with therapeutic intervention to prevent renal and cardiovascular diabetic complications in adulthood. PMID:26491340

  11. Papillary renal cell carcinoma: a clinicopathological and whole-genome exon sequencing study

    PubMed Central

    Liu, Kunpeng; Ren, Yuan; Pang, Lijuan; Qi, Yan; Jia, Wei; Tao, Lin; Hu, Zhengyan; Zhao, Jin; Zhang, Haijun; Li, Li; Yue, Haifeng; Han, Juan; Liang, Weihua; Hu, Jianming; Zou, Hong; Yuan, Xianglin; Li, Feng

    2015-01-01

    Papillary renal cell carcinoma (PRCC) represents the second most common histological subtype of RCC, and comprises 2 subtypes. Prognosis for type 1 PRCC is relatively good, whereas type 2 PRCC is associated with poor clinical outcomes. The aim of the present study was to evaluate the clinicopathological and mutations characteristics of PRCC. Hence, we reported on 13 cases of PRCC analyzed using whole-exome sequencing. Histologically, type 2 PRCC showed a higher nuclear grade and lymphovascular invasion rate versus type 1 PRCC (P < 0.05). Immunostaining revealed type 1 PRCC had higher CK7 and lower Top II? expression rates (P < 0.05). Whole-exome sequencing data analysis revealed that the mutational statuses of 373 genes (287 missense, 69 silent, 6 nonsense, and 11 synonymous mutations) differed significantly between PRCC and normal renal tissues (P < 0.05). Functional enrichment analysis was used to classify the 287 missense-mutated genes into 11 biological process clusters (comprised of 61 biological processes) and 5 pathways, involved in cell adhesion, microtubule-based movement, the cell cycle, polysaccharide biosynthesis, muscle cell development and differentiation, cell death, and negative regulation. Associated pathways included the ATP-binding cassette transporter, extracellular matrix-receptor interaction, lysosome, complement and coagulation cascades, and glyoxylate and dicarboxylate metabolism pathways. The missense mutation status of 19 genes differed significantly between the groups (P < 0.05), and alterations in the EEF1D, RFNG, GPR142, and RAB37 genes were located in different chromosomal regions in type 1 and 2 PRCC. These mutations may contribute to future studies on pathogenic mechanisms and targeted therapy of PRCC. PMID:26339402

  12. Chronic Renal Insufficiency Cohort Study (CRIC): Overview and Summary of Selected Findings.

    PubMed

    Denker, Matthew; Boyle, Suzanne; Anderson, Amanda H; Appel, Lawrence J; Chen, Jing; Fink, Jeffrey C; Flack, John; Go, Alan S; Horwitz, Edward; Hsu, Chi-Yuan; Kusek, John W; Lash, James P; Navaneethan, Sankar; Ojo, Akinlolu O; Rahman, Mahboob; Steigerwalt, Susan P; Townsend, Raymond R; Feldman, Harold I

    2015-11-01

    The Chronic Renal Insufficiency Cohort (CRIC) Study is a United States multicenter, prospective study of racially and ethnically diverse patients with CKD. Although the original aims of the study were to identify novel predictors of CKD progression and to elucidate the risk and manifestations of cardiovascular disease among nearly 4000 individuals with CKD, the CRIC Study has evolved into a national resource for investigation of a broad spectrum of CKD-related topics. The study has produced >90 published scientific articles, promoted many young investigative careers in nephrology, and fostered international collaborations focused on understanding the global burden of CKD. The third phase of the CRIC Study will complete enrollment of 1500 additional study participants in 2015 and is designed to answer questions regarding morbidity and mortality in mild-to-moderate CKD and to assess the burden of CKD in older persons. This review highlights some of the salient findings of the CRIC Study in the areas of race and ethnicity, CKD progression, CKD and cognition, and cardiovascular disease outcomes; it also outlines the ongoing and forthcoming opportunities for the global nephrology community to enhance its understanding of CKD and related complications through the study. PMID:26265715

  13. Is There Hope for Renal Growth on Imaging Studies Following Ureteral Reimplant for Boys With Fetal Hydronephrosis and Urinary Reflux?

    PubMed Central

    Wang, Ming-Hsien

    2015-01-01

    Reflux nephropathy is thought to be the etiology for renal maldevelopment. We present two boys with fetal hydronephrosis and sterile vesicoureteral reflux (VUR). There was lack of renal growth of the refluxing renal units on surveillance renal ultrasound. Parents elected to undergo open ureteral reimplants. Post-surgical ultrasounds demonstrated improved renal growth. PMID:26793522

  14. Radiology of renal failure

    SciTech Connect

    Griffiths, H.J.

    1990-01-01

    This book covers most aspects of imaging studies in patients with renal failure. The initial chapter provides basic information on contrast agents, intravenous urography, and imaging findings in the urinary tract disorders responsible for renal failure and in patients who have undergone transplantation. It illustrates common gastro-intestinal abnormalities seen on barium studies in patients with renal failure. It illustrates the cardiopulmonary complications of renal failure and offers advice for radiologic differentiation. It details different aspects of skeletal changes in renal failure, including a basic description of the pathophysiology of the changes; many excellent illustrations of classic bone changes, arthritis, avascular necrosis, and soft-tissue calcifications; and details of bone mineral analysis.

  15. Unclassified renal cell carcinoma: a clinicopathological, comparative genomic hybridization, and whole-genome exon sequencing study

    PubMed Central

    Hu, Zhen-Yan; Pang, Li-Juan; Qi, Yan; Kang, Xue-Ling; Hu, Jian-Ming; Wang, Lianghai; Liu, Kun-Peng; Ren, Yuan; Cui, Mei; Song, Li-Li; Li, Hong-An; Zou, Hong; Li, Feng

    2014-01-01

    Unclassified renal cell carcinoma (URCC) is a rare variant of RCC, accounting for only 3-5% of all cases. Studies on the molecular genetics of URCC are limited, and hence, we report on 2 cases of URCC analyzed using comparative genome hybridization (CGH) and the genome-wide human exon GeneChip technique to identify the genomic alterations of URCC. Both URCC patients (mean age, 72 years) presented at an advanced stage and died within 30 months post-surgery. Histologically, the URCCs were composed of undifferentiated, multinucleated, giant cells with eosinophilic cytoplasm. Immunostaining revealed that both URCC cases had strong p53 protein expression and partial expression of cluster of differentiation-10 and cytokeratin. The CGH profiles showed chromosomal imbalances in both URCC cases: gains were observed in chromosomes 1p11-12, 1q12-13, 2q20-23, 3q22-23, 8p12, and 16q11-15, whereas losses were detected on chromosomes 1q22-23, 3p12-22, 5p30-ter, 6p, 11q, 16q18-22, 17p12-14, and 20p. Compared with 18 normal renal tissues, 40 mutated genes were detected in the URCC tissues, including 32 missense and 8 silent mutations. Functional enrichment analysis revealed that the missense mutation genes were involved in 11 different biological processes and pathways, including cell cycle regulation, lipid localization and transport, neuropeptide signaling, organic ether metabolism, and ATP-binding cassette transporter signaling. Our findings indicate that URCC may be a highly aggressive cancer, and the genetic alterations identified herein may provide clues regarding the tumorigenesis of URCC and serve as a basis for the development of targeted therapies against URCC in the future. PMID:25120763

  16. Papillary renal cell carcinoma revisited: a comprehensive histomorphologic study with outcome correlations.

    PubMed

    Warrick, Joshua I; Tsodikov, Alex; Kunju, Lakshmi P; Chinnaiyan, Arul M; Palapattu, Ganesh S; Morgan, Todd M; Alva, Ajjai; Tomlins, Scott; Wu, Angela; Montgomery, Jeffrey S; Hafez, Khaled S; Wolf, J Stuart; Weizer, Alon Z; Mehra, Rohit

    2014-06-01

    Papillary renal cell carcinoma (P-RCC) is the second most common type of malignant renal epithelial tumor and can be subclassified into type 1, which demonstrates simple cuboidal low-grade epithelium and type 2, which demonstrates pseudostratified high-grade epithelium with abundant eosinophilic cytoplasm. Despite this clinically useful subclassification, P-RCCs exhibit considerable histomorphologic diversity, with many cases having features differing from classically described type 1 and type 2 tumors. To our knowledge, there has been no recent study that has methodically evaluated the histomorphologic features of a series of P-RCCs. To address this, we evaluated a cohort of P-RCCs diagnosed between 1997 and 2004 with long-term clinical follow-up data (n = 56). Histomorphologic features previously described in the spectrum of type 1 and type 2 P-RCCs were recorded for each tumor, including nuclear grade, complete tumor capsule, and cytoplasmic eosinophilia as well as several other features. The current TNM staging (American Joint Committee on Cancer, seventh edition) was assigned to all cases. Histomorphologic features were diverse, demonstrating classic type 1 P-RCC and classic type 2 P-RCC morphology and several tumors with nonclassic features. Four patients in this cohort had distant metastasis. The primary tumor was equally divided between type 1 (2 cases) and type 2 (2 cases) morphology in the cases with metastasis. All P-RCC cases with metastases demonstrated presence of high nuclear grade and high tumor stage in the primary tumor. Cluster analysis using staging parameters and histomorphologic features divided tumors into 2 primary clusters. All primary tumors associated with metastasis were in the same cluster. PMID:24767860

  17. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy.

    PubMed

    Nagarik, Amit P; Soni, Sachin S; Adikey, Gopal Kishan; Raman, Anuradha

    2010-05-01

    Systemic heparinization during continuous renal replacement therapy (CRRT) is associated with disadvantage of risk of bleeding. This study analyses the efficacy of frequent saline flushes compared with heparin anticoagulation to maintain filter life. From January 2004 to November 2007, 65 critically ill patients with acute renal failure underwent CRRT. Continuous venovenous hemodialfiltration (CVVHDF) was performed using Diapact Braun CRRT machine. 1.7% P.D. fluid was used as dialysate. 0.9% NS with addition of 10% Ca Gluconate, Magnesium Sulphate, Soda bicarbonate and Potassium Chloride added sequentially in separate units were used for replacement, carefully monitoring their levels. Anticoagulation of extracorporeal circuit was achieved with unfractionated heparin (250-500 units alternate hour) in 35 patients targeting aPTT of 45-55 seconds. No anticoagulation was used in 30 patients with baseline APTT > 55 seconds and extracorporeal circuit was maintained with saline flushes at 30 min interval. 65 patients including 42 males. Co-morbidities were comparable in both groups. HMARF was significantly more common in heparin group while Sepsis was comparable in both the groups. CRRT parameters were similar in both groups. Average filter life in heparin group was 26 +/- 6.4 hours while it was 24.5 +/- 6.36 hours in heparin free group (P=NS). Patients receiving heparin had 16 bleeding episodes (0.45/patient) while only four bleeding episodes occurred in heparin free group (0.13/patient, P < 0.05). Mortality was 71% in heparin group and 67% in heparin free group. Frequent saline flushes is an effective mode of maintainance of extracorporeal circuit in CRRT when aPTT is already on the higher side, with significantly decreased bleeding episodes. PMID:20427872

  18. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy.

    TOXLINE Toxicology Bibliographic Information

    Nagarik AP; Soni SS; Adikey GK; Raman A

    2010-05-01

    Systemic heparinization during continuous renal replacement therapy (CRRT) is associated with disadvantage of risk of bleeding. This study analyses the efficacy of frequent saline flushes compared with heparin anticoagulation to maintain filter life. From January 2004 to November 2007, 65 critically ill patients with acute renal failure underwent CRRT. Continuous venovenous hemodialfiltration (CVVHDF) was performed using Diapact Braun CRRT machine. 1.7% P.D. fluid was used as dialysate. 0.9% NS with addition of 10% Ca Gluconate, Magnesium Sulphate, Soda bicarbonate and Potassium Chloride added sequentially in separate units were used for replacement, carefully monitoring their levels. Anticoagulation of extracorporeal circuit was achieved with unfractionated heparin (250-500 units alternate hour) in 35 patients targeting aPTT of 45-55 seconds. No anticoagulation was used in 30 patients with baseline APTT > 55 seconds and extracorporeal circuit was maintained with saline flushes at 30 min interval. 65 patients including 42 males. Co-morbidities were comparable in both groups. HMARF was significantly more common in heparin group while Sepsis was comparable in both the groups. CRRT parameters were similar in both groups. Average filter life in heparin group was 26 +/- 6.4 hours while it was 24.5 +/- 6.36 hours in heparin free group (P=NS). Patients receiving heparin had 16 bleeding episodes (0.45/patient) while only four bleeding episodes occurred in heparin free group (0.13/patient, P < 0.05). Mortality was 71% in heparin group and 67% in heparin free group. Frequent saline flushes is an effective mode of maintainance of extracorporeal circuit in CRRT when aPTT is already on the higher side, with significantly decreased bleeding episodes.

  19. Renal hemodynamics in space.

    PubMed

    Kramer, H J; Heer, M; Cirillo, M; De Santo, N G

    2001-09-01

    Renal excretory function and hemodynamics are determined by the effective circulating plasma volume as well as by the interplay of systemic and local vasoconstrictors and vasodilators. Microgravity results in a headward shift of body fluid. Because the control conditions of astronauts were poorly defined in many studies, controversial results have been obtained regarding diuresis and natriuresis as well as renal hemodynamic changes in response to increased central blood volume, especially during the initial phase of space flight. Renal excretory function and renal hemodynamics in microgravity are affected in a complex fashion, because during the initial phase of space flight, variable mechanisms become operative to modulate the effects of increased central blood volume. They include interactions between vasodilators (dopamine, atrial natriuretic peptide, and prostaglandins) and vasoconstrictors (sympathetic nervous system and the renin-angiotensin system). The available data suggest a moderate rise in glomerular filtration rate during the first 2 days after launch without a significant increase in effective renal plasma flow. In contrast, too few data regarding the effects of space flight on renal function during the first 12 hours after launch are available and are, in addition, partly contradictory. Thus, detailed and well-controlled studies are required to shed more light on the role of the various factors besides microgravity that determine systemic and renal hemodynamics and renal excretory function during the different stages of space flight. PMID:11532705

  20. Effect of vitamin C on endothelial function of children with chronic renal failure: An experimental study

    PubMed Central

    Sabri, Mohammad Reza; Tavana, Esfandiar Najafi; Ahmadi, Alireza; Gheissari, Alaleh

    2015-01-01

    Background: It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF). Materials and Methods: In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial. Results: In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P < 0.05). FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05). Conclusion: The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed.

  1. USE OF THE SPONTANEOUS TSC2 KNOCKOUT (EKER) RAT MODEL OF HEREDITARY RENAL CELL CARCINOMA FOR THE STUDY OF RENAL CARCINOGENS

    EPA Science Inventory

    The kidney is a frequent site for chemically induced cancers in rodents and among the ten most frequent sites for cancer in human patients. Renal cell carcinoma (RCC) is the most frequent upper urinary tract cancer in humans and accounts for 80-85% of malignant renal tumors. He...

  2. Autofluorescence dynamics during reperfusion following long-term renal ischemia in a rat model

    SciTech Connect

    Raman, R N; Pivetti, C D; Matthews, D L; Troppmann, C; Demos, S G

    2008-02-08

    Optical properties of near-surface kidney tissue were monitored in order to assess response during reperfusion to long (20 minutes) versus prolonged (150 minutes) ischemia in an in vivo rat model. Specifically, autofluorescence images of the exposed surfaces of both the normal and the ischemic kidneys were acquired during both injury and reperfusion alternately under 355 nm and 266 nm excitations. The temporal profile of the emission of the injured kidney during the reperfusion phase under 355 nm excitation was normalized to that under 266 nm as a means to account for changes in tissue optical properties independent of ischemia as well as changes in the illumination/collection geometrical parameters in future clinical implementation of this technique using a hand-held probe. The scattered excitation light signal was also evaluated as a reference signal and found to be inadequate. Characteristic time constants were extracted using fit to a relaxation model and found to have larger mean values following 150 minutes of injury. The mean values were then compared with the outcome of a chronic survival study where the control kidney had been removed. Rat kidneys exhibiting longer time constants were much more likely to fail. This may lead to a method to assess kidney viability and predict its ability to recover in the initial period following transplantation or resuscitation.

  3. Autofluorescence dynamics during reperfusion following long-term renal ischemia in a rat model

    NASA Astrophysics Data System (ADS)

    Raman, Rajesh N.; Pivetti, Christopher D.; Matthews, Dennis L.; Troppmann, Christoph; Demos, Stavros G.

    2008-02-01

    Optical properties of near-surface kidney tissue were monitored in order to assess response during reperfusion to long (20 minutes) versus prolonged (150 minutes) ischemia in an in vivo rat model. Specifically, autofluorescence images of the exposed surfaces of both the normal and the ischemic kidneys were acquired during both injury and reperfusion alternately under 355 nm and 266 nm excitations. The temporal profile of the emission of the injured kidney during the reperfusion phase under 355 nm excitation was normalized to that under 266 nm as a means to account for changes in tissue optical properties independent of ischemia as well as changes in the illumination/collection geometrical parameters in future clinical implementation of this technique using a hand-held probe. The scattered excitation light signal was also evaluated as a reference signal and found to be inadequate. Characteristic time constants were extracted using a fit to a relaxation model and found to have larger mean values following 150 minutes of injury. The mean values were then compared with the outcome of a chronic survival study where the control kidney had been removed. Rat kidneys exhibiting longer time constants were much more likely to fail. This may lead to a method to assess kidney viability and predict its ability to recover in the initial period following transplantation or resuscitation.

  4. Oxidative stress influence on renal dysfunction in patients with obstructive jaundice: A case and control prospective study

    PubMed Central

    Martínez-Cecilia, David; Reyes-Díaz, María; Ruiz-Rabelo, Juan; Gomez-Alvarez, Manuel; Villanueva, Carmen Muñoz; Álamo, José; Muntané, Jordi; Padillo, Francisco Javier

    2015-01-01

    Background: Obstructive Jaundice (OJ) is associated with a significant risk of developing acute renal failure (ARF). The involvement of oxidative stress in the development of cholestasis has been demonstrated in different experimental models. However, its role in the morbidity of human cholestasis is far to be elucidated. The aim of the study was the evaluation of oxidative stress markers in blood from patients with OJ and its relation to complications and benign/malignant evolution of cholestasis. Methods: A prospective cross-sectional study of 105 patients with OJ and 34 control subjects were included. Several markers of liver function and oxidative stress, such as lipoperoxides (LPO), as well as reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities were assessed. Results: The patients with OJ showed a marked increase in plasma levels of LPO, SOD and GSH, while GSH-Px levels were decreased. The increase in lipid peroxidation products and the depletion of SOD activity in blood were also related to renal dysfunction. The highest level of LPO was associated with malignant etiology of the disease. The logistic regression analysis showed that the age of the patient and the levels of LPO in blood were predictors of renal dysfunction in OJ patients. Conclusions: This study demonstrates a correlation between oxidative stress and renal dysfunction patients with OJ. PMID:26774750

  5. Design and feasibility of PREMATurity as predictor of children's Cardiovascularrenal Health (PREMATCH): A pilot study

    PubMed Central

    Raaijmakers, Anke; Petit, Thibault; Gu, Yumei; Zhang, Zhenyu; Wei, Fangfei; Cools, Bjorn; Jacobs, Lotte; Thijs, Lutgarde; Thewissen, Liesbeth; Levtchenko, Elena; Staessen, Jan A.; Allegaert, Karel

    2015-01-01

    Abstract The microvasculature and macrovasculature undergo extensive, organ-specific perinatal maturation. Multiple studies show associations between low birth weight and subsequent cardiovascular dysfunction in adulthood, suggesting that extreme preterm birth interferes with this maturation process. Therefore, we designed PREMATCH (PREMATurity as predictor of Cardiovascularrenal Health) to phenotype the microcirculation and macrocirculation during childhood in former preterm infants. A well-characterized cohort of former extreme preterm birth survivors and gender- and age-matched controls (aged 813 years) will be investigated for microvascular and macrovascular structure and function. In addition to cognitive performance and anthropometrics, we will investigate (i) the microvascular structure and function by endothelial function (photoplethysmography), sublingual capillary glycocalyx function (sidestream dark field imaging) and retinal structure (diameters of arterioles and venules); and (ii) the macrovascular phenotype by cardiac and renal ultrasound, repeated blood pressure measurements and arterial pulse-wave recordings. The PREMATCH study is unique in its design, and ongoing recruitment demonstrates excellent feasibility. The expectation is that the results of this study will identify risk factors during childhood for subsequent cardiovascularrenal disease in the adult life of former preterm infants, while further analysis on mediators in neonatal life of this cardiovascularrenal outcome may provide new information on perinatal risk factors. PMID:26107770

  6. Renal Involvement in Primary Sjögren's Syndrome: A Clinicopathologic Study

    PubMed Central

    Maripuri, Saugar; Grande, Joseph P.; Osborn, Thomas G.; Fervenza, Fernando C.; Matteson, Eric L.; Donadio, James V.

    2009-01-01

    Background & objectives: Renal pathology and clinical outcomes in patients with primary Sjögren's syndrome (pSS) who underwent kidney biopsy (KB) because of renal impairment are reported. Design, setting, participants, & measurements: Twenty-four of 7276 patients with pSS underwent KB over 40 years. Patient cases were reviewed by a renal pathologist, nephrologist, and rheumatologist. Presentation, laboratory findings, renal pathology, initial treatment, and therapeutic response were noted. Results: Seventeen patients (17 of 24; 71%) had acute or chronic tubulointerstitial nephritis (TIN) as the primary lesion, with chronic TIN (11 of 17; 65%) the most common presentation. Two had cryoglobulinemic GN. Two had focal segmental glomerulosclerosis. Twenty patients (83%) were initially treated with corticosteroids. In addition, three received rituximab during follow-up. Sixteen were followed after biopsy for more than 12 mo (median 76 mo; range 17 to 192), and 14 of 16 maintained or improved renal function through follow-up. Of the seven patients presenting in stage IV chronic kidney disease, none progressed to stage V with treatment. Conclusions: This case series supports chronic TIN as the predominant KB finding in patients with renal involvement from pSS and illustrates diverse glomerular lesions. KB should be considered in the clinical evaluation of kidney dysfunction in pSS. Treatment with glucocorticoids or other immunosuppressive agents appears to slow progression of renal disease. Screening for renal involvement in pSS should include urinalysis, serum creatinine, and KB where indicated. KB with characteristic findings (TIN) should be considered as an additional supportive criterion to the classification criteria for pSS because it may affect management and renal outcome. PMID:19679669

  7. Renal hemodynamics, function, and oxygenation during cardiac surgery performed on cardiopulmonary bypass: a modeling study.

    PubMed

    Sgouralis, Ioannis; Evans, Roger G; Gardiner, Bruce S; Smith, Julian A; Fry, Brendan C; Layton, Anita T

    2015-01-01

    Acute kidney injury, a prevalent complication of cardiac surgery performed on cardiopulmonary bypass (CPB), is thought to be driven partly by hypoxic damage in the renal medulla. To determine the causes of medullary hypoxia during CPB, we modeled its impact on renal hemodynamics and function, and thus oxygen delivery and consumption in the renal medulla. The model incorporates autoregulation of renal blood flow and glomerular filtration rate and the utilization of oxygen for tubular transport. The model predicts that renal medullary oxygen delivery and consumption are reduced by a similar magnitude during the hypothermic (down to 28C) phase of CPB. Thus, the fractional extraction of oxygen in the medulla, an index of hypoxia, is increased only by 58% from baseline. However, during the rewarming phase (up to 37C), oxygen consumption by the medullary thick ascending limb increases 2.3-fold but medullary oxygen delivery increases only by 33%. Consequently, the fractional extraction of oxygen in the medulla is increased 2.7-fold from baseline. Thus, the renal medulla is particularly susceptible to hypoxia during the rewarming phase of CPB. Furthermore, autoregulation of both renal blood flow and glomerular filtration rate is blunted during CPB by the combined effects of hemodilution and nonpulsatile blood flow. Thus, renal hypoxia can be markedly exacerbated if arterial pressure falls below its target level of 50 mmHg. Our findings suggest that tight control of arterial pressure, and thus renal oxygen delivery, may be critical in the prevention of acute kidney injury associated with cardiac surgery performed on CPB. PMID:25602016

  8. Renal hemodynamics, function, and oxygenation during cardiac surgery performed on cardiopulmonary bypass: a modeling study

    PubMed Central

    Sgouralis, Ioannis; Evans, Roger G.; Gardiner, Bruce S.; Smith, Julian A.; Fry, Brendan C.; Layton, Anita T.

    2015-01-01

    Abstract Acute kidney injury, a prevalent complication of cardiac surgery performed on cardiopulmonary bypass (CPB), is thought to be driven partly by hypoxic damage in the renal medulla. To determine the causes of medullary hypoxia during CPB, we modeled its impact on renal hemodynamics and function, and thus oxygen delivery and consumption in the renal medulla. The model incorporates autoregulation of renal blood flow and glomerular filtration rate and the utilization of oxygen for tubular transport. The model predicts that renal medullary oxygen delivery and consumption are reduced by a similar magnitude during the hypothermic (down to 28C) phase of CPB. Thus, the fractional extraction of oxygen in the medulla, an index of hypoxia, is increased only by 58% from baseline. However, during the rewarming phase (up to 37C), oxygen consumption by the medullary thick ascending limb increases 2.3?fold but medullary oxygen delivery increases only by 33%. Consequently, the fractional extraction of oxygen in the medulla is increased 2.7?fold from baseline. Thus, the renal medulla is particularly susceptible to hypoxia during the rewarming phase of CPB. Furthermore, autoregulation of both renal blood flow and glomerular filtration rate is blunted during CPB by the combined effects of hemodilution and nonpulsatile blood flow. Thus, renal hypoxia can be markedly exacerbated if arterial pressure falls below its target level of 50 mmHg. Our findings suggest that tight control of arterial pressure, and thus renal oxygen delivery, may be critical in the prevention of acute kidney injury associated with cardiac surgery performed on CPB. PMID:25602016

  9. Follow-up (99m)Tc EC renal dynamic scintigraphy and DMSA-III SPECT/CT in unmasking a masqueraded case of Horseshoe kidney.

    PubMed

    Jain, T K; Basher, R K; Mittal, B R; Bhatia, A; Rao, K L N

    2015-01-01

    Hydronephrosis is a common finding in urinary tract outflow obstruction. Chronically obstructed hydronephrotic system may be associated with parenchymal changes. Ultrasound, intravenous urography, micturating cysto-urethrogram and scintigraphy are commonly performed to evaluate the cause of obstruction. In childhood, pelviureteric junction obstruction is a common cause of the hydronephrosis. Hydronephrosis can also be present in horseshoe kidneys due to poor drainage. However, a large sized hydronephrotic cavity may obscure the finding of horseshoe kidney. A case was reported, and it was diagnosed as horseshoe kidney on follow-up renal dynamic scan and confirmed with the help of dimercaptosuccinic acid SPECT/CT. PMID:26139030

  10. Differential uptake of Tc-99m DMSA and Tc-99m EC in renal tubular disorders: Report of two cases and review of the literature.

    PubMed

    Reddy Gorla, Arun Kumar; Agrawal, Kanhaiyalal; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2014-07-01

    Tc-99m DMSA and Tc-99m EC studies are invaluable functional imaging modalities for renal structural and functional assessment. Normally, the relative renal function estimated by the two methods correlates well with each other. We here present two patients with renal tubular acidosis who showed impaired/altered DMSA uptake with normal EC renal dynamic study depicting the pitfall of DMSA imaging in tubular disorders. The two presented cases also depict distinct pattern of Tc-99m DMSA scintigraphic findings in patients with proximal and distal renal tubular acidosis, thus highlighting the factors affecting DMSA kinetics. PMID:25210282

  11. Validation of the Korean coefficient for the modification of diet in renal disease study equation

    PubMed Central

    Oh, Yun Jung; Cha, Ran-hui; Lee, Seung Hwan; Yu, Kyung Sang; Kim, Satbyul Estella; Kim, Ho; Kim, Yon Su

    2016-01-01

    Background/Aims: Race and ethnicity are important determinants when estimatingglomerular filtration rate (GFR). The Korean coefficients for the isotope dilution mass spectrometry (IDMS) Modification of Diet in Renal Disease (MDRD) Study equations were developed in 2010. However, the coefficients have not been validated. The aim of this study was to validate the performance of the Korean coefficients for the IDMS MDRD Study equations. Methods: Equation development and validation were performed in separate groups (development group, n = 147 from 2008 to 2009; validation group, n = 125 from 2010 to 2012). We compared the performance of the original IDMS MDRD equations and modified equations with Korean coefficients. Performance was assessed by comparing correlation coefficients, bias, and accuracy between estimated GFR and measured GFR, with systemic inulin clearance using a single injection method. Results: The Korean coefficients for the IDMS MDRD equations developed previously showed good performance in the validation group. The new Korean coefficients for the four- and six-variable IDMS MDRD equations using both the development and validation cohorts were 1.02046 and 0.97300, respectively. No significant difference was detected for the new Korean coefficients, in terms of estimating GFR, between the original and modified IDMS MDRD Study equations. Conclusions: The modified equations with Korean coefficients for the IDMS MDRD Study equations were not superior to the original equations for estimating GFR. Therefore, we recommend using the original IDMS MDRD Study equation without ethnic adjustment in the Korean population. PMID:26759158

  12. Renal dysfunction in cirrhosis

    PubMed Central

    Urrunaga, Nathalie H.; Mindikoglu, Ayse L.; Rockey, Don C.

    2015-01-01

    Purpose of review Renal dysfunction causes significant morbidity in cirrhotic patients. Diagnosis is challenging because it is based on serum creatinine, which is used to calculate estimated glomerular filtration rate, which itself is not an ideal measure of renal function in patients with cirrhosis. Finding the exact cause of renal injury in patients with cirrhosis remains problematic due to the limitations of the current diagnostic tests. The purpose of this review is to highlight studies used to diagnose renal dysfunction in patients with renal dysfunction and review current treatments. Recent findings New diagnostic criteria and classification of renal dysfunction, especially for acute kidney injury (AKI), have been proposed in hopes of optimizing treatment and improving outcomes. New biomarkers that help to differentiate structural from functional AKI in cirrhotic patients have been developed, but require further investigation. Vasoconstrictors are the most commonly recommended treatment of hepatorenal syndrome (HRS). Given the high mortality in patients with type 1 HRS, all patients with HRS should be evaluated for liver transplantation. When renal dysfunction is considered irreversible, combined liver–kidney transplantation is advised. Summary Development of new biomarkers to differentiate the different types of AKI in cirrhosis holds promise. Early intervention in cirrhotic patients with renal dysfunction offers the best hope of improving outcomes. PMID:25763790

  13. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication)

    PubMed Central

    2016-01-01

    Purpose: The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI) by using an electrical circuit model to simulate renal blood flow. Methods: In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoffs current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research) and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Results: Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. Conclusion: This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings. PMID:26732576

  14. Quality of life, symptom distress, and social support among renal transplant recipients in Southern Taiwan: a correlational study.

    PubMed

    Chen, Wan-Chi; Chen, Ching-Huey; Lee, Po-Chang; Wang, Wen-Ling

    2007-12-01

    Quality of life is an important indicator for evaluating therapeutic outcomes and mortality in patients with end-stage renal disease. Few studies have explored the impact of symptom distress and social support on quality of life in this population. A correlational study was designed to examine the influence of symptom distress, social support and demographic characteristics on quality of life in renal transplant recipients. A convenience sample of 113 renal transplant recipients was recruited from a medical center in Southern Taiwan. A structured questionnaire was used to collect data. This four-part tool included: Quality of Life Index--Kidney Transplant Version III, Physical Symptom Distress Scale, Social Support Scale, and demographic characteristics. Data were analyzed by descriptive and inferential statistics (SPSS 10.1 statistical package). Percentage, rank, mean and standard deviation, t-tests, chi-square, ANOVA, Pearson's correlation and multiple regression were computed. Results showed that renal transplant recipients had a moderate quality of life. Social support and symptom distress, age, employment status, and household income significantly explained 28.8% of the variance in quality of life. Findings suggest implications for interventional programming and research aimed toward improving quality of life, including individual and family-based approaches designed to enhance recipients' social support and address effective management of symptoms. Recruiting a transplant clinical nurse specialist to design and implement an intervention program also is recommended. PMID:18080976

  15. An ontogenic study of renal tissue kallikrein in Okamoto spontaneously hypertensive rats: comparisons with human hypertensive nephropathy.

    PubMed

    Figueroa, C D; Bhoola, K D; MacIver, A G; Mackenzie, J C

    1992-01-01

    Urinary excretion of tissue kallikrein is reduced in essential hypertension. Although a similar finding has been reported in spontaneously hypertensive rats (SHR), only a few studies have been concerned with the amount of enzyme within the kidney both at the time of onset and during progression of the hypertension. We have performed an ontogenic study on the renal parenchymal values and immunoreactivity of tissue kallikrein in Okamoto SHR aged 4-78 weeks. Additionally, these two parameters were analysed in human biopsies taken from patients with hypertensive nephropathy. The enzymatic activity of renal tissue kallikrein (active and total; specifically antagonized by anti-tissue kallikrein antibodies), increased from 4 to 52 weeks in SHR when compared to normotensive Wistar Kyoto (WKY) rats; this increase was associated with a significant increase in blood pressure. In contrast, 78 weeks SHR and human biopsy tissue showed a substantial reduction in tissue kallikrein values. Also, both renal tissues showed a reduction in immunoreactivity in the cells of the connecting tubules that specifically store the enzyme. In advanced hypertension the observed reduction in tissue kallikrein was probably secondary to a loss of distal tubular mass, as a result of tubular atrophy and fibrosis. The greater values for renal tissue kallikrein in the kidney and reported reduced urinary excretion during the early phases of spontaneous hypertension may be explained by a primary defect in the mechanisms that regulate release of tissue kallikrein from the connecting tubule cells. PMID:1320231

  16. Predictors of the development of myocarditis or acute renal failure in patients with leptospirosis: An observational study

    PubMed Central

    2012-01-01

    Background Leptospirosis has a varied clinical presentation with complications like myocarditis and acute renal failure. There are many predictors of severity and mortality including clinical and laboratory parameters. Early detection and treatment can reduce complications. Therefore recognizing the early predictors of the complications of leptospirosis is important in patient management. This study was aimed at determining the clinical and laboratory predictors of myocarditis or acute renal failure. Methods This was a prospective descriptive study carried out in the Teaching Hospital, Kandy, from 1st July 2007 to 31st July 2008. Patients with clinical features compatible with leptospirosis case definition were confirmed using the Microscopic Agglutination Test (MAT). Clinical features and laboratory measures done on admission were recorded. Patients were observed for the development of acute renal failure or myocarditis. Chi-square statistics, Fisher's exact test and Mann-Whitney U test were used to compare patients with and without complications. A logistic regression model was used to select final predictor variables. Results Sixty two confirmed leptospirosis patients were included in the study. Seven patients (11.3%) developed acute renal failure and five (8.1%) developed myocarditis while three (4.8%) had both acute renal failure and myocarditis. Conjunctival suffusion - 40 (64.5%), muscle tenderness - 28 (45.1%), oliguria - 20 (32.2%), jaundice - 12 (19.3%), hepatomegaly - 10 (16.1%), arrhythmias (irregular radial pulse) - 8 (12.9%), chest pain - 6 (9.7%), bleeding - 5 (8.1%), and shortness of breath (SOB) 4 (6.4%) were the common clinical features present among the patients. Out of these, only oliguria {odds ratio (OR) = 4.14 and 95% confidence interval (CI) 1.003-17.261}, jaundice (OR = 5.13 and 95% CI 1.149-28.003), and arrhythmias (OR = 5.774 and 95% CI 1.001-34.692), were predictors of myocarditis or acute renal failure and none of the laboratory measures could predict the two complications. Conclusions This study shows that out of clinical and laboratory variables, only oliguria, jaundice and arrhythmia are strong predictors of development of acute renal failure or myocarditis in patients with leptospirosis presented to Teaching Hospital of Kandy, Sri Lanka. PMID:22243770

  17. A study exploring critical pathways in clear cell renal cell carcinoma

    PubMed Central

    ZENG, ZISAN; QUE, TENGCHENG; ZHANG, JIANGE; HU, YANLING

    2014-01-01

    Renal cell carcinoma (RCC) is the most lethal type of cancer in the urinary system and often presents as a metastatic disease. Furthermore, there are no effective treatments for the disease. Several studies based on gene expression profiling have been performed with the aim of gaining insights into the pathogenesis of RCC; however, few studies have investigated RCC at the pathway level to search for the possible pathways involved in clear cell RCC (CCRCC). In this study, gene set enrichment analysis (GSEA) was conducted on microarray datasets from CCRCC tissue. DAVID functional enrichment analysis was performed based on the dysregulated genes that were identified in a meta-analysis performed on the microarray datasets from CCRCC tissue. In GSEA, 17 down- and 12 upregulated pathways coexisted in six datasets. The majority of the upregulated pathways were associated with the immune system. In addition, 32 dysregulated pathways were obtained from DAVID functional enrichment analysis, based on the abnormal genes identified by meta-analysis. This study demonstrated that cross-GSEA is a useful method for exploring the critical pathways involved CCRCC; however, an individual dataset with a small sample may introduce bias. A cross-GSEA based on certain well-designed datasets may be required to further the progress made in this study, following the analysis of its results. PMID:24348776

  18. Preliminary shuttle structural dynamics modeling design study

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The design and development of a structural dynamics model of the space shuttle are discussed. The model provides for early study of structural dynamics problems, permits evaluation of the accuracy of the structural and hydroelastic analysis methods used on test vehicles, and provides for efficiently evaluating potential cost savings in structural dynamic testing techniques. The discussion is developed around the modes in which major input forces and responses occur and the significant structural details in these modes.

  19. Indium-111 leukocyte scanning. False-negative study in a renal abscess

    SciTech Connect

    Kumar, R.; Bedi, D.G.; Fawcett, H.D.; Winsett, M.Z.; Fagan, C.J.

    1986-04-01

    A 33-year-old man had clinical features of a right renal abscess. Results of excretory urography and ultrasonography showed a focal complex mass lesion in the right kidney. An In-111 leukocyte scan failed to detect the right renal abscess, which later was aspirated under CT guidance and explored surgically. The role of In-111 leukocyte imaging in the detection of intra-abdominal abscesses, with limitations of the procedure, is discussed.

  20. A Study of Varlilumab (Anti-CD27) and Sunitinib in Patients With Metastatic Clear Cell Renal Cell Carcinoma

    ClinicalTrials.gov

    2016-01-21

    Carcinoma, Renal Cell; Kidney Diseases; Kidney Neoplasms; Urogenital Neoplasms; Urologic Diseases; Urologic Neoplasms; Neoplasms; Neoplasms by Histologic Type; Clear-cell Metastatic Renal Cell Carcinoma

  1. Cadmium and renal cancer

    SciTech Connect

    Il'yasova, Dora; Schwartz, Gary G. . E-mail: gschwart@wfubmc.edu

    2005-09-01

    Background: Rates of renal cancer have increased steadily during the past two decades, and these increases are not explicable solely by advances in imaging modalities. Cadmium, a widespread environmental pollutant, is a carcinogen that accumulates in the kidney cortex and is a cause of end-stage renal disease. Several observations suggest that cadmium may be a cause of renal cancer. Methods: We performed a systematic review of the literature on cadmium and renal cancer using MEDLINE for the years 1966-2003. We reviewed seven epidemiological and eleven clinical studies. Results: Despite different methodologies, three large epidemiologic studies indicate that occupational exposure to cadmium is associated with increased risk renal cancer, with odds ratios varying from 1.2 to 5.0. Six of seven studies that compared the cadmium content of kidneys from patients with kidney cancer to that of patients without kidney cancer found lower concentrations of cadmium in renal cancer tissues. Conclusions: Exposure to cadmium appears to be associated with renal cancer, although this conclusion is tempered by the inability of studies to assess cumulative cadmium exposure from all sources including smoking and diet. The paradoxical findings of lower cadmium content in kidney tissues from patients with renal cancer may be caused by dilution of cadmium in rapidly dividing cells. This and other methodological problems limit the interpretation of studies of cadmium in clinical samples. Whether cadmium is a cause of renal cancer may be answered more definitively by future studies that employ biomarkers of cadmium exposure, such as cadmium levels in blood and urine.

  2. Organometallic Titanocene–Gold Compounds as Potential Chemotherapeutics in Renal Cancer. Study of their Protein Kinase Inhibitory Properties

    PubMed Central

    2015-01-01

    Early–late transition metal TiAu2 compounds [(η-C5H5)2Ti{OC(O)CH2PPh2AuCl}2] (3) and new [(η-C5H5)2Ti{OC(O)-4-C6H4PPh2AuCl}2] (5) were evaluated as potential anticancer agents in vitro against renal and prostate cancer cell lines. The compounds were significantly more effective than monometallic titanocene dichloride and gold(I) [{HOC(O)RPPh2}AuCl] (R = −CH2– 6, −4-C6H4– 7) derivatives in renal cancer cell lines, indicating a synergistic effect of the resulting heterometallic species. The activity on renal cancer cell lines (for 5 in the nanomolar range) was considerably higher than that of cisplatin and highly active titanocene Y. Initial mechanistic studies in Caki-1 cells in vitro coupled with studies of their inhibitory properties on a panel of 35 kinases of oncological interest indicate that these compounds inhibit protein kinases of the AKT and MAPKAPK families with a higher selectivity toward MAPKAPK3 (IC503 = 91 nM, IC505 = 117 nM). The selectivity of the compounds in vitro against renal cancer cell lines when compared to a nontumorigenic human embryonic kidney cell line (HEK-293T) and the favorable preliminary toxicity profile on C57black6 mice indicate that these compounds (especially 5) are excellent candidates for further development as potential renal cancer chemotherapeutics. PMID:25435644

  3. Liquid helium fluid dynamics studies

    SciTech Connect

    Van Sciver, S.W.

    1989-01-01

    The main focus of the first three year period of this research program was to set up our liquid helium flow facility and begin experiments on the flow of liquid helium within this system. The first task of our experimental program involved the set up and check out of the liquid helium flow facility (LHFF). This facility is the centerpost of our fluid dynamics experiments. The LHFF is designed to allow a variety of experiments which test important helium fluid dynamics behavior on a scale close to that involved in large scale applications. To achieve this goal, we chose a horizontal dewar configuration with a cold bore access on either end. A nominal length of five meters was selected with a sufficiently large inner diameter to allow insertion of various tubing configurations, flow metering devices and heat exchangers. Further, to minimize consumption of liquid helium, the dewar design includes two actively cooled shields; one cooled by LN/sub 2/ to 77 K and one at 4.5 K maintained by a closed cycle helium refrigerator. Helium flow is to be provided by a cold centrifugal pump. 4 refs., 2 figs.

  4. Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease.

    PubMed

    Gowan, Richard A; Lingard, Amy E; Johnston, Laura; Stansen, Wibke; Brown, Scott A; Malik, Richard

    2011-10-01

    Medical records (2005-2009) of a feline-only practice were searched for cats with degenerative joint disease (DJD) treated using meloxicam. DJD was diagnosed by the presence of at least two of the following: (i) altered mobility (observed by the owner), (ii) abnormal physical findings, (iii) characteristic radiographic changes. The primary study cohort consisted of cats older than 7 years that had received meloxicam for variable intervals in excess of 6 months, and for which complete records were available. These cats were subdivided according to whether detectable chronic kidney disease (CKD) was present ('renal group'), or not ('non-renal group'), and, for the 'renal group', according to the cat's IRIS category. Serum biochemistry, urinalysis (including urine specific gravity [USG]), body mass and condition score were monitored regularly. Progression of CKD in the 'renal group' and 'non-renal group' of cats was compared to two groups of age- and IRIS-matched control cats not receiving meloxicam (from the same clinic, over the same time period). The study was thus a case-control design, with two study groups. Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. Of these, 22 cats had stable CKD at the start of treatment (stage 1, eight cats; stage 2, 13 cats; stage 3, one cat). No cats initially had an elevated urinary protein to creatinine ratio. The remaining 16 cats initially had normal renal analytes and adequately concentrated urine. The median age of the 'renal' and 'non-renal' meloxicam groups was 15.5 and 13.4 years, respectively. The median treatment duration was 467 days in the 'renal group' and 327 days in the 'non-renal group'. After titration (to the lowest effective dose), the median maintenance dose was 0.02 mg/kg/day in both groups (range 0.015-0.033 mg/kg/day). There was no difference in sequential serum creatinine concentration or USG measurements between the 'non-renal group' treated with meloxicam compared to control cats not treated with meloxicam. There was less progression of renal disease in the 'renal group' treated with meloxicam compared to the age- and IRIS-matched cats with CKD not given meloxicam. These results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable. Long-term meloxicam therapy may slow the progression of renal disease in some cats suffering from both CKD and DJD. Prospective studies are required to confirm these findings. PMID:21906984

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

    PubMed Central

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

    2015-01-01

    It has been hypothesized that chronic renal failure (CRF) predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases) from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were collected. Samples were thoroughly examined with microscopy and three coproantigens detection kits. Enteric protozoa were detected in 21 cases and 14 controls. Blastocystis spp. were the most predominant parasite (16% in cases versus 8% in controls), followed by Giardia duodenalis (10% in cases versus 12% in controls) and Cryptosporidium spp. (10% in cases versus 6% in controls). Cyclospora cayetanensis was identified in two cases, while Entamoeba histolytica was described in one case and one control. Intestinal parasitism was positively associated with the male gender, urban residence, and travel history. Clinical symptoms of nausea/vomiting and abdominal pain were significantly varied between the parasitized cases and controls (P value ≤ 0.05). Given the results, we recommend screening all diarrheal feces for intestinal protozoa in the study's population, particularly those with CRF. PMID:26491455

  6. Cervicovaginal HPV infection in female renal transplant recipients: an observational, self-sampling based, cohort study.

    PubMed

    Meeuwis, K A P; Hilbrands, L B; IntHout, J; Slangen, B F M; Hendriks, I M P; Hinten, F; Christiaans, M H L; Quint, W G V; van de Kerkhof, P C M; Massuger, L F A G; Hoitsma, A J; van Rossum, M M; Melchers, W J G; de Hullu, J A

    2015-03-01

    Immunosuppressive treatment of organ transplant recipients is associated with an increase in the occurrence of human papillomavirus (HPV) related anogenital (pre)malignancies. This cohort study investigated the genotype-specific prevalence of HPV infections in a large cohort of female renal transplant recipients (RTRs). Participants self-collected a cervicovaginal sample for detection and genotyping of HPV. Besides, they completed a questionnaire regarding sociodemographic variables, medical data and sexual behavior. Anogenital screening was offered to all HPV-positive participants. A total number of 218 female RTRs was included. The prevalence of mucosal HPV infections was 27.1% and 17.4% for high risk HPV in particular. The studied cohort showed a broad range of HPV genotypes and multiple HPV genotypes were found in 27.1% of HPV-positive patients. Seven participants were identified with occult premalignant anogenital lesions. In conclusion, this study shows a high point-prevalence of HPV in female RTRs (age-matched West-European general population: 9-10%) with a shift in the distribution of genotypes as compared with the general population. Moreover, a substantial number of patients with occult premalignancies was identified. The introduction of self-sampling for HPV positivity can help in early detection of (pre)malignant anogenital lesions in this vulnerable population. PMID:25675976

  7. Incidence and Outcomes of Acute Renal Failure Following Liver Transplantation: A Population-Based Cohort Study.

    PubMed

    Chen, Hsiu-Pin; Tsai, Yung-Fong; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

    2015-12-01

    The aim of our large, population-based, cohort study was to explore the risk factors of acute renal failure (ARF) after liver transplant (LT) in Taiwan.From the Taiwanese National Health Insurance Research Database, 2862 patients who had undergone LT without pretransplant dialysis between July 1, 1998, and December 31, 2012, were identified. Preoperative, operative, and perioperative risks factors were considered and analyzed using logistic regression analysis, after adjusting for age and sex. All patients were followed up until the study endpoint or death.The final dataset included 214 patients with ARF and 2648 without ARF post-LT. Preoperative cerebrovascular diseases were the most important identifiable risk factor for ARF post-LT. Comparison of outcomes for patients "with" and "without" ARF indicated higher incidence rates of bacteremia, pneumonia, and postoperative bleeding, as well as longer stays in both intensive care unit and hospital. Kaplan-Meier mortality curves identified higher rates of mortality for patients' developing ARF at 1-year post-LT and overall at 14.5 years postsurgery.We provide evidence of a high incidence of ARF post-LT in Taiwan, with documented association of ARF with higher incidence rates of morbidity and mortality in this clinical population. The most important identifiable risk factor for ARF in our study was cerebrovascular diseases. PMID:26717368

  8. Irreversible Electroporation of Renal Cell Carcinoma: A First-in-Man Phase I Clinical Study

    SciTech Connect

    Pech, Maciej; Janitzky, Andreas; Wendler, Johann Jacob; Strang, Christof; Blaschke, Simon; Dudeck, Oliver; Ricke, Jens; Liehr, Uwe-Bernd

    2011-02-15

    Purpose: Irreversible electroporation (IRE) is a newly developed nonthermal tissue-ablation technique in which high-voltage electrical pulses of microsecond duration are applied to induce irreversible permeabilisation of the cell membrane, presumably through nanoscale defects in the lipid bilayer, leading to apoptosis. The purpose of this study was to assess the feasibility and safety of ablating renal cell carcinoma (RCC) tissue by IRE. Methods: Six patients scheduled for curative resection of RCC were included. IRE was performed during anaesthesia immediately before the resection with electrographic synchronisation. Central haemodynamics were recorded before and 5 min after electroporation. Five-channel electrocardiography (ECG) was used for detailed analysis of ST waveforms. Blood sampling and 12-lead ECG were performed before, during, and at scheduled intervals after the intervention. Results: Analysis of ST waveforms and axis deviations showed no relevant changes during the entire study period. No changes in central haemodynamics were seen 5 min after IRE. Similarly, haematological, serum biochemical, and ECG variables showed no relevant differences during the investigation period. No changes in cardiac function after IRE therapy were found. One case of supraventricular extrasystole was encountered. Initial histopathologic examination showed no immediate adverse effects of IRE (observation of delayed effects will require a different study design). Conclusion: IRE seems to offer a feasible and safe technique by which to treat patients with kidney tumours and could offer some potential advantages over current thermal ablative techniques.

