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Sample records for left staghorn kidney

  1. [Isotopic kidney investigations in staghorn lithiasis in the adult (author's transl)].

    PubMed

    Gaussin, G; Oliveux, A; Scheiben, C; Bollack, C

    1980-01-01

    The authors report a study of 37 kidneys in 30 patients with staghorn calculi undergoing isotopic investigation of renal function by sequential scintigraphy and isotopic nephrogram by gamma-camera. 7 of the patients had bilateral staghorn calculi. Tracers used: Hippuran labelled with I131 and DPTA labelled with Technetium 99 m. 62% of kidneys poorly tolerated their staghorn calculus as shown by severe impairment of the isotopic nephrogram involving the uptake phase. Amongst the 20 cases of unilateral lithiasis, a nephrectomy was performed whenever the functional value was less than 20% normal (7 kidneys). Twelve stones were removed with conservation of the kidney. It should be noted that with renal function greater than 70% normal, the thickness of the renal parenchyma as assessed by IVU is never less by more than 1/2 cm that of the contralateral kidney. In the group, 11 patients underwent postoperative urography and scintigraphy with a mean follow up of 4 years. All extractions of calculi by pyelotomy with or without a small nephrotomy benefited initially impaired kidneys. By contrast, in 5 kidneys where a large nephrotomy was made, there was a gain in function in only one. 1 remained stationary and the others lost respectively 20, 30 and 100% of their function. Correlation was good with other methods of split renal function studies (IVU and renal arteriography). Of essential importance is the fact that the irradiation associated with these isotopic investigations is 20 to 50 times less than that of IVU. Isotopic investigation is thus a good method for the assessment of changes in renal function after surgery for staghorn calculus.

  2. Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by 99mtechnetium-dimercaptosuccinic acid renal scintigraphy.

    PubMed

    Kawamura, J; Itoh, H; Okada, Y; Higashi, Y; Yoshida, O; Fujita, T; Torizuka, K

    1983-09-01

    99mTechnetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

  3. Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone

    PubMed Central

    Shahandeh, Zahra; Shafi, Hamid; Sadighian, Farahnaz

    2015-01-01

    Background: Stphylococcus cohnii is an organism of coagulase negative species which is considered as normal flora. However, it has been isolated from urinary tract infections and surgical prostheses but its relation with staghorn stones has not been reported, yet. Case Presentation: A 50-years-old woman presented with left renal staghorn stone in June 2014. She had bilateral staghorn stones 7 years ago. Staphylococcus cohnii subspecies urealyticum were detected from a removed stone. After 7 years, recurrence staghorn stone in her left kidney was diagnosed and patient underwent another surgery. The patient had several attacks of cystitis during these 7 years. The results of stone and urine cultures revealed staphylococcus cohnii subspecies urealyticum. Conclusion: This case report emphasizes a possible association between staphylococcus cohnii subspecies urealyticum infection and recurrence renal staghhorn stone. PMID:26221496

  4. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney.

    PubMed

    Xu, Guibin; Li, Xun; He, Yongzhong; He, Zhaohui

    2012-12-01

    The aim of this study was to evaluate the outcome of staged single-tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy as a minimally invasive option in the treatment of staghorn stone in patients with a solitary kidney. A total of 24 patients with staghorn stone in a solitary kidney were treated with single-tract MPCNL and flexible ureteroscopy by a single surgeon. All the patients underwent single-tract MPCNL through a 20 F tract and had most of the intrarenal calculi removed at the first stage. The second stage of retrograde flexible ureteroscopy was performed 3-5 days later, after the drainage was cleared. The preoperative patient, characteristics, stone size, operative time, renal functional status and postoperative outcomes were then evaluated. Sixteen patients were partial staghorn (66.7 %), and other eight were complete staghorn (33.3 %). The overall stone-free rate was 83.3 % after the second-stage procedures, and only four patients had significant residue. The hemoglobin drop ranged from 1.1 to 3.7 g/dl, and three patients required blood transfusion. The mean serum creatinine value was 1.7 ± 0.5 mg/dl before surgery and 1.3 ± 0.4 mg/dl at the end of the follow-up period with statistical significance (P < 0.05). None of the patients had increased serum creatinine, and needed dialysis at the end of the follow-up period. Staged single-tract MPCNL and flexible ureteroscopy are safe and effective for the management of staghorn stone in patients with a solitary kidney and even in patients with impaired renal functions.

  5. Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by /sup 99m/technetium-dimercaptosuccinic acid renal scintigraphy

    SciTech Connect

    Kawamura, J.; Itoh, H.; Okada, Y.; Higashi, Y.; Yoshida, O.; Fujita, T.; Torizuka, K.

    1983-09-01

    /sup 99m/Technetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

  6. Effects of Reduced Kidney Function Because of Living Kidney Donation on Left Ventricular Mass.

    PubMed

    Altmann, Ursula; Böger, Carsten A; Farkas, Stefan; Mack, Matthias; Luchner, Andreas; Hamer, Okka W; Zeman, Florian; Debl, Kurt; Fellner, Claudia; Jungbauer, Carsten; Banas, Bernhard; Buchner, Stefan

    2017-02-01

    Living kidney donation is associated with a small but significant increase in cardiovascular mortality. In addition, mildly decreased kidney function is associated with an increase of left ventricular mass and with cardiovascular disease in patients with chronic kidney disease. To investigate this association, we evaluated the impact of mildly decreased kidney function after living kidney donation on subclinical cardiac structural and functional changes. In this prospective cohort study, cardiac and renal magnetic resonance imaging and laboratory analyses were performed in 23 living kidney donors (mean age 54±10 years, 52% male) before donation and at 4 and 12 months after nephrectomy. Mean estimated glomerular filtration rate was 102±15 mL min(-1) 1.73 m(-2) before donation and 70±13 mL min(-1) 1.73 m(-2) at 12 months (P<0.001). Left ventricular mass increased from 112±22 to 115±23 g (P<0.001). In addition, heart rate was significantly increased (65±7 to 74±14; P=0.04). Concurrently, kidney and adrenal gland volume increased from 163±33 to 195±34 mL (P<0.001) and from 7.6±2.2 to 8.4±2.4 mL (P=0.032), respectively, as did procollagen type III (Δ0.11 ng/mL, P<0.001) and not N-terminal probrain natriuretic peptide (Δ14 pg/mL, P=0.25). The mild decrease in kidney function after living kidney donation leads to a significant but clinically negligible increase in left ventricular mass 12 months after living kidney donation. This study of a longitudinal analysis of living kidney donors provides direct evidence of a kidney-heart link.

  7. Comparison of the morphometric features of the left and right horse kidneys: a stereological approach.

    PubMed

    Bolat, D; Bahar, S; Tipirdamaz, S; Selcuk, M L

    2013-12-01

    The aims of this study were to determine the total volume of the horse kidney and volume fractions of its functional subcomponents (cortex, medulla, renal pelvis) using stereological methods and investigate any possible difference in the functional subcomponents of the right and left kidneys that may arise from differences in shape. The study was carried out on the kidneys of 5 horses of different breed and sex. The weight of the kidneys was measured by a digital scale, and kidney volume was calculated by Archimedes' principle. Total kidney volume and volume fractions of subcomponents of the right and left kidneys were estimated by the Cavalieri's principle. The weights of the right and left kidneys were 550 ± 25 g and 585 ± 23 g, respectively. The volumes of the right and left kidneys estimated using the Cavalieri method were 542 ± 46 ml and 581 ± 29 ml. The relative organ weight of the kidneys was calculated as 1:330. The densities of the right and left kidneys were determined to be 1.01 and 1.00, respectively. The mean volume fractions of the cortex, medulla and renal pelvis were determined as 55.6, 42.7 and 1.7 in both kidneys. No statistically significant difference existed between morphometric data pertaining to the right and left kidneys (P > 0.05). To determine precisely whether differences in shape cause any difference in the functional subcomponents of the right and left kidneys requires further investigation of differences in the number of microscopically functional unit of the kidney such as renal glomeruli and nephrons.

  8. Staghorn calculus endotoxin expression in sepsis.

    PubMed

    McAleer, Irene M; Kaplan, George W; Bradley, John S; Carroll, Stephen F

    2002-04-01

    Staghorn calculi are infrequent and generally are infected stones. Struvite or apatite calculi are embedded with gram-negative bacteria, which can produce endotoxin. Sepsis syndrome may occur after surgical therapy or endoscopic manipulation of infected or staghorn calculi. Sepsis, which can occur despite perioperative antibiotic use, may be due to bacteremia or endotoxemia. We present a child with an infected staghorn calculus who developed overwhelming sepsis and died after percutaneous stone manipulation. Endotoxin assay of stone fragments demonstrated an extremely high level of endotoxin despite low colony bacterial culture growth. This is the first reported case in which endotoxin was demonstrated in stone fragments from a child who died of severe sepsis syndrome after percutaneous staghorn stone manipulation.

  9. [Renal function after surgical treatment of stag-horned nephrolithiasis].

    PubMed

    Akulin, S M; Ianenko, E K; Demin, A I; Nikitinskaia, L P

    2010-01-01

    Renal function in patients with stag-horn nephrolithiasis was assessed after two surgical treatments--percutaneous nephrolitholapaxy (PCN L) and pyelonephrolithotomy. The function of the operated and contralateral kidneys was studied early and late after operation by parameters of blood biochemistry, Doppler investigation of renal parenchyma, dynamic nephroscintigraphy. Stabilization or improvement of blood biochemical indices was observed in 58 (70%) patients. A secretory renal function late after surgery (from 6 months to 2 years) evidenced for improvement or stabilization of renal function (according to radionuclide test) in 71 (85.5%) patients. Integral parameters of renal blood flow were physiological or improved versus preoperative ones. PCNL was made in patients with deficient secretion less than 70%, 35 (87.5%) patients were diagnosed to have stabilization or functional improvement. After open intervention functional improvement took place in 11 (25.6%) patients, stabilization of renal function occurred in 25 (58.1%) patients. Tubular secretion deterioration was seen much more frequently in patients after open intervention. PCNL is less invasive surgical intervention than pyelonephrolithotomy as this technique produces milder surgical trauma and does not result in intraoperative renal ischemia. PCNL is the most effective surgical modality in stag-horn concrements of the kidneys and significantly expands potential of low-invasive treatment of such patients.

  10. Natural Disease Resistance in Threatened Staghorn Corals

    PubMed Central

    Vollmer, Steven V.; Kline, David I.

    2008-01-01

    Disease epidemics have caused extensive damage to tropical coral reefs and to the reef-building corals themselves, yet nothing is known about the abilities of the coral host to resist disease infection. Understanding the potential for natural disease resistance in corals is critically important, especially in the Caribbean where the two ecologically dominant shallow-water corals, Acropora cervicornis and A. palmata, have suffered an unprecedented mass die-off due to White Band Disease (WBD), and are now listed as threatened under the US Threatened Species Act and as critically endangered under the IUCN Red List criteria. Here we examine the potential for natural resistance to WBD in the staghorn coral Acropora cervicornis by combining microsatellite genotype information with in situ transmission assays and field monitoring of WBD on tagged genotypes. We show that six percent of staghorn coral genotypes (3 out of 49) are resistant to WBD. This natural resistance to WBD in staghorn corals represents the first evidence of host disease resistance in scleractinian corals and demonstrates that staghorn corals have an innate ability to resist WBD infection. These resistant staghorn coral genotypes may explain why pockets of Acropora have been able to survive the WBD epidemic. Understanding disease resistance in these corals may be the critical link to restoring populations of these once dominant corals throughout their range. PMID:19005565

  11. Inferior early posttransplant outcomes for recipients of right versus left deceased donor kidneys: an ANZDATA registry analysis.

    PubMed

    Vacher-Coponat, H; McDonald, S; Clayton, P; Loundou, A; Allen, R D M; Chadban, S J

    2013-02-01

    Anatomical differences between right and left kidneys could influence transplant outcome. We compared graft function and survival for left and right kidney recipients transplanted from the same deceased organ donor. Adult recipients of 4900 single kidneys procured from 2450 heart beating deceased donors in Australia and New Zealand from 1995 to 2009 were included in a paired analysis. Right kidneys were associated with more delayed graft function (DGF) (25 vs. 21% for left kidneys, p < 0.001) and, if not affected by DGF, a slower fall in serum creatinine. One-year graft survival was lower for right kidneys (89.1 vs. 91.1% for left kidneys, p = 0.001), primarily attributed to surgical complications (66 versus 35 failures for left kidneys). Beyond the first posttransplant year, kidney side was not associated with eGFR, graft or patient survival. Receipt of a right kidney is a risk factor for inferior outcomes in the first year after transplantation. A higher incidence of surgical complications suggests the shorter right renal vein may be contributory. The higher susceptibility of right kidneys to injury should be considered in organ allocation.

  12. Management of Ruptured Occult Left Hydronephrotic Kidney in 7-Year - old Boy: A Case Report

    PubMed Central

    More, Santosh

    2014-01-01

    Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic shock and peritonitis. Skiagram of the abdomen showed haziness of the abdomen, without free gas under diaphragm. Ultrasonography (USG) of the abdomen revealed significant hemoperitoneum and gross hydronephrosis of the left kidney, which was undiagnosed previously. Exploratory laparotomy was done for peritonitis and the findings were hemoperitoneum, hematoma at the left mesocolon and left retroperitoneum. Postoperative computed tomography (CT) scan of the abdomen reported left hydronephrosis due to pelvi-ureteric junction (PUJ) obstruction with rupture of the renal pelvis. The ruptured hydronephrotic kidney was successfully managed by nephrostomy followed by delayed open dismembered Anderson-Hynes pyeloplasty. His postoperative recovery following pyeloplasty was uneventful and he was doing well at follow-up after a month of pyeloplasty. PMID:25478398

  13. Robotic extended pyelolithotomy for complete staghorn calculus.

    PubMed

    Sotelo, Rene; Astigueta, Juan Carlos; Giedelman, Camilo; de Andrade, Robert; Carmona, Oswaldo; Ramirez, Daniel; Clavijo, Rafael

    2010-08-01

    Staghorn stones represent a therapeutic challenge to urologists. We present our experience with laparoscopic extended pyelolithotomy for treatment of staghorn and complex renal calculi in highly selected cases. This approach provides the principles of open surgery with the advantages of minimally invasive surgery. We describe our experience with robot-assisted extended pyelolithotomy for complex coralliform calculi. Since January 2007, robotic extended pyelolithotomy has been performed by transperitoneal approach in two patients with complete coralliform lithiasis (calculi average size 8 cm). One patient had history of percutaneous nephrolithotomy. Demographic and operative data were collected. All procedures were technically successful without need for open conversion. Mean estimated blood loss was 175 ml (range 50-300 ml), and mean operative time was 150 min (range 120-150 min). A perinephric drain was employed in one patient with duration of 5 days. Postoperative imaging confirmed complete stone clearance. Robotic extended pyelolithotomy is a feasible and reproducible procedure for removal of complete and partial staghorn calculi in selected patients with complex nephrolithiasis. This approach might limit the role of open surgery for these calculi, but further publications with more cases are necessary to further define its utility.

  14. Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment

    PubMed Central

    Di Lullo, Luca; Gorini, Antonio; Russo, Domenico; Santoboni, Alberto; Ronco, Claudio

    2015-01-01

    Cardiovascular diseases represent the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). According to a well-established classification, cardiovascular involvement in CKD can be set in the context of cardiorenal syndrome type 4. Left ventricular hypertrophy (LVH) represents a key feature to provide an accurate picture of systolic-diastolic left heart involvement in CKD patients. Cardiovascular involvement is present in about 80% of prevalent hemodialysis patients, and it is evident in CKD patients since stage IIIb-IV renal disease (according to the K/DOQI CKD classification). According to the definition of cardiorenal syndrome type 4, kidney disease is detected before the development of heart failure, although timing of the diagnosis is not always possible. The evaluation of LVH is a bit heterogeneous, and few standard imaging methods can provide the accuracy of either CT- or MRI-derived left ventricular mass. Key principles in the treatment of LVH in CKD patients are mainly based on anemia and blood pressure control, together with the management of secondary hyperparathyroidism and sudden cardiac death prevention. This review is mainly focused on the clinical aspects of CKD-related LVH to provide practical guidelines both for cardiologists and nephrologists in the daily clinical approach to CKD patients. PMID:26648942

  15. Left Ventricle Hypertrophy, Dilatation and Ejection Fraction Changes Before and After Kidney Transplantation

    PubMed Central

    Tayebi-Khosroshahi, Hamid; Abbasnezhad, Mohsen; Habibzadeh, Afshin; Bakhshandeh, Masumeh; Chaichi, Parastoo

    2013-01-01

    Background Patients with end stage renal disease (ESRD) are at risk of complications in different organs including cardiovascular system. Renal transplantation is the best choice in these patients which diminishes these complications. It is observed that after renal transplantation, cardiac parameters have appropriate improvement. Current study evaluates echocardiographic findings in renal transplant recipients before and after kidney transplantation. Methods In an analytic cross sectional study, 30 patients (50% male, mean age of 45.57 ± 13.32 years) with ESRD who underwent renal transplantation were studied. All patients had echocardiographic studies after the last dialysis before and 6 months after transplantation. Echocardiographic study was done by Color Doppler two dimension methods and left ventricle ejection fraction was measured by Simpson method. All echocardiograms before and after transplantation were interpreted by the same cardiologist. Results Mean left ventricle ejection fraction before and after renal transplantation was 53.83±10.14% and 57.33±4.49%, respectively (P = 0.09). Left ventricle hypertrophy, mitral regurgitation and tricuspid regurgitation existed in 46.7%, 76.7% and 33.3% respectively, which was improved in 30%, 50% and 33.3% after renal transplantation. Conclusion According to the results of current study it is suggested that renal transplantation could improve left ventricle parameters in patients with end stage renal disease.

  16. Pre- and postoperative evaluation of renal function in patients with staghorn calculi utilizing quantitative renal scanning.

    PubMed

    Stage, K H; Lewis, S

    1981-01-01

    Differential quantitative renal scans using 99-technetium diethylene triaminepentaacetic acid (DTPA) or 131I Hippuran were obtained properatively on 12 patients with unilateral or bilateral staghorn calculi. Of the 14 renal units studied, 12 kidneys underwent anatrophic nephrolithotomy, pyelolithotomy, or a combination of both techniques; 2 patients underwent nephrectomy based on poor function of the affected side preoperatively. Postoperative follow-up scans were obtained on the 12 kidneys undergoing stone cleanout. Seven of 12 kidneys (58 per cent) studied pre- and postoperatively showed moderate to significant improvement in per cent contribution to total renal function. Seven of 10 kidneys (70 per cent) studied pre- and postoperatively showed improvement in glomerular filtration rate or effective renal plasma flow. The scans revelaed no dramatic difference in postoperative functional loss between pyelolithotomy and anatrophic nephrolithotomy. The computerizewd quantitative renal scan helps in selection of surgical technique and objective postoperative assessment of surgical results.

  17. Cardiac output and associated left ventricular hypertrophy in pediatric chronic kidney disease.

    PubMed

    Weaver, Donald J; Kimball, Thomas R; Koury, Phillip R; Mitsnefes, Mark M

    2009-03-01

    A significant number of children with chronic kidney disease (CKD) have eccentric left ventricular hypertrophy (LVH), suggesting the role of preload overload. Therefore, we hypothesized that increased cardiac output (CO) might be a contributing factor for increased left ventricular mass index (LVMI) in these children. Patients aged 6-20 years with CKD stages 2-4 were enrolled. Echocardiograms were performed to assess LV function and geometry at rest and during exercise. Heart rate, stroke volume, and CO were also assessed at rest and during exercise. Twenty-four-hour ambulatory blood pressure (AMBP) monitoring was performed. Of the patients enrolled in this study, 17% had LVH. Increased stroke volume and CO were observed in patients with LVH compared to patients without LVH. Univariate analysis revealed significant positive associations between LVMI and CO, stroke volume, body mass index, pulse pressure from mean 24-h AMBP, and mean 24-h systolic BP load. No association with heart rate, age, parathyroid hormone, glomerular filtration rate, or anemia was observed. Only CO (beta = 1.98, p = 0.0005) was independently associated with increased LVMI in multivariate modeling (model R (2) = 0.25). The results of this study suggest that increased CO might predispose to increased LVMI in pediatric patients with CKD. Adaptations may be required to meet increased metabolic demand in these patients.

  18. The Oak Ridge Polycystic Kidney (orpk) disease gene is required for left-right axis determination.

    PubMed

    Murcia, N S; Richards, W G; Yoder, B K; Mucenski, M L; Dunlap, J R; Woychik, R P

    2000-06-01

    Analysis of several mutations in the mouse is providing useful insights into the nature of the genes required for the establishment of the left-right axis during early development. Here we describe a new targeted allele of the mouse Tg737 gene, Tg737(Delta)2-3(beta)Gal), which causes defects in left-right asymmetry and other abnormalities during embryogenesis. The Tg737 gene was originally identified based on its association with the mouse Oak Ridge Polycystic Kidney (orpk) insertional mutation, which causes polycystic kidney disease and other defects. Complementation tests between the original orpk mutation and the new targeted knock-out mutation demonstrate that Tg737(Delta)2-3(beta)Gal) behaves as an allele of Tg737. The differences in the phenotype between the two mutations suggest that the orpk mutation is a hypomorphic allele of the Tg737 gene. Unlike the orpk allele, where all homozygotes survive to birth, embryos homozygous for the Tg737(Delta)2-3(beta)Gal) mutation arrest in development at mid-gestation and exhibit neural tube defects, enlargement of the pericardial sac and, most notably, left-right asymmetry defects. At mid-gestation the direction of heart looping is randomized, and at earlier stages in development lefty-2 and nodal, which are normally expressed asymmetrically, exhibit symmetrical expression in the mutant embryos. Additionally, we determined that the ventral node cells in mutant embryos fail to express the central cilium, which is a characteristic and potentially functional feature of these cells. The expression of both Shh and Hnf3(beta) is downregulated in the midline at E8.0, indicating that there are significant alterations in midline development in the Tg737(Delta)2-3(beta)Gal) homozygous embryos. We propose that the failure of ventral node cells to fully mature alters their ability to undergo differentiation as they migrate out of the node to contribute to the developing midline structures. Analysis of this new knockout allele

  19. The Association of Long-Functioning Hemodialysis Vascular Access with Prevalence of Left Ventricular Hypertrophy in Kidney Transplant Recipients

    PubMed Central

    Kujawa-Szewieczek, Agata; Szotowska, Magdalena; Więcek, Andrzej

    2014-01-01

    Left ventricular hypertrophy (LVH) is frequently observed in chronic dialysis patients and is also highly prevalent in kidney transplant recipients. This study evaluates the impact of long-functioning hemodialysis vascular access on LVH in single center cohort of kidney transplant recipients. 162 patients at 8.7 ± 1.8 years after kidney transplantation were enrolled. Echocardiography, carotid ultrasound, and assessment of pulse wave velocity were performed. LVH was defined based on left ventricular mass (LVM) indexed for body surface area (BSA) and height2.7. There were 67 patients with and 95 without patent vascular access. Both study groups were comparable with respect to gender, age, duration of dialysis therapy, and time after transplantation, kidney graft function, and cardiovascular comorbidities. Patients with patent vascular access were characterized by significantly elevated LVM and significantly greater percentage of LVH, based on LVMI/BSA (66.7 versus 48.4%, P = 0.02). OR for LVH in patients with patent vascular access was 2.39 (1.19–4.76), P = 0.01. Regression analyses confirmed an independent contribution of patent vascular access to higher LVM and increased prevalence of LVH. We concluded that long-lasting patent hemodialysis vascular access after kidney transplantation is associated with the increased prevalence of LVH in kidney transplant recipients. PMID:24616896

  20. The Role of Inflammatory Processes in Occurrence of Left Ventricular Failure in Patients with Chronic Kidney Disease

    PubMed Central

    Shemirani, Hassan; Tavakol, Sara; Atapoor, Abdolamir; Golshahi, Jafar

    2017-01-01

    Background: Recently, the relationship between increased level of inflammatory mediators and occurrence of left ventricular failure in patients with kidney disease has been suggested. The present study attempted to assess relationship between inflammatory mediators and occurrence of left ventricular failure in patients with chronic kidney disease. Materials and Methods: This cross-sectional study was performed at Noor and Hazrat Aliasghar hospital in Isfahan between September 2012 to September 2013 on patients aged >19 years that referred for following their chronic kidney disease. Serum level of inflammatory parameters including C-reactive protein (CRP) and Interleukin-6 (IL-6) was measured using spectrophotometer. All patients were also assessed using M-mode echocardiography to determine left ventricular ejection fraction (LVEF). Results: The group with significant reduced LVEF showed lower GFR when compared to the normal LVEF group (40.73 ± 20.61% versus 44.43 ± 17.98%, P = 0.032). Comparing GFR across the three groups with normal LVEF (>55%), with mild LV dysfunction (LVEF: 45 – 55) those with significant LV dysfunction (LVEF < 45%) showed significantly lower GFR level in latter group compared with normal LVEF and mild LV dysfunction group (P = 0.026). Although the level of serum CRP was significantly higher in patients with significant left ventricular failure than other groups (P = 0.018). Conclusion: Inflammatory processes can potentially affect left ventricular function in patients with chronic kidney disease. In this regard, increased level of CRP may be a main factor for predicting severity of left ventricular failure in these patients. PMID:28299305

  1. [Management of High-Risk Prostate Cancer and Left Ectopic Ureter Inserting into Seminal Vesicle with Ipsilateral Hypoplastic Kidney of a Young Patient : A Case Report].

    PubMed

    Matsumoto, Teppei; Koie, Takuya; Soma, Osamu; Kusaka, Ayumu; Hosogoe, Shogo; Hamano, Itsuto; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Ohyama, Chikara

    2016-06-01

    A 44-year-old male patient visited our hospital with a chief complaint of macroscopic hematuria. Prostate biopsies were performed due to prostate specific antigen (PSA) 11.6 ng/ml, and he was diagnosed with Gleason score 5+4 prostate cancer. Computed tomography showed a left hypoplastic kidney. T2- weighted magnetic resonance imaging showed the left ureter stump with ectopic insertion into the dilated left seminal vesicle. He was diagnosed with high-risk prostate cancer and left ectopic ureter inserting into the seminal vesicle with ipsilateral hypoplastic kidney. Laparoscopic left nephroureterectomy and open radical prostatectomy were performed.

  2. Association of Left Atrial Volume With Mortality Among ESRD Patients With Left Ventricular Hypertrophy Referred for Kidney Transplantation

    PubMed Central

    Patel, Rajan K.; Jardine, Alan G.M.; Mark, Patrick B.; Cunningham, Anthony F.; Steedman, Tracey; Powell, Joanna R.; McQuarrie, Emily P.; Stevens, Kathryn K.; Dargie, Henry J.; Jardine, Alan G.

    2010-01-01

    Background Left ventricular hypertrophy (LVH) is common in patients with end-stage renal disease (ESRD) and an independent risk factor for premature cardiovascular death. Left atrial volume (LAV), measured using echocardiography, predicts death in patients with ESRD. Cardiovascular magnetic resonance (CMR) imaging is a volume-independent method of accurately assessing cardiac structure and function in patients with ESRD. Study Design Single-center prospective observational study to assess the determinants of all-cause mortality, particularly LAV, in a cohort of ESRD patients with LVH, defined using CMR imaging. Setting & Participants 201 consecutive ESRD patients with LVH (72.1% men; mean age, 51.6 ± 11.7 years) who had undergone pretransplant cardiovascular assessment were identified using CMR imaging between 2002-2008. LVH was defined as left ventricular mass index >84.1 g/m2 (men) or >74.6 g/m2 (women) based on published normal left ventricle dimensions for CMR imaging. Maximal LAV was calculated using the biplane area-length method at the end of left ventricle systole and corrected for body surface area. Predictors CMR abnormalities, including LAV. Outcome All-cause mortality. Results 54 patients died (11 after transplant) during a median follow-up of 3.62 years. Median LAV was 30.4 mL/m2 (interquartile range, 26.2-58.1). Patients were grouped into high (median or higher) or low (less than median) LAV. There were no significant differences in heart rate and mitral valve Doppler early to late atrial peak velocity ratio. Increased LAV was associated with higher mortality. Kaplan-Meier survival analysis showed poorer survival in patients with higher LAV (log rank P = 0.01). High LAV and left ventricular systolic dysfunction conferred similar risk and were independent predictors of death using multivariate analysis. Limitations Only patients undergoing pretransplant cardiac assessment are included. Limited assessment of left ventricular diastolic function

  3. Urinary corticosteroid excretion predicts left ventricular mass and proteinuria in chronic kidney disease.

    PubMed

    McQuarrie, Emily P; Freel, E Marie; Mark, Patrick B; Fraser, Robert; Patel, Rajan K; Dargie, Henry G; Connell, John M C; Jardine, Alan G

    2012-09-01

    Blockade of the MR (mineralocorticoid receptor) in CKD (chronic kidney disease) reduces LVMI [LV (left ventricular) mass index] and proteinuria. The MR can be activated by aldosterone, cortisol and DOC (deoxycorticosterone). The aim of the present study was to explore the influence of mineralocorticoids on LVMI and proteinuria in patients with CKD. A total of 70 patients with CKD and 30 patients with EH (essential hypertension) were recruited. Patients underwent clinical phenotyping; biochemical assessment and 24 h urinary collection for THAldo (tetrahydroaldosterone), THDOC (tetrahydrodeoxycorticosterone), cortisol metabolites (measured using GC-MS), and urinary electrolytes and protein [QP (proteinuira quantification)]. LVMI was measured using CMRI (cardiac magnetic resonance imaging). Factors that correlated significantly with LVMI and proteinuria were entered into linear regression models. In patients with CKD, significant predictors of LVMI were male gender, SBP (systolic blood pressure), QP, and THAldo and THDOC excretion. Significant independent predictors on multivariate analysis were THDOC excretion, SBP and male gender. In EH, no association was seen between THAldo or THDOC and LVMI; plasma aldosterone concentration was the only significant independent predictor. Significant univariate determinants of proteinuria in patients with CKD were THAldo, THDOC, USod (urinary sodium) and SBP. Only THAldo excretion and SBP were significant multivariate determinants. Using CMRI to determine LVMI we have demonstrated that THDOC is a novel independent predictor of LVMI in patients with CKD, differing from patients with EH. Twenty-four hour THAldo excretion is an independent determinant of proteinuria in patients with CKD. These findings emphasize the importance of MR activation in the pathogenesis of the adverse clinical phenotype in CKD.

  4. Brown tumor and staghorn calculi in primary hyperparathyroidism.

    PubMed

    Philip George, Arun Jacob; Banerji, John S

    2013-08-01

    A case of primary hyperparathyroidism with bilateral renal staghorn calculi and brown tumor right thumb is reported in these images, along with the appropriate sequential management. Percutaneous nephrolithotomy (PCNL)was done after management of hypercalcemia and after parathyroidectomy. This case highlights the need for urologists and general practitioners to have a holistic approach in patient management.

  5. Percutaneous fenestration of aortic dissection: Salvage of an ischemic solitary left kidney

    SciTech Connect

    Park, Jae Hyung; Chung, Jin Wook; Cho, Yoon Koo; Kim, Sun Ho; Ahn, Hyuk; Oh, Byung Hee

    1997-03-15

    The false channel of a type III aortic dissection caused acute renal ischemia by compression of the origin of the left renal artery in a patient with status post-right nephrectomy. To relieve the ischemia and restore renal function, percutaneous balloon fenestration was performed successfully.

  6. 50 CFR 226.216 - Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 10 2014-10-01 2014-10-01 false Critical habitat for elkhorn (Acropora... MAMMALS DESIGNATED CRITICAL HABITAT § 226.216 Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals. Critical habitat is designated for both elkhorn and staghorn corals...

  7. 50 CFR 226.216 - Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 10 2013-10-01 2013-10-01 false Critical habitat for elkhorn (Acropora... MAMMALS DESIGNATED CRITICAL HABITAT § 226.216 Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals. Critical habitat is designated for both elkhorn and staghorn corals...

  8. The management of large staghorn renal stones by percutaneous versus laparoscopic versus open nephrolithotomy: a comparative analysis of clinical efficacy and functional outcome.

    PubMed

    Aminsharifi, Alireza; Irani, Dariush; Masoumi, Mansour; Goshtasbi, Bahman; Aminsharifi, Amirhossein; Mohamadian, Reza

    2016-11-01

    The objective of this study was to analyze the outcome of percutaneous nephrolithotomy (PCNL), laparoscopic and open anatrophic nephrolithotomy (AN) for management of patients with large staghorn renal stones. We analyzed the peri-operative parameters, overall treatment costs and changes in the function of the affected kidney on technetium-99 dimercaptosuccinic acid renal scintigraphy, done before the operation and before the final follow-up visit, in 45 adults who underwent PCNL (n = 16) versus laparoscopic (n = 15) versus open (n = 14) AN for large staghorn renal stones. All three groups had statistically similar preoperative characteristics, including the function of the operated kidney on renal scan. On the discharge day, the PCNL group had the lowest stone-free rate (43.75 %) compared to the laparoscopic (80 %) and open AN groups (92.85 %) (P = 0.009). After a mean follow-up period of 12.1 months, the decrease in the function of the operated kidney was greatest in the open AN group (-8.66 ± 4.97) compared to the laparoscopic AN (-6.04 ± 6.52) and PCNL group (-2.12 ± 2.77) (P = 0.003). The need for ancillary procedures to manage residual stones was greatest in the PCNL group and lowest in the open AN group. A similar trend was seen in overall treatment costs (P < 0.001). For management of large staghorn renal stones, the more invasive the procedure, the higher the one-session stone-free rate and the lower the need for ancillary procedures; however, greater renal functional loss can be anticipated. The need for ancillary procedures is a major determining factor in the overall cost of treatment, which was highest in the PCNL group.

  9. Relationship between cardiac calcification and left ventricular hypertrophy in patients with chronic kidney disease at hemodialysis initiation.

    PubMed

    Kitamura, Ken; Fujii, Hideki; Nakai, Kentaro; Kono, Keiji; Goto, Shunsuke; Nishii, Tatsuya; Kono, Atsushi; Nishi, Shinichi

    2017-03-21

    Coronary artery calcification (CAC), cardiac valve calcification (CVC) and left ventricular hypertrophy (LVH) are frequently observed in chronic kidney disease (CKD) patients. These abnormalities significantly affect morbidity and mortality. The aim of this study was to investigate the relationship between CAC, CVC and LVH in CKD patients. This study included 96 patients who were hospitalized and initiated hemodialysis between December 2011 and July 2014 at our five institutions. Multi-detector computed tomography for the quantification of CAC using the Agatston score and transthoracic echocardiography for assessing CVC and LVH were performed for all patients included in the study. We semi-quantitatively evaluated the severity of CVC as a valvular calcification score. We also assessed the presence of LVH in patients with CAC and/or CVC. Among the 96 patients, the prevalence of CAC was 81.3% and CVC was 65.0%. The severity of CAC was closely and significantly associated with that of CVC. The percentage of patients with LVH was the greatest in those with both severe CAC and CVC. CAC was significantly more severe in patients with concentric hypertrophy compared to those with normal geometry. At the initiation of hemodialysis, most CKD patients had CAC, CVC and LVH. In addition, cardiac calcification was significantly associated with LVH in these patients.

  10. Case report of primary renal pelvis squamous cell carcinoma coexisting with long-standing calculi in left kidney on 18F-FDG PET/CT

    PubMed Central

    Deng, Shengming; Zhang, Bin; Huang, Ying; Li, Jihui; Sang, Shibiao; Zhang, Wei

    2017-01-01

    Abstract Rationale: Primary renal pelvis squamous cell carcinoma (SCC) is an extremely rare neoplasm. In many patients, the SCC was associated with renal calculi. Patient concerns: A 61-year-old male presented with intermittent pain at the left lumbar region for 3 days. The PET/CT images demonstrated increased 18F-FDG uptake in the upper pole of the left kidney and left renal hilar lymph nodes. Diagnoses: Pathologic examination revealed well-moderately differentiated renal pelvis SCC with lymphatic metastasis. Interventions: The patient underwent a left nephrectomy a few days after the initial staging PET/CT study. Outcomes: No growing lesion or metastasis was observed during a 6-month follow-up. Lessons: Our case demonstrates that 18F-FDG PET/CT is a useful diagnostic tool to evaluate primary renal pelvic SCC and detect metastatic lymph nodes in patients with long-standing calculi. PMID:28296764

  11. Anatrophic nephrolithotomy for removal of staghorn or branched renal calculi.

    PubMed

    James, R; Novick, A C; Straffon, R A; Stewart, B H

    1980-02-01

    Forty anatrophic nephrolithotomies were performed in 38 patients between November, 1965, and December, 1977, to remove staghorn or branched renal calculi. Thirty-six (95 per cent) of the patients' preoperative urine cultures were infected, and postoperatively 35 of the cultures (88 per cent) were sterile. Magnesium ammonium phosphate calculi were present in the majority of patients (67 per cent). In 6 patients (15 per cent) transient nephrocutaneous fistulas developed. Thirty-six of the 40 renal units (90 per cent) had improved or stable intravenous pyelograms postoperatively. The patients had been followed for an average of twenty months (four to one hundred and twelve months). In 6 patients (15 per cent) recurrent renal calculi developed, and 3 patients (8 per cent) had residual calculi during this period.

  12. Facilitation in Caribbean coral reefs: high densities of staghorn coral foster greater coral condition and reef fish composition.

    PubMed

    Huntington, Brittany E; Miller, Margaret W; Pausch, Rachel; Richter, Lee

    2017-04-04

    Recovery of the threatened staghorn coral (Acropora cervicornis) is posited to play a key role in Caribbean reef resilience. At four Caribbean locations (including one restored and three extant populations), we quantified characteristics of contemporary staghorn coral across increasing conspecific densities, and investigated a hypothesis of facilitation between staghorn coral and reef fishes. High staghorn densities in the Dry Tortugas exhibited significantly less partial mortality, higher branch growth, and supported greater fish abundances compared to lower densities within the same population. In contrast, partial mortality, branch growth, and fish community composition did not vary with staghorn density at the three other study locations where staghorn densities were lower overall. This suggests that density-dependent effects between the coral and fish community may only manifest at high staghorn densities. We then evaluated one facilitative mechanism for such density-dependence, whereby abundant fishes sheltering in dense staghorn aggregations deliver nutrients back to the coral, fueling faster coral growth, thereby creating more fish habitat. Indeed, dense staghorn aggregations within the Dry Tortugas exhibited significantly higher growth rates, tissue nitrogen, and zooxanthellae densities than sparse aggregations. Similarly, higher tissue nitrogen was induced in a macroalgae bioassay outplanted into the same dense and sparse aggregations, confirming greater bioavailability of nutrients at high staghorn densities. Our findings inform staghorn restoration efforts, suggesting that the most effective targets may be higher coral densities than previously thought. These coral-dense aggregations may reap the benefits of positive facilitation between the staghorn and fish community, favoring the growth and survivorship of this threatened species.

  13. Relationship of left ventricular hypertrophy and diastolic function with cardiovascular and renal outcomes in African Americans with hypertensive chronic kidney disease.

    PubMed

    Peterson, Gail E; de Backer, Tine; Contreras, Gabriel; Wang, Xuelei; Kendrick, Cynthia; Greene, Tom; Appel, Lawrence J; Randall, Otelio S; Lea, Janice; Smogorzewski, Miroslaw; Vagaonescu, Tudor; Phillips, Robert A

    2013-09-01

    African Americans with hypertension are at high risk for adverse outcomes from cardiovascular and renal disease. Patients with stage 3 or greater chronic kidney disease have a high prevalence of left ventricular (LV) hypertrophy and diastolic dysfunction. Our goal was to study prospectively the relationships of LV mass and diastolic function with subsequent cardiovascular and renal outcomes in the African American Study of Kidney Disease and Hypertension cohort study. Of 691 patients enrolled in the cohort, 578 had interpretable echocardiograms and complete relevant clinical data. Exposures were LV hypertrophy and diastolic parameters. Outcomes were cardiovascular events requiring hospitalization or causing death; a renal composite outcome of doubling of serum creatinine or end-stage renal disease (censoring death); and heart failure. We found strong independent relationships between LV hypertrophy and subsequent cardiovascular (hazard ratio, 1.16; 95% confidence interval, 1.05-1.27) events, but not renal outcomes. After adjustment for LV mass and clinical variables, lower systolic tissue Doppler velocities and diastolic parameters reflecting a less compliant LV (shorter deceleration time and abnormal E/A ratio) were significantly (P<0.05) associated with future heart failure events. This is the first study to show a strong relationship among LV hypertrophy, diastolic parameters, and adverse cardiac outcomes in African Americans with hypertension and chronic kidney disease. These echocardiographic risk factors may help identify high-risk patients with chronic kidney disease for aggressive therapeutic intervention.

  14. Novel Faces of Fibroblast Growth Factor 23 (FGF23): Iron Deficiency, Inflammation, Insulin Resistance, Left Ventricular Hypertrophy, Proteinuria and Acute Kidney Injury.

    PubMed

    Kanbay, Mehmet; Vervloet, Marc; Cozzolino, Mario; Siriopol, Dimitrie; Covic, Adrian; Goldsmith, David; Solak, Yalcin

    2017-03-01

    FGF23 is a hormone that appears as the core regulator of phosphate metabolism. Great deal of data has accumulated to demonstrate increased FGF23 secretion from the bone to compensate for even subtle increases in serum phosphorus long before intact PTH. However, recent evidence points to the fact that actions and interactions of FGF23 are not limited solely to phosphate metabolism. FGF23 may be implicated in iron metabolism and erythropoiesis, inflammation, insulin resistance, proteinuria, acute kidney injury and left ventricular hypertrophy. In this review, we will summarize latest experimental and clinical data examining impact of FGF23 on aforementioned pathophysiologic pathways/disorders.

  15. [Percutaneous nephrolitholapaxy combined with extracorporeal shockwave lithotripsy in the treatment of staghorn lithiasis].

    PubMed

    Larrea Masvidal, E; García Serrano, C; Castillo Rodríguez, M; Hernández Silverio, D; Casals Armada, J; Valdés Gómez, C; Báez Hernández, D

    1990-05-01

    From December, 1988 to July, 1989, 41 patients with renal or juxtapyelic ureteral calculi were submitted to percutaneous litholapaxy (PCN) at the Stone Center of the Hermanos Amerijeiras Hospital in Havana. This series comprise our early experience utilizing this procedure. PCN was initially limited to pelvic and juxtapyelic ureteric calculi with dilated renal cavities. It was subsequently used in combination with extracorporeal lithotripsy (ESWL) in the treatment of staghorn stones. The present study analyzed the results achieved with PCN in 30 patients with staghorn calculi; 21 (70%) incomplete staghorns and 9 (30%) complete staghorns. Posteriorly, 6 additional borderline staghorns were completely removed by PCN and are not included in the present study. PCN was performed to reduce stone mass and for placement of a large renal drain to permit subsequent ESWL. At two months following treatment, 86.6% of the patients were completely stone-free. The remaining 13.4% with stone remnants presented anatomic and functional renal conditions that allow us to predict complete elimination within a short period of time. Since 6 months had not elapsed in these cases, these were not considered as residual fragments. One patient presented massive absorption of fluids. This was the only observed major and non-lethal complication. Episodes of fever were observed in 23% post-PCN. No patient presented severe sepsis. In our view, PCN combined with ESWL is one of the currently available therapeutic options in the treatment of staghorn calculi. This approach permits adequate resolution of cases that would have otherwise required surgery.

  16. Diverse staghorn coral fauna on the mesophotic reefs of north-east Australia.

    PubMed

    Muir, Paul; Wallace, Carden; Bridge, Tom C L; Bongaerts, Pim

    2015-01-01

    Concern for the future of reef-building corals in conditions of rising sea temperatures combined with recent technological advances has led to a renewed interest in documenting the biodiversity of mesophotic coral ecosystems (MCEs) and their potential to provide lineage continuation for coral taxa. Here, we examine species diversity of staghorn corals (genera Acropora and Isopora) in the mesophotic zone (below 30 m depth) of the Great Barrier Reef and western Coral Sea. Using specimen-based records we found 38 staghorn species in the mesophotic zone, including three species newly recorded for Australia and five species that only occurred below 30 m. Staghorn corals became scarce at depths below 50 m but were found growing in-situ to 73 m depth. Of the 76 staghorn coral species recorded for shallow waters (depth ≤ 30 m) in north-east Australia, 21% extended to mesophotic depths with a further 22% recorded only rarely to 40 m depth. Extending into the mesophotic zone provided shallow water species no significant advantage in terms of their estimated global range-size relative to species restricted to shallow waters (means 86.2 X 10(6) km2 and 85.7 X 10(6) km2 respectively, p = 0.98). We found four staghorn coral species at mesophotic depths on the Great Barrier Reef that were previously considered rare and endangered on the basis of their limited distribution in central Indonesia and the far western Pacific. Colonies below 40 m depth showed laterally flattened branches, light and fragile skeletal structure and increased spacing between branches and corallites. The morphological changes are discussed in relation to decreased light, water movement and down-welling coarse sediments. Staghorn corals have long been regarded as typical shallow-water genera, but here we demonstrate the significant contribution of this group to the region's mesophotic fauna and the importance of considering MCEs in reef biodiversity estimates and management.

  17. Diverse Staghorn Coral Fauna on the Mesophotic Reefs of North-East Australia

    PubMed Central

    Muir, Paul; Wallace, Carden; Bridge, Tom C. L.; Bongaerts, Pim

    2015-01-01

    Concern for the future of reef-building corals in conditions of rising sea temperatures combined with recent technological advances has led to a renewed interest in documenting the biodiversity of mesophotic coral ecosystems (MCEs) and their potential to provide lineage continuation for coral taxa. Here, we examine species diversity of staghorn corals (genera Acropora and Isopora) in the mesophotic zone (below 30 m depth) of the Great Barrier Reef and western Coral Sea. Using specimen-based records we found 38 staghorn species in the mesophotic zone, including three species newly recorded for Australia and five species that only occurred below 30 m. Staghorn corals became scarce at depths below 50 m but were found growing in-situ to 73 m depth. Of the 76 staghorn coral species recorded for shallow waters (depth ≤ 30 m) in north-east Australia, 21% extended to mesophotic depths with a further 22% recorded only rarely to 40 m depth. Extending into the mesophotic zone provided shallow water species no significant advantage in terms of their estimated global range-size relative to species restricted to shallow waters (means 86.2 X 106 km2 and 85.7 X 106 km2 respectively, p = 0.98). We found four staghorn coral species at mesophotic depths on the Great Barrier Reef that were previously considered rare and endangered on the basis of their limited distribution in central Indonesia and the far western Pacific. Colonies below 40 m depth showed laterally flattened branches, light and fragile skeletal structure and increased spacing between branches and corallites. The morphological changes are discussed in relation to decreased light, water movement and down-welling coarse sediments. Staghorn corals have long been regarded as typical shallow-water genera, but here we demonstrate the significant contribution of this group to the region’s mesophotic fauna and the importance of considering MCEs in reef biodiversity estimates and management. PMID:25714341

  18. Use of internal polyethylene ureteral stents in extracorporeal shock-wave lithotripsy of staghorn calculi.

    PubMed

    Pode, D; Shapiro, A; Verstandig, A; Pfau, A

    1987-01-01

    Ureteral stenting during extracorporeal shock-wave lithotripsy (ESWL) of complete staghorn calculi, using an internal polyethylene pigtail catheter, was found to be an efficient prophylactic measure against the high rate of complications in these cases. In the presence of a ureteral stent the stone fragments passed more easily into the bladder, accumulation of obstructing stone streets was prevented, and internal drainage of the urine was guaranteed. The need for auxiliary measures such as percutaneous nephrostomy, ureteroscopy or ureteral meatotomy was prevented in most cases. This prophylactic measure may turn ESWL to become the primary treatment of large staghorn calculi.

  19. Reappraisal in two European cohorts of the prognostic power of left ventricular mass index in chronic kidney failure.

    PubMed

    Tripepi, Giovanni; Pannier, Bruno; D'Arrigo, Graziella; Mallamaci, Francesca; Zoccali, Carmine; London, Gerard

    2017-03-01

    Left ventricular hypertrophy is a strong causal risk factor of cardiovascular morbidity and death in end stage kidney failure, and its prognostic value is taken for granted in this population. However, the issue has never been formally tested by state-of-art prognostic analyses. Therefore, we determined the prognostic power of the left ventricular mass index (LVMI) for all-cause and cardiovascular death beyond and above that provided by well validated clinical risk scores, the annualized rate of occurrence cohort risk scores (ARO, all cause death risk and cardiovascular risk). Two large cohorts that measured LVMI in 207 hemodialysis patients in the South Italian CREED cohort and 287 patients in the French Hospital Manhes cohort were analyzed. Over a two year follow-up, 123 patients died (cardiovascular death 65%). In Cox models both the LVMI and the ARO risk scores were significantly related to all-cause and cardiovascular death. In prognostic analyses, LVMI per se showed an inferior discriminatory power (Harrell's C index) to that of the ARO risk scores (all-cause death: -10%; cardiovascular death: -5%). LVMI largely failed to improve model calibration based on the ARO risk scores, and added nonsignificant discriminatory power (Integrated Discrimination Index +2% and +3%) and quite limited reclassification ability (Net Reclassification Index +4.3%, and +8.8) to the ARO risk scores. Thus, while left ventricular hypertrophy remains a fundamental treatment target in end stage kidney failure, the measurement of LVMI solely for risk stratification is unwarranted in this condition.

  20. Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12 years experience in a tertiary care centre.

    PubMed

    Purkait, Bimalesh; Kumar, Manoj; Sokhal, Ashok Kumar; Bansal, Ankur; Sankhwar, Satya Narayan; Gupta, Ashok Kumar

    2016-09-15

    To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (<15 years) of bilateral staghorn calculi from 2004 to 2015. Staged PCNL was done after 2-3 days if needed and opposite side PCNL was performed after 10-14 days. Fifty-one patients with bilateral staghorn renal calculi underwent PCNL. The mean age of the study group was 10.25 ± 2.13 (range 3-15). Mean stone burden was 778.3 + 613.4 (range 231-3850 mm(2)). Forty-five patients underwent single puncture, twenty-two patients underwent double punctures whereas six patients underwent triple punctures during first session PCNL procedure. Most common puncture location was through the superior calyx (58.82 %). The mean operating time was 77.25 + 30.21 (range 58-145). After the first session PCNL, the success rate was 76.47 %. Thirteen patients (17 renal units) underwent relook PCNL and seven patients underwent ESWL. Overall complication noted in twenty-four (47.05 %) cases. Most of the complications were minor grade. Percutaneous nephrolithotomy for staghorn calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.

  1. Spontaneous extrusion of staghorn renal calculus with nephrocutaneous fistula in a child.

    PubMed

    Purkait, Bimalesh; Sinha, Rahul Janak; Bansal, Ankur; Singh, Vishwajeet

    2016-04-11

    Renal stone disease may present as nephrocutaneous fistula. Spontaneous extrusion of renal stone with nephrocutaneous fistula is rare. Most of the cases have been reported in adults. We present a case of nephrocutaneous fistula with spontaneous extrusion of staghorn renal calculus in a paediatric patient.

  2. Genetic Signature of Resistance to White Band Disease in the Caribbean Staghorn Coral Acropora cervicornis

    PubMed Central

    Libro, Silvia; Vollmer, Steven V.

    2016-01-01

    Coral reefs are declining worldwide due to multiple factors including rising sea surface temperature, ocean acidification, and disease outbreaks. Over the last 30 years, White Band Disease (WBD) alone has killed up to 95% of the Caribbean`s dominant shallow-water corals—the staghorn coral Acropora cervicornis and the elkhorn coral A. palmata. Both corals are now listed on the US Endangered Species Act, and while their recovery has been slow, recent transmission surveys indicate that more than 5% of staghorn corals are disease resistant. Here we compared transcriptome-wide gene expression between resistant and susceptible staghorn corals exposed to WBD using in situ transmission assays. We identified constitutive gene expression differences underlying disease resistance that are independent from the immune response associated with disease exposure. Genes involved in RNA interference-mediated gene silencing, including Argonaute were up-regulated in resistant corals, whereas heat shock proteins (HSPs) were down-regulated. Up-regulation of Argonaute proteins indicates that post-transcriptional gene silencing plays a key, but previously unsuspected role in coral immunity and disease resistance. Constitutive expression of HSPs has been linked to thermal resilience in other Acropora corals, suggesting that the down-regulation of HSPs in disease resistant staghorn corals may confer a dual benefit of thermal resilience. PMID:26784329

  3. Genetic Signature of Resistance to White Band Disease in the Caribbean Staghorn Coral Acropora cervicornis.

    PubMed

    Libro, Silvia; Vollmer, Steven V

    2016-01-01

    Coral reefs are declining worldwide due to multiple factors including rising sea surface temperature, ocean acidification, and disease outbreaks. Over the last 30 years, White Band Disease (WBD) alone has killed up to 95% of the Caribbean`s dominant shallow-water corals--the staghorn coral Acropora cervicornis and the elkhorn coral A. palmata. Both corals are now listed on the US Endangered Species Act, and while their recovery has been slow, recent transmission surveys indicate that more than 5% of staghorn corals are disease resistant. Here we compared transcriptome-wide gene expression between resistant and susceptible staghorn corals exposed to WBD using in situ transmission assays. We identified constitutive gene expression differences underlying disease resistance that are independent from the immune response associated with disease exposure. Genes involved in RNA interference-mediated gene silencing, including Argonaute were up-regulated in resistant corals, whereas heat shock proteins (HSPs) were down-regulated. Up-regulation of Argonaute proteins indicates that post-transcriptional gene silencing plays a key, but previously unsuspected role in coral immunity and disease resistance. Constitutive expression of HSPs has been linked to thermal resilience in other Acropora corals, suggesting that the down-regulation of HSPs in disease resistant staghorn corals may confer a dual benefit of thermal resilience.

  4. 50 CFR 226.216 - Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 10 2012-10-01 2012-10-01 false Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals. 226.216 Section 226.216 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE...

  5. 50 CFR 226.216 - Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Critical habitat for elkhorn (Acropora palmata) and staghorn (A. cervicornis) corals. 226.216 Section 226.216 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE...

  6. Kidney Dysplasia

    MedlinePlus

    ... Disease Ectopic Kidney Medullary Sponge Kidney Kidney Dysplasia Kidney Dysplasia What is kidney dysplasia? Kidney dysplasia is a condition in which ... Kidney dysplasia in one kidney What are the kidneys and what do they do? The kidneys are ...

  7. Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi.

    PubMed

    Zhong, Wen; Zeng, Guohua; Wu, Wenqi; Chen, Wenzhong; Wu, Kaijun

    2011-04-01

    There has been continuing controversy regarding multiple tracts in a percutaneous nephrolithotomy (PCNL) session that may bring more complications, especially severe bleeding need for transfusion, even nephrectomy. Little tracts may bring less trauma to renal parenchyma than standard PCNL tracts. We carried minimally invasive PCNL (MPCNL) in treating staghorn calculi with multiple 16Fr percutaneous tracts in a single session, in an attempt to get high stone free with little trauma, and compared the morbidity of standard PCNL procedures in a prospective trial. A total of 54 consecutive patients with staghorn calculi were prospectively randomized for MPCNL (29) and PCNL (25). The size and location of stone, operative parameters, number of tracts, stone-free rate, operating time, hospital stay and complications were analyzed. In MPCNL group, a total of 67 percutaneous tracts were established in 29 renal units, while 28 tracts in 25 renal units in PCNL group. Compared to PCNL, MPCNL was associated with higher clearance rate (89.7 vs. 68%, p = 0.049), less chance need for adjunctive procedure of SWL or second-look PCNL (24.1 vs. 60%, p = 0.007), while a similar complication rate (37.9 vs. 52%, p = 0.300). In conclusion, with the development of instruments and increased experience, judiciously made multiple percutaneous tracts in a single session of MPCNL for treating staghorn calculi were safe, feasible and efficient with an acceptable morbidity.

  8. Prognostic Significance of Left Ventricular Mass Index and Renal Function Decline Rate in Chronic Kidney Disease G3 and G4

    PubMed Central

    Huang, Jiun-Chi; Chen, Szu-Chia; Tsai, Yi-Chun; Kuo, I-Ching; Chiu, Yi-Wen; Chang, Jer-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2017-01-01

    The effect of left ventricular mass index (LVMI) and estimated glomerular filtration rate (eGFR) decline rate on outcome prediction in patients with chronic kidney disease (CKD) remains unclear. We included 306 CKD G3 and G4 patients with LVMI assessed through echocardiography. Rapid decline in renal function was defined as the eGFR slope <−3 mL/min/1.73 m2/year. Patients were stratified into four groups using sex-specific median values of LVMI and rapid eGFR decline. The composite outcome was progression to maintenance dialysis or death. 32 patients had the composite outcome during a median follow-up of 2.7 years. In multivariate Cox analysis, compared with patients with non-rapid eGFR decline and lower LVMI, those with non-rapid eGFR decline and higher LVMI (hazard ratio [HR]: 5.908, 95% confidence interval [CI] = 1.304–26.780), rapid eGFR decline and lower LVMI (HR: 12.737, 95% CI = 2.297–70.636), and rapid eGFR decline and higher LVMI (HR: 15.249, 95% CI = 3.365–69.097) had an increased risk of progression to adverse outcomes. LVMI and eGFR decline synergistically effect the prognostic implications in CKD G3 and G4 patients. PMID:28195182

  9. [Assessment of the renal consequences as related to operative technique in surgery for 190 staghorn or calyceal calculi. Comparative value of renal scintigraphy and intravenous urography (author's transl)].

    PubMed

    Beurton, D; Gonties, D; Malloum, M; Ngeh, D; Daskalov, I; Pascal, B; Cukier, J

    1981-01-01

    The authors have studied 86 patients with staghorn calculi who underwent preoperative quantitative renal scintigraphy. 50 of them (63 kidneys) had one or two follow-up scans between 1 and 9 years after the operation. These scintigraphic data were compared with those of I.V.U. These 50 patients had undergone surgery on 60 kidneys (12 pyelotomies only, 26 pyelotomies associated with limited nephrotomies, 18 extended nephrotomies and finally 4 bi-value nephrotomies). In 46 of these patients, the urine became definitively sterile and there was no recurrence of lithiasis in any of them. These quite exceptional conditions were such that it is possible to bear in mind only the operative technique in assessing the possible harmful consequences of each type of operation. The authors clearly show that the threat to function of the kidney which has been operated upon is more threatened when there has been a nephrotomy and when such a nephrotomy has been more extensive. A limited nephrotomy is associated with a mean loss of (% of renal function. Extended nephrotomies or more than 3 cm result in a loss of function of approximately 22%. Large bi-value nephrotomies result in a 36% loss of function. Simultaneous study of scintigraphic scans and I.V.U. revealed that a loss of 1 cm in height of the renal parenchyma corresponds to a functional loss of 10% as determined by scintigraphy. Of basic importance is the fact that the impairment caused by nephrotomies remains stable and does not worsen with the passage of time.

  10. Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

    PubMed Central

    Atmoko, Widi; Birowo, Ponco; Rasyid, Nur

    2016-01-01

    Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery ( p = 0.01), stone burden ( p = < 0.001), and type of anesthesia ( p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free. PMID:27703669

  11. Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years.

    PubMed

    Atmoko, Widi; Birowo, Ponco; Rasyid, Nur

    2016-01-01

    Objectives: Percutaneous nephrolithotomy on staghorn calculi is challenging for urologists because it is difficult to remove all of the stones. The purpose of this study was to evaluate the associated factors of stone-free rate after primary percutaneous nephrolithotomy on staghorn calculi in a large series of patients at a single, tertiary referral, endourologic stone center. Methods: We collected data from medical record between January 2000 and December 2015. A total of 345 primary percutaneous nephrolithotomy procedures were performed for patients with staghorn calculi. This study included both and made no distinction between partial and complete staghorn calculi. Stone-free is defined as the absence of residual stones after undergoing percutaneous nephrolithotomy for the first time. Significant factors from univariate analysis that correlated with stone-free rate after primary percutaneous nephrolithotomy of staghorn stone were further analyzed using multivariate regression analysis. Results: The mean patient age was 52.23±10.38 years. The stone-free rate of percutaneous nephrolithotomy monotherapy was 62.6%. The mean operating time was 79.55±34.46 minutes. The mean length of stay in hospital was 4.29±3.00 days. Using the chi-square test, history of ipsilateral open renal stone surgery ( p = 0.01), stone burden ( p = < 0.001), and type of anesthesia ( p = 0.04) had a significant impact on the stone-free. From multivariate analysis, the history of ipsilateral open renal stone surgery [OR 0.48; 95% CI 0.28-0.81; p 0.01] and the stone burden [OR 0.28; 95% CI 0.18-0.45; p 0.00] were significant independent risk factors for stone-free.

  12. Multiple tracts percutaneous nephrolithotomy assisted by LithoClast master in one session for staghorn calculi: report of 117 cases.

    PubMed

    Chen, Jinbo; Zhou, Xu; Chen, Zhi; Liu, Longfei; Jiang, Li; Chen, Cheng; Qi, Lin; Zu, Xiongbing; Chen, Hequn

    2014-04-01

    The objective of the study is to evaluate the safety, efficacy and outcome of multiple tracts percutaneous nephrolithotomy (PCNL) assisted by LithoClast master (the third-generation Electro Medical System) in one session for the treatment of staghorn calculi. From October 2011 to March 2013, 117 patients with staghorn calculi underwent multiple tracts PCNL in our hospital. The combined pneumatic and ultrasonic powered lithotripter (EMS LithoClast master) was used to fragment and remove the calculi. The data were retrospectively analyzed with regard to stone burden, number of tracts, operation time, total operative blood loss, postoperative hospital stay, complications rate, and stone clearance rate. A total of 142 renal units in 117 patients (63 men and 54 women) were treated. Of the 142 renal units, 77 (54.2 %) had complete staghorn calculi, and 65 (45.8 %) had partial staghorn calculi. A total of 416 tracts were established in the 142 renal units. The mean number of tracts used in a single renal unit was 2.8 (range 2-4), most required three tracts. The mean (range) operating time is 72 (55-130) min. The mean (range) duration of postoperative hospital stay is 5.5 (3-9) days. Mean estimated operative blood loss is 150 (60-350) mL. The complications included blood transfusion in 9 (7.7 %) patients, high fever in 12 (10.3 %), sepsis in 5 (4.3 %), hydrothorax in 4 (3.4 %), and pseudoaneurysm in 3 (2.6 %). A complete stone clearance rate of 87.2 % (102/117) was achieved after one session of PCNL. This rate increased to 94.0 % after a secondlook procedure. In conclusion, multiple tracts PCNL assisted by EMS LithoClast master in one session is safe and effective in achieving a great stone clearance rate with acceptable morbidity for the treatment of staghorn calculi.

  13. Solitary Kidney

    MedlinePlus

    ... How They Work Kidney Disease A-Z Solitary Kidney What is a solitary kidney? When a person has only one kidney or ... ureter are removed (bottom right). What are the kidneys and what do they do? The kidneys are ...

  14. Evidence for delayed mortality in hurricane-damaged Jamaican staghorn corals

    NASA Astrophysics Data System (ADS)

    Knowlton, Nancy; Lang, Judith C.; Christine Rooney, M.; Clifford, Patricia

    1981-11-01

    Severe tropical storms can cause widespread mortality in reef corals1,2. The Caribbean staghorn coral, Acropora cervicornis, although dependent on fragmentation for asexual propagation3-5, is particularly vulnerable to hurricane damage6,7. The most important agents of post-hurricane mortality are assumed to be high wave energy6 and change in salinity8, factors which typically soon diminish in intensity. We report here that there was substantial delayed tissue and colony death in A. cervicornis on a Jamaican reef damaged by Hurricane Alien. This previously undocumented degree of secondary mortality, sustained for 5 months and unrelated to emersion9, was over one order of magnitude more severe than that caused by the immediate effects of the storm. The elimination of >98% of the original survivors suggests potentially complex responses to catastrophes, involving disease10,11 and predation, which may explain the widely variable rates of reef recovery previously reported12-15.

  15. The role of ultra-mini percutaneous nephrolithotomy in the treatment of kidney stones

    PubMed Central

    Tepeler, Abdulkadir; Başıbüyük, İsmail; Tosun, Muhammed; Armağan, Abdullah

    2016-01-01

    Objective In our study we aimed to evaluate outcomes of ultra-mini-percutaneous nephrolithotomy (UMP) performed for the treatment of kidney stones. Material and methods Between October 2014 and September 2015, a single surgeon performed UMP on a total of 49 consecutive patients with symptomatic kidney stones at our center. Pregnants, anticogulant users, patients with bleeding diathesis pyonephrosis, and partial/complete staghorn stones were excluded from the study. Patient characteristics, operative data and postoperative outcomes were assessed in detail. Results The UMP was performed on 50 (34 right/16 left) renal units of the 48 (28 male/20 female) patients included in this study. The mean age and body mass index was 36.5 (2–83) years and 26.2 (17.6–32.8) kg/m2, respectively. Mean stone size was calculated as 22.2 (10–55) mm. The mean durations of the operations and fluoroscopic examination were calculated as 65.4 (20–120) minutes and 89.4 (9–322) seconds, respectively. The mean duration of hospitalization was 1.4 (1–5) days. In 52% of the patients the procedure was terminated tubeless. Mean hemoglobin drop was 0.6 (0–3) g/dL. Our series experienced a 10% complication rate. The UMP procedure was successful in 96% of the renal units at the 1st month control visit assessment. Conclusion The outcomes of our study have demonstrated that UMP is an effective and safe treatment modality, especially in the treatment of medium-sized renal calculi. PMID:27909619

  16. [Thoracic kidney: congenital or traumatic origin?].

    PubMed

    Esquis, P; Osmak, L; Ognois, P; Goudet, P; Cougard, P

    2006-04-01

    The discovery of a thoracic kidney in adult patients can lead to three diagnoses, yielding different prognoses and treatment. It can either mean traumatic or congenital diaphragmatic hernia, or a congenital ectopic kidney. Intrathoracic herniation of the left kidney trough a left diaphragmatic rupture is an exceptional discovery. We report the case of a 44 year-old man who met with a car accident 20 years ago, and presented abdominal pain. CT-scan showed an intrathoracic herniation of the left kidney trough a left posterior diaphragmatic rupture. Laparoscopic approach in lateral position showed a traumatic hernia of the left costo-diaphragmatic hiatus only containing the left kidney and its pedicle. After reduction of herniated left kidney into the abdomen, the hiatus was closed by non-resorbable prosthetic mesh. Postoperative course was uneventful.

  17. Announcement: National Kidney Month - March 2017.

    PubMed

    2017-03-03

    Each year, March is designated National Kidney Month to raise awareness about the prevention and early detection of kidney disease. In the United States, kidney disease is the ninth leading cause of death (1). Approximately one in seven (15%) U.S. adults aged ≥20 years are estimated to have chronic kidney disease, most of whom are unaware of their condition (2). If left untreated, chronic kidney disease can lead to kidney failure, requiring dialysis or transplantation for survival (3).

  18. The Aristotelian kidney.

    PubMed

    Marandola, P; Musitelli, S; Jallous, H; Speroni, A; de Bastiani, T

    1994-01-01

    Aristotle incorrectly observed the absence of the kidney in fish and birds and deduced that it was not essential for the existence of a living organism. This underlies his observations on structure and function of the kidney. From examination of rhesus monkeys he generalized that the right kidney is higher than the left. Aristotle did not consider that the renal pelvis is divided by a filter membrane into 2 chambers, and wrote that no blood reaches the renal pelvis. The theory of the 'filter kidney' cannot thus be attributed to Aristotle. The function of the kidney was described as being to separate the surplus liquid from the blood inside the renal meat (not in the renal pelvis) and to transform this liquid into what Aristotle called residuum, i.e. the urine. Aristotle also considered that the kidneys acted to anchor the blood vessels to the body. He only briefly considered renal pathology.

  19. Identification of Candidate Coral Pathogens on White Band Disease-Infected Staghorn Coral

    PubMed Central

    Gignoux-Wolfsohn, Sarah A.; Vollmer, Steven V.

    2015-01-01

    Bacterial diseases affecting scleractinian corals pose an enormous threat to the health of coral reefs, yet we still have a limited understanding of the bacteria associated with coral diseases. White band disease is a bacterial disease that affects the two Caribbean acroporid corals, the staghorn coral Acropora cervicornis and the elkhorn coral A. palmate. Species of Vibrio and Rickettsia have both been identified as putative WBD pathogens. Here we used Illumina 16S rRNA gene sequencing to profile the bacterial communities associated with healthy and diseased A. cervicornis collected from four field sites during two different years. We also exposed corals in tanks to diseased and healthy (control) homogenates to reduce some of the natural variation of field-collected coral bacterial communities. Using a combination of multivariate analyses, we identified community-level changes between diseased and healthy corals in both the field-collected and tank-exposed datasets. We then identified changes in the abundances of individual operational taxonomic units (OTUs) between diseased and healthy corals. By comparing the diseased and healthy-associated bacteria in field-collected and tank-exposed corals, we were able to identify 16 healthy-associated OTUs and 106 consistently disease-associated OTUs, which are good candidates for putative WBD pathogens. A large percentage of these disease-associated OTUs belonged to the order Flavobacteriales. In addition, two of the putative pathogens identified here belong to orders previously suggested as WBD pathogens: Vibronales and Rickettsiales. PMID:26241853

  20. Kidney Diseases

    MedlinePlus

    ... Infections Your doctor can do blood and urine tests to check if you have kidney disease. If your kidneys fail, you will need dialysis or a kidney transplant. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  1. Kidney Failure

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  2. Kidney Transplant

    MedlinePlus

    Kidney transplant Overview By Mayo Clinic Staff A kidney transplant is a surgical procedure to place a healthy kidney ... bloodstream via a machine (dialysis) or a kidney transplant to stay alive. Mayo Clinic's approach . Mayo Clinic ...

  3. Kidney Disease

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Kidney Disease KidsHealth > For Teens > Kidney Disease Print A ... Syndrome Coping With Kidney Conditions What Do the Kidneys Do? You might never think much about some ...

  4. Kidney Disease

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Kidney Disease KidsHealth > For Teens > Kidney Disease A A ... Syndrome Coping With Kidney Conditions What Do the Kidneys Do? You might never think much about some ...

  5. Your Kidneys

    MedlinePlus

    ... Room? What Happens in the Operating Room? Your Kidneys KidsHealth > For Kids > Your Kidneys A A A ... and it will be lighter. What Else Do Kidneys Do? Kidneys are always busy. Besides filtering the ...

  6. Kidney Cysts

    MedlinePlus

    ... common type of PKD end up with kidney failure. PKD also causes cysts in other parts of ... and lifestyle changes, and if there is kidney failure, dialysis or kidney transplants. Acquired cystic kidney disease ( ...

  7. Magnetic resonance imaging of the kidneys

    SciTech Connect

    Leung, A.W.L.; Bydder, G.M.; Steinter, R.E.; Bryant, D.J.; Young, I.R.

    1984-12-01

    A study of the magnetic resonance imaging (MRI) appearance of the kidneys in six normal volunteers and 52 patients is reported. Corticomedullary differentiation was seen with the inversion-recovery (IR 1400/400) sequence in the normal volunteers and in patients with functioning transplanted kidneys and acute tubular necrosis. Partial or total loss of corticomedullary differentiation was seen in glomerulonephritis, acute and chronic renal failure, renal artery stenosis, and transplant rejection. The T1 of the kidneys was increased in glomerulonephritis with neuphrotic syndrome, but the T1 was within the normal range for renal medulla in glomerulonephritis without nephrotic syndrome, renal artery stenosis, and chronic renal failure. A large staghorn calculus was demonstrated with MRI, but small calculi were not seen. Fluid within the hydonephrosis, simple renal cysts, and polycystic kidneys displayed very low signal intensity and long T1 values. Tumors displayed varied appearances. Hypernephromas were shown to be hypo- or hyperintense with the renal medulla on the IR 1400/400 sequence. After intravenous injection of gadolinium-DTPA, there was marked decrease in the tumor T1.

  8. Disease dynamics and potential mitigation among restored and wild staghorn coral, Acropora cervicornis

    PubMed Central

    Lohr, Kathryn E.; Cameron, Caitlin M.; Williams, Dana E.; Peters, Esther C.

    2014-01-01

    The threatened status (both ecologically and legally) of Caribbean staghorn coral, Acropora cervicornis, has prompted rapidly expanding efforts in culture and restocking, although tissue loss diseases continue to affect populations. In this study, disease surveillance and histopathological characterization were used to compare disease dynamics and conditions in both restored and extant wild populations. Disease had devastating effects on both wild and restored populations, but dynamics were highly variable and appeared to be site-specific with no significant differences in disease prevalence between wild versus restored sites. A subset of 20 haphazardly selected colonies at each site observed over a four-month period revealed widely varying disease incidence, although not between restored and wild sites, and a case fatality rate of 8%. A tropical storm was the only discernable environmental trigger associated with a consistent spike in incidence across all sites. Lastly, two field mitigation techniques, (1) excision of apparently healthy branch tips from a diseased colony, and (2) placement of a band of epoxy fully enclosing the diseased margin, gave equivocal results with no significant benefit detected for either treatment compared to controls. Tissue condition of associated samples was fair to very poor; unsuccessful mitigation treatment samples had severe degeneration of mesenterial filament cnidoglandular bands. Polyp mucocytes in all samples were infected with suspect rickettsia-like organisms; however, no bacterial aggregates were found. No histological differences were found between disease lesions with gross signs fitting literature descriptions of white-band disease (WBD) and rapid tissue loss (RTL). Overall, our results do not support differing disease quality, quantity, dynamics, nor health management strategies between restored and wild colonies of A. cervicornis in the Florida Keys. PMID:25210660

  9. [Autosomal dominant polycystic kidney].

    PubMed

    Jorge Adad, S; Estevão Barbosa, M; Fácio Luíz, J M; Furlan Rodrigues, M C; Iwamoto, S

    1996-01-01

    A 48-year-old male had autosomic dominant polycystic kidneys with dimensions, to the best of our knowledge, never previously reported; the right kidney weighed 15,100 g and measured 53 x 33 x 9cm and the left one 10.200 g and 46 x 21 x 7cm, with cysts measuring up to 14cm in diameter. Nephrectomy was done to control persistent hematuria and to relief disconfort caused by the large kidneys. The renal function is stable four years after transplantation.

  10. Cystathione gamma lyase/Hydrogen Sulphide Pathway Up Regulation Enhances the Responsiveness of α1A and α1B-Adrenoreceptors in the Kidney of Rats with Left Ventricular Hypertrophy

    PubMed Central

    Ahmad, Ashfaq; Sattar, Munavvar A.; Azam, Maleeha; Abdulla, Mohammed H.; Khan, Safia A.; Hashmi, Fayyaz; Abdullah, Nor A.; Johns, Edward J.

    2016-01-01

    The purpose of the present study was to investigate the interaction between H2S and NO (nitric oxide) in the kidney and to evaluate its impact on the functional contribution of α1A and α1B-adrenoreceptors subtypes mediating the renal vasoconstriction in the kidney of rats with left ventricular hypertrophy (LVH). In rats the LVH induction was by isoprenaline administration and caffeine in the drinking water together with intraperitoneal administration of H2S. The responsiveness of α1A and α1B to exogenous noradrenaline, phenylephrine and methoxaminein the absence and presence of 5-methylurapidil (5-MeU) and chloroethylclonidine (CEC) was studied. Cystathione gamma lyase (CSE), cystathione β synthase (CBS), 3-mercaptopyruvate sulphar transferase (3-MST) and endothelial nitric oxide synthase (eNOS) were quantified. There was significant up regulation of CSE and eNOS in the LVH-H2S compared to the LVH group (P<0.05). Baseline renal cortical blood perfusion (RCBP) was increased (P<0.05) in the LVH-H2S compared to the LVH group. The responsiveness of α1A-adrenergic receptors to adrenergic agonists was increased (P<0.05) after administration of low dose 5-Methylurapidil in the LVH-H2S group while α1B-adrenergic receptors responsiveness to adrenergic agonists were increased (P<0.05) by both low and high dose chloroethylclonidine in the LVH-H2S group. Treatment of LVH with H2S resulted in up-regulation of CSE/H2S, CBS, and 3-MST and eNOS/NO/cGMP pathways in the kidney. These up regulation of CSE/H2S, CBS, and 3-MST and eNOS/NO/cGMP pathways enhanced the responsiveness of α1A and α1B-adrenoreceptors subtypes to adrenergic agonists in LVH-H2S. These findings indicate an important role for H2S in modulating deranged signalling in the renal vasculature resulting from LVH development. PMID:27191852

  11. Kidney Disease

    MedlinePlus

    ... version of this page please turn Javascript on. Kidney Disease What is Kidney Disease? What the Kidneys Do Click for more information You have two ... damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced ...

  12. Food habits of Arctic staghorn sculpin (Gymnocanthus tricuspis) and shorthorn sculpin (Myoxocephalus scorpius) in the northeastern Chukchi and western Beaufort Seas

    NASA Astrophysics Data System (ADS)

    Gray, Benjamin P.; Norcross, Brenda L.; Beaudreau, Anne H.; Blanchard, Arny L.; Seitz, Andrew C.

    2017-01-01

    Arctic staghorn sculpin (Gymnocanthus tricuspis) and shorthorn sculpin (Myoxocephalus scorpius) belong to Cottidae, the second most abundant fish family in the western Arctic. Although considered important in food webs, little is known about their food habits throughout this region. To address this knowledge gap, we examined and compared the diets of 515 Arctic staghorn sculpin and 422 shorthorn sculpin using stomachs collected over three summers in the northeastern Chukchi Sea (2010-2012) and one summer in the western Beaufort Sea (2011). We used permutational multivariate analysis of variance (PERMANOVA) and non-metric multidimensional scaling (nMDS) to compare sculpin diets between regions and selected size classes. Differences in mouth morphologies and predator size versus prey size relationships were examined using regression techniques. Arctic staghorn sculpin and shorthorn sculpin diet compositions differed greatly throughout the Chukchi and Beaufort Seas. Regardless of body size, the smaller-mouthed Arctic staghorn sculpin consumed mostly benthic amphipods and polychaetes, whereas the larger-mouthed shorthorn sculpin shifted from a diet composed of benthic and pelagic macroinvertebrates as smaller individuals to shrimps and fish prey as larger individuals. Within shared habitats, the sculpins appear to partition prey, either by taxa or size, in a manner that suggests no substantial overlap occurs between species. This study increases knowledge of sculpin feeding ecology in the western Arctic and offers regional, quantitative diet information that could support current and future food web modeling efforts.

  13. Tubulocystic carcinoma of the kidney

    PubMed Central

    Adair, Carol F.; Zhang, Haiying

    2015-01-01

    Tubulocystic carcinoma (TCC) of the kidney is a unique, rare, and recently recognized neoplasm. Although originally considered a low-grade collecting duct carcinoma, TCC is now considered to be a distinct entity. TCC should be considered in the differential diagnosis of cystic renal neoplasms. We report a case of TCC arising in the left kidney. PMID:26130898

  14. Kidney Tests

    MedlinePlus

    ... taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests. Early kidney disease usually does not have signs ...

  15. Kidney Cancer

    MedlinePlus

    ... common cancers in the United States. Cancer Home Kidney Cancer Language: English Español (Spanish) Recommend on Facebook ... work with the chemical trichloroethylene. What Are the Kidneys? The body has two kidneys, one on each ...

  16. Kidney Problems

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & Information The kidneys are two ... the production of red blood cells. What are Kidney Diseases? For about one-third of older people, ...

  17. Kidney School

    MedlinePlus

    ... copies? Read our licensing agreement Living Successfully with Kidney Disease People with kidney disease can live long ... Listen Printing multiple copies? Read our licensing agreement Kidneys: How They Work, How They Fail, What You ...

  18. Kidney Infection

    MedlinePlus

    ... X-ray called a voiding cystourethrogram. Antibiotics for kidney infections Antibiotics are the first line of treatment ... the infection is completely eliminated. Hospitalization for severe kidney infections For a severe kidney infection, your doctor ...

  19. Kidney: polycystic kidney disease.

    PubMed

    Paul, Binu M; Vanden Heuvel, Gregory B

    2014-01-01

    Polycystic kidney disease (PKD) is a life-threatening genetic disorder characterized by the presence of fluid-filled cysts primarily in the kidneys. PKD can be inherited as autosomal recessive (ARPKD) or autosomal dominant (ADPKD) traits. Mutations in either the PKD1 or PKD2 genes, which encode polycystin 1 and polycystin 2, are the underlying cause of ADPKD. Progressive cyst formation and renal enlargement lead to renal insufficiency in these patients, which need to be managed by lifelong dialysis or renal transplantation. While characteristic features of PKD are abnormalities in epithelial cell proliferation, fluid secretion, extracellular matrix and differentiation, the molecular mechanisms underlying these events are not understood. Here we review the progress that has been made in defining the function of the polycystins, and how disruption of these functions may be involved in cystogenesis.

  20. Injury - kidney and ureter

    MedlinePlus

    Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury; Pre-renal failure - injury, ...

  1. Kidney transplant

    MedlinePlus

    Renal transplant; Transplant - kidney ... Barry JM, Conlin MJ. In: Renal transplantation. Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 44. Kidney Disease: Improving Global Outcomes ( ...

  2. Kidney Biopsy

    MedlinePlus

    ... the right diagnosis. What should a person do days before a kidney biopsy? Days before the procedure, ... procedure. What can a person expect on the day of the kidney biopsy? A person should arrive ...

  3. Kidney Failure

    MedlinePlus

    Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your ... strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful ...