  9. Renal oncocytoma: new observations

    SciTech Connect

    Quinn, M.J.; Hartman, D.S.; Friedman, A.C.; Sherman, J.L.; Lautin, E.M.; Pyatt, R.S.; Ho, C.K.; Csere, R.; Fromowitz, F.B.

    1984-10-01

    Renal oncocytomas are uncommon, benign tumors that can be treated by local incision or heminephrectomy; their preoperative differentiation from renal cell carcinoma, treated by radical nephrectomy, would be invaluable. A particularly important finding, a central scar, not stressed in previous reports, is frequently demonstrated by CT examination. The authors evaluated radiographic studies of 18 pathologically confirmed cases of oncocytoma and compared findings with results of CT, sonography, and angiogrpahy studies of 18 renal cell carcinoma cases. Oncocytomas can be suggested if a stellate scar is identified within an otherwise homogeneous tumor on ultrasound (US) and CT; if the mass appears homogeneous but no scar is present, angiography should be performed.

  10. Pharmacodynamic study of low molecular weight dermatan sulphate (Desmin) after a single subcutaneous administration in patients with renal insufficiency.

    PubMed

    Saivin, S; Boneu, B; Ducret, F; Pourrat, J; Palazzini, E; Zamboni, W; Duchne, P; Houin, G

    2000-09-01

    The pharmacodynamic pattern of low molecular weight dermatan sulphate (CAS 24967-94-0, Desmin-LMWDS) was studied in patients presenting chronic renal insufficiency. Three groups of six patients were defined according to their creatinine clearance: group 1, more than 50 ml/min, group 2 between 10 and 50 ml/min and group 3 lower than 10 ml/min (haemodialized patients). Desmin-LMWDS concentrations were determined with the Heptest assay and the chromogenic specific heparin cofactor II dependent anti IIa assay. In patients of group 1 affected by moderate renal insufficiency, the pharmacodynamic profiles were roughly comparable to those obtained in normal subjects. In the two other groups, the profiles were markedly modified by the renal insufficiency. The maximal concentrations were doubled and the areas under the time-activity curve were 4-fold higher in haemodialyzed (group 3) and severe renal insufficient patients (group 2) than in patients of group 1. The clearance of the anti IIa activity were 13.98 +/- 6.25 l/h; 4.12 +/- 2.64 l/h and 2.94 +/- 1.53 l/h and the half-lives were 2.79 +/- 2.60 h, 6.15 +/- 4.02 h and 11.51 +/- 6.54 h in groups 1 to 3, respectively (p < 0.05). The Desmin-LMWDS clearance was directly correlated to the creatinine clearance (r = 0.8244, n = 18, p < 0.001). Thus, as for low molecular weight heparin, renal function plays a major role in the elimination of low molecular weight dermatan sulphate. PMID:11050699

  11. Study of the diagnosis and treatment of renal cell carcinoma using monoclonal antibodies

    SciTech Connect

    Chiou, R.K.

    1987-01-01

    Among the potential applications of monoclonal antibodies (Mabs) in the diagnosis and treatment of human cancer is the use in the specific detection of cancer sites and the selective destruction of cancer cells. Fetal kidney was used as an immunogen to develop Mab A6H, which is highly reactive to 16/16 renal cell carcinoma (RCC) cell lines and to 16/19 human RCC specimens. RCC xenografts as small as 40 mg have been imaged clearly in radioimmunoscintigraphy studies using A6H labeled with iodine-131. In Mab-targeted radiotherapy studies, 2 doses of 100-150 uCi /sup 131/I-labeled A6H or an /sup 131/ I-labeled A6H-C5H cocktail caused tumor regression or tumor growth arrest in >80% of treated mice, while no such effect was observed in mice treated with /sup 131/I-labeled control Mab or unlabeled A6H. Internal radiation dosimetry, which was calculated by computer analysis of sequential radioimmunoscintigraphy, showed that A6H delivered approximately 35 rad/uCi of the injected dose to RCC xenografts. When the radiation dose to the tumor was <2500 rad, stabilization in tumor growth was not observed. Radiation doses >3000 rad resulted in tumor regression or growth arrest in >85% of mice. A clinical trial using /sup 131/I-labeled A6H in the diagnosis and treatment of RCC is now underway at our institution.

  12. The incidence of end-stage renal disease in India: a population-based study.

    PubMed

    Modi, G K; Jha, V

    2006-12-01

    Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are emerging public health problems in developing countries, and need changes in health-care policy. ESRD incidence data are not available from large parts of the developing world including South Asia. We report the ESRD incidence in a large urban population in India. ESRD incidence was estimated for four consecutive calendar years (2002-2005) among 572 029 subjects residing in 36 of the 56 wards of the city of Bhopal. These subjects are beneficiaries of free health care in a hospital established after the 1984 Union Carbide Industrial Accident. Crude and age-adjusted incidence rates were calculated. A total of 346 new ESRD patients were diagnosed during the study period; 86 in 2002, 82 in 2003, 85 in 2004, and 93 in 2005. Average crude and age-adjusted incidence rates were 151 and 232 per million population, respectively. The mean age was 47 years, and 58% were males. Diabetic nephropathy was the commonest (44%) cause of ESRD. This study provides the first population-based ESRD incidence data from India and reveals it to be higher than previously estimated. Diabetic nephropathy is the leading cause of ESRD. Changes are required in health-care policy for optimal care of CKD patients and efficient resource utilization for management of those with ESRD. PMID:17063176

  13. The Choice of Renal Replacement Therapy (CORETH) project: study design and methods

    PubMed Central

    Robinski, Maxi; Mau, Wilfried; Lamprecht, Juliane; Krauth, Christian; Girndt, Matthias

    2014-01-01

    Background To date, research has neglected the patient's psychosocial and cognitive conditions as contributing factors to dialysis modality decision-making. Hence, the Choice of Renal Replacement Therapy (CORETH) study aims to examine these conditions with regard to their impact on the choice. Here we describe the design of the multicentre study, which is supported by a grant from the German Ministry for Education and Research. Methods Two groups of patients will be compared after having chosen peritoneal or haemodialysis as permanent treatment. About 1200 participants from 50 dialysis centres all over Germany will be questioned. The questionnaire addresses social, psychological and shared decision-making aspects. Furthermore, cognitive functioning will be tested. For an economic evaluation direct and indirect costs of treatment will be calculated. Changes will be examined through a one-year follow-up. Conclusions The results will enlighten the treatment choice under the German healthcare system. They will provide further insight regarding the discussion on patient autonomy. From the patients' perspective, the results will help to strengthen their participation in the individual process of health-related decision-making. PMID:25859375

  14. A randomized study of the efficacy of adjuvant local graft irradiation following renal transplantation

    SciTech Connect

    Torrisi, J.R.; Dritschilo, A.; Harter, K.W.; Helfrich, B.; Berg, C.D.; Whitfield, G.; Stablein, D.; Alijani, M. )

    1990-05-01

    A prospective randomized study investigating the effectiveness of adjuvant local graft irradiation (LGI) following renal transplantation was performed at Georgetown University Hospital from 1983 until 1988. One hundred and thirty-eight patients were enrolled in the study with 117 patients receiving cadaver kidney transplantations and 21 patients receiving living related kidney transplantations. Seventy-one patients were randomized to receive adjuvant local graft irradiation consisting of 600 cGy in four fractions with chemical immunosuppression whereas the remaining 67 patients received chemical immunosuppression only (control group). The two groups were comparable at entry with respect to potentially important prognostic variables. Median follow-up for all patients was 30 months. The 3-year actuarial allograft success rate was 75% and 68% for the local graft irradiation and control groups, respectively. A nonsignificant trend favoring the irradiated group was noted. Subgroup analysis of the 21 recipients of kidneys from living related donors suggested an improvement in allograft survival for the local graft irradiation arm. Cadaver allograft survival was not significantly different between the two treatment arms. There was no apparent benefit in kidney function or time to the first rejection episode in the group receiving local graft irradiation.

  15. Pregnancy and renal transplantation.

    PubMed

    Ba?aran, O; Emiro?lu, R; Seme, S; Moray, G; Haberal, M

    2004-01-01

    Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia. PMID:15013320

  16. Stratifying Risk for Renal Insufficiency Among Lithium-Treated Patients: An Electronic Health Record Study.

    PubMed

    Castro, Victor M; Roberson, Ashlee M; McCoy, Thomas H; Wiste, Anna; Cagan, Andrew; Smoller, Jordan W; Rosenbaum, Jerrold F; Ostacher, Michael; Perlis, Roy H

    2016-03-01

    Although lithium preparations remain first-line treatment for bipolar disorder, risk for development of renal insufficiency may discourage their use. Estimating such risk could allow more informed decisions and facilitate development of prevention strategies. We utilized electronic health records from a large New England health-care system between 2006 and 2013 to identify patients aged 18 years or older with a lithium prescription. Renal insufficiency was identified using the presence of renal failure by ICD9 code or laboratory-confirmed glomerular filtration rate below 60 ml/min. Logistic regression was used to build a predictive model in a random two-thirds of the cohort, which was tested in the remaining one-third. Risks associated with aspects of pharmacotherapy were also examined in the full cohort. We identified 1445 adult lithium-treated patients with renal insufficiency, matched by risk set sampling 1 : 3 with 4306 lithium-exposed patients without renal insufficiency. In regression models, features associated with risk included older age, female sex, history of smoking, history of hypertension, overall burden of medical comorbidity, and diagnosis of schizophrenia or schizoaffective disorder (p<0.01 for all contrasts). The model yielded an area under the ROC curve exceeding 0.81 in an independent testing set, with 74% of renal insufficiency cases among the top two risk quintiles. Use of lithium more than once daily, lithium levels greater than 0.6 mEq/l, and use of first-generation antipsychotics were independently associated with risk. These results suggest the possibility of stratifying risk for renal failure among lithium-treated patients. Once-daily lithium dosing and maintaining lower lithium levels where possible may represent strategies for reducing risk. PMID:26294109

  17. [A clinical study of associated bladder tumor in patients with renal pelvic and ureteral tumor].

    PubMed

    Sugano, O; Shouji, N; Horigome, T; Uchi, K; Katou, H

    1995-08-01

    We investigated the incidence of associated bladder tumor and prognosis in 101 cases with a pathological diagnosis of transitional cell carcinoma, selected from those with renal pelvic and ureteral tumor whom we had encountered over the 18 years between April 1976 and March 1993. Among these 101 cases, the incidence of associated bladder tumor was noted in 42 (41.6%), 23 (22.8%) with coexistence and 19 (18.8%) with subsequence. As for the primary site of renal pelvis and ureter, the coexistence was 15.4% and subsequence 20.5% in renal pelvis, and the coexistence was 24.6% and subsequence 19.3% in ureter, and the coexistence was 60.0% and subsequence 0.0% in both renal pelvis and ureter. The incidence of coexistent bladder tumor was high in both renal pelvis and ureter, but no significant difference was noted. As for the stage, the incidence of coexistence was high in T1, while subsequence was high in T2, but no significant difference was noted. As for the grade, the incidence of coexistence was high in G2, but no significant difference was noted. The 5 year survival rate was 58.2% in those without, 54.2% with coexistence, and 82.5% with subsequent bladder tumor, with a significant difference (p < 0.05) between the last two groups. The interval of subsequent bladder tumor ranged from 4 to 164 months (mean 27.7 months), with the incidence within 2 years being approximately 70.0%. It was found that the renal pelvic and ureteral tumors are frequently associated bladder tumor while associated bladder tumor dose not appear to have an ill effect on the prognosis. Therefore it is necessary that patients with renal pelvic and ureteral tumor be observed closely for 5 years, especially for the initial 2 years. PMID:7474623

  18. Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

    PubMed Central

    2012-01-01

    Background Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension. Methods Retrospective analysis of patients admitted with malignant hypertension in Amsterdam, the Netherlands between August 1992January 2010. Follow-up data on vital status, renal function and blood pressure (BP) were obtained from the outpatient department and from general practitioners. The primary composite endpoint was end-stage renal disease (ESRD) defined as the start of kidney replacement therapy (KRT) or???50% decline of estimated glomerular filtration rate (eGFR). The secondary endpoint was all cause mortality. Results A total of 120 patients admitted with malignant hypertension were included. After a median follow-up period of 67?months (IQR 28 to 108?months) the primary endpoint was reached by 37 (31%) patients, whereas 18 patients (15%) reached the secondary endpoint. Twenty-nine (24%) patients started KRT and 8 patients (7%) had an eGFR decline???50%. After the acute phase (> 3?months after admission), initial serum creatinine and follow-up BP were the main predictors of future ESRD with hazard ratios of 6.1 (95% CI, 2.217) for patients with initial serum creatinine???175??mol /L and 4.3 (95% CI, 1.414) for patients with uncontrolled hypertension. Conclusions Progressive renal function decline leading to ESRD remains a major threat to patients with malignant hypertension. BP control during follow-up was an important modifiable predictor of renal outcome. PMID:22846257

  19. Predictive performance study of two digoxin assays in subjects with various degrees of renal function.

    PubMed

    Spinler, S A; Al-Jazairi, A S; Cheng, J W; Kapoor, S; Kobrin, S; Shaw, L

    2000-12-01

    This prospective study was conducted to compare the predictive performance of fluorescence polarization immunoassay (FPIA, Abbott TDx Digoxin II) and radioimmunoassay (RIA, Kallestad Labs) with combined low-pressure liquid chromatography/RIA (LPLC/RIA) digoxin assay in measuring 15-17 serum digoxin concentrations (SDC) obtained after a single 10 microg/kg intravenous digoxin dose in patients with various degrees of renal function and at different SDC ranges. Eighteen men and women were stratified into 3 age- and gender-matched groups based upon renal function [N = 6 in each, group I (Cl(cr) < 10 mL/min), group II (Cl(cr) = 10-50 mL/min), and group III (Cl(cr) > 50 mL/min)]. Serum digoxin concentrations were measured at time zero; at 0.25, 0.5, 0.75, 1, 2, 3, 4, 6, 8, and 12 hours; and at 2, 3, 4, and 5-7 days after the digoxin dose, using the three different digoxin assays. TDx Digoxin II was unbiased [mean error -0.09 (95% CI -0.19, 0.01)] and RIA biased [mean error -0.29 (95% CI -0.36, -0.21)] to over-predict SDC by 14.2%. In group I patients, the analysis revealed a bias to over-predict SDC by 6.0% for TDx Digoxin II [mean error -0.16 (95% CI -0.29, -0.07)] and an unbiased performance by RIA. In groups II and III, both TDx Digoxin II and RIA showed biased performance, the mean magnitude of bias was low (< 20%). For intermediate SDC range (> 0.5 ng/mL and < or = 3.0 ng/mL), TDx Digoxin II was unbiased in predicting SDC, whereas RIA was biased to under-predict SDC [mean error 0.13 (95% CI 0.10, 0.16)] by 9.9%. The magnitude of bias observed in all cases was less than 20%. Both assays, TDx Digoxin II and RIA, imprecisely measured SDC for all samples combined, different groups and SDC ranges. In all time-paired samples, TDx Digoxin II (FPIA) performed better than the RIA. In conclusion, the magnitude of bias observed with either assay at different groups and SDC ranges was not likely to be clinically relevant. Therefore, either assay may be used to measure SDC in clinical practice. PMID:11128242

  20. Patient experiences with self-monitoring renal function after renal transplantation: results from a single-center prospective pilot study

    PubMed Central

    van Lint, Céline L; van der Boog, Paul JM; Wang, Wenxin; Brinkman, Willem-Paul; Rövekamp, Ton JM; Neerincx, Mark A; Rabelink, Ton J; van Dijk, Sandra

    2015-01-01

    Background After a kidney transplantation, patients have to visit the hospital often to monitor for early signs of graft rejection. Self-monitoring of creatinine in addition to blood pressure at home could alleviate the burden of frequent outpatient visits, but only if patients are willing to self-monitor and if they adhere to the self-monitoring measurement regimen. A prospective pilot study was conducted to assess patients’ experiences and satisfaction. Materials and methods For 3 months after transplantation, 30 patients registered self-measured creatinine and blood pressure values in an online record to which their physician had access to. Patients completed a questionnaire at baseline and follow-up to assess satisfaction, attitude, self-efficacy regarding self-monitoring, worries, and physician support. Adherence was studied by comparing the number of registered with the number of requested measurements. Results Patients were highly motivated to self-monitor kidney function, and reported high levels of general satisfaction. Level of satisfaction was positively related to perceived support from physicians (P<0.01), level of self-efficacy (P<0.01), and amount of trust in the accuracy of the creatinine meter (P<0.01). The use of both the creatinine and blood pressure meter was considered pleasant and useful, despite the level of trust in the accuracy of the creatinine device being relatively low. Trust in the accuracy of the creatinine device appeared to be related to level of variation in subsequent measurement results, with more variation being related to lower levels of trust. Protocol adherence was generally very high, although the range of adherence levels was large and increased over time. Conclusion Patients’ high levels of satisfaction suggest that at-home monitoring of creatinine and blood pressure after transplantation offers a promising strategy. Important prerequisites for safe implementation in transplant care seem to be support from physicians and patients’ confidence in both their own self-monitoring skills and the accuracy of the devices used. PMID:26673985

  1. Spiral CT Quantification of Aorto-Renal Calcification and Its Use in the Detection of Atheromatous Renal Artery Stenosis: A Study in 42 Patients

    SciTech Connect

    Gayard, Pierre; Garcier, Jean-Marc; Boire, Jean-Yves; Ravel, Anne; Perez, Nessim; Privat, Christian; Lucien, Pascal; Viallet, Jean-Francois; Boyer, Louis

    2000-01-15

    Purpose: To investigate whether a correlation exists between aortic and renal arterial calcifications detected with spiral CT and significant angiographic renal artery stenosis (RAS).Methods: Forty-two patients (mean age 67 years, range 37-84 years), of whom 24 were hypertensive, prospectively underwent abdominal helical CT and aortic and renal arteriography. The 3-mm thickness CT scans (pitch = 1) were reconstructed each millimeter. A manual outline of the renal artery including its ostial portion was produced. Calcific hyperdensities were defined as areas of density more than 130 HU. CT data were compared with the presence or absence of RAS on angiography (24 cases); hypertension and age were taken into account (Mann-Whitney U-test).Results: CT detection and quantification appeared to be reliable and reproductible. We did not find any correlation between aortic and renal arterial calcifications and RAS, even for the patients above 65 years, with or without hypertension. There was no correlation either between calcifications and hypertension in patients without RAS. Conclusion: In this population, aortic and renal arterial calcifications have no predictive value for RAS.

  2. Embolization of polycystic kidneys as an alternative to nephrectomy before renal transplantation: a pilot study.

    PubMed

    Cornelis, F; Couzi, L; Le Bras, Y; Hubrecht, R; Dodr, E; Genevive, M; Prot, V; Wallerand, H; Ferrire, J M; Merville, P; Grenier, N

    2010-10-01

    In autosomal polycystic kidney disease, nephrectomy is required before transplantation if kidney volume is excessive. We evaluated the effectiveness of transcatheter arterial embolization (TAE) to obtain sufficient volume reduction for graft implantation. From March 2007 to December 2009, 25 patients with kidneys descending below the iliac crest had unilateral renal TAE associated with a postembolization syndrome protocol. Volume reduction was evaluated by CT before, 3, and 6 months after embolization. The strategy was considered a success if the temporary contraindication for renal transplantation could be withdrawn within 6 months after TAE. TAE was well tolerated and the objective was reached in 21 patients. The temporary contraindication for transplantation was withdrawn within 3 months after TAE in 9 patients and within 6 months in 12 additional patients. The mean reduction in volume was 42% at 3 months (p = 0.01) and 54% at 6 months (p = 0.001). One patient required a cyst sclerosis to reach the objective. The absence of sufficient volume reduction was due to an excessive basal renal volume, a missed accessory artery and/or renal artery revascularization. Embolization of enlarged polycystic kidneys appears to be an advantageous alternative to nephrectomy before renal transplantation. PMID:21143393

  3. Prospective scintigraphic study of avascular necrosis of bone in renal transplant patients

    SciTech Connect

    Spencer, J.D.; Maisey, M.

    1985-04-01

    Avascular necrosis of bone (AVN) may cripple a patient who has had a successful renal transplant. The authors have attempted to gain more knowledge of this condition by undertaking a prospective survey to determine as accurately as possible the incidence of AVN in renal transplant patients. Routine six-month whole body bone scans were performed with /sup 99m/Technetium Methylene Diphosphonate in 42 consecutive surviving renal transplant patients. The survey started in 1978-79, and patients were followed for a minimum of two years and a maximum of three years. As a result, seven were found to have AVN that would have remained undetected in two of the patients if routine whole body bone scanning had not been conducted. Despite a reduction in steroid dosage in recent years, the incidence of AVN in the authors patients remains high at 17%. Bone scan appearances in renal transplant patients were classified and subdivided into four groups. By linking bone scans and radiographic and postmortem appearances of the femoral head, one very early case of AVN was detected. Routine bone scanning provided a more accurate estimation of the incidence of fractures in renal transplant patients (12%).

  4. MR-guided Periarterial Ethanol Injection for Renal Sympathetic Denervation: A Feasibility Study in Pigs

    SciTech Connect

    Streitparth, F. Walter, A.; Stolzenburg, N.; Heckmann, L.; Breinl, J.; Rinnenthal, J. L.; Beck, A.; De Bucourt, M.; Schnorr, J.; Bernhardt, U.; Gebauer, B.; Hamm, B.; Guenther, R. W.

    2013-06-15

    Purpose. To evaluate the feasibility and efficacy of image-guided periarterial ethanol injection as an alternative to transluminal radiofrequency ablation. Methods. Unilateral renal periarterial ethanol injection was performed under general anesthesia in 6 pigs with the contralateral kidney serving as control. All interventions were performed in an open 1.0 T MRI system under real-time multiplanar guidance. The injected volume was 5 ml (95 % ethanol labelled marked MR contrast medium) in 2 pigs and 10 ml in 4 pigs. Four weeks after treatment, the pigs underwent MRI including MRA and were killed. Norepinephrine (NE) concentration in the renal parenchyma served as a surrogate parameter to analyze the efficacy of sympathetic denervation. In addition, the renal artery and sympathetic nerves were examined histologically to identify evidence of vascular and neural injury. Results. In pigs treated with 10 ml ethanol, treatment resulted in neural degeneration. We found a significant reduction of NE concentration in the kidney parenchyma of 53 % (p < 0.02) compared with the untreated contralateral kidney. In pigs treated with 5 ml ethanol, no significant changes in histology or NE were observed. There was no evidence of renal arterial stenosis in MRI, macroscopy or histology in any pig. Conclusion. MR-guided periarterial ethanol injection was feasible and efficient for renal sympathetic denervation in a swine model. This technique may be a promising alternative to the catheter-based approach in the treatment of resistant arterial hypertension.

  5. Renal Carcinoma After Childhood Cancer: A Report From the Childhood Cancer Survivor Study

    PubMed Central

    2013-01-01

    Adult survivors of childhood cancer are known to be at increased risk of subsequent malignancy, but only limited data exist describing the incidence and risk factors for secondary renal carcinoma. Among 14 358 5-year survivors diagnosed between 1970 and 1986, we estimated standardized incidence ratios (SIRs) for subsequent renal carcinoma and identified associations with primary cancer therapy using Poisson regression. Twenty-six survivors were diagnosed with renal carcinoma (median = 22.6 years from diagnosis; range = 6.335.7 years), reflecting a statistically significant excess (SIR = 8.0, 95% confidence interval [CI] = 5.2 to 11.7) compared with the general population. Highest risk was observed among neuroblastoma survivors (SIR = 85.8, 95% CI = 38.4 to 175.2) and, in multivariable analyses, with renal-directed radiotherapy of 5 Gy or greater (relative risk [RR] = 3.8, 95% CI = 1.6 to 9.3) and platinum-based chemotherapy (RR = 3.5, 95% CI = 1.0 to 11.2). To our knowledge, this is the first report of an association between cisplatin and subsequent renal carcinoma among survivors of childhood cancer. PMID:23515901

  6. [Renal abnormalities in ankylosing spondylitis].

    PubMed

    Samia, Barbouch; Hazgui, Faial; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. PMID:22520483

  7. Dynamical studies of Saturn's rings

    NASA Technical Reports Server (NTRS)

    Nicholson, Philip D.; Porco, Carolyn C.

    1987-01-01

    Several investigations of Saturn's rings employing data from three Voyager experiments are discussed. These investigations concentrated on the regularily organized C ring. A search for eccentric or inclined features, a photometric study of regions of different optical depth, an analysis of wavelike structures at three locations, and a study of the size distribution of meter-sized particles are dicussed.

  8. A Parametric Study of Spur Gear Dynamics

    NASA Technical Reports Server (NTRS)

    Lin, Hsiang Hsi; Liou, Chuen-Huei

    1998-01-01

    A parametric study of a spur gear system was performed through a numerical analysis approach. This study used the gear dynamic program DANST, a computer simulator, to determine the dynamic behavior of a spur gear system. The analytical results have taken the deflection of shafts and bearings into consideration for static analysis, and the influence of these deflections on gear dynamics was investigated. Damping in the gear system usually is an unknown quantity, but it has an important effect in resonance vibration. Typical values as reported in the literature were used in the present analysis. The dynamic response due to different damping factors was evaluated and compared. The effect of the contact ratio on spur gear dynamic load and dynamic stress was investigated through a parameter study. The contact ratio was varied over the range of 1.26 to 2.46 by adjusting the tooth addendum. Gears with contact ratio near 2.0 were found to have the most favorable dynamic performance.

  9. Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study

    PubMed Central

    Anderson, Amanda Hyre; Yang, Wei; Hsu, Chi-yuan; Joffe, Marshall M.; Leonard, Mary B.; Xie, Dawei; Chen, Jing; Greene, Tom; Jaar, Bernard G.; Kao, Patricia; Kusek, John W.; Landis, J. Richard; Lash, James P.; Townsend, Raymond R.; Weir, Matthew R.; Feldman, Harold I.

    2012-01-01

    Background Glomerular filtration rate (GFR) is considered the best measure of kidney function, but repeated assessment is not feasible in most research studies. Study Design Cross-sectional study of 1,433 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study (i.e., the GFR subcohort) to derive an internal GFR estimating equation using a split sample approach. Setting & Participants Adults from 7 US metropolitan areas with mild to moderate chronic kidney disease; 48% had diabetes and 37% were black. Index Test CRIC GFR estimating equation Reference Test or Outcome Urinary 125I-iothalamate clearance testing (measured GFR) Other Measurements Laboratory measures including serum creatinine and cystatin C, and anthropometrics Results In the validation dataset, the model that included serum creatinine, serum cystatin C, age, gender, and race was the most parsimonious and similarly predictive of mGFR compared to a model additionally including bioelectrical impedance analysis phase angle, CRIC clinical center, and 24-hour urinary creatinine excretion. Specifically, the root mean square errors for the separate model were 0.207 vs. 0.202, respectively. The performance of the CRIC GFR estimating equation was most accurate among the subgroups of younger participants, men, non-blacks, non-Hispanics, those without diabetes, those with body mass index <30 kg/m2, those with higher 24-hour urine creatinine excretion, those with lower levels of high-sensitivity C-reactive protein, and those with higher mGFR. Limitations Urinary clearance of 125I-iothalamate is an imperfect measure of true GFR; cystatin C is not standardized to certified reference material; lack of external validation; small sample sizes limit analyses of subgroup-specific predictors. Conclusions The CRIC GFR estimating equation predicts measured GFR accurately in the CRIC cohort using serum creatinine and cystatin C, age, gender, and race. Its performance was best among younger and healthier participants. PMID:22658574

  10. A prospective study of alcohol consumption and renal cell carcinoma risk.

    PubMed

    Karami, Sara; Daugherty, Sarah E; Purdue, Mark P

    2015-07-01

    Recent epidemiological studies suggest that alcohol consumption may reduce renal cell carcinoma (RCC) risk, although inconsistent findings have been reported by sex and alcoholic beverage type. To better understand the relationship between alcohol consumption and RCC risk, we conducted an analysis within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We followed up participants in the analytic cohort (N?=?107,998) through 2010 for incident RCC (N?=?408), and computed hazard ratios (HRs) and 95% confidence intervals (CIs) for alcohol intake using Cox regression with adjustment for age, sex, race, study center, hypertension, body mass index, and smoking status. In this study population increasing alcohol consumption was associated with reduced RCC risk compared to non-drinkers (>9.75 g day(-1) : HR, 0.67; 95%CI, 0.50 to 0.89; p trend?=?0.002). We observed similar patterns of association for men and women as well as by alcohol beverage type. In analyses stratified by smoking status, the inverse association with consumption was apparent for ever smokers (HR, 0.51; 95%CI, 0.36 to 0.73; p trend<0.0001) but not among never smokers (HR, 1.08; 95%CI, 0.66 to 1.76; P trend?=?0.78; p interaction?=?0.01). Our study findings offer further support that alcohol consumption is associated with reduced RCC risk, regardless of sex or alcoholic beverage type. The finding of interaction with smoking is novel and requires confirmation. PMID:25431248

  11. A case-control study of occupational sunlight exposure and renal cancer risk.

    PubMed

    Karami, Sara; Colt, Joanne S; Stewart, Patricia A; Schwartz, Kendra; Davis, Faith G; Ruterbusch, Julie J; Chow, Wong-Ho; Wacholder, Sholom; Graubard, Barry I; Purdue, Mark P; Moore, Lee E

    2016-04-01

    Epidemiological evidence of a relationship between vitamin D and kidney cancer risk has been inconsistent despite experimental data indicating that vitamin D and its metabolites may inhibit carcinogenesis. Previously we reported an inverse association between renal cell carcinoma (RCC) risk and occupational ultraviolet (UV) exposure among European men. In this study, we examined the association between occupational UV exposure and RCC risk among US residents and investigated whether this association varied by race and sex. Lifetime occupational data for 1,217 RCC cases and 1,235 controls in a population-based case-control study, conducted from 2002 to 2007, were assessed for occupational UV exposure. We evaluated exposure metrics in quartiles based on control exposure levels and calculated associations between RCC risk and occupational UV exposure using unconditional logistic regression adjusted for sex, race, body mass index, smoking, hypertension, center, education, family history of cancer and dietary vitamin D intake. A general pattern of decreasing RCC risk with increasing UV exposure was observed. Cases had significantly lower cumulative occupational UV exposure than controls (fourth quartile vs. first: odds ratio = 0.74 [95% confidence interval = 0.56-0.99], p-trend = 0.03). Similar results were observed for other UV exposure metrics. The association with occupational UV exposure was stronger for women than for men, but did not differ by race. Our findings suggest an inverse association between occupational UV exposure and RCC, particularly among women. Given the sex finding discrepancies in this study versus our previous study, additional research is need to clarify whether the protective effects of occupational UV exposure and RCC risk are real. PMID:26505275

  12. Renal erythropoietin-producing cells in health and disease

    PubMed Central

    Souma, Tomokazu; Suzuki, Norio; Yamamoto, Masayuki

    2015-01-01

    Erythropoietin (Epo) is an indispensable erythropoietic hormone primarily produced from renal Epo-producing cells (REPs). Epo production in REPs is tightly regulated in a hypoxia-inducible manner to maintain tissue oxygen homeostasis. Insufficient Epo production by REPs causes renal anemia and anemia associated with chronic disorders. Recent studies have broadened our understanding of REPs from prototypic hypoxia-responsive cells to dynamic fibrogenic cells. In chronic kidney disease, REPs are the major source of scar-forming myofibroblasts and actively produce fibrogenic molecules, including inflammatory cytokines. Notably, myofibroblast-transformed REPs (MF-REPs) recover their original physiological properties after resolution of the disease insults, suggesting that renal anemia and fibrosis could be reversible to some extent. Therefore, understanding the plasticity of REPs will lead to the development of novel targeted therapeutics for both renal fibrosis and anemia. This review summarizes the regulatory mechanisms how hypoxia-inducible Epo gene expression is attained in health and disease conditions. PMID:26089800

  13. Renal flow studies after abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft: case report

    SciTech Connect

    LaManna, M.M.; Yussen, P.S.

    1988-03-01

    Vascular disorders affecting the kidneys are either acquired or congenital. Included in this category are common multiplicity of renal arteries, the rare arteriovenous malformation, stresses due to fibromuscular disease or atherosclerosis including abdominal aortic aneurysms, arterial thrombosis, venous thrombosis, and infarction. In contrast to the group of cystic and neoplastic kidneys where scintigraphic or pathologic are not diagnostic, scintigraphic or pathologic anatomy in vascular disease is often diagnostic by nuclear medicine techniques. The authors present an interesting case of evaluation of acute renal failure in a patient abdominal aortic aneurysmectomy and axillo-bifemoral bypass graft.

  14. A genome-wide association study of renal cell carcinoma among African Americans.

    PubMed

    Purdue, Mark P; Ye, Yuanqing; Wang, Zhaoming; Colt, Joanne S; Schwartz, Kendra L; Davis, Faith G; Rothman, Nathaniel; Chow, Wong-Ho; Wu, Xifeng; Chanock, Stephen J

    2014-01-01

    Genome-wide association studies (GWAS) of renal cell carcinoma (RCC) in populations of European ancestry have identified four susceptibility loci. No GWAS has been conducted among African Americans (AA), who experience a higher incidence of RCC. We conducted a GWAS in which we analyzed 1,136,723 common single-nucleotide polymorphisms (SNP) among 255 cases and 375 controls of African ancestry, and further investigated 16 SNPs in a replication set (140 cases and 543 controls). The 12p11.23 variant rs10771279, located 77 kb from the European-ancestry RCC marker rs718314, was associated with RCC risk in the GWAS (P = 1.2 × 10(-7)) but did not replicate (P = 0.99). Consistent with European-ancestry findings, the A allele of rs7105934 on 11q13.3 was associated with decreased risk [OR, 0.76, 95% confidence interval (CI), 0.64-0.91; P = 0.0022]. The frequency of this allele was higher than that observed in the European-ancestry GWAS (0.56 and 0.07, respectively, among controls). The rs7105934 association was stronger for clear cell RCC (ccRCC: OR, 0.56; P = 7.4 × 10(-7)) and absent for cases of other or unknown histology (OR, 1.02; P = 0.86). Analyses of rs7105934 by subtype among European-ancestry participants from these studies yielded similar findings (ORs 0.69 and 0.92, respectively). This study provides, to our knowledge, the first evidence that rs7105934 is an RCC susceptibility locus among AAs. Our finding that the association with this SNP may be specific to clear-cell RCC is novel and requires additional investigation. Additional investigation of rs10771279 and other suggestive GWAS findings is also needed. PMID:24220910

  15. Renal excretion of pseudoephedrine.

    PubMed

    Brater, D C; Kaojarern, S; Benet, L Z; Lin, E T; Lockwood, T; Morris, R C; McSherry, E J; Melmon, K L

    1980-11-01

    A patient with renal acidosis developed unanticipated toxicity after ordinary doses of pseudoephedrine, prompting us to study renal determinants of its elimination. We presumed that our patient accumulated the drug because of her persistently alkaline urine, which would favor tubular resorption of this weak base (pKa = 9.4). We studied normal adults and children and one adult and one child with renal tubular acidosis. Increasing urine pH increased the serum elimination half-life from 1.9 to 21 hr. While urinary pH remained alkaline, renal excretion of pseudoephedrine and its metabolite, norpseudoephedrine, was directly correlated with the flow rate of urine in each subject. Both urine pH and flow are important determinants of the elimination of pseudoephedrine in man and could be critical determinants of unanticipated toxicity. PMID:7438686

  16. Influence of the renal endothelin system on the autoregulation of renal blood flow in spontaneously hypertensive rats.

    PubMed

    Braun, C; Lang, C; Hocher, B; Gretz, N; van der Woude, F J; Rohmeiss, P

    1997-01-01

    The renal endothelin (ET) system has been claimed to play an important role in the regulation of renal blood flow (RBF) and sodium excretion in primary hypertension. The aim of the present study was to investigate the contribution of the endogenous ET system in the autoregulation of total RBF, cortical blood flow (CBF), pressure-dependent plasma renin activity (PRA) and pressure natriuresis in spontaneously hypertensive rats (SHR) by means of the combined (A/B) ET-receptor antagonist, bosentan. In anesthetized rats, RBF was measured by transit-time flow probes and CBF by laser flow probes. During the experiments, the rats received an intrarenal infusion of either bosentan (1 mg/kg/h) or vehicle. Renal perfusion pressure (RPP) was lowered in pressure steps of 5 mm Hg with a servo-controlled electropneumatic device via an inflatable suprarenal cuff. Bosentan had no effect on resting RPP, CBF, PRA and renal sodium excretion, whereas RBF was lowered by 30% (p < 0.05). Furthermore after bosentan the rats revealed a complete loss of RBF autoregulation. In contrast no changes in autoregulation of CBF, pressure-dependent PRA and pressure natriuresis were observed. Our findings demonstrate a significant impairment in total RBF autoregulatory ability during renal ET-receptor blockade which is not confined to the cortical vessels. These data suggest that the renal ET system plays an important role in the dynamic regulation of renal blood flow in SHR. PMID:9192904

  17. CHESAPEAKE BAY NUTRIENT DYNAMICS STUDY

    EPA Science Inventory

    This study had two major objectives. The first was to fill gaps in our understanding of important biological, chemical, and physical processes occurring in the Bay. This information was required to make the best use of existing data and to develop future data needs to further und...

  18. Clinicohistological characteristics of renal cell carcinoma in children: A multicentre study

    PubMed Central

    Kim, Jeong Ho; Seo, Seong Il; Song, Cheryn; Chung, Jinsoo; Kwak, Cheol; Hong, Sung-Hoo

    2015-01-01

    Introduction: In this retrospective multicentre study, we compared the clinicohistological characteristics of renal cell carcinoma (RCC) between pediatric and adult patients. Methods: Data for patients who underwent radical or partial nephrectomy for RCC between 1988 and 2014 at multiple institutions were collected. Patients were divided into 2 groups according to age at diagnosis: pediatric patients (age ?18 years) and adult patients (age ?40 years). The groups were compared for clinical and pathologic variables, and survival analysis was performed. Results: The median follow-up period was 64 (range: 3091) months for pediatric patients versus 44 (range: 1959) months for adult patients (p = 0.026). Pediatric patients were mostly female (p = 0.003), had symptoms at presentation (p < 0.001), and had a high-stage tumour (p = 0.014) than adult patients. Among the symptomatic patients, gross hematuria was the most common symptom. The median tumour size was not different between groups. Regarding histologic types, pediatric patients had more papillary tumours (p < 0.001), more unclassified tumours (p < 0.001), and fewer clear cell carcinomas (p < 0.001). Five-year cancer-specific survival rates were 85% and 87.4% in pediatric and adult patients, respectively (log rank p = 0.901). Recurrence-free survival was better in adult patients, although this did not reach statistical significance (log rank p = 0.272). This study has several limitations, including its retrospective nature and the relatively small number of pediatric RCC cases. Conclusion: RCC in children is rare and is characterized by features that differ from those in adult RCC. Prognosis did not differ between groups.

  19. Effect of beta-D-xyloside on the renal glomerular cells. II. Morphological studies

    SciTech Connect

    Kanwar, Y.S.; Rosenzweig, L.J.; Jakubowski, M.L.

    1987-02-01

    The effect of p-nitrophenyl-beta-D-xylopyranoside on the renal glomerulus was studied. Rat kidneys were labeled with (35S)sulfate in the presence or absence of beta-xyloside by using an isolated organ perfusion system and were processed subsequently for morphological studies. By using electron microscopy, preferential intracytoplasmic vesiculation of the visceral epithelium was observed in the beta-xyloside-treated kidneys. The vesicles were distributed throughout the cytoplasm, particularly in the vicinity of Golgi apparatus. They were acid-phosphatase negative, devoid of clathrin-coat, and contained osmium-impregnated reaction products. The visceral epithelial foot processes remained firmly attached to the glomerular basement membrane. No loss of cell-surface associated sialoglycoproteins, as evidenced by colloidal iron staining, was observed. No significant change in the morphological features of glomerular endothelial or mesangial cells was noted. By using electron microscopy autoradiography, a significant increase in the number of silver grains over the epithelium, and a decrease in the number over the extracellular matrices was observed. The majority of the grains were either associated with intracytoplasmic vesicles or Golgi apparatus. The mean grain densities (concentration of radiation) increased by 3.6-fold for the epithelium, and decreased by 2.4- and 1.6-fold for the basement membrane and mesangial matrix, respectively. The grain densities over the endothelial and mesangial cells were similar in control and experimental groups. These data indicate that xyloside induces selective alterations in Golgi apparatus of the visceral epithelium and a dramatic imbalance in the de novo synthesized sulfated macromolecules of cellular and extracellular compartments.

  20. Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments.

    PubMed

    Schnabel, M J; Gierth, M; Chaussy, C G; Dötzer, K; Burger, M; Fritsche, H M

    2014-06-01

    Shock wave lithotripsy (SWL) is the gold standard for the treatment of upper urinary tract stones. Despite being relatively non-invasive, SWL can cause renal hematoma (RHT). The aim of this study was to determine incidence and risk factors for RHT following SWL. 857 patients were included in a prospectively maintained database. The observation period spans from 2007 to 2012. 1,324 procedures were performed due to kidney stones. Treatment protocol included power ramping and shock wave frequency of 60-90 per minute as well as an ultrasound check within 3 days of SWL for all patients. Patients with RHT were analyzed, and treatment characteristics were compared with the complete population in a non-statistical manner due to the low event count. RHTs after SWL, sized between 2.6 × 0.6 cm and 17 × 15 cm, were verified in seven patients (0.53%). In four patients, the RHT was asymptomatic. Three patients developed pain after SWL treatment due to a RHT. In one patient surgical intervention was necessary due to a symptomatic RHT, the kidney was preserved. The risk of RHT following SWL treatment of kidney stones is about 0.5%. Clinically relevant or symptomatic RHTs occur in 0.23%, RHTs requiring surgical intervention are extremely rare. Older age and vascular comorbidities appear to be risk factors for the development of RHT. The technical characteristics of SWL treatment and intake of low-dose acetylsalicylic acid due to an imperative cardiologic indication do not appear to influence the risk. Prospective studies are warranted. PMID:24419328

  1. The Effects of Resveratrol in Rats with Simultaneous Type 2 Diabetes and Renal Hypertension: a Study of Antihypertensive Mechanisms

    PubMed Central

    Mozafari, Masoud; Nekooeian, Ali Akbar; Panjeshahin, Mohammad Reza; Zare, Hamid Reza

    2015-01-01

    Background Resveratrol has beneficial effects on cardiovascular system. This study aimed at examining antidiabetic and antihypertensive effects of resveratrol in rats with simultaneous type 2 diabetes and renal hypertension. Methods Eight groups (8-10 each) of male Spargue-Dawley rats, including a control, a diabetic (induced by streptozotocin and nicotinamide), a renal hypertensive (induced by placing plexiglas clips on the left renal arteries), a sham, a simultaneously hypertensive-diabetic receiving vehicle, and 3 simultaneous hypertensive-diabetic receiving resveratrol at 5, 10 or 20 mg/kg/day were used. Four weeks after the induction of diabetes, renal hypertension was induced and animals were given vehicle or resveratrol for the next four weeks. Afterwards, blood pressure and glucose, serum markers of oxidative stress were measured and animals aortic rings were used for isolated studies. Results Serum malondialdehyde, systolic blood pressure, heart rate, fasting blood glucose, maximal response and effective concentration 50 of phenylephrine, and inhibitory concentration 50 of acetylcholine of hypertensive-diabetic group receiving vehicle were significantly higher than those of the control group, and treatment with resveratrol caused significant reduction of these variables. Moreover, serum superoxide dismutase, glutathione reductase, and maximal response to acetylcholine of hypertensive-diabetic group receiving vehicle were significantly lower than those of the control group, and treatment with resveratrol caused significant increase of these variables. Conclusion The findings indicate that resveratrol has antidiabetic and antihypertensive effects, which may be partly due to antioxidant mechanism. They also show that antihypertensive effect of resveratrol may be additionally mediated by improving the release of nitric oxide and sympathoplegic activities. PMID:25821295

  2. Dynamical Studies of Saturn's Rings

    NASA Technical Reports Server (NTRS)

    Nicholson, P. D.; Porco, C.

    1985-01-01

    The data returned by the Voyager on the Saturnian system has revealed the structure of Saturn's ring system to be dominated by many abrupt transitions in optical depth, narrow well-defined ringlets and gaps, and spiral density and bending waves. A handful of these features were attributed with reasonable certainty to the resonant influence of external satellites, but the vast majority of the structure remains unexplained. The entire C ring was studied with particular emphasis on the search for unrecognized eccentric or inclined features, and the role, if any, played by satellite resonances in controlling C ring structure.