  4. Occupation Dynamics and Impacts of Damselfish Territoriality on Recovering Populations of the Threatened Staghorn Coral, Acropora cervicornis

    PubMed Central

    Schopmeyer, Stephanie A.; Lirman, Diego

    2015-01-01

    Large-scale coral reef restoration is needed to help recover structure and function of degraded coral reef ecosystems and mitigate continued coral declines. In situ coral propagation and reef restoration efforts have scaled up significantly in past decades, particularly for the threatened Caribbean staghorn coral, Acropora cervicornis, but little is known about the role that native competitors and predators, such as farming damselfishes, have on the success of restoration. Steep declines in A. cervicornis abundance may have concentrated the negative impacts of damselfish algal farming on a much lower number of coral prey/colonies, thus creating a significant threat to the persistence and recovery of depleted coral populations. This is the first study to document the prevalence of resident damselfishes and negative effects of algal lawns on A. cervicornis along the Florida Reef Tract (FRT). Impacts of damselfish lawns on A. cervicornis colonies were more prevalent (21.6% of colonies) than those of other sources of mortality (i.e., disease (1.6%), algal/sponge overgrowth (5.6%), and corallivore predation (7.9%)), and damselfish activities caused the highest levels of tissue mortality (34.6%) among all coral stressors evaluated. The probability of damselfish occupation increased as coral colony size and complexity increased and coral growth rates were significantly lower in colonies with damselfish lawns (15.4 vs. 29.6 cm per year). Reduced growth and mortality of existing A. cervicornis populations may have a significant effect on population dynamics by potentially reducing important genetic diversity and the reproductive potential of depleted populations. On a positive note, however, the presence of resident damselfishes decreased predation by other corallivores, such as Coralliophila and Hermodice, and may offset some negative impacts caused by algal farming. While most negative impacts of damselfishes identified in this study affected large individual colonies and

  5. Occupation Dynamics and Impacts of Damselfish Territoriality on Recovering Populations of the Threatened Staghorn Coral, Acropora cervicornis.

    PubMed

    Schopmeyer, Stephanie A; Lirman, Diego

    2015-01-01

    Large-scale coral reef restoration is needed to help recover structure and function of degraded coral reef ecosystems and mitigate continued coral declines. In situ coral propagation and reef restoration efforts have scaled up significantly in past decades, particularly for the threatened Caribbean staghorn coral, Acropora cervicornis, but little is known about the role that native competitors and predators, such as farming damselfishes, have on the success of restoration. Steep declines in A. cervicornis abundance may have concentrated the negative impacts of damselfish algal farming on a much lower number of coral prey/colonies, thus creating a significant threat to the persistence and recovery of depleted coral populations. This is the first study to document the prevalence of resident damselfishes and negative effects of algal lawns on A. cervicornis along the Florida Reef Tract (FRT). Impacts of damselfish lawns on A. cervicornis colonies were more prevalent (21.6% of colonies) than those of other sources of mortality (i.e., disease (1.6%), algal/sponge overgrowth (5.6%), and corallivore predation (7.9%)), and damselfish activities caused the highest levels of tissue mortality (34.6%) among all coral stressors evaluated. The probability of damselfish occupation increased as coral colony size and complexity increased and coral growth rates were significantly lower in colonies with damselfish lawns (15.4 vs. 29.6 cm per year). Reduced growth and mortality of existing A. cervicornis populations may have a significant effect on population dynamics by potentially reducing important genetic diversity and the reproductive potential of depleted populations. On a positive note, however, the presence of resident damselfishes decreased predation by other corallivores, such as Coralliophila and Hermodice, and may offset some negative impacts caused by algal farming. While most negative impacts of damselfishes identified in this study affected large individual colonies and

  6. Doxorubicin cardiomyopathy in children with left-sided Wilms tumor

    SciTech Connect

    Pinkel, D.; Camitta, B.; Kun, L.; Howarth, C.; Tang, T.

    1982-01-01

    Two children with Wilms tumor of the left kidney experienced severe anthracycline cardiomyopathy after irradiation to the tumor bed and conventional dosage of doxorubicin. The cardiomyopathy is attributed 1) to the fact that radiation fields for left Wilms tumor include the lower portion of the heart and 2) to the interaction of doxorubicin and irradiation on cardiac muscle. It is recommended that doxorubicin dosage be sharply restricted in children with Wilms tumor of the left kidney who receive postoperative irradiation.

  7. Kidney Failure: What to Expect

    MedlinePlus

    ... Kidneys & How They Work Kidney Disease A-Z Kidney Failure What is kidney failure and how is it treated? Kidney failure ... Methods for Kidney Failure: Peritoneal Dialysis . Peritoneal dialysis Kidney Transplant A kidney transplant places a healthy kidney ...

  8. Kidney Stones

    MedlinePlus

    ... History Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  9. Kidney Cancer

    MedlinePlus

    You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and ... blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes ...

  10. Kidney Stones

    MedlinePlus

    ... great pain. The following may be signs of kidney stones that need a doctor's help: Extreme pain in your back ... won't pass on its own, you may need treatment. It can be done with shock waves; with a ... National Institute of Diabetes and Digestive and Kidney Diseases

  11. Targeted Therapies for Kidney Cancer

    MedlinePlus

    ... Therapy for Kidney Cancer Targeted Therapies for Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer Chemotherapy for Kidney Cancer Pain ... Therapy for Kidney Cancer Targeted Therapies for Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer Chemotherapy for Kidney Cancer Pain ...

  12. Kidney (Renal) Failure

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, ... evaluated? How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain ...

  13. Chronic Kidney Diseases

    MedlinePlus

    ... los dientes Video: Getting an X-ray Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  14. Chronic Kidney Diseases

    MedlinePlus

    ... Room? What Happens in the Operating Room? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases A ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  15. Kidney disease - resources

    MedlinePlus

    Resources - kidney disease ... The following organizations are good resources for information on kidney disease: National Kidney Disease Education Program -- www.nkdep.nih.gov National Kidney Foundation -- www.kidney.org National ...

  16. RNA-seq Profiles of Immune Related Genes in the Staghorn Coral Acropora cervicornis Infected with White Band Disease

    PubMed Central

    Libro, Silvia; Kaluziak, Stefan T.; Vollmer, Steven V.

    2013-01-01

    Coral diseases are among the most serious threats to coral reefs worldwide, yet most coral diseases remain poorly understood. How the coral host responds to pathogen infection is an area where very little is known. Here we used next-generation RNA-sequencing (RNA-seq) to produce a transcriptome-wide profile of the immune response of the Staghorn coral Acropora cervicornis to White Band Disease (WBD) by comparing infected versus healthy (asymptomatic) coral tissues. The transcriptome of A. cervicornis was assembled de novo from A-tail selected Illumina mRNA-seq data from whole coral tissues, and parsed bioinformatically into coral and non-coral transcripts using existing Acropora genomes in order to identify putative coral transcripts. Differentially expressed transcripts were identified in the coral and non-coral datasets to identify genes that were up- and down-regulated due to disease infection. RNA-seq analyses indicate that infected corals exhibited significant changes in gene expression across 4% (1,805 out of 47,748 transcripts) of the coral transcriptome. The primary response to infection included transcripts involved in macrophage-mediated pathogen recognition and ROS production, two hallmarks of phagocytosis, as well as key mediators of apoptosis and calcium homeostasis. The strong up-regulation of the enzyme allene oxide synthase-lipoxygenase suggests a key role of the allene oxide pathway in coral immunity. Interestingly, none of the three primary innate immune pathways - Toll-like receptors (TLR), Complement, and prophenoloxydase pathways, were strongly associated with the response of A. cervicornis to infection. Five-hundred and fifty differentially expressed non-coral transcripts were classified as metazoan (n = 84), algal or plant (n = 52), fungi (n = 24) and protozoans (n = 13). None of the 52 putative Symbiodinium or algal transcript had any clear immune functions indicating that the immune response is driven by the coral host, and not its algal

  17. RNA-seq profiles of immune related genes in the staghorn coral Acropora cervicornis infected with white band disease.

    PubMed

    Libro, Silvia; Kaluziak, Stefan T; Vollmer, Steven V

    2013-01-01

    Coral diseases are among the most serious threats to coral reefs worldwide, yet most coral diseases remain poorly understood. How the coral host responds to pathogen infection is an area where very little is known. Here we used next-generation RNA-sequencing (RNA-seq) to produce a transcriptome-wide profile of the immune response of the Staghorn coral Acropora cervicornis to White Band Disease (WBD) by comparing infected versus healthy (asymptomatic) coral tissues. The transcriptome of A. cervicornis was assembled de novo from A-tail selected Illumina mRNA-seq data from whole coral tissues, and parsed bioinformatically into coral and non-coral transcripts using existing Acropora genomes in order to identify putative coral transcripts. Differentially expressed transcripts were identified in the coral and non-coral datasets to identify genes that were up- and down-regulated due to disease infection. RNA-seq analyses indicate that infected corals exhibited significant changes in gene expression across 4% (1,805 out of 47,748 transcripts) of the coral transcriptome. The primary response to infection included transcripts involved in macrophage-mediated pathogen recognition and ROS production, two hallmarks of phagocytosis, as well as key mediators of apoptosis and calcium homeostasis. The strong up-regulation of the enzyme allene oxide synthase-lipoxygenase suggests a key role of the allene oxide pathway in coral immunity. Interestingly, none of the three primary innate immune pathways--Toll-like receptors (TLR), Complement, and prophenoloxydase pathways, were strongly associated with the response of A. cervicornis to infection. Five-hundred and fifty differentially expressed non-coral transcripts were classified as metazoan (n = 84), algal or plant (n = 52), fungi (n = 24) and protozoans (n = 13). None of the 52 putative Symbiodinium or algal transcript had any clear immune functions indicating that the immune response is driven by the coral host, and not its algal

  18. A rare case of ectopic thoracic kidney and spleen.

    PubMed

    Krishnan, Babu; Lakshminarayanan, P; Sudhakar, M K; Vishwanathan, K N

    2011-07-01

    A 23-year-old male presented with fever of 5 days duration. His peripheral smear was positive for Plasmodium vivax. He was treated for malaria and responded. During investigation with USG it was found that he had absent left kidney. An abdominal contrast enhanced CT scan revealed ectopic kidney and spleen in the left hemithorax. This was a rare case of ectopic thoracic kidney and spleen.

  19. Kidney stones

    MedlinePlus Videos and Cool Tools

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

  20. Kidney biopsy

    MedlinePlus

    Renal biopsy; Biopsy - kidney ... Barisoni L, Arend LJ, Thomas DB. Introduction to renal biopsy. In: Zhou M, Mari-Galluzzi C, eds. ... Saunders; 2015:chap 7. Topham PS, Chen Y. Renal biopsy. In: Johnson RJ, Feehally J, Floege J, ...

  1. Kidney removal

    MedlinePlus

    ... and medical centers are doing this surgery using robots . Why the Procedure is Performed Kidney removal may ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  2. Kidney Stones

    MedlinePlus

    ... pain medication and drink lots of water to pass a kidney stone. In other instances — for example, ... through a strainer to catch stones that you pass. Lab analysis will reveal the makeup of your ...

  3. Kidney Failure

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. October 2, 2013 Contact Us Health Information Center Phone: 1-800-860- ...

  4. Sonographic Growth Charts for Kidney Length in Normal Korean Children: a Prospective Observational Study.

    PubMed

    Oh, Min-Su; Hwang, Geol; Han, Sanghoon; Kang, Hyun Sik; Kim, Seung Hyo; Kim, Young Don; Kang, Ki-Soo; Shin, Kyung-Sue; Lee, Mu Sook; Choi, Guk Myung; Han, Kyoung Hee

    2016-07-01

    Kidney length is the most useful parameter for clinical measurement of kidney size, and is useful to distinguish acute kidney injury from chronic kidney disease. In this prospective observational study of 437 normal children aged between 0 and < 13 years, kidney length was measured using sonography. There were good correlations between kidney length and somatic values, including age, weight, height, and body surface area. The rapid growth of height during the first 2 years of life was intimately associated with a similar increase in kidney length, suggesting that height should be considered an important factor correlating with kidney length. Based on our findings, the following regression equation for the reference values of bilateral kidney length for Korean children was obtained: kidney length of the right kidney (cm) = 0.051 × height (cm) + 2.102; kidney length of the left kidney (cm) = 0.051 × height (cm) + 2.280. This equation may aid in the diagnosis of various kidney disorders.

  5. Case report: a left upper quadrant complex cystic mass.

    PubMed

    Choi, Lydia; Mirani, Neena; Kim, Steve H

    2012-01-01

    A 61-year-old woman presented with left upper quadrant/flank pain and increasing abdominal girth. CT scan showed a large complex, multi-cystic lesion in the left abdomen. Laparotomy revealed a large retroperitoneal mass attached to the left kidney. Left nephrectomy was performed and pathology demonstrated a benign cystic nephroma. Surgical oncologists should be aware of this rare renal lesion as the clinical and radiographic presentation may mimic other intra-abdominal cystic lesions.

  6. Acquired Cystic Kidney Disease

    MedlinePlus

    ... They Work Kidney Disease A-Z Acquired Cystic Kidney Disease What is acquired cystic kidney disease? Acquired cystic kidney disease happens when a ... cysts. What are the differences between acquired cystic kidney disease and polycystic kidney disease? Acquired cystic kidney ...

  7. Simple Kidney Cysts

    MedlinePlus

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

  8. Kidney cancer.

    PubMed

    Linehan, W Marston; Rathmell, W Kimryn

    2012-01-01

    Over 65,000 Americans are diagnosed with kidney cancer each year and nearly 13,000 die of this disease. Kidney cancer is not a single disease, it is made up of a number of different types of cancer, each with a different histology, a different clinical course, responding differently to therapy and caused by a different gene. Study of the 13 genes that are known to cause kidney cancer has led to the understanding that kidney cancer is a metabolic disease. Recent discoveries of chromatin remodeling/histone modifying genes, such as PBRM1 and SETD2, have opened up new areas of intense interest in the study of the fundamental genetic basis of kidney cancer. New approaches to immunotherapy with agents such as the CTLA4 inhibitor, ipilumumab, have opened up promising new directions for clinical trials. A number of new agents targeting of VEGF receptor signaling and the mTOR pathways as well as novel approaches targeting HIF2 will hopefully provide the foundation for the development of effective forms of therapy for this disease.

  9. Chronic Kidney Disease (CKD)

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  10. American Kidney Fund

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  11. Tests for Kidney Health

    MedlinePlus

    ... upcoming screening events. Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... support of AKF. Kidney Action Day Kidney Action Day Learn about our signature outreach event. Free health ...

  12. Organ Facts: Kidney / Pancreas

    MedlinePlus

    ... Lung Kidney Pancreas Kidney/Pancreas Liver Intestine Kidney/Pancreas Facts The kidneys are a pair of reddish- ... the chemical (electrolyte) composition of the blood. The pancreas is a five to six inch gland located ...

  13. Polycystic kidney disease

    MedlinePlus

    Cysts - kidneys; Kidney - polycystic; Autosomal dominant polycystic kidney disease; ADPKD ... Polycystic kidney disease (PKD) is passed down through families (inherited). The 2 inherited forms of PKD are autosomal dominant ...

  14. Kidney Stones (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Kidney Stones KidsHealth > For Parents > Kidney Stones Print A ... other treatments to help remove the stones. How Kidney Stones Form It's the kidneys' job to remove ...

  15. Kidneys and Urinary Tract

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Kidneys and Urinary Tract KidsHealth > For Teens > Kidneys and ... be a sign of diabetes . continue What the Kidneys and Urinary Tract Do Although the two kidneys ...

  16. Extraintestinal Complications: Kidney Disorders

    MedlinePlus

    ... Extraintestinal Complications: Kidney Disorders Go Back Extraintestinal Complications: Kidney Disorders Email Print + Share The kidneys filter the ... but some less serious ones occur more frequently. Kidney stones These are probably the most commonly encountered ...

  17. Kidney Stones (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Kidney Stones KidsHealth > For Parents > Kidney Stones A A ... other treatments to help remove the stones. How Kidney Stones Form It's the kidneys' job to remove ...

  18. Serendipitous finding of transitional cell carcinoma of the kidney on bone and gallium imaging

    SciTech Connect

    Moreno, A.J.; Toney, M.A.; Griffith, J.C.; Rodriguez, A.A.; Turnbull, G.L. )

    1991-03-01

    A 50-year-old woman presented with low back pain. Bone scintigraphy showed a focus of increased activity in the upper pole of the left kidney. Subsequent Ga-67 citrate scintigraphy demonstrated this same abnormal focus as a region of increased activity. Ultrasonography showed a renal mass in the upper pole of the left kidney. At surgery a transitional cell carcinoma of the upper pole of the left kidney was found.

  19. Ruptured Hemangioma of a Native Kidney: An Unusual Cause of Postoperative Hemorrhage in Kidney Transplant Recipients.

    PubMed

    Poznańska, Grażyna; Wlazlak, Michał; Hogendorf, Piotr; Szymański, Dariusz; Strzelczyk, Janusz; Durczyński, Adam

    2017-03-14

    BACKGROUND Retroperitoneal bleeding as a consequence of non-traumatic kidney or allograft rupture is well known, but there are no reports on hemorrhagia from a native kidney after allogeneic renal transplantation. Therefore, we present the first such case to be published and highlight the possibility of this complication after renal transplantation. CASE REPORT We report the case of a 28-year-old male patient who developed early post-transplant hemorrhagia from a ruptured native kidney. The patient underwent left-sided nephrectomy. Histopathological examination revealed ruptured hemangioma of the patient's native left kidney. The further postoperative period was not complicated. The patient was discharged on the 18th postoperative day, with good transplant function. CONCLUSIONS Transplantologists should be aware of the fact that in patients with uncontrolled blood pressure, native kidney hemangioma may rupture in the early post-transplant period, and it can be a life-threating and difficult to diagnose complication.

  20. Rare case of thoracic kidney detected by renal scintigraphy

    PubMed Central

    Natarajan, Aravintho; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-01-01

    Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen. PMID:27385896

  1. Kidney pain (image)

    MedlinePlus

    A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size of sand or ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the ...

  2. [Mucinous adenocarcinoma of the renal pelvis associated with renal calculi of the inflammatory type].

    PubMed

    Kalafatis, P; Zarifis, I; Sotrillis, T; Stefis, A

    1999-03-01

    A rare case of mucinous adenocarcinoma of the renal pelvis associated with renal staghorn calculosis in a 60-years-old male patient with pyuria and mucin content of the urine is presented. History was significant for recurrent calculosis of the left kidney. A non functioning hydronephrotic left kidney with staghorn calculosis was diagnosed. Laboratory tests were remarkable only for Carcinoembrionic Antigen (CEA). Pathology of the surgical specimen followed by its immunoreactivity revealed an intestinal type metaplasia and papillary, tubular and mucinous adenocarcinoma of the renal pelvis. Pathogenesis of the intestinal metaplasia and the role of chronic irritation of the urothelium are mentioned.

  3. Hypoplastic left heart syndrome

    MedlinePlus

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in females. As ...

  4. Kidneys and How They Work

    MedlinePlus

    ... Childhood Nephrotic Syndrome Hemolytic Uremic Syndrome in Children Treatment for Kidney Failure in Children Caring for a ... Sponge Kidney Kidney Dysplasia Kidney Failure Choosing a Treatment for Kidney Failure Hemodialysis Peritoneal Dialysis Kidney Transplant ...

  5. A new apparatus for standardized rat kidney biopsy.

    PubMed

    Schirutschke, Holger; Gladrow, Lars; Norkus, Christian; Parmentier, Simon Paul; Hohenstein, Bernd; Hugo, Christian P M

    2014-01-01

    Survival biopsies are frequently applied in rat kidney disease models, but several drawbacks such as surgical kidney trauma, bleeding risk and variable loss of kidney tissue are still unsolved. Therefore, we developed an easy-to-use core biopsy instrument and evaluated whether two consecutive kidney biopsies within the same kidney can be carried out in a standardized manner. On day 0, 18 Lewis rats underwent a right nephrectomy and 9 of these rats a subsequent first biopsy of the left kidney (Bx group). 9 control rats had a sham biopsy of the left kidney (Ctrl group). On day 7, a second kidney biopsy/sham biopsy was performed. On day 42, all animals were sacrificed and their kidneys were removed for histology. Biopsy cylinders contained 57±28 glomeruli per transversal section, representing an adequate sample size. PAS staining showed that the biopsy depth was limited to the renal cortex whereas surgical tissue damage was limited to the area immediately adjacent to the taken biopsy cylinder. On day 42, the reduction of functional renal mass after two biopsies was only 5.2% and no differences of body weight, blood pressure, proteinuria, serum creatinine, glomerulosclerosis, interstitial fibrosis or number of ED-1 positive macrophages were found between both groups. In summary, our apparatus offers a safe method to perform repetitive kidney biopsies with minimal trauma and sufficient sample size and quality even in experimental disease models restricted to one single kidney.

  6. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1979-01-01

    A kidney cell electrophoresis technique is described in four parts: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characteristics of kidney cells.

  7. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1980-01-01

    The following aspects of kidney cell electrophoresis are discussed: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characterization of kidney cells.

  8. Diabetic Kidney Problems

    MedlinePlus

    ... too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste ... in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. It ...

  9. Kidney Cancer in Children

    MedlinePlus

    What is Kidney Cancer in Children? Kidney (renal) tumors are very rare in children. Still, the three most common renal tumors ... treatable and curable. What are the Types of Kidney Cancer in Children? Male urinary tract Medical Illustration ...

  10. Chronic Kidney Disease

    MedlinePlus

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  11. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  12. Radiation damage in rat kidney microvasculature.

    PubMed

    Nelson, A C; Shah-Yukich, A; Babayan, R

    1984-01-01

    Scanning electron microscopy (SEM) combined with a specialized polymer injection casting technique permits the analysis of radiation induced damage in rat kidney glomeruli. A lead shielding device is constructed to enable the irradiation of the living rat left kidney, while the remainder of the animal is shielded from the dose, the right kidney serves as a control. The source of radiation is 137Cs which produces 0.66 MeV gamma-rays to achieve a kidney dose of 100 rad and 5000 rad in these experiments. Radiation damage to kidney glomeruli is assessed at intervals of 0, 1, 3 and 7 days post-irradiation at the two dose levels. It is found that radiation damage to kidney glomeruli is expressed morphologically at 7 days post-irradiation at the 100 rad dose level, while glomerular damage is apparent as early as 3 days post-irradiation at the 5000 rad dose level. Moreover, by 7 days post-irradiation with a 5000 rad dose, the kidney glomerulus thoroughly degenerates to a leaky fused mass of vessels. From a morphological viewpoint, kidney glomeruli are significantly more sensitive to radiation than surrounding vasculature. The methods developed here for assessment of radiation damage are highly repeatable and could serve as a standard technique in radiobiology.

  13. Cadmium and the kidney.

    PubMed Central

    Friberg, L

    1984-01-01

    The paper is a review of certain aspects of importance of cadmium and the kidney regarding the assessment of risks and understanding of mechanisms of action. The review discusses the following topics: history and etiology of cadmium-induced kidney dysfunction and related disorders; cadmium metabolism, metallothionein and kidney dysfunction; cadmium in urine as indicator of body burden, exposure and kidney dysfunction; cadmium levels in kidney and liver as indicators of kidney dysfunction; characteristics of early kidney dysfunction; the critical concentration concept; critical concentrations of cadmium in kidney cortex; and prognosis. PMID:6734547

  14. Supernumerary kidney with ipsilateral cryptorchidism in a cat.

    PubMed

    Paradise, Danielle; Clark, David

    2013-01-01

    An 8 wk old male domestic longhair was presented with an abdominal mass and cryptorchidism. A 2 cm mass was palpable in the midabdomen. Ultrasonography confirmed a complex, septated, cystic mass adjacent and caudal to the right kidney. A normally appearing left kidney was present. Pathologic examination of the excised abdominal mass revealed it to be a kidney with an attached, normal caliber ureter. At surgery, this kidney was separate from the parenchyma of the second, cranial, right kidney. Subsequently, the second right kidney became hydronephrotic and was removed together with the cryptorchid testis and an apparently hypoplastic ureter. This is the first report of a supernumerary kidney in a cat, adding it to the differential diagnoses of abdominal masses.

  15. Distribution and concentration of cadmium in human kidney

    SciTech Connect

    Svartengren, M.; Elinder, C.G.; Friberg, L.; Lind, B.

    1986-01-01

    The left kidneys from twenty males, aged 30 to 59, were examined. On an average, the cortex, medulla, and the remainder (renal pelvis and adjacent fatty tissue) constituted 65, 27, and 8 percent of the whole kidney weight, respectively. The mean cadmium concentrations were 18.4, 6.9,, and 3.2 ..mu..g Cd/g wet wt, respectively. The mean whole kidney cadmium concentration was 14.4 ..mu..g Cd/g wet wt. The kidney cortex concentration of cadmium can be approximated by multiplying the whole kidney concentration by a factor of 1.25, which is somewhat lower than the factor of 1.5 previously used. It may be necessary to recalculate previously reported estimates of critical concentrations for cadmium in kidney cortex based on neutron activation analyses in vivo of whole kidney.

  16. Allograft loss from acute Page kidney secondary to trauma after kidney transplantation.

    PubMed

    Takahashi, Kazuhiro; Prashar, Rohini; Putchakayala, Krishna G; Kane, William J; Denny, Jason E; Kim, Dean Y; Malinzak, Lauren E

    2017-02-24

    We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria. His serum creatinine level was slightly elevated from his baseline. Computer tomography revealed a large subscapular hematoma around the transplant kidney. The patient was observed to have renal trauma grade II at the hospital over a period of three days, and he was finally transferred to a transplant center after his urine output significantly decreased. Doppler ultrasound demonstrated an extensive peri-allograft hypoechoic area and abnormal waveforms with absent arterial diastolic flow and a patent renal vein. Despite surgical decompression, the allograft failed to respond appropriately due to the delay in surgical intervention. This is the third reported case of allograft loss from acute Page kidney following kidney transplantation. This case reinforces that kidney care differs if the kidney is solitary or a transplant. Early recognition and aggressive treatments are mandatory, especially in a case with Doppler signs that are suggestive of compression.

  17. Allograft loss from acute Page kidney secondary to trauma after kidney transplantation

    PubMed Central

    Takahashi, Kazuhiro; Prashar, Rohini; Putchakayala, Krishna G; Kane, William J; Denny, Jason E; Kim, Dean Y; Malinzak, Lauren E

    2017-01-01

    We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria. His serum creatinine level was slightly elevated from his baseline. Computer tomography revealed a large subscapular hematoma around the transplant kidney. The patient was observed to have renal trauma grade II at the hospital over a period of three days, and he was finally transferred to a transplant center after his urine output significantly decreased. Doppler ultrasound demonstrated an extensive peri-allograft hypoechoic area and abnormal waveforms with absent arterial diastolic flow and a patent renal vein. Despite surgical decompression, the allograft failed to respond appropriately due to the delay in surgical intervention. This is the third reported case of allograft loss from acute Page kidney following kidney transplantation. This case reinforces that kidney care differs if the kidney is solitary or a transplant. Early recognition and aggressive treatments are mandatory, especially in a case with Doppler signs that are suggestive of compression. PMID:28280700

  18. Biologic Therapy (Immunotherapy) for Kidney Cancer

    MedlinePlus

    ... Stage for Kidney Cancer Kidney Cancer Treating Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer The goal of biologic therapy ... Therapy for Kidney Cancer Targeted Therapies for Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer Chemotherapy for Kidney Cancer Pain ...

  19. Prorenin receptor in kidney development.

    PubMed

    Yosypiv, Ihor V

    2017-03-01

    Prorenin receptor (PRR), a receptor for renin and prorenin and an accessory subunit of the vacuolar proton pump H(+)-ATPase, is expressed in the developing kidney. Global loss of PRR is lethal in mice, and PRR mutations are associated with a high blood pressure, left ventricular hypertrophy and X-linked mental retardation in humans. With the advent of modern gene targeting techniques, including conditional knockout approaches, several recent studies have demonstrated critical roles for the PRR in several lineages of the developing kidney. PRR signaling has been shown to be essential for branching morphogenesis of the ureteric bud (UB), nephron progenitor survival and nephrogenesis. PRR regulates these developmental events through interactions with other transcription and growth factors. Several targeted PRR knockout animal models have structural defects mimicking congenital anomalies of the kidney and urinary tract observed in humans. The aim of this review, is to highlight new insights into the cellular and molecular mechanisms by which PRR may regulate UB branching, terminal differentiation and function of UB-derived collecting ducts, nephron progenitor maintenance, progression of nephrogenesis and normal structural kidney development and function.

  20. Left ventricular bronchogenic cyst.

    PubMed

    Wei, Xiang; Omo, Alfred; Pan, Tiecheng; Li, Jun; Liu, Ligang; Hu, Min

    2006-04-01

    Bronchogenic cysts occurring in the left ventricle are a medical rarity. One successfully operated case is reported herein. The location of the cyst was just between the epicardium and myocardium of the inferior left ventricular wall, adjacent to the apex of the heart. Complete excision was achieved through a left anterolateral thoracotomy without extracorporeal circulation.

  1. Polycystic Kidney Disease

    MedlinePlus

    ... Disease Chronic Kidney Disease (CKD) What Is Chronic Kidney Disease? Causes of CKD Tests & Diagnosis Managing CKD Eating Right Preventing CKD What If My Kidneys Fail? Clinical Trials Anemia High Blood Pressure Heart ... Nephropathy Kidney Disease in Children Childhood Nephrotic Syndrome Hemolytic ...

  2. Supernumerary Kidney Associated with Horseshoe Malformation: A Case Report and Review of Literature.

    PubMed

    Jamshidian, Hassan; Tavakoli, Kiana; Salahshour, Faeze; Nabighadim, Amirreza; Amini, Erfan

    2017-02-01

    We report a case of supernumerary kidney associated with horseshoe malformation. A 35-year-old man presented complaining of vague and intermittent left flank pain from few months ago. Ultrasonography of urinary tract showed bilateral hydronephrosis and was suggestive of the horseshoe anomaly. Further evaluation with Intravenous urography showed three renal moieties consisting of a horseshoe kidney and a malrotated right kidney cephalad to and fused with the right moiety of horseshoe kidney.

  3. Chronic Kidney Disease in Kidney Stone Formers

    PubMed Central

    Krambeck, Amy E.; Lieske, John C.

    2011-01-01

    Summary Recent population studies have found symptomatic kidney stone formers to be at increased risk for chronic kidney disease (CKD). Although kidney stones are not commonly identified as the primary cause of ESRD, they still may be important contributing factors. Paradoxically, CKD can be protective against forming kidney stones because of the substantial reduction in urine calcium excretion. Among stone formers, those with rare hereditary diseases (cystinuria, primary hyperoxaluria, Dent disease, and 2,8 dihydroxyadenine stones), recurrent urinary tract infections, struvite stones, hypertension, and diabetes seem to be at highest risk for CKD. The primary mechanism for CKD from kidney stones is usually attributed to an obstructive uropathy or pyelonephritis, but crystal plugs at the ducts of Bellini and parenchymal injury from shockwave lithotripsy may also contribute. The historical shift to less invasive surgical management of kidney stones has likely had a beneficial impact on the risk for CKD. Among potential kidney donors, past symptomatic kidney stones but not radiographic stones found on computed tomography scans were associated with albuminuria. Kidney stones detected by ultrasound screening have also been associated with CKD in the general population. Further studies that better classify CKD, better characterize stone formers, more thoroughly address potential confounding by comorbidities, and have active instead of passive follow-up to avoid detection bias are needed. PMID:21784825

  4. Left Ventricular Mass: Correlation with Fatness, Hemodynamics and Renal Morphology

    PubMed Central

    Wykrętowicz, Mariusz; Katulska, Katarzyna; Milewska, Agata; Krauze, Tomasz

    2014-01-01

    Summary Background Left ventricular mass (LVM) is correlated with body composition and central hemodynamics as well as kidney function. Recently, fat-free mass has been considered to be more strongly correlated with LVM in comparison to other descriptors of fatness. We therefore address the question of whether comprehensive descriptors of fatness, central hemodynamics and renal characteristics demonstrate the association with left ventricular mass in healthy non-obese population. Material/Methods 119 healthy non-obese subjects (53 females, 66 males, mean age 50 yrs) were evaluated. Central hemodynamics was measured by Pulse Wave Analysis, left ventricular mass was assessed by echocardiography, fatness was evaluated by anthropometry, bioimpedance, and ultrasound. Results Left ventricular mass index (LVMI) correlated to the same extent with central and peripheral blood pressure but not with descriptors of wave reflection. Fat-free mass as well as intraabdominal fat correlated to a similar extent with LVMI. Kidney morphological characteristics indexed to body surface area were associated inversely and independently with LVMI. Conclusions Comprehensive assessment of fatness reinforced the concept that intraabdominal fat compartment is strongly correlated with left ventricular mass. Descriptors of wave reflection are not associated with left ventricular mass. The interrelationsh between kidney morphology and LVMI indicates that such associations may be a biologically plausible phenomenon. PMID:25436020

  5. Upper Tract Urothelial Carcinoma in Ectopic Pelvic Kidney.

    PubMed

    Halalsheh, Omar; Ghawanmeh, Hamzeh M; Alshammari, Ahmed; Sahawneh, Firas; Al-Okour, Radwan; Al Karasneh, Anas; Ghawanmeh, Malik

    2017-02-01

    Upper tract urothelial carcinoma (UC) is an uncommon tumor. Ectopic kidney is also a rare entity. The combination of these two conditions is very rare. A 49-year-old male complained of right flank pain with hematuria. On CT scan he was found to have a malrotated right kidney with soft tissue seen in the upper calyceal group and a normal left kidney. Diagnostic cystoscopy was unremarkable. Radical nephroureterectomy with bladder cuff excision was performed. Pathology report revealed low grade urothelial carcinoma. Patient's symptoms disappeared postoperatively. Follow up showed no recurrence during the first two years in the bladder and upper tract in the contralateral kidney. Isolated UC of ectopic kidney is rare disease three cases were reported in literature. Although treatment of this tumor can be challenging due to its complex blood supply and position inside the pelvis, treatment strategy is still similar as for orthotopic kidneys.

  6. Glomerulocystic kidney disease in an adult with enlarged kidneys: a case report and review of the literature.

    PubMed

    Obata, Y; Furusu, A; Miyazaki, M; Nishino, T; Kawazu, T; Kanamoto, Y; Nishikido, M; Taguchi, T; Kohno, S

    2011-02-01

    We report the case of a 31-year-old male with enlarged kidneys and glomerulocystic kidney disease (GCKD). The patient had no family history of renal disease or other diseases. On initial presentation he complained of poor eyesight, and hypertensive retinopathy and elevated serum creatinine (5.0 mg/dl) were found at that time. Renal biopsy showed cystic dilatation of Bowman's capsule and atrophy of the glomerular tuft. Thus, an adult case of sporadic GCKD was diagnosed. Based on previous reports, kidney size in patients with adult type GCKD varies from small to large. Our patient's kidneys are the largest ever reported (right kidney was 22 cm×10 cm, left kidney was 19 cm×10 cm). A review of the literature dealing with sporadic adult GCKD suggested that it is difficult to diagnose this disease early in its course.

  7. Living with Kidney Cancer

    MedlinePlus

    ... Award Living With Kidney Cancer Living With Cancer Day to Day The impact of kidney cancer on your life ... least one half hour of exercise every other day. Vigorous walking, jogging, swimming, or other aerobic exercise ...

  8. Acute arterial occlusion - kidney

    MedlinePlus

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  9. Acute Kidney Failure

    MedlinePlus

    ... through your urine Impaired blood flow to the kidneys Diseases and conditions that may slow blood flow ... anaphylaxis) Severe burns Severe dehydration Damage to the kidneys These diseases, conditions and agents may damage the ...

  10. Testing for Kidney Disease

    MedlinePlus

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014​​ Contact Us Health Information Center Phone: 1-800-860- ...

  11. Kidney Disease Basics

    MedlinePlus

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. March 1, 2012​ Contact Us Health Information Center Phone: 1-800-860- ...

  12. Diabetes and Kidney Disease

    MedlinePlus

    ... disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose , also called ... I keep my kidneys healthy if I have diabetes? The best way to slow or prevent diabetes- ...

  13. Pain Medicines and Kidney Damage

    MedlinePlus

    ... Work Kidney Disease A-Z Pain Medicine and Kidney Damage An analgesic is any medicine intended to ... of chronic kidney disease called analgesic nephropathy. Acute Kidney Failure Some patient case reports have attributed incidents ...

  14. [Kidney diseases in pregnancy].

    PubMed

    Kolesárova, Eva; Sirotiaková, Jana; Kozárová, Miriam

    2010-01-01

    Knowledge of important morphological, functional and hemodynamic changes occurring in the kidneys during physiological pregnancy is a prerequisite for proper diagnostics and therapy of renal diseases in pregnancy. Kidney diseases may be kidney diseases complicating pregnancy in previously healthy women, or pre-existing or superposed kidney diseases. Knowledge of renal insufficiency management in pregnancy, including haemodialysis treatment and management of pregnancy in patients who have undergone transplantation, is also important.

  15. Hydronephrosis of one kidney

    MedlinePlus

    ... Acute hydronephrosis; Urinary obstruction; Unilateral hydronephrosis; Nephrolithiasis - hydronephrosis; Kidney stone - hydronephrosis; Renal calculi - hydronephrosis; Ureteral calculi - hydronephrosis; ...

  16. Breast cancer metastatic to the kidney with renal vein involvement.

    PubMed

    Nasu, Hatsuko; Miura, Katsutoshi; Baba, Megumi; Nagata, Masao; Yoshida, Masayuki; Ogura, Hiroyuki; Takehara, Yasuo; Sakahara, Harumi

    2015-02-01

    The common sites of breast cancer metastases include bones, lung, brain, and liver. Renal metastasis from the breast is rare. We report a case of breast cancer metastatic to the kidney with extension into the renal vein. A 40-year-old woman had undergone left mastectomy for breast cancer at the age of 38. A gastric tumor, which was later proved to be metastasis from breast cancer, was detected by endoscopy. Computed tomography performed for further examination of the gastric tumor revealed a large left renal tumor with extension into the left renal vein. It mimicked a primary renal tumor. Percutaneous biopsy of the renal tumor confirmed metastasis from breast cancer. Surgical intervention of the stomach and the kidney was avoided, and she was treated with systemic chemotherapy. Breast cancer metastatic to the kidney may present a solitary renal mass with extension into the renal vein, which mimics a primary renal tumor.

  17. Left heart catheterization

    MedlinePlus

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  18. Left Ventricular Hypertrophy

    MedlinePlus

    ... at the time of their diagnosis with hypertension. Aortic valve stenosis. This disease is a narrowing of the tissue ... muscle and disease. In addition to hypertension and aortic valve stenosis, factors that increase your risk for left ventricular ...

  19. Left Atrial Myxoma

    DTIC Science & Technology

    2006-09-01

    enhanced pulmonary CT angiogram demonstrated normal pulmonary arteries (i.e. no pulmonary embolus) and confirmed the presence of left-sided pulmonary ... arteries without evidence for pulmonary embolism but note of patchy airspace disease within the left upper and lower lobes (Figure 1C), which...1A) and lateral (Figure 1B) chest radiographs were obtained and the patient also underwent a contrast-enhanced pulmonary CT angiogram (CTA; Figure

  20. What Is Kidney Cancer (Renal Cell Carcinoma)?

    MedlinePlus

    ... Treatment? Kidney Cancer About Kidney Cancer What Is Kidney Cancer? Kidney cancer is a cancer that starts ... and spread, see What Is Cancer? About the kidneys To understand more about kidney cancer, it helps ...

  1. Overview of Kidney Diseases in Children

    MedlinePlus

    ... Childhood Nephrotic Syndrome Hemolytic Uremic Syndrome in Children Treatment for Kidney Failure in Children Caring for a ... Sponge Kidney Kidney Dysplasia Kidney Failure Choosing a Treatment for Kidney Failure Hemodialysis Peritoneal Dialysis Kidney Transplant ...

  2. Sonographic Growth Charts for Kidney Length in Normal Korean Children: a Prospective Observational Study

    PubMed Central

    2016-01-01

    Kidney length is the most useful parameter for clinical measurement of kidney size, and is useful to distinguish acute kidney injury from chronic kidney disease. In this prospective observational study of 437 normal children aged between 0 and < 13 years, kidney length was measured using sonography. There were good correlations between kidney length and somatic values, including age, weight, height, and body surface area. The rapid growth of height during the first 2 years of life was intimately associated with a similar increase in kidney length, suggesting that height should be considered an important factor correlating with kidney length. Based on our findings, the following regression equation for the reference values of bilateral kidney length for Korean children was obtained: kidney length of the right kidney (cm) = 0.051 × height (cm) + 2.102; kidney length of the left kidney (cm) = 0.051 × height (cm) + 2.280. This equation may aid in the diagnosis of various kidney disorders. PMID:27366007

  3. Polycystic kidneys in the red panda (Ailurus fulgens).

    PubMed

    Makungu, Modesta; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N; Groenewald, Hermanus B

    2013-09-01

    An intact adult male 14.3-yr-old red panda (Ailurus fulgens) presented for health examination with a history of slowly progressing loss of body condition. Abdominal radiographs revealed a truncated abdomen with poor serosal abdominal detail and multiple areas of spondylosis with some collapsed intervertebral disc spaces. On computed tomography, multiple ovoid hypoattenuating lesions were seen in the left and right kidneys. Gross pathology and histopathology revealed multiple cystic lesions in the kidneys concurrent with pancreatic cysts on histopathology. To the best of the authors' knowledge, polycystic kidneys have not been reported in this species.