  3. Improved effectiveness and safety of flexible ureteroscopy for renal calculi (<2 cm): A retrospective study

    PubMed Central

    Chen, Shuqiu; Xu, Bin; Liu, Ning; Jiang, Hua; Zhang, Xiaowen; Yang, Yu; Liu, Jing; Sha, Guozhu; Zhu, Weidong; Chen, Ming

    2015-01-01

    Introduction: We discuss the efficacy and safety of flexible ureteroscopy for renal calculi with a burden of <2 cm, as well as the prevention and treatment of complications. Methods: A total of 108 renal calculi with flexible ureteroscopy and holmium laser treatment were retrospectively analyzed. The stone-free rate was evaluated. The effectiveness, safety, surgical technique, incidence of complications, and relevant treatments were analyzed. Results: All patients underwent only one lithotripsy procedure. The success rate of flexible ureteroscopy was 97.2% (105/108). Among the 105 cases, the total lithotripsy success rate was 97.1% (101/105). The total stone-free rate after 8 weeks post-operation was 94.3% (99/105), the stone-free rate of the lower calyx was 85.7% (30/35); it was 98.6% (69/70) in the middleupper calyceal and renal pelvis. The incidence of complications was 12.9% (14/108). None of the patients had serious adverse outcomes. Conclusion: Flexible ureteroscopy represents an optimal treatment option for selected renal calculi with burden of <2 cm. The effectiveness and safety of flexible ureteroscopy can be further improved through reasonable preoperative evaluation and advances in surgical techniques, as well as a better understanding of the inducement and treatment of complications. PMID:26029294

  4. Urea recycling from the renal pelvis in sheep: A study with ( sup 14 C)urea

    SciTech Connect

    Cirio, A.; Boivin, R. )

    1990-05-01

    To test the hypothesis that urea can be recycled from the renal pelvis, (14C)urea diluted in native urine (1 microCi/ml) was perfused (0.5 ml/min) into one of the pelvises of sheep fed either normal (NP) or low (LP)-protein diets. Blood samples were obtained from the ipsilateral renal vein and from the carotid artery throughout the perfusions. 14C activity determinations in urine and plasma demonstrated a flux of (14C)urea from the pelvis to renal vein blood (40,000 in NP and 130,000 disintegrations/min in LP sheep, P less than 0.01). The corresponding flux of native urea was only 1.5 times higher in NP than in LP sheep (6.8 +/- 1.1 vs. 4.7 +/- 2.9 mumol/min, not significant) despite their 8 times higher urinary concentration of urea. The fraction of filtered urea that was reabsorbed in the pelvis was larger in LP sheep (7.5 +/- 3.7 vs. 1.9 +/- 0.7% in NP sheep, P less than 0.05). A fraction of urea is thus actually recycled from the renal pelvis in sheep, and this pelvic retention is enhanced in LP animals. The importance of this phenomenon in the nitrogen economy is discussed.

  5. Blood, urine and faecal metabolite profiles in the study of adult renal disease.

    PubMed

    Barrios, Clara; Spector, Tim D; Menni, Cristina

    2016-01-01

    Chronic kidney disease (CKD) is a major public health burden and to date traditional biomarkers of renal function (such as serum creatinine and cystatin C) are unable to identify at-risk individuals before the disease process is well under way. To help preventive strategies and maximize the potential for effective interventions, it is important to characterise the molecular changes that take place in the development of renal damage. Metabolomics is a promising tool to identify markers of renal disease since the kidneys are involved in the handling of major biochemical classes of metabolites. These metabolite levels capture a snap-shot of the metabolic profile of the individual, allowing for the potential identification of early biomarkers, and the monitoring of real-time kidney function. In this review, we describe the current status of the identification of blood/urine/faecal metabolic biomarkers in different entities of kidney diseases including: acute kidney injury, chronic kidney disease, renal transplant, diabetic nephropathy and other disorders. PMID:26476344

  6. Kinetic factors influencing the dissolution behavior of calcium oxalate renal stones: a constant composition study.

    PubMed

    White, D J; Coyle-Rees, M; Nancollas, G H

    1988-11-01

    A constant composition method has been used to examine the dissolution kinetics of calcium oxalate renal stones over a wide range of undersaturation in vitro. Demineralization experiments have been carried out with the concentrations of calcium and oxalate ions and ionic strength (hence the solution undersaturation) held constant by the potentiometrically controlled addition of medium electrolyte solution as diluent, triggered by a calcium ion electrode. Kinetic data for renal stones have been compared with results obtained for synthetic calcium oxalate. In addition, constant composition results have been directly compared with results obtained using conventional dissolution methods for both calculi and synthetic calcium oxalate. Overall, calcium oxalate renal stones exhibited markedly different kinetic dissolution behavior as compared with synthetic controls. The renal stone samples dissolved more slowly at all undersaturations, exhibited increased kinetic orders of reaction, and showed reduced sensitivity to solution hydrodynamics. Stones composed of mixed hydrates of calcium oxalate (mono- and di-) came to dihydrate equilibrium in conventional experiments and underwent net dissolution in solutions supersaturated to monohydrate under constant composition conditions. No conversion of di- to monohydrate was observed under these experimental conditions. These results indicate that stone dissolution is strongly influenced by adsorbed inhibitors, presumably including matrix components, which may complicate efforts to develop systemic and/or irrigation measures effective for in situ solubilization. PMID:3145798

  7. Multimegawatt dynamic NEP PMAD study

    SciTech Connect

    Metcalf, K.J.

    1992-11-01

    The National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) is developing a FORTRAN-based model of a complete nuclear electric propulsion (NEP) vehicle to be used for piloted or cargo missions to the Moon or Mars. The proposed vehicle will use either a Brayton or K-Rankine power conversion cycle, and either ion or magnetoplasmadynamic (MPD) thrusters. In support of this effort, Rocketdyne evaluated various power management and distribution (PMAD) approaches and selected a low-frequency design that is based on the direct use of the alternator voltage and frequency for power transmission. This approach was compared with dc and high-frequency ac designs, and selected on the basis of mass, efficiency, and qualitative assessment of power quality, reliability and development costs. This low-frequency architecture will be used as the reference in future NEP PMAD studies and for the subsequent FORTRAN model development.

  8. Multimegawatt dynamic NEP PMAD study

    SciTech Connect

    Metcalf, K.J. )

    1993-01-20

    The National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) is developing a Fortran--based model of a complete nuclear electric propulsion (NEP) vehicle to be used for piloted or cargo missions to the Moon or Mars. The proposed vehicle will use either a Brayton or K-Rankine power conversion cycle, and either ion or magnetoplasmadynamic (MPD) thrusters. In support of this effort, Rocketdyne evaluated various power management and distribution (PMAD) approaches and selected a low-frequency design that is based on the direct use of the alternator voltage and frequency for power transmission. This approach was compared with dc and high-frequency ac designs, and selected on the basis of mass, efficiency, and qualitative assessments of power quality, reliability and development costs. This low-frequency architecture will be used as the reference in future NEP PMAD studies and for the subsequent Fortran model development.

  9. Multimegawatt dynamic NEP PMAD study

    NASA Technical Reports Server (NTRS)

    Metcalf, Kenneth J.

    1992-01-01

    The National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) is developing a FORTRAN-based model of a complete nuclear electric propulsion (NEP) vehicle to be used for piloted or cargo missions to the Moon or Mars. The proposed vehicle will use either a Brayton or K-Rankine power conversion cycle, and either ion or magnetoplasmadynamic (MPD) thrusters. In support of this effort, Rocketdyne evaluated various power management and distribution (PMAD) approaches and selected a low-frequency design that is based on the direct use of the alternator voltage and frequency for power transmission. This approach was compared with dc and high-frequency ac designs, and selected on the basis of mass, efficiency, and qualitative assessment of power quality, reliability and development costs. This low-frequency architecture will be used as the reference in future NEP PMAD studies and for the subsequent FORTRAN model development.

  10. Renal and perirenal abscesses

    SciTech Connect

    Patterson, J.E.; Andriole, V.T.

    1987-12-01

    Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references.

  11. Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline Characteristics and Associations with Kidney Function

    PubMed Central

    Go, Alan S.; Appel, Lawrence J.; He, Jiang; Ojo, Akinlolu; Rahman, Mahboob; Townsend, Raymond R.; Xie, Dawei; Cifelli, Denise; Cohan, Janet; Fink, Jeffrey C.; Fischer, Michael J.; Gadegbeku, Crystal; Hamm, L. Lee; Kusek, John W.; Landis, J. Richard; Narva, Andrew; Robinson, Nancy; Teal, Valerie; Feldman, Harold I.

    2009-01-01

    Background and objectives: The Chronic Renal Insufficiency Cohort (CRIC) Study was established to examine risk factors for the progression of chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with CKD. We examined baseline demographic and clinical characteristics. Design, setting, participants, & measurements: Seven clinical centers recruited adults who were aged 21 to 74 yr and had CKD using age-based estimated GFR (eGFR) inclusion criteria. At baseline, blood and urine specimens were collected and information regarding health behaviors, diet, quality of life, and functional status was obtained. GFR was measured using radiolabeled iothalamate in one third of participants. Results: A total of 3612 participants were enrolled with mean age SD of 58.2 11.0 yr; 46% were women, and 47% had diabetes. Overall, 45% were non-Hispanic white, 46% were non-Hispanic black, and 5% were Hispanic. Eighty-six percent reported hypertension, 22% coronary disease, and 10% heart failure. Mean body mass index was 32.1 7.9 kg/m2, and 47% had a BP >130/80 mmHg. Mean eGFR was 43.4 13.5 ml/min per 1.73 m2, and median (interquartile range) protein excretion was 0.17 g/24 h (0.07 to 0.81 g/24 h). Lower eGFR was associated with older age, lower socioeconomic and educational level, cigarette smoking, self-reported CVD, peripheral arterial disease, and elevated BP. Conclusions: Lower level of eGFR was associated with a greater burden of CVD as well as lower socioeconomic and educational status. Long-term follow-up of participants will provide critical insights into the epidemiology of CKD and its relationship to adverse outcomes. PMID:19541818

  12. A Prospective, Multinational Pharmacoepidemiological Study of Clinical Conversion to Sirolimus Immunosuppression after Renal Transplantation

    PubMed Central

    Kasiske, Bertram L.; Nashan, Bjorn; Del Carmen Rial, Maria; Raffaele, Pablo; Russ, Graeme; Campistol, Josep; Pescovitz, Mark D.; Keown, Paul A.

    2012-01-01

    This prospective pharmacoepidemiological study examined treatment and outcomes in patients converted to sirolimus (SRL) after renal transplantation. 484 subjects in 36 centres in 7 countries were followed for up to 5 years. Principal reasons for conversion were declining graft function (146/484, 30%) and side effects of prior therapy (144/484, 30%) and the major treatment combinations after conversion were SRL MMF (62%), SRL + TAC (21.5%), SRL + CSA (16.5%). The cumulative probability of biopsy-confirmed acute rejection (BCAR) was 5% (n = 22), death-censored graft loss 12% (n = 56) and death 6% (n = 22), and there was no significant relationship to the treatment combination employed. Median calculated creatinine clearance was 48.4 (29.3, 64.5)?mL/min at conversion, rising to 54.1 (41.2, 69.0)?mL/min at month 1, 55.7 (39.0, 73.0)?mL/min at month 12, 58.6 (39.7, 75.2)?mL/min at two years and 60.9 (36.0, 77.0)?mL/min at three years post-conversion. The most common adverse events were hypertension (47%), hyperlipidemia (26%), urinary tract infections (25%), anaemia (24%) and diarrhea (14%), and cardiac events, hyperlipemia and CMV infection were more common in patients converted during the first year. SRL was most frequently combined with MMF after conversion, but principal clinical outcomes were not significantly influenced by the treatment combination employed in normal practice. PMID:22934151

  13. Impairment of renal function with increasing blood lead concentrations in the general population. The Cadmibel Study Group

    SciTech Connect

    Staessen, J.A.; Lauwerys, R.R.; Buchet, J.P.; Bulpitt, C.J.; Rondia, D.; Vanrenterghem, Y.; Amery, A. )

    1992-07-16

    Nephropathy is known to occur in persons with heavy exposure to lead. Whether exposure to lead in the general population leads to impaired renal function is not known. We studied renal function and indexes of lead exposure in a random population sample of 965 men and 1016 women (age range, 20 to 88 years). In all the subjects we measured creatinine clearance and blood concentrations of lead and zinc protoporphyrin (an indirect measure of blood lead level). The mean (+/- SD) creatinine clearance rate was 99 +/- 30 ml per minute in the men and 80 +/- 25 ml per minute in the women. In the men the geometric mean blood lead concentration was 114 micrograms per liter (0.55 mumol per liter) (range, 23 to 725 micrograms per liter (0.11 to 3.5 mumol per liter)), and in the women 75 micrograms per liter (0.36 mumol per liter) (range, 17 to 603 micrograms per liter (0.08 to 2.9 mumol per liter)); the zinc protoporphyrin values in blood averaged 1.0 and 1.1 micrograms per gram of hemoglobin, respectively. The creatinine clearance rate was inversely correlated with blood lead and zinc protoporphyrin values in the men and the women both before and after adjustments for age, bodymass index, and diuretic treatment. A 10-fold increase in blood lead concentration was associated with a reduction of 10 to 13 ml per minute in creatinine clearance. We also found a positive correlation between serum beta 2-microglobulin (which is inversely related to the glomerular filtration rate) and blood lead in men, between serum beta 2-microglobulin and zinc protoporphyrin in both sexes, and between serum creatinine and zinc protoporphyrin in men. Exposure to lead may impair renal function in the general population. The alternative hypothesis that renal impairment may lead to an increase in the blood lead concentration cannot be excluded, however.

  14. Precision-cut kidney slices (PCKS) to study development of renal fibrosis and efficacy of drug targeting ex vivo

    PubMed Central

    Poosti, Fariba; Pham, Bao Tung; Oosterhuis, Dorenda; Poelstra, Klaas; van Goor, Harry; Olinga, Peter; Hillebrands, Jan-Luuk

    2015-01-01

    ABSTRACT Renal fibrosis is a serious clinical problem resulting in the greatest need for renal replacement therapy. No adequate preventive or curative therapy is available that could be clinically used to target renal fibrosis specifically. The search for new efficacious treatment strategies is therefore warranted. Although in vitro models using homogeneous cell populations have contributed to the understanding of the pathogenetic mechanisms involved in renal fibrosis, these models poorly mimic the complex in vivo milieu. Therefore, we here evaluated a precision-cut kidney slice (PCKS) model as a new, multicellular ex vivo model to study the development of fibrosis and its prevention using anti-fibrotic compounds. Precision-cut slices (200-300??m thickness) were prepared from healthy C57BL/6 mouse kidneys using a Krumdieck tissue slicer. To induce changes mimicking the fibrotic process, slices were incubated with TGF?1 (5?ng/ml) for 48?h in the presence or absence of the anti-fibrotic cytokine IFN? (1?g/ml) or an IFN? conjugate targeted to PDGFR? (PPB-PEG-IFN?). Following culture, tissue viability (ATP-content) and expression of ?-SMA, fibronectin, collagen I and collagen III were determined using real-time PCR and immunohistochemistry. Slices remained viable up to 72?h of incubation, and no significant effects of TGF?1 and IFN? on viability were observed. TGF?1 markedly increased ?-SMA, fibronectin and collagen I mRNA and protein expression levels. IFN? and PPB-PEG-IFN? significantly reduced TGF?1-induced fibronectin, collagen I and collagen III mRNA expression, which was confirmed by immunohistochemistry. The PKCS model is a novel tool to test the pathophysiology of fibrosis and to screen the efficacy of anti-fibrotic drugs ex vivo in a multicellular and pro-fibrotic milieu. A major advantage of the slice model is that it can be used not only for animal but also for (fibrotic) human kidney tissue. PMID:26112172

  15. Left renal atrophy

    PubMed Central

    Davran, Ramazan; Helvaci, Mehmet Rami; Davarci, Mursel

    2014-01-01

    Background: We tried to understand whether or not there is a higher risk of left renal atrophy in human being. Methods: All patients applying to the Hematology Service with any underlying complaint were studied. Results: The study included 2,417 cases (1,248 females). The mean ages were 47.3 versus 50.7 years in females and males, respectively (p<0.000). There were 33 cases (1.3%) with the left renal atrophy against five cases (0.2%) with the right (p<0.001). The left renal atrophy cases have splenomegaly (SM) in 51.5%, thalassemia minors (TMs) in 30.3%, sickle cell diseases (SCDs) in 27.2%, myeloproliferative disorders in 18.1%, chronic lymphocytic leukemia in 6.0%, cirrhosis in 6.0%, solid organ malignancies in 6.0%, chronic obstructive pulmonary disease in 3.0%, multiple myeloma in 3.0%, and Waldenstrms macroglobulinemia in 3.0%. Similarly, the right renal atrophy cases have SM in 20.0%, TMs in 40.0%, and SCDs in 20.0%. Conclusion: Left renal atrophy may be significantly higher than the right side in human being. Aortic pressure induced flow disorders in the left renal vein, structural anomalies of the left renal vein, and possibly the higher arterial pressure of the left kidney due to the shorter distance to the heart as an underlying cause of atherosclerosis may be some of the possible causes. Due to the stronger arterial wall protecting itself from compression and high prevalences of SM and left varicocele in population, SM induced flow disorders of the left renal vein may be the most common cause. PMID:25035786

  16. Studies on phenolic steriods in human subjects. XXI. renal metabolism, conjugation and excretion of four androgens: a comparison with estriol.

    PubMed

    Kirdani, R; Barua, N R; Sandberg, A A

    1977-06-01

    The present study was conducted in order to ascertain whether the human kidney can conjugate androgens to an extent similar to that of estriol (E3). Differently labeled androgens (testosterone, DHT and androstenedione) were injected simultaneously into a peripheral vein and the renal artery. The excretion of the radioactivity in the early urine collections served as an index of the ability of the kidney to conjugate and/or metabolize the various steroids administered. It was shown that the human kidney can conjugate testosterone to some extent as the 17-glucuronide of DHT, but to a much lesser degree that E3. Androstenedione was not conjugated by the kidney and the excretion DHT was paradoxically lower following its renal artery administration than following its peripheral injection. We interpret the latter to indicate that some kidney cells may contain receptors with very high affinity for DHT, thus leading to the lower excretion observed. The administration of androstenediol (into the renal artery) and E3 (peripherally) indicated that the diol was not conjugated as readily as E3. The results point to the ability of the kidney to conjugate testosterone to some extent; however, in no case was it able to conjugate an androgen with the same facility as it does E3. PMID:194910

  17. Atheroembolic renal disease

    MedlinePLUS

    Renal disease - atheroembolic; Cholesterol embolization syndrome; Atheroemboli - renal; Atherosclerotic disease - renal ... disorder of the arteries. It occurs when fat, cholesterol, and other substances build up in the walls ...

  18. Renal Tumors

    PubMed Central

    Tan, Puay Hoon; Cheng, Liang; Rioux-Leclercq, Nathalie; Merino, Maria J.; Netto, George; Reuter, Victor E.; Shen, Steven S.; Grignon, David J.; Montironi, Rodolfo; Egevad, Lars; Srigley, John R.; Delahunt, Brett; Moch, Holger

    2016-01-01

    The International Society of Urological Pathology convened a consensus conference on renal cancer, preceded by an online survey, to address issues relating to the diagnosis and reporting of renal neoplasia. In this report, the role of biomarkers in the diagnosis and assessment of prognosis of renal tumors is addressed. In particular we focused upon the use of immunohistochemical markers and the approach to specific differential diagnostic scenarios. We enquired whether cytogenetic and molecular tools were applied in practice and asked for views on the perceived prognostic role of biomarkers. Both the survey and conference voting results demonstrated a high degree of consensus in participants responses regarding prognostic/predictive markers and molecular techniques, whereas it was apparent that biomarkers for these purposes remained outside the diagnostic realm pending clinical validation. Although no individual antibody or panel of antibodies reached consensus for classifying renal tumors, or for confirming renal metastatic disease, it was noted from the online survey that 87% of respondents used immunohistochemistry to subtype renal tumors sometimes or occasionally, and a majority (87%) used immunohistochemical markers (Pax 2 or Pax 8, renal cell carcinoma [RCC] marker, panel of pan-CK, CK7, vimentin, and CD10) in confirming the diagnosis of metastatic RCC. There was consensus that immunohistochemistry should be used for histologic subtyping and applied before reaching a diagnosis of unclassified RCC. At the conference, there was consensus that TFE3 and TFEB analysis ought to be requested when RCC was diagnosed in a young patient or when histologic appearances were suggestive of the translocation subtype; whereas Pax 2 and/or Pax 8 were considered to be the most useful markers in the diagnosis of a renal primary. PMID:24025522

  19. Increasing Use of Vitamin D Supplementation in the Chronic Renal Insufficiency Cohort Study

    PubMed Central

    Mariani, Laura H.; White, Matthew T.; Shults, Justine; Anderson, Cheryl A. M.; Feldman, Harold I.; Wolf, Myles; Reese, Peter P.; Denburg, Michelle R.; Townsend, Raymond R.; Lo, Joan C.; Cappola, Anne R.; Carlow, Dean; Gadegbeku, Crystal A.; Steigerwalt, Susan; Leonard, Mary B.

    2014-01-01

    Objective This study examined rates and determinants of vitamin D supplementation among Chronic Renal Insufficiency Cohort (CRIC) participants and determined the association between dose and 25-hydroxyvitamin D (25(OH)D) level. The 2010 Institute of Medicine Report noted a significant increase in vitamin D supplementation in the general population, but use in chronic kidney disease (CKD) is unknown. Methods CRIC is a multicenter prospective observational cohort study of 3,939 participants with a median baseline age of 60 and an estimated glomerular filtration rate (eGFR) of 42.1 mL/minute per 1.73 m2. Of the cohort, 54.9% was male, 42.1% were Black, and 48.4% were diabetic. Multivariable logistic generalized estimating equations were used to examine determinants of supplementation use assessed annually between 2003 and 2011. Cross-sectional linear regression models, based on a subset of 1,155 participants, assessed associations between supplement dose and 25(OH)D level, measured by high-performance liquid chromatography coupled with tandem mass spectrometry. Results The proportion of participants reporting supplement use increased (P < .0001), from 10% at baseline to 44% at 7-year follow-up visits. This was largely due to initiation of products containing only ergocalciferol or cholecalciferol. The odds of supplementation were greater in older, female, non-Black, married participants with greater education and lower body mass index. Among participants taking supplementation, dose was positively associated with 25(OH)D level, adjusted for race, season, diabetes, dietary intake, eGFR, and proteinuria. Only 3.8% of non-Black and 16.5% of Black participants taking a supplement were deficient (<20 ng/mL), whereas 22.7% of non-Black and 62.4% of Black participants not reporting supplement use were deficient. Conclusions Vitamin D supplementation rates rose significantly among CRIC participants over 7 years of follow-up and were associated with greater serum 25(OH)D levels. Studies of vitamin D levels on clinical outcomes in CKD and future vitamin D interventional studies should consider these changes in supplementation practices. PMID:24613295

  20. [Determination of factors conditioning adherence and accomplishment of renal protection diet in patients with chronic renal failure: pilot study for the elaboration of a dietary guideline].

    PubMed

    Orzez Villanueva, M T; Rodrguez Cisneros, A; Morales Ruiz, E; Martinz Rincn, C

    2006-01-01

    There are seldom studies on dietary behavior of patients with chronic renal failure (CRF). The aim of this study has been to know, by means of a previously validated questionnaire, which are the psycho-sociocultural factors that affect, and to what extent, assumption and adherence the dietary therapy while determining the degree of disease perception and several factors related with it. The study population is comprised by 81 patients from the nephrology clinic of the "12 de Octubre" Hospital of Madrid, with CRF in a pre-dialysis status. Seventy-seven point seventy-four percent answered "well" or "very well" to questions relating to disease knowledge and perception. Emotional and auto-management factors have little relevance according to 69.87% of patients. Fifty-nine point twenty-six percent feel a high level of familial support, and 35.77% alters dietary behavior when environmental conditions change. Most of the interviewees (87.65%) do not have difficulties finding the prescribed foods, and 70.37% considers their cost is not excessive. For almost half of the patients (48.76%), renal protection diet represents a variation in their dietary habits, a similar percentage expresses difficulty with elaboration. Food palatability is not a problem in 67.90% of the cases. Fifty-one point twenty-four percent does not perceive difficulty with cooking procedures. Seventy point ninety-nine percent feels support in one way or the other, by health care staff, although just 56.79% reports that the diet has not been explained to them. Only 18.51% questions the diet effectiveness as regards to their disease course. As for the gender variable, there were significant differences (p < 0.05), with a higher influence on men, in sections relating to disease knowledge, and influence of apathy and family support, the women those having the highest scores for food management, diet transgression at family meetings, and less information received about the prescribed diet. As for family support, there are significant differences only by age groups, patients aged more than 65 years being those feeling more this psychological support. The group of patients with a creatinine clearance less than 25 mL/min is the one expressing less categorically their appreciation on diet effectiveness. There are factors in which significant difficulty percentages are observed and that may induce diet transgression, in some cases without the patient being completely aware of, such as environmental changes, change in traditional habits, the degree of diet explanation, the organoleptic characteristics, and the lack of knowledge of appropriate cooking procedures. All these indicators confirm the need for enhancing nutritional education of these patients and their family environment, also showing the need for a nutritional intervention that completely supports patients in the process of adaptation and maintenance of their new dietary habit. PMID:16734066

  1. Automated motion correction based on target tracking for dynamic nuclear medicine studies

    NASA Astrophysics Data System (ADS)

    Cao, Xinhua; Tetrault, Tracy; Fahey, Fred; Treves, Ted

    2008-03-01

    Nuclear medicine dynamic studies of kidneys, bladder and stomach are important diagnostic tools. Accurate generation of time-activity curves from regions of interest (ROIs) requires that the patient remains motionless for the duration of the study. This is not always possible since some dynamic studies may last from several minutes to one hour. Several motion correction solutions have been explored. Motion correction using external point sources is inconvenient and not accurate especially when motion results from breathing, organ motion or feeding rather than from body motion alone. Centroid-based motion correction assumes that activity distribution is only inside the single organ (without background) and uniform, but this approach is impractical in most clinical studies. In this paper, we present a novel technique of motion correction that first tracks the organ of interest in a dynamic series then aligns the organ. The implementation algorithm for target tracking-based motion correction consists of image preprocessing, target detection, target positioning, motion estimation and prediction, tracking (new search region generation) and target alignment. The targeted organ is tracked from the first frame to the last one in the dynamic series to generate a moving trajectory of the organ. Motion correction is implemented by aligning the organ ROIs in the image series to the location of the organ in the first image. The proposed method of motion correction has been applied to several dynamic nuclear medicine studies including radionuclide cystography, dynamic renal scintigraphy, diuretic renography and gastric emptying scintigraphy.

  2. Dynamism in gene expression across multiple studies

    PubMed Central

    Morgan, Alexander A.; Dudley, Joel T.; Deshpande, Tarangini

    2010-01-01

    In this study we develop methods of examining gene expression dynamics, how and when genes change expression, and demonstrate their application in a meta-analysis involving over 29,000 microarrays. By defining measures across many experimental conditions, we have a new way of characterizing dynamics, complementary to measures looking at changes in absolute variation or breadth of tissues showing expression. We show conservation in overall patterns of dynamism across three species (human, mouse, and rat) and show associations with known disease-related genes. We discuss the enriched functional properties of the sets of genes showing different patterns of dynamics and show that the differences in expression dynamics is associated with the variety of different transcription factor regulatory sites. These results can influence thinking about the selection of genes for microarray design and the analysis of measurements of mRNA expression variation in a global context of expression dynamics across many conditions, as genes that are rarely differentially expressed between experimental conditions may be the subject of increased scrutiny when they significantly vary in expression between experimental subsets. PMID:19920211

  3. VUV studies of molecular photofragmentation dynamics

    SciTech Connect

    White, M.G.

    1993-12-01

    State-resolved, photoion and photoelectron methods are used to study the neutral fragmentation and ionization dynamics of small molecules relevant to atmospheric and combustion chemistry. Photodissociation and ionization are initiated by coherent VUV radiation and the fragmentation dynamics are extracted from measurements of product rovibronic state distributions, kinetic energies and angular distributions. The general aim of these studies is to investigate the multichannel interactions between the electronic and nuclear motions which determine the evolution of the photoexcited {open_quotes}complex{close_quotes} into the observed asymptotic channels.

  4. A casecontrol study of occupation/industry and renal cell carcinoma risk

    PubMed Central

    2012-01-01

    Background The role of occupation in the etiology of renal cell carcinoma (RCC) is unclear. Here, we investigated associations between employment in specific occupations and industries and RCC, and its most common histologic subtype, clear cell RCC (ccRCC). Methods Between 2002 and 2007, a population-based casecontrol study of Caucasians and African Americans (1,217 cases; 1,235 controls) was conducted within the Detroit and Chicago metropolitan areas to investigate risk factors for RCC. As part of this study, occupational histories were ascertained through in-person interviews. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating occupation and industry to RCC risk using adjusted unconditional logistic regression models. Results Employment in the agricultural crop production industry for five years or more was associated with RCC (OR?=?3.3 [95% CI?=?1.0-11.5]) and ccRCC in particular (OR?=?6.3 [95% CI?=?1.7-23.3], P for trend with duration of employment?=?0.0050). Similarly, RCC risk was elevated for employment of five years or longer in non-managerial agricultural and related occupations (ORRCC?=?2.1 [95% CI?=?1.0-4.5]; ORccRCC?=?3.1 [95% CI?=?1.4-6.8]). Employment in the dry-cleaning industry was also associated with elevated risk (ORRCC?=?2.0 [95% CI?=?0.9-4.4], P for trend?=?0.093; ORccRCC?=?3.0 [95% CI?=?1.2-7.4], P for trend?=?0.031). Suggestive elevated associations were observed for police/public safety workers, health care workers and technicians, and employment in the electronics, auto repair, and cleaning/janitorial services industries; protective associations were suggested for many white-collar jobs including computer science and administrative occupations as well employment in the business, legislative, and education industries. Conclusions Our findings provide support for an elevated risk of RCC in the agricultural and dry-cleaning industries and suggest that these associations may be stronger for the ccRCC subtype. Additional studies are needed to confirm these findings. PMID:22873580

  5. Can Tc 99m DTPA be Used in Adult Patients in Evaluation of Relative Renal Function Measurement as the Reference Tc 99m DMSA Method?

    PubMed Central

    Yalçın, Hülya; Özen, Aynur; Günay, Emel Ceylan; Özaslan, İnci Aliç; Özer, Cahit

    2011-01-01

    Objective: In the literature, there are many reports comparing relative renal function calculated with Tc 99m DTPA and Tc 99m DMSA in adults and children. However, there is no consensus about the results. As there is indeterminacy in the reliability of Tc 99m DTPA for the calculation of the relative renal functions, we retrospectively designed a study to compare the relative renal functions measured with Tc 99m DMSA and Tc 99m DTPA in adult patients with renal diseases Material and Methods: We retrospectively analyzed the data of 144 patients who applied to Nuclear Medicine Department of three hospitals between 2009 and 2010 and who had both dynamic and static renal imaging. Renal dynamic scintigraphies were compared to the relative function measured using Tc 99m DMSA static scintigraphy. Comparison of relative renal function measurements using dynamic and static renal scintigraphies was performed using Pearson correlation test. The comparison results were expressed with Bland-Altman analysis. Results: The study was conducted with 144 patients and 288 kidneys. Fifty six of patients were male. Mean age was 39.9±15.2 years. Thirty four patients had hydronephrosis, 28 pyelonephritis, 53 renal calculi, 3 chronic renal failure, 2 acute renal failure, 1 benign renal neoplasia, 15 renal atrophy, 8 ureteropelvic junction stenosis. Relative renal function was calculated in Tc 99m DMSA and 99m Tc-DTPA studies. The mean relative renal functions measured with Tc 99m DTPA was 52.54±23.09% and 47.25±23.09, with Tc 99m DMSA 52.85±21.80% and 47.07±21.77% for right and left kidneys, respectively. In bivariate correlation analysis (Pearson) a significant positive correlation was found between the relative renal functions calculated with Tc 99m DTPA and Tc 99m DMSA (r =0.937, p< 0.001). In Bland-Altman plots, the mean difference between two methods was 0.3 and the correlation limits were between 16.2 to -15.5. Conclusion: As a result, we concluded that Tc 99m DTPA is also a good method for the relative renal function evaluation when compared to Tc 99m DMSA scan. Although Tc 99m DMSA is the most reliable method for the calculation of relative renal function, Tc 99m DTPA can be another choice for the calculation of relative renal function without a complementary DMSA scan particularly in patients who require renogram curve and GFR calculations. Conflict of interest:None declared. PMID:23486843

  6. Parametric Imaging Of Digital Subtraction Angiography Studies For Renal Transplant Evaluation

    NASA Astrophysics Data System (ADS)

    Gallagher, Joe H.; Meaney, Thomas F.; Flechner, Stuart M.; Novick, Andrew C.; Buonocore, Edward

    1981-11-01

    A noninvasive method for diagnosing acute tubular necrosis and rejection would be an important tool for the management of renal transplant patients. From a sequence of digital subtraction angiographic images acquired after an intravenous injection of radiographic contrast material, the parametric images of the maximum contrast, the time when the maximum contrast is reached, and two times the time at which one half of the maximum contrast is reached are computed. The parametric images of the time when the maximum is reached clearly distinguish normal from abnormal renal function. However, it is the parametric image of two times the time when one half of the maximum is reached which provides some assistance in differentiating acute tubular necrosis from rejection.

  7. A study of renal blood flow regulation using the discrete wavelet transform

    NASA Astrophysics Data System (ADS)

    Pavlov, Alexey N.; Pavlova, Olga N.; Mosekilde, Erik; Sosnovtseva, Olga V.

    2010-02-01

    In this paper we provide a way to distinguish features of renal blood flow autoregulation mechanisms in normotensive and hypertensive rats based on the discrete wavelet transform. Using the variability of the wavelet coefficients we show distinctions that occur between the normal and pathological states. A reduction of this variability in hypertension is observed on the microscopic level of the blood flow in efferent arteriole of single nephrons. This reduction is probably associated with higher flexibility of healthy cardiovascular system.

  8. Population pharmacokinetics of edoxaban and its main metabolite in a dedicated renal impairment study.

    PubMed

    Jnsson, Siv; Simonsson, Ulrika S H; Miller, Raymond; Karlsson, Mats O

    2015-11-01

    A model characterizing the population pharmacokinetics (PK) of edoxaban and its major metabolite, M4, following a single oral dose of 15?mg administered to subjects with varying kidney function was developed. Thirty-two subjects contributed with edoxaban plasma, edoxaban urine, and M4 plasma concentrations. Edoxaban urine concentrations allowed estimation of renal clearance, and high contribution of renal to total clearance enabled estimation of absolute oral bioavailability. A 2-compartment model with delayed absorption and elimination parameterized as renal clearance linearly related to creatinine clearance (CLcr ) and nonrenal clearance forming M4 described edoxaban PK. The PK of M4 was described with a 1-compartment model. For a typical subject (70?kg; CLcr , 100?mL/min) bioavailability, clearance, and central and peripheral volume of distribution for edoxaban was estimated to 72.3%, 21.0 L/h, 95.4 L, and 54.3 L, respectively. For both edoxaban and M4, the model predicted systemic exposure to increase 57.0%, 35.0%, and 11.6% in a subject having CLcr of 30, 50, and 80?mL/min, respectively, compared with a subject having a CLcr of 100?mL/min. Concentration ratios (M4 over edoxaban) were predicted to vary with time after dose, but with minor influence of kidney function and body weight. Results were in agreement with previous analyses. PMID:25966665

  9. Mechanisms of HO-1 mediated attenuation of renal immune injury: a gene profiling study.

    PubMed

    Duann, Pu; Lianos, Elias A

    2011-10-01

    Using a mouse model of immune injury directed against the renal glomerular vasculature and resembling human forms of glomerulonephritis (GN), we assessed the effect of targeted expression of the cytoprotective enzyme heme oxygenase (HO)-1. A human (h) HO-1 complementary DNAN (cDNA) sequence was targeted to glomerular epithelial cells (GECs) using a GEC-specific murine nephrin promoter. Injury by administration of antibody against the glomerular basement membrane (anti-GBM) to transgenic (TG) mice with GEC-targeted hHO-1 was attenuated compared with wild-type (WT) controls. To explore changes in the expression of genes that could mediate this salutary effect, we performed gene expression profiling using a microarray analysis of RNA isolated from the renal cortex of WT or TG mice with or without anti-GBM antibody-induced injury. Significant increases in expression were detected in 9 major histocompatibility complex (MHC)-class II genes, 2 interferon-? (IFN-?)-inducible guanosine triphosphate (GTP)ases, and 3 genes of the ubiquitin-proteasome system. The increase in MHC-class II and proteasome gene expression in TG mice with injury was validated by real-time polymerase chain reaction (PCR) or Western blot analysis. The observations point to novel mechanisms underlying the cytoprotective effect of HO-1 in renal immune injury. PMID:21925121

  10. Lunar libration point flight dynamics study

    NASA Technical Reports Server (NTRS)

    1969-01-01

    Two satellite concepts, Halo and Hummingbird, for a lunar libration point satellite to be used as a tracking and communications link with the far side of the moon were evaluated. Study areas included flight dynamics, communications, attitude control, propulsion, and system integration. Both concepts were proved feasible, but Halo was shown to be the better concept.

  11. The scintigraphic pattern of renal angiomyolipoma

    SciTech Connect

    Jaikishen, P.; Oster, Z.H.; Atkins, H.L. )

    1990-03-01

    The patterns of renal and gallium scintigraphy in a patient with renal angiomyolipoma are presented. Renal study with Tc-99m DTPA demonstrated a photopenic area in the flow and delayed images. Ga-67 citrate imaging did not show any evidence of increased activity. Although this pattern is also seen in renal cysts, scintigraphy seems to be valuable in the evaluation of angiomyolipoma. It helps differentiate it from renal carcinoma or renal abscess (which may be gallium avid), especially when the tumor is characterized by a paucity of adipose tissue and complicated by hemorrhage, in which case CT and ultrasonographic patterns are not diagnostic.

  12. New insights into the dynamic regulation of water and acid-base balance by renal epithelial cells.

    PubMed

    Brown, Dennis; Bouley, Richard; P?unescu, Teodor G; Breton, Sylvie; Lu, Hua A J

    2012-05-15

    Maintaining tight control over body fluid and acid-base homeostasis is essential for human health and is a major function of the kidney. The collecting duct is a mosaic of two cell populations that are highly specialized to perform these two distinct processes. The antidiuretic hormone vasopressin (VP) and its receptor, the V2R, play a central role in regulating the urinary concentrating mechanism by stimulating accumulation of the aquaporin 2 (AQP2) water channel in the apical membrane of collecting duct principal cells. This increases epithelial water permeability and allows osmotic water reabsorption to occur. An understanding of the basic cell biology/physiology of AQP2 regulation and trafficking has informed the development of new potential treatments for diseases such as nephrogenic diabetes insipidus, in which the VP/V2R/AQP2 signaling axis is defective. Tubule acidification due to the activation of intercalated cells is also critical to organ function, and defects lead to several pathological conditions in humans. Therefore, it is important to understand how these "professional" proton-secreting cells respond to environmental and cellular cues. Using epididymal proton-secreting cells as a model system, we identified the soluble adenylate cyclase (sAC) as a sensor that detects luminal bicarbonate and activates the vacuolar proton-pumping ATPase (V-ATPase) via cAMP to regulate tubular pH. Renal intercalated cells also express sAC and respond to cAMP by increasing proton secretion, supporting the hypothesis that sAC could function as a luminal sensor in renal tubules to regulate acid-base balance. This review summarizes recent advances in our understanding of these fundamental processes. PMID:22460710

  13. Role of Adding Spironolactone and Renal Denervation in True Resistant Hypertension: One-Year Outcomes of Randomized PRAGUE-15 Study.

    PubMed

    Rosa, Jn; Widimsk, Petr; Waldauf, Petr; Lambert, Luk; Zelinka, Tom; Tborsk, Milo; Branny, Marian; Touek, Petr; Petrk, Ond?ej; ?urila, Karol; Bedn?, Frantiek; Holaj, Robert; trauch, Branislav; Vclavk, Jan; Nykl, Igor; Krtk, Zuzana; Kocinov, Eva; Jiravsk, Otakar; Rappov, Gabriela; Indra, Tom; Widimsk, Ji?

    2016-02-01

    This randomized, multicenter study compared the relative efficacy of renal denervation (RDN) versus pharmacotherapy alone in patients with true resistant hypertension and assessed the effect of spironolactone addition. We present here the 12-month data. A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline systolic blood pressure of 15917 and 15517 mm Hg and average number of drugs 5.1 and 5.4, respectively. Twelve-month results are available in 101 patients. The intention-to-treat analysis found a comparable mean 24-hour systolic blood pressure decline of 6.4 mm Hg, P=0.001 in RDN versus 8.2 mm Hg, P=0.002 in the pharmacotherapy group. Per-protocol analysis revealed a significant difference of 24-hour systolic blood pressure decline between complete RDN (6.3 mm Hg, P=0.004) and the subgroup where spironolactone was added, and this continued within the 12 months (15 mm Hg, P= 0.003). Renal artery computed tomography angiograms before and after 1 year post-RDN did not reveal any relevant changes. This study shows that over a period of 12 months, RDN is safe, with no serious side effects and no major changes in the renal arteries. RDN in the settings of true resistant hypertension with confirmed compliance is not superior to intensified pharmacological treatment. Spironolactone addition (if tolerated) seems to be more effective in blood pressure reduction. PMID:26693818

  14. A Study of Relationship of Atheroembolic Risk Factors with Postoperative Recovery in Renal Function after Partial Nephrectomy in Patients Staged T1-2 Renal Cell Carcinoma during Median 4-Year Follow-up

    PubMed Central

    Kim, Sung Han; Kang, Kyung Min; Yu, Ami; Lee, Jung Hoon; Nam, Byung Ho; Lee, Eun Sik

    2016-01-01

    Purpose The objective of this study is to evaluate the relationship of atheroembolic risk factors with postoperative recovery of renal function after on-clamp partial nephrectomy (PN) with warm ischemia in patients with staged T1-2 renal cell carcinoma (RCC). Materials and Methods A total of 234 patients from 2004 to 2012 were included, and their clinicopathologic and operative parameters, including atheroembolic risk factors were reviewed retrospectively. Renal function, as determined by estimated glomerular filtration rate (eGFR) and measurement of serum creatinine level (Cr) at each scheduled follow-up for a median four years, was compared between the high-risk (HR) group (n=49, ? five risk factors) and the low-risk (LR) group (n=185, < five risk factors). Results Except for baseline renal function and number of risk factors for atheroembolism, differences in characteristics between groups were comparatively insignificant. At 3 months after the operation, Cr and eGFR differed significantly between the two groups (p < 0.05), but no differences were observed afterward. Significant deterioration from baseline in Cr and eGFR was observed in both groups at 1 month after the operation, with a greater change in the HR group (p < 0.05). From measurement to measurement, significantly faster deterioration in Cr and eGFR was observed in the HR group than in the LR group until 6 months after the operation (Cr: LR, 0.02 mg/dL and HR, 0.13 mg/dL; eGFR: LR, 1.50 mL/min/1.73 m2 and HR, 6.38 mL/min/1.73 m2; p < 0.05). Conclusion The presence of atheroembolic risk factors may negatively influence postoperative recovery of renal function after PN in patients with localized RCC. PMID:25943322

  15. Recruitment of Hispanics into an observational study of chronic kidney disease: the Hispanic Chronic Renal Insufficiency Cohort Study experience.

    PubMed

    Lora, Claudia M; Ricardo, Ana C; Brecklin, Carolyn S; Fischer, Michael J; Rosman, Robert T; Carmona, Eunice; Lopez, Amada; Balaram, Manjunath; Nessel, Lisa; Tao, Kaixiang Kelvin; Xie, Dawei; Kusek, John W; Go, Alan S; Lash, James P

    2012-11-01

    Despite the large burden of chronic kidney disease (CKD) in Hispanics, this population has been underrepresented in research studies. We describe the recruitment strategies employed by the Hispanic Chronic Renal Insufficiency Cohort Study, which led to the successful enrollment of a large population of Hispanic adults with CKD into a prospective observational cohort study. Recruitment efforts by bilingual staff focused on community clinics with Hispanic providers in high-density Hispanic neighborhoods in Chicago, academic medical centers, and private nephrology practices. Methods of publicizing the study included church meetings, local Hispanic print media, Spanish television and radio stations, and local health fairs. From October 2005 to July 2008, we recruited 327 Hispanics aged 21-74 years with mild-to-moderate CKD as determined by age-specific estimated glomerular filtration rate (eGFR). Of 716 individuals completing a screening visit, 49% did not meet eGFR inclusion criteria and 46% completed a baseline visit. The mean age at enrollment was 57.1 and 67.1% of participants were male. Approximately 75% of enrolled individuals were Mexican American, 15% Puerto Rican, and 10% had other Latin American ancestry. Eighty two percent of participants were Spanish-speakers. Community-based and academic primary care clinics yielded the highest percentage of participants screened (45.9% and 22.4%) and enrolled (38.2% and 24.5%). However, academic and community-based specialty clinics achieved the highest enrollment yield from individuals screened (61.9% to 71.4%). A strategy focused on primary care and nephrology clinics and the use of bilingual recruiters allowed us to overcome barriers to the recruitment of Hispanics with CKD. PMID:22841929

  16. 3D element imaging using NSECT for the detection of renal cancer: a simulation study in MCNP

    NASA Astrophysics Data System (ADS)

    Viana, R. S.; Agasthya, G. A.; Yoriyaz, H.; Kapadia, A. J.

    2013-09-01

    This work describes a simulation study investigating the application of neutron stimulated emission computed tomography (NSECT) for noninvasive 3D imaging of renal cancer in vivo. Using MCNP5 simulations, we describe a method of diagnosing renal cancer in the body by mapping the 3D distribution of elements present in tumors using the NSECT technique. A human phantom containing the kidneys and other major organs was modeled in MCNP5. The element composition of each organ was based on values reported in literature. The two kidneys were modeled to contain elements reported in renal cell carcinoma (RCC) and healthy kidney tissue. Simulated NSECT scans were executed to determine the 3D element distribution of the phantom body. Elements specific to RCC and healthy kidney tissue were then analyzed to identify the locations of the diseased and healthy kidneys and generate tomographic images of the tumor. The extent of the RCC lesion inside the kidney was determined using 3D volume rendering. A similar procedure was used to generate images of each individual organ in the body. Six isotopes were studied in this work—32S, 12C, 23Na, 14N, 31P and 39K. The results demonstrated that through a single NSECT scan performed in vivo, it is possible to identify the location of the kidneys and other organs within the body, determine the extent of the tumor within the organ, and to quantify the differences between cancer and healthy tissue-related isotopes with p ≤ 0.05. All of the images demonstrated appropriate concentration changes between the organs, with some discrepancy observed in 31P, 39K and 23Na. The discrepancies were likely due to the low concentration of the elements in the tissue that were below the current detection sensitivity of the NSECT technique.

  17. 3D element imaging using NSECT for the detection of renal cancer: a simulation study in MCNP.

    PubMed

    Viana, R S; Agasthya, G A; Yoriyaz, H; Kapadia, A J

    2013-09-01

    This work describes a simulation study investigating the application of neutron stimulated emission computed tomography (NSECT) for noninvasive 3D imaging of renal cancer in vivo. Using MCNP5 simulations, we describe a method of diagnosing renal cancer in the body by mapping the 3D distribution of elements present in tumors using the NSECT technique. A human phantom containing the kidneys and other major organs was modeled in MCNP5. The element composition of each organ was based on values reported in literature. The two kidneys were modeled to contain elements reported in renal cell carcinoma (RCC) and healthy kidney tissue. Simulated NSECT scans were executed to determine the 3D element distribution of the phantom body. Elements specific to RCC and healthy kidney tissue were then analyzed to identify the locations of the diseased and healthy kidneys and generate tomographic images of the tumor. The extent of the RCC lesion inside the kidney was determined using 3D volume rendering. A similar procedure was used to generate images of each individual organ in the body. Six isotopes were studied in this work - (32)S, (12)C, (23)Na, (14)N, (31)P and (39)K. The results demonstrated that through a single NSECT scan performed in vivo, it is possible to identify the location of the kidneys and other organs within the body, determine the extent of the tumor within the organ, and to quantify the differences between cancer and healthy tissue-related isotopes with p ? 0.05. All of the images demonstrated appropriate concentration changes between the organs, with some discrepancy observed in (31)P, (39)K and (23)Na. The discrepancies were likely due to the low concentration of the elements in the tissue that were below the current detection sensitivity of the NSECT technique. PMID:23920157

  18. Retinopathy and the risk of cardiovascular disease in patients with chronic kidney disease (from the Chronic Renal Insufficiency Cohort study).