  4. Cuba's kidney transplantation program.

    PubMed

    Mármol, Alexander; Pérez, Alexis; Pérez de Prado, Juan C; Fernández-Vega, Silvia; Gutiérrez, Francisco; Arce, Sergio

    2010-10-01

    The first kidney transplant in Cuba was performed on 24 February 1970, using a cadaveric donor. In 1979, living donor kidney transplantation began between first-degree relatives. A total of 2775 patients are enrolled in renal replacement therapy in 47 hospitals across the country, 1440 of whom are awaiting kidney transplantation. Organs for the kidney program are procured in 63 accredited hospitals equipped for multidisciplinary management of brain death. Accordingly, over 90% of transplanted kidneys are from cadaveric donors. Identification of potential recipients is carried out through a national, computerized program that affords all patients the same opportunity regardless of distance from a transplant center, and selection of the most suitable candidate is based primarily on HLA compatibility. KEYWORDS Chronic renal failure, kidney transplantation.

  5. [CKD-MBD (Chronic Kidney Disease-Mineral and Bone Disorder). Effect of vitamin D on kidney and cardiovascular system].

    PubMed

    Fujii, Hideki

    2010-07-01

    Recently, many investigators have reported that treatment with vitamin D improves outcomes of patients with chronic kidney disease. Though the detailed mechanisms have remained unclear, it has been speculated that such a treatment may prevent progression of chronic kidney disease and cardiovascular disease. It has been reported that Vitamin D may attenuate renal injury and ameliorate renal function and proteinuria. In addition, several studies have shown that vitamin D may prevent progression of atherosclerosis, vascular calcification and left ventricular hypertrophy. The emerging experimental and clinical evidence has suggested that vitamin D may protect kidney and cardiovascular system.

  6. Hypoplastic left heart syndrome (image)

    MedlinePlus

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  7. Kidney Transplantation: MedlinePlus Health Topic

    MedlinePlus

    ... Start Here Kidney Transplant (Mayo Foundation for Medical Education and Research) Kidney Transplant (National Kidney Foundation) Treatment Methods for Kidney Failure: Transplantation (National Institute of Diabetes ...

  8. Epigenetics of kidney disease.

    PubMed

    Wanner, Nicola; Bechtel-Walz, Wibke

    2017-03-13

    DNA methylation and histone modifications determine renal programming and the development and progression of renal disease. The identification of the way in which the renal cell epigenome is altered by environmental modifiers driving the onset and progression of renal diseases has extended our understanding of the pathophysiology of kidney disease progression. In this review, we focus on current knowledge concerning the implications of epigenetic modifications during renal disease from early development to chronic kidney disease progression including renal fibrosis, diabetic nephropathy and the translational potential of identifying new biomarkers and treatments for the prevention and therapy of chronic kidney disease and end-stage kidney disease.

  9. Reversal of "one kidney" to "two kidney" tipe of Goldblatt hypertension in a patient with bilateral artery stenosis.

    PubMed

    Scherer, B; Uhlich, E; Weber, P C; Heberer, G

    1977-09-15

    A 32-year old hypertensive woman with bilateral renal artery stenosis of more than 50% on both sides was studied. Renal vein renin levels were low (0.3 ng/ml/h on the right side and 0.42 on the left) before surgical correction of the left renal artery. Thereafter, blood pressure was only temporarily reduced. Four months later a repeat angiography demonstrated a widely patent left renal artery and the stenosis on the right side was unchanged. Renal vein renin was 5.12 on the left and 11.2 on the right. Subsequent operation on the right side lead to normalization of blood pressure. Thus, our patient seems to demonstrate in sequence the characteristics of the tow types of experimental renovacular hypertension known as "one kidney hypertension" and "two kidney hypertension". Our findings usggest that the pathomechanisms of these experimental models are operative in man too.

  10. Giant left ventricular pseudoaneurysm.

    PubMed

    Prakash, Sumi; Garg, Nadish; Xie, Gong-Yuan; Dellsperger, Kevin C

    2010-01-01

    Left ventricular (LV) pseudoaneurysm (PS) is an uncommon, often fatal complication associated with myocardial infarction, cardiothoracic surgery, trauma, and, rarely, infective endocarditis. A 28-year-old man with prior history of bioprosthetic mitral valve replacement presented with congestive heart failure and bacteremia with Abiotrophia granulitica. Transesophageal echocardiogram showed bioprosthesis dysfunction, large vegetations, mitral regurgitation, and probable PS. Cardiac and chest CT confirmed a PS communicating with the left ventricle Patient had pulseless electrical activity and died. Autopsy showed a giant PS with layered thrombus and pseudo-endothelialized cavity. Our case highlights the importance of multimodality imaging as an important tool in management of PS.

  11. Pancake kidney with a single ureter: a rare incidental observation at autopsy.

    PubMed

    Kanchan, Tanuj; Murlimanju, B V; Saralaya, Vasudha V

    2017-01-01

    We report an extremely rare case of a pancake kidney with a single ureter. During the medicolegal autopsy on the body of a traffic accident victim, the kidneys were not located in the abdomen. The anterior surfaces of both kidneys were completely fused in the pelvic cavity, and the kidney was shaped like a pancake. This pancake kidney had accessory renal arteries around it and one renal vein from each kidney. The left renal vein was much smaller in diameter than the right one. There were two major calyces, one each from each kidney. The major calyces joined to form a single renal pelvis from both the kidneys, which continued as a single ureter. The renal pelvis and ureter lay posterior to the pancake kidney. Urologists and pelvic surgeons should be aware of the variant anatomy of the pancake kidney, particularly concerning its vasculature, to prevent unexpected catastrophic bleeding. If the kidneys are not located in the abdominal cavity, the autopsy surgeon must consider the possibility of its presence in the pelvic cavity. This could be especially important during medicolegal investigations into allegations of missing kidneys and unlawful kidney transplantations.

  12. MiniJFil®: A New Safe and Effective Stent for Well-Tolerated Repeated Extracorporeal Shockwave Lithotripsy or Ureteroscopy for Medium-to-Large Kidney Stones?

    PubMed Central

    Vogt, Benoit; Desfemmes, Francois-Noel; Desgrippes, Arnaud; Ponsot, Yves

    2016-01-01

    Background Percutaneous nephrolithotomy (PCNL) is recommended for treating staghorn stones or stones measuring > 20 mm. Extracorporeal shockwave lithotripsy (ESWL) or flexible ureteroscopy (URS) may be used as a complement. However, PCNL can cause trauma to the kidney parenchyma, and patients may find a noninvasive procedure, such as ESWL, to be more attractive. Objectives The aim of this study was to evaluate the clinical efficiency of MiniJFil® stenting associated with ESWL or second-line URS for the treatment of medium-to-large kidney stones. The MiniJFil® is a stent reduced to a suture of 0.3F attached to a renal pigtail. The entire ureter is occupied only by the suture of the stent. Methods We retrospectively analyzed the data of 28 patients. Twenty-four patients had kidney stones measuring > 15 mm (group 1) and four patients had staghorn stones (group 2). All of the patients were fitted with MiniJFil® 2 - 3 weeks before any treatment. ESWL was always our first-line therapy. Stone-free (SF) status was defined as no evidence of stones. Results In group 1, the mean largest and cumulative stone diameters, respectively, were 18.7 ± 5.7 mm and 45.0 ± 12.0 mm. In group 2, the mean volume was 6,288.4 ± 2,733.0 mm3. The overall SF was 96.4% (100% for group 1 and 75% for group 2). The mean number of sessions of ESWL and URS, respectively, was 1.4 ± 0.7 and 0.8 ± 0.9 in group 1 and 4.0 ± 2.0 and 1.5 ± 1.3 in group 2. The mean times to achieve these rates were 3.2 ± 1.7 months and 5.6 ± 2.3 months for groups 1 and 2, respectively. One patient in group 2 was treated with only three sessions of ESWL. Renal colic was observed in only five patients (17.9%). Conclusions MiniJFil® stenting is safe and may be an alternative for the treatment of kidney stones during minimally invasive procedures. PMID:27878116

  13. No Baby Left behind

    ERIC Educational Resources Information Center

    Blanton, Dorothy

    2007-01-01

    "No Baby Left Behind" was created to have an impact on the school readiness of children in the community today and in the future. Each year, there are an increasing number of students who have learning difficulties. Many of these problems are preventable. Accidents, poor nutrition (of the mother and/or child), drug use, alcohol use, and lack of…

  14. No Cow Left Behind

    ERIC Educational Resources Information Center

    Remsen, Kenneth A.

    2004-01-01

    As a principal facing the task of figuring out all the complexities of the No Child Left Behind legislation, Kenneth Remsen, has concluded there is a strong belief that testing students is the answer to bringing about improvements in student performance. Because testing seems to be a cornerstone to improving performance, he doesn't understand why…

  15. Accountability Left Behind

    ERIC Educational Resources Information Center

    Testani, Rocco E.; Mayes, Joshua A.

    2008-01-01

    This article describes the reversal of the dismissal of an "unfunded-mandates" challenge to the No Child Left Behind Act (NCLB) brought by the National Education Association (NEA), several of its affiliates, and a number of school districts by the United States Court of Appeals for the Sixth Circuit. The decision in "School District…

  16. Keep Your Kidneys Healthy

    MedlinePlus

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014​​​​ Contact Us Health Information Center Phone: 1-800-860- ...

  17. Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience.

    PubMed

    Dağgülli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utanğaç, Mehmet Mazhar; Bodakçi, Mehmet Nuri; Penbegül, Necmettin; Hatipoğlu, Namık Kemal; Çakmakçı, Süleyman

    2015-11-01

    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70% of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80% (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL.

  18. Acute kidney injury during pregnancy.

    PubMed

    Van Hook, James W

    2014-12-01

    Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared.

  19. Bioengineering Kidneys for Transplantation

    PubMed Central

    Madariaga, Maria Lucia L.; Ott, Harald C.

    2014-01-01

    One in ten Americans suffer from chronic kidney disease, and close to 90,000 people die each year from causes related to kidney failure. Patients with end-stage renal disease are faced with two options: hemodialysis or transplantation. Unfortunately, the reach of transplantation is limited because of the shortage of donor organs and the need for immunosuppression. Bioengineered kidney grafts theoretically present a novel solution to both problems. Herein we discuss the history of bioengineering organs, the current status of bioengineered kidneys, considerations for the future of the field, and challenges to clinical translation. We hope that by integrating principles of tissue engineering, and stem cell and developmental biology, bioengineered kidney grafts will advance the field of regenerative medicine while meeting a critical clinical need. PMID:25217267

  20. [Aspergillosis located on polycystic kidney treated with retroperitoneal nephrectomy].

    PubMed

    Rabii, R; Hoznek, A; Salomon, L; Bourg, S; Chopin, D K; Abbou, C C

    2001-03-01

    We reported an uncommon case of 40 years old man, cardiac transplant recipient with chronic renal faillure who consulted for infected left polycystic renal. The serum creatinine level was 750 mmol/L, and urine culture isolated a E. Ecol germe. The abdominopelvic computed tomography showed a bilateral large polycystic renal cortex and suspected the infected cyst in lower pole of left kidney. The retroperitoneal laparoscopic nephrectomy was performed confirming a renal invasive aspergillosa. About this case we should have a high index of suspicion for fungal aetiology in kidney infection in transplant patients and the management of non functioning infected polycystic kidney can use laparoscopic retroperitoneal nephrectomy. This approach can offers a minimal morbidity and alternative to open surgery.

  1. Hereditary kidney cancer syndromes.

    PubMed

    Haas, Naomi B; Nathanson, Katherine L

    2014-01-01

    Inherited susceptibility to kidney cancer is a fascinating and complex topic. Our knowledge about types of genetic syndromes associated with an increased risk of disease is continually expanding. Currently, there are 10 syndromes associated with an increased risk of all types of kidney cancer, which are reviewed herein. Clear cell kidney cancer is associated with von Hippel Lindau disease, chromosome 3 translocations, PTEN hamartomatous syndrome, and mutations in the BAP1 gene as well as several of the genes encoding the proteins comprising the succinate dehydrogenase complex (SDHB/C/D). Type 1 papillary kidney cancers arise in conjunction with germline mutations in MET and type 2 as part of hereditary leiomyomatosis and kidney cell cancer (fumarate hydratase [FH] mutations). Chromophone and oncocytic kidney cancers are predominantly associated with Birt-Hogg-Dubé syndrome. Patients with Tuberous Sclerosis Complex (TSC) commonly have angiomyolipomas and rarely their malignant counterpart epithelioid angiomyolipomas. The targeted therapeutic options for the kidney cancer associated with these diseases are just starting to expand and are an area of active clinical research.

  2. Left musculus sternalis.

    PubMed

    Arráez-Aybar, L A; Sobrado-Perez, J; Merida-Velasco, J R

    2003-07-01

    During routine dissection in the Morphological Sciences Department II of the Universidad Complutense de Madrid, the presence of a sternalis muscle was observed in the left hemithorax of a 70-year-old male cadaver. We report on its position, relationships, and innervation, as well as its clinical relevance, indicating some guidelines for its physical examination. We also present a brief overview of the existing literature regarding the nomenclature, historical reports, and incidence of this muscle.

  3. Ablation and Other Local Therapy for Kidney Cancer

    MedlinePlus

    ... Therapy for Kidney Cancer Targeted Therapies for Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer Chemotherapy for Kidney Cancer Pain ... Therapy for Kidney Cancer Targeted Therapies for Kidney Cancer Biologic Therapy (Immunotherapy) for Kidney Cancer Chemotherapy for Kidney Cancer Pain ...

  4. What Happens After Treatment for Kidney Cancer?

    MedlinePlus

    ... Cancer After Treatment What Happens After Treatment for Kidney Cancer? For some people with kidney cancer, treatment can ... Treatment for Kidney Cancer Stops Working More In Kidney Cancer About Kidney Cancer Causes, Risk Factors, and Prevention ...

  5. Rapamycin reduces kidney volume and delays the loss of renal function in a patient with autosomal-dominant polycystic kidney disease.

    PubMed

    Peces, Ramón; Peces, Carlos; Pérez-Dueñas, Virginia; Cuesta-López, Emilio; Azorín, Sebastián; Selgas, Rafael

    2009-04-01

    This is the first report of a case of a reduction in kidney volume and preservation of renal function in a patient with autosomal-dominant polycystic kidney disease (ADPKD) receiving rapamycin. A 42-year-old man with ADPKD and a severe persistent bleeding from his solitary left kidney was successfully treated with tranexamic acid (TXA). He also received low-dose rapamycin for 8 months, and this was associated with a 23.5% reduction in kidney volume, improvement and stabilization of renal function, and normalization of haemoglobin levels. When treatment with rapamycin was interrupted, renal function deteriorated within an 8-month period and haemodialysis (HD) became necessary. Kidney volume increased at once, and life-threatening bleeding prompted a nephrectomy 4 months after the onset of HD. These data suggest that the reduction in kidney volume and preservation of renal function with rapamycin could be the result of the antiangiogenic, antiproliferative effects of rapamycin.

  6. Close view looking to left side of statue showing left ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Close view looking to left side of statue showing left hand, shield, and laurel wreath - U.S. Capitol, Statue of Freedom, Intersection of North, South, & East Capitol Streets & Capitol Mall, Washington, District of Columbia, DC

  7. Preoperative CT-Angiography Predicts Ex Vivo Vein Length for Right Kidneys After Laparoscopic Donor Nephrectomy.

    PubMed

    Özdemir-van Brunschot, Denise M D; Rottier, Simone J; den Ouden, Judith E; van der Jagt, Michel F; d'Ancona, Frank C; Kloke, Heinrich; van der Vliet, Daan J A; Schultze Kool, Leo J; Warlé, Michiel C

    2015-09-10

    BACKGROUND Implantation of a kidney with a short renal vein is technically more challenging and therefore prone for technique-related complications. It remains unclear whether pre-operative computed tomography angiography (CTA), to assess vascular anatomy of the donor kidney, can be used to predict renal vein length. MATERIAL AND METHODS Right and left renal vein lengths of 100 consecutive kidney donors were measured in an oblique-coronal plane multiplanar reconstruction image of 100 consecutive kidney donors in whom ex vivo vein length was measured after recovery. In a second retrospective cohort of 100 consecutive kidney donors donating a right kidney, preoperative CTA vein length measurements were correlated to anastomosis time and early graft outcome. RESULTS Left and right renal vein lengths, measured on CTA, were 43.2 mm and 30.0 mm, respectively. No correlation was found between CTA and ex vivo measurements for the left renal vein (p=.610), whereas a significant correlation was found for the right renal vein (p=.021). In the retrospective cohort, right renal vein length was significantly correlated with the anastomosis time but not with early graft outcome. CONCLUSIONS The length of the right, but not the left, renal vein can be predicted by preoperative CTA, but this does not hold true for the left renal vein.

  8. Extensive Thrombosis of the Inferior Vena Cava and Left Renal Vein in a Neonate

    PubMed Central

    Kdous, Moez; Khlifi, Oussema; Brahem, Marwene; Khrouf, Mohamed; Amari, Sarah; Ferchiou, Monia; Zhioua, Fethi

    2015-01-01

    Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child. PMID:26124971

  9. Your Kidney Test Results

    MedlinePlus

    ... blood vessels healthy. Vitamin D is important for bones and heart health. 1 Your Kidney Test Results Other Important Tests, continued A1C (for patients with diabetes) Results Goal: Your Result: Total Cholesterol Normal: Less ...

  10. Kidney Replacement Therapy

    MedlinePlus

    ... week, and lasts 3 to 5 hours each time. Blood travels through the artificial kidney, where waste products are ... eat a more normal diet and have more time for work and travel. Peritoneal dialysis is not for everyone, however. A ...

  11. Medullary Sponge Kidney

    MedlinePlus

    ... thus increase the chance of calciumcontaining kidney stones forming. Foods rich in animal proteins such as meat, ... chance of uric acid stones and calcium stones forming. People who form stones should limit their meat ...

  12. [Sexuality after kidney transplantation].

    PubMed

    Steiner, T; Wunderlich, H; Ott, U

    2009-12-01

    The quality of life of patients after kidney transplantation is of increasing interest. In this connection, issues of sexuality are meaningful too. Many patients with end-stage kidney disease suffer from sexual disorders. More than 50% of the male patients on dialysis and even more females are affected by disturbances such as erectile dysfunction and loss of libido or abnormal menstrual cycles. After successful kidney transplantation most symptoms in women are improved, whereas in men disturbances in erectile function often persist or even deteriorate. In these patients treatment with inhibitors of phosphodiesterase type 5 is a valid option with an effective response. In women with stable graft function pregnancy can be achieved successfully. Nevertheless, pregnant kidney allograft recipients should be considered as high-risk patients needing special care under the supervision of a team of obstetricians and nephrologists.

  13. Sulfadiazine for kidney disease

    USGS Publications Warehouse

    Rucker, R.R.; Bernier, A.F.; Whipple, W.J.; Burrows, R.E.

    1951-01-01

    The blueback salmon fingerlings (Oncorhynchus nerka) at the U.S. Fish-Cultural Station at Winthrop, Washington, underwent an infection that was caused by a very short, Gram-positive, nonmotile, rod-shaped bacterium. A further description is impossible at this time, as the organism has not been grown satisfactorily for proper identification. The disease was characterized by white, raised areas of dead tissue mainly in the kidney: for this reason it is referred to as kidney disease. Belding and Merrill (1935) described a disease among the brook, brown, and rainbow trout at a State hatchery in Massachusetts which, from the description, might be the same as kidney disease. J.H. Wales of the California Division of Fish and Game described (unpublished manuscript, 1941) a disease in hatchery trout in California which seems to be identical to kidney disease.

  14. Kidneys and Urinary Tract

    MedlinePlus

    ... through pores (tiny holes) in the skin. Water vapor and carbon dioxide are exhaled (breathed out) from ... receive enough water, the kidneys also regulate blood pressure and the level of vital salts in the ...

  15. Medullary cystic kidney disease

    MedlinePlus

    ... to avoid dehydration. As the disease gets worse, kidney failure develops. Treatment may involve taking medicines and diet changes, limiting foods containing phosphorus and potassium. You may need dialysis and a ...

  16. Kidney transplant - slideshow

    MedlinePlus

    ... ency/presentations/100087.htm Kidney transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  17. [Hereditary kidney diseases in children].

    PubMed

    Zhang, Yan-qin; Ding, Jie; Wang, Fang; Zhang, Hong-wen

    2013-04-18

    About 10 to 15 percent of kidney diseases are inherited or related to genetic factors. While, hereditary kidney diseases have no specific clinical manifestations and react poorly to the therapy, as a result, about 30 percent of hospitalized children with chronic renal failure is due to hereditary kidney diseases in our country. Hereditary kidney diseases are related to many genes. Molecular genetic analysis plays an important role in the diagnosis and prenatal diagnosis of hereditary kidney diseases. Our group have made a series of research in hereditary kidney diseases for nearly 30 years. Here we review the research work and the main results in hereditary kidney diseases of our group.

  18. Left ventricular pseudoaneurysm perceived as a left lung mass

    PubMed Central

    Yaliniz, Hafize; Gocen, Ugur; Atalay, Atakan; Salih, Orhan Kemal

    2016-01-01

    Left ventricular pseudoaneurysm is a rare complication of aneurysmectomy. We present a case of a surgically treated left ventricular pseudoaneurysm, which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation, and surgical repair are described. PMID:27516793

  19. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P. W.

    1985-01-01

    Tasks were undertaken in support of two objectives. They are: (1) to carry out electrophoresis experiments on cells in microgravity; and (2) assess the feasibility of using purified kidney cells from embryonic kidney cultures as a source of important cell products. Investigations were carried out in the following areas: (1) ground based electrophoresis technology; (2) cell culture technology; (3) electrophoresis of cells; (4) urokinase assay research; (5) zero-g electrophoresis; and (6) flow cytometry.

  20. Osteoprotegerin and kidney disease.

    PubMed

    Montañez-Barragán, Alejandra; Gómez-Barrera, Isaias; Sanchez-Niño, Maria D; Ucero, Alvaro C; González-Espinoza, Liliana; Ortiz, Alberto

    2014-12-01

    Vascular calcification in chronic kidney disease (CKD) patients is associated to increased mortality. Osteoprotegerin (OPG) is a soluble tumor necrosis factor (TNF) superfamily receptor that inhibits the actions of the cytokines receptor activator of nuclear factor kappa-B ligand (RANKL) and TNF-related apoptosis-inducing ligand (TRAIL) by preventing their binding to signaling receptors in the cell membrane. OPG-deficient mice display vascular calcification while OPG prevented calcification of cultured vascular smooth muscle cells and protected kidney cells from TRAIL-induced death. OPG may be a biomarker in patients with kidney disease. Circulating OPG is increased in predialysis, dialysis and transplant CKD patients and may predict vascular calcification progression and patient survival. By contrast, circulating OPG is decreased in nephrotic syndrome. In addition, free and exosome-bound urinary OPG is increased in human kidney disease. Increased urinary OPG has been associated with lupus nephritis activity. Despite the association of high OPG levels with disease, experimental functional information available suggests that OPG might be protective in kidney disease and in vascular injury in the context of uremia. Thus, tissue injury results in increased OPG, while OPG may protect from tissue injury. Recombinant OPG was safe in phase I randomized controlled trials. Further research is needed to fully define the therapeutic and biomarker potential of OPG in patients with kidney disease.

  1. Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints

    SciTech Connect

    Dewit, L.; Anninga, J.K.; Hoefnagel, C.A.; Nooijen, W.J. )

    1990-10-01

    Renal function was prospectively analyzed in 26 evaluable patients, irradiated to various doses on their kidneys for neoplastic disease. Glomerular function was assessed by 99mTc-DTPA renography, creatinine clearance, and serum beta 2-microglobulin, whereas tubular function was monitored by 99mTc-DMSA scintigraphy, urine beta 2-microglobulin, urine N-acetyl glucosaminidase, and alanine aminopeptidase and a urine concentration test. In the patients given the highest irradiation dose to the entire left kidney, that is, 40 Gy in 5 1/2 weeks, glomerular and tubular functional impairment, as assessed scintigraphically, progressed at a rate of 2.0 +/- 1.0% (+/- 1 SD) and 2.0 +/- 0.5% per month, respectively, down to 30-40% after 3 to 5 years. The overall glomerular function, as assessed by creatinine clearance, decreased by only 20%. In the patients irradiated unilaterally on the upper pole to 40 Gy in 4 weeks, glomerular and tubular function in the left kidney deteriorated at 0.75 +/- 0.33% and 0.75 +/- 0.20% per month in the first 2 years, down to 75-80% at 5 years. This smaller reduction was due to shielding of a part of the left kidney. No changes were observed, thus far, after bilateral whole kidney irradiation to 17-18 Gy in 3 1/2 weeks. The concentration capacity of the kidney after total volume irradiation was not impaired. There was a trend for an increase in diastolic blood pressure in 3 out of 5 patients given the high dose irradiation to the entire left kidney and in 2 out of 7 patients irradiated on the upper pole of the left kidney. The progressive nature of the radiation nephropathy stresses the need for long term follow-up to determine more accurately the tolerance dose of the human kidney for irradiation.

  2. FGF23 induces left ventricular hypertrophy

    PubMed Central

    Faul, Christian; Amaral, Ansel P.; Oskouei, Behzad; Hu, Ming-Chang; Sloan, Alexis; Isakova, Tamara; Gutiérrez, Orlando M.; Aguillon-Prada, Robier; Lincoln, Joy; Hare, Joshua M.; Mundel, Peter; Morales, Azorides; Scialla, Julia; Fischer, Michael; Soliman, Elsayed Z.; Chen, Jing; Go, Alan S.; Rosas, Sylvia E.; Nessel, Lisa; Townsend, Raymond R.; Feldman, Harold I.; St. John Sutton, Martin; Ojo, Akinlolu; Gadegbeku, Crystal; Di Marco, Giovana Seno; Reuter, Stefan; Kentrup, Dominik; Tiemann, Klaus; Brand, Marcus; Hill, Joseph A.; Moe, Orson W.; Kuro-o, Makoto; Kusek, John W.; Keane, Martin G.; Wolf, Myles

    2011-01-01

    Chronic kidney disease (CKD) is a public health epidemic that increases risk of death due to cardiovascular disease. Left ventricular hypertrophy (LVH) is an important mechanism of cardiovascular disease in individuals with CKD. Elevated levels of FGF23 have been linked to greater risks of LVH and mortality in patients with CKD, but whether these risks represent causal effects of FGF23 is unknown. Here, we report that elevated FGF23 levels are independently associated with LVH in a large, racially diverse CKD cohort. FGF23 caused pathological hypertrophy of isolated rat cardiomyocytes via FGF receptor–dependent activation of the calcineurin-NFAT signaling pathway, but this effect was independent of klotho, the coreceptor for FGF23 in the kidney and parathyroid glands. Intramyocardial or intravenous injection of FGF23 in wild-type mice resulted in LVH, and klotho-deficient mice demonstrated elevated FGF23 levels and LVH. In an established animal model of CKD, treatment with an FGF–receptor blocker attenuated LVH, although no change in blood pressure was observed. These results unveil a klotho-independent, causal role for FGF23 in the pathogenesis of LVH and suggest that chronically elevated FGF23 levels contribute directly to high rates of LVH and mortality in individuals with CKD. PMID:21985788

  3. Increased angiotensinogen expression, urinary angiotensinogen excretion, and tissue injury in nonclipped kidneys of two-kidney, one-clip hypertensive rats.

    PubMed

    Shao, Weijian; Miyata, Kayoko; Katsurada, Akemi; Satou, Ryousuke; Seth, Dale M; Rosales, Carla B; Prieto, Minolfa C; Mitchell, Kenneth D; Navar, L Gabriel

    2016-08-01

    In angiotensin II (ANG II)-dependent hypertension, there is an angiotensin type 1 receptor-dependent amplification mechanism enhancing intrarenal angiotensinogen (AGT) formation and secretion in the tubular fluid. To evaluate the role of increased arterial pressure, AGT mRNA, protein expression, and urinary AGT (uAGT) excretion and tissue injury were assessed in both kidneys of two-kidney, one-clip Sprague-Dawley hypertensive rats subjected to left renal arterial clipping (0.25-mm gap). By 18-21 days, systolic arterial pressure increased to 180 ± 3 mmHg, and uAGT increased. Water intake, body weights, 24-h urine volumes, and sodium excretion were similar. In separate measurements of renal function in anesthetized rats, renal plasma flow and glomerular filtration rate were similar in clipped and nonclipped kidneys and not different from those in sham rats, indicating that the perfusion pressure to the clipped kidneys remained within the autoregulatory range. The nonclipped kidneys exhibited increased urine flow and sodium excretion. The uAGT excretion was significantly greater in nonclipped kidneys compared with clipped and sham kidneys. AGT mRNA was 2.15-fold greater in the nonclipped kidneys compared with sham (1.0 ± 0.1) or clipped (0.98 ± 0.15) kidneys. AGT protein levels were also greater in the nonclipped kidneys. The nonclipped kidneys exhibited greater glomerular expansion and immune cell infiltration, medullary fibrosis, and cellular proliferation than the clipped kidneys. Because both kidneys have elevated ANG II levels, the greater tissue injury in the nonclipped kidneys indicates that an increased arterial pressure synergizes with increased intrarenal ANG II to stimulate AGT production and exert greater renal injury.

  4. Automatic segmentation of kidneys from non-contrast CT images using efficient belief propagation

    NASA Astrophysics Data System (ADS)

    Liu, Jianfei; Linguraru, Marius George; Wang, Shijun; Summers, Ronald M.

    2013-03-01

    CT colonography (CTC) can increase the chance of detecting high-risk lesions not only within the colon but anywhere in the abdomen with a low cost. Extracolonic findings such as calculi and masses are frequently found in the kidneys on CTC. Accurate kidney segmentation is an important step to detect extracolonic findings in the kidneys. However, noncontrast CTC images make the task of kidney segmentation substantially challenging because the intensity values of kidney parenchyma are similar to those of adjacent structures. In this paper, we present a fully automatic kidney segmentation algorithm to support extracolonic diagnosis from CTC data. It is built upon three major contributions: 1) localize kidney search regions by exploiting the segmented liver and spleen as well as body symmetry; 2) construct a probabilistic shape prior handling the issue of kidney touching other organs; 3) employ efficient belief propagation on the shape prior to extract the kidneys. We evaluated the accuracy of our algorithm on five non-contrast CTC datasets with manual kidney segmentation as the ground-truth. The Dice volume overlaps were 88%/89%, the root-mean-squared errors were 3.4 mm/2.8 mm, and the average surface distances were 2.1 mm/1.9 mm for the left/right kidney respectively. We also validated the robustness on 27 additional CTC cases, and 23 datasets were successfully segmented. In four problematic cases, the segmentation of the left kidney failed due to problems with the spleen segmentation. The results demonstrated that the proposed algorithm could automatically and accurately segment kidneys from CTC images, given the prior correct segmentation of the liver and spleen.

  5. Kidney biomarkers in cirrhosis.

    PubMed

    Francoz, Claire; Nadim, Mitra K; Durand, François

    2016-10-01

    Impaired renal function due to acute kidney injury (AKI) and/or chronic kidney diseases (CKD) is frequent in cirrhosis. Recurrent episodes of AKI may occur in end-stage cirrhosis. Differential diagnosis between functional (prerenal and hepatorenal syndrome) and acute tubular necrosis (ATN) is crucial. The concept that AKI and CKD represent a continuum rather than distinct entities, is now emerging. Not all patients with AKI have a potential for full recovery. Precise evaluation of kidney function and identification of kidney changes in patients with cirrhosis is central in predicting reversibility. This review examines current biomarkers for assessing renal function and identifying the cause and mechanisms of impaired renal function. When CKD is suspected, clearance of exogenous markers is the reference to assess glomerular filtration rate, as creatinine is inaccurate and cystatin C needs further evaluation. Recent biomarkers may help differentiate ATN from hepatorenal syndrome. Neutrophil gelatinase-associated lipocalin has been the most extensively studied biomarker yet, however, there are no clear-cut values that differentiate each of these conditions. Studies comparing ATN and hepatorenal syndrome in cirrhosis, do not include a gold standard. Combinations of innovative biomarkers are attractive to identify patients justifying simultaneous liver and kidney transplantation. Accurate biomarkers of underlying CKD are lacking and kidney biopsy is often contraindicated in this population. Urinary microRNAs are attractive although not definitely validated. Efforts should be made to develop biomarkers of kidney fibrosis, a common and irreversible feature of CKD, whatever the cause. Biomarkers of maladaptative repair leading to irreversible changes and CKD after AKI are also promising.

  6. Left ventricular apical diseases.

    PubMed

    Cisneros, Silvia; Duarte, Ricardo; Fernandez-Perez, Gabriel C; Castellon, Daniel; Calatayud, Julia; Lecumberri, Iñigo; Larrazabal, Eneritz; Ruiz, Berta Irene

    2011-08-01

    There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

  7. Peroxisomes and Kidney Injury

    PubMed Central

    2016-01-01

    Abstract Significance: Peroxisomes are organelles present in most eukaryotic cells. The organs with the highest density of peroxisomes are the liver and kidneys. Peroxisomes possess more than fifty enzymes and fulfill a multitude of biological tasks. They actively participate in apoptosis, innate immunity, and inflammation. In recent years, a considerable amount of evidence has been collected to support the involvement of peroxisomes in the pathogenesis of kidney injury. Recent Advances: The nature of the two most important peroxisomal tasks, beta-oxidation of fatty acids and hydrogen peroxide turnover, functionally relates peroxisomes to mitochondria. Further support for their communication and cooperation is furnished by the evidence that both organelles share the components of their division machinery. Until recently, the majority of studies on the molecular mechanisms of kidney injury focused primarily on mitochondria and neglected peroxisomes. Critical Issues: The aim of this concise review is to introduce the reader to the field of peroxisome biology and to provide an overview of the evidence about the contribution of peroxisomes to the development and progression of kidney injury. The topics of renal ischemia–reperfusion injury, endotoxin-induced kidney injury, diabetic nephropathy, and tubulointerstitial fibrosis, as well as the potential therapeutic implications of peroxisome activation, are addressed in this review. Future Directions: Despite recent progress, further studies are needed to elucidate the molecular mechanisms induced by dysfunctional peroxisomes and the role of the dysregulated mitochondria–peroxisome axis in the pathogenesis of renal injury. Antioxid. Redox Signal. 25, 217–231. PMID:26972522

  8. Necroinflammation in Kidney Disease.

    PubMed

    Mulay, Shrikant R; Linkermann, Andreas; Anders, Hans-Joachim

    2016-01-01

    The bidirectional causality between kidney injury and inflammation remains an area of unexpected discoveries. The last decade unraveled the molecular mechanisms of sterile inflammation, which established danger signaling via pattern recognition receptors as a new concept of kidney injury-related inflammation. In contrast, renal cell necrosis remained considered a passive process executed either by the complement-related membrane attack complex, exotoxins, or cytotoxic T cells. Accumulating data now suggest that renal cell necrosis is a genetically determined and regulated process involving specific outside-in signaling pathways. These findings support a unifying theory in which kidney injury and inflammation are reciprocally enhanced in an autoamplification loop, referred to here as necroinflammation. This integrated concept is of potential clinical importance because it offers numerous innovative molecular targets for limiting kidney injury by blocking cell death, inflammation, or both. Here, the contribution of necroinflammation to AKI is discussed in thrombotic microangiopathies, necrotizing and crescentic GN, acute tubular necrosis, and infective pyelonephritis or sepsis. Potential new avenues are further discussed for abrogating necroinflammation-related kidney injury, and questions and strategies are listed for further exploration in this evolving field.

  9. Kidney and innate immunity.

    PubMed

    Wang, Ying-Hui; Zhang, Yu-Gen

    2017-03-01

    Innate immune system is an important modulator of the inflammatory response during infection and tissue injury/repair. The kidney as a vital organ with high energy demand plays a key role in regulating the disease related metabolic process. Increasing research interest has focused on the immune pathogenesis of many kidney diseases. However, innate immune cells such as dendritic cells, macrophages, NK cells and a few innate lymphocytes, as well as the complement system are essential for renal immune homeostasis and ensure a coordinated balance between tissue injury and regeneration. The innate immune response provides the first line of host defense initiated by several classes of pattern recognition receptors (PRRs), such as membrane-bound Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs), together with inflammasomes responsible for early innate immune response. Although the innate immune system is well studied, the research on the detailed relationship between innate immunity and kidney is still very limited. In this review, we will focus on the innate immune sensing system in renal immune homeostasis, as well as the corresponding pathogenesis of many kidney diseases. The pivotal roles of innate immunity in renal injury and regeneration with special emphasis on kidney disease related immunoregulatory mechanism are also discussed.

  10. Orphan kidney diseases.

    PubMed

    Soliman, Neveen A

    2012-01-01

    Rare kidney diseases are a unique subset of renal disorders that are often termed 'orphan' as a result of a multitude of reasons: the small number of patients with the consequent lack of well-defined natural history and course of many of these diseases, limited awareness among the medical community, and finally the significant cost of developing novel therapeutics which makes many of these diseases unattractive targets for the pharmaceutical industry. Nevertheless, in the last decade the study and clinical management of rare kidney disease patients has been the focus of many investigative efforts. In recent years we have witnessed an enormous expansion in our knowledge of the genetic nature of a number of rare kidney diseases. Moreover, the investigation of the role of genetic disruption aiming at elucidating the pathogenesis of different and complex renal diseases has helped not only in understanding the disease states, but has also given us fundamental insights into a number of kidney developmental and physiological functions. This article will give an overview of orphan renal diseases with particular emphasis on monogenic kidney diseases. It will also focus on the classification of these diseases while highlighting a prominent example in each category.

  11. Ear length and kidney function decline after kidney donation.

    PubMed

    Katavetin, Pisut; Watanatorn, Salin; Townamchai, Natavudh; Avihingsanon, Yingyos; Praditpornsilpa, Kearkiat

    2016-11-01

    The preservation of kidney function after kidney donation depends on the kidney reserve - the potential of the remaining kidney to boost their function after loss of the other kidney. In Traditional Chinese Medicine, size and shape of the external ears are examined to evaluate the person's kidney health. We hypothesized that ear size might be a practical yet overlooked marker of kidney reserve. Fifty kidney transplantation donors were participated in this study. The length and width of both ears of all participants were measured during one of the post-donation visits. Pre-donation serum creatinine and post-donation serum creatinine as well as other relevant parameters (age, sex, weight, height, etc.) of the participants were extracted from medical records. The estimated GFR was calculated from serum creatinine, age and sex using the CKD-EPI equation. Ear length negatively associated with %GFR decline after kidney donation. For every 1 cm increase in ear length, it was associated with 5.7% less GFR decline after kidney donation (95% Confidence Interval 0.2 to 11.3, P = 0.04). Ear width, as well as age, sex, body weight, height, body mass index, and pre-donation eGFR did not significantly associate with the GFR decline. Our findings support the notion of Traditional Chinese Medicine that ear morphology may be associated with kidney health and suggest that ear length might be a useful predictor of kidney function decline after kidney donation.

  12. [Pregnancy and kidney diseases].

    PubMed

    Siekierka-Harreis, M; Rump, L C

    2011-10-01

    The prevalence of chronic kidney disease in women of childbearing age reaches approximately 0.2%. Under physiological conditions pregnancy results in important hemodynamic changes on the maternal organism. In the case of chronic kidney disease these adaptations often are only partial. Physiological changes of immune response during pregnancy may contribute to the progress of renal disease. Regardless of the underlying kidney disease, one can assume that the better the glomerular filtration rate and blood pressure are the more favorable the course of pregnancy will be with the chance for a healthy child and stable renal function. To achieve this goal, a close interaction is required between gynecologist, nephrologist, and other specialists in a center with appropriate experience.

  13. Obesity and kidney transplantation.

    PubMed

    Jindal, Rahul M; Zawada, Edward T

    2004-06-01

    There is a worldwide epidemic of obesity, and an increasing number of patients who are obese are presenting for solid-organ transplantation. Obesity increases the risk for delayed graft function and local wound complications after technically successful kidney transplantation. Obese patients are more likely to have comorbid factors leading to premature death with a functioning kidney transplant. We suggest the use of World Health Organization criteria when reporting the impact of obesity on recipients of solid-organ transplants. Prospective multicenter studies are indicated to evaluate long-term outcomes in obese patients who successfully receive a kidney transplant. Rigorous efforts should be made to optimize weight before and after solid-organ transplantation by a judicious combination of diet, exercise, minimization of steroid therapy, surgery, and psychological therapies.

  14. Brain–kidney crosstalk

    PubMed Central

    2014-01-01

    Encephalopathy and altered higher mental functions are common clinical complications of acute kidney injury. Although sepsis is a major triggering factor, acute kidney injury predisposes to confusion by causing generalised inflammation, leading to increased permeability of the blood–brain barrier, exacerbated by hyperosmolarity and metabolic acidosis due to the retention of products of nitrogen metabolism potentially resulting in increased brain water content. Downregulation of cell membrane transporters predisposes to alterations in neurotransmitter secretion and uptake, coupled with drug accumulation increasing the risk of encephalopathy. On the other hand, acute brain injury can induce a variety of changes in renal function ranging from altered function and electrolyte imbalances to inflammatory changes in brain death kidney donors. PMID:25043644

  15. Nutrition in kidney transplantation.

    PubMed

    Veroux, Massimiliano; Corona, Daniela; Sinagra, Nunziata; Tallarita, Tiziano; Ekser, Burcin; Giaquinta, Alessia; Zerbo, Domenico; Veroux, Pierfrancesco

    2013-10-01

    Organ transplantation has progressively established itself as the preferred therapy for many end-stage organ failures. However, many of these chronic diseases and their treatments can negatively affect nutritional status, leading to malnutrition and mineral deficiencies.Nutritional status is an important determinant of the clinical outcome of kidney transplant recipients.Malnutrition and obesity may represent a contraindication to transplantation in many cases and may increase the risk of postoperative complications after the transplantation. Nutritional support in kidney transplant recipients is challenging, since it must take into account the pre-transplant nutritional status, the side effects of immunosuppression, the function of the transplanted graft, the presence of infection, and the general status of the patient at the time of the transplantation.With these considerations in mind, we reviewed current literature on the impact of nutritional status on the outcome of kidney transplantation.

  16. [Left-handedness and health].

    PubMed

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  17. Chronic Kidney Disease.

    PubMed

    Webster, Angela C; Nagler, Evi V; Morton, Rachael L; Masson, Philip

    2017-03-25

    The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m(2), or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries. Incidence, prevalence, and progression of CKD also vary within countries by ethnicity and social determinants of health, possibly through epigenetic influence. Many people are asymptomatic or have non-specific symptoms such as lethargy, itch, or loss of appetite. Diagnosis is commonly made after chance findings from screening tests (urinary dipstick or blood tests), or when symptoms become severe. The best available indicator of overall kidney function is GFR, which is measured either via exogenous markers (eg, DTPA, iohexol), or estimated using equations. Presence of proteinuria is associated with increased risk of progression of CKD and death. Kidney biopsy samples can show definitive evidence of CKD, through common changes such as glomerular sclerosis, tubular atrophy, and interstitial fibrosis. Complications include anaemia due to reduced production of erythropoietin by the kidney; reduced red blood cell survival and iron deficiency; and mineral bone disease caused by disturbed vitamin D, calcium, and phosphate metabolism. People with CKD are five to ten times more likely to die prematurely than they are to progress to end stage kidney disease. This increased risk of death rises exponentially as kidney function worsens and is largely attributable to death from cardiovascular disease, although cancer incidence and mortality are also increased. Health-related quality of life is substantially lower for people with CKD than for the general population, and falls as GFR

  18. Ultrastructural cytochemistry of the ischemic (endocrine) kidney.

    PubMed Central

    Araujo-Nascimento, M. d.; Désormeaux, Y.; Cantin, M.

    1976-01-01

    Partial ligation of the aorta between the renal arteries induces marked atrophy of the cortical tubules (including the macula densa) of the left (endocrine) kidney with a remarkable increase in the number and granularity of hypersecretory juxtaglomerular granulated cells (JGC) which are found not only at the glomerular pole of arterioles but also in the walls of arteries and arterioles far removed from the glomerulus. Staining of fine sections of Araldite-embedded endocrine kidneys according to the periodic acid-thiocarbohydrazide-silver proteinate technique of Thiery reveals abundant glycogen in the JGC and less in the blood vessels and tubules. Juxtaglomerular granules are argentaphobic, but their rim is positively stained when ultrathin sections of glutaraldehyde-fixed, glycol methacrylate-embedded kidneys are exposed to phosphotungstic acid at a low pH. A positive reaction is also shown by the cell coat and lysosomes of JGC as well as by the thickened basal lamina, cell coat, cytosomes, and cytosegresomes of the atrophic tubules. Atrophy is most pronounced in the proximal convoluted tubules, which lose their apical microvilli, their basal infoldings and the majority of their mitochondria and cytosomes. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:1258975

  19. Glibenclamide improves kidney and heart structure and function in the adenine-diet model of chronic kidney disease.

    PubMed

    Diwan, Vishal; Gobe, Glenda; Brown, Lindsay

    2014-01-01

    The development of chronic kidney disease (CKD) and associated cardiovascular disease involves free radical damage and inflammation. Addition of adenine to the diet induces inflammation followed by CKD and cardiovascular disease. NOD-like receptor protein-3 (NLRP-3) is pro-inflammatory in the kidney; glibenclamide inhibits production of NLRP-3. Male Wistar rats were fed either control rat food or adenine (0.25%) in this food for 16 weeks. Glibenclamide (10 mg/kg/day) was administered to two groups with and without adenine for the final 8 weeks. Kidney function (blood urea nitrogen/BUN, plasma creatinine/PCr, plasma uric acid, proteinuria), kidney structure (fibrosis, inflammation), cardiovascular parameters (blood pressure, left ventricular stiffness, vascular responses and echocardiography) and protein expression of markers for oxidative stress (HO-1), and inflammation (TNF-α, NLRP-3) were assessed. In adenine-fed rats, glibenclamide decreased BUN (controls: 6±0.6; adenine: 56.6±5.4; adenine+glibenclamide: 19.4±2.7 mmol/L), PCr (controls: 42±2.8; adenine: 268±23; adenine+glibenclamide: 81±10 μmol/L), proteinuria (controls: 150±7.4; adenine: 303±19; adenine+glibenclamide: 220±13 μmol/L) (all p<0.05). Glibenclamide decreased infiltration of chronic inflammatory cells, fibrosis, tubular damage and expression of HO-1, TNF-α and NLRP-3 in the kidney. Glibenclamide did not alter plasma uric acid concentrations (controls: 38±1; adenine: 63±4; adenine+glibenclamide: 69±14 μmol/L). Cardiovascular changes included decreased systolic blood pressure and improved vascular responses although cardiac fibrosis, left ventricular stiffness and hypertrophy were not reduced. Glibenclamide improved kidney structure and function in CKD and decreased some cardiovascular parameters. Inflammatory markers and cell populations were attenuated by glibenclamide in kidneys.

  20. Variation in the position, relation and vasculature of left suprarenal gland: a case report.

    PubMed

    Oztürk, N C; Uzmansel, D; Kara, A; Oztürk, H

    2010-12-01

    A malposition of the left suprarenal gland with varied relations and vasculature was observed in a 50-year-old male cadaver during the routine dissection of the abdominal region. The gland was partly situated over the hilum of the left kidney. Its posterior surface was related to the left crus of the diaphragm and to the hilum of the left kidney extending some distance above on the medial margin of the kidney. Its anterior surface was totally covered by the body of the pancreas and the splenic artery and vein. There were only two suprarenal arteries. A left lateral branch of the aorta divided into three branches of which the middle and inferior branches entered the gland as seperate suprarenal arteries. There were the two suprarenal veins of the gland which were draining into the left renal vein. Such a malposition with varied relations and vasculature is of utmost importance from the surgical point of view because it can affect the orientation of the surgeon in laparoscopic adrenalectomy.

  1. Aging changes in the kidneys

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/004010.htm Aging changes in the kidneys and bladder To use ... in the reproductive system can affect bladder control. AGING CHANGES AND THEIR EFFECTS ON THE KIDNEYS AND ...

  2. Anemia in Chronic Kidney Disease

    MedlinePlus

    ... Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition ... they should. How is anemia related to chronic kidney disease? Anemia commonly occurs in people with chronic ...

  3. FastStats: Kidney Disease

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Kidney Disease Recommend on Facebook Tweet Share Compartir Data are ... the U.S. Morbidity Number of adults with diagnosed kidney disease: 4.9 million Percent of adults with diagnosed ...

  4. At Risk for Kidney Disease?

    MedlinePlus

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. March 5, 2014​ Contact Us Health Information Center Phone: 1-800-860- ...

  5. Morphological Characteristics of Renal Artery and Kidney in Rats

    PubMed Central

    Yoldas, Atilla; Dayan, Mustafa Orhun

    2014-01-01

    The gross anatomy and morphometry of the kidney and renal arteries were studied in the strains of laboratory rat: Sprague-Dawley (Sp) and Wistar (W) rats. Total of 106 three-dimensional endocasts of the intrarenal arteries of kidney that were prepared using standard injection-corrosion techniques were examined. A single renal artery was observed in 100% of the cases. The renal arteries were divided into a dorsal and a ventral branch. The dorsal and ventral branches were divided into two branches, the cranial and caudal branch. Renal arteries were classified into types I and II, depending on the cranial and caudal branches and their made of branching. The present study also showed that the right kidney was slightly heavier than the left one and that the kidney of the male was generally larger than that of the female. The mean live weights of the Sprague-Dawley and Wistar rats were found to be 258.26 ± 5.9 and 182.4 ± 19.05 g, respectively. The kidney weights were significantly correlated (P < 0.01) with body weights. The kidney weights were not found significantly correlated (P > 0.01) with the length of renal arteries. PMID:24737971

  6. When Your Child Needs a Kidney Transplant

    MedlinePlus

    ... 2-Year-Old When Your Child Needs a Kidney Transplant KidsHealth > For Parents > When Your Child Needs ... to monitor their new kidney function. About the Kidneys Kidneys are bean-shaped organs located near the ...

  7. Neonatal Acute Kidney Injury.

    PubMed

    Selewski, David T; Charlton, Jennifer R; Jetton, Jennifer G; Guillet, Ronnie; Mhanna, Maroun J; Askenazi, David J; Kent, Alison L

    2015-08-01

    In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates <1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations.

  8. Chronic Kidney Disease

    MedlinePlus

    ... factors. It is important to diagnose CKD early. Diagnosis & TestsHow can my doctor tell if I have CKD?There are three simple tests that your doctor might do if he or she suspects you might have chronic kidney disease:Blood pressure testUrine albumin (a test to see ...

  9. Leiomyosarcoma of the kidney.

    PubMed

    Aiken, W; Gibson, T; Williams, S; Gaskin, D

    2009-03-01

    The case of a 42-year-old woman with leiomyosarcoma of the kidney, a very rare renal lesion, is presented. Leiomyosarcomas are the most common of the primary renal sarcomas which account for less than 1% of renal tumours in adults.

  10. Monitoring Your Kidney Health

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ​​September 17, 2014​​ ​​ Contact Us Health Information Center Phone: 1-800-860- ...

  11. Medicines and Kidney Disease

    MedlinePlus

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ​​September 17, 2014 ​​ Contact Us Health Information Center Phone: 1-800-860- ...

  12. Kidney (Renal) Failure

    MedlinePlus

    ... the ureter (s) or a tube connected to an external drainage bag. Both options are used to unblock the ureters in order to allow proper urine flow from the kidneys if this has been identified as the cause for the renal failure. Surgical treatment such as a urinary stent or ...

  13. 1. Postandbeam garage (far left), oneroom log cabin (left of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Post-and-beam garage (far left), one-room log cabin (left of center), house (right of center), garden shed and outhouse (far right). View to west-southwest. - William & Lucina Bowe Ranch, County Road 44, 0.1 mile northeast of Big Hole River Bridge, Melrose, Silver Bow County, MT

  14. 6. Livestock barn (far left), log drafthorse barn (left of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Livestock barn (far left), log draft-horse barn (left of center), loafing shed (center), log calving barn (right of center). View to west-northwest. - William & Lucina Bowe Ranch, County Road 44, 0.1 mile northeast of Big Hole River Bridge, Melrose, Silver Bow County, MT

  15. 3. Log bunkhouse (far left), log chicken house (left of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Log bunkhouse (far left), log chicken house (left of center), equipment shed (center), and workshop (far right). View to northwest. - William & Lucina Bowe Ranch, County Road 44, 0.1 mile northeast of Big Hole River Bridge, Melrose, Silver Bow County, MT

  16. Hypertension in Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Chapman, Arlene B.; Stepniakowski, Konrad; Rahbari-Oskoui, Frederic

    2010-01-01

    Hypertension is common and occurs in a majority of autosomal dominant polycystic kidney disease (ADPKD) patients prior to loss of kidney function. Hypertension relates to progressive kidney enlargement, and is a significant independent risk factor for progression to end stage renal disease. The pathogenesis of hypertension in ADPKD is complex and dependent on many factors that influence each other. Pkd1 and Pkd2 expression levels are highest in the major vessels and are present in the cilia of endothelial cells and in vascular smooth muscle cells. Decreased or absent polycystin 1 or 2 expression is associated with abnormal vascular structure and function. Pkd1/Pkd2 deficiency results in reduced nitric oxide (NO) levels, altered endothelial response to shear stress with attenuation in vascular relaxation. 10–20% of ADPKD children demonstrate hypertension and the majority of adults are hypertensive before any loss of kidney function. Cardiac abnormalities such as left ventricular hypertrophy and carotid intimal wall thickening are present prior to the development of hypertension in ADPKD. Activation of the renin-angiotensin-aldosterone system occurs in ADPKD due to decreased NO production as well as bilateral cyst expansion and intra-renal ischemia. With increasing cyst size, further activation of the RAAS occurs, blood pressure increases and a vicious cycle ensues with enhanced cyst growth and hypertension ultimately leading to ESRD. Inhibition of the angiotensin aldosterone system is possible with angiotensin converting enzyme inhibitors and angiotensin receptor blockers. However, interventional studies have not yet demonstrated benefit in slowing progression to renal failure in ADPKD. Currently, large multicenter studies are being performed to determine the beneficial effects of RAAS inhibition both early and late in ADPKD. PMID:20219618

  17. Unique molecular changes in kidney allografts after simultaneous liver-kidney compared with solitary kidney transplantation.

    PubMed

    Taner, Timucin; Park, Walter D; Stegall, Mark D

    2017-02-20

    Kidney allografts transplanted simultaneously with liver allografts from the same donor are known to be immunologically privileged. This is especially evident in recipients with high levels of donor-specific anti-HLA antibodies. Here we investigated the mechanisms of liver's protective impact using gene expression in the kidney allograft. Select solitary kidney transplant or simultaneous liver-kidney transplant recipients were retrospectively reviewed and separated into four groups: 16 cross-match negative kidney transplants, 15 cross-match positive kidney transplants, 12 cross-match negative simultaneous liver-kidney transplants, and nine cross-match-positive simultaneous liver-kidney transplants. Surveillance biopsies of cross-match-positive kidney transplants had increased expression of genes associated with donor-specific antigens, inflammation, and endothelial cell activation compared to cross-match-negative kidney transplants. These changes were not found in cross-match-positive simultaneous liver-kidney transplant biopsies when compared to cross-match-negative simultaneous liver-kidney transplants. In addition, simultaneously transplanting a liver markedly increased renal expression of genes associated with tissue integrity/metabolism, regardless of the cross-match status. While the expression of inflammatory gene sets in cross-match-positive simultaneous liver-kidney transplants was not completely reduced to the level of cross-match-negative kidney transplants, the downstream effects of donor-specific anti-HLA antibodies were blocked. Thus, simultaneous liver-kidney transplants can have a profound impact on the kidney allograft, not only by decreasing inflammation and avoiding endothelial cell activation in cross-match-positive recipients, but also by increasing processes associated with tissue integrity/metabolism by unknown mechanisms.

  18. Giant kidney worms in a patient with renal cell carcinoma.

    PubMed

    Kuehn, Jemima; Lombardo, Lindsay; Janda, William M; Hollowell, Courtney M P

    2016-03-07

    Dioctophyma renale (D. renale), or giant kidney worms, are the largest nematodes that infect mammals. Approximately 20 cases of human infection have been reported. We present a case of a 71-year-old man with a recent history of unintentional weight loss and painless haematuria, passing elongated erythematous tissue via his urethra. CT revealed a left renal mass with pulmonary nodules and hepatic lesions. On microscopy, the erythematous tissue passed was identified as D. renale. On subsequent renal biopsy, pathology was consistent with renal cell carcinoma. This is the first reported case of concomitant D. renale infection and renal cell carcinoma, and the second reported case of D. renale infection of the left kidney alone.

  19. Inflammatory pseudotumor of the kidney: a case report

    PubMed Central

    2011-01-01

    Introduction Inflammatory pseudotumors, also known as inflammatory myofibroblastic tumors, are uncommon benign tumors of unknown etiology which may develop at several anatomical sites. In the urogenital tract, inflammatory pseudotumor usually affects the urinary bladder or the prostate. Inflammatory pseudotumor of the kidney is very rare. It is considered as a reactive inflammatory lesion that features very good prognosis. Case presentation We present the case of a 57-year-old Moroccan man who presented with a two-month history of gross hematuria and left lumbar pain. Imaging investigations revealed a left kidney mass and pathological examination of the nephrectomy specimen showed an inflammatory pseudotumor. Conclusion As the preoperative definitive diagnosis of such a tumor is not possible, surgery is advised because only pathological examination of the nephrectomy specimen can establish the diagnosis with certainty. From one case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of this rare tumor. PMID:21864369

  20. Isolation and structural characterization of unusual pyranoanthocyanins and related anthocyanins from Staghorn sumac (Rhus typhina L.) via UPLC-ESI-MS, (1)H, (13)C, and 2D NMR spectroscopy.

    PubMed

    Kirby, Christopher W; Wu, Tao; Tsao, Rong; McCallum, Jason L

    2013-10-01

    The six major anthocyanins found in the burgundy coloured fruits of Staghorn sumac (Rhus typhina L.) were isolated and the structures of four compounds were determined by NMR spectroscopic methods as being: 7-O-methyl-delphinidin-3-O-(2″galloyl)-β-d-galactopyranoside; 7-O-methyl-cyanidin-3-O-(2″galloyl)-β-d-galactopyranoside; 7-O-methyl-delphinidin-3-O-(2″'galloyl)-β-d-galactopyranoside-4-vinyl-catechol-3″-O-β-d-glucopyranoside; and 7-O-methyl-cyanidin-3-O-(2″'galloyl)-β-d-galactopyranoside-4-vinyl-catechol-3″-O-β-d-glucopyranoside, respectively. Additionally, two related anthocyanin compounds, cyanidin-3-O-(2″galloyl)-β-d-galactopyranoside and 7-O-methyl-cyanidin-3-O-β-d-galactopyranoside were also recovered, with NMR spectroscopic values closely matching previous reports from other plant species. The prevalence of 7-O-methyl anthocyanins and their galloylated derivatives in sumac is highly unusual, and warrants special attention. Additionally, the in planta occurrence of two 7-O-methyl-pyranoanothocyanin-vinyl-catechol aglycones, Sumadin A and Sumadin B, and their derivatives is noted. To our knowledge, E-ring glycosylated vinyl-catechol pyranoanthocyanins were previously unknown.

  1. [Kidney donor with severe disseminated intravascular coagulation: transplantation however successful].

    PubMed

    Keeris, Lodewijk M; Bergmans, Dennis C J J; van der Sande, Frank M; Wind, Tineke J; van Suylen, Robert Jan; van Mook, Walther N K A

    2009-01-01

    A 41-year-old male, with no previous medical history, was admitted to our intensive care unit with severe isolated neurotrauma and a Glasgow Coma Scale of E1-M1-V1, mid-dilated unreactive pupils and severe abnormalities on the brain CT-scan. A severe syndrome of disseminated intravascular coagulation (DIC) and non-oliguric renal insufficiency developed. Following clinical and neurophysiological examination the patient was declared brain-dead, and the family gave permission for organ donation. The left kidney was transplanted and functioned well immediately. However, in view of the DIC and renal function disorders the right kidney was not considered usable for transplantation elsewhere. Pathological examination revealed many fibrin thrombi in the glomerular capillaries and acute tubular necrosis. This case supports the view that thrombotic microangiopathy in kidneys of patients with DIS, even with renal function impairment, is not an a priori reason for excluding donation.

  2. Kidney diseases and tissue engineering.

    PubMed

    Moon, Kyung Hyun; Ko, In Kap; Yoo, James J; Atala, Anthony

    2016-04-15

    Kidney disease is a worldwide public health problem. Renal failure follows several disease stages including acute and chronic kidney symptoms. Acute kidney injury (AKI) may lead to chronic kidney disease (CKD), which can progress to end-stage renal disease (ESRD) with a mortality rate. Current treatment options are limited to dialysis and kidney transplantation; however, problems such as donor organ shortage, graft failure and numerous complications remain a concern. To address this issue, cell-based approaches using tissue engineering (TE) and regenerative medicine (RM) may provide attractive approaches to replace the damaged kidney cells with functional renal specific cells, leading to restoration of normal kidney functions. While development of renal tissue engineering is in a steady state due to the complex composition and highly regulated functionality of the kidney, cell therapy using stem cells and primary kidney cells has demonstrated promising therapeutic outcomes in terms of restoration of renal functions in AKI and CKD. In this review, basic components needed for successful renal kidney engineering are discussed, and recent TE and RM approaches to treatment of specific kidney diseases will be presented.

  3. Left ventricular wall stress compendium.

    PubMed

    Zhong, L; Ghista, D N; Tan, R S

    2012-01-01

    Left ventricular (LV) wall stress has intrigued scientists and cardiologists since the time of Lame and Laplace in 1800s. The left ventricle is an intriguing organ structure, whose intrinsic design enables it to fill and contract. The development of wall stress is intriguing to cardiologists and biomedical engineers. The role of left ventricle wall stress in cardiac perfusion and pumping as well as in cardiac pathophysiology is a relatively unexplored phenomenon. But even for us to assess this role, we first need accurate determination of in vivo wall stress. However, at this point, 150 years after Lame estimated left ventricle wall stress using the elasticity theory, we are still in the exploratory stage of (i) developing left ventricle models that properly represent left ventricle anatomy and physiology and (ii) obtaining data on left ventricle dynamics. In this paper, we are responding to the need for a comprehensive survey of left ventricle wall stress models, their mechanics, stress computation and results. We have provided herein a compendium of major type of wall stress models: thin-wall models based on the Laplace law, thick-wall shell models, elasticity theory model, thick-wall large deformation models and finite element models. We have compared the mean stress values of these models as well as the variation of stress across the wall. All of the thin-wall and thick-wall shell models are based on idealised ellipsoidal and spherical geometries. However, the elasticity model's shape can vary through the cycle, to simulate the more ellipsoidal shape of the left ventricle in the systolic phase. The finite element models have more representative geometries, but are generally based on animal data, which limits their medical relevance. This paper can enable readers to obtain a comprehensive perspective of left ventricle wall stress models, of how to employ them to determine wall stresses, and be cognizant of the assumptions involved in the use of specific models.

  4. Mercury and selenium concentrations in skeletal muscle, liver, and regions of the heart and kidney in bearded seals from Alaska, USA.

    PubMed

    Correa, Lucero; Castellini, J Margaret; Quakenbush, Lori T; O'Hara, Todd M

    2015-10-01

    Mean concentrations of total mercury ([THg]) and selenium ([TSe]) (mass and molar-based) were determined for 5 regions of the heart and 2 regions of the kidney of bearded seals (Erignathus barbatus) harvested in Alaska, USA, in 2010 and 2011. Mean [THg] and [TSe] of bearded seal liver and skeletal muscle tissues were used for intertissular comparison. The Se:Hg molar ratios were used to investigate elemental associations and potential antioxidant protection against Hg toxicosis. Age was an important factor in [THg] and Se:Hg molar ratios in heart and kidney. Small but statistically significant differences in mean [THg] occurred among some of the 5 heart regions (p < 0.05). Mean [THg] was highest in liver, 3.057 µg/g, and lowest in heart left ventricle, 0.017 µg/g. Mean [THg] ranked: liver > kidney cortex > kidney medulla > skeletal muscle > heart left ventricle (p < 0.001). Mean [TSe] was highest in liver, 3.848 µg/g, and lowest in heart left ventricle, 0.632 µg/g. Mean [TSe] ranked: liver > kidney cortex > kidney medulla > skeletal muscle > heart left ventricle (p < 0.001). The Se:Hg molar ratios were significantly greater than 1.0 in all tissues (p < 0.001) and represented baselines for normal [TSe] under relatively low [THg]. Mean Se:Hg molar ratios ranked: heart left ventricle > kidney medulla > kidney cortex (p < 0.001).

  5. The Kidney Research Predicament

    PubMed Central

    Bryan, Lisa; Ibrahim, Tod; Fischer, Michael J.

    2014-01-01

    Research funding from public and private sources has reached an all-time low. Economic conditions, sequestration, and a trend of low award success rates have created an imbalance between the supply of highly qualified research investigators and the availability of critically necessary research dollars. This grim environment continues to hinder the success of established investigators and deter potential investigators from joining the research workforce. Without action and support of innovative science, the future of the US health care system is in jeopardy, and its leadership role in medical research will decrease. This work discusses the effects of the decline in research funding, the plight of kidney research, and the impact of the American Society of Nephrology Grants Program on scientists. The ASN also calls on the entire nephrology community to rejuvenate the research environment, improve the lives of millions of people with kidney disease, and ultimately, find a cure. PMID:24652790

  6. The kidney research predicament.

    PubMed

    Bryan, Lisa; Ibrahim, Tod; Zent, Roy; Fischer, Michael J

    2014-05-01

    Research funding from public and private sources has reached an all-time low. Economic conditions, sequestration, and a trend of low award success rates have created an imbalance between the supply of highly qualified research investigators and the availability of critically necessary research dollars. This grim environment continues to hinder the success of established investigators and deter potential investigators from joining the research workforce. Without action and support of innovative science, the future of the US health care system is in jeopardy, and its leadership role in medical research will decrease. This work discusses the effects of the decline in research funding, the plight of kidney research, and the impact of the American Society of Nephrology Grants Program on scientists. The ASN also calls on the entire nephrology community to rejuvenate the research environment, improve the lives of millions of people with kidney disease, and ultimately, find a cure.

  7. Acupuncture and kidney disease.

    PubMed

    Garcia, Gabriela E; Ma, Sheng-Xing; Feng, Lili

    2005-07-01

    Acupuncture as a complex therapeutic system has been used to treat a variety of diseases and pathological conditions. Although the exact mechanism(s) of acupuncture remains unknown, some evidence suggests a mechanism initially involving signal transduction through connective tissue, with secondary involvement of other systems including the nervous system. Acupuncture has become increasingly popular in the Western countries as a therapy for pain and several chronic disorders difficult to manage with conventional treatments. Acupuncture and acupuncture-like somatic nerve stimulation have been used in different kidney diseases and several complications related to them. The effect of acupuncture techniques in some kidney diseases is reviewed on the basis of clinical reports as well as mechanisms that may possibly explain the beneficial effects mediated by acupressure/acupuncture. The potential effect of acupressure techniques in renal inflammation and whether these effects could be mediated through the newly identified cholinergic anti-inflammatory pathway are discussed.

  8. Kidney Cell Electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1985-01-01

    Materials and procedures for microgravity electrophoresis of living human embryonic kidney cells were evaluated, ground support in the form of analytical cell electrophoresis and flow cytometry was provided and cells returned from space flight were analyzed. Preflight culture media, electrophoresis buffer, fraction collection media, temperature profiles, and urokinase assay procedures were tested prior to flight. Electrophoretic mobility distributions of aliquots of the cell population to be fractionated in flight were obtained. The protocol established and utilized is given.

  9. [Acute Kidney Injury].

    PubMed

    Brix, Silke; Stahl, Rolf

    2017-02-01

    Acute kidney injury (AKI) is an important part of renal diseases and a common clinical problem. AKI is an acute decline in renal function. Due to a lack of therapeutic options, prevention and optimal management of patients with AKI are the most important strategies. Although seldom the sole cause of patients' death, AKI is associated with a significant increase in mortality. Our objective is to draw the attention towards the prevention of AKI of non-renal causes.

  10. Pregnancy and kidney transplantation.

    PubMed

    Josephson, Michelle A; McKay, Dianne B

    2011-01-01

    Despite decades of experience with child bearing in women with kidney transplants, these pregnancies remain high risk with an increased prevalence of hypertension and pre-eclampsia. Infertility, common in women with end-stage renal disease, is rapidly restored after transplant although pregnancy rates appear lower in transplant recipients than the general public. Many unanswered questions exist, some old questions such as what is the optimal timing of pregnancy after transplant, whether breast feeding is safe, the long-term impact if any on the offspring, and whether pregnancy negatively affects the kidney graft; and some new questions such as whether to modify immunosuppression in a patient taking a mycophenolic acid-containing drug, whether kidney donation has a deleterious impact on future pregnancies, whether to use erythropoietin-stimulating agents, and the role of BK virus. Counseling about contraception and pregnancy after transplant should be initiated during the pretransplant evaluation process. It is important because of the rapid restoration of fertility that occurs after transplant as well as the many risks and unanswered questions that remain.

  11. [Imaging of the kidney].

    PubMed

    Renard-Penna, Raphaelle; Marcy, Pierre-Yves; Lacout, Alexis; Thariat, Juliette

    2012-03-01

    Imaging of the kidney relies on three main imaging modalities: ultrasound, CT scan and MRI, on one hand, and scintigraphy, on the other hand. First intent ultrasound provides anatomic/vascular and functional information. Tissue perfusion assessment using ultrasound can be improved using contrast agents. Renal ultrasound is particularly useful but remains operator and tumor/patient-dependent (obese, ectopic kidney, type and site of tumor). It is cheap and does not irradiate. Ultrasound contrast agents can improve the sensitivity of ultrasound in many clinical situations. Intravenous urography has been replaced by CT scan. Multi-slice CT scan is indeed the main renal imaging modality: it allows for angiographic and urographic explorations. MRI provides anatomic and functional information. Renal failure must be looked for before performing CT scan or MRI so as to avoid iatrogenic complications. Severe renal failure is a contraindication to both. Each imaging modality has pros and cons and specific indications. CT scan is the mainstay of renal imaging provided that standardized injection protocols are used, that the dose is limited (low-dose protocol) and renal function is assessed. Dynamic renal scintigraphy can be used in situations where information on the function of each kidney is necessary.

  12. Claudins and the kidney.

    PubMed

    Yu, Alan S L

    2015-01-01

    Claudins are tight-junction membrane proteins that function as both pores and barriers in the paracellular pathway in epithelial cells. In the kidney, claudins determine the permeability and selectivity of different nephron segments along the renal tubule. In the proximal tubule, claudins have a role in the bulk reabsorption of salt and water. In the thick ascending limb, claudins are important for the reabsorption of calcium and magnesium and are tightly regulated by the calcium-sensing receptor. In the distal nephron, claudins need to form cation barriers and chloride pores to facilitate electrogenic sodium reabsorption and potassium and acid secretion. Aldosterone and the with-no-lysine (WNK) proteins likely regulate claudins to fine-tune distal nephron salt transport. Genetic mutations in claudin-16 and -19 cause familial hypomagnesemic hypercalciuria with nephrocalcinosis, whereas polymorphisms in claudin-14 are associated with kidney stone risk. It is likely that additional roles for claudins in the pathogenesis of other types of kidney diseases have yet to be uncovered.

  13. Connexins and the kidney

    PubMed Central

    Hanner, Fiona; Sorensen, Charlotte Mehlin; Holstein-Rathlou, Niels-Henrik

    2010-01-01

    Connexins (Cxs) are widely-expressed proteins that form gap junctions in most organs, including the kidney. In the renal vasculature, Cx37, Cx40, Cx43, and Cx45 are expressed, with predominant expression of Cx40 in the endothelial cells and Cx45 in the vascular smooth muscle cells. In the tubules, there is morphological evidence for the presence of gap junction plaques only in the proximal tubules. In the distal nephron, Cx30, Cx30.3, and Cx37 are expressed, but it is not known whether they form gap junctions connecting neighboring cells or whether they primarily act as hemichannels. As in other systems, the major function of Cxs in the kidney appears to be intercellular communication, although they may also form hemichannels that allow cellular secretion of large signaling molecules. Renal Cxs facilitate vascular conduction, juxtaglomerular apparatus calcium signaling, and tubular purinergic signaling. Accordingly, current evidence points to roles for these Cxs in several important regulatory mechanisms in the kidney, including the renin angiotensin system, tubuloglomerular feedback, and salt and water reabsorption. At the systemic level, renal Cxs may help regulate blood pressure and may be involved in hypertension and diabetes. PMID:20164205

  14. Connexins and the kidney.

    PubMed

    Hanner, Fiona; Sorensen, Charlotte Mehlin; Holstein-Rathlou, Niels-Henrik; Peti-Peterdi, János

    2010-05-01

    Connexins (Cxs) are widely-expressed proteins that form gap junctions in most organs, including the kidney. In the renal vasculature, Cx37, Cx40, Cx43, and Cx45 are expressed, with predominant expression of Cx40 in the endothelial cells and Cx45 in the vascular smooth muscle cells. In the tubules, there is morphological evidence for the presence of gap junction plaques only in the proximal tubules. In the distal nephron, Cx30, Cx30.3, and Cx37 are expressed, but it is not known whether they form gap junctions connecting neighboring cells or whether they primarily act as hemichannels. As in other systems, the major function of Cxs in the kidney appears to be intercellular communication, although they may also form hemichannels that allow cellular secretion of large signaling molecules. Renal Cxs facilitate vascular conduction, juxtaglomerular apparatus calcium signaling, and tubular purinergic signaling. Accordingly, current evidence points to roles for these Cxs in several important regulatory mechanisms in the kidney, including the renin angiotensin system, tubuloglomerular feedback, and salt and water reabsorption. At the systemic level, renal Cxs may help regulate blood pressure and may be involved in hypertension and diabetes.

  15. The first simultaneous kidney-adrenal gland-pancreas transplantation: outcome at 1 year.

    PubMed

    Vouillarmet, J; Buron, F; Houzard, C; Carlier, M C; Chauvet, C; Brunet, M; Thivolet, C; Morelon, E; Badet, L

    2013-07-01

    Adrenal insufficiency is a rare but life-threatening disease. Replacement therapy sometimes fails to prevent an acute adrenal crisis and most often does not lead to restoration of well-being. We report here the 1-year outcome of the first simultaneous kidney-adrenal gland-pancreas transplantation in a 33-year-old patient with type 1 diabetes and concomitant autoimmune adrenal insufficiency. En bloc left adrenal gland and kidney grafts were anastomosed on the left iliac vessels in normal vascular conditions and the pancreas graft was anastomosed on the right iliac vessels. The immunosuppressive regimen was not modified by the addition of the adrenal gland. We observed no additional morbidity due to the adrenal gland transplantation, as there were no surgical complications. One-year kidney and pancreas graft functions were satisfactory (estimated glomerular filtration rate: 55 mL/min/1.73 m(2) and HbA1c: 4.8%). The adrenal graft functioned well at 12 months with a normalization of cortisol and aldosterone baseline levels. Functional imaging at 3 months showed good uptake of [(123) I]-metaiodobenzylguanidine by the adrenal graft. Transplantation of the adrenal gland en bloc with the left kidney appears to be a good therapeutic option in patients with adrenal insufficiency awaiting kidney or kidney-pancreas transplantation.

  16. Traumatic amputation of the left lower renal pole in children

    SciTech Connect

    Waxman, J.; Belman, A.B.; Kass, E.J.

    1985-07-01

    Four children between 5 and 10 years old suffered traumatic amputation of the left lower renal pole following flank trauma. All patients were evaluated with excretory urography and isotope renography. The renal scan clearly demonstrated failure of perfusion of the lower renal pole and urinary extravasation, and was believed to be more valuable than the standard excretory urogram as a diagnostic tool. All children were managed similarly: delayed (72 to 96 hours) exploration, simple removal of the amputated segment and insertion of a Penrose drain. They all have done well. The patients were normotensive at followup and had excellent function of the remaining portion of the kidney.

  17. Surgical Treatment of a Voluminous Infrarenal Abdominal Aortic Aneurysm with Horseshoe Kidney: Tips and Tricks

    PubMed Central

    Massara, Mafalda; Greco, Michele; Mastrojeni, Claudio; Serra, Raffaele; Salomone, Ignazio; La Spada, Michele

    2015-01-01

    Horseshoe kidney is a common urology anomaly, while its association with infrarenal abdominal aortic aneurysm represents a very rare condition. Surgical approach remains controversial however, we believe that the left retroperitoneal approach should be preferred in order to avoid isthmus resection with any subsequent renal infarction, urinary tract damage and to facilitate renal arteries reimplantation, when required. We present a case of voluminous infrarenal abdominal aortic aneurysm associated with horseshoe kidney, successfully treated through a left retroperitoneal approach on the retro-renal space. PMID:26730260

  18. Four miniature kidneys: supernumerary kidney and multiple organ system anomalies.

    PubMed

    Afrouzian, Marjan; Sonstein, Joseph; Dadfarnia, Tahereh; Sreshta, J Nicholas; Hawkins, Hal K

    2014-05-01

    More than 350 years after Martius's first reported case in 1656, supernumerary kidney (SNK) continues to fascinate the world of medicine, generating new ideas in the domain of embryogenesis. Association of a normal kidney with a second or third ipsilateral smaller kidney is an extremely rare anomaly with only a total of 81 cases reported until today. We are reporting a case of SNK, clinically diagnosed as right hydronephrosis, associated with an ipsilateral ectopic ureter, a contralateral partially duplicated ureter, and a multiseptate gallbladder. Pathologic examination of the nephrectomy revealed 4 miniature kidneys, joining a dilated ureter through 4 separate conduits. Our patient is the first reported case of SNK with absent ipsilateral normal kidney, presence of more than 3 kidneys on 1 side, and associated anomaly in the gallbladder. This case represents a unique combination of rarities, suggesting insights in the domain of molecular embryology.

  19. Persistent Mullerian Duct Syndrome with Embryonal Cell Carcinoma along with Ectopic Cross Fused Kidney

    PubMed Central

    Bharath, NR Manju; Narayana, V; Raja, V Om Pramod Kumar; Jambula, Pranav Reddy

    2016-01-01

    Persistent Mullerian Duct Syndrome (PMDS) is a form of internal male pseudohermaphroditism, where there is normal development of male secondary sexual characters, along with the presence of bilateral fallopian tubes and uterus. Majority of these cases go undetected and some cases are accidentally diagnosed while investigating for other problems. Cross fused renal ectopia is a condition where one kidney lies in the opposite side, fused to the other kidney. We present an extremely rare case of a phenotypical male presenting with mass per abdomen and bilateral cryptorchidism, turned out to have uterus with bilateral fallopian tubes, ectopic cross fused right kidney and Embryonal cell carcinoma of left undescended testis. PMID:26894123

  20. Multiple Aneurysms and a Transplanted Kidney in Behçet Disease.

    PubMed

    Ali, Oroog; Nicholl, Philip; Carruthers, David; Geoghegan, James; Tiwari, Alok

    2017-02-01

    Arterial manifestation of Behçet disease represents a challenging clinical scenario with a potential for fatal complications. This case depicts the surgical management of a 4.5-cm infrarenal aortic aneurysm and a 6-cm left renal artery aneurysm in a patient with known Behçet disease. The presence of a contralateral living donor kidney transplant added to the complexity of the case. Open surgical repair was performed on both aneurysms with the use of axillofemoral bypass to protect the transplanted kidney. This case highlights the challenges of treating an aortic aneurysm in a patient with Behçet disease and a kidney transplant.

  1. The evaluation and comparison of kidney length obtained from axial cuts in spiral CT scan with its true length

    PubMed Central

    Karami, Mehdi; Rahimi, Farshad; Tajadini, Mohammadhasan

    2015-01-01

    Background: Increased size of kidney is the main symptom of pyelonephritis and renal ischemia in children. Ultrasound and computed tomography (CT) scan methods are the imaging methods for evaluating the urogenital system. The aim of this study is to compare the kidney length obtained from spiral CT scan with the true length obtained from multi-slice CT. Materials and Methods: From 100 patients 200 kidneys were examined in Alzahra Hospital in 2012. Multi-slice CT was used to obtain coronal and sagittal cuts to find the length of kidneys. Results: The mean values of true size of axial sections of the right and left kidneys were 108.37 ± 12.3 mm and 109.74 ± 13.6 mm, respectively. The mean difference of axial sections’ lengths in the right and left kidneys was 1.37 ± 1.22 mm. The mean values of length in the spiral CT scan of the right and left kidneys were 98.61 ± 15.8 mm and 103.11 ± 15.9 mm, respectively. The difference in the estimated size by multi-slice CT scan in oblique and axial images was significant (9.77 ± 1.19 mm and 6.63 ± 0.8 mm for the right and left kidneys, respectively (P < 0.001). Conclusion: The average size of both kidneys determined in axial images was smaller than the actual size. The estimation of kidney size in axial images is not reliable, and to obtain the actual size, it is required to have the coronal and sagittal cuts with proper quality, which could be achieved by multi-slice method. PMID:25709984

  2. Left-Sided Inferior Vena Cava Encountered During Organ Retrieval Surgery: Report of Two Cases

    PubMed Central

    Rajabnejad, Y.; Aliakbarian, M.; Rajabnejad, A.; Motie, M. R.