    PubMed

    Grunwald, Juan E; Pistilli, Maxwell; Ying, Gui-Shuang; Maguire, Maureen; Daniel, Ebenezer; Whittock-Martin, Revell; Parker-Ostroff, Candace; Mohler, Emile; Lo, Joan C; Townsend, Raymond R; Gadegbeku, Crystal Ann; Lash, James Phillip; Fink, Jeffrey Craig; Rahman, Mahboob; Feldman, Harold; Kusek, John W; Xie, Dawei

    2015-11-15

    Patients with chronic kidney disease (CKD) experience other diseases such as cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess whether retinopathy predicts future CVD events in a subgroup of the participants of the Chronic Renal Insufficiency Cohort (CRIC) study. In this ancillary investigation, 2,605 participants of the CRIC study were invited to participate, and nonmydriatic fundus photographs were obtained in 1,936 subjects. Using standard protocols, presence and severity of retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed at a central photograph reading center by trained graders masked to study participant's information. Patients with a self-reported history of cardiovascular disease were excluded. Incident CVD events were adjudicated using medical records. Kidney function measurements, traditional and nontraditional risk factors, for CVD were obtained. Presence and severity of retinopathy were associated with increased risk of development of any CVD in this population of CKD patients, and these associations persisted after adjustment for traditional risk factors for CVD. We also found a direct relation between increased venular diameter and risk of development of CVD; however, the relation was not statistically significant after adjustment for traditional risk factors. In conclusion, the presence of retinopathy was associated with future CVD events, suggesting that retinovascular pathology may be indicative of macrovascular disease even after adjustment for renal dysfunction and traditional CVD risk factors. Assessment of retinal morphology may be valuable in assessing risk of CVD in patients with CKD, both clinically and in research settings. PMID:26409637

  19. Comparative imaging study in ultrasound, MRI, CT, and DSA using a multimodality renal artery phantom

    SciTech Connect

    King, Deirdre M.; Fagan, Andrew J.; Moran, Carmel M.; Browne, Jacinta E.

    2011-02-15

    Purpose: A range of anatomically realistic multimodality renal artery phantoms consisting of vessels with varying degrees of stenosis was developed and evaluated using four imaging techniques currently used to detect renal artery stenosis (RAS). The spatial resolution required to visualize vascular geometry and the velocity detection performance required to adequately characterize blood flow in patients suffering from RAS are currently ill-defined, with the result that no one imaging modality has emerged as a gold standard technique for screening for this disease. Methods: The phantoms, which contained a range of stenosis values (0%, 30%, 50%, 70%, and 85%), were designed for use with ultrasound, magnetic resonance imaging, x-ray computed tomography, and x-ray digital subtraction angiography. The construction materials used were optimized with respect to their ultrasonic speed of sound and attenuation coefficient, MR relaxometry (T{sub 1},T{sub 2}) properties, and Hounsfield number/x-ray attenuation coefficient, with a design capable of tolerating high-pressure pulsatile flow. Fiducial targets, incorporated into the phantoms to allow for registration of images among modalities, were chosen to minimize geometric distortions. Results: High quality distortion-free images of the phantoms with good contrast between vessel lumen, fiducial markers, and background tissue to visualize all stenoses were obtained with each modality. Quantitative assessments of the grade of stenosis revealed significant discrepancies between modalities, with each underestimating the stenosis severity for the higher-stenosed phantoms (70% and 85%) by up to 14%, with the greatest discrepancy attributable to DSA. Conclusions: The design and construction of a range of anatomically realistic renal artery phantoms containing varying degrees of stenosis is described. Images obtained using the main four diagnostic techniques used to detect RAS were free from artifacts and exhibited adequate contrast to allow for quantitative measurements of the degree of stenosis in each phantom. Such multimodality phantoms may prove useful in evaluating current and emerging US, MRI, CT, and DSA technology.

  20. Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

    PubMed Central

    2012-01-01

    Objective To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods The studied population included patients who sustained high grades renal injury (grades III to V) successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (99mTc EC), using captopril stimulation to verify renal vascular etiology. Results Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions), and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4?years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA). DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2??5.5% for grade III, 35.3??12.8% for grade IV, 13.5??19.1 for grade V). Six patients (19.4%) had severe compromised function (< 30%). There was statistically significant difference in the decrease in renal function between parenchymal and vascular causes for grade IV injuries (p?renal injury, and average post-injury time was 7.8?years. Seven patients had negative captopril renography. Conclusions Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function. PMID:22852875

  1. Renal and perinephric abscesses in West China Hospital: 10-year retrospective-descriptive study

    PubMed Central

    Liu, Xiao-Qin; Wang, Cheng-Cheng; Liu, Yan-Bin; Liu, Kai

    2016-01-01

    AIM: To elucidate the clinical, radiological and laboratory profiles of renal abscess (RA) and perinephric abscess (PNA), along with related treatment and outcome. METHODS: Ninety-eight patients diagnosed with RA or PNA using the primary discharge diagnoses identified from the International Statistical Classification of Diseases and Related Health Problems Tenth Edition (ICD-10) codes (RA: N15.101, PNA: N15.102) between September 2004 and December 2014 in West China Hospital were selected. Medical records including patients’ characteristics, symptoms and signs, high-risk factors, radiological features, causative microorganisms and antibiotic-resistance profiles, treatment approaches, and clinical outcomes were collected and analyzed. RESULTS: The mean age of the patients was 46.49 years with a male to female ratio of 41:57. Lumbar pain (76.5%) and fever (53.1%) were the most common symptoms. Other symptoms and signs included chills (28.6%), anorexia and vomiting (25.5%), lethargy (10.2%), abdominal pain (11.2%), flank mass (12.2%), flank fistula (2.0%), gross hematuria (7.1%), frequency (14.3%), dysuria (9.2%), pyuria (5.1%) and weight loss (1.0%). Painful percussion of the costovertebral angle (87.8%) was the most common physical finding. The main predisposing factors were lithiasis (48.0%), diabetes mellitus (33.7%) followed by history of urological surgery (16.3%), urinary tract infections (14.3%), renal function impairment (13.3%), liver cirrhosis (2.0%), neurogenic bladder (1.0%), renal cyst (1.0%), hydronephrosis (1.0%), chronic hepatitis B (1.0%), post-discectomy (1.0%) and post-colectomy (1.0%). Ultrasound (US) and computed tomography were the most valuable diagnostic tools and US was recommended as the initial diagnostic imaging choice. Escherichia coli (51.4%), Staphylococcus aureus (10.0%) and Klebsiella pneumoniae (8.6%) were the main causative microorganisms. Intravenous antibiotic therapy was necessary while intervention including surgical and nonsurgical approaches were reserved for larger abscesses, multiple abscesses, PNAs and non-responders. CONCLUSION: Heightened alertness, prompt diagnosis, and especially proper antibiotics in conjunction with interventional approaches allow a promising clinical outcome of renal and perinephric abscesses. PMID:26788470

  2. The renal scan in pregnant renal transplant patients

    SciTech Connect

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  3. Effects of salt rich diet in the obese Zucker rats: studies on renal function during isotonic volume expansion.

    PubMed

    Pamidimukkala, Jaya; Jandhyala, Bhagavan S

    2004-01-01

    Obese Zucker rats (OZR) are hyperinsulenemic, hyperglycemic and dyslipidemic and develop salt dependent hypertension. Since salt sensitivity is considered to be due to impaired handling of renal sodium excretion, these studies were conducted in the obese and lean Zucker rats (LZR) anesthetized with Inactin to evaluate renal function under basal conditions and during acute isotonic fluid volume expansion (VE). Mean Arterial blood pressure (MBP), heart rate (HR), renal blood flow(RBF) and glomerular filtration rate (GFR) were not significantly different between the lean Zucker rats fed normal diet or that fed salt rich diet(8% NaCI). However, basal UV and UNaV were significantly greater in the LZR fed high salt. During VE essentially identical increases occurred in GFR, UV and UNaV in both the lean groups. In the OZR fed salt rich diet also, there were no significant changes in the heart rate, RBF and GFR. However, arterial blood pressure of the OZR fed salt rich diet was significantly greater than that of the OZR on the normal diet as well as that of both the lean groups. Also, as in the LZR, basal UV and UNaV were significantly greater in the salt fed obese rats. During volume expansion there were no impairments in the ability of the obese groups fed normal or salt rich diet to eliminate sodium and water during volume load. In fact, the net sodium and water excretions during and 60 min after VE in both the obese groups were significantly greater than that of corresponding lean groups. Furthermore, these values in the OZR fed salt rich diet were significantly greater than that of the obese rats on normal salt diet perhaps due to the contribution of pressure natriuretic mechanisms'. These data demonstrate that although OZR are salt sensitive, the renal mechanisms that would collectively respond to acute isotonic VE were fully functional. An unexpected and a novel finding in these studies is that the salt rich diet, in addition to increasing arterial blood pressure also significantly lowered plasma of insulin levels and enhanced glucose and cholesterol levels in the obese Zucker rats. PMID:15000297

  4. Continuous game dynamics: an experimental study.

    SciTech Connect

    Patelli, P.; Sato, Yuzuru

    2004-01-01

    In this paper we study an experiment with human agents strategically interacting in a game characterized by continuous time and continuous strategy space. The research is focused in studying the agents interaction dynamic under different experimental settings. The agents play a two person game that is an extension of the classic Cournot duopoly. Having agents making decision continuously allows us to track the temporal structure of strategy evolution very precisely. We can follow the agents continuous behavior evolution avoiding the data under-sampling. To our knowledge this is the first attempt to approach experimentally the continuous time decision making. We also emphasize that the focus of our work is not the Cournot model but rather the more general problem of studying the agents strategic interaction dynamic in continuous space time. Flaming the problem as the well studied Cournot Duopoly would be a good starting point. In economics dynamics studies the oligopoly model literature in both discrete and continuous time is one of the richest. There is also a vast literature in experimental economics about repeated games in general and more specifically in duopoly/oligopoly models. Cox and Walker studied whether subjects can learn to play the Cournot Duopoly strategies comparing the experimental results with the theoretical prediction of learning models. The Cox Walker experiment differs from our settings because it is in discrete time and is an evolutionary dynamics framework through a random matching mechanism of the experimental subjects. From the theoretical perspective many works have been focused in studying the Cournot model in a dynamical settings. Okuguchi and Szidarovsky formulated a continuous time version of the Cournot Oligopoly with multiproduct firms. They analyzed the stability of the equilibrium and proved that it is stable, under certain conditions, independently from the value of the adjustments. Chiarella and Khomin extended this analysis to unstable dynamics in Cournot duopoly. They used analytical and numerical tools to study the relevance of time lags and nonlinearities in relation with the convergence of quantities and prices to some stable attractors. Lately, Chiarella and Szidarovsky analyzed the case with continuously distributed time lags and without full information: firms experiences time lag in obtaining and implementing information in the price and the outputs. They showed that without time-lag a steady state is always asymptotically stable. Vice versa in presence of time lags local instability can occur. Other studies, like in Kopel, discussed the effect on non-monotonic reaction curves on the system dynamical properties. We can have non monotonic reaction function if, for example, quantity demanded is reciprocal to price and firms are facing constant unit costs or vice versa with linear demand function and cubic marginal costs function. The non-monotonic reaction function assumption causes chaotic dynamic in pricing.

  5. Renal circulation and cellular metabolism during left ventricular assisted circulation: comparison study of pulsatile and nonpulsatile assists.

    PubMed

    Sezai, A; Shiono, M; Orime, Y; Nakata, K; Hata, M; Yamada, H; Iida, M; Kashiwazaki, S; Kinishita, J; Nemoto, M; Koujima, T; Sezai, Y; Saitoh, T

    1997-07-01

    We examined left ventricular assist during 6 h for an acute myocardial infarction model in pigs. The outflow cannula was placed in the ascending aorta and an inflow cannula in the left atrium. A pump (Pulsatile group: Zeon Medical and Nonpulsatile group: Nikkiso HPM-15) was connected to each cannula. Items measured were the regional blood flow of the cortex and the medulla in the kidney, renal arterial flow, arterial blood ketone body ratio (AKBR), lactate/pyruvic acid, BUN, creatinine and beta 2-microglobulin. After experimental study, the kidneys were removed, and a pathological study was performed. In the pulsatile assisted group, renal cortical blood flow increased but medulla blood flow decreased. On the other hand, in the nonpulsatile assisted group, both regional blood flows decreased. That means that in the pulsatile assisted group intrarenal redistribution improved, rather than in the nonpulsatile assisted group. The results of our study indicated that pulsatile assist produced superior circulation in the kidney, and the microcirculation on the cell level was superior as well in early treatment of acute left heart failure. PMID:9212968

  6. Association of tibia lead and blood lead with end-stage renal disease: A pilot study of African-Americans

    SciTech Connect

    Muntner, Paul . E-mail: pmuntner@tulane.edu; Menke, Andy; Batuman, Vecihi; Rabito, Felicia A.; He Jiang; Todd, Andrew C.

    2007-07-15

    The association between body lead burden and kidney disease remains controversial. Fifty-five African-American end-stage renal disease (ESRD) cases and 53 age- and sex-matched African-American controls without known renal disease were recruited from Tulane University-affiliated dialysis clinics and out-patient clinics, respectively. Blood lead was measured via atomic absorption spectrophotometry and tibia lead (a measure of body lead) was measured via {sup 109}Cd-based K shell X-ray fluorescence. Median blood lead levels were significantly higher among ESRD cases (6 {mu}g/dL) compared to their control counterparts (3 {mu}g/dL; P<0.001). Although no participants had overt lead poisoning (blood lead {>=}25 {mu}g/dL), seven cases but no controls had blood lead levels above 10 {mu}g/dL (P=0.006). The median tibia lead level was 17 micrograms of lead per gram of bone mineral ({mu}g/g) and 13 {mu}g/g among ESRD cases and their control counterparts, respectively (P=0.134). Four ESRD cases (7%), but no controls, had a tibia lead level above 40 {mu}g/g (P=0.115) while a similar proportion of cases and controls had tibia lead between 20 and 39 {mu}g/g (33% and 32%, respectively; P=0.726). After adjustment for potential confounders, the odds ratios of ESRD associated with a tibia lead {>=}20 {mu}g/g and each four-fold higher tibia lead (e.g., 5-20 {mu}g/g) were 1.55 (95% CI: 0.55, 4.41) and 1.88 (95% CI: 0.53, 6.68), respectively. These findings support the need for prospective cohort studies of body lead burden and renal disease progression.

  7. Importance and Repercussions of Renal and Cardiovascular Pathology on Stroke in Young Adults: An Anatomopathologic Study of 52 Clinical Necropsies

    PubMed Central

    Arismendi-Morillo, Gabriel; Fernndez-Abreu, Mary; Cardozo-Duran, Jos; Vilchez-Barrios, Gustavo

    2008-01-01

    INTRODUCTION Stroke in young adults has seldom been studied in a necropsy series. The objective of the present clinical necropsy-based investigation was to analyze stroke and its relationship with cardiovascular and renal pathology in young adults. MATERIALS AND METHODS The protocols of 52 clinical necropsies with diagnoses of stroke in patients aged 18 49 years, performed between the years 19902006, were reviewed. RESULTS Hemorrhagic stroke was diagnosed in 36 patients (69.3%), whereas the remaining 16 (30.7%) had ischemic stroke. Hypertensive cardiopathy was evident in 88.4% of the cases. Chronic renal pathology, directly or indirectly related to hypertension, was observed in 55.7% of the patients. Ischemic stroke as a result of occlusive atherosclerotic disease was seen in 50% of cases. Cardiogenic emboli were found in 25% of the cadavers. Hemorrhagic stroke was associated with hypertension in 43% of the cases, with ruptured vascular malformations in 29%, and coagulopathies in 17% of the cases. Hypertensive cardiopathy was present in patients with either ischemic or hemorrhagic stroke (81.2% and 91.6%, respectively). The most frequently observed renal ailments were chronic pyelonephritis (23%) and nephrosclerosis (21.1%). These were associated with ischemic stroke in 43.7%, and 12.5% of the cases, respectively, and with 13.8% and 25% of the hemorrhagic stroke cases. DISCUSSION Hypertensive cardiopathy, occlusive atherosclerotic disease, chronic pyelonephritis and nephrosclerosis are among the pathophysiologycal mechanisms that apparently and eventually interact to induce a significant number of cases of stroke in young adults. A chronic systemic inflammatory state appears to be an important related condition because it possibly constitutes an accelerant of the pathophysiologycal process. PMID:18297202

  8. Incidence of End-Stage Renal Disease in the Turkish-Cypriot Population of Northern Cyprus: A Population Based Study

    PubMed Central

    Connor, Thomas M. F.; Oygar, D. Deren; Gale, Daniel P.; Steenkamp, Retha; Nitsch, Dorothea; Neild, Guy H.; Maxwell, Patrick H.

    2013-01-01

    Background This is the first report of the incidence and causes of end-stage renal disease (ESRD) of the Turkish-Cypriot population in Northern Cyprus. Methods Data were collected over eight consecutive years (2004–2011) from all those starting renal replacement therapy (RRT) in this population. Crude and age-standardised incidence at 90 days was calculated and comparisons made with other national registries. We collected DNA from the entire prevalent population. As an initial experiment we looked for two genetic causes of ESRD that have been reported in Greek Cypriots. Results Crude and age-standardised incidence at 90 days was 234 and 327 per million population (pmp) per year, respectively. The mean age was 63, and 62% were male. The age-adjusted prevalence of RRT in Turkish-Cypriots was 1543 pmp on 01/01/2011. The incidence of RRT is higher than other countries reporting to the European Renal Association – European Dialysis and Transplant Association, with the exception of Turkey. Diabetes is a major cause of ESRD in those under 65, accounting for 36% of incident cases followed by 30% with uncertain aetiology. 18% of the incident population had a family history of ESRD. We identified two families with thin basement membrane nephropathy caused by a mutation in COL4A3, but no new cases of CFHR5 nephropathy. Conclusions This study provides the first estimate of RRT incidence in the Turkish-Cypriot population, describes the contribution of different underlying diagnoses to ESRD, and provides a basis for healthcare policy planning. PMID:23349874

  9. Midterm renal functions following acute renal infarction.

    PubMed

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven

    2015-10-01

    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.715.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.823.2mL/min/1.73m(2) at admission and increased to 82.323.4mL/min/1.73m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions. PMID:26520692

  10. Molecular dynamics studies of polyurethane nanocomposite hydrogels

    NASA Astrophysics Data System (ADS)

    Strankowska, J.; Piszczyk, Ł.; Strankowski, M.; Danowska, M.; Szutkowski, K.; Jurga, S.; Kwela, J.

    2013-10-01

    Polyurethane PEO-based hydrogels have a broad range of biomedical applicability. They are attractive for drug-controlled delivery systems, surgical implants and wound healing dressings. In this study, a PEO based polyurethane hydrogels containing Cloisite® 30B, an organically modified clay mineral, was synthesized. Structure of nanocomposite hydrogels was determined using XRD technique. Its molecular dynamics was studied by means of NMR spectroscopy, DMA and DSC analysis. The mechanical properties and thermal stability of the systems were improved by incorporation of clay and controlled by varying the clay content in polymeric matrix. Molecular dynamics of polymer chains depends on interaction of Cloisite® 30B nanoparticles with soft segments of polyurethanes. The characteristic nanosize effect is observed.

  11. Theoretical Study on Vibrational Dynamics of Cupredoxin

    NASA Astrophysics Data System (ADS)

    Sugiyama, A.; Saito, H.; Yoshimoto, T.; Nagao, H.; Sakurai, T.; Nishikawa, K.

    2004-04-01

    Azurin is a relatively small metalloprotein of the mononuclear blue copper protein found in plants and bacteria. In this study, we investigate the vibrational motion of the active site of azurin by molecular dynamics (MD) calculations and estimatethe Resonance Raman(RR) spectrum of azurin from the analysis of the time correlation function, and compare the experimentally measured RR spectrum with one obtained from MD calculations.

  12. Molecular dynamics studies of superionic conductors

    SciTech Connect

    Rahman, A.; Vashishta, P.

    1980-01-01

    Structural and dynamical properties of superionic conductors AgI and CuI are studied using molecular dynamics (MD) techniques. Our model of these superionic conductors is based on the use of effective pair potentials. To determine the constants in these potentials, cohesive energy and bulk modulus are used as input; in addition one uses notions of ionic size based on the known crystal structure. Salient features of the MD technique are outlined. Methods of treating long range Coulomb forces are discussed in detail. This includes the manner of doing Ewald sum for MD cells of arbitrary shape. Features which can be incorporated to expedite the MD calculations are also discussed. A novel MD technique which allows for a dynamically controlled variation of the shape and size of the MD cell is described briefly. The development of this novel technique has made it possible to study structural phase transitions in super-ionic conductors. For ..cap alpha..-AgI, among the structural properties we have studied are: partial pair correlation functions, mean square displacements of iodines, cation density maps, Havens ratio, etc. The dynamical properties examined include cation self-diffusion, nature of cation jumps, bias in successive jumps, velocity auto correlation functions, current-current correlation functions. In CuI, we have examined the microscopic nature of ..gamma --> cap alpha.. transition. It is found that at about 700 K the copper ions undergo an order-disorder transformation leading to a specific heat anomaly. The nature of the first-order transition and its precursor effects are also analyzed. In AgI the ..cap alpha.. reversible ..beta.. transition is studied. In our model, upon heating ..beta..-AgI, the iodines undergo hcp..-->..bcc transformation and the silver ions become mobile, whereas the reverse transformation is observed on cooling ..cap alpha..-AgI.

  13. Theoretical studies of chemical reaction dynamics

    SciTech Connect

    Schatz, G.C.

    1993-12-01

    This collaborative program with the Theoretical Chemistry Group at Argonne involves theoretical studies of gas phase chemical reactions and related energy transfer and photodissociation processes. Many of the reactions studied are of direct relevance to combustion; others are selected they provide important examples of special dynamical processes, or are of relevance to experimental measurements. Both classical trajectory and quantum reactive scattering methods are used for these studies, and the types of information determined range from thermal rate constants to state to state differential cross sections.

  14. Renal capsule as a stem cell niche

    PubMed Central

    Yasuda, Kaoru; Kuo, Mei-Chuan; Ni, Jie; Ratliff, Brian; Chander, Praveen; Goligorsky, Michael S.

    2010-01-01

    Renal resident stem cells were previously reported within the renal tubules and papillary area. The aim of the present study was to determine whether renal capsules harbor stem cells and whether this pool can be recruited to the renal parenchyma after ischemic injury. We demonstrated the presence of label-retaining cells throughout the renal capsule, at a density of ?10 cells/mm2, and their close apposition to the blood vessels. By flow cytometry, in vitro cultured cells derived from the renal capsule were positive for mesenchymal stem cell (MSC) markers (CD29+, vimentin+, Sca-1+, nestin+) but did not express hematopoietic and endothelial stem cell markers. Moreover, renal capsule-derived cells also exhibited self-renewal, clonogenicity, and multipotency in differentiation conditions, all favoring stem cell characteristics and identifying them with MSC. In situ labeling of renal capsules with CM-DiI CellTracker demonstrated in vivo a directed migration of CM-DiI-labeled cells to the ischemic renal parenchyma, with the rate of migration averaging 30 ?m/h. Decapsulation of the kidneys during ischemia resulted in a modest, but statistically significant, deceleration of recovery of plasma creatinine compared with ischemic kidneys with intact renal capsule. Comparison of these conditions allows the conclusion that renal capsular cells may contribute ?2530% of the recovery from ischemia. In conclusion, the data suggest that the renal capsule may function as a novel stem cell niche harboring MSC capable of participating in the repair of renal injury. PMID:20200095

  15. Fractionated total lymphoid irradiation as preparative immunosuppression in high risk renal transplantation: clinical and immunological studies

    SciTech Connect

    Najarian, J.S.; Ferguson, R.M.; Sutherland, D.E.; Slavin, S.; Kim, T.; Kersey, J.; Simmons, R.S.

    1982-10-01

    Twenty-two patients at high risk to reject renal allografts have been treated with fractionated total lymphoid irradiation (FTLI) prior to transplantation of primary (2), secondary (16) or teritary (4) renal allografts. All patients undergoing retransplantation had rapidly rejected previous grafts. At 24 months following transplantation, 72% of grafts were functioning in the TLI group compared with a 38% graft function in an historical control group of recipients receiving secondary or tertiary grafts and treated with conventional immunosuppression. Important variables in determining success of transplantation following fractionated TLI include the dose of TLI, the interval from radiation to transplantation, and maintenance, post-transplant immunosuppressive therapy. Optimal results were achieved with 2500 rads delivered in 100 rad fractions followed by transplantation within two weeks, and a tapering prednisone schedule and maintenance azathioprine post-transplantation. Seventeen patients had significant complications of the radiation treatment and there was one death, prior to transplantation, associated with pneumonitis. In vitro assessment of immune function demonstrated marked peripheral T cell depletion and loss of in vitro responsiveness to mitogen and allogeneic stimulation following FTLI. The administration of donor bone marrow at the time of transplantation did not produce chimerism. The results suggest that when properly utilized FTLI can produce effective adjunctive immunosuppression for clinical transplantation.

  16. [Surgical complications of renal transplantation in children. Retrospective study of 372 cases].

    PubMed

    Beurton, D; Trmeaux, J C; Terdjman, S; Hacker, P; Charbit, L; Gonties, D; Ewald, N; Magnier, M; Grall, J; Cukier, J

    1987-01-01

    On the basis of a personal series of 372 cases of renal transplantation performed in children, half of whom presented congenital urinary tract malformations, the authors report 110 complications (29.6%). The most frequent complications were urological (14.2%), consisting essentially of fistulae (8.9%) and stenoses (3%). These were followed by vascular complications (6.4%) generally in the form of stenoses (4.8%) and rarely thromboses (1.1%). The authors also report the various local complications which were infectious (wall abscess, suppuration of the renal compartment), haemorrhagic (haematomas) or stones (stones forming on non-resorbable sutures) as well as 5 cases of lymphocele. The prophylaxis of these complications depends on the care taken in collection of the graft (en bloc removal of both kidneys), the restoration of the continuity of the urinary tract (as much as possible Lich-Gregoire extravesical uretero-vesical reimplantation), the vascular anastomoses (vascular dissection limited to a strict minimum), the choice of suture material (resorbable synthetic suture material) and the prevention of infection by systematic pre-, intra- and post-operative antibiotic therapy. PMID:3320214

  17. Kinks of the Transplant Renal Artery Without Accompanying Intraarterial Pressure Gradient Do Not Require Correction: Five-Year Outcome Study

    SciTech Connect

    Chua, Gim Chuah; Snowden, Sue; Patel, Uday

    2004-11-15

    Significant transplant renal artery stenosis (TRAS) results in an intraarterial pressure gradient and increasing graft dysfunction correctable by endovascular therapy. Kinks of the transplant artery cause velocity gradients on Doppler ultrasound, but some will have no intraarterial pressure gradient across the kink. It is not known whether these nonflow limiting kinks progress further to threaten graft function and should undergo endovascular correction. This is a longitudinal study of conservatively managed arterial kinks to define their natural history. Fourteen patients who had undergone angiography over a 5-year period for suspected TRAS had kinks of the renal artery. True intraarterial pressures were measured in all cases by slow withdrawal of an end-hole catheter after intraarterial injection of a vasodilator. Those with a significant pressure change ({>=}10% change in peak systolic pressure across the area of suspicion) underwent endovascular treatment. The rest were managed conservatively, with maximal antihypertensive therapy. Outcome of all 14 cases was determined by follow-up of creatinine levels, blood pressure (BP) control and graft outcome over a 3-5-year period (median 4 years). Of the 14 patients with kinks, 10 were male and 4 female; age range 23-67 years (mean 47 years). Eleven had received cadaveric transplants and 3 were allografts; 12 had end-to-side and 2 end-to-end anastomosis, 11/14 cases had an intraarterial pressure ratio of <10% and at median 4 years follow-up on conservative treatment, the serum creatinine of these 11 patients did not differ significantly from those who underwent successful endovascular treatment (mean 118 {mu}mol/l versus 149 {mu}mol/l; p = 0.30, Mann Whitney test). Mean blood pressure was 137/82 mmHg, with a range of 124-155/56-95 mmHg. Only one patient has required an unexplainable increase in antihypertensive medication. Grafts (2/11) were lost and both had chronic rejection on histology. There were no unexplained graft failures. Kinks of the renal transplant artery with normal intraarterial pressures do not appear to progress and threaten renal graft function. Satisfactory graft outcome was seen on 5-year follow-up with conservative therapy alone.

  18. Does the kidney play a role in the aetiology of primary hypertension? Evidence from renal transplantation studies in rats and humans.

    PubMed

    Rettig, R

    1993-04-01

    In renal cross-transplantation studies between four different strains of genetically hypertensive rats including Dahl salt-sensitive hypertensive rats, Milan hypertensive rats, spontaneously hypertensive rats (SHR) and stroke-prone SHR (SHRSP) on the one hand and their respective normotensive control strains on the other hand, it was found that BP determinants were carried within the kidney. To determine whether post-transplantation hypertension in recipients of an SHRSP kidney was due to a primary or secondary defect in the renal graft, hypertension in SHRSP kidney donors was prevented by chronic antihypertensive drug treatment. Despite sustained BP normalisation in SHRSP kidney donors, the recipients developed post-transplantation hypertension. This finding indicates that SHRSP kidneys carry a primary defect which can elicit hypertension. F1 hybrids bred from SHRSP and normotensive Wistar-Kyoto rat (WKY) parents show an age-related increase in arterial BP up to borderline hypertensive levels. Renal transplantation studies in young rats indicate that the development of borderline hypertension in (SHRSP x WKY)-F1 hybrids can be blunted by bilateral nephrectomy and transplantation of a WKY kidney. Clinical studies in human renal transplant patients also indicate that the genetic background of the kidney donor with respect to predisposition for genetic hypertension significantly influences BP and/or the need for antihypertensive medication in the recipients. Together, the results of renal transplantation studies in animals and humans suggest that a genetic defect in the kidney plays a major role in the pathogenesis of primary hypertension. PMID:8510091

  19. Renal physiology of nocturia.

    PubMed

    Verbalis, Joseph G

    2014-04-01

    Renal function, diurnal fluctuations in arginine vasopressin (AVP) secretion, sex, and advanced age affect urine formation and may contribute to nocturia. Renal effects of AVP are mediated by AVP V2 receptors in the kidney collecting duct. Changes in AVP concentration have the greatest relative effects on urine volume when AVP levels are low; therefore small changes can have a large effect on renal water excretion. AVP is the major regulator of water excretion by the kidneys, and AVP levels have been shown to affect nocturnal voiding. Results of several studies show that patients with nocturia had no significant variation in plasma AVP, whereas patients without nocturia had significant diurnal variation in plasma AVP. The V2 receptor gene is located on the X chromosome, which has important sex-specific consequences. For example, mutations in the V2 gene can cause nephrogenic diabetes insipidus, predominantly in men. Age-related changes in water metabolism are associated with overall body composition, kidney, and brain. Older people generally experience decreased extracellular fluid and plasma volume, which leads to increased adverse consequences from net body water gain or loss. Renal function declines with age, and the ability to concentrate urine and conserve sodium is reduced in the elderly. Thirst perception is also decreased in the elderly, who, compared with younger people, tend to hypersecrete AVP in response to higher plasma osmolality, possibly resulting in hyponatremia. These aspects of renal physiology should be considered when antidiuretic drugs are prescribed for the treatment of nocturia. PMID:24729151

  20. Comparative study on the protective role of vitamin C and L-arginine in experimental renal ischemia reperfusion in adult rats

    PubMed Central

    Mohamed, Abd El-Hamid A; Lasheen, Noha N

    2014-01-01

    Ischemia reperfusion (I/R) injury is a main cause of transplanted kidney dysfunction and rejection. Reactive oxygen species (ROS) play a causal role in cellular damage induced by I/R. Antioxidant vitamins and Nitric oxide (NO) were postulated to play renoprotective effects against I/R. This study compares the protective effects of vitamin C with that of the nitric oxide donor, L-arginine, on renal I/R injury in adult rats. The study was performed on 50 adult Wistar rats of both sexes, divided into 5 groups: I: Control group, receive daily intraperitoneal (i.p.) saline for 3 days. II: Renal I/R group, received i.p saline for 3 days and subjected to renal I/R. III: L-arginine Pretreated, 400 mg/kg/day i.p. for 3 days prior to I/R. IV: Vitamin C Pretreated, 500 mg/kg/day i.p. 24 hours prior to I/R. V: combined L-arginine and Vitamin C Pretreated, exposed to Renal I/R group. At the end of the experiment, plasma urea and creatinine were determined. Kidney tissue malondialdehyde (MDA), NO, catalase and superoxide dismutase (SOD) activity were measured and kidneys were examined histologically. Results: I/R group showed significant increase in plasma urea, creatinine, and renal MDA, and a significant decrease in renal catalase with marked necrotic epithelial cells and infiltration by inflammatory cells in kidney section compared to the control group. All the treated groups showed significant decrease in urea, creatinine, and MDA, and a significant increase in catalase with less histopathological changes in kidney sections compared to I/R group. However, significant improvements in urea, MDA, and catalase were found in vitamin C pretreated and combined treated groups than L-arginine pretreated group. Conclusion: Oxidative stress is the primary element involved in renal I/R injury. So, antioxidants play an important renoprotective effects than NO donors. PMID:25349638

  1. Osmosis : a molecular dynamics computer simulation study

    NASA Astrophysics Data System (ADS)

    Lion, Thomas

    Osmosis is a phenomenon of critical importance in a variety of processes ranging from the transport of ions across cell membranes and the regulation of blood salt levels by the kidneys to the desalination of water and the production of clean energy using potential osmotic power plants. However, despite its importance and over one hundred years of study, there is an ongoing confusion concerning the nature of the microscopic dynamics of the solvent particles in their transfer across the membrane. In this thesis the microscopic dynamical processes underlying osmotic pressure and concentration gradients are investigated using molecular dynamics (MD) simulations. I first present a new derivation for the local pressure that can be used for determining osmotic pressure gradients. Using this result, the steady-state osmotic pressure is studied in a minimal model for an osmotic system and the steady-state density gradients are explained using a simple mechanistic hopping model for the solvent particles. The simulation setup is then modified, allowing us to explore the timescales involved in the relaxation dynamics of the system in the period preceding the steady state. Further consideration is also given to the relative roles of diffusive and non-diffusive solvent transport in this period. Finally, in a novel modification to the classic osmosis experiment, the solute particles are driven out-of-equilibrium by the input of energy. The effect of this modification on the osmotic pressure and the osmotic ow is studied and we find that active solute particles can cause reverse osmosis to occur. The possibility of defining a new "osmotic effective temperature" is also considered and compared to the results of diffusive and kinetic temperatures..

  2. Solar dynamic power system definition study

    NASA Technical Reports Server (NTRS)

    Wallin, Wayne E.; Friefeld, Jerry M.

    1988-01-01

    The solar dynamic power system design and analysis study compared Brayton, alkali-metal Rankine, and free-piston Stirling cycles with silicon planar and GaAs concentrator photovoltaic power systems for application to missions beyond the Phase 2 Space Station level of technology for all power systems. Conceptual designs for Brayton and Stirling power systems were developed for 35 kWe and 7 kWe power levels. All power systems were designed for 7-year end-of-life conditions in low Earth orbit. LiF was selected for thermal energy storage for the solar dynamic systems. Results indicate that the Stirling cycle systems have the highest performance (lowest weight and area) followed by the Brayton cycle, with photovoltaic systems considerably lower in performance. For example, based on the performance assumptions used, the planar silicon power system weight was 55 to 75 percent higher than for the Stirling system. A technology program was developed to address areas wherein significant performance improvements could be realized relative to the current state-of-the-art as represented by Space Station. In addition, a preliminary evaluation of hardenability potential found that solar dynamic systems can be hardened beyond the hardness inherent in the conceptual designs of this study.

  3. Fluorescence Techniques to Study Lipid Dynamics

    PubMed Central

    Sezgin, Erdinc; Schwille, Petra

    2011-01-01

    Biological research has always tremendously benefited from the development of key methodology. In fact, it was the advent of microscopy that shaped our understanding of cells as the fundamental units of life. Microscopic techniques are still central to the elucidation of biological units and processes, but equally important are methods that allow access to the dimension of time, to investigate the dynamics of molecular functions and interactions. Here, fluorescence spectroscopy with its sensitivity to access the single-molecule level, and its large temporal resolution, has been opening up fully new perspectives for cell biology. Here we summarize the key fluorescent techniques used to study cellular dynamics, with the focus on lipid and membrane systems. PMID:21669985

  4. Reproducibility of Dynamic Contrast-Enhanced MRI in Renal Cell Carcinoma: A Prospective Analysis on Intra- and Interobserver and Scan-Rescan Performance of Pharmacokinetic Parameters.

    PubMed

    Wang, Haiyi; Su, Zihua; Ye, Huiyi; Xu, Xiao; Sun, Zhipeng; Li, Lu; Duan, Feixue; Song, Yuanyuan; Lambrou, Tryphon; Ma, Lin

    2015-09-01

    The objective of this study was to investigate the intra- and interobserver as well as scan-rescan reproducibility of quantitative parameters of renal cell carcinomas (RCCs) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). A total of 21 patients with clear cell RCCs (17 men, 4 woman; age 37-69 years, mean age 54.6 years, mean size, 5.0??2.2?cm) were prospectively recruited from September 2012 to November 2012. Patients underwent paired DCE-MRI studies on a 3.0 T MR system with an interval of 48 to 72 hours. The extended-Tofts model and population-based arterial input function were used to calculate kinetic parameters. Three observers defined the 2-dimensional whole-tumor region of interest at the slice with the maximum diameter of the RCC. Intraobserver and scan-rescan differences were assessed using paired t tests, whereas interobserver differences using two-way analysis of variance. Intra- and interobserver reproducibility and scan-rescan reproducibility were evaluated using within-subject coefficient of variation (wCoV) and intraclass correlation coefficient (ICC). There were no significant intra-, interobserver, or scan-rescan differences in parameters (all P?>?0.05). All ICCs for intra- and interobserver agreements were >0.75 (P?30%). DCE-MRI demonstrated good intra- and interobserver reproducibility and moderate to good scan-rescan performance in the assessment of RCC using K(trans), K(ep), and V(e) as parameters under noncontinuous scanning mode. V(p) showed poor reproducibility, and thus may not be suitable for this scanning protocol. PMID:26376399

  5. Renal function in fulminant hepatic failure: haemodynamics and renal prostaglandins.

    PubMed Central

    Guarner, F; Hughes, R D; Gimson, A E; Williams, R

    1987-01-01

    Eighteen patients with fulminant liver failure were studied, 10 with normal renal function (group A) and eight with renal failure (group B, plasma creatinine greater than 200 mumol/l). Renal function was assessed by standard clearance techniques and patients in group B had a marked reduction compared with group A in both renal plasma flow and glomerular filtration rate. Raised plasma renin activity was observed in both groups, but levels in group B were significantly higher than in group A. Renal prostacyclin production was estimated by radioimmunoassay (RIA) of 6-keto-prostaglandin F1 alpha in urine, and the excretion rate was markedly increased in group A as compared with nine healthy controls, but was low in group B. The plasma concentrations of 6-keto-prostaglandin F1 alpha and thromboxane B2 were similar in groups A and B and were both significantly higher than in controls. Haemodynamic measurements showed a high cardiac output with low vascular resistance and mean arterial pressure within normal limits in both groups. The pulse pressure, however, was significantly higher in group B than in group A. In conclusion, patients in FHF with renal failure have marked renal vasoconstriction with increased plasma renin activity and reduced renal prostaglandin excretion indicative of an imbalance between vasoactive forces. PMID:3322960

  6. Longitudinal study of living kidney donor glomerular dynamics after nephrectomy

    PubMed Central

    Lenihan, Colin R.; Busque, Stephan; Derby, Geraldine; Blouch, Kristina; Myers, Bryan D.; Tan, Jane C.

    2015-01-01

    BACKGROUND. Over 5,000 living kidney donor nephrectomies are performed annually in the US. While the physiological changes that occur early after nephrectomy are well documented, less is known about the long-term glomerular dynamics in living donors. METHODS. We enrolled 21 adult living kidney donors to undergo detailed long-term clinical, physiological, and radiological evaluation pre-, early post- (median, 0.8 years), and late post- (median, 6.3 years) donation. A morphometric analysis of glomeruli obtained during nephrectomy was performed in 19 subjects. RESULTS. Donors showed parallel increases in single-kidney renal plasma flow (RPF), renocortical volume, and glomerular filtration rate (GFR) early after the procedure, and these changes were sustained through to the late post-donation period. We used mathematical modeling to estimate the glomerular ultrafiltration coefficient (Kf), which also increased early and then remained constant through the late post-donation study. Assuming that the filtration surface area (and hence, Kf) increased in proportion to renocortical volume after donation, we calculated that the 40% elevation in the single-kidney GFR observed after donation could be attributed exclusively to an increase in the Kf. The prevalence of hypertension in donors increased from 14% in the early post-donation period to 57% in the late post-donation period. No subjects exhibited elevated levels of albuminuria. CONCLUSIONS. Adaptive hyperfiltration after donor nephrectomy is attributable to hyperperfusion and hypertrophy of the remaining glomeruli. Our findings point away from the development of glomerular hypertension following kidney donation. TRIAL REGISTRATION. Not applicable. FUNDING. NIH (R01DK064697 and K23DK087937); Astellas Pharma US; the John M. Sobrato Foundation; the Satellite Extramural Grant Foundation; and the American Society of Nephrology. PMID:25689253

  7. Occupational and other exposures associated with male end-stage renal disease: a case/control study.

    PubMed Central

    Steenland, N K; Thun, M J; Ferguson, C W; Port, F K

    1990-01-01

    We conducted a case-control study of 325 men ages 30-69 who were diagnosed with end-stage renal disease (ESRD) between 1976 and 1984, and resided in four urban areas of Michigan in 1984. Cases were selected from the Michigan Kidney Registry and excluded men with diabetic, congenital, and obstructive nephropathies. Controls were selected by random-digit dialing and were pair-matched to cases for age, race, and area of residence. Telephone interviews were conducted with 69 percent of eligible cases and 79 percent of eligible controls. Risk of ESRD was significantly related to phenacetin or acetaminophen consumption (odds ratio(OR) = 2.66), moonshine consumption (OR = 2.43), a family history of renal disease (OR = 9.30); and regular occupational exposures to solvents (OR = 1.51) or silica (OR = 1.67). Particular occupational exposures with elevated risk were solvents used as cleaning agents and degreasers (OR = 2.50) silica exposure in foundries or brick factories (OR = 1.92), and silica exposure during sandblasting (OR = 3.83). Little or no trend of increased risk with duration of exposure was found for these occupational exposures, with the exception of silica in sandblasting. Limitations of these data include representativeness of cases, possible overreporting by cases, and misclassification of exposures inherent in self-reports. PMID:2153349

  8. Absorption capacity of renal proximal tubular cells studied by combined injections of YFP and GFP in Rana temporaria L.

    PubMed

    Prutskova, N P; Seliverstova, E V

    2013-09-01

    The capacity for protein reabsorption in the renal proximal tubule (PT) was studied in Rana temporaria frogs by separate, simultaneous and sequential introduction of yellow fluorescent protein (YFP) and green fluorescent protein (GFP). The uptake patterns of YFP and GFP in PT epithelial cells were investigated 15-120min after their bolus intravenous and intraperitoneal injection. As shown by confocal microscopy, the tubular uptake of YFP and GFP was time- and dose-dependent. These proteins are absorbed in similar way and can be accumulated in the same endocytic vesicles after their combined injections. When GFP was injected 30 and 90min before YFP, and vice versa, the number of vesicles with pre-injected protein increased and the percentage of vesicles with colocalized GFP and YFP reduced. At the same time, the uptake rate of a protein injected later progressively and significantly decreased. Subcellular localization of endocytic receptors, megalin and cubilin, in renal PT cells after intravenous YFP introduction were revealed by immunofluorescent microscopy. Colocalization of internalized YFP with megalin or cubilin in the endocytic vesicles was demonstrated. The data suggest the possibility of protein uptake by receptor-mediated endocytosis and the existence of a mechanism limiting the protein absorption rate in wintering frogs. PMID:23719184

  9. Occupational and other exposures associated with male end-stage renal disease: A case/control study

    SciTech Connect

    Steenland, N.K.; Thun, M.J.; Ferguson, C.W.; Port, F.K. )

    1990-02-01

    We conducted a case-control study of 325 men ages 30-69 who were diagnosed with end-stage renal disease (ESRD) between 1976 and 1984, and resided in four urban areas of Michigan in 1984. Cases were selected from the Michigan Kidney Registry and excluded men with diabetic, congenital, and obstructive nephropathies. Controls were selected by random-digit dialing and were pair-matched to cases for age, race, and area of residence. Telephone interviews were conducted with 69 percent of eligible cases and 79 percent of eligible controls. Risk of ESRD was significantly related to phenacetin or acetaminophen consumption (odds ratio(OR) = 2.66), moonshine consumption (OR = 2.43), a family history of renal disease (OR = 9.30); and regular occupational exposures to solvents (OR = 1.51) or silica (OR = 1.67). Particular occupational exposures with elevated risk were solvents used as cleaning agents and degreasers (OR = 2.50) silica exposure in foundries or brick factories (OR = 1.92), and silica exposure during sandblasting (OR = 3.83). Little or no trend of increased risk with duration of exposure was found for these occupational exposures, with the exception of silica in sandblasting. Limitations of these data include representativeness of cases, possible overreporting by cases, and misclassification of exposures inherent in self-reports.

  10. Beneficial effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin in rats: A histological and biochemical study.

    PubMed

    Elbe, H; Dogan, Z; Taslidere, E; Cetin, A; Turkoz, Y

    2016-03-01

    Ciprofloxacin is a broad-spectrum quinolone antibiotic commonly used in clinical practice. Quercetin is an antioxidant belongs to flavonoid group. It inhibits the production of superoxide anion. In this study, we aimed to evaluate the effects of quercetin on renal injury and oxidative stress caused by ciprofloxacin. Twenty-eight female Wistar albino rats were divided into four groups: control, quercetin (20 mg kg(-1) day(-1) gavage for 21 days), ciprofloxacin (20 mg kg(-1) twice a day intraperitoneally for 10 days), and ciprofloxacin + quercetin. Samples were processed for histological and biochemical evaluations. Malondialdehyde (MDA) and glutathione (GSH) levels, superoxide dismutase (SOD), and catalase (CAT) activities were measured in kidney tissue. The ciprofloxacin group showed histopathological changes such as infiltration, dilatation in tubules, tubular atrophy, reduction of Bowman's space, congestion, hemorrhage, and necrosis. In the ciprofloxacin + quercetin group, these histopathological changes markedly reduced. MDA levels increased in the ciprofloxacin group and decreased in the ciptofloxacin + quercetin group. SOD and CAT activities and GSH levels significantly decreased in the ciprofloxacin group. On the other hand, in the ciprofloxacin + quercetin group, SOD and CAT activities and GSH levels significantly increased with regard to the ciprofloxacin group. We concluded that quercetin has antioxidative and therapeutic effects on renal injury and oxidative stress caused by ciprofloxacin in rats. PMID:25929518

  11. N-acetylcysteine does not prevent contrast nephropathy in patients with renal impairment undergoing emergency CT: a randomized study

    PubMed Central

    2013-01-01

    Background Patients admitted to the emergency room with renal impairment and undergoing a contrast computed tomography (CT) are at high risk of developing contrast nephropathy as emergency precludes sufficient hydration prior to contrast use. The value of an ultra-high dose of intravenous N-acetylcysteine in this setting is unknown. Methods From 2008 to 2010, we randomized 120 consecutive patients admitted to the emergency room with an estimated clearance lower than 60ml/min/1.73m2 by MDRD (mean GFR 42ml/min/1.73m2) to either placebo or 6000mgN-acetylcysteine iv one hour before contrast CT in addition to iv saline. Serum cystatin C and creatinine were measured one hour prior to and at day 2, 4 and 10 after contrast injection. Nephrotoxicity was defined either as 25% or 44?mol/l increase in serum creatinine or cystatin C levels compared to baseline values. Results Contrast nephrotoxicity occurred in 22% of patients who received placebo (13/58) and 27% of patients who received N-acetylcysteine (14/52, p = 0.66). Ultra-high dose intravenous N-acetylcysteine did not alter creatinine or cystatin C levels. No secondary effects were noted within the 2 groups during follow-up. Conclusions An ultra-high dose of intravenous N-acetylcysteine is ineffective at preventing nephrotoxicity in patients with renal impairment undergoing emergency contrast CT. Trial registration The study was registered as Clinical trial (NCT01467154). PMID:23731573

  12. Medications Associated with Restless Legs Syndrome: A Case Control Study in the US Renal Data System (USRDS)

    PubMed Central

    Bliwise, Donald L.; Zhang, Rebecca H.; Kutner, Nancy G.

    2014-01-01

    Objective To determine the association between the usage of four classes of at risk medications (antidepressants, neuroleptics, antihistamines, and anti-emetics with dopamine blockade) and restless legs syndrome (RLS) in dialysis patients within the United States Renal Data System (USRDS). Methods This was a case-control design within a national (United States) patient registry of all patients with End Stage Renal Disease (ESRD) in the USRDS anytime during the period of October 1, 2006 and December 31, 2010, inclusive. A total of 16,165 ESRD patients (3,234 Cases; 12,931 age-, sex-, and race-matched Controls) were studied. Results All four classes of at risk medications see widespread use among patients in the USRDS. All were associated with increased odds of a RLS diagnosis (range of Odds Ratios: 1.47 to 2.28, all p < .0001) during the period of observation. Results were unchanged when controlling for time on hemodialysis. Usage of more than one class of medication increased the odds for having RLS. Conclusions ESRD patients often receive medication intended for relief of conditions associated with their disease, such as depression and psychological issues, pruritis and gastroparesis, however such medications may increase risk for RLS. Given the high prevalence of RLS in ESRD patients, these medications should only be used when their benefits clearly outweigh the risk of development of the troubling and distressing symptoms of restless legs syndrome. PMID:25156752

  13. The cell biology of renal filtration

    PubMed Central

    Quaggin, Susan E.

    2015-01-01

    The function of the kidney, filtering blood and concentrating metabolic waste into urine, takes place in an intricate and functionally elegant structure called the renal glomerulus. Normal glomerular function retains circulating cells and valuable macromolecular components of plasma in blood, resulting in urine with just trace amounts of proteins. Endothelial cells of glomerular capillaries, the podocytes wrapped around them, and the fused extracellular matrix these cells form altogether comprise the glomerular filtration barrier, a dynamic and highly selective filter that sieves on the basis of molecular size and electrical charge. Current understanding of the structural organization and the cellular and molecular basis of renal filtration draws from studies of human glomerular diseases and animal models of glomerular dysfunction. PMID:25918223

  14. Assessment of renal transplantation using a gamma camera computer system

    SciTech Connect

    Critchley, M.

    1981-04-01

    Five hundred eleven isotope studies were performed following renal transplantation in 130 patients, using a standard technique and a gamma camera computer system in a nuclear medicine department situated half a mile away from the renal transplant unit. A comprehensive picture of renal function is obtained from perfusion studies, renography, effective renal plasma flow, I-131-Hippuran uptake, and excretion measurements.

  15. [Side effects of nalidixic acid in a patient with severe renal failure. Clinical study and proposal of a pharmacokinetic model].

    PubMed

    Mobbs, J P; Balant, L; Revillard, C; Favre, H

    1977-03-01

    Side effects due to ingestion of nalidixic acid in a 46 year old patient with phenacetine-induced interstitial nephritis and severe renal failure are reported. This observation underlines the point that, besides the direct neurotoxic effect of nalidixic acid, disturbance of the acid-basic equilibrium could be seen in patients with renal failure in particular. A hypothetical pharmacokinetic model suggests that two metabolites of nalidixic acid could provide enough hydrogen ion to induce acidosis in cases of renal failure. PMID:847456

  16. Validating single-cell genomics for the study of renal development.

    PubMed

    Jain, Sanjay; Noordam, Michiel J; Hoshi, Masato; Vallania, Francesco L; Conrad, Donald F

    2014-11-01

    Single-cell genomics will enable studies of the earliest events in kidney development, although it is unclear if existing technologies are mature enough to generate accurate and reproducible data on kidney progenitors. Here we designed a pilot study to validate a high-throughput assay to measure the expression levels of key regulators of kidney development in single cells isolated from embryonic mice. Our experiment produced 4608 expression measurements of 22 genes, made in small cell pools, and 28 single cells purified from the RET-positive ureteric bud. There were remarkable levels of concordance with expression data generated by traditional microarray analysis on bulk ureteric bud tissue with the correlation between our average single-cell measurements and GUDMAP measurements for each gene of 0.82-0.85. Nonetheless, a major motivation for single-cell technology is to uncover dynamic biology hidden in population means. There was evidence for extensive and surprising variation in expression of Wnt11 and Etv5, both downstream targets of activated RET. The variation for all genes in the study was strongly consistent with burst-like promoter kinetics. Thus, our results can inform the design of future single-cell experiments, which are poised to provide important insights into kidney development and disease. PMID:24759149

  17. Renal cell carcinoma after neuroblastoma: A case study and review of the literature

    PubMed Central

    Wallace, Brendan; Organ, Michael; Bagnell, Scott; Rendon, Ricardo; Merrimen, Jennifer

    2015-01-01

    We present a case of renal cell carcinoma (RCC) arising in a 26-year-old patient with a history of neuroblastoma. RCC after a previous diagnosis of neuroblastoma is very uncommon, and there have only been 23 reported cases. Using the results of our patient workup, we hoped to determine whether there was a genetic predisposition or iatrogenic cause for the RCC. There is no clear explanation why neuroblastoma survivors are prone to developing RCC. However, genetic predisposition and previous treatment likely play a role. Since there have been few cases described, and few investigations into the genetics of this subtype of RCC, it remains important for individual cases to be added to the literature of this recently described and rare entity. PMID:26029305

  18. Flip-flop phenomenon in radiohippuran renal imaging. A sign of obstructive nephropathy

    SciTech Connect

    Shih, W.J.; DeLand, F.H.; Domstad, P.A.

    1986-10-01

    In the dynamic radionuclide brain study, decreased flow in one cerebral hemisphere during the arterial phase followed by relatively increased radioactivity as compared with the contralateral hemisphere has been termed the flip-flop phenomenon, and reflects the development of collateral circulation to the affected side. In I-131 Hippuran renal imaging, relatively decreased activity in one kidney frequently is observed during the initial phase of the study, and is followed by a gradual increase of radioactivity in the late images when compared with the contralateral kidney. To evaluate the significance of this renal flip-flop phenomenon, the studies from 23 patients with these findings were retrospectively compared with the clinical data and findings from other diagnostic studies (CT, ultrasound, intravenous pyelogram, autopsy). Partial obstruction of the renal collecting system was found in all 23 patients. The causes were various malignant tumors in nine patients (colonic carcinoma, three patients; transitional cell carcinoma, three patients; prostatic carcinoma, two patients; seminoma, one patient), ureteropelvic obstruction in three patients, papillary necrosis in one patient, and ureteral fibrosis in one patient. The flip-flop phenomenon reflects asymmetric renal tubular function with decrease (prolonged parenchymal transit time) in the affected kidney as a result of ipsilateral obstruction of the collecting system, while contralateral renal function remains normal or relatively normal. The presence of the flip-flop phenomenon in an I-131 Hippuran renal study suggests the existence of some degree of collecting system obstruction that has persisted long enough to result in renal parenchymal damage.

  19. On methods for studying stochastic disease dynamics.

    PubMed

    Keeling, M J; Ross, J V

    2008-02-01

    Models that deal with the individual level of populations have shown the importance of stochasticity in ecology, epidemiology and evolution. An increasingly common approach to studying these models is through stochastic (event-driven) simulation. One striking disadvantage of this approach is the need for a large number of replicates to determine the range of expected behaviour. Here, for a class of stochastic models called Markov processes, we present results that overcome this difficulty and provide valuable insights, but which have been largely ignored by applied researchers. For these models, the so-called Kolmogorov forward equation (also called the ensemble or master equation) allows one to simultaneously consider the probability of each possible state occurring. Irrespective of the complexities and nonlinearities of population dynamics, this equation is linear and has a natural matrix formulation that provides many analytical insights into the behaviour of stochastic populations and allows rapid evaluation of process dynamics. Here, using epidemiological models as a template, these ensemble equations are explored and results are compared with traditional stochastic simulations. In addition, we describe further advantages of the matrix formulation of dynamics, providing simple exact methods for evaluating expected eradication (extinction) times of diseases, for comparing expected total costs of possible control programmes and for estimation of disease parameters. PMID:17638650

  20. Prospective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer

    SciTech Connect

    Jansen, Edwin; Boot, Henk; Cats, Annemieke

    2007-03-01

    Purpose: Postoperative chemoradiotherapy in gastric cancer improves locoregional control and survival. Reports on late toxicity, however, have been scarce thus far. Because renal toxicity is one of the most serious late complications in upper abdominal radiotherapy, we prospectively analyzed kidney function in patients who underwent postoperative chemoradiotherapy for gastric cancer. Patients and Methods: In 44 patients, Tc{sup 99m}-thiatide renography was performed before and at regular intervals after postoperative chemoradiotherapy. The left-to-right (L/R) ratio was used as an index of the relative kidney function. Mean L/R values were calculated for four follow-up time intervals. For all patients, kidney V{sub 20} (percentage of the volume of the kidney that received more than 20 Gy) and mean dose of both kidneys were retrieved from the three-dimensional dose-volume histograms. Results: We observed a progressive decrease in left renal function of 11% (p = 0.012) after 6 months, up to 52% (p < 0.001) after >18 months. The V{sub 20} (left kidney) and mean left kidney dose were identified as parameters associated with decreased kidney function. Mean serum creatinine was increased from 74.6 {mu}mol/L before treatment to 86.1 {mu}mol/L at 1 year after chemoradiotherapy (p < 0.001). In patients with a follow-up of 18-28 months, one case of severe renovascular hypertension was observed. Conclusion: A progressive relative functional impairment of the left kidney in patients after postoperative chemoradiotherapy for gastric cancer is demonstrated. To optimize the survival benefit that can be established with adjuvant regimens, strategies to minimize the dose to the kidneys and other critical organs should be explored.

  1. Protective effect of propolis ethanol extract on ethanol-induced renal toxicity: an in-vivo study.

    PubMed

    Liu, Chi-Feng; Lin, Chia-Hsien; Lin, Chun-Ching; Lin, Yun-Ho; Chen, Chin-Fa; Lin, Song-Chow

    2005-01-01

    Acute p.o. administration of absolute ethanol (10 ml/kg) to fasted mice would produce extensive renal failure. Pretreatment with p.o. administration of propolis ethanol extract (PEE) could prevent such renal failure effectively and dose dependently. This renal protective effect of PEE may be contributed, at least in part, to its antioxidative activity. The maximal antioxidative effect against absolute ethanol (AE)-induced renal failure could be observed 1 hour after PEE administration. In order to further investigate the renal protective mechanism of PEE, lipid peroxidation and superoxide scavenging activity were conducted in vivo. PEE exhibited dose-dependent antioxidative effects on lipid peroxidation in mice renal homogenate. Results indicated that mice with acute renal failure have higher malonic dialdehyde (MDA) levels compared with those in PEE administered mice. It was concluded that the renal protective mechanism of PEE could be contributed, at least in part, to its prominent superoxide scavenging effect; hence, it could protect, indirectly, the kidney from superoxide-induced renal damages. PMID:16265990

  2. Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment a comparative study

    PubMed Central

    2013-01-01

    Background Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacists intervention in improving dosing inadequacy in these patients when compared with usual care. Methods The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists intervention was 0.73% [95% CI (?6.0) - 7.5] and after the pharmacists intervention it was 13.5% [95% CI 8.0 - 19.5] (p?renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results. PMID:23849005

  3. Ultrasonography in chronic renal failure.

    PubMed

    Buturovi?-Ponikvar, Jadranka; Visnar-Perovic, Alenka

    2003-05-01

    Many chronic renal diseases lead to the final common state of decrease in renal size, parenchymal atrophy, sclerosis and fibrosis. The ultrasound image show a smaller kidney, thinning of the parenchyma and its hyperechogenicity (reflecting sclerosis and fibrosis). The frequency of renal cysts increases with the progression of the disease. Ultrasound generally does not allow for the exact diagnosis of an underlying chronic disease (renal biopsy is usually required), but it can help to determine an irreversible disease, assess prognosis and avoid unnecessary diagnostic or therapeutic procedures. The main exception in which the ultrasound image does not show a smaller kidney with parenchymal atrophy is diabetic nephropathy, the leading cause of chronic and end-stage renal failure in developed countries in recent years. In this case, both renal size and parenchymal thickness are preserved until end-stage renal failure. Doppler study of intrarenal vessels can provide additional information about microvascular and parenchymal lesions, which is helpful in deciding for or against therapeutic intervention and timely planning for optimal renal replacement therapy option. PMID:12714227

  4. Renal Denervation: Where to Now?

    PubMed

    Wimmer, Neil J; Mauri, Laura

    2015-12-01

    Resistant hypertension remains a growing problem worldwide. Renal sympathetic denervation was thought to be a new method for the treatment for resistant hypertension. Early studies demonstrated a marked benefit in patients who underwent renal denervation procedures, but the pivotal SYMPLICITY 3-HTN trial, the only sham-controlled randomized trial performed, did not show a benefit for patients treated with the procedure compared to sham. There is still much to learn about the physiology and anatomy of renal sympathetic pathways as well as careful attention to medication adherence in order to understand the role of renal sympathetic denervation in treating hypertensive patients. While renal denervation technology remains available in clinical practice outside of the USA, we expect further development of this technology in the upcoming years and the continued evaluation of this technology in patients with hypertension as well as other disease states to fully understand its role. PMID:26482759

  5. Chemical Renal Denervation in the Rat

    SciTech Connect

    Consigny, Paul M. Davalian, Dariush; Donn, Rosy Hu, Jie; Rieser, Matthew Stolarik, DeAnne

    2013-12-03

    Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10{sup −5} M through 10{sup −2} M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

  6. In vitro studies on mangiferin protection against cadmium-induced human renal endothelial damage and cell death via the MAP kinase and NF-κB pathways.

    PubMed

    Rajendran, Peramaiyan; Rengarajan, Thamaraiselvan; Nishigaki, Yutaka; Palaniswami, Rajendran; Nishigaki, Ikuo

    2016-02-01

    The therapeutic effects of the natural antioxidant mangiferin (a xanthonoid and potent oxygen free radical scavenger), which is widely distributed in mango fruit, against CdCl2-induced toxicity in human renal glomerulus endothelial cells (HRGEC) were investigated. The viability of HREGCs that were treated with CdCl2 (25 µ mol) and co-treated with mangiferin (75 µ mol) for 24 h was measured by crystal violet dye. The exposure of human glomerulus renal endothelial cells to cadmium promotes a polarized apical secretion of IL-6 and IL-8, two pivotal proinflammatory cytokines known to play a significant role in renal inflammation. Proinflammatory cytokine secretion by human renal glomerulus endothelial cells could be the result of cadmium-induced IL-6 secretion via an NF-κB-dependent pathway. However, IL-8 secretion involves the phosphor-JNK phospho-p38 signaling pathway. The results of the current study reveal that mangiferin could prevent both cadmium-induced IL-6 and IL-8 secretion by human glomerulus endothelial cells and be used to prevent renal inflammation. PMID:25798666

  7. Renal hemodynamics: the influence of the renal artery ostium flow diverter

    NASA Astrophysics Data System (ADS)

    Rossmann, Jenn Stroud; Albert, Scott; Balaban, Robert

    2013-11-01

    The recently identified renal artery ostium flow diverter may preferentially direct blood flow to the renal arteries, and may also influence flow patterns and recirculation known to be involved in atherogenesis. Three-dimensional computational fluid dynamics (CFD) simulations of steady and pulsatile blood flow are performed to investigate the influence of diverter size and position, and vascular geometry, on the flow patterns and fluid mechanical forces in the neighborhood of the diverter. CFD results show that the flow diverter does affect the blood distribution: depending on the diverter's position, the flow to the renal arteries may be increased or reduced. The results of simulations also show the diverter's effect on the Wall Shear Stress (WSS) distribution, and suggest that the diverter contributes to an atherogenic environment in the abdominal aorta, while being atheroprotective in the renal arteries themselves. These results support previous clinical findings, and suggest directions for further clinical study. The results of this work have direct implications in understanding the physiological significance of the diverter, and its potential role in the pathophysiological development of atherosclerosis.

  8. Stability studies of Solar Optical Telescope dynamics

    NASA Astrophysics Data System (ADS)

    Gullapalli, Sarma N.; Pal, Parimal K.; Ruthven, Gregory P.

    The Solar Optical Telescope (SOT) is designed to operate as an attached payload mounted on the Instrument Pointing System (IPS) in the cargo bay of the Shuttle Orbiter. Pointing and control of SOT is accomplished by an active Articulated Primary Mirror (APM), an active Tertiary Mirror (TM), an elaborate set of optical sensors, electromechanical actuators and programmable controllers. The structural interactions of this complex control system are significant factors in the stability of the SOT. The preliminary stability study results of the SOT dynamical system are presented. Structural transfer functions obtained from the NASTRAN model of the structure were used. These studies apply to a single degree of freedom (elevation). Fully integrated model studies will be conducted in the future.

  9. Stability studies of Solar Optical Telescope dynamics

    NASA Technical Reports Server (NTRS)

    Gullapalli, Sarma N.; Pal, Parimal K.; Ruthven, Gregory P.

    1987-01-01

    The Solar Optical Telescope (SOT) is designed to operate as an attached payload mounted on the Instrument Pointing System (IPS) in the cargo bay of the Shuttle Orbiter. Pointing and control of SOT is accomplished by an active Articulated Primary Mirror (APM), an active Tertiary Mirror (TM), an elaborate set of optical sensors, electromechanical actuators and programmable controllers. The structural interactions of this complex control system are significant factors in the stability of the SOT. The preliminary stability study results of the SOT dynamical system are presented. Structural transfer functions obtained from the NASTRAN model of the structure were used. These studies apply to a single degree of freedom (elevation). Fully integrated model studies will be conducted in the future.

  10. Multiple spacecraft study of solar wind dynamics

    NASA Astrophysics Data System (ADS)

    Gonzalez-Esparza, A.; Romero Hernandez, E.

    2011-12-01

    We combined simultaneous solar wind observations from five different spacecraft: Helios 1, Helios 2, IMP-8, Voyager 1 and Voyager 2, from November 1977 to February 1978 (ascending phase of solar cycle 21). During this period the large-scale dynamics of the solar wind near of the ecliptic plane was characterized by transient forward shocks (TFSs), Coronal Mass Eyections (CMEs), stream interaction regions (SIRs), and complex and variable magnetic sector structures. We characterize the solar wind streams observed by the five spacecraft. We employ maps of large-scale features to study the location of TFSs and SIRs with respect to the magnetic sector structure detected by each spacecraft. We study the geometry of the SIRs by analyzing the orientation of their Stream Interaction Regions. We study the variations of the sheath width for all the shock-CME events.

  11. Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched-cohort and population-based study in Taiwan.

    PubMed

    Chen, Shih-Feng; Wang, I-Jen; Lang, Hui-Chu

    2016-01-01

    The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure (CRF) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation (RT), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population-based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis (HD), 351 patients on peritoneal dialysis (PD), and 322 patients who had RT. We followed all individuals until the occurrence of major depression or the date of loss to follow-up. The PD group had the highest risk (hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.26-4.69), whereas the RT group had the lowest risk (HR 0.18; 95% CI 0.03-1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09-4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF. Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD. PMID:26179222

  12. [THE DYNAMICS OF THE MORBIDITY RATE OF HEMORRHAGIC FEVER WITH RENAL SYNDROME IN THE POPULATION OF THE CITY OF NABEREZHNYE CHELNY].

    PubMed

    Leont'ev, V V

    2015-01-01

    In the article there are considered the environmental and biological prerequisites for the dynamics of hemorrnagic fever with renal syndrome (HFRS) morbidity rate in the population of the city of Naberezhnye Chelny and the municipal districts located in the north-eastern part of the Republic of Tatarstan, a subdivision of Russian Federation. The territory of the Republic of Tatarstan is included into the body of Volga Federal District of the Russian Federation and is located within the boundaries in coniferous taiga and temperate forests, forest-steppe and steppe geographical areas. The endowment of large forests as well as weather and climatic conditions play an important role in the activity and rhythmicity of this natural focal viral infection, the virus carriers of which are mouse-like rodents. The virus belongs to the family Bunyaviridae and is a representative of the genus Hantavirus. On the base of the epidemiological and clinical data of State Autonomous Healthcare Institution "Naberezhno-Chelninskaya Infectious Diseases Hospital" there was performed the analysis of seasonal and the long-term HFRS morbidity rate from 2008 to 2012 with consideration of age and gender cohorts during the period from 2008 to 2012. There were shown both the seasonal character of the development of infectious disease and its unstable rhythmicity in the long-term dynamics. The most number of cases was observed in the summer-autumn period. 84,32% out of all disease cases were occurred in the male population, adults' morbidity rate was averagely 28 times more than the children's morbidity rate, which was due to the more frequent stay in the foci of the virus circulation. In the long-term dynamics the fever development is indirectly related with the weather and climate conditions of the whole region that influence on biology and the dynamics of rodents' population. So 2010 was differed by anomalously hot summer that led to a significant reduction in the number of the disease cases among the human population of the area. PMID:26302552

  13. Inter-rater reliability of surgical reviews for AREN03B2: A COG renal tumor committee study?

    PubMed Central

    Hamilton, Thomas E.; Barnhart, Douglas; Gow, Kenneth; Ferrer, Fernando; Kandel, Jessica; Glick, Richard; Dasgupta, Roshni; Naranjo, Arlene; He, Ying; Gratias, Eric; Geller, James; Mullen, Elizabeth; Ehrlich, Peter

    2014-01-01

    Purpose The Children's Oncology Group (COG) renal tumor study (AREN03B2) requires real-time central review of radiology, pathology, and the surgical procedure to determine appropriate risk-based therapy. The purpose of this study was to determine the inter-rater reliability of the surgical reviews. Methods Of the first 3200 enrolled AREN03B2 patients, a sample of 100 enriched for blood vessel involvement, spill, rupture, and lymph node involvement was selected for analysis. The surgical assessment was then performed independently by two blinded surgical reviewers and compared to the original assessment, which had been completed by another of the committee surgeons. Variables assessed included surgeon-determined local tumor stage, overall disease stage, type of renal procedure performed, presence of tumor rupture, occurrence of intraoperative tumor spill, blood vessel involvement, presence of peritoneal implants, and interpretation of residual disease. Inter-rater reliability was measured using the Fleiss' Kappa statistic two-sided hypothesis tests (Kappa, p-value). Results Local tumor stage correlated in all 3 reviews except in one case (Kappa = 0.9775, p < 0.001). Similarly, overall disease stage had excellent correlation (0.9422, p < 0.001). There was strong correlation for type of renal procedure (0.8357, p < 0.001), presence of tumor rupture (0.6858, p < 0.001), intraoperative tumor spill (0.6493, p < 0.001), and blood vessel involvement (0.6470, p < 0.001). Variables that had lower correlation were determination of the presence of peritoneal implants (0.2753, p < 0.001) and interpretation of residual disease status (0.5310, p < 0.001). Conclusion The inter-rater reliability of the surgical review is high based on the great consistency in the 3 independent review results. This analysis provides validation and establishes precedent for real-time central surgical review to determine treatment assignment in a risk-based stratagem for multimodal cancer therapy. PMID:24439601

  14. Magnetoencephalography in the study of brain dynamics

    PubMed Central

    Pizzella, Vittorio; Marzetti, Laura; Penna, Stefania Della; de Pasquale, Francesco; Zappasodi, Filippo; Romani, Gian Luca

    2014-01-01

    Summary To progress toward understanding of the mechanisms underlying the functional organization of the human brain, either a bottom-up or a top-down approach may be adopted. The former starts from the study of the detailed functioning of a small number of neuronal assemblies, while the latter tries to decode brain functioning by considering the brain as a whole. This review discusses the top-down approach and the use of magnetoencephalography (MEG) to describe global brain properties. The main idea behind this approach is that the concurrence of several areas is required for the brain to instantiate a specific behavior/functioning. A central issue is therefore the study of brain functional connectivity and the concept of brain networks as ensembles of distant brain areas that preferentially exchange information. Importantly, the human brain is a dynamic device, and MEG is ideally suited to investigate phenomena on behaviorally relevant timescales, also offering the possibility of capturing behaviorally-related brain connectivity dynamics. PMID:25764254

  15. SERUM ALDOSTERONE AND DEATH, END STAGE RENAL DISEASE AND CARDIOVASCULAR EVENTS IN BLACKS AND WHITES: FINDINGS FROM THE CRIC STUDY

    PubMed Central

    Deo, Rajat; Yang, Wei; Khan, Abigail M.; Bansal, Nisha; Zhang, Xiaoming; Leonard, Mary B.; Keane, Martin G.; Soliman, Elsayed Z.; Steigerwalt, Susan; Townsend, Raymond R.; Shlipak, Michael G.; Feldman, Harold I.

    2014-01-01

    Prior studies have demonstrated that elevated aldosterone concentrations are an independent risk factor for death in patients with cardiovascular disease. Limited studies, however, have evaluated systematically the association between serum aldosterone and adverse events in the setting of chronic kidney disease (CKD). We investigated the association between serum aldosterone and death and end-stage renal disease (ESRD) in 3,866 participants from the Chronic Renal Insufficiency Cohort. We also evaluated the association between aldosterone and incident congestive heart failure (CHF) and atherosclerotic events in participants without baseline cardiovascular disease. Cox proportional hazards models were used to evaluate independent associations between elevated aldosterone concentrations and each outcome. Interactions were hypothesized and explored between aldosterone and sex, race, and the use of loop diuretics and RAAS inhibitors. Over a median follow-up period of 5.4 years, 587 participants died, 743 developed ESRD, 187 developed CHF, and 177 experienced an atherosclerotic event. Aldosterone concentrations (per standard deviation of the log transformed aldosterone) were not an independent risk factor for death (adjusted HR 1.00, 95% CI [0.93–1.12]), ESRD (adjusted HR 1.07, 95% CI [0.99–1.17]), or atherosclerotic events (adjusted HR 1.04, 95% CI [0.85–1.18]). Aldosterone was associated with CHF (adjusted HR 1.21, 95% CI [1.02–1.35]). Among participants with CKD, higher aldosterone concentrations were independently associated with the development of CHF, but not for death, ESRD, or atherosclerotic events. Further studies should evaluate whether mineralocorticoid receptor antagonists may reduce adverse events in individuals with CKD since elevated cortisol levels may activate the mineralocorticoid receptor. PMID:24752431

  16. Vitamin K Dependent Protection of Renal Function in Multi-ethnic Population Studies

    PubMed Central

    Wei, Fang-Fei; Drummen, Nadja E.A.; Schutte, Aletta E.; Thijs, Lutgarde; Jacobs, Lotte; Petit, Thibaut; Yang, Wen-Yi; Smith, Wayne; Zhang, Zhen-Yu; Gu, Yu-Mei; Kuznetsova, Tatiana; Verhamme, Peter; Allegaert, Karel; Schutte, Rudolph; Lerut, Evelyne; Evenepoel, Pieter; Vermeer, Cees; Staessen, Jan A.

    2016-01-01

    Background Following activation by vitamin K (VK), matrix Gla protein (MGP) inhibits arterial calcification, but its role in preserving renal function remains unknown. Methods In 1166 white Flemish (mean age, 38.2 years) and 714 South Africans (49.2% black; 40.6 years), we correlated estimated glomerular filtration (eGFR [CKD-EPI formula]) and stage of chronic kidney disease (CKD [KDOQI stages 2–3]) with inactive desphospho-uncarboxylated MGP (dp-ucMGP), using multivariable linear and logistic regression. Results Among Flemish and white and black Africans, between-group differences in eGFR (90, 100 and 122 mL/min/1.73 m2), dp-ucMGP (3.7, 6.5 and 3.2 μg/L), and CKD prevalence (53.5, 28.7 and 10.5%) were significant, but associations of eGFR with dp-ucMGP did not differ among ethnicities (P ≥ 0.075). For a doubling of dp-ucMGP, eGFR decreased by 1.5 (P = 0.023), 1.0 (P = 0.56), 2.8 (P = 0.0012) and 2.1 (P < 0.0001) mL/min/1.73 m2 in Flemish, white Africans, black Africans and all participants combined; the odds ratios for moving up one CKD stage were 1.17 (P = 0.033), 1.03 (P = 0.87), 1.29 (P = 0.12) and 1.17 (P = 0.011), respectively. Interpretation In the general population, eGFR decreases and CKD risk increases with higher dp-ucMGP, a marker of VK deficiency. These findings highlight the possibility that VK supplementation might promote renal health. PMID:26981580

  17. Vortex dynamics studies in supersonic flow

    NASA Astrophysics Data System (ADS)

    Vergine, Fabrizio

    This dissertation covers the study of selected vortex interaction scenarios both in cold and high enthalpy reacting flows. Specifically, the experimental results and the analysis of the flowfields resulting from two selected supersonic vortex interaction modes in a Mach 2.5 cold flow are presented. Additionally, the experiment design, based on vortex dynamics concepts, and the reacting plume survey of two pylon injectors in a Mach 2.4 high enthalpy flow are shown. All the cold flow experiments were conducted in the supersonic wind tunnel of the Aerodynamics Research Center at the University of Texas at Arlington. A strut injector equipped with specified ramp configurations was designed and used to produce the flowfields of interest. The reacting flow experiments were conducted in the the Expansion Tube Facility located in the High Temperature Gasdynamics Laboratory of Stanford University. A detailed description of the supersonic wind tunnel, the instrumentation, the strut injector and the supersonic wake flow downstream is shown as part of the characterization of the facility. As Stereoscopic Particle Image Velocimetry was the principal flow measurement technique used in this work to probe the streamwise vortices shed from ramps mounted on the strut, this dissertation provides a deep overview of the challenges and the application of the aforementioned technique to the survey of vortical flows. Moreover, the dissertation provides the comprehensive analysis of the mean and fluctuating velocity flowfields associated with two distinct vortex dynamics scenarios, as chosen by means of the outcomes of the simulations of a reduced order model developed in the research group. Specifically, the same streamwise vortices (strength, size and Reynolds number) were used experimentally to investigate both a case in which the resulting dynamics evolve in a vortex merging scenario and a case where the merging process is voluntarily avoided in order to focus the analysis on the fundamental differences associated with the amalgamation processes alone. The results from the mean flow highlight major differences between the two cases and will justify the use of the inviscid reduced order model used to predict the main flow physics. The analysis of the turbulence quantities based on concepts borrowed from incompressible turbulence theory explains interesting features of the fluctuating flowfields, suggesting that turbulence associated with the inspected flow conditions is essentially incompressible. Once the interactions among the vortical structures in cold flow were assessed, these vortex dynamics concepts were probed in a reacting environment. The dissertation describes the design phase of two pylon injectors based on the prediction capabilities of the aforementioned model. Then, the results of a set of combustion experiments conducted utilizing hydrogen fuel injected into Mach 2.4, high-enthalpy (2.8MJ/kg) air flow are discussed. The results show that, for the heat release levels considered in this study, the morphology of the plume and its evolution is very similar to the results produced by the code, enabling an interpretation of the phenomena based on vortex dynamics considerations. The persistence of the streamwise vortical structures created by the selected ramp configurations is shown together with the effectiveness of the coherent structures in successfully anchoring the flame very close to the injection point. The work shows the possibility of a new approach in the design of injection strategies (i.e., not limited to injection devices) suitable for adoption in scramjet combustors based on the ability to predict, with basic vortex dynamics concepts and a highly reduced computational cost, the main features of flows of technological interest.

  18. End-stage renal disease and low level exposure to lead, cadmium and mercury; a population-based, prospective nested case-referent study in Sweden

    PubMed Central

    2013-01-01

    Background Cadmium (Cd), lead (Pb), and mercury (Hg) cause toxicological renal effects, but the clinical relevance at low-level exposures in general populations is unclear. The objective of this study is to assess the risk of developing end-stage renal disease in relation to Cd, Pb, and Hg exposure. Methods A total of 118 cases who later in life developed end-stage renal disease, and 378 matched (sex, age, area, and time of blood sampling) referents were identified among participants in two population-based prospective cohorts (130,000 individuals). Cd, Pb, and Hg concentrations were determined in prospectively collected samples. Results Erythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean in cases 76 ?g/L; odds ratio (OR) 1.54 for an interquartile range increase, 95% confidence interval (CI) 1.18-2.00), while erythrocyte mercury was negatively associated (2.4 ?g/L; OR 0.75 for an interquartile range increase, CI 0.56-0.99). For erythrocyte cadmium, the OR of developing end-stage renal disease was 1.15 for an interquartile range increase (CI 0.99-1.34; mean Ery-Cd among cases: 1.3 ?g/L). The associations for erythrocyte lead and erythrocyte mercury, but not for erythrocyte cadmium, remained after adjusting for the other two metals, smoking, BMI, diabetes, and hypertension. Gender-specific analyses showed that men carried almost all of the erythrocyte lead and erythrocyte cadmium associated risks. Conclusions Erythrocyte lead is associated with end-stage renal disease but further studies are needed to evaluate causality. Gender-specific analyses suggest potential differences in susceptibility or in exposure biomarker reliability. PMID:23343055

  19. Metabolic syndrome in hemodialysis patients as a risk factor for new-onset diabetes mellitus after renal transplant: a prospective observational study

    PubMed Central

    Bonet, Josep; Martinez-Castelao, Albert; Bays, Beatriz

    2013-01-01

    Purpose Metabolic syndrome is a cluster of biochemical abnormalities including cardiovascular and diabetes risk factors. The development of diabetes mellitus after renal transplant represents a major posttransplant complication that may adversely affect graft/patient survival. The aim of this study was to assess the role of metabolic syndrome in patients on hemodialysis as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant. Patients and methods This was a prospective observational epidemiologic study carried out in adult nondiabetic patients undergoing chronic hemodialysis and on the renal transplant waiting list between November 2008 and April 2009. Patients were followed up from Visit 1 (baseline) to 6 months after the renal transplant. The analysis of the role of metabolic syndrome in hemodialysis patients as a risk factor for the incidence of new-onset diabetes mellitus after renal transplant included the estimation of relative risk and its 95% confidence interval (CI). Results A total of 383 evaluable patients were entered into the study (mean age, 52.7 years; male, 57.7%; Caucasian, 90.1%). The prevalence of metabolic syndrome on hemodialysis was 30.4% (95% CI, 25.8%35.4%). Hypertension was the most prevalent criterion for metabolic syndrome (65.0%), followed by low levels of high-density lipoprotein cholesterol (52.7%), abdominal obesity (36.2%), hypertriglyceridemia (32.4%), and impaired glucose (8.9%). After the renal transplant, the prevalence of metabolic syndrome was still 25.8%. During the posttransplant period, the incidence of new-onset diabetes mellitus reached 13.0% (95% CI, 7.8%20.6%) and patients with pretransplant metabolic syndrome were 2.6 times (95% CI, 1.0436.608) more likely to develop new-onset diabetes mellitus after the renal transplant than those without metabolic syndrome. Conclusion The presence of metabolic syndrome in patients undergoing hemodialysis represents an independent risk factor for the incidence of new-onset diabetes mellitus after renal transplant. PMID:24082792

  20. A study of gizzard nematodes and renal coccidiosis in Canada geese (Branta canadensis interior) of the Mississippi Valley population

    USGS Publications Warehouse

    Tuggle, B.N.

    1982-01-01

    A total of 309 Mississippi Valley Population Canada geese, Branta canadensis interior, of different sex and age groups was collected from three locations in the Mississippi Flyway from 1979-1981 and examined for gizzard nematodes and renal coccidia. Three species of nematodes were removed from the gizzards, Amidostomum anseris, A. spatulatum, and Epomidiostomum crami. The latter two species are reported from this population of geese for the first time. Gizzard nematodes were found in 95.2% of all Canada geese examined, with A. anseris being the most abundant of the three species. There was no statistically significant difference between immatures and adults in the abundance of total nematodes species however, immature geese carried significantly more A. anseris and adult geese harbored significantly more A. spatulatum and E. crami infections. No significant difference in gizzard worm infections between male and female birds was observed. The abundance of overall gizzard nematodes was greatest in Canada geese from Winisk, Ontario (11.9), but the abundance of worms in southern Illinois geese (10.0) was similar. Geese from Horicon National Wildlife Refuge had the lowest abundance of infection, 7.5. The overall abundance of nematodes showed a general increase the second year of the study in each sex and age group and at each collection area. Each of three species of nematodes was responsible for some degree of damage to the gizzard lining and koilin, but E. crami was the most pathogenic of the species recovered. The occurrence of renal coccidiosis in Canada geese of this flyway is reported for the first time; the etiologic agent is Eimeria clarkei. The oocysts and/or endogenous stages of E. clarkei were present in 6.8% of the Canada geese sampled and this was the only species found. Male and female geese showed no significant differences in E. clarkei infections, however, significantly more immature geese than adult geese were infected with this species. A cell mediated response to the presence of E. clarkei oocysts and endogenous stages was seen in 83.3% of infected adult geese, but only 20% of immature geese showed a macrophage response to the infective stages of this parasite. A massive E. clarkei infection caused the death of one goose collected at Horicon National Wildlife Refuge. Amidostomiasis, epomidiostomiasis, and renal coccidiosis were important pathogenic diseases in the Mississippi Valley Population Canada geese but did not directly cause significant mortality in the population.

  1. Microscopical and ultrastructural studies of the renal artery in domestic swine.

    PubMed

    Vodenicharov, A; Cirnuchanov, P

    1995-12-01

    Both renal arteries from six, 8-month old, Camborow hybrid pigs were examined in histological, semithin and ultrathin sections. It was established that the membrana elastica interna showed an expressed degree of wrinkliness. In certain sections, sometimes occupying 20% of the diameter of across-section, its curves were considerably higher and wider than those in the remaining part. The inner elastic membrane in these sections was cleaved in two layers. Estates of lengthwise-situated smooth muscle cells of an elliptical form were located in the middle shell (tunica media). Furthermore, a great quantity of mast cells were found in the middle shell. The electron-microscopic observations showed that their granules had various sizes and shapes. The outer shell (tunica adventitia) had an irregular thickness. In some parts, a few elastic fibres entered the middle shell. They had a tuft-like shape with a wedge-like or elongated configuration, and were situated among the layers of smooth-muscle cells. PMID:8592976

  2. Epidemic of nosocomial Legionnaires' disease in renal transplant recipients: a case-control and environmental study.

    PubMed Central

    Le Saux, N M; Sekla, L; McLeod, J; Parker, S; Rush, D; Jeffery, J R; Brunham, R C

    1989-01-01

    An outbreak of Legionella pneumophila pneumonia occurred in 6 of 49 new renal transplant recipients over the course of 13 months. We compared infected patients (cases) and uninfected patients (controls) with respect to potential risk factors. Corticosteroid use, need for hemodialysis and number of days of hemodialysis were significantly greater among the cases. Logistic regression analysis identified corticosteroid dosage and number of days of hemodialysis as independent risk factors. Lymphopenia and monocytopenia were correlated with the amount of corticosteroid administered and occurred to a greater degree in the cases. All clinical isolates were of L. pneumophila serogroup 1, subtype Philadelphia 1, which was also cultured from a recovery room sink outside the operating room where the transplants were done. Other areas of the hospital were colonized with other, heterogeneous strains of L. pneumophila. The organism was not eliminated from the hospital water supply despite shock chlorination and superheating of water tanks. The epidemic ended when new transplant recipients routinely received prophylactic trimethoprim-sulfamethoxazole (160-800 mg given orally once daily) while in hospital after transplantation. Corticosteroid-induced monocytopenia and lymphopenia and the complement activation and monocyte depletion effects of hemodialysis may combine to increase susceptibility to Legionnaires' disease. PMID:2650836

  3. Longitudinal Studies of a B Cell-Derived Signature of Tolerance in Renal Transplant Recipients.

    PubMed

    Newell, K A; Asare, A; Sanz, I; Wei, C; Rosenberg, A; Gao, Z; Kanaparthi, S; Asare, S; Lim, N; Stahly, M; Howell, M; Knechtle, S; Kirk, A; Marks, W H; Kawai, T; Spitzer, T; Tolkoff-Rubin, N; Sykes, M; Sachs, D H; Cosimi, A B; Burlingham, W J; Phippard, D; Turka, L A

    2015-11-01

    Biomarkers of transplant tolerance would enhance the safety and feasibility of clinical tolerance trials and potentially facilitate management of patients receiving immunosuppression. To this end, we examined blood from spontaneously tolerant renal transplant recipients and patients enrolled in two interventional tolerance trials using flow cytometry and gene expression profiling. Using a previously reported tolerant cohort as well as newly identified tolerant patients, we confirmed our previous finding that tolerance was associated with increased expression of B cell-associated genes relative to immunosuppressed patients. This was not accounted for merely by an increase in total B cell numbers, but was associated with the increased frequencies of transitional and nave B cells. Moreover, serial measurements of gene expression demonstrated that this pattern persisted over several years, although patients receiving immunosuppression also displayed an increase in the two most dominant tolerance-related B cell genes, IGKV1D-13 and IGLL-1, over time. Importantly, patients rendered tolerant via induction of transient mixed chimerism, and those weaned to minimal immunosuppression, showed similar increases in IGKV1D-13 as did spontaneously tolerant individuals. Collectively, these findings support the notion that alterations in B cells may be a common theme for tolerant kidney transplant recipients, and that it is a useful monitoring tool in prospective trials. PMID:26461968

  4. Total parathyroidectomy with presternal intramuscular autotransplantation in renal patients: a prospective study of 66 patients.

    PubMed

    Santos, R O; Ohe, M N; Carvalho, A B; Neves, M C; Kunii, I; Lazaretti-Castro, M; Abraho, M; Cervantes, O; Vieira, J G H

    2012-01-01

    Surgical treatment of secondary (SHPT) and tertiary hyperparathyroidism (THPT) may involve various surgical approaches. The aim of this paper was to evaluate presternal intramuscular autotransplantation of parathyroid tissue as a surgical option in SHPT and THPT treatment. 66 patients with renal chronic disease underwent surgery from April 2000 to April 2005 at Universidade Federal So Paulo, Brazil. There were 38 SHPT patients (24 women/14 men), mean age of 39.yrs (range: 14-58), and 28 THPT patients (14 women/14 men), mean age of 43.4 yrs (range: 24-62). Postoperative average followup was 42.9 months (range: 12-96). Postoperative intact PTH increased throughout followup from 73.5 pg/mL to 133?pg/mL on average from 1st to the 5th year, respectively, in SHPT and from 54.9?pg/mL to 94.7?pg/mL on average from 1st to 5th year, respectively, in THPT group. Definitive hypoparathyroidism was observed in 4 (6.06%) patients and graft-dependent recurrence in 6 (9.09%). Presternal intramuscular autotransplantation of parathyroid tissue is a feasible and safe surgical option in SHPT and THPT treatment. PMID:22496985

  5. Should We Still Focus That Much on Cardiovascular Mortality in End Stage Renal Disease Patients? The CONvective TRAnsport STudy

    PubMed Central

    den Hoedt, Claire H.; Bots, Michiel L.; Grooteman, Muriel P. C.; Mazairac, Albert H. A.; Penne, E. Lars; van der Weerd, Neelke C.; ter Wee, Piet M.; Nub, Menso J.; Levesque, Rene; Blankestijn, Peter J.; van den Dorpel, Marinus A.

    2013-01-01

    Background We studied the distribution of causes of death in the CONTRAST cohort and compared the proportion of cardiovascular deaths with other populations to answer the question whether cardiovascular mortality is still the principal cause of death in end stage renal disease. In addition, we compared patients who died from the three most common death causes. Finally, we aimed to study factors related to dialysis withdrawal. Methods We used data from CONTRAST, a randomized controlled trial in 714 chronic hemodialysis patients comparing the effects of online hemodiafiltration versus low-flux hemodialysis. Causes of death were adjudicated. The distribution of causes of death was compared to that of the Dutch dialysis registry and of the Dutch general population. Results In CONTRAST, 231 patients died on treatment. 32% died from cardiovascular disease, 22% due to infection and 23% because of dialysis withdrawal. These proportions were similar to those in the Dutch dialysis registry and the proportional cardiovascular mortality was similar to that of the Dutch general population. cardiovascular death was more common in patients <60 years. Patients who withdrew were older, had more co-morbidity and a lower mental quality of life at baseline. Patients who withdrew had much co-morbidity. 46% died within 5 days after the last dialysis session. Conclusions Although the absolute risk of death is much higher, the proportion of cardiovascular deaths in a prevalent end stage renal disease population is similar to that of the general population. In older hemodialysis patients cardiovascular and non-cardiovascular death risk are equally important. Particularly the registration of dialysis withdrawal deserves attention. These findings may be partly limited to the Dutch population. PMID:23620729

  6. Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study

    PubMed Central

    2009-01-01

    Background Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI). Methods A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. Results We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC) transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI. Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. Conclusion Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery. PMID:19772621

  7. Association Between Chronic Osteomyelitis and Risk of End-Stage Renal Disease: A Nationwide Population-Based Cohort Study.

    PubMed

    Lin, Shih-Yi; Lin, Cheng-Li; Tseng, Chun-Hung; Chang, Yen-Jung; Wang, I-Kuan; Yeh, Hung-Chieh; Kao, Chia-Hung

    2015-07-01

    Inflammation, which initiates endothelial dysfunction, vascular atherosclerosis, and oxidative stress, may negatively influence renal function and accelerate the development of end-stage renal disease (ESRD). The role of chronic osteomyelitis (COM), a chronic inflammatory disease, in the development of ESRD has not been investigated. This study explored whether patients with COM have a higher risk of ESRD than that of patients without COM.Taiwan National Health Insurance claims from 1997 to 2010 were used to identify 24,267 newly diagnosed patients with COM and 97,068 age- and sex-matched non-COM controls for comparison. The risks of ESRD among COM patients, with adjustment for comorbidities, namely, hypertension, diabetes, coronary artery disease, congestive heart failure, and hyperlipidemia, were assessed until the end of 2010.ESRD risk was 2.01-fold higher (95% confidence interval [CI]: 1.81-2.25) in the COM cohort than in the non-COM cohort. Regarding the joint effect of COM with comorbidity, the ESRD risk was 1.57-fold higher (95% CI: 1.23-2.00) for the COM cohort without comorbidities and increased to 2.25 (95% CI: 1.97-2.57) for the COM cohort with at least 1 comorbidity. Age-specific analysis revealed that the adjusted ESRD risk for the COM cohort increased as age decreased, with the highest hazard ratio being 17.8 (95% CI: 5.18-61.4) for patients aged 20-34 years.This was the first study to report that COM is associated with an increased risk of ESRD, particularly among patients with comorbidities and younger patients. PMID:26166123

  8. Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study

    PubMed Central

    Bayliss, George P.; Weinrauch, Larry A.; Gleason, Ray E.; Lee, Annette T.; D'Elia, John A.