    2016-01-01

    Left-sided inferior vena cava (IVC) is the second most common anatomical anomaly of the IVC after duplication. Herein, we present two cases of left-sided IVC, diagnosed during organ retrieval procedure. In a young brain-dead man, a single left-sided IVC was observed; it originated from iliac confluence in the left side of the aorta and extended throughout the abdomen. There was no retrohepatic IVC in the patient; hepatic veins drained directly into the right atrium. The second case was a brain-dead young woman with a left-sided IVC originated from iliac confluence to the kidney level; then, the IVC crossed anterior to the abdominal aorta to join a normally positioned retrohepatic IVC. In cases of retroperitoneal surgeries, IVC anomalies should be considered during preoperative imaging studies, because they may be misdiagnosed as para-aortic lymphadenopathy, tumor or dilated gonadal vein that may result in iatrogenic damage during surgery. PMID:28078062

  3. Ex Vivo Removal of Stones in Donor Kidneys by Flexible Ureteroscopy Prior to Renal Transplantation: A Case Report

    PubMed Central

    Wang, Na; Zhou, Honglan; Shi, Bo; Wang, Jinguo

    2017-01-01

    Patient: Male, 33 Final Diagnosis: Donation after cardiac death (DCD) Symptoms: None Medication:— Clinical Procedure: Ex vivo removal of stones in donor kidneys by flexible ureteroscop Specialty: Transplantology Objective: Rare co-existance of disease or pathology Background: Because of the shortage of grafts, many attempts have been made to treat calculi in donor kidneys and have achieved successful management. This case report is the first to present removal of stones from bilateral kidneys from a single donor through flexible ureteroscopy before transplantation. Case Report: The present case report shows the clinical management of bilateral donor kidneys with calculi, which were taken from a 33-year-old man through donation after cardiac death (DCD). Computed tomography showed 2 stones in the right donor kidney and 1 in the left donor kidney. Two stones were removed ex vivo using a flexible ureteroscope before transplantation, and the third one turned out to be a renal papillae calcification, which was left in place without surgical treatment. The bilateral donor kidneys were transplanted to 2 recipients. Conclusions: There is a possibility of increasing the kidney pool by using donor kidneys containing calculi, which should be removed before transplantation. PMID:28255156

  4. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  5. The use of dual vacuum stabilization device to reduce kidney motion for stereotactic radiotherapy planning.

    PubMed

    Pham, Daniel; Kron, Tomas; Styles, Colin; Whitaker, May; Bressel, Mathias; Foroudi, Farshad; Schneider, Michal; Devereux, Thomas; Dang, Kim; Siva, Shankar

    2015-04-01

    Abdominal stereotactic ablative body radiotherapy is aided by motion management strategies to ensure accurate dose delivery as targets such as the kidney are easily influenced by breathing motion. Commercial devices such as compression plates and dual vacuum technology have been demonstrated to reduce the motion of lung and liver tumors. The aim of this study was to evaluate the effectiveness of a dual vacuum system in reducing kidney motion as well to investigate any relationship between abdominal wall motions with kidney motion. Ten healthy volunteers were set up with and without vacuum compression (Elekta BodyFIX(TM)) to simulate free and dampened breathing. Ultrasound imaging was used to visualize kidney motion at the same time an abdominal surface marker was monitored using infrared imaging (Varian, Real Time Position Management). The resulting kidney and abdominal motion tracks were imported into motion analysis (Physmo(TM)) and custom built software (Matlab) to calculate amplitude of motion independent of shifting baselines. Thirty-four kidney datasets were available for analysis, with six datasets unable to be retrieved. With vacuum compression six out of nine participants showed a mean reduction of kidney motion ranging between 1.6 and 8 mm (p < 0.050). One participant showed an increase in motion of 8.2 mm (p < 0.001) with vacuum compression. Two participants showed no significant change (<1 mm) in kidney motion. No relationship was observed for abdominal wall motion and motion changes in the left kidney (r = 0.345, p = 0.402) or right kidney (r = 0.527, p = 0.145). Vacuum compression reduced kidney motion in the majority of participants; however larger breathing motion can also result from its use. No pattern emerged regarding which patients may benefit from vacuum immobilization as abdominal wall motion was not found to be an adequate surrogate for kidney motion.

  6. [Human physiology: kidney].

    PubMed

    Natochin, Iu V

    2010-01-01

    The content of human physiology as an independent part of current physiology is discussed. Substantiated is the point that subjects of human physiology are not only special sections of physiology where functions are inherent only in human (physiology of intellectual activity, speech, labor, sport), but also in peculiarities of functions, specificity of regulation of each of physiological systems. By the example of physiology of kidney and water-salt balance there are shown borders of norm, peculiarities of regulation in human, new chapters of renal physiology which have appeared in connection with achievements of molecular physiology.

  7. Pregnancy and the kidney.

    PubMed

    Maynard, Sharon E; Thadhani, Ravi

    2009-01-01

    Nephrologists are frequently called on to diagnose and treat renal disorders in pregnant women. In this review, we update recent literature pertinent to pregnancy and renal disease. We initially begin by describing the application of common clinical estimators of GFR and proteinuria in pregnancy and then summarize recent studies regarding pregnancy in women with chronic kidney disease and the latest information on the use of common renal medications in pregnancy. In the final section, we describe advances in our understanding of the pathophysiology of preeclampsia and the potential clinical implications of these discoveries for screening, prevention, and treatment of preeclampsia.

  8. Boron and the kidney.

    PubMed

    Pahl, Madeleine V; Culver, B Dwight; Vaziri, Nosratola D

    2005-10-01

    Boron, the fifth element in the periodic table, is ubiquitous in nature. It is present in food and in surface and ocean waters, and is frequently used in industrial, cosmetic, and medical settings. Exposure to boron and related compounds has been recently implicated as a potential cause of chronic kidney disease in Southeast Asia. This observation prompted the present review of the published data on the effects of acute and chronic exposure to boron on renal function and structure in human beings and in experimental animals.

  9. Closed kidney injury.

    PubMed

    Viola, Tracey A

    2013-04-01

    The purpose of this article is to discuss the prevalence of blunt renal trauma and the nature of the problem, including the risk of renal injury with sports participation and epidemiology. Patient history of mechanism of injury, as well as examination findings, will risk-stratify patients to determine who needs immediate surgical intervention, who requires imaging, and what patients do not need further imaging. Computed tomography is readily available, fast, and accurate in the diagnosis of renal injury. Discussion of the athlete with congenital renal disease and the solitary kidney concludes this article.

  10. Kidney transplantation in patients with Fabry disease.

    PubMed

    Cybulla, Markus; Walter, Kerstin Nanette; Schwarting, Andreas; Divito, Raffaelle; Feriozzi, Sandro; Sunder-Plassmann, Gere

    2009-04-01

    Little is known about the effects of enzyme replacement therapy (ERT) in kidney transplant recipients with Fabry disease. Clinical characteristics of transplant recipients in the Fabry Outcome Survey (FOS) were therefore examined in patients with Fabry disease with or without ERT. Of the 837 European patients in FOS (March 2006), 34 male patients and two female patients had received kidney transplants. Mean age at transplantation was 37.6 +/- 10.9 years, mean time since transplantation was 7.7 +/- 6.4 years, median estimated glomerular filtration rate (eGFR) was 44.4 ml/min/1.73 m(2), and median proteinuria was 296 mg/24 h. Of 27 patients with baseline data, 59% had hypertension, 74% had left ventricular hypertrophy, 22% had cardiac valve disease, 30% had arrhythmia, and 22% had transient ischaemic attacks and 15% stroke. Twenty patients (74%; two female patients, 18 male patients) were receiving ERT with agalsidase alfa. At enrollment or at the start of ERT, median eGFRs were 59 and 35 ml/min/1.73 m(2) (P = 0.05) and median proteinuria levels were 240 and 420 mg/24 h (not significant) in treated and untreated patients respectively. Renal function remained stable in patients receiving ERT. In conclusion, agalsidase alfa is well tolerated in patients with Fabry disease who have undergone renal transplantation.

  11. Kidney Exchange to Overcome Financial Barriers to Kidney Transplantation.

    PubMed

    Rees, M A; Dunn, T B; Kuhr, C S; Marsh, C L; Rogers, J; Rees, S E; Cicero, A; Reece, L J; Roth, A E; Ekwenna, O; Fumo, D E; Krawiec, K D; Kopke, J E; Jain, S; Tan, M; Paloyo, S R

    2017-03-01

    Organ shortage is the major limitation to kidney transplantation in the developed world. Conversely, millions of patients in the developing world with end-stage renal disease die because they cannot afford renal replacement therapy-even when willing living kidney donors exist. This juxtaposition between countries with funds but no available kidneys and those with available kidneys but no funds prompts us to propose an exchange program using each nation's unique assets. Our proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers. By making developed-world health care available to impoverished patients in the developing world, we replace unethical transplant tourism with global kidney exchange-a modality equally benefitting rich and poor. We report the 1-year experience of an initial Filipino pair, whose recipient was transplanted in the United states with an American donor's kidney at no cost to him. The Filipino donor donated to an American in the United States through a kidney exchange chain. Follow-up care and medications in the Philippines were supported by funds from the United States. We show that the logistical obstacles in this approach, although considerable, are surmountable.

  12. Pruritus in Kidney Disease.

    PubMed

    Combs, Sara A; Teixeira, J Pedro; Germain, Michael J

    2015-07-01

    Pruritus is a common and distressing symptom in patients with chronic kidney disease. The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus and that uremic pruritus (UP) has a major clinical impact, being associated strongly with poor quality of life, impaired sleep, depression, and increased mortality. The pathogenesis of UP remains largely unclear, although several theories on etiologic or contributing factors have been proposed including increased systemic inflammation; abnormal serum parathyroid hormone, calcium, and phosphorus levels; an imbalance in opiate receptors; and a neuropathic process. UP can present somewhat variably, although it tends to affect large, discontinuous, but symmetric, areas of skin and to be most symptomatic at night. A variety of alternative systemic or dermatologic conditions should be considered, especially in patients with asymmetric pruritus or other atypical features. Treatment initially should focus on aggressive skin hydration, patient education on minimizing scratching, and optimization of the aspects of chronic kidney disease care that are most relevant to pruritus, including dialysis adequacy and serum parathyroid hormone, calcium, and phosphorus management. Data for therapy specifically for UP remain limited, although topical therapies, gabapentin, type B ultraviolet light phototherapy, acupuncture, and opioid-receptor modulators all may play a role.

  13. [Kidney diseases: new issues].

    PubMed

    Ronco, Pierre

    2012-03-01

    Chronic kidney disease (CKD) affects two to four million people in France and most of them are not aware of their disease. CKD is a major, independent risk factor of cardiovascular mortality and morbidity; the cardiovascular risk increases with the severity of renal failure. Evaluation of renal function (GFR) relies on MDRD and CKD-EPI equations. The French CKD-REIN cohort with more than 3000 patients followed for 5 years, will hopefully provide substantial advances in the knowledge of CKD epidemiology, of risk factors and mechanisms of CKD progression and medical practices. Improving CKD screening based on blood pressure, proteinuria (microalbuminuria in diabetic patients) and serum creatinine, is a national duty in high risk patients (with diabetes, hypertension and cardiovascular diseases). A major research goal is to identify new therapeutic targets and biomarkers, in order to treat kidney diseases before the occurrence of renal insufficiency, to halt their progression and to decrease cardiovascular risk. Careful therapeutic education of patients is required to successfully implement established guidelines, appropriate diets and new therapeutic strategies.

  14. Acute Kidney Injury

    PubMed Central

    Zuk, Anna; Bonventre, Joseph V.

    2016-01-01

    Acute kidney injury (AKI) is a global public health concern associated with high morbidity, mortality, and healthcare costs. Other than dialysis, no therapeutic interventions reliably improve survival, limit injury, or speed recovery. Despite recognized shortcomings of in vivo animal models, the underlying pathophysiology of AKI and its consequence, chronic kidney disease (CKD), is rich with biological targets. We review recent findings relating to the renal vasculature and cellular stress responses, primarily the intersection of the unfolded protein response, mitochondrial dysfunction, autophagy, and the innate immune response. Maladaptive repair mechanisms that persist following the acute phase promote inflammation and fibrosis in the chronic phase. Here macrophages, growth-arrested tubular epithelial cells, the endothelium, and surrounding pericytes are key players in the progression to chronic disease. Better understanding of these complex interacting pathophysiological mechanisms, their relative importance in humans, and the utility of biomarkers will lead to therapeutic strategies to prevent and treat AKI or impede progression to CKD or end-stage renal disease (ESRD). PMID:26768243

  15. [Left pulmonary agenesis diagnosed late].

    PubMed

    Deleanu, Oana; Pătraşcu, Natalia; Nebunoiu, Ana-Maria; Vintilă, V; Ulmeanu, Ruxandra; Mihălţan, F D

    2010-01-01

    We present the case of a 51 years old female-patient, with severe dextroscoliosis, having like unique symptom progressive dyspnea. The blood samples reveals polycythemia, the radiological exam shows the opacification of 2/3 of the left thorax, the absence of the lung structure in the other 1/3, the deviation of the mediastinum, and dextroscoliosis; the computed tomography reveals the absence of the left lung artery and the left airways, compensatory hyperinflation of the right lung and dilatation of the trunk and right pulmonary artery; the bronchoscopy does not visualize the carina or the left main bronchus, typical for pulmonary agenesis. Echocardiography confirmed the absence of left pulmonary artery and shows mild pulmonary hypertension (systolic pressure in the pulmonary artery of 33 mmHg) with dilatation of the right cavities, but good cinetics. We face a case of pulmonary agenesis lately diagnosed, with modest functional cardiologic implications, limited therapeutic options and good survival, justified by the late appearance of the pulmonary hypertension of low severity and without worsening in time.

  16. Kidney Disease: Early Detection and Treatment

    MedlinePlus

    ... Bar Home Current Issue Past Issues Special Section Kidney Disease: Early Detection and Treatment Past Issues / Winter ... called a "urine albumin-to-creatinine ratio." Treating Kidney Disease Kidney disease is usually a progressive disease, ...

  17. Kidney Stones in Children and Teens

    MedlinePlus

    ... Issues Listen Español Text Size Email Print Share Kidney Stones in Children and Teens Page Content Article ... teen girls having the highest incidence. Types of Kidney Stones There are many different types of kidney ...

  18. Genetics Home Reference: polycystic kidney disease

    MedlinePlus

    ... Testing Registry: Polycystic kidney disease, adult type Other Diagnosis and Management Resources (3 links) GeneReview: Polycystic Kidney Disease, Autosomal Dominant GeneReview: Polycystic Kidney Disease, Autosomal Recessive ...

  19. Synergistic Interaction of Hypertension and Diabetes in Promoting Kidney Injury and the Role of Endoplasmic Reticulum Stress.

    PubMed

    Wang, Zhen; do Carmo, Jussara M; Aberdein, Nicola; Zhou, Xinchun; Williams, Jan M; da Silva, Alexandre A; Hall, John E

    2017-05-01

    Diabetes mellitus and hypertension are major risk factors for chronic kidney injury, together accounting for >70% of end-stage renal disease. In this study, we assessed interactions of hypertension and diabetes mellitus in causing kidney dysfunction and injury and the role of endoplasmic reticulum (ER) stress. Hypertension was induced by aorta constriction (AC) between the renal arteries in 6-month-old male Goto-Kakizaki (GK) type 2 diabetic and control Wistar rats. Fasting plasma glucose averaged 162±11 and 87±2 mg/dL in GK and Wistar rats, respectively. AC produced hypertension in the right kidney (above AC) and near normal blood pressure in the left kidney (below AC), with both kidneys exposed to the same levels of glucose, circulating hormones, and neural influences. After 8 weeks of AC, blood pressure above the AC (and in the right kidney) increased from 109±1 to 152±5 mm Hg in GK rats and from 106±4 to 141±5 mm Hg in Wistar rats. The diabetic-hypertensive right kidneys in GK-AC rats had much greater increases in albumin excretion and histological injury compared with left kidneys (diabetes mellitus only) of GK rats or right kidneys (hypertension only) of Wistar-AC rats. Marked increases in ER stress and oxidative stress indicators were observed in diabetic-hypertensive kidneys of GK-AC rats. Inhibition of ER stress with tauroursodeoxycholic acid for 6 weeks reduced blood pressure (135±4 versus 151±4 mm Hg), albumin excretion, ER and oxidative stress, and glomerular injury, while increasing glomerular filtration rate in hypertensive-diabetic kidneys. These results suggest that diabetes mellitus and hypertension interact synergistically to promote kidney dysfunction and injury via ER stress.

  20. ABO-Incompatible Kidney Transplantation

    PubMed Central

    Morath, Christian; Zeier, Martin; Döhler, Bernd; Opelz, Gerhard; Süsal, Caner

    2017-01-01

    ABO-incompatible (ABOi) kidney transplantation has long been considered a contraindication to successful kidney transplantation. During the last 25 years, increasing organ shortage enforced the development of strategies to overcome the ABO antibody barrier. In the meantime, ABOi kidney transplantation has become a routine procedure with death-censored graft survival rates comparable to the rates in compatible transplantations. Desensitization is usually achieved by apheresis and B cell-depleting therapies that are accompanied by powerful immunosuppression. Anti-A/B antibodies are aimed to be below a certain threshold at the time of ABOi kidney transplantation and during the first 2 weeks after surgery. Thereafter, even a rebound of anti-A/B antibodies does not appear to harm the kidney transplant, a phenomenon that is called accommodation, but is poorly understood. There is still concern, however, that infectious complications such as viral disease, Pneumocystis jirovecii pneumonia, and severe urinary tract infections are increased after ABOi transplantations. Recent data from the Collaborative Transplant Study show that during the first year after kidney transplantation, one additional patient death from an infectious complication occurs in 100 ABOi kidney transplant recipients. Herein, we review the recent evidence on ABOi kidney transplantation with a focus on desensitization strategies and respective outcomes. PMID:28321223

  1. ABO-Incompatible Kidney Transplantation.

    PubMed

    Morath, Christian; Zeier, Martin; Döhler, Bernd; Opelz, Gerhard; Süsal, Caner

    2017-01-01

    ABO-incompatible (ABOi) kidney transplantation has long been considered a contraindication to successful kidney transplantation. During the last 25 years, increasing organ shortage enforced the development of strategies to overcome the ABO antibody barrier. In the meantime, ABOi kidney transplantation has become a routine procedure with death-censored graft survival rates comparable to the rates in compatible transplantations. Desensitization is usually achieved by apheresis and B cell-depleting therapies that are accompanied by powerful immunosuppression. Anti-A/B antibodies are aimed to be below a certain threshold at the time of ABOi kidney transplantation and during the first 2 weeks after surgery. Thereafter, even a rebound of anti-A/B antibodies does not appear to harm the kidney transplant, a phenomenon that is called accommodation, but is poorly understood. There is still concern, however, that infectious complications such as viral disease, Pneumocystis jirovecii pneumonia, and severe urinary tract infections are increased after ABOi transplantations. Recent data from the Collaborative Transplant Study show that during the first year after kidney transplantation, one additional patient death from an infectious complication occurs in 100 ABOi kidney transplant recipients. Herein, we review the recent evidence on ABOi kidney transplantation with a focus on desensitization strategies and respective outcomes.

  2. Left Hemisphere Dysfunction and Left Hemisphere Overactivation in Schizophrenia

    ERIC Educational Resources Information Center

    Gur, Raquel E.

    1978-01-01

    Reports two studies relating schizophrenia to functional brain asymmetry. The first study found support for the hypothesis of left hemisphere dysfunction in schizophrenia, occurring at a rather early stage of information processing; the second study, using eye directionality as a measure of hemispheric activation, found that schizophrenics…

  3. SIRT1 and Kidney Function

    PubMed Central

    Guan, Yi; Hao, Chuan-Ming

    2016-01-01

    Background SIRT1 is a nicotinamide adenine dinucleotide-dependent deacetylase belonging to the class III histone deacetylases. Abundantly expressed in the kidney, especially in the renal medulla, SIRT1 is closely involved in renal physiology and pathology. Summary SIRT1 targets both histone and nonhistone proteins, participates in many important signaling pathways and mediates the regulation of longevity, metabolic homeostasis, acute stress response and DNA integrity. With regard to the kidney, SIRT1 attenuates diabetic albuminuria, reduces blood pressure and related cardiovascular diseases, resists acute kidney injury, delays kidney fibrogenesis, promotes cyst formation and benefits renal ageing. Key Messages This review summarizes the biology of SIRT1 and focuses on the latest studies concerning SIRT1 as a potential therapeutic target for kidney diseases. PMID:27536685

  4. Macrophage polarization in kidney diseases.

    PubMed

    Tian, Shaojiang; Chen, Shi-You

    Macrophage accumulation associates closely with the degree of renal structural injury and renal dysfunction in human kidney diseases. Depletion of macrophages reduces while adoptive transfer of macrophages worsens inflammation in animal models of the renal injury. However, emerging evidence support that macrophage polarization plays a critical role in the progression of a number of kidney diseases including obstructive nephropathy, ischemia-reperfusion injury, glomerulonephritis, diabetic nephropathy, and other kidney diseases. In this mini-review, we briefly summarize the macrophage infiltration and polarization in these inflammatory and fibrotic kidney diseases, discussing the results mostly from studies in animal models. In view of the critical role of macrophage in the progression of these diseases, manipulating macrophage phenotype may be a potential effective strategy to treat various kidney diseases.

  5. The left atrial "Medusa myxoma".

    PubMed

    Williams, Elbert E; Pratt, Jerry W; Martin, David E

    2014-02-01

    Although myxomas are the most commonly seen primary cardiac tumors, encompassing 30% to 50% of all primary tumors of the heart, they remain a rare finding with an annual reported incidence of 0.5 per million. The presenting symptoms of an atrial myxoma are widely varied as are the clinical consequences. Regardless of presentation, once a diagnosis is made prompt surgical excision is recommended to minimize the potential complications of obstruction or embolization. We present the "Medusa myxoma," an arborizing 4-fingered left atrial myxoma extending from the fossa ovalis across the left atrium.

  6. Kidney and calcium homeostasis.

    PubMed

    Jeon, Un Sil

    2008-12-01

    Plasma calcium concentration is maintained within a narrow range (8.5-10.5 mg/dL) by the coordinated action of parathyroid hormone (PTH), 1,25(OH)2D3, calcitonin, and ionized calcium (iCa(2+)) itself. The kidney plays a key role in this process by the fine regulation of calcium excretion. More than 95% of filtered calcium is reabsorbed along the renal tubules. In the proximal tubules, 60% of filtered calcium is reabsorbed by passive mechanisms. In the thick ascending limb, 15% of calcium is reabsorbed by paracellular diffusion through paracellin-1 (claudin-16). The calcium sensing receptor (CaSR) in the basolateral membrane of the thick ascending limb senses the change in iCa(2+) and inhibits calcium reabsorption independent to PTH and 1,25(OH)2D3. The fine regulation of calcium excretion occurs in the distal convoluted tubules and connecting tubules despite the fact that only 10-15% of filtered calcium is reabsorbed there. Transient receptor potential vanilloid 5 (TRPV5) and 6 (TRPV6) in the apical membrane act as the main portal of entry, calbindin-D28K delivers Ca(2+) in the cytoplasm, and then Na(2+)/Ca(2+) exchanger (NCX1) and plasma membrane Ca(2+)-ATPase in the basolateral membrane serve as an exit. In the cortical collecting duct, TRPV6 is expressed, but the role might be negligible. In addition to PTH and 1,25(OH)2D3, acid-base disturbance, diuretics, and estrogen affect on these calcium channels. Recently, klotho and fibroblast growth factor 23 (FGF23) are suggested as new players in the calcium metabolism. Klotho is exclusively expressed in the kidney and co-localized with TRPV5, NCX1, and calbindin-D28K. Klotho increases calcium reabsorption through trafficking of TRPV5 to the plasma membrane, and also converts FGF receptor to the specific FGF23 receptor. FGF23:klotho complex bound to FGF receptor inhibits 1α-hydroxylase of vitamin D, and contributes to calcium reabsorption and phosphate excretion in the kidney.

  7. [Rare case of congenital cystic adenomatoid malformation associated with polycystic kidney disease].

    PubMed

    Jabłoński, Janusz; Jankowski, Zbigniew; Sitkiewicz, Anna; Lewandowska, Małgorzata; Andrzejewska, Ewa

    2011-01-01

    Congenital cystic adenomatoid malformation (CCAM) is a rare pulmonary abnormality that results from aberrant fetal lung development. It about 4-26% of cases it can be associated with other congenital abnormalities. We describe a case of congenital cystic adenomatoid malformation 2 associated with polycystic kidney disease. The association of these two congenital malformations is exceptional. Only four similar cases have been reported in the literature. A 2-year-old girl was referred to the Department of Paediatric Surgery and Oncology Medical University of Lodz with pneumonia and left pneumothorax. For three weeks prior to referral the patient was treated with antibiotics. Chest x-ray revealed hyperinflation of left upper lobe with mediastinal shift to right. Computer tomographic scan of the lung revealed multiple cyst in the left upper lobe, left-site pneumothorax and mediastinal shift to the right. The patient underwent thoracotomy. Intraoperatively, multiple cysts in the left upper lobe were found and left upper lobectomy was performed. Histologic study was compatible with type 2 congenital cystic adenomatoid malformation. Ultrasound examination showed multilocular cysts in both kidneys. The dimensions of the cysts were: MWR4. 54x45x45 mm and 25x21x24 mm on the left and right sides, respectively. Significant increase in cyst size on the left side was observed. Ten months after first hospitalization resection of the cystic lower pole of the left kidney was performed. The presence of even a single renal cyst in a child with CCAM is an indication for further follow up examinations.

  8. Synchronous Renal Neoplasm: Clear Cell Renal Cell Carcinoma and Papillary Urothelial Carcinoma in the Same Kidney.

    PubMed

    Benavides-Huerto, Miguel Armando; Chávez-Valencia, Venice; Lagunas-Rangel, Francisco Alejandro

    2017-02-01

    Abdominal computed tomography in a 64 year-old male presenting hematuria showed two malignant tumors in the left kidney, thus radical nephrectomy was realized. In histological preparations a clear cell renal cell carcinoma and a papillary urothelial carcinoma were identified occurring synchronously, which is a rare occurrence having only about 50 cases reported in the literature.

  9. Post-Kidney Transplantation Iliac Artery Stenosis due toIatrogenic Injury: Case Report

    SciTech Connect

    Khankan, Azzam Anwar Maeda, Munehiro; Osuga, Keigo; Murakami, Takamichi; Nakamura, Hironobu

    2003-04-15

    We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.

  10. Stereological assessment of normal Persian squirrels (Sciurus anomalus) kidney.

    PubMed

    Akbari, Mohsen; Goodarzi, Nader; Tavafi, Majid

    2017-03-01

    The functions of the mammalian kidney are closely related to its structure. This suggests that renal function can be completely characterized by accurate knowledge of its quantitative morphological features. The aim of this study was to investigate the histomorphometric features of the kidney using design-based and unbiased stereological methods in the Persian squirrel (Sciurus anomalus), which is the only representative of the Sciuridae family in the Middle East. The left kidneys of five animals were examined. Total volume of the kidney, cortex, and medulla were determined to be 960.75 ± 87.4, 754.31 ± 77.09 and 206.1 ± 16.89 mm(3), respectively. The glomerular number was 32844.03 ± 1069.19, and the total glomerular volume was estimated to be 36.7 ± 1.45 mm(3). The volume and length of the proximal convoluted tubule were estimated at 585.67 ± 60.7 mm(3) and 328.8 ± 14.8 m, respectively, with both values being greater than those reported in the rat kidney. The volume and length of the distal convoluted tubule were calculated at 122.34 ± 7.38 mm(3) and 234.4 ± 17.45 m, respectively, which are also greater than those reported in the rat kidney. Despite the comparable body weight, the total number and mean individual volume of glomeruli in the Persian squirrel kidney were greater than those in the rat kidney. Overall, the stereological variables of the kidneys elucidated in this study are exclusive to the Persian squirrel. Our findings, together with future renal physiological data, will contribute to a better understanding of the renal structure-function relationship in the Persian squirrel.

  11. Wars, disasters and kidneys.

    PubMed

    Lameire, N

    2014-12-01

    This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes.

  12. Epidemiology of Kidney Cancer

    PubMed Central

    Pascual, D.; Borque, A.

    2008-01-01

    Some tumors are known to have a definite cause-effect etiology, but renal cell carcinoma (RCC) is not one of them precisely. With regard to RCC we can only try to identify some clinical and occupational factors as well as substances related to tumorigenesis. Smoking, chemical carcinogens like asbestos or organic solvents are some of these factors that increase the risk of the RCC. Viral infections and radiation therapy have also been described as risk factors. Some drugs can increase the incidence of RCC as well as other neoplasms. Of course, genetics plays an outstanding role in the development of some cases of kidney cancer. Chronic renal failure, hypertension, and dialysis need to be considered as special situations. Diet, obesity, lifestyle, and habits can also increase the risk of RCC. The aim of this review is to summarize the well-defined causes of renal cell carcinoma. PMID:19009036

  13. Metals and kidney autoimmunity.

    PubMed Central

    Bigazzi, P E

    1999-01-01

    The causes of autoimmune responses leading to human kidney pathology remain unknown. However, environmental agents such as microorganisms and/or xenobiotics are good candidates for that role. Metals, either present in the environment or administered for therapeutic reasons, are prototypical xenobiotics that cause decreases or enhancements of immune responses. In particular, exposure to gold and mercury may result in autoimmune responses to various self-antigens as well as autoimmune disease of the kidney and other tissues. Gold compounds, currently used in the treatment of patients with progressive polyarticular rheumatoid arthritis, can cause a nephrotic syndrome. Similarly, an immune-mediated membranous nephropathy frequently occurred when drugs containing mercury were commonly used. Recent epidemiologic studies have shown that occupational exposure to mercury does not usually result in autoimmunity. However, mercury induces antinuclear antibodies, sclerodermalike disease, lichen planus, or membranous nephropathy in some individuals. Laboratory investigations have confirmed that the administration of gold or mercury to experimental animals leads to autoimmune disease quite similar to that observed in human subjects exposed to these metals. In addition, studies of inbred mice and rats have revealed that a few strains are susceptible to the autoimmune effects of gold and mercury, whereas the majority of inbred strains are resistant. These findings have emphasized the importance of genetic (immunogenetic and pharmacogenetic) factors in the induction of metal-associated autoimmunity. (italic)In vitro(/italic) and (italic)in vivo(/italic) research of autoimmune disease caused by mercury and gold has already yielded valuable information and answered a number of important questions. At the same time it has raised new issues about possible immunostimulatory or immunosuppressive mechanisms of xenobiotic activity. Thus it is evident that investigations of metal

  14. Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Schrier, Robert W.; Abebe, Kaleab Z.; Perrone, Ronald D.; Torres, Vicente E.; Braun, William E.; Steinman, Theodore I.; Winklhofer, Franz T.; Brosnahan, Godela; Czarnecki, Peter G.; Hogan, Marie C.; Miskulin, Dana C.; Rahbari-Oskoui, Frederic F.; Grantham, Jared J.; Harris, Peter C.; Flessner, Michael F.; Bae, Kyongtae T.; Moore, Charity G.; Chapman, Arlene B.

    2015-01-01

    BACKGROUND Hypertension is common in autosomal dominant polycystic kidney disease (ADPKD) and is associated with increased total kidney volume, activation of the renin–angiotensin–aldosterone system, and progression of kidney disease. METHODS In this double-blind, placebo-controlled trial, we randomly assigned 558 hypertensive participants with ADPKD (15 to 49 years of age, with an estimated glomerular filtration rate [GFR] >60 ml per minute per 1.73 m2 of body-surface area) to either a standard blood-pressure target (120/70 to 130/80 mm Hg) or a low blood-pressure target (95/60 to 110/75 mm Hg) and to either an angiotensin-converting–enzyme inhibitor (lisinopril) plus an angiotensin-receptor blocker (telmisartan) or lisinopril plus placebo. The primary outcome was the annual percentage change in the total kidney volume. RESULTS The annual percentage increase in total kidney volume was significantly lower in the low-blood-pressure group than in the standard-blood-pressure group (5.6% vs. 6.6%, P = 0.006), without significant differences between the lisinopril–telmisartan group and the lisinopril–placebo group. The rate of change in estimated GFR was similar in the two medication groups, with a negative slope difference in the short term in the low-blood-pressure group as compared with the standard-blood-pressure group (P<0.001) and a marginally positive slope difference in the long term (P = 0.05). The left-ventricular-mass index decreased more in the low-blood-pressure group than in the standard-blood-pressure group (−1.17 vs. −0.57 g per square meter per year, P<0.001); urinary albumin excretion was reduced by 3.77% with the low-pressure target and increased by 2.43% with the standard target (P<0.001). Dizziness and light-headedness were more common in the low-blood-pressure group than in the standard-blood-pressure group (80.7% vs. 69.4%, P = 0.002). CONCLUSIONS In early ADPKD, the combination of lisinopril and telmisartan did not significantly

  15. Mutism following left hemisphere infarction.

    PubMed Central

    David, A S; Bone, I

    1984-01-01

    A case of mutism due to left hemisphere infarction is described. Recovery revealed mild motor dysphasia. Review of the literature showed that the case resembles aphemia but is unique by virtue of its duration, and the absence of associated apraxia and paresis. Images PMID:6210346

  16. Solitary kidney with renal artery aneurysm repaired by ex vivo reconstruction.

    PubMed

    Palcau, Laura; Gouicem, Djelloul; Joguet, Etienne; Cameliere, Lucie; Berger, Ludovic

    2014-01-01

    A 22-year-old pregnant female with pyelonephritis was found to have a 26-mm left renal artery aneurysm with unknown right kidney agenesis diagnosed by magnetic resonance imaging. Computed tomographic angiography with 3-dimensional reconstructions confirmed a saccular aneurysm localized at the bifurcation of the left posterior segmental artery. The patient ultimately underwent successful ex vivo left renal artery aneurysm repair with autotransplantation. Pathologic evaluation of the resected aneurysm confirmed the diagnosis of fibromuscular dysplasia. Fibromuscular dysplasia is the most common cause of renal artery stenosis and renovascular hypertension and can, in rare cases, be associated with the development of renal artery aneurysms.

  17. Kidney-Shaped Impact

    NASA Technical Reports Server (NTRS)

    2006-01-01

    23 February 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows an unusally-shaped (not circular) impact crater in the Elysium region of Mars. A dark-toned lava flow surface is seen in the southern (lower) portion of the image.

    Location near: 5.9oN, 220.0oW Image width: 3 km (1.9 mi) Illumination from: lower left Season: Northern Winter

  18. A kidney from hell? A nephrological view of the Whitechapel murders in 1888.

    PubMed

    Wolf, Gunter

    2008-10-01

    In the poor Whitechapel district of the East End of London in the fall of 1888, at least five prostitutes were brutally murdered, and in all but one case, also mutilated. The murderer was never caught and became known by his nickname 'Jack the Ripper'. The left kidney and the uterus were cut out and taken away from one of the victims named Catherine Eddowes. A kidney was also cut out of the body from another victim, but not taken away. Two weeks later, George Lusk, president of the Whitechapel Vigilance Committee, received a small cardboard box with half of a longitudinally divided kidney and a letter entitled 'From hell' claiming that the kidney inside the box was taken from the victim. The kidney was brought to Dr Thomas Horrocks Openshaw, the Curator of the London Pathological Museum, where the kidney could be microscopically examined. The press jumped on the topic and made a circumstantial case that this kidney had been indeed torn from the body of Catherine Eddowes. According to the later memoirs of Major Henry Smith of the City Police published more than 20 years after the incident, the kidney left in the corpse of Catherine Eddowes was in an advanced stage of Bright's disease and the kidney sent to George Lusk was in exactly a similar stage. Today, the majority of criminologists believe that the kidney sent to Mr Lusk was a hoax as were other letters signed with Jack the Ripper. However, the murderer took organs from his victims, and in the case of Catherine Eddowes, the kidney. Serial killers often mutilate their victims and abscond with the removed body parts as trophies. By removing the kidney from Catherine Eddowes, Jack the Ripper may have tried to take possession of the conscience, emotions and desires of one of his victims, attributes residing in the kidney as described in the Bible. Jack the Ripper was never caught; many suspects have been suggested, and the murder series ended as suddenly as it had begun. We will never know who this mentally

  19. [MicroRNAs and kidneys].

    PubMed

    Stříteská, Jana; Nekvindová, Jana; Cerný, Vladimír; Palička, Vladimír

    2014-01-01

    MicroRNAs are short non-coding ribonucleic acid molecules that regulate gene expression at the post-transcriptional level thus affecting important physiological as well as pathophysiological processes in the organism, for example cell differentiation, proliferation, apoptosis, and metabolism. They are involved in pathogenesis of many diseases including cancer. Many microRNAs are tissue or organ-specific which implies their possible potential as biomarkers or maybe even therapeutical agents as documented by microRNA research interest rising exponentially during last years. Among all, microRNAs are important also for physiological function of the kidney and they are involved in various renal disorders. Today research is focused mainly on renal and urinary tract carcinogenesis, acute kidney injury, chronic renal diseases (polycystic kidney disease) or renal complications of systemic diseases such as diabetic or hypertension nephropathy and autoimmune kidney injury including acute allograft rejection after kidney transplantation. The review summarizes current information about microRNA effect on kidney development and function and also on the most common kidney diseases.

  20. Systems biology of kidney diseases.

    PubMed

    He, John Cijiang; Chuang, Peter Y; Ma'ayan, Avi; Iyengar, Ravi

    2012-01-01

    Kidney diseases manifest in progressive loss of renal function, which ultimately leads to complete kidney failure. The mechanisms underlying the origins and progression of kidney diseases are not fully understood. Multiple factors involved in the pathogenesis of kidney diseases have made the traditional candidate gene approach of limited value toward full understanding of the molecular mechanisms of these diseases. A systems biology approach that integrates computational modeling with large-scale data gathering of the molecular changes could be useful in identifying the multiple interacting genes and their products that drive kidney diseases. Advances in biotechnology now make it possible to gather large data sets to characterize the role of the genome, epigenome, transcriptome, proteome, and metabolome in kidney diseases. When combined with computational analyses, these experimental approaches will provide a comprehensive understanding of the underlying biological processes. Multiscale analysis that connects the molecular interactions and cell biology of different kidney cells to renal physiology and pathology can be utilized to identify modules of biological and clinical importance that are perturbed in disease processes. This integration of experimental approaches and computational modeling is expected to generate new knowledge that can help to identify marker sets to guide the diagnosis, monitor disease progression, and identify new therapeutic targets.

  1. Autophagy in Acute Kidney Injury

    PubMed Central

    Livingston, Man J.; Dong, Zheng

    2014-01-01

    Acute kidney injury is a major kidney disease associated with poor clinical outcomes. The pathogenesis of acute kidney injury is multifactorial and is characterized by tubular cell injury and death. Recent studies have demonstrated autophagy induction in proximal tubular cells during acute kidney injury. The regulatory mechanisms of tubular cell autophagy are poorly understood; however, some recent findings have set up a foundation for further investigation. Although autophagy may promote cell death under certain experimental conditions, pharmacological and autophagy-related gene knockout studies have established a renoprotective role for autophagy in acute kidney injury. The mechanisms by which autophagy protects cells from injury and how, possibly, its pro-survival role switches to pro-death under certain conditions are discussed. Further research is expected to help us understand the regulatory network of tubular cell autophagy, define its precise roles in specific context of acute kidney injury, and identify autophagy-targeting strategies for the prevention and treatment of acute kidney injury. PMID:24485026

  2. What Research Tells Us About Left Handedness.

    ERIC Educational Resources Information Center

    Arnold, Rita

    Left handed people have had bad publicity throughout history, and the resulting myths and disadvantages of left handedness have often not been properly dealt with in the classroom. Our language itself maintains a bias against the left, and many other cultures have defined the left as disreputable. Today's life style also provides many physical…

  3. Definition and Facts for Kidney Stones in Adults

    MedlinePlus

    ... Trials Kidney Stones in Children Definition & Facts for Kidney Stones What are kidney stones? Kidney stones are hard, pebble-like pieces ... stone may get stuck along the way. Do kidney stones have another name? The scientific name for ...

  4. Low scale left-right-right-left symmetry

    NASA Astrophysics Data System (ADS)

    Abbas, Gauhar

    2017-01-01

    We propose an effective left-right-right-left model with a parity breaking scale around a few TeV. One of the main achievements of the model is that the mirror fermions as well as the mirror gauge sector simultaneously could be at TeV scale. It is shown that the most dangerous quadratic divergence of the SM Higgs boson involving the top quark in the loop is naturally suppressed, and begins at three loop. The model postpones the fine-tuning of the mass of the SM Higgs boson up to a sufficiently high scale. The model explains the smallness of the neutrino masses whether they are Dirac or Majorana. Furthermore, the strong C P phase is zero in this model.

  5. Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis

    PubMed Central

    Cheungpasitporn, Wisit; Thongprayoon, Charat; Mao, Michael A; Kittanamongkolchai, Wonngarm; Jaffer Sathick, Insara J; Dhondup, Tsering; Erickson, Stephen B

    2016-01-01

    AIM To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients. METHODS A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a random-effects model to estimate the incidence of kidney stones. RESULTS Twenty one studies with 64416 kidney transplant patients were included in the analyses to assess the incidence of kidney stones after kidney transplantation. The estimated incidence of kidney stones was 1.0% (95%CI: 0.6%-1.4%). The mean duration to diagnosis of kidney stones after kidney transplantation was 28 ± 22 mo. The mean age of patients with kidney stones was 42 ± 7 years. Within reported studies, approximately 50% of kidney transplant recipients with kidney stones were males. 67% of kidney stones were calcium-based stones (30% mixed CaOx/CaP, 27%CaOx and 10%CaP), followed by struvite stones (20%) and uric acid stones (13%). CONCLUSION The estimated incidence of kidney stones in patients after kidney transplantation is 1.0%. Although calcium based stones are the most common kidney stones after transplantation, struvite stones (also known as “infection stones”) are not uncommon in kidney transplant recipients. These findings may impact the prevention and clinical management of kidney stones after kidney transplantation. PMID:28058231

  6. A step-by-step regressed pediatric kidney depth formula validated by a reasonable index

    PubMed Central

    Hongwei, Si; Yingmao, Chen; Li, Li; Guangyu, Ma; Liuhai, Shen; Zhifang, Wu; Mingzhe, Shao; Sijin, Li

    2017-01-01

    Abstract In predicting pediatric kidney depth, we are especially interested in that the errors of most estimates are within a narrow range. Therefore, this study was intended to use the proportion of estimates within a range of −5 to 5 mm (P5 mm) to evaluate the formulas and tried to regress a kidney depth formula for children. The enrolled children aged from 1 to 19 years were randomly sampled into group A and group B (75% and 25% of all recruits, respectively). Using data of the group A, the test formula was regressed by nonlinear regression and subsequently Passing & Bablok regression, and validated in group B. The Raynaud, Gordon, Tonnesen, Taylor, and the test formulas were evaluated in the 2 groups. Accuracy was evaluated by bias, absolute bias, and P5 mm; and precision was evaluated by correlation coefficient. In addition, root-mean square error was used as a mixed index for both accuracy and precision. Body weight, height, and age did not have significant differences between the 2 groups. In the nonlinear regression, coefficients of the formula (kidney depth = a × weight/height + b × age) from group A were in narrower 95% confidence intervals. After the Passing & Bablok regression, biases of left and right kidney estimates were significantly decreased. In the evaluation of formulas, the test formula was obviously better than other formulas mentioned above, and P5 mm for left and right kidneys was about 60%. Among children younger than 10 years, P5 mm was even more than 70% for left and right kidney depths. To predict pediatric kidney depth, accuracy and precision of a step-by-step regressed formula were better than the 4 “standard” formulas. PMID:28353617

  7. The blind kidney: disorders affecting kidneys and eyes.

    PubMed

    Russell-Eggitt, Isabelle; Bockenhauer, Detlef

    2013-12-01

    There are many disorders that can affect both the kidneys and the eyes. Awareness of the ocular manifestations of kidney disorders is important as it can guide the diagnosis and facilitate the choice of a specific treatment. Conversely, ophthalmologists need to be aware of potential renal manifestations in disorders presenting initially with visual failure. We review disorders affecting both of these organ systems, based upon cases from our clinical practice to highlight the importance of interdisciplinary collaboration.

  8. Robotic kidney implantation for kidney transplantation: initial experience.

    PubMed

    Hagen, Monika E; Pugin, Francois; Bucher, Pascal; Fasel, Jean; Markar, Sheraz; Morel, Philippe

    2010-12-01

    Despite improvements in minimally invasive techniques over recent decades, kidney implantation into the iliac fossa has remained a domain of open surgery. However, it was hypothesized that it would be feasible to perform robotic transplant kidney implantation as a means of reducing surgical trauma. Two robotic kidney transplantations into the iliac fossa were attempted in human cadavers. In the first cadaver, a 5 cm incision was placed in the right lower abdomen, the peritoneum was mobilized in a cranial direction, the iliac vessels were identified, and the kidney placed in the pre-peritoneal space. The incision was sealed with a gel port through which the Vinci(©) Surgical System was installed. In the second cadaver, a robotic kidney implantation with robotically sutured vascular and ureteric anastomoses was performed trans-abdominally. Open incision, identification, placement of gel port, and robotic docking were feasible. Robotic performance of vascular anastomosis was not possible in the first cadaver because of advanced decay and excess fat in the surgical field. Robotic kidney positioning was feasible and anastomoses were performed successfully in the second cadaver within 35, 25, and 20 min (arterial, venous, and ureteric, respectively). Robotic kidney transplantation seems feasible in human cadavers if tissue condition is suitable, but is very technically challenging. Because of the delicacy of anatomical structures, the cadaveric model with the risk of advanced decay and the absence of circulation sets limits on the exploration of this complex procedure. Hence, further research and animal work in this area is critical to improve understanding of the benefits and limitations of robotic kidney implantation.

  9. [Autosomal dominant polycystic kidney disease: is the treatment for tomorrow?].

    PubMed

    Cornec-Le Gall, Emilie; Le Meur, Yannick

    2014-11-01

    Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent Mendelian inherited disorder. It covers 6.1% of incident ESRD patients in France in 2011. Long left untreated, this disease will soon benefit from targeted therapies currently under evaluation. Several molecules have already reached the stage of clinical trials: the evaluation of mTOR inhibitors yielded deceiving results and, more recently, 2 different molecules demonstrated a slight impact on the progression of total kidney volume (TKV): tolvaptan, vasopressin receptor-V2 inhibitor and somatostatin analogues; both of these molecules acting throughout the decrease of intracellular AMPc. The purpose of this review is to briefly describe the signaling pathways involved, then to present both the published and ongoing clinical trials and the promising molecules evaluated in murine models.

  10. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial.

    PubMed

    Moosanejad, N; Firouzian, A; Hashemi, S A; Bahari, M; Fazli, M

    2016-01-01

    This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques regarding their rates of success and complications in patients with kidney stones. Patients were randomly assigned to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years) received totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or ureteral catheter after PCNL) and 40 patients (18 men; mean age: 49.95 ± 13.38 years) underwent standard PCNL (a nephrostomy catheter and ureteral catheter were used after PCNL). All surgeries were performed by one surgeon. Postoperative changes in hemoglobin, the blood transfusion rate, changes in creatinine levels, operation time, analgesic need, hospitalization time, and complication rate were compared between the groups. No significant differences were observed in age, gender, stone size, and surgery side between the groups (P<0.05). The operation time was significantly lower in the totally tubeless PCNL group than in the standard PCNL group (P=0.005). Pethidine requirements were significantly higher in the standard PCNL group than the totally tubeless PCNL group (P=0.007). Hospitalization time was significantly higher in the standard PCNL group than in the totally tubeless PCNL group (P<0.0001). The complication rate was 15% in the standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73). The totally tubeless PCNL technique is safe and effective, even for patients with staghorn stones. This technique is associated with decreased pain, analgesic needs, and operative and hospitalization time. We believe that a normal peristaltic ureter is the best drainage tube.

  11. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial

    PubMed Central

    Moosanejad, N.; Firouzian, A.; Hashemi, S.A.; Bahari, M.; Fazli, M.

    2016-01-01

    This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques regarding their rates of success and complications in patients with kidney stones. Patients were randomly assigned to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years) received totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or ureteral catheter after PCNL) and 40 patients (18 men; mean age: 49.95±13.38 years) underwent standard PCNL (a nephrostomy catheter and ureteral catheter were used after PCNL). All surgeries were performed by one surgeon. Postoperative changes in hemoglobin, the blood transfusion rate, changes in creatinine levels, operation time, analgesic need, hospitalization time, and complication rate were compared between the groups. No significant differences were observed in age, gender, stone size, and surgery side between the groups (P<0.05). The operation time was significantly lower in the totally tubeless PCNL group than in the standard PCNL group (P=0.005). Pethidine requirements were significantly higher in the standard PCNL group than the totally tubeless PCNL group (P=0.007). Hospitalization time was significantly higher in the standard PCNL group than in the totally tubeless PCNL group (P<0.0001). The complication rate was 15% in the standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73). The totally tubeless PCNL technique is safe and effective, even for patients with staghorn stones. This technique is associated with decreased pain, analgesic needs, and operative and hospitalization time. We believe that a normal peristaltic ureter is the best drainage tube. PMID:27007650

  12. Page kidney due to a renal pseudocyst in a setting of pancreatitis

    PubMed Central

    Aswani, Yashant; Anandpara, Karan Manoj; Hira, Priya

    2015-01-01

    Pancreatic pseudocysts are notorious for their extension beyond the normal confines of the pancreatic bed due to dissection of the enzymatic pseudocyst fluid along fascial planes. Such collections of pancreatic juice may compress the kidney. Extension of the pseudocyst into the perirenal space is, however, uncommon. We report a case of pseudocyst of pancreas lying in the subcapsular plane of the left kidney with a patent communication with the pancreatic duct (pancreaticorenal fistula). The compressive effect of the pseudocyst on the kidney compromised intrarenal perfusion as evidenced by a faint nephrogram but a normal renal artery. This led to renin–angiotensin–aldosterone mediated hypertension—the Page kidney phenomenon. Extensive literature search revealed our case to be the only one to describe such an occurrence. PMID:25618881

  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. Biomarkers in chronic kidney disease, from kidney function to kidney damage

    PubMed Central

    Lopez-Giacoman, Salvador; Madero, Magdalena

    2015-01-01

    Chronic kidney disease (CKD) typically evolves over many years, with a long latent period when the disease is clinically silent and therefore diagnosis, evaluation and treatment is based mainly on biomarkers that assess kidney function. Glomerular filtration rate (GFR) remains the ideal marker of kidney function. Unfortunately measuring GFR is time consuming and therefore GFR is usually estimated from equations that take into account endogenous filtration markers like serum creatinine (SCr) and cystatin C (CysC). Other biomarkers such as albuminuria may precede kidney function decline and have demonstrated to have strong associations with disease progression and outcomes. New potential biomarkers have arisen with the promise of detecting kidney damage prior to the currently used markers. The aim of this review is to discuss the utility of the GFR estimating equations and biomarkers in CKD and the different clinical settings where these should be applied. The CKD-Epidemiology Collaboration equation performs better than the modification of diet in renal disease equation, especially at GFR above 60 mL/min per 1.73 m2. Equations combining CysC and SCr perform better than the equations using either CysC or SCr alone and are recommended in situations where CKD needs to be confirmed. Combining creatinine, CysC and urine albumin to creatinine ratio improves risk stratification for kidney disease progression and mortality. Kidney injury molecule and neutrophil gelatinase-associated lipocalin are considered reasonable biomarkers in urine and plasma to determine severity and prognosis of CKD. PMID:25664247

  15. Treatment Methods for Kidney Failure: Transplantation

    MedlinePlus

    ... is a kidney transplant and how does it work? A kidney transplant is surgery to place a healthy kidney from a donor into your ... many members, including your surgeon—the doctor who places the kidney in ... health. The nephrologist may work in partnership with a nurse practitioner or a ...

  16. Ultrasonography of the Kidney: A Pictorial Review

    PubMed Central

    Hansen, Kristoffer Lindskov; Nielsen, Michael Bachmann; Ewertsen, Caroline

    2015-01-01

    Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound are highlighted. PMID:26838799

  17. How Is Kidney Cancer Diagnosed?

    MedlinePlus

    ... a person is healthy enough for surgery . Blood chemistry tests Blood chemistry tests are usually done in people who might ... a doctor to order a bone scan. Blood chemistry tests also look at kidney function, which is ...

  18. Autosomal Dominant Polycystic Kidney Disease

    MedlinePlus

    ... with available imaging techniques (ultrasound and computerized tomography). Diagnosis of earlier stages of disease in children and young adults was much more difficult. Few treatments were available for chronic kidney disease in general, and there was no specific therapy ...

  19. Electroporation of Embryonic Kidney Explants

    NASA Astrophysics Data System (ADS)

    Haddad, Nicholas; Houle, Daniel; Gupta, Indra R.

    Metanephric kidney development in the mouse begins at embryonic day (E) 10.5, when the ureteric bud (UB), an outgrowth of the epithelial nephric duct, invades the neighboring metanephric mesenchyme (MM). The ureteric bud then undergoes a series of branching events to form the collecting duct network of the adult kidney (Fig. 19.1). As each ureteric bud tip forms, the adjacent undifferentiated mesenchyme is induced to epithelialize and form a nephron, the functional unit of the adult kidney that filters waste. Rodent embryonic kidneys can be dissected and cultured as explants such that branching morphogenesis and nephrogenesis can be observed ex vivo (Rothenpieler and Dressler, 1993; Vega et al., 1996; Piscione et al., 1997; Gupta et al., 2003).

  20. Boari flap reconstruction in a male infant with solitary kidney and associated megaureter.

    PubMed

    Saini, Durgesh Kumar; Sinha, Rahul Janak; Sokhal, Ashok Kumar; Singh, Vishwajeet

    2016-12-15

    A 1-year-old male infant presented with fever and abdominal lump for 3 months with increased leucocyte count (15 300/mm(3)) and serum creatinine (0.83 mg%). Abdominal ultrasound and renal scan demonstrated solitary left kidney with dilated tortuous left ureter. Voiding cystourethrogram was unequivocal. Left percutaneous nephrostomy was placed after poor response to perurethral catheterisation. His serum creatinine dropped to 0.58 mg/dL. Subsequent percutaneous nephrostogram and CT nephrostogram showed dilated left pelvicalyceal system, dilated, tortuous left ureter. A diagnosis of obstructed megaureter was made and ureteric plication and reimplantation planned. Intraoperatively, there were primitive ureteral valves until proximal one-third of the ureter. The distance between the upper ureter and bladder was ∼6 cm. This defect was bridged by Boari flap. The postoperative period was uneventful and now after 6 months of follow-up, he is doing fine.

  1. The left-sided pancreas

    SciTech Connect

    Dunn, G.D.; Gibson, R.N.

    1986-06-01

    Ultrasonography (US) performed in nine patients (two with pancreatic carcinoma, one with hepatomegaly), six with no relevant abdominal disease) showed the pancreas to lie wholly to the left of the aorta. This not uncommon location may give rise to difficulty in demonstrating the pancreas on real-time US scans. The superior mesenteric vessels and splenic vein remain useful land-marks for locating the head of the pancreas in this position.

  2. Tumours of the kidney

    PubMed Central

    Nielsen, Svend W.; Mackey, L. J.; Misdorp, W.

    1976-01-01

    The most frequent renal tumours of animals are renal cell carcinoma and nephroblastoma. Renal cell carcinomas are seen mainly in dogs and cattle and nephroblastoma is encountered in pigs, puppies, and calves. Renal cell carcinomas are usually papillary in the dog. They show a marked propensity for vascular invasion, penetration of the posterior vena cava, and subsequent pulmonary metastasis. Nephroblastoma, which is morphologically identical to Wilms' tumour of children, is almost always a benign tumour in animals. It is one of the most frequent neoplasms of pigs, possibly owing to the fact that most pigs are slaughtered (and examined) when a few months old. Lymphosarcoma involving the kidney is particularly frequent in the cat, but is also seen in other species as part of a generalized disease. ImagesFig. 5,6Fig. 7Fig. 8Fig. 1,2Fig. 3,4Fig. 16,17,18,19Fig. 9,10Fig. 11Fig. 12Fig. 13Fig. 14,15 PMID:1086154

  3. Stress and the Kidney

    PubMed Central

    Bruce, Marino A.; Griffith, Derek M.; Thorpe, Roland J.

    2016-01-01

    The prevalence of CKD has increased considerably over the past 2 decades. The rising rates of CKD have been attributed to known comorbidities such as diabetes, hypertension, and obesity; however, recent research has begun to explore the degree to which social, economic, and psychological factors have implications for the prevalence and progression of CKD, especially among high-risk populations such as African Americans. It has been suggested that stress can have implications for CKD, but this area of research has been largely unexplored. One contributing factor associated with the paucity of research on CKD is that many of the social, psychological, and environmental stressors cannot be recreated or simulated in a laboratory setting. Social science has established that stress can have implications for health, and we believe that stress is an important determinant of the development and progression of CKD. We draw heavily from the social scientific and social epidemiologic literature to present an intersectional conceptual frame specifying how stress can have implications for kidney disease, its progression, and its complications through multiple stressors and pathways. PMID:25573512

  4. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature

    PubMed Central

    Altun, A.; Kurna, S. A.; Sengor, T.; Altun, G.; Oflaz, A.; Sonmez, H. S.

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature. PMID:26090250

  5. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature.

    PubMed

    Altun, A; Kurna, S A; Sengor, T; Altun, G; Oflaz, A; Sonmez, H S

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature.

  6. Loss of the Ciliary Kinase Nek8 Causes Left-Right Asymmetry Defects

    PubMed Central

    Manning, Danielle K.; Sergeev, Mikhail; van Heesbeen, Roy G.; Wong, Michael D.; Oh, Jin-Hee; Liu, Yan; Henkelman, R. Mark; Drummond, Iain; Shah, Jagesh V.

    2012-01-01

    A missense mutation in mouse Nek8, which encodes a ciliary kinase, produces the juvenile cystic kidneys (jck) model of polycystic kidney disease, but the functions of Nek8 are incompletely understood. Here, we generated a Nek8-null allele and found that homozygous mutant mice die at birth and exhibit randomization of left-right asymmetry, cardiac anomalies, and glomerular kidney cysts. The requirement for Nek8 in left-right patterning is conserved, as knockdown of the zebrafish ortholog caused randomized heart looping. Ciliogenesis was intact in Nek8-deficient embryos and cells, but we observed misexpression of left-sided marker genes early in development, suggesting that nodal ciliary signaling was perturbed. We also generated jck/Nek8 compound heterozygotes; these mutants developed less severe cystic disease than jck homozygotes and provided genetic evidence that the jck allele may encode a gain-of-function protein. Notably, NEK8 and polycystin-2 (PC2) proteins interact, and we found that Nek8−/− and Pkd2−/− embryonic phenotypes are strikingly similar. Nek8-deficient embryos and cells did express PC2 normally, which localized properly to the cilia. However, similar to cells lacking PC2, NEK8-depleted inner medullary collecting duct cells exhibited a defective response to fluid shear, suggesting that NEK8 may play a role in mediating PC2-dependent signaling. PMID:23274954

  7. Medullary sponge kidney presenting in a neonate with distal renal tubular acidosis and failure to thrive: a case report

    PubMed Central

    2009-01-01

    Introduction Medullary sponge kidney is a congenital anomaly characterized by diffuse ectasy of the collecting tubules of one or both kidneys. It is usually diagnosed in the second or third decade of life. Case presentation Distal renal tubular acidosis is commonly observed in patients with medullary sponge kidney. We describe here a 50-day-old Egyptian Caucasian girl with medullary sponge kidney who had features of distal renal tubular acidosis, (persistent alkaline urine, hypercalciuria, hypocitraturia) and failure to thrive. Renal ultrasound revealed left renal increased medullary echogenicity and bilateral nephrocalcinosis. Conclusion Early gene(s) expression of medullary sponge kidney disease might be responsible for persistent metabolic acidosis during the neonatal period. PMID:19830120

  8. Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury.

    PubMed

    Heilman, R L; Smith, M L; Kurian, S M; Huskey, J; Batra, R K; Chakkera, H A; Katariya, N N; Khamash, H; Moss, A; Salomon, D R; Reddy, K S

    2015-08-01

    Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ≥2.0 mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes.

  9. [Kidney donors and kidney transplantation in the elderly].

    PubMed

    Giessing, M; Conrad, S; Schönberger, B; Huland, H; Budde, K; Neumayer, H-H; Loening, S A

    2004-08-01

    The likelihood of terminal renal insufficiency escalates with age, increasing the risk of dying as a patient requiring dialysis. In 1999, Eurotransplant initiated the Eurotransplant Senior Programm (ESP), in which the kidneys of old donors (>64 years) are allocated to recipients 64 years and older. Allocation does not take HLA-matching into account and is performed regionally only according to blood-group-compatibility to keep the storage time short. As a consequence of the short ischemic time, and thus reduced non-immunological damage to the anyways susceptible old kidney, graft-function and graft-survival in the ESP are very good. The results of the initial 5 years of this program show that it successfully utilizes more kidneys from old donors and that more old recipients are being transplanted, with a satisfactory graft-function. Increased donor- and/or recipient age require a thorough evaluation to exclude malignant and other diseases. Furthermore, short term controls on the waiting list and following kidney transplantation are prerequisites for successful transplantation in the aged recipient. If this is guaranteed, kidney transplantation in the old recipient-even with old donor organs-is a good alternative to the morbidity of a prolonged dialysis. Nevertheless, the role of HLA-matching should be reconsidered to reduce rejections.

  10. Do Kidney Stone Formers Have A Kidney Disease?

    PubMed Central

    Zisman, Anna L.; Evan, Andrew P.; Coe, Fredric L.; Worcester, Elaine M.

    2015-01-01

    Nephrolithiasis is a highly prevalent disorder affecting approximately one in eleven people and is associated with multiple complications including hypertension, cardiovascular disease, and chronic kidney disease. Significant epidemiologic associations with chronic kidney disease and ESRD have been noted and are reviewed herein, but debate persists in the literature as to whether kidney stone formation is a pathogenic process contributing to kidney disease. Corroborating evidence supporting the presence of kidney disease in stone formers includes the variability of renal function by stone type, the positive association of stone size with renal dysfunction, the presence of markers of renal injury in the urine of even asymptomatic stone formers, and direct evidence of renal tissue injury on histopathology. Proposed pathogenic mechanisms include recurrent obstruction and comorbid conditions such as recurrent urinary tract infections and structural abnormalities. Recent work evaluating the renal histopathology of different groups of stone formers adds further granularity, suggesting variability in mechanisms of renal injury by stone type and confirming the pathogenic effects of crystal formation. Genetic abnormalities leading to stone formation including cystinuria and primary hyperoxaluria, among others, contribute to the burden of disease in the stone-forming population. PMID:26376133

  11. Renal failure in patients with left ventricular assist devices.

    PubMed

    Patel, Ami M; Adeseun, Gbemisola A; Ahmed, Irfan; Mitter, Nanhi; Rame, J Eduardo; Rudnick, Michael R

    2013-03-01

    Implantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation or as destination therapy in patients with end stage heart failure refractory to conventional medical therapy. A significant number of these patients have associated renal dysfunction before LVAD implantation, which may improve after LVAD placement due to enhanced perfusion. Other patients develop AKI after implantation. LVAD recipients who develop AKI requiring renal replacement therapy in the hospital or who ultimately require long-term outpatient hemodialysis therapy present management challenges with respect to hemodynamics, volume, and dialysis access. This review discusses the mechanics of a continuous-flow LVAD (the HeartMate II), the effects of continuous blood flow on the kidney, renal outcomes of patients after LVAD implantation, dialysis modality selection, vascular access, hemodynamic monitoring during the dialytic procedure, and other issues relevant to caring for these patients.

  12. Percutaneous Treatment of Pyocystis in Patients with Autosomal Dominant Polycystic Kidney Disease

    SciTech Connect

    Akinci, Devrim Turkbey, Baris; Yilmaz, Rahmi; Akpinar, Erhan; Ozmen, Mustafa N.; Akhan, Okan

    2008-09-15

    The course of autosomal dominant polycystic kidney disease (ADPKD) is frequently complicated by infection of a cyst within a polycystic kidney, which is a diagnostic and therapeutic dilemma damaging the clinical course of patients. The aim of this study was to demonstrate the safety and efficacy of percutaneous drainage in management of infected cysts in ADPKD patients. Between May 2003 and December 2006, percutaneous drainage was performed in 16 infected renal cysts of four kidneys in three patients (two females, one male), with a mean age of 57.3 years. Cyst dimensions, total amount of drained cyst fluid, catheterization duration, isolated microorganisms, and follow-up duration were recorded. Technical, clinical success rates were 100%; the complication rate was 0%. Diameters of cysts ranged between 3 and 8 cm. Average volume of drained fluid and average duration of catheterization for one cyst were 226 ml and 9.8 days. No recurrence was encountered but one patient (no. 3), who had pyocystis in the right kidney and was treated with catheterization, referred with left flank pain due to pyocystis in her left kidney 3 months later. Follow-up durations were 35, 47, and 11 months for patients 1, 2, and 3, respectively. For patient 3, follow-up duration for the second procedure was 7 months. We conclude that percutaneous drainage with antibiotic therapy should be the initial method in management of infected cysts in ADPKD patients, with high success and low complication rates.

  13. Current Bioengineering Methods for Whole Kidney Regeneration

    PubMed Central

    Yamanaka, Shuichiro; Yokoo, Takashi

    2015-01-01

    Kidney regeneration is likely to provide an inexhaustible source of tissues and organs for immunosuppression-free transplantation. It is currently garnering considerable attention and might replace kidney dialysis as the ultimate therapeutic strategy for renal failure. However, anatomical complications make kidney regeneration difficult. Here, we review recent advances in the field of kidney regeneration, including (i) the directed differentiation of induced pluripotent stem cells/embryonic stem cells into kidney cells; (ii) blastocyst decomplementation; (iii) use of a decellularized cadaveric scaffold; (iv) embryonic organ transplantation; and (v) use of a nephrogenic niche for growing xenoembryos for de novo kidney regeneration from stem cells. All these approaches represent potentially promising therapeutic strategies for the treatment of patients with chronic kidney disease. Although many obstacles to kidney regeneration remain, we hope that innovative strategies and reliable research will ultimately allow the restoration of renal function in patients with end-stage kidney disease. PMID:26089921

  14. Facts about Hypoplastic Left Heart Syndrome

    MedlinePlus

    ... working with this defect. After the Baby Is Born Babies with hypoplastic left heart syndrome might not ... a baby with hypoplastic left heart syndrome is born, multiple surgeries done in a particular order are ...

  15. Molecular Imaging of the Kidneys

    PubMed Central

    Szabo, Zsolt; Alachkar, Nada; Xia, Jinsong; Mathews, William B.; Rabb, Hamid

    2010-01-01

    Radionuclide imaging of the kidneys with gamma cameras involves the use of labeled molecules seeking functionally critical molecular mechanisms in order to detect the pathophysiology of the diseased kidneys and achieve an early, sensitive and accurate diagnosis. The most recent imaging technology, PET, permits quantitative imaging of the kidney at a spatial resolution appropriate for the organ. H215O, 82RbCl, and [64Cu] ETS are the most important radiopharmaceuticals for measuring renal blood flow. The renin angiotensin system is the most important regulator of renal blood flow; this role is being interrogated by detecting angiotensin receptor subtype AT1R using in vivo PET imaging. Membrane organic anion transporters are important for the function of the tubular epithelium; therefore, Tc-99m MAG3 as well as some novel radiopharmaceuticals such as copper-64 labeled mono oxo-tetraazamacrocyclic ligands have been utilized for molecular renal imaging. Additionally, other radioligands that interact with the organic cation transporters or peptide transporters have developed. Focusing on early detection of kidney injury at the molecular level is an evolving field of great significance. Potential imaging targets are the kidney injury molecule- 1 (KIM-1) that is highly expressed in kidney injury and renal cancer but not in normal kidneys. While pelvic clearance, in addition to parenchymal transport, is an important measure in obstructive nephropathy, techniques that focus on upregulated molecules in response to tissue stress resulted from obstruction will be of great implication. Monocyte chemoattractant protein -1 (MCP-1) is a well-suited molecule in this case. The greatest advances in molecular imaging of the kidneys have been recently achieved in detecting renal cancer. In addition to the ubiquitous [18F]FDG, other radioligands such as [11C]acetate and anti-[18F]FACBC have emerged. Radioimmuno-imaging with [124I]G250 could lead to radioimmunotherapy for renal cancer

  16. Living kidney donors and ESRD.

    PubMed

    Ross, Lainie Friedman

    2015-07-01

    There are more than 325 living kidney donors who have developed end-stage renal disease and have been listed on the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor kidney wait list. The OPTN/UNOS database records where these kidney donors are listed and, if they donated after April 1994, where that donation occurred. These 2 locations are often not the same. In this commentary, I examine whether a national living donor registry should be created and whether transplantation centers should be notified when one of their living kidney donors develops end-stage renal disease. I consider and refute 5 potential objections to center notification. I explain that transplantation centers should look back at these cases and input data into a registry to attempt to identify patterns that could improve donor evaluation protocols. Creating a registry and mining the information it contains is, in my view, our moral and professional responsibility to future patients and the transplantation endeavor. As individuals and as a community, we need to acknowledge the many unknown risks of living kidney donation and take responsibility for identifying these risks. We then must share information about these risks, educate prospective donors about them, and attempt to minimize them.

  17. Left supraclavicular spindle cell lipoma.

    PubMed

    Olaleye, Oladejo; Fu, Bertram; Moorthy, Ram; Lawson, Charles; Black, Myles; Mitchell, David

    2010-01-01

    Background. Spindle cell lipoma (SCL) is a benign lipomatous tumour, typically occurring in the posterior neck, shoulder or upper back of elderly males. They compose of fat, CD34 positive spindle cells, and ropey collagen on a myxoid matrix. This case highlights a rare presentation of SCL and the need for pre-operative diagnosis. Case Report. A 63-year-old gentleman presented with a pre-existing left supraclavicular mass that had recently increased in size. FNA and CT Scans were performed and results discussed in the mutidisciplinary team meeting. Excisional biopsy was recommended. Radiology. CT neck showed a left supraclavicular mass of fatty density with fine internal septations. A low-grade liposarcoma could not be excluded. Histopathology. FNA was indeterminate. Histology of specimen showed bland spindle cells with no evidence of malignancy. Immuno-histochemistry showed SCL with CD34 positivity and negative staining on CDK4 and p16. Management. Excision biopsy of the mass was performed which was technically difficult as the mass invaginated around the brachial plexus. The patient recovered well post-operatively with no neurological deficits. Conclusion. Spindle cell lipoma is a rare benign tumour and a pre-operative diagnosis based on the clinical context, imaging and immuno-histochemistry is crucial to management.

  18. Left-handed Children in Singapore.

    ERIC Educational Resources Information Center

    Gan, Linda

    1998-01-01

    Used teacher questionnaires to examine incidence of left-handedness in nearly 2,800 Singaporean children, racial differences in this left-handed population, and educational provisions in preschool and primary school. Findings indicated that 7.5% of preschoolers and 6.3% of primary children were left-handed, with a higher proportion being Chinese…

  19. The Left-Handed: "Their Sinister" History.

    ERIC Educational Resources Information Center

    Costas, Elaine Fowler

    The history of left-handedness can provide teachers and parents a better understanding of left-handed children and give those children more pride in their difference. No child should be made to feel that he or she is abnormal because of using the left hand, although some specific instruction for these students is necessary in handwriting. Many…

  20. Mononuclear phagocyte subpopulations in the mouse kidney.

    PubMed

    George, James F; Lever, Jeremie M; Agarwal, Anupam

    2017-04-01

    Mononuclear phagocytes are the most common cells in the kidney associated with immunity and inflammation. Although the presence of these cells in the kidney has been known for decades, the study of mononuclear phagocytes in the context of kidney function and dysfunction is still at an early stage. The purpose of this review is to summarize the present knowledge regarding classification of these cells in the mouse kidney and to identify relevant questions that would further advance the field and potentially lead to new opportunities for treatment of acute kidney injury and other kidney diseases.

  1. Total ureterectomy and ileal ureteric replacement for TCC ureter in a solitary kidney.

    PubMed

    Banerji, John S; George, Arun J P

    2014-11-01

    Traditional treatment of upper tract transitional cell carcinoma (TCC) is nephroureterectomy with a bladder cuff. This is in keeping with the nature of the disease, in that TCC is a panurothelial disease. However, there are a few rare occasions when this would mean making a subject anephric, as in a TCC in a solitary kidney or bilateral synchronous/metachronous disease. We present a case of a patient with a dysplastic, poorly functioning left kidney and with a TCC of the ureter on the right side.

  2. Computational analysis of kidney scintigrams

    SciTech Connect

    Vrincianu, D.; Puscasu, E.; Creanga, D.; Stefanescu, C.

    2013-11-13

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

  3. Computational analysis of kidney scintigrams

    NASA Astrophysics Data System (ADS)

    Vrincianu, D.; Puscasu, E.; Creanga, D.; Stefanescu, C.

    2013-11-01

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

  4. Radiation-Associated Kidney Injury

    SciTech Connect

    Dawson, Laura A.; Kavanagh, Brian D.; Paulino, Arnold C.; Das, Shiva K.; Miften, Moyed; Li, X. Allen; Pan, Charlie; Ten Haken, Randall K.; Schultheiss, Timothy E.

    2010-03-01

    The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.

  5. [Kidneys in diffuse systemic sclerosis].

    PubMed

    Dębowska, Małgorzata; Staszków, Monika

    Systemic scleroderma is a chronic, autoimmune disease of the connective tissue that involves skin, subcutaneous tissue, muscles and joints, as well as the internal organs: kidneys, lungs, heart. Depending on the extent it can occur as limited or diffuse clinical variant. In 60-80 % of patients with diffuse scleroderma, autopsy studies have shown pathologic changes in the kidneys. About half of the patients with renal involvement the clinical manifestation is limited to a moderate increase in serum creatinine, mild proteinuria, and moderate hypertension. The most serious complication remains sclerodermal renal crisis. It develops in 5-20 % of patients and is characterized by severe hypertension, acute kidney injury with oliguria, proteinuria and erythrocyturia, and microangiopathic hemolytic anemia with thrombocytopenia. In this article pathogenesis, risk factors, symptoms and treatment of scleroderma renal crisis have been reviewed.

  6. The exposome for kidney stones

    PubMed Central

    2015-01-01

    The exposome is the assembly and measure of all the exposures of an individual in a lifetime. An individual’s exposures begin before birth and include insults from environmental and occupational sources. The associated field is called exposomics, which relies on the application of internal and external exposure assessment methods. Exposomics has not yet been thoroughly applied to the study of kidney stones although much is known about how diet and fluid intake affect nephrolithiasis. Some other novel exposures that may contribute to kidney stones are discussed including use of antibiotics, urbanization and migration to urban heat islands, and occupation. People whose school and jobs limit their access to fluids and adequate bathroom facilities may have higher prevalence of stones. Examples include athletes, teachers, heathcare workers, and cab drivers. Occupational kidney stones have received scant attention and may represent a neglected, and preventable, type of stone. An exposomic-oriented history would include a careful delineation of occupation and activities. PMID:26615595

  7. Serum-stabilized naked caspase-3 siRNA protects autotransplant kidneys in a porcine model.

    PubMed

    Yang, Cheng; Zhao, Tian; Zhao, Zitong; Jia, Yichen; Li, Long; Zhang, Yufang; Song, Mangen; Rong, Ruiming; Xu, Ming; Nicholson, Michael L; Zhu, Tongyu; Yang, Bin

    2014-10-01

    The naked small interfering RNA (siRNA) of caspase-3, a key player in ischemia reperfusion injury, was effective in cold preserved and hemoreperfused kidneys, but not autotransplanted kidneys in our porcine models. Here, chemically modified serum stabilized caspase-3 siRNAs were further evaluated. The left kidney was retrieved and infused by University of Wisconsin solution with/without 0.3 mg caspase-3 or negative siRNA into the renal artery for 24-hour cold storage (CS). After an intravenous injection of 0.9 mg siRNA and right-uninephrectomy, the left kidney was autotransplanted for 2 weeks. The effectiveness of caspase-3 siRNA was confirmed by caspase-3 knockdown in the post-CS and/or post-transplant kidneys with reduced apoptosis and inflammation, while the functional caspase-3 siRNA in vivo was proved by detected caspase-3 mRNA degradation intermediates. HMGB1 protein was also decreased in the post-transplanted kidneys; correlated positively with renal IL-1β mRNA, but negatively with serum IL-10 or IL-4. The minimal off-target effects of caspase-3 siRNA were seen with favorable systemic responses. More importantly, renal function, associated with active caspase-3, HMGB1, apoptosis, inflammation, and tubulointerstitial damage, was improved by caspase-3 siRNA. Taken together, the 2-week autotransplanted kidneys were protected when caspase-3 siRNA administrated locally and systemically, which provides important evidence for future clinical trials.

  8. Xenopus: leaping forward in kidney organogenesis.

    PubMed

    Krneta-Stankic, Vanja; DeLay, Bridget D; Miller, Rachel K

    2017-04-01

    While kidney donations stagnate, the number of people in need of kidney transplants continues to grow. Although transplanting culture-grown organs is years away, pursuing the engineering of the kidney de novo is a valid means of closing the gap between the supply and demand of kidneys for transplantation. The structural organization of a mouse kidney is similar to that of humans. Therefore, mice have traditionally served as the primary model system for the study of kidney development. The mouse is an ideal model organism for understanding the complexity of the human kidney. Nonetheless, the elaborate structure of the mammalian kidney makes the discovery of new therapies based on de novo engineered kidneys more challenging. In contrast to mammals, amphibians have a kidney that is anatomically less complex and develops faster. Given that analogous genetic networks regulate the development of mammalian and amphibian nephric organs, using embryonic kidneys of Xenopus laevis (African clawed frog) to analyze inductive cell signaling events and morphogenesis has many advantages. Pioneering work that led to the ability to generate kidney organoids from embryonic cells was carried out in Xenopus. In this review, we discuss how Xenopus can be utilized to compliment the work performed in mammalian systems to understand kidney development.

  9. Mathematical Modeling of Kidney Transport

    PubMed Central

    Layton, Anita T.

    2013-01-01

    In addition to metabolic waste and toxin excretion, the kidney also plays an indispensable role in regulating the balance of water, electrolytes, nitrogen, and acid-base. In this review, we describe representative mathematical models that have been developed to better understand kidney physiology and pathophysiology, including the regulation of glomerular filtration, the regulation of renal blood flow by means of the tubuloglomerular feedback mechanisms and of the myogenic mechanism, the urine concentrating mechanism, epithelial transport, and regulation of renal oxygen transport. We discuss the extent to which these modeling efforts have expanded our understanding of renal function in both health and disease. PMID:23852667

  10. Neprilysin inhibition in chronic kidney disease

    PubMed Central

    Judge, Parminder; Haynes, Richard; Landray, Martin J.; Baigent, Colin

    2015-01-01

    Despite current practice, patients with chronic kidney disease (CKD) are at increased risk of progression to end-stage renal disease and cardiovascular events. Neprilysin inhibition (NEPi) is a new therapeutic strategy with potential to improve outcomes for patients with CKD. NEPi enhances the activity of natriuretic peptide systems leading to natriuresis, diuresis and inhibition of the renin–angiotensin system (RAS), which could act as a potentially beneficial counter-regulatory system in states of RAS activation such as chronic heart failure (HF) and CKD. Early NEPi drugs were combined with angiotensin-converting enzyme inhibitors but were associated with unacceptable rates of angioedema and, therefore, withdrawn. However, one such agent (omapatrilat) showed promise of NEP/RAS inhibition in treating CKD in animal models, producing greater reductions in proteinuria, glomerulosclerosis and tubulointerstitial fibrosis compared with isolated RAS inhibition. A new class of drug called angiotensin receptor neprilysin inhibitor (ARNi) has been developed. One such drug, LCZ696, has shown substantial benefits in trials in hypertension and HF. In CKD, HF is common due to a range of mechanisms including hypertension and structural heart disease (including left ventricular hypertrophy), suggesting that ARNi could benefit patients with CKD by both retarding the progression of CKD (hence delaying the need for renal replacement therapy) and reducing the risk of cardiovascular disease. LCZ696 is now being studied in a CKD population. PMID:25140014

  11. Neprilysin inhibition in chronic kidney disease.

    PubMed

    Judge, Parminder; Haynes, Richard; Landray, Martin J; Baigent, Colin

    2015-05-01

    Despite current practice, patients with chronic kidney disease (CKD) are at increased risk of progression to end-stage renal disease and cardiovascular events. Neprilysin inhibition (NEPi) is a new therapeutic strategy with potential to improve outcomes for patients with CKD. NEPi enhances the activity of natriuretic peptide systems leading to natriuresis, diuresis and inhibition of the renin-angiotensin system (RAS), which could act as a potentially beneficial counter-regulatory system in states of RAS activation such as chronic heart failure (HF) and CKD. Early NEPi drugs were combined with angiotensin-converting enzyme inhibitors but were associated with unacceptable rates of angioedema and, therefore, withdrawn. However, one such agent (omapatrilat) showed promise of NEP/RAS inhibition in treating CKD in animal models, producing greater reductions in proteinuria, glomerulosclerosis and tubulointerstitial fibrosis compared with isolated RAS inhibition. A new class of drug called angiotensin receptor neprilysin inhibitor (ARNi) has been developed. One such drug, LCZ696, has shown substantial benefits in trials in hypertension and HF. In CKD, HF is common due to a range of mechanisms including hypertension and structural heart disease (including left ventricular hypertrophy), suggesting that ARNi could benefit patients with CKD by both retarding the progression of CKD (hence delaying the need for renal replacement therapy) and reducing the risk of cardiovascular disease. LCZ696 is now being studied in a CKD population.