    2013-01-01

    Background Diabetic patients on hemodialysis are at high risk of death from cardiovascular disease, and research has suggested that various biologic markers of inflammation, oxidative stress and hemostasis may give added value to clinical information for predicting cardiovascular event (CVE)-free survival. This information could be particularly important in evaluating this population for renal transplant, given the scarcity of organs. We hypothesized that in diabetic patients undergoing renal replacement therapy (RRT) these biologic markers would prove useful in predicting event-free follow-up in a prospective study. Methods One hundred and fifty diabetic (76 type 1, 74 type 2) and 27 non-diabetic stable RRT patients were followed for 0.0413.69 years for CVE (myocardial infarction, coronary arterial intervention, peripheral arterial bypass or amputation, cerebrovascular accident or carotid artery intervention), cardiac and all-cause mortality. Measured biologic markers of inflammation included the following: Il-6, C reactive protein, fibrinogen; of hemostasis: fibrinogen, plasminogen activator inhibitor (PAI), fibrinolytic activity, von Willebrand factor VII (vWF), platelet-selectin, viscosity and of oxidative stress: advanced glycated end products and antibody to oxidized low-density lipoprotein. For each, upper versus lower tertiles were compared for duration of event-free follow-up. Results Cardiovascular events prior to study entry occurred in 51.3% of DM1, 54.0% of DM2 and 25.9% of DM0 patients. Subsequent cardiovascular events were noted in 31.6% of DM1, 45.9% of DM2 and 11.1% of DM0 patients. All mean levels of biologic markers at baseline were abnormal (P < 0.05). Conclusions In this RRT population, all biologic marker levels except PAI did not improve clinical prediction of events. PMID:26069829

  9. Tools for the study of dynamical spacetimes

    NASA Astrophysics Data System (ADS)

    Zhang, Fan

    This thesis covers a range of topics in numerical and analytical relativity, centered around introducing tools and methodologies for the study of dynamical spacetimes. The scope of the studies is limited to classical (as opposed to quantum) vacuum spacetimes described by Einstein's general theory of relativity. The numerical works presented here are carried out within the Spectral Einstein Code (SpEC) infrastructure, while analytical calculations extensively utilize Wolfram's Mathematica program. We begin by examining highly dynamical spacetimes such as binary black hole mergers, which can be investigated using numerical simulations. However, there are difficulties in interpreting the output of such simulations. One difficulty stems from the lack of a canonical coordinate system (henceforth referred to as gauge freedom) and tetrad, against which quantities such as Newman-Penrose Psi4 (usually interpreted as the gravitational wave part of curvature) should be measured. We tackle this problem in Chapter 2 by introducing a set of geometrically motivated coordinates that are independent of the simulation gauge choice, as well as a quasi-Kinnersley tetrad, also invariant under gauge changes in addition to being optimally suited to the task of gravitational wave extraction. Another difficulty arises from the need to condense the overwhelming amount of data generated by the numerical simulations. In order to extract physical information in a succinct and transparent manner, one may define a version of gravitational field lines and field strength using spatial projections of the Weyl curvature tensor. Introduction, investigation and utilization of these quantities will constitute the main content in Chapters 3 through 6. For the last two chapters, we turn to the analytical study of a simpler dynamical spacetime, namely a perturbed Kerr black hole. We will introduce in Chapter 7 a new analytical approximation to the quasi-normal mode (QNM) frequencies, and relate various properties of these modes to wave packets traveling on unstable photon orbits around the black hole. In Chapter 8, we study a bifurcation in the QNM spectrum as the spin of the black hole approaches extremality.

  10. Ultrasonic Study of Dislocation Dynamics in Lithium -

    NASA Astrophysics Data System (ADS)

    Han, Myeong-Deok

    1987-09-01

    Experimental studies of dislocation dynamics in LiF single crystals, using ultrasonic techniques combined with dynamic loading, were performed to investigate the time evolution of the plastic deformation process under a short stress pulse at room temperature, and the temperature dependence of the dislocation damping mechanism in the temperature range 25 - 300(DEGREES)K. From the former, the time dependence of the ultrasonic attenuation was understood as resulting from dislocation multiplication followed by the evolution of mobile dislocations to immobile ones under large stress. From the latter, the temperature dependence of the ultrasonic attenuation was interpreted as due to the motion of the dislocation loops overcoming the periodic Peierls potential barrier in a manner analogous to the motion of a thermalized sine-Gordon chain under a small stress. The Peierls stress obtained from the experimental results by application of Seeger's relaxation model with exponential dislocation length distribution was 4.26MPa, which is consistent with the lowest stress for the linear relation between the dislocation velocity and stress observed by Flinn and Tinder.

  11. Molecular beam studies of reaction dynamics

    SciTech Connect

    Lee, Yuan T.

    1991-03-01

    The major thrust of this research project is to elucidate detailed dynamics of simple elementary reactions that are theoretically important and to unravel the mechanism of complex chemical reactions or photochemical processes that play important roles in many macroscopic processes. Molecular beams of reactants are used to study individual reactive encounters between molecules or to monitor photodissociation events in a collision-free environment. Most of the information is derived from measurement of the product fragment energy, angular, and state distributions. Recent activities are centered on the mechanisms of elementary chemical reactions involving oxygen atoms with unsaturated hydrocarbons, the dynamics of endothermic substitution reactions, the dependence of the chemical reactivity of electronically excited atoms on the alignment of excited orbitals, the primary photochemical processes of polyatomic molecules, intramolecular energy transfer of chemically activated and locally excited molecules, the energetics of free radicals that are important to combustion processes, the infrared-absorption spectra of carbonium ions and hydrated hydronium ions, and bond-selective photodissociation through electric excitation.

  12. Molecular beam studies of reaction dynamics

    SciTech Connect

    Lee, Y.T.

    1993-12-01

    The major thrust of this research project is to elucidate detailed dynamics of simple elementary reactions that are theoretically important and to unravel the mechanism of complex chemical reactions or photochemical processes that play important roles in many macroscopic processes. Molecular beams of reactants are used to study individual reactive encounters between molecules or to monitor photodissociation events in a collision-free environment. Most of the information is derived from measurement of the product fragment energy, angular, and state distributions. Recent activities are centered on the mechanisms of elementary chemical reactions involving oxygen atoms with unsaturated hydrocarbons, the dynamics of endothermic substitution reactions, the dependence of the chemical reactivity of electronically excited atoms on the alignment of excited orbitals, the primary photochemical processes of polyatomic molecules, intramolecular energy transfer of chemically activated and locally excited molecules, the energetics of free radicals that are important to combustion processes, the infrared-absorption spectra of carbonium ions and hydrated hydronium ions, and bond-selective photodissociation through electric excitation.

  13. Vicarious liver visualization in solitary functioning kidney with technetium-99m ethylenedicysteine renal scintigraphy

    PubMed Central

    Jain, Tarun Kumar; Phulsunga, Rohit Kumar; Gupta, Nitin; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2015-01-01

    We present a case of 3-year-old boy who was incidentally diagnosed to have single left kidney on ultrasonography. Dynamic technetium-99m ethylenedicysteine renal scintigraphy was acquired for assessing the existing kidney function showed the tracer localization in bilateral renal fossae during the entire study. The single-photon emission computerized tomography/computerized tomography study revealed activity in the right renal fossa to be in the enlarged right lobe of the liver, which was mimicking as impaired functioning right kidney in planar images. The hybrid imaging helped in accurate delineation of tracer uptake by confirming it to be the false appearance of the right kidney in planar imaging. This case report also highlights the possible mechanism of renal tracer uptake in the liver parenchyma. PMID:26170576

  14. Randomized comparison of renal denervation versus intensified pharmacotherapy including spironolactone in true-resistant hypertension: six-month results from the Prague-15 study.

    PubMed

    Rosa, Jn; Widimsk, Petr; Touek, Petr; Petrk, Ond?ej; ?urila, Karol; Waldauf, Petr; Bedn?, Frantiek; Zelinka, Tom; Holaj, Robert; trauch, Branislav; omlov, Zuzana; Tborsk, Milo; Vclavk, Jan; Kocinov, Eva; Branny, Marian; Nykl, Igor; Jiravsk, Otakar; Widimsk, Ji?

    2015-02-01

    This prospective, randomized, open-label multicenter trial evaluated the efficacy of catheter-based renal denervation (Symplicity, Medtronic) versus intensified pharmacological treatment including spironolactone (if tolerated) in patients with true-resistant hypertension. This was confirmed by 24-hour ambulatory blood pressure monitoring after excluding secondary hypertension and confirmation of adherence to therapy by measurement of plasma antihypertensive drug levels before enrollment. One-hundred six patients were randomized to renal denervation (n=52), or intensified pharmacological treatment (n=54) with baseline systolic blood pressure of 15917 and 15517 mm Hg and average number of drugs 5.1 and 5.4, respectively. A significant reduction in 24-hour average systolic blood pressure after 6 months (-8.6 [95% cofidence interval: -11.8, -5.3] mm Hg; P<0.001 in renal denervation versus -8.1 [95% cofidence interval: -12.7, -3.4] mm Hg; P=0.001 in pharmacological group) was observed, which was comparable in both groups. Similarly, a significant reduction in systolic office blood pressure (-12.4 [95% cofidence interval: -17.0, -7.8] mm Hg; P<0.001 in renal denervation versus -14.3 [95% cofidence interval: -19.7, -8.9] mm Hg; P<0.001 in pharmacological group) was present. Between-group differences in change were not significant. The average number of antihypertensive drugs used after 6 months was significantly higher in the pharmacological group (+0.3 drugs; P<0.001). A significant increase in serum creatinine and a parallel decrease of creatinine clearance were observed in the pharmacological group; between-group difference were borderline significant. The 6-month results of this study confirmed the safety of renal denervation. In conclusion, renal denervation achieved reduction of blood pressure comparable with intensified pharmacotherapy. PMID:25421981

  15. Long-term renal allograft function under maintenance immunosuppression with cyclosporin A or azathioprine. A single center, five-year follow-up study.

    PubMed

    Linder, R; Lindholm, A; Restifo, A; Duraj, F; Groth, C G

    1991-09-01

    In order to evaluate long-term renal graft function, 149 cyclosporin A and prednisolone (CyA/P)-treated renal transplant recipients were compared with 119 azathioprine and prednisolone (Aza/P)-treated patients. Only patients who had a functioning graft for at least 1 year and who were maintained on their initial immunosuppressive protocol were included. The minimum follow-up period was 4 years. Renal graft function was estimated by yearly determinations of serum creatinine and creatinine clearance. The CyA/P-treated patients had a significantly higher serum creatinine and a significantly lower creatinine clearance at every point in time post-transplantation than Aza/P-treated patients (P less than 0.001). The evolution of renal graft function, as reflected in the line of regression for serum creatinine and creatinine clearance versus time, was estimated for each individual patient. There was an almost stable renal function, as assessed by the median of the slopes of the regression line for serum creatinine versus time in both groups. The median increase in serum creatinine was only 1.4 mumol/l per year for Aza/P-treated patients and 2.4 mumol/l per year for CyA/P-treated patients (difference NS). The median decline in creatinine clearance was 2.18 ml/min per 1.73 m2/year in the Aza/P group and 1.07 ml/min per 1.73 m2/year in the CyA/P group (P = 0.05). In patients with a functioning graft for at least 5 years, creatinine clearance remained unchanged in both groups during the study period. In conclusion, renal graft function, as assessed by measurements of serum creatinine and creatinine clearance, remained essentially unchanged for at least 5 years after transplantation, regardless of the immunosuppressive protocol used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1958282

  16. The impact of pretransplant donor-specific antibodies on graft outcome in renal transplantation: a six-year follow-up study

    PubMed Central

    David-Neto, Elias; Souza, Patricia Soares; Panajotopoulos, Nicolas; Rodrigues, Helcio; Ventura, Carlucci Gualberto; David, Daisa Silva Ribeiro; Lemos, Francine Brambate Carvalhinho; Agena, Fabiana; Nahas, William Carlos; Kalil, Jorge Elias; Castro, Maria Cristina Ribeiro

    2012-01-01

    OBJECTIVE: The significance of pretransplant, donor-specific antibodies on long-term patient outcomes is a subject of debate. This study evaluated the impact and the presence or absence of donor-specific antibodies after kidney transplantation on short- and long-term graft outcomes. METHODS: We analyzed the frequency and dynamics of pretransplant donor-specific antibodies following renal transplantation from a randomized trial that was conducted from 2002 to 2004 and correlated these findings with patient outcomes through 2009. Transplants were performed against a complement-dependent T- and B-negative crossmatch. Pre- and posttransplant sera were available from 94 of the 118 patients (80%). Antibodies were detected using a solid-phase (Luminex), single-bead assay, and all tests were performed simultaneously. RESULTS: Sixteen patients exhibited pretransplant donor-specific antibodies, but only 3 of these patients (19%) developed antibody-mediated rejection and 2 of them experienced early graft losses. Excluding these 2 losses, 6 of 14 patients exhibited donor-specific antibodies at the final follow-up exam, whereas 8 of these patients (57%) exhibited complete clearance of the donor-specific antibodies. Five other patients developed de novo posttransplant donor-specific antibodies. Death-censored graft survival was similar in patients with pretransplant donor-specific and non-donor-specific antibodies after a mean follow-up period of 70 months. CONCLUSION: Pretransplant donor-specific antibodies with a negative complement-dependent cytotoxicity crossmatch are associated with a risk for the development of antibody-mediated rejection, although survival rates are similar when patients transpose the first months after receiving the graft. Our data also suggest that early posttransplant donor-specific antibody monitoring should increase knowledge of antibody dynamics and their impact on long-term graft outcome. PMID:22522761

  17. Neutrophil Gelatinase-Associated Lipocalin (NGAL) predicts renal injury in acute decompensated cardiac failure: a prospective observational study

    PubMed Central

    2012-01-01

    Background Acute Decompensated Cardiac Failure (ADCF) is frequently associated with deterioration in renal function. Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker of kidney injury. We aimed to determine if NGAL measured at admission predicts in-hospital acute kidney injury (AKI) in ADCF. Methods A prospective observational study measured NGAL and B-natriuretic peptide (BNP) from patients with ADCF presenting to two tertiary hospitals. Patients received standard care and were followed up daily as inpatients. ADCF was defined by PRIDE score ? 6 and AKI by RIFLE criteria. Results One hundred and two patients (median age 80, IQR 69-84 years, 52% male) were enrolled. AKI developed in 22 (25%) of 90 for whom outcome data was available. Seven patients died. NGAL was significantly elevated in those who developed AKI versus those who did not (median 130 ng/ml vs 69 ng/ml, p = 0.002). NGAL was also higher in those who died (median 136 ng/ml vs 68 ng/ml, p = 0.005). AKI was significantly associated with risk of death (5/22 (23%) vs 1/68 (1.5%), p = 0.001), but not length of hospital stay. NGAL significantly correlated with admission eGFR but not BNP. For prediction of AKI, NGAL > 89 ng/ml had sensitivity of 68% and specificity of 70% with area under the receiver operator characteristic (ROC) curve of 0.71 (0.58-0.84). After adjustment for baseline renal function, the odds ratio (OR) for AKI was 3.73 (1.26-11.01) if admission NGAL > 89 ng/ml. Conclusions Elevated NGAL at admission is associated with in-hospital AKI and mortality in patients with ADCF. However, it has only moderate diagnostic accuracy in this setting. PMID:22340728

  18. Renal Denervation

    PubMed Central

    Persu, Alexandre; Renkin, Jean; Thijs, Lutgarde; Staessen, Jan A.

    2013-01-01

    The term “ultima ratio” has multiple, though related, meanings. The motto “ultima ratio regum,” cast on the cannons of the French army of King Louis XIV, meant that war is the last argument of kings, that is, the one to be used after all diplomatic arguments have failed. Along similar lines, we propose that, given the current evidence, renal denervation should be used as a last resort, after state-of-the-art drug treatment optimized at expert centers failed to control blood pressure. PMID:22851728

  19. A dynamical study of Phoebe's rotation

    NASA Astrophysics Data System (ADS)

    Cottereau, L.

    2011-10-01

    With a fast non synchronous rotation, Phoebe is a particular satellite in the Saturnian system (most of the satellites are synchronously rotating) and must show a very different rotational evolution. We propose for the first time to determine the combined motion of the precession and nutation of Phoebe considered as a rigid body by numerical and analytical integration. We further compare our results with those obtained by Kinoshita for the Earth (1977), emphasizing their astonishing similarities (obliquity, value of the precession, nutation amplitudes and arguments). Moreover we show that a pure analytical accurate model of the nutation is not easy to construct due to the fact that the orbital motion of Phoebe is far from being Keplerian. At last we present the prospect for future studies among which are the effect of the Sun, Titan and the dynamical ellipticity of Saturn on the precession-nutation motion.

  20. Non Linear Beam Dynamics Studies at SPEAR

    SciTech Connect

    Terebilo, A.; Pellegrini, C.; Cornacchia, M.; Corbett, J.; Martin, D.; /SLAC

    2011-09-12

    The frequency map analysis of a Hamiltonian system recently introduced to accelerators physics in combination with turn-by-turn phase space measurements opens new experimental opportunities for studying non linear dynamic in storage rings. In this paper we report on the experimental program at SPEAR having the goal of measuring the frequency map of the machine. In this paper we discuss the accuracy of the instantaneous tune extraction from experimental data and demonstrate the possibility of the frequency map measurement. The instantaneous tune extraction technique can be applied to experimental tracking data with reasonable accuracy. Frequency map can be experimentally determined using the existing turn-by-turn phase space measurement techniques and NAFF instantaneous tune extraction.

  1. Dynamic speckle study of microbial growth

    NASA Astrophysics Data System (ADS)

    Vincitorio, F. M.; Mulone, C.; Marcuzzi, P. A.; Budini, N.; Freyre, C.; Lopez, A. J.; Ramil, A.

    2015-08-01

    In this work we present a characterization of yeast dynamic speckle activity during growth in an isolated agar culture medium. We found that it is possible to detect the growth of the microorganisms even before they turn out to be visible. By observing the time evolution of the speckle activity at different regions of the culture medium we could extract a map of the growth process, which served to analyze how the yeast develops and spreads over the agar's medium. An interesting point of this study concerns with the influence of the laser light on the yeast growth rate. We have found that yeast finds hard to develop at regions with higher laser light illumination, although we used a synchronous system to capture the speckle pattern. The results obtained in this work would serve us as a starting point to fabricate a detector of growing microorganism colonies, with obvious interesting applications in diverse areas.

  2. Molecular dynamics study of polyethylene extension

    NASA Astrophysics Data System (ADS)

    Melker, Alexander I.; Soloviev, Dmitri V.

    1999-05-01

    Molecular dynamics study of polyethylene extension is presented. The simulations were made using a model of a polyethylene globule containing 500 carbon and 1002 hydrogen atoms, which represents a small part of a bulk polymer specimen. The main objective of this work was to analyze the macromolecule structure evolution as well as to obtain stress- strain diagrams for the process. It is found that the stress- strain diagrams consist of three parts. The first part is due to deformation annealing, the second part is associated with work-hardening and the third one is connected with formation of an oriented structure. On the basis of the structure changes a molecular theory of deformation is suggested.

  3. NMR Methods to Study Dynamic Allostery

    PubMed Central

    Grutsch, Sarina; Brüschweiler, Sven; Tollinger, Martin

    2016-01-01

    Nuclear magnetic resonance (NMR) spectroscopy provides a unique toolbox of experimental probes for studying dynamic processes on a wide range of timescales, ranging from picoseconds to milliseconds and beyond. Along with NMR hardware developments, recent methodological advancements have enabled the characterization of allosteric proteins at unprecedented detail, revealing intriguing aspects of allosteric mechanisms and increasing the proportion of the conformational ensemble that can be observed by experiment. Here, we present an overview of NMR spectroscopic methods for characterizing equilibrium fluctuations in free and bound states of allosteric proteins that have been most influential in the field. By combining NMR experimental approaches with molecular simulations, atomistic-level descriptions of the mechanisms by which allosteric phenomena take place are now within reach. PMID:26964042

  4. [Prostaglandin F2 alpha and renal hypertension].

    PubMed

    Milanov, S; Belovezhdov, N; Milkov, V; Gurev, I; Kiperova, B

    1981-01-01

    The values of PGf2 alpha were studied in 20 renal patients with renal hypertension, with and without chronic renal insufficiency via a radioimmunologic method. A control group of 10 healthy volunteers wer used without data from arterial hypertension. Values (672.0 +/- 99.5 pg/ml), being, with statistically significant difference, increased as compared with the healthy volunteers (347.13 +/- 49.9 pg/ml) were found in renal patients with chronic renal insufficiency. With the advancement of CRI in patients with renal hypertension, PG concentration was also increased (505.5 +/- 77.6 pg/ml) but it was not significant as in the patients without CRI. The elevated values of PGF2+ alpha suggest their participation in the pathogenesis of renal hypertension. PMID:6950590

  5. Renal amyloidosis. Evaluation by gallium imaging

    SciTech Connect

    Lee, V.W.; Skinner, M.; Cohen, A.S.; Ngai, S.; Peng, T.T.

    1986-09-01

    A study has been performed to evaluate the efficacy of gallium imaging in the detection of renal amyloidosis. Ten of the 11 patients who had biopsy-proven renal amyloidosis demonstrated marked uptake in both kidneys. One patient revealed moderate gallium uptake in his kidneys. None of the patients had underlying renal or extrarenal pathology other than amyloidosis, which could account for renal gallium uptake (renal infection, neoplasm, hepatic failure or frequent blood transfusions). Four patients also had extrarenal foci of abnormal gallium uptake, suggesting other sites of amyloid deposits. Our data strongly suggest that gallium imaging has a high sensitivity for detection of renal amyloidosis. Its specificity is enhanced significantly by careful review of the clinical history to exclude other known causes of renal gallium uptake. Potentially, gallium imaging may be used to monitor the progress of patients under experimental therapy.

  6. Brain Default Mode Network Changes after Renal Transplantation: A Diffusion-Tensor Imaging and Resting-State Functional MR Imaging Study.

    PubMed

    Zhang, Long Jiang; Wen, Jiqiu; Liang, Xue; Qi, Rongfeng; Schoepf, U Joseph; Wichmann, Julian L; Milliken, Cole M; Chen, Hui Juan; Kong, Xiang; Lu, Guang Ming

    2016-02-01

    Purpose To investigate structural and functional alterations of the default mode network (DMN) in the brain after renal transplantation in patients with end-stage renal disease by using diffusion-tensor imaging and resting-state functional MR imaging. Materials and Methods This prospective study was approved by the local medical research ethics committee, and written informed consent was obtained. Twenty-one patients with end-stage renal disease (15 men, six women; mean age standard deviation, 32 years 9.5) who were scheduled to undergo renal transplantation and 21 healthy control subjects (15 men, six women; mean age, 31 years 6.5) were included. Diffusion-tensor imaging and resting-state functional MR imaging were performed in all subjects. Patients were imaged both before and 1 month after renal transplantation. Structural (mean diffusivity, fractional anisotropy, path length, and number of tracts derived from diffusion-tensor imaging tractography) and functional (temporal correlation coefficient derived from resting-state functional MR imaging) connectivity of the DMN were quantitatively compared with two-sample t tests or paired t tests. Intergroup correlation analysis was performed to compare structural or functional indexes and results of neuropsychological or blood biochemistry tests. Results Mean diffusivity was decreased in the fiber bundles connecting the posterior cingulate cortex and the precuneus to the bilateral inferior parietal lobules in patients after renal transplantation compared with that in patients before transplantation (P < .05). Temporal correlation coefficients for patients after renal transplantation nearly reached the levels of those for control subjects (all, P > .05). The change in mean diffusivity of the fiber bundles connecting the posterior cingulate cortex and the precuneus to the right inferior parietal lobule positively correlated with the change in hematocrit levels (r = 0.522, P = .015), the change in temporal correlation coefficients between the posterior cingulate cortex or precuneus and left or right inferior parietal lobules correlated with changes in number connection test type A scores (r = -0.549, P = .010) and digit symbol test scores (r = 0.533, P = .013). Conclusion Functional connectivity changes in the DMN, which were associated with improved hematocrit levels and cognitive function, may recover earlier than structural connectivity changes do 1 month after renal transplantation. () RSNA, 2015 Online supplemental material is available for this article. PMID:26200603

  7. Isolated Spontaneous Renal Artery Dissection Presented with Flank Pain

    PubMed Central

    Gandhi, Shruti P.; Patel, Kajal; Pal, Bipin C.

    2015-01-01

    Spontaneous renal artery dissection is a rare but important cause of flank pain. We report a case of isolated spontaneous renal artery dissection in 56-year-old man complicated by renal infarction presented with flank pain. Doppler study pointed towards vascular pathology. Computed tomography (CT) angiography was used to make final diagnosis which demonstrated intimal flap in main renal artery with renal infarction. PMID:26090259

  8. Stereophotogrammetry in studies of riparian vegetation dynamics

    NASA Astrophysics Data System (ADS)

    Hortobagyi, Borbala; Vautier, Franck; Corenblit, Dov; Steiger, Johannes

    2014-05-01

    Riparian vegetation responds to hydrogeomorphic disturbances and also controls sediment deposition and erosion. Spatio-temporal riparian vegetation dynamics within fluvial corridors have been quantified in many studies using aerial photographs and GIS. However, this approach does not allow the consideration of woody vegetation growth rates (i.e. vertical dimension) which are fundamental when studying feedbacks between the processes of fluvial landform construction and vegetation establishment and succession. We built 3D photogrammetric models of vegetation height based on aerial argentic and digital photographs from sites of the Allier and Garonne Rivers (France). The models were realized at two different spatial scales and with two different methods. The "large" scale corresponds to the reach of the river corridor on the Allier river (photograph taken in 2009) and the "small" scale to river bars of the Allier (photographs taken in 2002, 2009) and Garonne Rivers (photographs taken in 2000, 2002, 2006 and 2010). At the corridor scale, we generated vegetation height models using an automatic procedure. This method is fast but can only be used with digital photographs. At the bar scale, we constructed the models manually using a 3D visualization on the screen. This technique showed good results for digital and also argentic photographs but is very time-consuming. A diachronic study was performed in order to investigate vegetation succession by distinguishing three different classes according to the vegetation height: herbs (<1 m), shrubs (1-4 m) or trees (>4 m). Both methods, i.e. automatic and manual, were employed to study the evolution of the three vegetation classes and the recruitment of new vegetation patches. A comparison was conducted between the vegetation height given by models (automatic and manual) and the vegetation height measured in the field. The manually produced models (small scale) were of a precision of 0.5-1 m, allowing the quantification of woody vegetation growth rates. Thus, our results show that the manual method we developed is accurate to quantify vegetation growth rates at small scales, whereas the less accurate automatic method is appropriate to study vegetation succession at the corridor scale. Both methods are complementary and will contribute to a further exploration of the mutual relationships between hydrogeomorphic processes, topography and vegetation dynamics within alluvial systems, adding the quantification of the vertical dimension of riparian vegetation to their spatio-temporal characteristics.

  9. Cordyceps sinensis attenuates renal fibrosis and suppresses BAG3 induction in obstructed rat kidney

    PubMed Central

    Du, Feng; Li, Si; Wang, Tian; Zhang, Hai-Yan; Zong, Zhi-Hong; Du, Zhen-Xian; Li, De-Tian; Wang, Hua-Qin; Liu, Bo; Miao, Jia-Ning; Bian, Xiao-Hui

    2015-01-01

    BAG3 regulates a number of cellular processes, including cell proliferation, apoptosis, adhesion and migration, and epithelial-mesenchymal transition (EMT). However, the role of BAG3 in renal tubular EMT and renal interstitial fibrosis remains elusive. This study aimed to examine the dynamic expression of BAG3 during renal fibrosis, and to investigate the efficacy of Cordyceps sinensis (C. sinensis) on renal fibrosis. A rat model of unilateral ureteral obstruction (UUO) was established, and the expression of BAG3 and ?-SMA, and the efficacy of C. sinensis on renal fibrosis induced by UUO were examined. The results showed that UUO led to collagen accumulation, which was significantly suppressed by C. sinensis. UUO increased the expression of BAG3 and ?-SMA, a mesenchymal marker, while UUO induced BAG3 and ?-SMA expression was significantly inhibited by C. sinensis. In addition, immunohistochemical staining demonstrated that BAG3 immunoreactivity was restricted to tubular epithelium. In conclusion, BAG3 is a potential target for the prevention and/or treatment of renal fibrosis, and C. Sinensis is a promising agent for renal fibrosis. PMID:26175854

  10. Cordyceps sinensis attenuates renal fibrosis and suppresses BAG3 induction in obstructed rat kidney.

    PubMed

    Du, Feng; Li, Si; Wang, Tian; Zhang, Hai-Yan; Zong, Zhi-Hong; Du, Zhen-Xian; Li, De-Tian; Wang, Hua-Qin; Liu, Bo; Miao, Jia-Ning; Bian, Xiao-Hui

    2015-01-01

    BAG3 regulates a number of cellular processes, including cell proliferation, apoptosis, adhesion and migration, and epithelial-mesenchymal transition (EMT). However, the role of BAG3 in renal tubular EMT and renal interstitial fibrosis remains elusive. This study aimed to examine the dynamic expression of BAG3 during renal fibrosis, and to investigate the efficacy of Cordyceps sinensis (C. sinensis) on renal fibrosis. A rat model of unilateral ureteral obstruction (UUO) was established, and the expression of BAG3 and ?-SMA, and the efficacy of C. sinensis on renal fibrosis induced by UUO were examined. The results showed that UUO led to collagen accumulation, which was significantly suppressed by C. sinensis. UUO increased the expression of BAG3 and ?-SMA, a mesenchymal marker, while UUO induced BAG3 and ?-SMA expression was significantly inhibited by C. sinensis. In addition, immunohistochemical staining demonstrated that BAG3 immunoreactivity was restricted to tubular epithelium. In conclusion, BAG3 is a potential target for the prevention and/or treatment of renal fibrosis, and C. Sinensis is a promising agent for renal fibrosis. PMID:26175854

  11. Molecular Dynamics Study of Helicobacter pylori Urease

    PubMed Central

    2015-01-01

    Helicobacter pylori have been implicated in an array of gastrointestinal disorders including, but not limited to, gastric and duodenal ulcers and adenocarcinoma. This bacterium utilizes an enzyme, urease, to produce copious amounts of ammonia through urea hydrolysis in order to survive the harsh acidic conditions of the stomach. Molecular dynamics (MD) studies on the H. pylori urease enzyme have been employed in order to study structural features of this enzyme that may shed light on the hydrolysis mechanism. A total of 400 ns of MD simulation time were collected and analyzed in this study. A wide-open flap state previously observed in MD simulations on Klebsiella aerogenes [Roberts et al. J. Am. Chem. Soc.2012, 134, 9934] urease has been identified in the H. pylori enzyme that has yet to be experimentally observed. Critical distances between residues on the flap, contact points in the closed state, and the separation between the active site Ni2+ ions and the critical histidine ?322 residue were used to characterize flap motion. An additional flap in the active site was elaborated upon that we postulate may serve as an exit conduit for hydrolysis products. Finally we discuss the internal hollow cavity and present analysis of the distribution of sodium ions over the course of the simulation. PMID:24839409

  12. A two-yr prospective study of bone health in children after renal transplantation employing two imaging techniques.

    PubMed

    Christoforidis, Athanasios; Printza, Nikoleta; Gkogka, Chrysa; Kazantzidou, Eirini; Papachristou, Fotios

    2013-01-01

    The aim of this study was to prospectively and longitudinally evaluate bone properties with the use of two bone imaging techniques (dual energy X-ray absorptiometry [DXA], and quantitative ultraSonography [QUS]) in pediatric renal transplant recipients. Fourteen patients (eight boys and six girls) with a mean age of 12.25 3.11 yr (range: 8-17.5 yr) completed a two-yr follow-up. Measurements of bone mineral density (BMD) by DXA at lumbar spine and hip and speed of sound (SOS) by QUS at radius and tibia were performed at the beginning and at the end of the study. A significant improvement in mean Z-score of SOS values measured at tibia (1.01 1.31 vs. -0.46 1.14, p = 0.005) was observed. On the contrary, mean Z-score of BMD values measured at femoral neck was significantly reduced (-1.95 2.15 vs. -0.33 1.13, p = 0.041). Finally, multivariate stepwise regression analyses showed that glomerular filtration rate at the beginning of the study was the best predictor of the difference in BMD Z-scores measured at lumbar spine. Additionally, values of intact parathormone (iPTH) at the beginning of the study and the change in iPTH throughout the study predicted the 72.3% of the difference in Z-score of SOS measured at radius with an inverse relationship. PMID:24033832

  13. The role of Wnt/beta-catenin signaling in renal carcinogenesis: lessons from cadmium toxicity studies.

    PubMed

    Thvenod, F; Chakraborty, P K

    2010-06-01

    Wnt/beta-catenin signaling plays a crucial role during embryogenesis. However, this signaling pathway also plays a role in normal adult tissues and in carcinogenesis, including cadmium (Cd2+) induced nephrocarcinogenesis, which is the topic of this review. Wnt/beta-catenin signaling is tightly regulated in mature epithelia to balance cell proliferation, differentiation and death. This is accomplished by modulating phosphorylation of the multifunctional protein beta-catenin which in turn determines its preference for a particular fate, i.e. cell-cell adhesion by binding to E-cadherin, proteasomal degradation, or co-activation of the transcription factor Tcf/Lef. The pivotal role of beta-catenin is not limited to Wnt signaling, but can be challenged by other transcription factors under stress conditions (e.g. FOXO, HIF-1alpha, NF-kappaB, c-jun), where beta-catenin acts as a molecular switch in response to the cellular redox status. Aberrant Wnt/beta-catenin signaling can contribute to carcinogenesis of intestinal, lung or kidney epithelia, either by mutations of its signaling components and/or disruption of linked signaling networks. The nephrotoxic metal Cd2+ causes renal cancer in humans. Because it is not genotoxic Cd2+ is thought to induce mutations and carcinomas indirectly: Possible mechanisms include oxidative stress, inhibition of DNA repair, aberrant gene expression, deregulation of cell proliferation, resistance to apoptosis, and/or disruption of cell adhesion. Wnt signaling may contribute to Cd2+ carcinogenesis because Cd2+ disrupts the junctional E-cadherin/beta-catenin complex, resulting in excessive nuclear translocation of beta-catenin and activation of Tcf4. Up-regulation of target genes of the beta-catenin/Tcf4 complex, such as c-myc, cyclin D1 and the multidrug transporter P-glycoprotein (MDR1/ABCB1), leads to increased proliferation, evasion of apoptosis, adaptation to Cd2+ toxicity and thereby promotes the selection of mutated and pre-neoplastic cells. PMID:20455852

  14. Systems-Dynamic Analysis for Neighborhood Study

    EPA Science Inventory

    Systems-dynamic analysis (or system dynamics (SD)) helps planners identify interrelated impacts of transportation and land-use policies on neighborhood-scale economic outcomes for households and businesses, among other applications. This form of analysis can show benefits and tr...

  15. Studying Atomic Dynamics with Designer Pulses

    SciTech Connect

    Reinhold, C.O.; Burgdorfer, J.; Frey, M.T.; Dunning, F.B.

    1997-09-01

    We present a brief review of recent experimental and theoretical progress on the dynamics of Rydberg atoms using short half cycle pulses. We discuss new possibilities in coherent control and non-linear dynamics of atoms which have lately become possible using various superpositions of such pulses.

  16. Long term prognosis of acute coronary syndrome with chronic renal dysfunction treated in different therapy units at department of cardiology: a retrospective cohort study

    PubMed Central

    Fu, Cong; Sheng, Zulong; Yao, Yuyu; Wang, Xin; Yu, Chaojun; Ma, Genshan

    2015-01-01

    Coronary care unit is common in hospitals and clinical centers which offer intensive care and therapy for severe coronary artery disease patients. However, if coronary care unit could improve the long term prognosis of acute coronary syndrome patients with renal dysfunction remain unknown. Accordingly, we designed this study to evaluate the differences of incidence of major adverse cardiovascular events for acute coronary syndromes patients with renal dysfunction who treated in coronary care unit or normal unit. The primary end point was all cause mortality. A total of 414 acute coronary syndromes patients with renal dysfunction involved in the study. The results showed that during 12-48 months follow-up, death of any cause occurred in 1.8% patients (4 of 247) in coronary care unit group, as compared with 1.8% in the normal group (3 of 167) (hazard ratio, 1.098; 95% confidence interval, 0.246 to 4.904; P=0.903). Kaplan-Meier survival analysis showed that there were no significant differences between the two groups with respect to the risk of death (P=0.903), revascularization (P=0.948), stroke (P=0.542), heart failure (P=0.198). This trial firstly revealed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit and normal units. Our study showed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit obtained no significant benefits compared with patients in normal units, although there was a declining tendency of the risk of major adverse cardiovascular effectswith patients in coronary care unit.

  17. Persistent High Serum Bicarbonate and the Risk of Heart Failure in Patients With Chronic Kidney Disease (CKD): A Report From the Chronic Renal Insufficiency Cohort (CRIC) Study

    PubMed Central

    Dobre, Mirela; Yang, Wei; Pan, Qiang; Appel, Lawrence; Bellovich, Keith; Chen, Jing; Feldman, Harold; Fischer, Michael J.; Ham, L. L.; Hostetter, Thomas; Jaar, Bernard G.; Kallem, Radhakrishna R.; Rosas, Sylvia E.; Scialla, Julia J.; Wolf, Myles; Rahman, Mahboob

    2015-01-01

    Background Serum bicarbonate varies over time in chronic kidney disease (CKD) patients, and this variability may portend poor cardiovascular outcomes. The aim of this study was to conduct a time?updated longitudinal analysis to evaluate the association of serum bicarbonate with long?term clinical outcomes: heart failure, atherosclerotic events, renal events (halving of estimated glomerular filtration rate [eGFR] or end?stage renal disease), and mortality. Methods and Results Serum bicarbonate was measured annually, in 3586 participants with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Marginal structural models were created to allow for integration of all available bicarbonate measurements and proper adjustment for time?dependent confounding. During the 6 years follow?up, 512 participants developed congestive heart failure (26/1000 person?years) and 749 developed renal events (37/1000 person?years). The risk of heart failure and death was significantly higher for participants who maintained serum bicarbonate >26 mmol/L for the entire duration of follow?up (hazard ratio [HR] 1.66; 95% confidence interval [CI], 1.23 to 2.23, and HR 1.36, 95% CI 1.02 to 1.82, respectively) compared with participants who kept their bicarbonate 22 to 26 mmol/L, after adjusting for demographics, co?morbidities, medications including diuretics, eGFR, and proteinuria. Participants who maintained serum bicarbonate <22 mmol/L had almost a 2?fold increased risk of renal disease progression (HR 1.97; 95% CI, 1.50 to 2.57) compared with participants with bicarbonate 22 to 26 mmol/L. Conclusion In this large CKD cohort, persistent serum bicarbonate >26 mmol/L was associated with increased risk of heart failure events and mortality. Further studies are needed to determine the optimal range of serum bicarbonate in CKD to prevent adverse clinical outcomes. PMID:25896890

  18. Specificity of brachyury in the distinction of chordoma from clear cell renal cell carcinoma and germ cell tumors: a study of 305 cases.

    PubMed

    Sangoi, Ankur R; Karamchandani, Jason; Lane, Brooke; Higgins, John P; Rouse, Robert V; Brooks, James D; McKenney, Jesse K

    2011-03-01

    Brachyury is recognized as a specific marker for notochord-derived tissues and neoplasms, and has become a defining immunohistochemical feature of chordoma. The main differential diagnostic consideration for chordoma is chondrosarcoma, which is known to lack brachyury expression. However, within the spectrum of genitourinary neoplasia, metastatic germ cell tumors and clear cell renal cell carcinoma may also be close morphological mimics of chordoma, particularly given the increasing prevalence of small tissue samples from image-guided biopsies. Although immunoreactivity for brachyury has been reported in a few germ cell tumors, a thorough characterization of staining by specific subtype has not been performed in a large series. Additionally, brachyury expression in clear cell renal cell carcinoma has not been well studied. In this study, immunohistochemical expression with the brachyury antibody was evaluated in 111 germ cell tumors, 30 non-neoplastic and neoplastic (non-germ cell) testicular tissues, and 184 metastatic clear cell renal cell carcinomas using tissue microarray technology. In addition, immunoreactivity for PAX-8 and SALL-4 was evaluated in 12 chordomas on whole section. No nuclear brachyury expression was identified in any of the 101 germ cell tumors within the tissue microarray (including choriocarcinoma (1), embryonal carcinoma (20), intratubular germ cell neoplasia unclassified (2), seminoma (64), spermatocytic seminoma (1), teratoma (5) and yolk sac tumor (8)), in any of the 30 non-neoplastic and neoplastic (non-germ cell) testicular tissues, or in any of the 10 whole-section seminomas. All 184 metastatic clear cell renal cell carcinomas were also non-reactive for brachyury. All 12 chordomas showed strong nuclear immunoreactivity for brachyury, but no expression of SALL-4. In all, 1 of 12 chordoma cases showed patchy, 1+ nuclear immunoreactivity for PAX-8. This study confirms the specificity of brachyury for chordoma in the differential diagnostic distinction from the potential genitourinary mimics, germ cell tumors and metastatic clear cell renal cell carcinoma. PMID:21102418

  19. Molecular dynamics studies on nanoscale gas transport

    NASA Astrophysics Data System (ADS)

    Barisik, Murat

    Three-dimensional molecular dynamics (MD) simulations of nanoscale gas flows are studied to reveal surface effects. A smart wall model that drastically reduces the memory requirements of MD simulations for gas flows is introduced. The smart wall molecular dynamics (SWMD) represents three-dimensional FCC walls using only 74 wall Molecules. This structure is kept in the memory and utilized for each gas molecule surface collision. Using SWMD, fluid behavior within nano-scale confinements is studied for argon in dilute gas, dense gas, and liquid states. Equilibrium MD method is employed to resolve the density and stress variations within the static fluid. Normal stress calculations are based on the Irving-Kirkwood method, which divides the stress tensor into its kinetic and virial parts. The kinetic component recovers pressure based on the ideal gas law. The particle-particle virial increases with increased density, while the surface-particle virial develops due to the surface force field effects. Normal stresses within nano-scale confinements show anisotropy induced primarily by the surface force-field and local variations in the fluid density near the surfaces. For dilute and dense gas cases, surface-force field that extends typically 1nm from each wall induces anisotropic normal stress. For liquid case, this effect is further amplified by the density fluctuations that extend beyond the three field penetration region. Outside the wall force-field penetration and density fluctuation regions the normal stress becomes isotropic and recovers the thermodynamic pressure, provided that sufficiently large force cut-off distances are utilized in the computations. Next, non-equilibrium SWMD is utilized to investigate the surface-gas interaction effects on nanoscale shear-driven gas flows in the transition and free molecular flow regimes. For the specified surface properties and gas-surface pair interactions, density and stress profiles exhibit a universal behavior inside the wall force penetration region at different flow conditions. Shear stress results are utilized to calculate the tangential momentum accommodation coefficient (TMAC) between argon gas and FCC walls. The TMAC value is shown to he independent of the now properties and Knudsen number in all simulations. Velocity profiles show distinct deviations from the kinetic theory based solutions inside the wall force penetration depth, while they match the linearized Boltzmann equation solution outside these zones. Afterwards, surface effects are studied as a function of the surface-gas potential strength ratio (epsilon wf/epsilonff) for the shear driven argon gas flows in the early transition and tree molecular flow regimes. Results show that increased epsilonwf/epsilon ff results in increased gas density, leading towards monolayer adsorption on surfaces. The near wall velocity profile shows reduced gas slip, and eventually velocity stick with increased epsilonwf/epsilon ff. Similarly, using MD predicted shear stress values and kinetic theory, TMAC are calculated as a function of epsilonwf/epsilon ff and TMAC values are shown to be independent of the Knudsen number. Results indicate emergence of the wall force field penetration depth as an additional length scale for gas flows in nano-channels, breaking the dynamic similarity between rarefied and nano-scale gas flows solely based on the Knudsen and Mach numbers.

  20. Functional MRI techniques demonstrate early vascular changes in renal cell cancer patients treated with sunitinib: a pilot study

    PubMed Central

    ter Voert, E.G.W.; Hambrock, Th.; van Asten, J.J.A.; van Spronsen, D.J.; Mulders, P.F.A.; Heerschap, A.; van der Graaf, W.T.A.; van Laarhoven, H.W.M.; van Herpen, C.M.L.

    2011-01-01

    Abstract Objective: To assess the early vascular effects of sunitinib in patients with renal cell carcinoma (RCC) with diffusion-weighted magnetic resonance imaging (DWI), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and T2* perfusion MRI. Patients and methods: In 10 patients with abdominal RCC lesions, DWI, DCE-MRI and T2* perfusion MRI measurements at 3 Tesla were performed at baseline, 3 and 10 days after start of sunitinib. VEGF-A plasma levels were measured on days 0, 3 and 10. Results: DWI showed a significant increase in the apparent diffusion coefficient (10?6?s/mm2) from baseline (mean 1158, range 8142003) to day 3 (mean 1306, range 10082097, P?=?0.015) followed by a decrease to baseline levels at day 10 (mean 1132, range 7192005, P?=?0.001). No significant changes were found in mean DCE-MRI parameters. T2* perfusion MRI showed a significant decrease in relative tumor blood volume (rBV) and relative tumor blood flow (rBF) at day 3 (rBV P?=?0.037, rBF P?=?0.018) and day 10 (rBV P?=?0.006, rBF P?=?0.009). VEGF-A plasma levels significantly increased after 10 days, but did not correlate with MRI parameters. Conclusions: Sunitinib induces antiangiogenic effects as measured by DWI and T2*-perfusion MRI, 3 and 10 days after the start of the initial treatment. DCE-MRI did not show significant changes. In the near future, early functional MRI-based evaluation can play an important role in tailoring treatment to the individual patient with RCC. Further investigation is warranted. PMID:22245974

  1. Metoclopramide and renal vascular resistance.

    PubMed

    Manara, A R; Bolsin, S; Monk, C R; Hartnell, G; Harris, R A

    1991-01-01

    We have studied the effect of i.v. metoclopramide on renal vascular resistance in nine healthy volunteers. Peak systolic and end-diastolic frequencies were measured using duplex Doppler ultrasound of a renal interlobar artery, before and after the administration of i.v. metoclopramide 10 mg, and the resistance index derived. There was no significant change in mean arterial pressure or resistance index following metoclopramide. PMID:1997046

  2. Thyroid function modifies the association between ratio of triglyceride to high-density lipoprotein cholesterol and renal function: a multicenter cross-sectional study.

    PubMed

    Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun

    2015-01-01

    Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P?renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism. PMID:26179571

  3. Metabonomics study of the acute graft rejection in rat renal transplantation using reversed-phase liquid chromatography and hydrophilic interaction chromatography coupled with mass spectrometry.

    PubMed

    Chen, Jihong; Wen, Hao; Liu, Jian; Yu, Che; Zhao, Xinjie; Shi, Xianzhe; Xu, Guowang

    2012-03-01

    Acute graft rejection is one of the most common and serious post complications in renal transplantation, noninvasive diagnosis of acute graft rejection is essential for reducing risk of surgery and timely treatment. In this study, a non-targeted metabonomics approach based on ultra performance liquid chromatography (UPLC) coupled with quadrupole time-of-flight mass spectrometry (MS) is used to investigate the effect of acute graft rejection in rat renal transplantation on metabolism. To collect more metabolite information both hydrophilic interaction chromatography and reversed-phase liquid chromatography were used. Using the partial least squares-discriminant analysis, we found that the change of metabonome in a sham-operated group and a non-graft rejection group had a similar trend, while that of the acute graft rejection group was clearly different. Several discriminating metabolites of the acute graft rejection were identified, including creatinine, phosphatidyl-cholines, lyso-phosphatidylcholines, carnitine C16:0, free fatty acids and indoxyl sulfate etc. These discriminating metabolites suggested that acute graft rejection in renal transplantation can lead to the accumulation of creatinine in the body, and also the abnormal metabolism of phospholipids. These findings are useful to understand the mechanisms of the rejection, it also means that a UPLC-MS metabonomic approach is a suitable tool to investigate the metabolic abnormality in the acute graft rejection in renal transplantation. PMID:22237823

  4. A Transgenic Mouse Model for Studying the Role of the Parathyroid Hormone-Related Protein System in Renal Injury

    PubMed Central

    Bosch, Ricardo J.; Ortega, Arantxa; Izquierdo, Adriana; Arribas, Ignacio; Bover, Jordi; Esbrit, Pedro

    2011-01-01

    Parathyroid hormone- (PTH-) related protein (PTHrP) and its receptor, the PTH1 receptor (PTH1R), are widely expressed in the kidney, where PTHrP exerts a modulatory action on renal function. PTHrP is known to be upregulated in several experimental nephropathies such as acute renal failure (ARF), obstructive nephropathy (ON) as well as diabetic nephropathy (DN). In this paper, we will discuss the functional consequences of chronic PTHrP overexpression in the damaged kidney using a transgenic mouse strain overexpressing PTHrP in the renal proximal tubule. In both ARF and ON, PTHrP displays proinflammatory and profibrogenic actions including the induction of epithelia to mesenquima transition. Moreover, PTHrP participates in the mechanisms of renal hypertrophy as well as proteinuria in experimental DN. Angiotensin II (Ang II), a critical factor in the progression of renal injury, appears to be, at least in part, responsible for endogenous PTHrP upregulation in these pathophysiological settings. These findings provide novel insights into the well-known protective effects of Ang II antagonists in renal diseases, paving the way for new therapeutic approaches. PMID:21052497

  5. Effect of severe renal impairment on umeclidinium and umeclidinium/vilanterol pharmacokinetics and safety: a single-blind, nonrandomized study

    PubMed Central

    Mehta, Rashmi; Hardes, Kelly; Brealey, Noushin; Tombs, Lee; Preece, Andrew; Kelleher, Dennis

    2015-01-01

    Background Umeclidinium and vilanterol, long-acting bronchodilators for the treatment of chronic obstructive pulmonary disease, are primarily eliminated via the hepatic route; however, severe renal impairment may adversely affect some elimination pathways other than the kidney. Objectives To evaluate the effect of severe renal impairment on the pharmacokinetics of umeclidinium and umeclidinium/vilanterol. Methods Nine patients with severe renal impairment (creatinine clearance <30 mL/min) and nine matched healthy volunteers received a single dose of umeclidinium 125 ?g; and after a 7- to 14-day washout, a single dose of umeclidinium/vilanterol 125/25 ?g. Results No clinically relevant increases in plasma umeclidinium or vilanterol systemic exposure (area under the curve or maximum observed plasma concentration) were observed following umeclidinium 125 ?g or umeclidinium/vilanterol 125/25 ?g administration. On average, the amount of umeclidinium excreted in 24 hours in urine (90% confidence interval) was 88% (81%93%) and 89% (81%93%) lower in patients with severe renal impairment compared with healthy volunteers following umeclidinium 125 ?g and umeclidinium/vilanterol 125/25 ?g administration, respectively. Treatments were well tolerated in both populations. Conclusion Umeclidinium 125 ?g or umeclidinium/vilanterol 125/25 ?g administration to patients with severe renal impairment did not demonstrate clinically relevant increases in systemic exposure compared with healthy volunteers. No dose adjustment for umeclidinium and umeclidinium/vilanterol is warranted in patients with severe renal impairment. PMID:25565796

  6. Animal Models to Study Links between Cardiovascular Disease and Renal Failure and Their Relevance to Human Pathology

    PubMed Central

    Hewitson, Tim D.; Holt, Stephen G.; Smith, Edward R.

    2015-01-01

    The close association between cardiovascular pathology and renal dysfunction is well documented and significant. Patients with conventional risk factors for cardiovascular disease like diabetes and hypertension also suffer renal dysfunction. This is unsurprising if the kidney is simply regarded as a “modified blood vessel” and thus, traditional risk factors will affect both systems. Consistent with this, it is relatively easy to comprehend how patients with either sudden or gradual cardiac and or vascular compromise have changes in both renal hemodynamic and regulatory systems. However, patients with pure or primary renal dysfunction also have metabolic changes (e.g., oxidant stress, inflammation, nitric oxide, or endocrine changes) that affect the cardiovascular system. Thus, cardiovascular and renal systems are intimately, bidirectionally and inextricably linked. Whilst we understand several of these links, some of the mechanisms for these connections remain incompletely explained. Animal models of cardiovascular and renal disease allow us to explore such mechanisms, and more importantly, potential therapeutic strategies. In this article, we review various experimental models used, and examine critically how representative they are of the human condition. PMID:26441970

  7. Improvement in late renal allograft survival between 1990 and 2002 in Spain: results from a multicentre case-control study.

    PubMed

    Moreso, Francesc; Alonso, Angel; Gentil, Miguel A; Gonzlez-Molina, Miguel; Capdevila, Lluis; Marcn, Roberto; Pascual, Julio; Sern, Daniel

    2010-09-01

    Epidemiological studies have failed to show an improvement in graft survival beyond 1 year after kidney transplantation possibly because of an increased number of expanded donors and older recipients. Thus, we performed a case-control study matching patients transplanted in different eras by donor and recipient characteristics. We considered renal transplant recipients included in the database of the Spanish Chronic Allograft Dysfunction Study Group in 1990, 1994, 1998 and 2002 (n = 4842). We matched patients from these cohorts considering the following variables: donor and recipient age, cause of donor death, hepatitis C virus, panel reactive antibodies and re-transplantation. We identified a total of 896 patients distributed in four cohorts of 224 matched patients. Between 1990 and 2002, the use of cyclosporin decreased (96%, 94%, 80% and 23% respectively, P = 0.001), while the use of tacrolimus increased (0%, 1%, 15% and 63% respectively, P = 0.001) and the prevalence of acute rejection decreased (46%, 37.9%, 20.6% and 15.8% respectively, P < 0.001). One-year serum creatinine was 1.63 +/- 0.66, 1.64 +/- 0.70, 1.44 +/- 0.52 and 1.38 +/- 0.75 respectively, P = 0.001. Graft survival beyond the first year between 1990 and 2002 significantly improved while patient survival did not. Transplant outcome has improved between 1990 and 2002 when donors and recipients of similar characteristics are compared. PMID:20230537

  8. Cell proliferation and renal carcinogenesis.

    PubMed Central

    Short, B G

    1993-01-01

    Enhanced cell proliferation occurs at several stages of renal tumorigenesis. Initiation by genotoxic nephrocarcinogens such as dimethylnitrosamine (DMN) is likely a result of DNA damage coupled with an initial burst of DNA synthesis associated with the cytotoxic effects of the compound. The level of initiation by DMN can be further enhanced by unilateral nephrectomy or hydronephrosis, which induces a brief burst of cell proliferation followed by tumorigenesis in the contralateral kidney. The role of sustained cell proliferation in renal tumor development is less well understood. The most compelling evidence comes from studies with nongenotoxic renal carcinogens such as unleaded gasoline and d-limonene, which induce alpha 2u-globulin (alpha G) nephropathy and renal epithelial tumors exclusively in male rats. Sustained increases in cell proliferation in these studies depend on the presence of a chemical-alpha G complex in phagolysosomes of P2 proximal tubule cells, which results in cytotoxicity and compensatory hyperplasia only in male F344 rats, but not female F344 rats or alpha G deficient male NBR rats. Furthermore, initiation-promotion experiments demonstrated a strong correlation between the dose-response of cell proliferation and the incidence of preneoplastic and neoplastic lesions. Clearly, similar correlative studies with a number of other renal carcinogens and non-carcinogens are warranted before general conclusions can be made. Cell proliferation is excessively elevated in tubules affected by chronic progressive nephropathy, but the significance of the lesion to renal carcinogenesis is unclear. Elucidating mechanisms of renal cell proliferation are necessary for our understanding of cause and effect relationships. An exciting recent finding is altered expression of transforming growth factor-alpha in hereditary rat renal cell carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7516872

  9. [Multiple myeloma and renal impairment].

    PubMed

    Takahashi, Naoto

    2015-01-01

    Renal impairment (RI) is a common complication and it impacts on a survival of patients with systemic multiple myeloma (MM). In a cohort study in Akita, about 20-26% patients with MM showed RI at diagnosis and it was independently associated with overall survival. Cast nephropathy, amyloidosis, and monoclonal immunoglobulin deposition disease (Randall type) are known as three pathological findings of kidney in MM patients with RI. Recently, the term monoclonal gammopathy of renal significance (MGRS) was proposed because of a causal relationship between the monoclonal gammopathy and the renal damage. Bortezomib-based regimens may improve renal function in the majority of MM patients with RI. We discussed an epidemiology, clinic-pathological findings and treatments of MM with RI in this review. PMID:25626301

  10. Fluorescence spectroscopic studies of DNA dynamics

    SciTech Connect

    Scalettar, B.A.

    1987-04-01

    Random solvent induced motions of DNA are manifest as nanosecond torsional oscillations of the helix backbone, nanosecond through millisecond bending deformations and overall rotational and translational diffusion of the polymer. Fluorescence spectroscopy is used to study this spectrum of DNA motions while ethidium monoazide was covalently bounded. The steady state fluorescence depolarization data indicate that the covalent monoazide/DNA complex exhibits internal motions characterized by an average angular amplitude of 26 degrees confirming reports of fast torsional oscillations in noncovalent ethidium bromide/DNA systems. Data obtained by use of a new polarized photobleaching recovery technique (FPR) reflect both the rotational dynamics of the polymer and the reversible photochemistry of the dye. To isolate the reorientational motion of the DNA, the FPR experiments were ran in two modes that differ only in the polarization of the bleaching light. A quotient function constructed from the data obtained in these two modes monitors only the rotational component of the FPR recovery. In specific applications those bending deformations of long DNA molecules that have characteristic relaxation times on the order of 100 microseconds have been resolved. A fluorescence correlation technique that relates fluctuations in particle number to center-of-mass motion was used to measure translational diffusion on coefficients of the plasmid PBR322 and a short oligomeric DNA. A theory that describes angular correlation in systems exhibiting cyclic, biologically directed reorientation and random Brownian rotation is developed.

  11. Dynamics of crowd disasters: an empirical study.

    PubMed

    Helbing, Dirk; Johansson, Anders; Al-Abideen, Habib Zein

    2007-04-01

    Many observations of the dynamics of pedestrian crowds, including various self-organization phenomena, have been successfully described by simple many-particle models. For ethical reasons, however, there is a serious lack of experimental data regarding crowd panic. Therefore, we have analyzed video recordings of the crowd disaster in Mina/Makkah during the Hajj in 1426H on 12 January 2006. They reveal two subsequent, sudden transitions from laminar to stop-and-go and "turbulent" flows, which question many previous simulation models. While the transition from laminar to stop-and-go flows supports a recent model of bottleneck flows [D. Helbing, Phys. Rev. Lett. 97, 168001 (2006)], the subsequent transition to turbulent flow is not yet well understood. It is responsible for sudden eruptions of pressure release comparable to earthquakes, which cause sudden displacements and the falling and trampling of people. The insights of this study into the reasons for critical crowd conditions are important for the organization of safer mass events. In particular, they allow one to understand where and when crowd accidents tend to occur. They have also led to organizational changes, which have ensured a safe Hajj in 1427H. PMID:17500963

  12. Sample Preheating Capability for Dynamic Material Studies*

    NASA Astrophysics Data System (ADS)

    Wise, J.; Dalton, D.; Hickman, R.; Kaufman, M.; Leffler, S.; Jones, M.; Lynch, J.; Bowers, A.

    2013-06-01

    Coordinated analysis, design, software development, hardware fabrication, and testing activities have yielded a new control system and experimental load design for dynamic material studies on specimens heated to temperatures exceeding 650°C prior to high-rate compression on a pulsed-power (e.g., Z machine) or gun platform. A proportional integral derivative controller supplies power for up to 16 resistive cartridge heaters mounted in a load assembly containing one or more test samples. The electrical output from this LabVIEW-based controller to each heater is continuously adjusted using feedback from thermocouples embedded in the load and in each heater. Experiments confirm steady temperature regulation to within +/-2°C of the selected set point, as well as adequate surge protection from built-in electromagnetic pulse isolation circuitry. ANSYS thermomechanical simulations have guided the refinement of load design to minimize sample temperature gradients and thermal distortion. Improved thin-film coatings for the sample/window interface are being developed to ensure the viability of velocity interferometry measurements on preheated samples. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the U.S. Department of Energy's National Nuclear Security Administration under Contract DE-AC04-94AL85000;

  13. Looking skyward to study ecosystem carbon dynamics

    USGS Publications Warehouse

    Dye, Dennis G.

    2012-01-01

    Between May and October 2011 the U.S. Geological Survey (USGS), in cooperation with the U.S. Department of Energy's Atmospheric Radiation Measurement (ARM) program, conducted a field campaign at the ARM Southern Great Plains site in north central Oklahoma to evaluate a new instrument for quantitative image-based monitoring of sky conditions and solar radiation. The High Dynamic Range All-Sky Imaging System (HDR-ASIS) was developed by USGS to support studies of cloud- and aerosol-induced variability in the geometric properties of solar radiation (the sky radiance distribution) and its effects on photosynthesis and uptake of carbon dioxide (CO2) by terrestrial ecosystems. Under a clean, cloudless atmosphere when the Sun is above the horizon, most of the solar radiation reaching an area of the Earth's surface is concentrated in a beam coming directly from the Sun; a relatively small proportion arrives as diffuse radiation from the rest of the sky. Clouds and atmospheric aerosols cause increased scattering of the beam radiation, which increases the proportion of diffuse radiation at the surface.

  14. Functions of the Renal Nerves.

    ERIC Educational Resources Information Center

    Koepke, John P.; DiBona, Gerald F.

    1985-01-01

    Discusses renal neuroanatomy, renal vasculature, renal tubules, renin secretion, renorenal reflexes, and hypertension as related to renal nerve functions. Indicates that high intensitites of renal nerve stimulation have produced alterations in several renal functions. (A chart with various stimulations and resultant renal functions and 10-item,

  15. [Growth and renal function].

    PubMed

    Antoniazzi, F; Mengarda, F; Lauriola, S; Serra, A; Zamboni, G; Tat, L

    1997-01-01

    Some genetic conditions, as cystinosis, familial hypophosphataemic rickets, type-I vitamin D-resistant rickets and renal tubular acidosis have an impact on growth and growth failure is one of the major problem in children with chronic renal failure (CRF). In early childhood, anorexia and malnutrition, electrolyte disturbances and metabolic acidosis are the main contributing factors for reduced growth, whereas renal osteodystrophy, anemia and hormonal disturbances are responsible for growth impairment later and during puberty. During infancy, loss of growth potential can be prevented by adequate nutrition. Later in life, catch-up growth cannot be induced by nutritional intervention or dialysis and renal transplantation allows catch-up growth in only a small percentage of patients. There is evidence for a state of resistance to growth hormone (GH) and insulin-like growth factor-I (IGF-I) in CRF. GH secretion is normal, but GH half-life is prolonged and the binding activity of the GH-binding protein is reduced, which points to a low receptor expression. IGF-I production may be diminished and the serum concentration of IGF-binding proteins (IGFBP-1 and 3) is increased. The imbalance between normal IGF-I and excessive IGFBP serum levels results in decreased IGF bioactivity that plays a pathogenic role in the growth failure. This insensitivity seems to be overcome by supraphysiological doses of recombinant human GH (rhGH). Many clinical studies have confirmed that rhGH increases growth velocity in children with CRF with and without dialysis and after renal transplant, without significant side-effects. The improvement of growth is more marked in prepubertal patients and during the first year of rhGH treatment. Long-term rhGH treatment in children with CRF improves the growth potential of children, achieving target adult height. The Authors discuss the recent studies employing rhGH in renal diseases and attempt to give some guide lines to rhGH treatment in these illnesses. PMID:9493225

  16. The study of streak camera dynamic distortion

    NASA Astrophysics Data System (ADS)

    Deng, Bo; Li, Jing; Chen, Tao; Hu, Xin; Liu, Shenye

    2012-10-01

    Dynamic distortion, which is caused by space-charge effect, widely exists in streak camera. When input light intensity becomes too large, the electric field caused by electric beam turns out analogous to that caused by image converter tube, which leads to the dynamic distortion. In this article, we analyze the theory of the dynamic distortion by experiments and simulations upon CST Particle Studio software. Results show that: the intensity of current and the space position along the photocathode shall affect the dynamic distortion, leading to defocusing effect and reduce both the spatial resolution and the temporal resolution. All above assist us to better understand the electric-optic system of image converter tube, and provide ideas for further experimental diagnose design.

  17. Nanotube nanoscience: A molecular-dynamics study

    NASA Astrophysics Data System (ADS)

    Omata, Yasuaki; Yamagami, Yuichiro; Tadano, Kotaro; Miyake, Takashi; Saito, Susumu

    2005-11-01

    Carbon nanotubes, fullerenes, and other nanostructured carbon materials are now the most important material phases in the field of nanoscience and nanotechnology. We study the structural stabilities and the interconversion of carbon nanotubes and various other carbon nanostructured phases at elevated temperatures as well as under high pressure using the molecular dynamics method combined with a newly parametrized transferable tight-binding model. The model can deal with not only sp2 and sp3 covalent bonds but also the interaction between sp2 layers, which plays an important role in the structural and electronic properties of carbon nanostructured materials. It is found that, during a thermal transformation process of carbon nanotubes with C60 fullerenes trapped inside into double-walled carbon nanotubes, the outer carbon-nanotube wall is chemically active and forms covalent bonds with inner carbon atoms, and that most vacancies on the initially imperfect outer tube wall are eventually filled with atoms migrated from inner fullerenes. It is also found that external pressure of about 20 GPa induces a variety of structural transformations in carbon nanostructures. On the other hand, pressure of 30 GPa or higher usually results in sp3-rich amorphous carbon materials. Finally, the rotational interlayer friction force in double-walled carbon nanotubes is studied for the system of (4,4)@(9,9), and the torque of the friction force per unit area acting on each nanotube of the system is found to be as small as 9.710-4 N/m. This small value indicates the importance of carbon nanostuctured materials not only for nanoelectronics but also for nanometer-scale machines in the future.

  18. Studies of dynamical processes affecting global climate

    SciTech Connect

    Keller, C.; Cooper, D.; Eichinger, W.

    1998-12-31

    This is the final report of a three-year, Laboratory Directed Research and Development project at the Los Alamos National Laboratory (LANL). The main objective was, by a combined theoretical and observational approach, to develop improved models of dynamic processes in the oceans and atmosphere and to incorporate them into large climate codes, chiefly in four main areas: numerical physics, chemistry, water vapor, and ocean-atmosphere interactions. Main areas of investigation included studies of: cloud parameterizations for global climate codes, Lidar and the planetary boundary layer, chemistry, climate variability using coupled ocean-atmospheric models, and numerical physical methods. This project employed a unique approach that included participation of a number of University of California faculty, postdoctoral fellows and graduate students who collaborated with Los Alamos research staff on specific tasks, thus greatly enhancing the research output. Overall accomplishments during the sensing of the atmospheric planetary were: (1) first two- and three-dimensional remote sensing of the atmospheric planetary boundary layer using Lidars, (2) modeling of 20-year cycle in both pressure and sea surface temperatures in North Pacific, (3) modeling of low frequency internal variability, (4) addition of aerosols to stratosphere to simulate Pinatubo effect on ozone, (5) development of fast, comprehensive chemistry in the troposphere for urban pollution studies, (6) new prognostic cloud parameterization in global atmospheric code remedied problems with North Pacific atmospheric circulation and excessive equatorial precipitation, (7) development of a unique aerosol analysis technique, the aerosol time-of-flight mass spectrometer (ATOFMS), which allows real-time analysis of the size and chemical composition of individual aerosol particles, and (8) numerical physics applying Approximate Inertial Manifolds to ocean circulation. 14 refs., 6 figs.

  19. Thermal transpiration: A molecular dynamics study

    SciTech Connect

    T, Joe Francis; Sathian, Sarith P.

    2014-12-09

    Thermal transpiration is a phenomenon where fluid molecules move from the cold end towards the hot end of a channel under the influence of longitudinal temperature gradient alone. Although the phenomenon of thermal transpiration is observed at rarefied gas conditions in macro systems, the phenomenon can occur at atmospheric pressure if the characteristic dimensions of the channel is less than 100 nm. The flow through these nanosized channels is characterized by the free molecular flow regimes and continuum theory is inadequate to describe the flow. Thus a non-continuum method like molecular dynamics (MD) is necessary to study such phenomenon. In the present work, MD simulations were carried out to investigate the occurance of thermal transpiration in copper and platinum nanochannels at atmospheric pressure conditions. The mean pressure of argon gas confined inside the nano channels was maintained around 1 bar. The channel height is maintained at 2nm. The argon atoms interact with each other and with the wall atoms through the Lennard-Jones potential. The wall atoms are modelled using an EAM potential. Further, separate simulations were carried out where a Harmonic potential is used for the atom-atom interaction in the platinum channel. A thermally insulating wall was introduced between the low and high temperature regions and those wall atoms interact with fluid atoms through a repulsive potential. A reduced cut off radius were used to achieve this. Thermal creep is induced by applying a temperature gradient along the channel wall. It was found that flow developed in the direction of the increasing temperature gradient of the wall. An increase in the volumetric flux was observed as the length of the cold and the hot regions of the wall were increased. The effect of temperature gradient and the wall-fluid interaction strength on the flow parameters have been studied to understand the phenomenon better.

  20. Comparative studies of the proteome, glycoproteome, and N-glycome of clear cell renal cell carcinoma plasma before and after curative nephrectomy.

    PubMed

    Gbormittah, Francisca O; Lee, Ling Y; Taylor, KyOnese; Hancock, William S; Iliopoulos, Othon

    2014-11-01

    Clear cell renal cell carcinoma is the most prevalent of all reported kidney cancer cases, and currently there are no markers for early diagnosis. This has stimulated great research interest recently because early detection of the disease can significantly improve the low survival rate. Combining the proteome, glycoproteome, and N-glycome data from clear cell renal cell carcinoma plasma has the potential of identifying candidate markers for early diagnosis and prognosis and/or to monitor disease recurrence. Here, we report on the utilization of a multi-dimensional fractionation approach (12P-M-LAC) and LC-MS/MS to comprehensively investigate clear cell renal cell carcinoma plasma collected before (disease) and after (non-disease) curative nephrectomy (n = 40). Proteins detected in the subproteomes were investigated via label-free quantification. Protein abundance analysis revealed a number of low-level proteins with significant differential expression levels in disease samples, including HSPG2, CD146, ECM1, SELL, SYNE1, and VCAM1. Importantly, we observed a strong correlation between differentially expressed proteins and clinical status of the patient. Investigation of the glycoproteome returned 13 candidate glycoproteins with significant differential M-LAC column binding. Qualitative analysis indicated that 62% of selected candidate glycoproteins showed higher levels (upregulation) in M-LAC bound fraction of disease samples. This observation was further confirmed by released N-glycans data in which 53% of identified N-glycans were present at different levels in plasma in the disease vs non-disease samples. This striking result demonstrates the potential for significant protein glycosylation alterations in clear cell renal cell carcinoma cancer plasma. With future validation in a larger cohort, information derived from this study may lead to the development of clear cell renal cell carcinoma candidate biomarkers. PMID:25184692

  1. Serum urate gene associations with incident gout, measured in the Framingham Heart Study, are modified by renal disease and not by body mass index.

    PubMed

    Reynolds, Richard J; Vazquez, Ana I; Srinivasasainagendra, Vinodh; Klimentidis, Yann C; Bridges, S Louis; Allison, David B; Singh, Jasvinder A

    2016-02-01

    We hypothesized that serum urate-associated SNPs, individually or collectively, interact with BMI and renal disease to contribute to risk of incident gout. We measured the incidence of gout and associated comorbidities using the original and offspring cohorts of the Framingham Heart Study. We used direct and imputed genotypes for eight validated serum urate loci. We fit binomial regression models of gout incidence as a function of the covariates, age, type 2 diabetes, sex, and all main and interaction effects of the eight serum urate SNPs with BMI and renal disease. Models were also fit with a genetic risk score for serum urate levels which corresponds to the sum of risk alleles at the eight SNPs. Model covariates, age (P=5.95E-06), sex (P=2.46E-39), diabetes (P=2.34E-07), BMI (P=1.14E-11) and the SNPs, rs1967017 (P=9.54E-03), rs13129697 (P=4.34E-07), rs2199936 (P=7.28E-03) and rs675209 (P=4.84E-02) were all associated with incident gout. No BMI by SNP or BMI by serum urate genetic risk score interactions were statistically significant, but renal disease by rs1106766 was statistically significant (P=6.12E-03). We demonstrated that minor alleles of rs1106766 (intergenic, INHBC) were negatively associated with the risk of incident gout in subjects without renal disease, but not for individuals with renal disease. These analyses demonstrate that a significant component of the risk of gout may involve complex interplay between genes and environment. PMID:26427508

  2. Comparative Studies of the Proteome, Glycoproteome, and N-Glycome of Clear Cell Renal Cell Carcinoma Plasma before and after Curative Nephrectomy

    PubMed Central

    2015-01-01

    Clear cell renal cell carcinoma is the most prevalent of all reported kidney cancer cases, and currently there are no markers for early diagnosis. This has stimulated great research interest recently because early detection of the disease can significantly improve the low survival rate. Combining the proteome, glycoproteome, and N-glycome data from clear cell renal cell carcinoma plasma has the potential of identifying candidate markers for early diagnosis and prognosis and/or to monitor disease recurrence. Here, we report on the utilization of a multi-dimensional fractionation approach (12P-M-LAC) and LC–MS/MS to comprehensively investigate clear cell renal cell carcinoma plasma collected before (disease) and after (non-disease) curative nephrectomy (n = 40). Proteins detected in the subproteomes were investigated via label-free quantification. Protein abundance analysis revealed a number of low-level proteins with significant differential expression levels in disease samples, including HSPG2, CD146, ECM1, SELL, SYNE1, and VCAM1. Importantly, we observed a strong correlation between differentially expressed proteins and clinical status of the patient. Investigation of the glycoproteome returned 13 candidate glycoproteins with significant differential M-LAC column binding. Qualitative analysis indicated that 62% of selected candidate glycoproteins showed higher levels (upregulation) in M-LAC bound fraction of disease samples. This observation was further confirmed by released N-glycans data in which 53% of identified N-glycans were present at different levels in plasma in the disease vs non-disease samples. This striking result demonstrates the potential for significant protein glycosylation alterations in clear cell renal cell carcinoma cancer plasma. With future validation in a larger cohort, information derived from this study may lead to the development of clear cell renal cell carcinoma candidate biomarkers. PMID:25184692

  3. Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study

    PubMed Central

    Link, Andreas; Girndt, Matthias; Selejan, Simina; Rbah, Ranja; Bhm, Michael

    2008-01-01

    Introduction Approximately one third of all patients with cardiogenic shock suffer from acute kidney injury. Percutaneous coronary intervention, intra-aortic balloon pump, and continuous renal replacement therapy (CRRT) require effective antiplatelet therapy and anticoagulation, resulting in a high risk for platelet loss and bleeding events. The reversible platelet glycoprotein IIb/IIIa receptor inhibitor tirofiban was investigated to preserve platelet number and activation in a prospective open-blinded endpoint evaluation study. Methods Forty patients with cardiogenic shock and acute kidney injury requiring CRRT were randomly assigned to two groups receiving unfractioned heparin (UFH) (n = 20) or a combined anticoagulation with UFH and tirofiban (n = 20). The primary endpoint was platelet loss during CRRT. Secondary endpoints were urea reduction, haemofilter life span, bleeding events, and necessity for platelet transfusions. Results In UFH-treated patients, the percentage of platelet-monocyte aggregates significantly increased (P < 0.001) and consecutively platelet cell count significantly decreased (P < 0.001). In contrast, combined treatment with UFH and tirofiban significantly decreased platelet-monocyte aggregates and platelet numbers (P < 0.001). Conclusions This pilot study provides evidence that the use of tirofiban in addition to UFH prevents platelet loss and preserves platelet function in patients with cardiogenic shock and acute kidney injury requiring CRRT. The pathophysiological inhibition of platelet aggregation and platelet-monocyte interaction appears to be causally involved. PMID:18759963

  4. Copeptin is associated with kidney length, renal function, and prevalence of simple cysts in a population-based study.

    PubMed

    Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Pchre-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier; Bochud, Murielle

    2015-06-01

    Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (?=-2.1; 95% confidence interval [95% CI], -3.3 to -0.8; P=0.002) and kidney length (?=-1.2; 95% CI, -1.9 to -0.4; P=0.003) but positively with 24-hour urinary albumin excretion (?=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (?=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. PMID:25270071

  5. Dynamics of anti-human leukocyte antigen antibodies after renal transplantation and their impact on graft outcome.

    PubMed

    de Souza, Patrcia Soares; David-Neto, Elias; Panajotopolous, Nicolas; Agena, Fabiana; Rodrigues, Hlcio; Ronda, Carla; David, Dasa Ribeiro; Kalil, Jorge; Nahas, Wiliam Carlos; de Castro, Maria Cristina Ribeiro

    2014-11-01

    The purpose of this study was to sequentially monitor anti-HLA antibodies and correlate the results with antibody-mediated rejection (AMR), graft survival (GS), and graft function (GF). We collected sera from 111 kidney transplant recipients on transplant days 0, 7, 14, 30, 60, 90, 180, and 360 and analyzed PRA levels by ELISA. DSAs were analyzed by single-antigen beads in rejecting kidneys. At pre-transplant, 79.3% of the patients were non-sensitized (PRA=0%) and 20.7% were sensitized (PRA>1%). After transplant, patients were grouped by PRA profile: no anti-HLA antibodies pre- or post-transplant (group HLApre-/post-; n=80); de novo anti-HLA antibodies post-transplant (group HLApre-/post+; n=8); sensitized pre-transplant/increased PRA post-transplant (group HLApre+/post?; n=9); and sensitized pre-transplant/decreased PRA post-transplant (group HLApre+/post?; n=14). De novo anti-HLA antibodies were detected at 7-180d. In sensitized patients, PRA levels changed within the first 30d post-transplant. Incidence of AMR was higher in HLApre-/post+ and HLApre+/post? than in HLApre-/post-, and HLApre+/post? (p<0.001) groups. One-yr death-censored GS was 36% in group HLApre+/post?, compared with 98%, 88% and 100% in groups HLApre-/post-, HLApre-/post+, and HLApre+/post?, respectively (p<0.001). Excluding first-year graft losses, GF and GS were similar among the groups. In conclusion, post-transplant antibody monitoring can identify recipients at higher risk of AMR. PMID:25142061

  6. Hepcidin Mitigates Renal Ischemia-Reperfusion Injury by Modulating Systemic Iron Homeostasis.

    PubMed

    Scindia, Yogesh; Dey, Paromita; Thirunagari, Abhinav; Liping, Huang; Rosin, Diane L; Floris, Matteo; Okusa, Mark D; Swaminathan, Sundararaman

    2015-11-01

    Iron-mediated oxidative stress is implicated in the pathogenesis of renal ischemia-reperfusion injury. Hepcidin is an endogenous acute phase hepatic hormone that prevents iron export from cells by inducing degradation of the only known iron export protein, ferroportin. In this study, we used a mouse model to investigate the effect of renal ischemia-reperfusion injury on systemic iron homeostasis and determine if dynamic modulation of iron homeostasis with hepcidin has therapeutic benefit in the treatment of AKI. Renal ischemia-reperfusion injury induced hepatosplenic iron export through increased ferroportin expression, which resulted in hepatosplenic iron depletion and an increase in serum and kidney nonheme iron levels. Exogenous hepcidin treatment prevented renal ischemia-reperfusion-induced changes in iron homeostasis. Hepcidin also decreased kidney ferroportin expression and increased the expression of cytoprotective H-ferritin. Hepcidin-induced restoration of iron homeostasis was accompanied by a significant reduction in ischemia-reperfusion-induced tubular injury, apoptosis, renal oxidative stress, and inflammatory cell infiltration. Hepcidin -: deficient mice demonstrated increased susceptibility to ischemia-reperfusion injury compared with wild-type mice. Reconstituting hepcidin-deficient mice with exogenous hepcidin induced hepatic iron sequestration, attenuated the reduction in renal H-ferritin and reduced renal oxidative stress, apoptosis, inflammation, and tubular injury. Hepcidin-mediated protection was associated with reduced serum IL-6 levels. In summary, renal ischemia-reperfusion injury results in profound alterations in systemic iron homeostasis. Hepcidin treatment restores iron homeostasis and reduces inflammation to mediate protection in renal ischemia-reperfusion injury, suggesting that hepcidin-ferroportin pathway holds promise as a novel therapeutic target in the treatment of AKI. PMID:25788528

  7. Studies on the dynamics of DNA melting

    SciTech Connect

    Zhuang, W.

    1992-01-01

    In this study the self-consistent phonon theory is applied to the understanding of DNA melting from a microscopic point of view. Studies of the dynamics of hydrogen bond motion for a model of replicating fork at room temperature are given. The anharmonic effect increases the hydrogen bond fluctuation by more than a factor of 2 over the harmonic result in some frequency regions. The frequency dependence of the h-bond motion suggests spectral features that could be regarded as a signature for the existence of forks in DNA samples. The effect of an open loop of various sizes on the thermal stability of the adjoining intact base pairs in a duplex DNA chain is studied. For a Y-shaped fork configuration the thermal fluctuation at the fork is so enhanced that the life time of the adjoining base pair is much smaller than the 1 millisecond time scale associated with helicase separation of a base pair. The analysis indicates the significance of thermal fluctuational base pair opening in facilitating the enzyme unwinding process during chain elongation of a replicating DNA. It is likely that the thermal fluctuational opening of the base pair at the junction of a replicating fork is fast enough so that a DNA unwinding enzyme can encounter an unstacked base pair with reasonable probability. The algorithm of calculating base pair opening probability is applied to a localized structure, the replicating fork. The addition of two hot phonons to some local modes can lead to the separation of the last closed base pair. The contribution of various vibrational modes to the melting of poly(dG)[center dot]poly(dC) is studied. The principal contribution comes from the H-bond breathing modes that have been observed in Raman scattering and that have been associated with helix melting. The softening of these modes on approach to melting is in agreement with the observed behavior. The contribution to melting from base rotation modes that are important in melting is also discussed.

  8. Renal Clearance of Mineral Metabolism Biomarkers.

    PubMed

    van Ballegooijen, Adriana J; Rhee, Eugene P; Elmariah, Sammy; de Boer, Ian H; Kestenbaum, Bryan

    2016-02-01

    CKD leads to disturbances in multiple interrelated hormones that regulate bone and mineral metabolism. The renal handling of mineral metabolism hormones in humans is incompletely understood. We determined the single-pass renal clearance of parathyroid hormone, fibroblast growth factor 23, vitamin D metabolites, and phosphate from paired blood samples collected from the abdominal aorta and renal vein in 17 participants undergoing simultaneous right and left heart catheterization and estimated associations of eGFR with the renal elimination of metabolites. The mean age ±SD of the study population was 71.4±10.0 years and 11 participants (65%) were male. We found a relatively large mean±SD single-pass renal extraction of parathyroid hormone (44.2%±10.3%) that exceeded the extraction of creatinine (22.1%±7.9%). The proportionate renal extraction of parathyroid hormone correlated with eGFR. The renal extraction of fibroblast growth factor 23 was, on average, lower than that of parathyroid hormone with greater variability across individuals (17.1%±19.5%). There were no differences in the mean concentrations of vitamin D metabolites across the renal vein and artery. In summary, we demonstrate substantial single-pass renal extraction of parathyroid hormone at a rate that exceeds glomerular filtration. Impaired renal clearance of parathyroid hormone may contribute to secondary hyperparathyroidism in CKD. PMID:26047790

  9. Focus on renal congestion in heart failure

    PubMed Central

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-01-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure. PMID:26798459

  10. Focus on renal congestion in heart failure.

    PubMed

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet

    2016-02-01

    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure. PMID:26798459

  11. CTLA-4 and CD28 genes' polymorphisms and renal cell carcinoma susceptibility in the Polish population--a prospective study.

    PubMed

    Tupikowski, K; Partyka, A; Kolodziej, A; Dembowski, J; Debinski, P; Halon, A; Zdrojowy, R; Frydecka, I; Karabon, L

    2015-11-01

    Polymorphisms in co-stimulatory genes are associated with susceptibility to several malignances such as breast cancer, cervical cancer and chronic lymphocytic leukemia, but have been scarcely investigated in renal cell cancer (RCC). A total of 310 RCC patients and 518 controls were genotyped for single-nucleotide polymorphisms (SNPs) in the CTLA-4 and CD28 genes: CTLA-4c.49A>G (rs231775), CTLA-4g.319C>T (rs5742909), CTLA-4g.*6230G>A (CT60; rs3087243), CTLA-4g.*10223G>T (Jo31; rs11571302), CD28c.17+3T>C (rs3116496) and CD28c.-1042G>A (rs3181098). The distribution of the alleles, genotypes and haplotypes in the CTLA-4 and CD28 genes were similar in the RCC patients and in the controls. However, among the patients with a clear cell RCC (CCRCC), the G allele carriers of CT60 and Jo31 SNPs were overrepresented, and the overrepresentation became significant for the carriers of CT60[G] allele in CCRCC patients with necrosis in the primary tumor (P = 0.046). The CTLA-4c.49A>G[A]/CTLA-4g.319C>T[C]/CT60[A]/Jo31[T]/CD28c.17+3T>C[T]/ CD28c.1042G>A[G] haplotype was associated with an approximately threefold increased risk of primary tumor necrosis in CCRCC patients (P corrected = 0.0000007) and with the advanced stage of disease (IV) (P corrected = 0.001). When stratified by gender, CD28c.-1042G>A[GG] genotype was more frequent in the female CCRCC patients compared with healthy women (P = 0.042). Polymorphisms in the CTLA-4 and CD28 genes, in particular considered together as haplotypes, were associated with increased risk of CCRCC, especially with necrosis and with the advanced stage of disease. The CD28c.-1042G>A SNP modulates the risk of CCRCC in women. These findings indicate that the associations of the CTLA-4 and CD28 polymorphisms with the risk of renal cancer are worth further study in a larger group of patients. PMID:26403483

  12. Renal Clearance of Nanoparticles

    PubMed Central

    Choi, Hak Soo; Liu, Wenhao; Misra, Preeti; Tanaka, Eiichi; Zimmer, John P.; Ipe, Binil Itty; Bawendi, Moungi G.; Frangioni, John V.

    2008-01-01

    SUMMARY The field of nanotechnology holds great promise for the diagnosis and treatment of human disease. However, the size and charge of most nanoparticles preclude their efficient clearance from the body as intact nanoparticles. Without such clearance or their biodegradation into biologically benign components, toxicity is potentially amplified and radiological imaging is hindered. Using quantum dots (QDs) as a model system, we have precisely defined the requirements for renal filtration and urinary excretion of inorganic, metal-containing nanoparticles. Zwitterionic or neutral organic coatings prevented adsorption of serum proteins, which otherwise increased hydrodynamic diameter (HD) by over 15 nm and prevented renal excretion. A final HD smaller than 5.5 nm resulted in rapid and efficient urinary excretion, and elimination of QDs from the body. This study provides a foundation for the design and development of biologically targeted nanoparticles for biomedical applications. PMID:17891134

  13. Eight-year results of the Spiesser study, a randomized trial comparing de novo sirolimus and cyclosporine in renal transplantation.

    PubMed

    Gatault, Philippe; Bertrand, Dominique; Bchler, Matthias; Colosio, Charlotte; Hurault de Ligny, Bruno; Weestel, Pierre-Franois; Rerolle, Jean-Philippe; Thierry, Antoine; Sayegh, Johnny; Moulin, Bruno; Snanoudj, Renaud; Rivalan, Joseph; Heng, Anne-Elisabeth; Sautenet, Bndicte; Lebranchu, Yvon

    2016-01-01

    We present the results at 8years of the Spiesser study, a randomized trial comparing de novo sirolimus and cyclosporine in kidney transplant recipients at low immunologic risk. We assessed estimated glomerular filtration (eGFR), graft, patient, and death-censored graft survival (log-rank compared), de novo DSA appearance, risk of malignancy, post-transplant diabetes mellitus (PTDM), and anemia. Intent-to-treat and on-treatment analyses were performed. Graft survival was similar in both groups (sirolimus: 73.3%, cyclosporine: 77.7, P=0.574). No difference was observed between treatment groups concerning patient survival (P=0.508) and death-censored graft survival (P=0.858). In conditional intent-to-treat analysis, mean eGFR was greater in sirolimus than in cyclosporine group (62.527.3ml/min vs. 47.817.1ml/min, P=0.004), in particular because graft function was excellent in patients maintained under sirolimus (eGFR=74.0ml/min). Importantly, no detrimental impact was observed in patients in whom sirolimus has been withdrawn (eGFR=49.5ml/min). Overall, 17 patients showed de novo DSAs, with no difference between the two groups (P=0.520). Malignancy did not differ by treatment. An initial maintenance regimen based on sirolimus provides a long-term improvement in renal function for kidney transplant patients, especially for those maintained on sirolimus. PMID:26285161

  14. Impact of nitric-oxide-mediated vasodilation and oxidative stress on renal medullary oxygenation: a modeling study.

    PubMed

    Fry, Brendan C; Edwards, Aurlie; Layton, Anita T

    2016-02-01

    The goal of this study was to investigate the effects of nitric oxide (NO)-mediated vasodilation in preventing medullary hypoxia, as well as the likely pathways by which superoxide (O2 (-)) conversely enhances medullary hypoxia. To do so, we expanded a previously developed mathematical model of solute transport in the renal medulla that accounts for the reciprocal interactions among oxygen (O2), NO, and O2 (-) to include the vasoactive effects of NO on medullary descending vasa recta. The model represents the radial organization of the vessels and tubules, centered around vascular bundles in the outer medulla and collecting ducts in the inner medulla. Model simulations suggest that NO helps to prevent medullary hypoxia both by inducing vasodilation of the descending vasa recta (thus increasing O2 supply) and by reducing the active sodium transport rate (thus reducing O2 consumption). That is, the vasodilative properties of NO significantly contribute to maintaining sufficient medullary oxygenation. The model further predicts that a reduction in tubular transport efficiency (i.e., the ratio of active sodium transport per O2 consumption) is the main factor by which increased O2 (-) levels lead to hypoxia, whereas hyperfiltration is not a likely pathway to medullary hypoxia due to oxidative stress. Finally, our results suggest that further increasing the radial separation between vessels and tubules would reduce the diffusion of NO towards descending vasa recta in the inner medulla, thereby diminishing its vasoactive effects therein and reducing O2 delivery to the papillary tip. PMID:26831340

  15. A Study of Atherosclerosis in Patients with Chronic Renal Failure with Special Reference to Carotid Artery Intima Media Thickness

    PubMed Central

    Paul, Jayanta; Dasgupta, Somnath; Ghosh, Mrinal Kanti; Shaw, Kishore; Roy, Keshab Sinha; Niyogi, Syamal Mitra

    2012-01-01

    Objectives: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic renal failure (CRF). This study attempts to identify the factors responsible for atherosclerosis in CRF patients using carotid artery intima media thickness (CAIMT) as a surrogate marker of atherosclerosis. Materials and Methods: CAIMT was measured by high-resolution B-mode ultrasonography in 100 CRF patients and 50 age- and sex-matched healthy controls. Data were analyzed by software SPSS (17th version) for Windows. Results: CRF patients had a significantly higher CAIMT (1026.83 17.19 micron, mean SE, P < 0.001) than age- and sex-matched healthy controls (722.46 7.61 micron). There was inverse correlation between CAIMT and glomerular filtration rate (GFR) (P < 0.001) independent of traditional risk factors. There was also significant positive correlation between CAIMT and traditional risk factors of atherosclerosis. Ischemic heart disease (IHD) also showed positive correlation with CAIMT (P = 0.007) and inverse correlation with GFR (P = 0.005). Conclusions: There is high prevalence of atherosclerosis in CRF patients. CAIMT can be used to detect and predict future incidence of IHD in CRF patients. PMID:23181176

  16. Uranyl nitrate inhibits lactate gluconeogenesis in isolated human and mouse renal proximal tubules: A {sup 13}C-NMR study

    SciTech Connect

    Renault, Sophie; Faiz, Hassan; Gadet, Rudy; Ferrier, Bernard; Martin, Guy; Baverel, Gabriel; Conjard-Duplany, Agnes

    2010-01-01

    As part of a study on uranium nephrotoxicity, we investigated the effect of uranyl nitrate in isolated human and mouse kidney cortex tubules metabolizing the physiological substrate lactate. In the millimolar range, uranyl nitrate reduced lactate removal and gluconeogenesis and the cellular ATP level in a dose-dependent fashion. After incubation in phosphate-free Krebs-Henseleit medium with 5 mM L-[1-{sup 13}C]-, or L-[2-{sup 13}C]-, or L-[3-{sup 13}C]lactate, substrate utilization and product formation were measured by enzymatic and NMR spectroscopic methods. In the presence of 3 mM uranyl nitrate, glucose production and the intracellular ATP content were significantly reduced in both human and mouse tubules. Combination of enzymatic and NMR measurements with a mathematical model of lactate metabolism revealed an inhibition of fluxes through lactate dehydrogenase and the gluconeogenic enzymes in the presence of 3 mM uranyl nitrate; in human and mouse tubules, fluxes were lowered by 20% and 14% (lactate dehydrogenase), 27% and 32% (pyruvate carboxylase), 35% and 36% (phosphoenolpyruvate carboxykinase), and 39% and 45% (glucose-6-phosphatase), respectively. These results indicate that natural uranium is an inhibitor of renal lactate gluconeogenesis in both humans and mice.

  17. Milling dynamics. I - Attritor dynamics: Results of a cinematographic study

    NASA Technical Reports Server (NTRS)

    Rydin, R. W.; Maurice, D.; Courtney, T. H.

    1993-01-01

    The motions of grinding media and powder in an attritor canister were studied by means of filming the agitated charge and frame-by-frame scrutiny of the footage. In conjunction with auxiliary experiments, this permitted semiquantitative analysis of the milling action. In particular, the mill can be divided into several regions characterized by different balances between direct impacts and rolling/sliding of the grinding media. Simple calculations suggest that impacts are more capable of effecting mechanical alloying (MA) than are rolling or sliding events in an attritor. Powder circulation within an operating mill was also investigated. Based on the results and the accompanying analysis, concepts for improved attritor design are presented.

  18. 'Fluid Dynamics,' mixed media by Tina York depicts fluid dynamics studies at the Ames Research

    NASA Technical Reports Server (NTRS)

    2001-01-01

    'Fluid Dynamics,' mixed media by Tina York depicts fluid dynamics studies at the Ames Research Center. The purpose of such studies is to learn more about what happens to an object when it encounters the friction of atmospheric resistence (such as a plane encountering resistance as it speeds through the air). used in Ames 60 year history by Glenn Bugos NASA SP-4314

  19. Dynamical studies of confined fluids and polymers

    NASA Astrophysics Data System (ADS)

    Grabowski, Christopher A.

    Soft matter, a class of materials including polymers, colloids, and surfactant molecules, are ubiquitous in our everyday lives. Plastics, soaps, foods and living organisms are mostly comprised of soft materials. Research conducted to understand soft matter behavior at the molecular level is essential to create new materials with unique properties. Self-healing plastics, targeted drug delivery, and nanowire assemblies have all been further advanced by soft matter research. The author of this dissertation investigates fundamental soft matter systems, including polymer solutions and melts, colloid dispersions in polymer melts, and interfacial fluids. The dynamics of polymers and confined fluids were studied using the single-molecule sensitive technique of fluorescence correlation spectroscopy (FCS). Here, fluorescent dyes are attached to polymer coils or by introducing free dyes directly into the solution/film. Complementary experiments were also performed, utilizing atomic force microscopy (AFM) and ellipsometry. FCS and AFM experiments demonstrated the significant difference in properties of thin fluid films of the nearly spherical, nonpolar molecule TEHOS (tetrakis(2-ethylhexoxy)silane) when compared to its bulk counterpart. AFM experiments confirmed TEHOS orders in layers near a solid substrate. FCS experiments show that free dyes introduced in these thin films do not have a single diffusion coefficient, indicating that these films have heterogeneity at the molecular level. FCS experiments have been applied to study the diffusion of gold colloids. The diffusion of gold colloids in polymer melts was found to dramatically depart from the Stokes-Einstein prediction when colloid size was smaller than the surrounding polymer mesh size. This effect is explained by noting the viscosity experienced by the colloid is not equivalent to the overall bulk viscosity of the polymer melt. The conformational change of polymers immersed in a binary solvent was measured via FCS. This experiment was conducted to test a theory proposed by Brochard and de Gennes, who postulated a polymer chain undergoes a collapse and a dramatic re-swelling as the critical point of the binary mixture is approached. Measuring polymer chain diffusion as a function of temperature, this theory was confirmed. To my knowledge, this was the first experimental evidence of contraction/re-swelling for polymers in critical binary solvents.

  20. Renal and adrenal tumors: Pathology, radiology, ultrasonography, therapy, immunology

    SciTech Connect

    Lohr, E.; Leder, L.D.

    1987-01-01

    Aspects as diverse as radiology, pathology, urology, pediatrics and immunology have been brought together in one book. The most up-do-date methods of tumor diagnosis by CT, NMR, and ultrasound are covered, as are methods of catheter embolization and radiation techniques in case of primarily inoperable tumors. Contents: Pathology of Renal and Adrenal Neoplasms; Ultrasound Diagnosis of Renal and Pararenal Tumors; Computed-Body-Tomography of Renal Carcinoma and Perirenal Masses; Magnetic Resonance Imaging of Renal Mass Lesions; I-125 Embolotherapy of Renal Tumors; Adrenal Mass Lesions in Infants and Children; Computed Tomography of the Adrenal Glands; Scintigraphic Studies of Renal and Adrenal Function; Surgical Management of Renal Cell Carcinoma; Operative Therapy of Nephroblastoma; Nonoperative Treatment of Renal Cell Carcinoma; Prenatal Wilms' Tumor; Congenital Neuroblastoma; Nonsurgical Management of Wilms' Tumor; Immunologic Aspects of Malignant Renal Disease.

  1. Nuclear medicine in acute and chronic renal failure

    SciTech Connect

    Sherman, R.A.; Byun, K.J.

    1982-07-01

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

  2. Detrended Fluctuation Analysis of Heart Rate Dynamics Is an Important Prognostic Factor in Patients with End-Stage Renal Disease Receiving Peritoneal Dialysis

    PubMed Central

    Lin, Lian-Yu; Chang, Chin-Hao; Chu, Fang-Ying; Lin, Yen-Hung; Wu, Cho-Kai; Lee, Jen-Kuang; Hwang, Juei-Jen; Lin, Jiunn-Lee; Chiang, Fu-Tien

    2016-01-01

    Background and Objectives Patients with severe kidney function impairment often have autonomic dysfunction, which could be evaluated noninvasively by heart rate variability (HRV) analysis. Nonlinear HRV parameters such as detrended fluctuation analysis (DFA) has been demonstrated to be an important outcome predictor in patients with cardiovascular diseases. Whether cardiac autonomic dysfunction measured by DFA is also a useful prognostic factor in patients with end-stage renal disease (ESRD) receiving peritoneal dialysis (PD) remains unclear. The purpose of the present study was designed to test the hypothesis. Materials and Methods Patients with ESRD receiving PD were included for the study. Twenty-four hour Holter monitor was obtained from each patient together with other important traditional prognostic makers such as underlying diseases, left ventricular ejection fraction (LVEF) and serum biochemistry profiles. Short-term (DFAα1) and long-term (DFAα2) DFA as well as other linear HRV parameters were calculated. Results A total of 132 patients (62 men, 72 women) with a mean age of 53.7±12.5 years were recruited from July 2007 to March 2009. During a median follow-up period of around 34 months, eight cardiac and six non-cardiac deaths were observed. Competing risk analysis demonstrated that decreased DFAα1 was a strong prognostic predictor for increased cardiac and total mortality. ROC analysis showed that the AUC of DFAα1 (<0.95) to predict mortality was 0.761 (95% confidence interval (CI). = 0.617–0.905). DFAα1≧ 0.95 was associated with lower cardiac mortality (Hazard ratio (HR) 0.062, 95% CI = 0.007–0.571, P = 0.014) and total mortality (HR = 0.109, 95% CI = 0.033–0.362, P = 0.0003). Conclusion Cardiac autonomic dysfunction evaluated by DFAα1 is an independent predictor for cardiac and total mortality in patients with ESRD receiving PD. PMID:26828209

  3. Beam Dynamics Studies for the SPARC Project

    SciTech Connect

    Ferrario, M.; Biagini, Maria E.; Boscolo, M.; Fusco, V.; Guiducci, S.; Migliorati, M.; Serafini, L.; Vaccarezza, C.; Bartolini, R.; Giannessi, L.; Quattromini, M.; Ronsivalle, C.; Limborg, C.G.; /Unlisted /Unlisted /ENEA, Frascati /SLAC

    2008-03-17

    The aim of the SPARC project, is to promote an R&D activity oriented to the development of a high brightness photoinjector to drive SASE-FEL experiments. We discuss in this paper the status of the beam dynamics simulation activities.

  4. Dynamic property studies of Sterling engines

    NASA Technical Reports Server (NTRS)

    Tani, Y.; Seibara, M.; Takenai, K.; Yamaguchi, W.

    1984-01-01

    A description is given of the results of dynamic property tests that were carried out using a trial produced prototype of a 50 KW Sterling engine. The features of the engine are shown graphically. A high thermal efficiency is found in the low rotation region.

  5. DHEA-induced modulation of renal gluconeogenesis, insulin sensitivity and plasma lipid profile in the control- and dexamethasone-treated rabbits. Metabolic studies.

    PubMed

    Kiersztan, Anna; Nagalski, Andrzej; Nalepa, Paweł; Tempes, Aleksandra; Trojan, Nina; Usarek, Michał; Jagielski, Adam K

    2016-02-01

    In view of antidiabetic and antiglucocorticoid effects of dehydroepiandrosterone (DHEA) both in vitro and in vivo studies were undertaken: (i) to elucidate the mechanism of action of both dexamethasone phosphate (dexP) and DHEA on glucose synthesis in primary cultured rabbit kidney-cortex tubules and (ii) to investigate the influence of DHEA on glucose synthesis, insulin sensitivity and plasma lipid profile in the control- and dexP-treated rabbits. Data show, that in cultured kidney-cortex tubules dexP significantly stimulated gluconeogenesis by increasing flux through fructose-1,6-bisphosphatase (FBPase). DexP-induced effects were dependent only upon glucocorticoid receptor. DHEA decreased glucose synthesis via inhibition of glucose-6-phosphatase (G6Pase) and suppressed the dexP-induced stimulation of renal gluconeogenesis. Studies with the use of inhibitors of DHEA metabolism in cultured renal tubules showed for the first time that DHEA directly affects renal gluconeogenesis. However, in view of analysis of glucocorticoids and DHEA metabolites levels in urine, it seems likely, that testosterone may also contribute to DHEA-evoked effects. In dexP-treated rabbits, plasma glucose level was not altered despite increased renal and hepatic FBPase and G6Pase activities, while a significant elevation of both plasma insulin and HOMA-IR was accompanied by a decline of ISI index. It thus appears that increased insulin levels were required to maintain normoglycaemia and to compensate the insulin resistance. DHEA alone affected neither plasma glucose nor lipid levels, while it increased insulin sensitivity and diminished both renal and hepatic G6Pase activities. Surprisingly, DHEA co-administrated with dexP did not alter insulin sensitivity, while it partially suppressed the dexP-induced elevation of renal G6Pase activity and plasma cholesterol and triglyceride contents. As (i) gluconeogenic pathway in rabbit is similar to that in human, and (ii) DHEA counteracts several dexP-evoked effects, it seems likely, that its supplementation might be beneficial to patients treated with glucocorticoids. PMID:26616007

  6. Does Nucleos(t)ide Analogues Treatment Affect Renal Function in Chronic Hepatitis B Patients Who Have Already Decreased eGFR? A Longitudinal Study

    PubMed Central

    Tsai, Ming-Chao; Chen, Chien-Hung; Tseng, Po-Lin; Hung, Chao-Hung; Chiu, King-Wah; Chang, Kuo-Chin; Yen, Yi-Hao; Lin, Ming-Tsung; Hu, Tsung-Hui

    2016-01-01

    This study aimed to assess the renal function in chronic hepatitis B (CHB) patients who received nucleos(t)ide analogues (NAs) therapy using estimated glomerular filtration rate (eGFR) titer. We performed a longitudinal observational study of 37 tenofovir-, 42 telbivudine-, and 62 entecavir-naïve CHB patients, who had impaired renal function (eGFR, 90–30 ml/min/1.73m2) without history of diabetes, hypertension, and chemotherapy. Calculation and evaluation of eGFR was performed with the Modification of Diet in Renal Disease, Chronic Kidney Disease Epidemiology Collaboration, and Cockcroft-Gault formula at pretreatment, at baseline, and after the 1st and 2nd year of treatment. The eGFR was significantly increased in patients given telbivudine or entecavir (p = 0.003 and p = 0.012, respectively), but the eGFR was decreased in patients given tenofovir (p = 0.001) after 2 years of treatment. Of all patients, eGFR was stable one year prior to treatment. If we analyzed the renal function by change of chronic kidney disease (CKD) category with a change of 25% of eGFR, the proportion of uncertain drop (drop in CKD category with <25% decrease in eGFR) and certain drop (drop in CKD category with ≧25% decrease in eGFR) in tenofovir group was smaller (5.4%) than those of telbivudine (12.9%) or entecavir (6.5%). Furthermore, telbivudine had the lowest stable rate (76.2%), the highest certain rise rate (9.5%), and certain drop rate (7.1%) compared to the other groups (p = 0.049). In conclusion, in NAs-naïve CHB patients with impaired renal function, telbivudine and entecavir resulted in a significant increase in eGFR while tenofovir resulted in a significant decrease after a 2-year treatment. Interestingly, TDF had the lowest proportion of patients reclassified to certain and uncertain drop groups; in contrast, LdT had a higher proportion in both raise and drop groups. The outcomes of this renal effect remain to be determined. PMID:26964034

  7. Use of renal risk drugs in patients with renal impairment.

    PubMed

    Holm, Hilde; Bjerke, Kirsti; Holst, Lone; Mathiesen, Liv

    2015-12-01

    Background Renal impairment often goes unrecognised until the most advanced stages. Patients with renal impairment use a variety of drugs and the pharmacokinetics and drug effects are prone to change. Objective Describe drug related problems in a population of patients with renal impairment, investigate possible risk factors, and investigate whether the clinical pharmacist can propose relevant measures to solve the problems. Setting The internal medicine department at Innlandet Hospital Trust Gjvik, Norway. Method A prospective study enrolling patients (?18years) with moderate and severe renal impairment, i.e. with glomerular filtration rate of 30-59 and 15-29ml/min/1.73m(2), respectively, and using at least one drug. The clinical pharmacist reviewed the patients' drug regimen with focus on drug related problems, related to renal function. Problems identified were discussed with the multidisciplinary team, or directly with the physician. Main outcome measure The number of drug related problems. Results The results are based on data from 79 patients, 21 with severe and 58 with moderate renal impairment. Most patients, 92.4%, used 5 or more drugs; in average 10.2 (range 2-27). In total, 88 drug related problems were identified in 49 patients, i.e. in 62%. The most frequently occurring problems were incorrect dose (45.5%) and inappropriate drug (41.0%). There was a significant correlation between both the degree of renal impairment and the number of drugs, and the number of drug related problems. The acceptance rate of the clinical pharmacist's interventions was 95.7%. The drugs most frequently associated with drug related problems were metformin, benzylpenicillin and furosemide. Conclusion Drug related problems often occur in patients with renal impairment. Incorrect drug dose and inappropriate drug choice according to the patients' renal function were the most common problems. Patients with the most complex drug treatment, i.e. with increasing degree of renal impairment and increasing number of drugs, are at greater risk of drug related problems. The high acceptance rate for the pharmacist's interventions supports the inclusion of a clinical pharmacist in the multidisciplinary treatment team to increase awareness and optimisation of the drug treatment in this patient group. PMID:26280885

  8. Pharmacokinetic studies and renal dehydropeptidase stability of the new beta-lactamase inhibitor BRL 42715 in animals.

    PubMed Central

    Coleman, K; Griffin, D R; Upshon, P A

    1991-01-01

    BRL 42715 is a novel, highly potent beta-lactamase inhibitor with good activity against a broad range of beta-lactamases, including the class I enzymes of Enterobacter and Citrobacter spp. (K. Coleman, D.R.J. Griffin, J.W.J. Page, and P.A. Upshon, Antimicrob. Agents Chemother. 33:1580-1587, 1989). The pharmacokinetics of BRL 42715 were studied following oral and parenteral administration in mice, rats, rabbits, beagle dogs, and cynomolgus monkeys. The elimination half-life (t1/2) of BRL 42715 following intravenous administration was 7 min in rats, 6.2 min in rabbits, 11 min in dogs, and 18 min in cynomolgus monkeys; and interspecies scaling indicated a t1/2 of 31 min in humans. Urinary recovery was 24 to 43% in the three species studied. A linear relationship was observed between the dose and the theoretical concentration in blood at time zero and between the dose and area under the concentration-time curve following intravenous administration to mice. Extravascular dosing in mice, rats, and dogs resulted in an increase in t1/2, suggesting a depot effect. BRL 42715 was absorbed in mice following an oral dose (bioavailability of 0.2), but was not absorbed in rats, dogs, or cynomolgus monkeys to any significant extent. The binding of BRL 42715 in serum was 27 to 38% in mouse, rat, and dog sera but was somewhat higher (68 to 70%) in primate and human sera. BRL 42715 was not readily hydrolyzed by the renal dehydropeptidase enzymes of any of the five species studied. PMID:1952842

  9. Urinary magnesium excretion and risk of hypertension: the prevention of renal and vascular end-stage disease study.

    PubMed

    Joosten, Michel M; Gansevoort, Ron T; Mukamal, Kenneth J; Kootstra-Ros, Jenny E; Feskens, Edith J M; Geleijnse, Johanna M; Navis, Gerjan; Bakker, Stephan J L

    2013-06-01

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this association. We examined 5511 participants aged 28 to 75 years free of hypertension in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study, a prospective population-based cohort study. Circulating magnesium was measured in plasma and urinary magnesium in two 24-hour urine collections, both at baseline. Incident hypertension was defined as blood pressure ?140 mm Hg systolic or ?90 mm Hg diastolic, or initiation of antihypertensive medication. During a median follow-up of 7.6 years (interquartile range, 5.0-9.3 years), 1172 participants developed hypertension. The median urinary magnesium excretion was 3.8 mmol/24 hour (interquartile range, 2.9-4.8 mmol/24 hour). Urinary magnesium excretion was associated with risk of hypertension in an inverse log-linear fashion, and this association remained after adjustment for age, sex, body mass index, smoking status, alcohol intake, parental history of hypertension, and urinary excretion of sodium, potassium, and calcium. Each 1-unit increment in ln-transformed urinary magnesium excretion was associated with a 21% lower risk of hypertension after multivariable adjustment (adjusted hazard ratio, 0.79; 95% confidence interval, 0.71-0.88). No associations were observed between circulating magnesium and risk of hypertension. In conclusion, in this cohort of men and women, urinary magnesium excretion was inversely associated with risk of hypertension across the entire range of habitual dietary intake. PMID:23608650

  10. Study of pomegranate (Punica granatum L.) peel extract containing anthocyanins on fatty streak formation in the renal arteries in hypercholesterolemic rabbits

    PubMed Central

    Sharifiyan, Fatemeh; Movahedian-Attar, Ahmad; Nili, Nafiseh; Asgary, Sedigheh

    2016-01-01

    Background: The influence of the supplementation of pomegranate peel extract containing anthocyanins on atherosclerotic plaque formation induced by hypercholesterolemia was investigated in renal arteries in rabbits. Materials and Methods: After the determination of polyphenol and anthocyanin's content of P. granatum peel hydroalcoholic extract, 30 male rabbits were randomly divided into three groups. They were fed basic diet, hypercholesterolemic diet and hypercholesterolemic diet along with P. granatum peel extract (polyphenolic content for each rabbit 1 g/kg diet) for 2 month. Blood samples were collected at the begging, middle and end of the study in order to measure lipid concentration and oxidative and antioxidative status variables, and renal arteries were taken for the assessment of atherosclerotic plaques at the end of the study. Results: The results reveal that P. granatum peel extract significantly increases serum antioxidant capacity in the extract recipient group in comparison with hypercholesterolemic control (P < 0.05). No significant differences are observed in total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, very low-density lipoprotein and in mean size of accumulated fatty streaks in renal arteries in the extract treatment group in comparison with hypercholesterolemic control (P > 0.05). Conclusion: The results of this study indicate that consumption of pomegranate peel extract containing anthocyanins (polyphenol content 1 g/kg diet) despite of a significant increase in serum antioxidant capacity cannot protect the kidneys from hypercholesterolemia-induced damages during the treatment period. PMID:26962510

  11. A pilot study to assess markers of renal damage in the rodent kidney after exposure to 7 MHz ultrasound pulse sequences designed to cause microbubble translation and disruption

    PubMed Central

    Johnson, Kennita; Cianciolo, Rachel; Gessner, Ryan C.; Dayton, Paul A.

    2013-01-01

    Acoustic radiation force has been proposed as a mechanism to enhance microbubble concentration for therapeutic and molecular imaging applications. It is hypothesized that once microbubbles are localized, bursting them with acoustic pressure could result in local drug delivery. It is known that low-frequency, high-amplitude acoustic energy combined with cavitation nuclei can result in bioeffects. However, little is known about the bioeffects potential of acoustic parameters involved in radiation-force and microbubble destruction pulse sequences applied at higher frequencies. In this pilot study, rat kidneys are exposed to high-duty cycle, low-amplitude pulse sequences known to cause substantial bubble translation due to radiation force, as well as high-amplitude short pulse sequences known to cause microbubble destruction. Both studies are performed at 7 MHz on a clinical ultrasound system, and implemented in 3-D for entire kidney exposure. Analysis of biomarkers of renal injury and renal histopathology indicate that there was no significant renal damage due to these ultrasound parameters in conjunction with microbubbles within the study group. PMID:22104535

  12. Renal angiography with iohexol and metrizoate

    SciTech Connect

    Toernquist, C.; Holtaes, S.

    1984-02-01

    The nephrotoxicity of the ionic contrast medium metrizoate was compared with that of nonionic iohexol when used for renal angiography. Fifteen patients who underwent renal angiography with metrizoate and 15 with iohexol were studied. Serum creatinine level, Cr-51-EDTA clearance, and urine albumin level were recorded before and after angiography. Metrizoate affected renal function, as indicated both by a transient decrease in glomerular filtration rate and by a transient albuminuria. Renal function was unaffected by iohexol. Furthermore, iohexol produced less subjective discomfort than metrizoate. There appeared to be no difference in the quality of the angiograms obtained with the two media.

  13. Hereditary Papillary Renal Cell Carcinoma

    MedlinePLUS

    ... Renal Carcinoma Request Permissions Print to PDF Hereditary Papillary Renal Carcinoma Approved by the Cancer.Net Editorial Board , 12/2015 What is hereditary papillary renal carcinoma? Hereditary papillary renal carcinoma (HPRC) is a hereditary ...

  14. Study of the association between the donors and recipients angiotensin-converting enzyme insertion/deletion gene polymorphism and the acute renal allograft rejection

    PubMed Central

    Azmandian, Jalal; Mohamadifar, Mohamadamir; Rahmanian-Koshkaki, Sara; Mehdipoor, Mohammad; Nematollahi, Mohamad-Hadi; Saburi, Amin; Mandegary, Ali

    2015-01-01

    Background: Angiotensin converting enzyme (ACE) is involved in various pathophysiological conditions including renal function. ACE levels are under genetic control. Objectives: This study was designed to investigate the association between the donors and recipients ACE-I/D gene polymorphism and risk of acute rejection outcome in renal allograft recipients. Patients and Methods: ACE-I/D polymorphism was determined in 200 donor-recipient pairs who had been referred to Afzalipour hospital in Kerman. ACE-I/D polymorphism was detected using polymerase chain reaction (PCR). Acute rejection (AR) during at least six months post-transplantation was defined as a 20% increase in creatinine level from the postoperative baseline in the absence of other causes of graft dysfunction which responded to antirejection therapy. Results: The observed allele frequencies were II 9.8%, ID 35.6% and DD 44.4% in donors and II 9.8%, ID 35.1% and DD 52.7% in recipients. There were no significant association between ACE genotypes and AR episodes (ORID=0.96 [0.18-5.00] and ORDD: 1.24 [0.25-6.07] for the donors) and (ORID: 0.29 [0.06-1.45] and ORDD: 0.75 [0.19-2.90] for the recipients). Conclusions: It seems that donor and recipient ACE-I/D genotype might not be a risk factor for acute renal allograft rejection. However, due to conflicting results from this and other studies, multicenter collaborative studies with more participants and concomitant evaluation of ACE polymorphism with other polymorphisms in reninangiotensin system (RAS) are suggested to determine whether ACE genotypes are significant predictors of renal allograft rejection. PMID:26311652

  15. Bacterial factors in the formation of renal scars. An experimental study on the role of Escherichia coli P-fimbriation and hydrophobicity.

    PubMed

    Arnold, A J; Sunderland, D; Rickwood, A M; Hart, C A

    1993-11-01

    A model capable of comparing the effects of bacterial virulence factors on renal scarring in vivo has been developed using the female piglet. By creating, at open surgery, unilateral vesicoureteric reflux (VUR) and quantifying scarring both by uptake of an isotope bound to functioning renal parenchyma and by planimetry of the surface area scarred, the effects of 2 organisms, a P-fimbriate Escherichia coli and an E. coli K1 have been compared. The P-fimbriate E. coli was shown to express P-fimbriae in freshly voided urine, was more hydrophobic and produced smaller scars. This indicates that neither the hydrophobicity nor P-fimbriation of the organism causing urinary tract infection (UTI) is of prime importance for the development of renal scars and is evidence against the "big bang" theory for the development of renal scars. Studies on the association of UTI with VUR showed that infection with both E. coli under study led to VUR on the side contralateral to the side undergoing surgery. It seems likely that a non-specific effect of UTI, such as bladder oedema, is responsible for this acquired VUR. An effect of the 2 bacteria under study on the lower urinary tract was observed in that infection with the P-fimbriate E. coli allowed the retention of an intravesical wax plug, whereas infection with E. coli K1 did not. Epidemiological data have shown that the majority of upper urinary tract infections in children are associated with UTI by P-fimbriate organisms. Such an association may be explained in part by an effect of P-fimbriate bacteria on lower urinary tract function rather than an effect on the upper urinary tract. PMID:10071534

  16. A study of petrol engine dynamics

    SciTech Connect

    Winterbone, D.E.; Richards, P.

    1983-11-01

    A microprocessor controlled test bed was built for steady state mapping of petrol engines using a sweep mapping technique. The addition of an electric motor to the fast acting dynamometer allowed rapid load changes to be applied at nominally constant speed. This made it possible to consider the dynamic behaviour of the power generation sub-system of the engine. The engine was initially subjected to ramp changes of torque but these did not give consistent results. PRBS signals were then used for the same variable and a mathematical transfer function model developed for the engine power system. The engine was considered both as a continuous and sample data system. Results will be presented which show fuel management has an appreciable effect on the engine dynamic response.

  17. Theoretical study of microbubble dynamics in sonoporation.

    PubMed

    Yu, Hao; Lin, Zhongshi; Xu, Liang; Liu, Dalong; Shen, Yuanyuan

    2015-08-01

    Sonoporation is a promising technology for promoting the transfer of drug or gene into cells using ultrasound-mediated microbubbles that transiently break up the cell membrane. In this article, a model is established to analyze the dynamics of ultrasound-mediated microbubble near the cell membrane, which may be especially useful for understanding the mechanisms of sonoporation. In the model, the velocity potential of fluid on the microbubble surface and on the cell membrane is obtained by the unsteady Bernoulli equations, and it is solved by using the boundary integral equations. By numerically analyzing the model, the typical microbubble dynamics near the cell membrane are enumerated, which may be mainly governed by mechanical index. The model also established the connections among the parameters of ultrasound exposure, microbubble characteristics, and cell membrane properties in sonoporation. PMID:25957067

  18. A pilot study of autologous tumor lysate-loaded dendritic cell vaccination combined with sunitinib for metastatic renal cell carcinoma

    PubMed Central

    2014-01-01

    Background Sunitinib, a tyrosine kinase inhibitor currently in use for the treatment of metastatic renal cell carcinoma (mRCC), has been reported to modulate immunosuppressive cells such as myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in addition to exerting anti-angiogenic effects. We conducted a clinical trial of dendritic cell (DC)-based immunotherapy together with sunitinib in mRCC patients in an effort to enhance immunotherapeutic efficacy by inhibiting immunosuppressive cells. Methods Patients aged ?20years with advanced or recurrent mRCC who underwent nephrectomy were eligible for this study. Autologous tumor samples were obtained by surgery under aseptic conditions and used for preparing autologous tumor lysate. About 4weeks after surgery, leukapheresis was performed to isolate peripheral blood mononuclear cells (PBMCs). DCs were generated from adherent PBMCs in the presence of recombinant human granulocyte macrophage colony-stimulating factor (GM-CSF) (500IU/ml) and recombinant human IL-4 (500IU/ml). Autologous tumor lysate was loaded into mature DC by electroporation. Eight patients were enrolled in the study and received sunitinib at a dose of 50mg p.o. daily for 28days followed by 14days of rest. Tumor lysate-loaded DCs were administered subcutaneously every two weeks, with concomitant sunitinib. Results No severe adverse events related to vaccination were observed. Sunitinib decreased the frequencies of MDSCs in peripheral blood of 5 patients and of Tregs in 3. Tumor lysate-reactive CD4 or CD8 T cell responses were observed in 5 patients, 4 of whom showed decreased frequencies of Tregs and/or MDSCs. The remaining 3 patients who failed to develop tumor-reactive T cell responses had high levels of IL-8 in their sera and did not show consistent reductions in MDSCs and Tregs. Conclusions DC-based immunotherapy combined with sunitinib is safe and feasible for patients with mRCC. Trial registration UMIN000002136 PMID:25694811

  19. Albuminuria, renal dysfunction and circadian blood pressure rhythm in older men: a population-based longitudinal cohort study

    PubMed Central

    Xu, Hong; Huang, Xiaoyan; Risrus, Ulf; Cederholm, Tommy; Sjgren, Per; Lindholm, Bengt; rnlv, Johan; Carrero, Juan Jess

    2015-01-01

    Background Both albuminuria and kidney dysfunction may affect circadian blood pressure (BP) rhythm, while exacerbating each other's effects. We investigated associations and interactions of these two risk factors with circadian BP rhythm variation and non-dipper pattern progression in community-dwelling older men. Methods This was a cross-sectional and longitudinal analyses in the third and fourth cycles of the Uppsala Longitudinal Study of Adult Men, including 1051 men (age 71 years) with assessments on urinary albumin excretion rate (UAER), 24-h ambulatory BP monitoring (ABPM) and cystatin-C-estimated glomerular filtration rate (eGFR). Of these, 574 men attended re-examination after 6 years. Study outcomes were ABMP changes and non-dipping BP pattern (prevalence and progression). Results UAER associated with circadian BP rhythm both cross-sectionally and longitudinally. Longitudinally, significant interactions were observed between UAER and kidney dysfunction (eGFR < 60 mL/min/1.73 m2) in its association with the changes of both night-time systolic BP (SBP) and nightday SBP ratio. After stratification, UAER strongly predicted nightday SBP ratio change only in those with concurrent kidney dysfunction. At re-examination, 221 new cases of non-dipper were identified. In multivariable logistic models, high UAER associated with increased likelihood of non-dipper progression, but more strongly so among individuals with concurrent kidney dysfunction. These associations were evident also in the subpopulation of non-diabetics and in participants with normal range UAER. Conclusions UAER associates with circadian BP rhythm variation and non-dipper progression in elderly men. Concurrent renal dysfunction modifies and exacerbates these associations. PMID:26413281

  20. Urinary mercury and biomarkers of early renal dysfunction in environmentally and occupationally exposed adults: a three-country study.

    PubMed

    Jarosi?ska, Dorota; Horvat, Milena; Sllsten, Gerd; Mazzolai, Barbara; Dabkowska, Beata; Prokopowicz, Adam; Biesiada, Marek; Barregrd, Lars

    2008-10-01

    We conducted a cross-sectional study in Sweden, Italy and Poland to assess environmental and occupational exposure to mercury from chloralkali (CA) plants and the potential association with biomarkers of early renal dysfunction. Questionnaire data and first-morning urine samples were collected from 757 eligible subjects. Urine samples were analysed for mercury corrected for creatinine (U-HgC), alpha-1-microglobulin (A1M), N-acetyl-beta-glucosaminidase (NAG) and albumin. Determinants of urinary mercury excretion were examined. Levels of kidney markers were compared in three U-HgC categories, and differences were tested taking age and other covariates into account. In the general population, the median U-HgC was higher in Italian (1.2 microg/gC) than in Polish (0.22 microg/gC) or Swedish (0.21 microg/gC) subjects, and no effect of living close to CA plants could be shown. Dental amalgam, chewing on amalgam, and fish consumption were positively associated with U-HgC. In subjects from the general population, no effects on the kidney markers could be detected, while in men, including workers occupationally exposed to mercury, U-HgC was positively associated with the kidney markers, especially with NAG, but to some extent also with A1M and albumin. Differences in urinary mercury and kidney markers in the general population between three studied countries could possibly be due to dietary factors, increased susceptibility to mercury at low selenium intake or co-exposure to other nephrotoxic metals. PMID:18684440

  1. Secular trends in end-stage renal disease requiring dialysis inManitoba, Canada: a population-based study

    PubMed Central

    Yu, Nancy; Leung, Stella; Bernstein, Keevin; Blanchard, James; Sood, Manish; Rigatto, Claudio; Tangri, Navdeep

    2015-01-01

    Background End-stage renal disease (ESRD) requiring dialysis is expensive and is associated with disproportionately poor health outcomes and quality of life. Understanding regional long-term secular trends in the incidence and prevalence of dialysis will allow for the alignment of appropriate and efficient delivery of care. The primary objective of this study was to describe long-term secular and geographic trends in ESRD over a 22-year period in a single-provider Canadian health care setting. Methods Using a previously validated case definition, we described the annual incidence and prevalence of ESRD in Manitoba from 1989 to 2010, stratified by age, sex and geographic location within the province. Results We searched more than 1.2million records within the Manitoba Health repository. We identified 9489patients in the Manitoba Health Physician Claims database with at least 1 claim for dialysis from 1989 through Mar. 31, 2010. Using the case definition of any 2dialysis treatment claims, the total annual incidence of ESRD increased 2.5-fold from 15.8 to 40.2 per 100000 during the study period. Of note, the northern rural portions of the province saw a 12-fold unadjusted increase in ESRD, from 8.1 per 100 000 in 1989 to 96.3 per 100000 in 2009. Interpretation The incidence and prevalence of ESRD is increasing in Manitoba, most notably in the north of the province. Innovative interventions, such as primary screening and treatment initiatives, should specially target northern rural regions. PMID:25844374

  2. [Effect of enalapril on progression of chronic renal insufficiency caused by diabetes and other etiologies: a 2-year study].

    PubMed

    Trbojevi?, Jasna; Stojimirovi?, Biljana

    2002-01-01

    Chronic renal failure (CRF) is almost always associated with high arterial blood pressure. Adequate control of hypertension slows down the progression of the disease, Inhibitors of angiotenzin-converting enzyme (ACE inhibitors) have proved to be very efficacious in decreasing high blood pressure. The aim of this study was to assess the influence of ACE inhibitor enalapril on the progression of CRF in patients with diabetic nephropathy and nephropathies of other origin. During 1998 and 1999 thirty patients (20 males and 10 females, aged 525 +/- 1.3) have been followed-up at the Department of Nephrology, Clinical Centre of Serbia. On regular monthly controls serum creatinine, urea, calcium and protein levels, creatinine clearance, and blood pressure, were measured. All patients were suggested a low protein diet. Progression of the disease was expressed by the slope of the regression line showing reciprocal serum creatinine values. Proteinaemia was significantly higher in diabetic patients after 12 months (p < 0.35), but in the next 12 months the difference between groups disappeared. The same patients had significantly lower serum urea (p < 0.05) after 24 months and creatinine values (p < 0.05) during the whole study. Other variables changed in the same manner and with similar progression in both groups. The direction of slope lines suggested recovery of kidney function in both examined groups. However, a smaller slope in patients with diabetic nephropathy together with other results showed that enalapril had better influence on slowing down the progression of CRF in this group of patients. PMID:12154520

  3. Elevated Circulating Osteoprotegerin and Renal Dysfunction Predict 15-Year Cardiovascular and All-Cause Mortality: A Prospective Study of Elderly Women

    PubMed Central

    Zhu, Kun; Lim, Ee M.; Bollerslev, Jens; Prince, Richard L.

    2015-01-01

    Background Data on the predictive role of estimated glomerular filtration rate (eGFR) and osteoprotegerin (OPG) for cardiovascular (CVD) and all-cause mortality risk have been presented by our group and others. We now present data on the interactions between OPG with stage I to III chronic kidney disease (CKD) for all-cause and CVD mortality. Methods and Results The setting was a 15-year study of 1,292 women over 70 years of age initially randomized to a 5-year controlled trial of 1.2 g of calcium daily. Serum OPG and creatinine levels with complete mortality records obtained from the Western Australian Data Linkage System were available. Interactions were detected between OPG levels and eGFR for both CVD and all-cause mortality (P < 0.05). Compared to participants with eGFR ≥60ml/min/1.73m2 and low OPG, participants with eGFR of <60ml/min/1.73m2 and elevated OPG had a 61% and 75% increased risk of all-cause and CVD mortality respectively (multivariate-adjusted HR, 1.61; 95% CI, 1.27-2.05; P < 0.001 and HR, 1.75; 95% CI, 1.22-2.55; P = 0.003). This relationship with mortality was independent of decline in renal function (P<0.05). Specific causes of death in individuals with elevated OPG and stage III CKD highlighted an excess of coronary heart disease, renal failure and chronic obstructive pulmonary disease deaths (P < 0.05). Conclusion The association between elevated OPG levels with CVD and all-cause mortality was more evident in elderly women with poorer renal function. Assessment of OPG in the context of renal function may be important in studies investigating its relationship with all-cause and CVD mortality. PMID:26222774

  4. Preoperative statin therapy is associated with lower requirement of renal replacement therapy in patients undergoing cardiac surgery: a meta-analysis of observational studies

    PubMed Central

    Singh, Inderjeet; Rajagopalan, Sujit; Srinivasan, Anand; Achuthan, Shyambalaji; Dhamija, Puneet; Hota, Debasish; Chakrabarti, Amitava

    2013-01-01

    OBJECTIVES Acute kidney injury (AKI) following cardiac surgery is a common complication associated with serious morbidity and mortality. Activation of inflammatory cascade and vascular endothelial dysfunction plays a vital role during the perioperative period leading to AKI. Statins are known to suppress inflammation and improve endothelial dysfunction over and above the cholesterol lowering efficacy. METHODS Observational studies with a defined population in terms of preoperative statin therapy and no preoperative statin therapy undergoing cardiac surgery (CABG, isolated valve surgery or both) and with reported data on the incidence of acute renal failure/injury and/or mortality were identified and analysed for inclusion in the analysis. Outcomes evaluated were occurrence of postoperative acute kidney injury/failure, requirement of any postoperative renal replacement therapy and short-term all-cause mortality rate. A meta-analysis was conducted and a pooled estimate of odds ratio (OR) was calculated using the inverse variance method. RESULTS A total of 17 studies with a total population of 24 998 statin users and 22 082 non-statin users were included in the final analysis. PST resulted in a significantly lower incidence of renal replacement therapy in patients undergoing CABG (OR: 0.56 [0.410.76]) but not in isolated valve surgery (OR: 1.80 [0.734.44]). Also preoperative statin therapy resulted in a significantly lower postoperative mortality (0.72 [0.610.84]) irrespective of the type of surgery. There was no effect of preoperative statin therapy on the incidence of AKI in any of the sub-group of the patients. CONCLUSIONS Patients undergoing CABG might derive benefit from preoperative statin therapy in terms of reducing the need for postoperative renal replacement therapy and mortality. However, the uncertainty concerning the reno-protective efficacy of preoperative statin therapy in patients undergoing isolated valve surgery needs further investigation. PMID:23628654

  5. The renal microcirculation in sepsis.

    PubMed

    Ergin, Bulent; Kapucu, Aysegul; Demirci-Tansel, Cihan; Ince, Can

    2015-02-01

    Despite identification of several cellular mechanisms being thought to underlie the development of septic acute kidney injury (AKI), the pathophysiology of the occurrence of AKI is still poorly understood. It is clear, however, that instead of a single mechanism being responsible for its aetiology, an orchestra of cellular mechanisms failing is associated with AKI. The integrative physiological compartment where these mechanisms come together and exert their integrative deleterious action is the renal microcirculation (MC). This is why it is opportune to review the response of the renal MC to sepsis and discuss the determinants of its (dys)function and how it contributes to the pathogenesis of renal failure. A main determinant of adequate organ function is the adequate supply and utilization of oxygen at the microcirculatory and cellular level to perform organ function. The highly complex architecture of the renal microvasculature, the need to meet a high energy demand and the fact that the kidney is borderline ischaemic makes the kidney a highly vulnerable organ to hypoxaemic injury. Under normal, steady-state conditions, oxygen (O2) supply to the renal tissues is well regulated; however, under septic conditions the delicate balance of oxygen supply versus demand is disturbed due to renal microvasculature dysfunction. This dysfunction is largely due to the interaction of renal oxygen handling, nitric oxide metabolism and radical formation. Renal tissue oxygenation is highly heterogeneous not only between the cortex and medulla but also within these renal compartments. Integrative evaluation of the different determinants of tissue oxygen in sepsis models has identified the deterioration of microcirculatory oxygenation as a key component in the development AKI. It is becoming clear that resuscitation of the failing kidney needs to integratively correct the homeostasis between oxygen, and reactive oxygen and nitrogen species. Several experimental therapeutic modalities have been found to be effective in restoring microcirculatory oxygenation in parallel to improving renal function following septic AKI. However, these have to be verified in clinical studies. The development of clinical physiological biomarkers of AKI specifically aimed at the MC should form a valuable contribution to monitoring such new therapeutic modalities. PMID:24848133

  6. Renal cell carcinoma

    MedlinePLUS

    Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) ... Renal cell carcinoma is the most common type of kidney cancer in adults. It occurs most often in men ...

  7. Emerging Entities in Renal Neoplasia.

    PubMed

    Mehra, Rohit; Smith, Steven C; Divatia, Mukul; Amin, Mahul B

    2015-12-01

    This article reviews emerging entities in renal epithelial neoplasia, including tubulocystic carcinoma, clear-cell-papillary renal cell carcinoma (RCC), thyroid-like follicular RCC, ALK-related RCC, translocation RCC, acquired cystic disease-related RCC, succinate dehydrogenase-deficient RCC, and hereditary leiomyomatosis-RCC syndrome-associated RCC. Many of these rarer subtypes of RCC were recently studied in more depth and are included in the upcoming version of the World Health Organization classification of tumors. Emphasis is placed on common gross and morphologic features, differential diagnoses, use of ancillary studies for making accurate diagnoses, molecular alterations, and predicted biologic behavior based on previous studies. PMID:26612218

  8. Continuous renal replacement therapy in children with severe sepsis and multiorgan dysfunction - A pilot study on timing of initiation

    PubMed Central

    Gulla, Krishna Mohan; Sachdev, Anil; Gupta, Dhiren; Gupta, Neeraj; Anand, Kanav; Pruthi, P. K.

    2015-01-01

    Objective: Scanty literature is available regarding continuous renal replacement therapy (CRRT) utility in severe sepsis with multiorgan dysfunction syndrome (MODS) from developing countries. Author unit's experience in pediatric CRRT is described and outcome of early initiation of CRRT with sepsis and MODS is assessed. Materials and Methods: Children aged <16 years with sepsis and MODS who required CRRT from September 2010 to February 2015 were analyzed on demographic factors, timing of initiation of CRRT, mode of CRRT, effect of CRRT onhemodynamics, oxygenation parameters, and outcome. Results: Twenty-seven children required CRRT (male - 16). The median age was 11 years (range 1.116). Twenty-one had severe sepsis with MODS. Eighteen patients were given CRRT within 48 h of admission to Intensive Care Unit (ICU). Statistically significant improvement in the P/F ratio, decrement in plateau pressure and vasoactive-inotropic score were noted in survivor group compared to nonsurvivor group (P = 0.022, 0.00, and 0.03, respectively). There was no statistically significant difference in duration of ICU stay, fluid overload, CRRT duration, PRISM score at 12 and 24 h, percentage of decrease in inotrope score, plateau pressure, and percentage of increase in P/F ratio in relation to timing of CRRT initiation. However, the survival rate was 61.1% (11/18) who received CRRT within 48 h of ICU admission compared to 33.3% (3/9) who received after 48 h (P = 0.0001). Conclusion: Our study emphasizes the CRRT role in improving the oxygenation status and hemodynamics. Survival benefit may be expected in those children who receive CRRT early in the course of sepsis. However, multicenter RCTs are required to prove mortality benefit. PMID:26628828

  9. An investigation of risk factors for renal cell carcinoma by histologic subtype in two case-control studies.

    PubMed

    Purdue, Mark P; Moore, Lee E; Merino, Maria J; Boffetta, Paolo; Colt, Joanne S; Schwartz, Kendra L; Bencko, Vladimir; Davis, Faith G; Graubard, Barry I; Janout, Vladimir; Ruterbusch, Julie J; Beebe-Dimmer, Jennifer; Cote, Michele L; Shuch, Brian; Mates, Dana; Hofmann, Jonathan N; Foretova, Lenka; Rothman, Nathaniel; Szeszenia-Dabrowska, Neonilia; Matveev, Vsevolod; Wacholder, Sholom; Zaridze, David; Linehan, W Marston; Brennan, Paul; Chow, Wong-Ho

    2013-06-01

    To investigate whether renal cell carcinoma (RCC) histologic subtypes possess different etiologies, we conducted analyses of established RCC risk factors by subtype (clear cell, papillary and chromophobe) in two case-control studies conducted in the United States (1,217 cases, 1,235 controls) and Europe (1,097 cases, 1,476 controls). Histology was ascertained for 706 U.S. cases (58% of total) and 917 European cases (84%) through a central slide review conducted by a single pathologist. For the remaining cases, histology was abstracted from the original diagnostic pathology report. Case-only analyses were performed to compute odds ratios (ORs) and 95% confidence intervals (CI) summarizing subtype differences by age, sex and race. Case-control analyses were performed to compute subtype-specific ORs for other risk factors using polytomous regression. In case-only analyses, papillary cases (N = 237) were older (OR = 1.2, 95% CI = 1.1-1.4 per 10-year increase), less likely to be female (OR = 0.5, 95% CI = 0.4-0.8) and more likely to be black (OR = 2.6, 95% CI = 1.8-3.9) as compared to clear cell cases (N = 1,524). In case-control analyses, BMI was associated with clear cell (OR = 1.2, 95% CI = 1.1-1.3 per 5 kg/m(2) increase) and chromophobe RCC (N = 80; OR = 1.2, 95% CI = 1.1-1.4), but not papillary RCC (OR = 1.1, 95% CI = 1.0-1.2; test versus clear cell, p = 0.006). No subtype differences were observed for associations with smoking, hypertension or family history of kidney cancer. Our findings support the existence of distinct age, sex and racial distributions for RCC subtypes, and suggest that the obesity-RCC association differs by histology. PMID:23150424

  10. Alleviative effect of myricetin on ochratoxin A-induced oxidative stress in rat renal cortex: histological and biochemical study.

    PubMed

    El-Haleem, Manal R Abdel; Kattaia, Asmaa A A; El-Baset, Samia A Abdel; Mostafa, Heba El Sayed

    2016-04-01

    Ochratoxins (OTA) are secondary metabolites of Aspergillus and Penicillium. The detoxification of OTA has been of major interest due to its widespread threat to human health. We aimed to investigate the possible alleviative effect of myricetin (MYR) against OTA-induced damage in renal cortex of rats. Thirty adult male albino rats were randomized into five equal groups: control (untreated), vehicle control (0.5 ml corn oil/day including dimethylsulfoxide [DMSO]), MYR (100 mg MYR/kg b.w./day in distilled water), OTA (0.5 mg OTA/kg b.w./day; dissolved in 10% DMSO and then corn oil) and OTA + MYR group (received OTA and MYR at similar doses). All treatments were given by oral gavage for 2 weeks. At the end of the experiment, renal cortices were processed for light and electron microscope examinations. Immunohistochemical staining for localization of proliferating cell nuclear antigen (PCNA), p53 and transforming growth factor beta 1 (TGF-β1) was carried out. Biochemical analysis of tissue glutathione peroxidase (GPX), catalase (CAT) and superoxide dismutase (SOD) were determined to evaluate oxidative stress. OTA administration induced deleterious renal injury evidenced by the structural and ultra-structural changes. Immunohistochemical expression of p53, PCNA and TGF-β1 were significantly up regulated compared with control. Alterations in antioxidant parameters supported that oxidative stress was one of the mechanisms involved in OTA toxicity. On the contrary, co-administration of MRY partially ameliorated OTA-induced renal injury. We suggest the potential effectiveness of MYR to counteract OTA-induced toxic oxidative stress on the renal cortex. PMID:26571153

  11. Renal clearance studies of effect of left atrial distension in the dog.

    NASA Technical Reports Server (NTRS)

    Kinney, M. J.; Discala, V. A.

    1972-01-01

    Investigation of the water diuresis of left atrial distension in 16 dogs on the basis of clearance studies employing hydration, chronic and acute salt loading, deoxycorticosterone (DOCA) in excess, and distal tubular nephron blockade with diuretics. The diuresis was found in hydrated and salt-loaded dogs and was independent of DOCA and presumed renin depletion. It was not found in five dogs after distal tubular blockade. No significant reproducible saluresis was ever documented. The water diuresis was always stopped by exogenous vasopressin (seven dogs). Antidiuretic hormone inhibition with distal tubular nephron water permeability changes appears to be the sole mechanism of the diuresis of left atrial distension in the dog.

  12. Molecular beam studies of reaction dynamics

    SciTech Connect

    Lee, Y.T.

    1987-03-01

    Purpose of this research project is two-fold: (1) to elucidate detailed dynamics of simple elementary reactions which are theoretically important and to unravel the mechanism of complex chemical reactions or photo chemical processes which play an important role in many macroscopic processes and (2) to determine the energetics of polyatomic free radicals using microscopic experimental methods. Most of the information is derived from measurement of the product fragment translational energy and angular distributions using unique molecular beam apparati designed for these purposes.

  13. Response of human renal tubular cells to cyclosporine and sirolimus: a toxicogenomic study.

    PubMed

    Pallet, Nicolas; Rabant, Marion; Xu-Dubois, Yi-Chun; Lecorre, Delphine; Mucchielli, Marie-Hélène; Imbeaud, Sandrine; Agier, Nicolas; Hertig, Alexandre; Thervet, Eric; Legendre, Christophe; Beaune, Philippe; Anglicheau, Dany

    2008-06-01

    The molecular mechanisms involved in the potentially nephrotoxic response of tubular cells to immunosuppressive drugs remain poorly understood. Transcriptional profiles of human proximal tubular cells exposed to cyclosporine A (CsA), sirolimus (SRL) or their combination, were established using oligonucleotide microarrays. Hierarchical clustering of genes implicated in fibrotic processes showed a clear distinction between expression profiles with CsA and CsA+SRL treatments on the one hand and SRL treatment on the other. Functional analysis found that CsA and CsA+SRL treatments preferentially alter biological processes located at the cell membrane, such as ion transport or signal transduction, whereas SRL modifies biological processes within the nucleus and related to transcriptional activity. Genome wide expression analysis suggested that CsA may induce an endoplasmic reticulum (ER) stress in tubular cells in vitro. Moreover we found that CsA exposure in vivo is associated with the upregulation of the ER stress marker BIP in kidney transplant biopsies. In conclusion, this toxicogenomic study highlights the molecular interaction networks that may contribute to the tubular response to CsA and SRL. These results may also offer a new working hypothesis for future research in the field of CsA nephrotoxicity. Further studies are needed to evaluate if ER stress detection in tubular cells in human biopsies can predict CsA nephrotoxicity. PMID:18331748

  14. Response of human renal tubular cells to cyclosporine and sirolimus: A toxicogenomic study

    SciTech Connect

    Pallet, Nicolas Rabant, Marion; Xu-Dubois, Yi-Chun; LeCorre, Delphine; Mucchielli, Marie-Helene; Imbeaud, Sandrine; Agier, Nicolas; Thervet, Eric; Legendre, Christophe; Beaune, Philippe; Anglicheau, Dany

    2008-06-01

    The molecular mechanisms involved in the potentially nephrotoxic response of tubular cells to immunosuppressive drugs remain poorly understood. Transcriptional profiles of human proximal tubular cells exposed to cyclosporine A (CsA), sirolimus (SRL) or their combination, were established using oligonucleotide microarrays. Hierarchical clustering of genes implicated in fibrotic processes showed a clear distinction between expression profiles with CsA and CsA + SRL treatments on the one hand and SRL treatment on the other. Functional analysis found that CsA and CsA + SRL treatments preferentially alter biological processes located at the cell membrane, such as ion transport or signal transduction, whereas SRL modi