  12. Why kidneys fail in autosomal dominant polycystic kidney disease.

    PubMed

    Grantham, Jared J; Mulamalla, Sumanth; Swenson-Fields, Katherine I

    2011-08-23

    The weight of evidence gathered from studies in humans with hereditary polycystic kidney disease (PKD)1 and PKD2 disorders, as well as from experimental animal models, indicates that cysts are primarily responsible for the decline in glomerular filtration rate that occurs fairly late in the course of the disease. The processes underlying this decline include anatomic disruption of glomerular filtration and urinary concentration mechanisms on a massive scale, coupled with compression and obstruction by cysts of adjacent nephrons in the cortex, medulla and papilla. Cysts prevent the drainage of urine from upstream tributaries, which leads to tubule atrophy and loss of functioning kidney parenchyma by mechanisms similar to those found in ureteral obstruction. Cyst-derived chemokines, cytokines and growth factors result in a progression to fibrosis that is comparable with the development of other progressive end-stage renal diseases. Treatment of renal cystic disorders early enough to prevent or reduce cyst formation or slow cyst growth, before the secondary changes become widespread, is a reasonable strategy to prolong the useful function of kidneys in patients with autosomal dominant polycystic kidney disease.

  13. BP control and left ventricular hypertrophy regression in children with CKD.

    PubMed

    Kupferman, Juan C; Aronson Friedman, Lisa; Cox, Christopher; Flynn, Joseph; Furth, Susan; Warady, Bradley; Mitsnefes, Mark

    2014-01-01

    In adult patients with CKD, hypertension is linked to the development of left ventricular hypertrophy, but whether this association exists in children with CKD has not been determined conclusively. To assess the relationship between BP and left ventricular hypertrophy, we prospectively analyzed data from the Chronic Kidney Disease in Children cohort. In total, 478 subjects were enrolled, and 435, 321, and 142 subjects remained enrolled at years 1, 3, and 5, respectively. Echocardiograms were obtained 1 year after study entry and then every 2 years; BP was measured annually. A linear mixed model was used to assess the effect of BP on left ventricular mass index, which was measured at three different visits, and a mixed logistic model was used to assess left ventricular hypertrophy. These models were part of a joint longitudinal and survival model to adjust for informative dropout. Predictors of left ventricular mass index included systolic BP, anemia, and use of antihypertensive medications other than angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Predictors of left ventricular hypertrophy included systolic BP, female sex, anemia, and use of other antihypertensive medications. Over 4 years, the adjusted prevalence of left ventricular hypertrophy decreased from 15.3% to 12.6% in a systolic BP model and from 15.1% to 12.6% in a diastolic BP model. These results indicate that a decline in BP may predict a decline in left ventricular hypertrophy in children with CKD and suggest additional factors that warrant additional investigation as predictors of left ventricular hypertrophy in these patients.

  14. Mechanics of the left ventricle.

    PubMed

    Chadwick, R S

    1982-09-01

    A theory is presented for the mechanics of the left ventricle. A linear continuum description of the myocardium is developed, which incorporates anisotropic elastic effects due to the fiber direction field. The relation between fiber tension and fiber strain contains a time-dependent activation function that drives the ventricle around its cycle. The theory is applied to a simplified geometry consisting of a thick-walled finite cylinder in which fibers spiral on helical paths and terminate on planar end surfaces. The helix pitch angle varies continuously through the wall. The ventricular cycle is analyzed by specifying the pressures at which the aortic and mitral valves open and close. Key quantities are tabulated which permit a simple determination of the properties of the model under changes of wall thickness, fiber angles, muscle parameters, preload, afterload, etc. It is shown how the active muscle parameters can be inferred from a measurement of the end systolic pressure-volume line.

  15. Left Atrial Appendage Closure Devices

    PubMed Central

    Romero, Jorge; Perez, Irving E; Krumerman, Andrew; Garcia, Mario J; Lucariello, Richard J

    2014-01-01

    Atrial fibrillation (AF) increases the risk for thromboembolic stroke five-fold. The left atrial appendage (LAA) has been shown to be the main source of thrombus formation in the majority of strokes associated with AF. Oral anticoagulation with warfarin and novel anticoagulants remains the standard of care; however, it has several limitations, including bleeding and poor compliance. Occlusion of the LAA has been shown to be an alternative therapeutic approach to drug therapy. The purpose of this article is to review the different techniques and devices that have emerged for the purpose of occluding this structure, with a particular emphasis on the efficacy and safety studies published to date in the medical literature. PMID:24963274

  16. Giant and thrombosed left ventricular aneurysm.

    PubMed

    de Agustin, Jose Alberto; de Diego, Jose Juan Gomez; Marcos-Alberca, Pedro; Rodrigo, Jose Luis; Almeria, Carlos; Mahia, Patricia; Luaces, Maria; Garcia-Fernandez, Miguel Angel; Macaya, Carlos; de Isla, Leopoldo Perez

    2015-07-26

    Left ventricular aneurysms are a frequent complication of acute extensive myocardial infarction and are most commonly located at the ventricular apex. A timely diagnosis is vital due to the serious complications that can occur, including heart failure, thromboembolism, or tachyarrhythmias. We report the case of a 78-year-old male with history of previous anterior myocardial infarction and currently under evaluation by chronic heart failure. Transthoracic echocardiogram revealed a huge thrombosed and calcified anteroapical left ventricular aneurysm. Coronary angiography demonstrated that the left anterior descending artery was chronically occluded, and revealed a big and spherical mass with calcified borders in the left hemithorax. Left ventriculogram confirmed that this spherical mass was a giant calcified left ventricular aneurysm, causing very severe left ventricular systolic dysfunction. The patient underwent cardioverter-defibrillator implantation for primary prevention.

  17. Asymptomatic post-rheumatic giant left atrium

    PubMed Central

    Özkartal, Tardu; Tanner, Felix C; Niemann, Markus

    2016-01-01

    A 78-year-old asymptomatic woman was referred to our clinic for a second opinion regarding indication for mitral valve surgery. An echocardiogram showed a moderate mitral stenosis with a concomitant severe regurgitation. The most striking feature, however, was a giant left atrium with a parasternal anteroposterior diameter of 79 mm and a left atrial volume index of 364 mL/m². There are various echocardiographic definitions of a giant left atrium, which are mainly based on measurements of the anteroposterior diameter of the left atrium using M-mode in the parasternal long axis view. Since the commonly accepted method for echocardiographic evaluation of left atrial size is left atrial volume index, we propose a cut-off value of 140 mL/m2 for the definition of a “giant left atrium”. PMID:27354895

  18. Control Blood Pressure, Protect Your Kidneys

    MedlinePlus

    ... Bar Home Current Issue Past Issues Health Lines Control Blood Pressure, Protect Your Kidneys Past Issues / Fall ... Not Alone / Keep Weight Off / Facts About Fat / Control Blood Pressure, Protect Your Kidneys Fall 2008 Issue: ...

  19. Kidney Transplant Survival Up Among Babies, Kids

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_163937.html Kidney Transplant Survival Up Among Babies, Kids Patients under age ... News) -- Survival rates for children who get kidney transplants have improved significantly over the last half-century, ...

  20. Growth Failure in Children with Kidney Disease

    MedlinePlus

    ... Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease Weight ... Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease Weight ...

  1. Drugs Approved for Kidney (Renal Cell) Cancer

    MedlinePlus

    ... Ask about Your Treatment Research Drugs Approved for Kidney (Renal Cell) Cancer This page lists cancer drugs ... that are not listed here. Drugs Approved for Kidney (Renal Cell) Cancer Afinitor (Everolimus) Aldesleukin Avastin (Bevacizumab) ...

  2. Acute kidney injury after pediatric cardiac surgery

    PubMed Central

    Singh, Sarvesh Pal

    2016-01-01

    Acute kidney injury is a common complication after pediatric cardiac surgery. The definition, staging, risk factors, biomarkers and management of acute kidney injury in children is detailed in the following review article. PMID:27052074

  3. Kidney stones - what to ask your doctor

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000186.htm Kidney stones - what to ask your doctor To use the ... features on this page, please enable JavaScript. A kidney stone is a solid piece of material that forms ...

  4. Tyrosol attenuates ischemia-reperfusion-induced kidney injury via inhibition of inducible nitric oxide synthase.

    PubMed

    Wang, Pengqi; Zhu, Qingjun; Wu, Nan; Siow, Yaw L; Aukema, Harold; O, Karmin

    2013-04-17

    Tyrosol is a natural phenolic antioxidant compound. Oxidative stress represents one of the important mechanisms underlying ischemia-reperfusion-induced kidney injury. The aim of this study was to investigate the effect of tyrosol against ischemia-reperfusion-induced acute kidney injury. The left kidney of Sprague-Dawley rats was subjected to 45 min of ischemia followed by reperfusion for 6 h. Ischemia-reperfusion caused an increase in peroxynitrite formation and lipid peroxidation. The level of nitric oxide (NO) metabolites and the mRNA of inducible nitric oxide synthase (iNOS) were elevated in ischemia-reperfused kidneys. Administration of tyrosol (100 mg/kg body weight) to rats prior to the induction of ischemia significantly reduced peroxynitrite formation, lipid peroxidation, and the level of NO metabolites. Tyrosol administration also attenuated ischemia-reperfusion-induced NF-κB activation and iNOS expression. Such a treatment improved kidney function. Results suggest that tyrosol may have a protective effect against acute kidney injury through inhibition of iNOS-mediated oxidative stress.

  5. What Should You Ask Your Doctor about Kidney Cancer?

    MedlinePlus

    ... Staging What Should You Ask Your Doctor About Kidney Cancer? It’s important to have frank, open discussions ... Ask Your Doctor About Kidney Cancer? More In Kidney Cancer About Kidney Cancer Causes, Risk Factors, and ...

  6. Sepsis and Acute Kidney Injury.

    PubMed

    Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

    2014-12-01

    Acute kindney injury (AKI) is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate, causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid base disorders. In intensive care unit sepsis and septic shock are leading causes of AKI. Sepsis-induced AKI literally acts as a biologic indicator of clinical deterioration. AKI triggers variety of immune, inflammatory, metabolic and humoral patways; ultimately leading distant organ dysfunction and increases morbidity and mortality. Serial mesurements of creatinine and urine volume do not make it possible to diagnose AKI at early stages. Serum creatinine influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reason we need new markers, and many biomarkers in the diagnosis of early AKI activity is assessed. Historically "Risk-Injury-Failure-Loss-Endstage" (RIFLE), "Acute Kidney Injury Netwok" (AKIN) and "The Kidney Disease/ Improving Global Outcomes" (KDIGO) classification systems are used for diagnosing easily in clinical practice and research and grading disease. Classifications including diagnostic criteria are formed for the identification of AKI. Neutrophil gelatinase associated lipocalin (NGAL), cystatin-C (Cys-C), kidney injury molecule-1 (KIM-1) and also "cell cycle arrest" molecules has been concerned for clinical use. In this review the pathophysiology of AKI, with the relationship of sepsis and the importance of early diagnosis of AKI is evaluated.

  7. Sepsis and Acute Kidney Injury

    PubMed Central

    Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

    2014-01-01

    Acute kindney injury (AKI) is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate, causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid base disorders. In intensive care unit sepsis and septic shock are leading causes of AKI. Sepsis-induced AKI literally acts as a biologic indicator of clinical deterioration. AKI triggers variety of immune, inflammatory, metabolic and humoral patways; ultimately leading distant organ dysfunction and increases morbidity and mortality. Serial mesurements of creatinine and urine volume do not make it possible to diagnose AKI at early stages. Serum creatinine influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reason we need new markers, and many biomarkers in the diagnosis of early AKI activity is assessed. Historically “Risk-Injury-Failure-Loss-Endstage” (RIFLE), “Acute Kidney Injury Netwok” (AKIN) and “The Kidney Disease/ Improving Global Outcomes” (KDIGO) classification systems are used for diagnosing easily in clinical practice and research and grading disease. Classifications including diagnostic criteria are formed for the identification of AKI. Neutrophil gelatinase associated lipocalin (NGAL), cystatin-C (Cys-C), kidney injury molecule-1 (KIM-1) and also “cell cycle arrest” molecules has been concerned for clinical use. In this review the pathophysiology of AKI, with the relationship of sepsis and the importance of early diagnosis of AKI is evaluated. PMID:27366441

  8. Keeping Your Single Kidney Healthy

    MedlinePlus

    ... are not harmful to your kidney. Copyright 2008 © Children’s Oncology Group All rights reserved worldwide Page 1 of ... and Josee Pacifico RN, BSc (N). Copyright 2008 © Children’s Oncology Group All rights reserved worldwide Page 2 of ...

  9. Can kidney regeneration be visualized?

    PubMed Central

    Peti-Peterdi, János; Burford, James L.; Hackl, Matthias J.

    2014-01-01

    Background Various cell types, including podocytes and parietal epithelial cells (PECs), play important roles in the development and progression of glomerular kidney diseases, albuminuria and glomerulosclerosis. Besides their role in renal pathologies, glomerular cells have emerging new functions in endogenous repair mechanisms. Better understanding of the dynamics of the glomerular environment and cellular composition in the intact living kidney is critically important for the development of new regenerative therapeutic strategies for kidney diseases. However, progress in this field has been hampered by the lack of in vivo research tools. Summary This review summarizes the current state-of-the-art in the application of the unique intravital imaging technology of multiphoton fluorescence microscopy for the dynamic visualization of glomerular structure and function over time in the intact, living kidney. Recently, this imaging approach in combination with transgenic mouse models allowed to track the fate of individual glomerular cells in vivo over several days and depicted the highly dynamic nature of the glomerular environment, particularly in disease conditions. Key Messages The technology is ready and available for future intravital imaging studies investigating new glomerular regenerative approaches in animal models. PMID:24854647

  10. Kidney Tumors | Office of Cancer Genomics

    Cancer.gov

    Pediatric kidney tumors fall into four primary categories: Wilms tumors (~85% of all cases), clear cell sarcomas of the kidney (~5%), congenital mesoblastic nephromas (~4%), and rhabdoid tumors of the kidney (~3%). The TARGET initiative is investigating three of these tumor types.

  11. Transplantation of horseshoe kidney en bloc.

    PubMed

    Nahas, W C; Hakim, N S; Mazzucchi, E; Antonopoulos, L M; Eltayar, A R; Labruzzo, C; Chocair, P R; Arap, S

    2000-01-01

    Horseshoe kidney is probably the most common renal fusion anomaly. With the continuous donor shortage, transplant surgeons tend to accept donors previously considered unsuitable. We present a successful case of en bloc horseshoe kidney transplant in a single recipient. The literature is reviewed. The use of horseshoe kidneys in transplantation is recommended in selected cases.

  12. Kidneys and Urinary Tract (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Kidneys and Urinary Tract KidsHealth > For Parents > Kidneys and ... en español Los riñones y las vías urinarias Kidneys and Urinary Tract Basics Our bodies produce several ...

  13. Ectopic Pelvic Kidney Mimicking Sacral Metastasis on Post-Therapy Iodine-131 Scan of a Thyroid Cancer Patient

    PubMed Central

    Soyluoğlu Demir, Selin; Ege Aktaş, Gül; Polat, Ahmet; Sarıkaya, Ali

    2017-01-01

    A 25-year-old woman had total thyroidectomy and iodine-131 ablation therapy for papillary thyroid carcinoma. Whole body imaging on the 7th day of therapeutic activity demonstrated radioiodine uptake in the remnant tissue and intense heterogeneous uptake at the sacral region prominently in the posterior image. Initial interpretation was suspicious for sacral metastasis. Technetium-99m-methylene diphosphonate bone scan demonstrated normal bone uptake and the absence of left kidney. On blood-pool phase of bone scan, the absence of left renal activity and an extra area of uptake in the sacral region suggestive of pelvic kidney were noticed. Magnetic resonance imaging scan confirmed the ectopic pelvic kidney overlying the sacrum. PMID:28291010

  14. Blood pressure, blood flow, and oxygenation in the clipped kidney of chronic 2-kidney, 1-clip rats: effects of tempol and Angiotensin blockade.

    PubMed

    Palm, Fredrik; Onozato, Maristela; Welch, William J; Wilcox, Christopher S

    2010-02-01

    Angiotensin II maintains renal cortical blood flow and renal oxygenation in the clipped kidney of early 2-kidney, 1-clip Goldblatt hypertensive (2K,1C) rats. The involvement of Ang II is believed to decline, whereas oxidative stress increases during the progression of 2K,1C hypertension. We investigated the hypothesis that the acute administration of drugs to inhibit reactive oxygen species (Tempol), angiotensin II type 1 receptors (candesartan), or angiotensin-converting enzyme (enalaprilat) lowers mean arterial pressure and increases kidney blood flow and oxygenation in the clipped kidney of chronic 2K,1C rats in contrast to sham controls. Twelve months after left renal artery clipping or sham, mean arterial pressure, renal cortical blood flow, and renal cortical and medullary oxygen tension were measured after acute administration of Tempol followed by enalaprilat or candesartan followed by enalaprilat. The mean arterial pressure of the 2K,1C rat was reduced by candesartan (-9%) and, more effectively, by Tempol (-35%). All of the applied treatments had similar blood pressure-lowering effects in sham rats (average: -21%). Only Tempol increased cortical blood flow (+35%) and cortical and medullary oxygen tensions (+17% and +94%, respectively) in clipped kidneys of 2K,1C rats. Administration of enalaprilat had no additional effect, except for a modest reduction in cortical blood flow in the clipped kidney of 2K,1C rats when coadministered with candesartan (-10%). In conclusion, acute administration of Tempol is more effective than candesartan in reducing the mean arterial blood pressure and improving renal blood perfusion and oxygenation in the clipped kidney of chronic 2K,1C rats.

  15. Configuring a Better Estimation of Kidney Size in Obese Children and Adolescents

    PubMed Central

    Soheilipour, Fahimeh; Jesmi, Fatemeh; Rahimzadeh, Nahid; Pishgahroudsari, Mohadeseh; Almassinokian, Fariba; Mazaherinezhad, Ali

    2016-01-01

    Background Obesity ignites numerous health and psychosocial problems and is associated with various comorbidities. Body mass index (BMI) is also independently associated with improved risk for numerous kidney disorders. As renal length is considered a vital parameter in the clinical assessment of renal patients, normal renal length has to be defined in accordance to BMI. Objectives The aim of this study was to define normal kidney length in obese children, comparing ultrasound measurements of the kidney length in obese and non-obese children and adolescents, in order to reduce unnecessary evaluations for nephromegaly. Patients and Methods Fifty obese children and adolescents and 50 non-obese children and adolescents, aged 1-19 years, were selected from patients of pediatric clinics in two hospitals (Rasoul-e-Akram and Shahid Fahmideh) in Tehran between June 2010 and 2012. After the nephrologist’s and endocrinologist’s approval, the largest longitudinal renal dimension was measured in deep inspiration position by abdomino-pelvic ultrasonography in both groups. Results It was revealed that both kidneys in obese group were significantly larger than in control group (P = 0.044 and 0.040, respectively). Obesity status, height and age were proven to be significant and independent predictors of length of both kidneys. In both groups length of left kidney was significantly larger than that of right kidney (P < 0.001). Conclusions A specific standard cut-point limit or norm gram has to be formulated for obese children and adolescents in order to facilitate the diagnosis of kidney diseases, including organomegaly, in these patients. PMID:27307971

  16. Utilization of kidneys with similar kidney donor risk index values from standard versus expanded criteria donors.

    PubMed

    Woodside, K J; Merion, R M; Leichtman, A B; de los Santos, R; Arrington, C J; Rao, P S; Sung, R S

    2012-08-01

    With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4-2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

  17. Kidney stones: pathophysiology, diagnosis and management.

    PubMed

    Cunningham, Priscilla; Noble, Helen; Al-Modhefer, Abdul-Kadhum; Walsh, Ian

    2016-11-10

    The prevalence of kidney stones is increasing, and approximately 12 000 hospital admissions every year are due to this condition. This article will use a case study to focus on a patient diagnosed with a calcium oxalate kidney stone. It will discuss the affected structures in relation to kidney stones and describe the pathology of the condition. Investigations for kidney stones, differential diagnosis and diagnosis, possible complications and prognosis, will be discussed. Finally, a detailed account of management strategies for the patient with kidney stones will be given, looking at pain management, medical procedures and dietary interventions.

  18. Papillary thyroid carcinoma-like tumor of the kidney: a case report.

    PubMed

    Khoja, Hatim A; Almutawa, Abdulmonem; Binmahfooz, Ali; Aslam, Muhammad; Ghazi, Abdullah A; Almaiman, Sara

    2012-08-01

    Thyroid carcinoma-like tumor of the kidney is an extremely rare variant of renal cell carcinoma. Most previously reported cases were incidental finding; and none of them showed papillary thyroid carcinoma (PTC) nuclear features. This study reports the first case of PTC (follicular variant)-like tumor of the kidney in which a female patient presented with hematuria, weight loss, and flank pain. Imaging studies revealed a left renal mass with enlarged hilar lymph nodes. Histologically, the renal tumor had a striking resemblance to follicular variant of PTC. However, no radiological abnormalities were found in the thyroid, mediastinum, or pelvis. Tumor cells were negative for thyroid markers (thyroglobulin and TTF1). According to the authors, this is the first case of PTC (follicular variant)-like tumor of the kidney.

  19. Cilia in vertebrate left-right patterning.

    PubMed

    Dasgupta, Agnik; Amack, Jeffrey D

    2016-12-19

    Understanding how left-right (LR) asymmetry is generated in vertebrate embryos is an important problem in developmental biology. In humans, a failure to align the left and right sides of cardiovascular and/or gastrointestinal systems often results in birth defects. Evidence from patients and animal models has implicated cilia in the process of left-right patterning. Here, we review the proposed functions for cilia in establishing LR asymmetry, which include creating transient leftward fluid flows in an embryonic 'left-right organizer'. These flows direct asymmetric activation of a conserved Nodal (TGFβ) signalling pathway that guides asymmetric morphogenesis of developing organs. We discuss the leading hypotheses for how cilia-generated asymmetric fluid flows are translated into asymmetric molecular signals. We also discuss emerging mechanisms that control the subcellular positioning of cilia and the cellular architecture of the left-right organizer, both of which are critical for effective cilia function during left-right patterning. Finally, using mosaic cell-labelling and time-lapse imaging in the zebrafish embryo, we provide new evidence that precursor cells maintain their relative positions as they give rise to the ciliated left-right organizer. This suggests the possibility that these cells acquire left-right positional information prior to the appearance of cilia.This article is part of the themed issue 'Provocative questions in left-right asymmetry'.

  20. Anarchy, socialism and a Darwinian left.

    PubMed

    Clarke, Ellen

    2006-03-01

    In A Darwinian left Peter Singer aims to reconcile Darwinian theory with left wing politics, using evolutionary game theory and in particular a model proposed by Robert Axelrod, which shows that cooperation can be an evolutionarily successful strategy. In this paper I will show that whilst Axelrod's model can give support to a kind of left wing politics, it is not the kind that Singer himself envisages. In fact, it is shown that there are insurmountable problems for the idea of increasing Axelrodian cooperation within a welfare state. My surprising conclusion will be that a Darwinian left worthy of the name would be anarchistic.

  1. Ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius)

    PubMed Central

    Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

    2012-01-01

    This study describes the ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius). Images of the liver were obtained from the 11th to 5th intercostal spaces (ICSs). The distance between the dorsal liver margin and the midline of the back was shortest (39.1 ± 7.4 cm) at the 11th ICS and increased cranially to 5th ICS. The size of the liver was largest at the 9th ICS and smallest at the 5th ICS. In 6 camels the right kidney was visualized from the 10th and 11th ICSs and upper right flank and in the 10th and 11th ICSs in the remaining 16 camels. In all camels, the left kidney was imaged from the caudal left flank. In 21 camels, the differentiation between the renal cortex and medulla was clearly visible in the ultrasonograms. Ultrasonographic description of the liver and kidneys provides a basic reference for diagnosing hepatic and renal disorders in camels. PMID:23729824

  2. Ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius).

    PubMed

    Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

    2012-12-01

    This study describes the ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius). Images of the liver were obtained from the 11th to 5th intercostal spaces (ICSs). The distance between the dorsal liver margin and the midline of the back was shortest (39.1 ± 7.4 cm) at the 11th ICS and increased cranially to 5th ICS. The size of the liver was largest at the 9th ICS and smallest at the 5th ICS. In 6 camels the right kidney was visualized from the 10th and 11th ICSs and upper right flank and in the 10th and 11th ICSs in the remaining 16 camels. In all camels, the left kidney was imaged from the caudal left flank. In 21 camels, the differentiation between the renal cortex and medulla was clearly visible in the ultrasonograms. Ultrasonographic description of the liver and kidneys provides a basic reference for diagnosing hepatic and renal disorders in camels.

  3. IgG4-related Kidney Disease Mimicking Malignant Ureter Tumor: Case Report and Literature Review.

    PubMed

    Lei, Wen-Hui; Xin, Jun; Shao, Chu-Xiao; Mao, Ming-Feng; Zhu, Chao-Yong; Wu, Chui-Fen; Jin, Lie

    2016-01-01

    Immunoglobulin G4-related disease is a recently recognized systemic disease that can affect any organ or tissue in the body, including the kidneys. IgG4-related kidney disease (IgG4-RKD) is an important part of immunoglobulin G4-related disease. The most common renal manifestation of IgG4-RKD is tubulointerstitial nephritis and glomerular lesions. There, however, is few case of IgG4-RKD mimicking malignant ureter tumor leading to severe hydronephrosis. We herein report an unusual case of IgG4-RKD mimicking malignancy.A 66-year-old Asian man presented to the nephrologist with soreness of loins, anorexia, and acute kidney injury in 2010. His renal function spontaneously improved after 2 weeks' hemodialysis without systemic steroid therapy. Four years later, he presented to the urologist with severe left hydronephrosis because of marked thickness of the left ureter wall. As a ureteral malignancy could not be ruled out, laparoscopic nephroureterectomy was performed.IgG4-related kidney disease was confirmed by the histologic examination. Then, repeat laboratory test showed almost complete recovery of renal function after initiation of steroidal therapy.This case highlights the rare possibility of IgG4-RKD mimicking malignant ureter tumor. Nephrologist and pathologists should be aware of the possibility that hydronephrosis with ureter obstruction may be involved in IgG4-RKD.

  4. Abdominal aortic aneurysm repair in a patient with a congenital solitary pelvic kidney. A case report.

    PubMed

    Murakami, T; Makino, Y; Suto, Y; Yasuda, K

    2004-10-01

    Abdominal aortic aneurysm (AAA) is rarely associated witha congenital pelvic kidney. To date only 11 cases have been reported in the literature in which a solitary pelvic' kidney was associated in only 1 patient. Repair of thesaneurysm is technically demanding because the abnormal origin of the renal arteries presents the problem of renal ischemia duringaortic cross-clamping. We report a case of a 77-year-old man who was found to have an AAA associated with a congenital solitary pelvic kidney. An abdominal aortography dearly showed 2 aberrant renal arteries, one of which originated from the aortic wall just above the aortic bifurcation and the other from the left common iliac artery. At surgery, we found other associated anomalies including malrotation of the gut and a left undescended testis. The surgical procedure consisted of an aneurysmorrhaphy followed by a tube graft replacement with therenal arteries being left intact to the distal aortic wall or below. Renal preservation during aortic cross-clamping was achieved by direct perfusion of the upper renal artery with cold lactated Ringer's solution together with topical cooling with ice slush. The patient's postoperative course was uneventful. Urinary output was satisfactory and serum creatinine level remained unchanged throughout his hospital stay. The renal preservation method used in this case was simple and effective.

  5. Giant hepatic hemangioma and cross-fused ectopic kidney in a spaceflight participant.

    PubMed

    Jennings, Richard T; Garriott, Owen K; Bogomolov, Valery V; Pochuev, Vladimir I; Morgun, Valery V; Garriott, Richard A

    2010-02-01

    Commercial spaceflight participants are typically older than traditional astronauts and often have medical conditions that make medical certification for flight difficult. This case report considers a 43-yr-old spaceflight participant who planned a short-duration Soyuz flight to the International Space Station (ISS). While he participated in many hazardous activities such as parachuting, hang gliding, scuba diving, Antarctic and jungle exploration, and deep sea submersible operations, he knew that several of his medical conditions precluded serving as a career astronaut. At the time of his initial spaceflight prescreen examination, he was known to have previous bilateral photorefractive keratectomy (PRK) for myopia and a cross-fused left ectopic kidney that would be disqualifying for a career astronaut. During the evaluation for the left single cross-fused ectopic kidney, a giant hepatic hemangioma was also discovered. In order to medically qualify for flight, the giant hepatic hemangioma was surgically removed. This case summary investigat*es the implications of a single cross-fused left ectopic kidney and the decision process and treatment implications for spaceflight medical certification in an individual with an asymptomatic giant hepatic hemangioma.

  6. [ACE inhibitors and the kidney].

    PubMed

    Hörl, W H

    1996-01-01

    Treatment with ACE inhibitors results in kidney protection due to reduction of systemic blood pressure, intraglomerular pressure, an antiproliferative effect, reduction of proteinuria and a lipid-lowering effect in proteinuric patients (secondary due to reduction of protein excretion). Elderly patients with diabetes melitus, coronary heart disease or peripheral vascular occlusion are at risk for deterioration of kidney function due to a high frequency of renal artery stenosis in these patients. In patients with renal insufficiency dose reduction of ACE inhibitors is necessary (exception: fosinopril) but more important is the risk for development of hyperkalemia. Patients at risk for renal artery stenosis and patients pretreated with diuretics should receive a low ACE inhibitor dosage initially ("start low - go slow"). For compliance reasons once daily ACE inhibitor dosage is recommended.

  7. Macrophage in chronic kidney disease

    PubMed Central

    Flaquer, Maria; Cruzado, Josep M.

    2016-01-01

    Chronic kidney disease (CKD) has become a major health problem worldwide. This review describes the role of macrophages in CKD and highlights the importance of anti-inflammatory M2 macrophage activation in both renal fibrosis and wound healing processes. Furthermore, the mechanisms by which M2 macrophages induce renal repair and regeneration are still under debate and currently demand more attention. The M1/M2 macrophage balance is related to the renal microenvironment and could influence CKD progression. In fact, an inflammatory renal environment and M2 plasticity can be the major hurdles to establishing macrophage cell-based therapies in CKD. M2 macrophage cell-based therapy is promising if the M2 phenotype remains stable and is ‘fixed’ by in vitro manipulation. However, a greater understanding of phenotype polarization is still required. Moreover, better strategies and targets to induce reparative macrophages in vivo should guide future investigations in order to abate kidney diseases. PMID:27994852

  8. Aging Biology in the Kidney.

    PubMed

    Bitzer, Markus; Wiggins, Jocelyn

    2016-01-01

    The notion that kidney function declines with age in the general population is well known in the Nephrology community and the average loss of glomerular filtration rate (GFR) about 1ml per year in most longitudinal studies. There is much debate within the community about whether this represents "normal aging" or whether this constitutes a form of renal disease. However this debate turns out, the real question is whether this decline is preventable - can it be modified or slowed? Efforts to find drivers of this decline are still in the very earliest stages, but have shown some promise at elucidating some of the pathologies involved. This article will address both the wider issue of the biology of aging as well as the specific pathologies of the aging kidney.

  9. Dietary phosphorus and kidney disease.

    PubMed

    Uribarri, Jaime

    2013-10-01

    High serum phosphate is linked to poor health outcome and mortality in chronic kidney disease (CKD) patients before or after the initiation of dialysis. Therefore, maintenance of normal serum phosphate levels is a major concern in the clinical care of this population with dietary phosphorus restriction and/or use of oral phosphate binders considered to be the best corrective care. This review discusses (1) evidence for an association between serum phosphate levels and bone and cardiovascular disease (CVD) in CKD patients as well as progression of kidney disease itself; (2) the relationship between serum phosphate and dietary phosphorus intake; and (3) implications from these data for future research. Increasing our understanding of the relationship between altered phosphorus metabolism and disease in CKD patients may clarify the potential role of excess dietary phosphorus as a risk factor for disease in the general population.

  10. Pregnancy and chronic kidney disease.

    PubMed

    Davison, John M; Lindheimer, Marshall D

    2011-01-01

    This article reviews the association of chronic renal disease and pregnancy. Included are discussions of guidelines for counseling pregnant women with underlying chronic renal disease who are considering conceiving as well as management of those already pregnant. Specifically highlighted are recent studies that question the validity of using estimated glomerular filtration rate and other formulae and questions of whether we should strive to replace the classic counseling approaches based primarily on serum creatinine levels with guidelines based on chronic kidney disease classification. The article concludes with a review as well as a critique of recent research on the prevalence of preeclampsia in women with underlying chronic renal disease, as well as if women with preeclampsia and underlying kidney disease have accelerated courses toward end-stage renal disease.

  11. Mitochondrial biogenesis in kidney disease.

    PubMed

    Weinberg, Joel M

    2011-03-01

    The transcriptional regulation of mitochondrial biogenesis by normal metabolic adaptation or injury has been clarified over the past decade. Mitochondrial biogenesis and its attendant processes enhance metabolic pathways such as fatty acid oxidation and increase antioxidant defense mechanisms that ameliorate injury from aging, tissue hypoxia, and glucose or fatty acid overload, all of which contribute to the pathogenesis of acute and chronic kidney disease. There has been considerable interest in peroxisome proliferator-activated receptors (PPAR) in the kidney, which affect multiple processes in addition to mitochondrial biogenesis. As yet there is relatively little information focused specifically on mitochondrial biogenesis and its regulation by PPARγ coactivators and their modulators such as SIRT1. The available data indicate that these pathways will be fruitful areas for study in the modification of renal disease.

  12. Acute Pancreatitis after Kidney Transplantation

    PubMed Central

    Tabakovic, Mithat; Salkic, Nermin N.; Bosnjic, Jasmina; Alibegovic, Ervin

    2012-01-01

    Acute pancreatitis is a rare but life-threatening complication in patients with transplanted kidney. The incidence of acute pancreatitis after kidney transplantation ranges from 2% to 7%, with mortality rate between 50 and 100%. We report a case of a female patient aged 46 years, developing an interstitial acute pancreatitis 8 years following a renal transplantation. The specific aethiological factor was not clearly established, although possibility of biliary pancreatitis with spontaneous stone elimination and/or medication-induced pancreatitis remains the strongest. Every patient after renal transplantation with an acute onset of abdominal pain should be promptly evaluated for presence of pancreatitis with a careful application of the most appropriate diagnostic procedure for each individual patient. PMID:23259142

  13. Resetting of renal tissular renin-angiotensin and bradykinin-kallikrein systems after unilateral kidney denervation in rats.

    PubMed

    Bohlender, Jürgen M; Nussberger, Jürg; Birkhäuser, Frédéric; Grouzmann, Eric; Thalmann, George N; Imboden, Hans

    2017-02-20

    The renal tissular renin-angiotensin and bradykinin-kallikrein systems control kidney function together with the renal sympathetic innervation but their interaction is still unclear. To further elucidate this relationship, we investigated these systems in rats 6 days after left kidney denervation (DNX, n = 8) compared to sham-operated controls (CTR, n = 8). Plasma renin concentration was unchanged in DNX vs. CTR (p = NS). Kidney bradykinin (BK) and angiotensin (Ang) I and II concentrations decreased bilaterally in DNX vs. CTR rats (~20 to 40%, p < 0.05) together with Ang IV and V concentrations that were extremely low (p = NS). Renin, Ang III and dopamine concentrations decreased by ~25 to 50% and norepinephrine concentrations by 99% in DNX kidneys (p < 0.05) but were unaltered in opposite kidneys. Ang II/I and KA were comparable in DNX, contralateral and CTR kidneys. Ang III/II increased in right vs. DNX or CTR kidneys (40-50%, p < 0.05). Ang II was mainly located in tubular epithelium by immunocytological staining and its cellular distribution was unaffected by DNX. Moreover, the angiotensinergic and catecholaminergic innervation of right kidneys was unchanged vs. CTR. We found an important dependency of tissular Ang and BK levels on the renal innervation that may contribute to the resetting of kidney function after DNX. The DNX-induced peptide changes were not readily explained by kidney KA, renin or plasma Ang I generation. However, tissular peptide metabolism and compartmentalization may have played a central role. The mechanisms behind the concentration changes remain unclear and deserve further clarification.

  14. Conkiss: Conformal Kidneys Sparing 3D Noncoplanar Radiotherapy Treatment for Pancreatic Cancer As an Alternative to IMRT

    SciTech Connect

    Sebestyen, Zsolt; Kovacs, Peter; Gulyban, Akos; Farkas, Robert; Bellyei, Szabolcs; Liposits, Gabor; Szigeti, Andras; Esik, Olga; Derczy, Katalin; Mangel, Laszlo

    2011-04-01

    When treating pancreatic cancer using standard (ST) 3D conformal radiotherapy (3D-CRT) beam arrangements, the kidneys often receive a higher dose than their probable tolerance limit. Our aim was to elaborate a new planning method that-similarly to IMRT-effectively spares the kidneys without compromising the target coverage. Conformal kidneys sparing (CONKISS) 5-field, noncoplanar plans were compared with ST plans for 23 consecutive patients retrospectively. Optimal beam arrangements were used consisting of a left- and right-wedged beam-pair and an anteroposterior beam inclined in the caudal direction. The wedge direction determination (WEDDE) algorithm was developed to adjust the adequate direction of wedges. The aimed organs at risk (OARs) mean dose limits were: kidney <12 Gy, liver <25 Gy, small bowels <30 Gy, and spinal cord maximum <45 Gy. Conformity and homogeneity indexes with z-test were used to evaluate and compare the different planning approaches. The mean dose to the kidneys decreased significantly (p < 0.05): left kidney 7.7 vs. 10.7 Gy, right kidney 9.1 vs. 11.7 Gy. Meanwhile the mean dose to the liver increased significantly (18.1 vs. 15.0 Gy). The changes in the conformity, homogeneity, and in the doses to other OARs were not significant. The CONKISS method balances the load among the OARs and significantly reduces the dose to the kidneys, without any significant change in the conformity and homogeneity. Using 3D-CRT the CONKISS method can be a smart alternative to IMRT to enhance the possibility of dose escalation.

  15. Endogenous Inhibitors of Kidney Inflammation

    PubMed Central

    Trostel, Jessica; Garcia, Gabriela E.

    2015-01-01

    Although inflammation is the physiological response to pathogen invasion and tissue damage, it can also be responsible for significant tissue damage. Therefore, the inflammatory response must be carefully regulated to prevent critical inflammatory damage to vital organs. Typically, local endogenous regulatory mechanisms adjust the magnitude of the response such that the injurious condition is resolved and homeostasis is mantained. Humoral mechanisms that restrain or inhibit inflammation include glucocorticoid hormones, anti-inflammatory cytokines such as IL-10 and transforming growth factor-β (TGF-β), and soluble cytokine receptors; other mediators facilitate tissue healing, like lipoxins and resolvins. There is growing evidence that inflammation plays a critical role in the development and progression of heart disease, cancer, stroke, diabetes, kidney diseases, sepsis, and several fibroproliferative disorders. Consequently, understanding the mechanisms that regulate inflammation may offer therapeutic targets for inhibiting the progression of several diseases. In this article, we review the significance of several novel endogenous anti-inflammatory mediators in the protection from kidney injury and the potential of these regulatory molecules as therapeutic targets for treatment of kidney inflammatory diseases. PMID:26779569

  16. NAFLD and Chronic Kidney Disease.

    PubMed

    Marcuccilli, Morgan; Chonchol, Michel

    2016-04-14

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries and it is now considered a risk factor for cardiovascular disease. Evidence linking NAFLD to the development and progression of chronic kidney disease (CKD) is emerging as a popular area of scientific interest. The rise in simultaneous liver-kidney transplantation as well as the significant cost associated with the presence of chronic kidney disease in the NAFLD population make this entity a worthwhile target for screening and therapeutic intervention. While several cross-sectional and case control studies have been published to substantiate these theories, very little data exists on the underlying cause of NAFLD and CKD. In this review, we will discuss the most recent publications on the diagnosis of NAFLD as well new evidence regarding the pathophysiology of NAFLD and CKD as an inflammatory disorder. These mechanisms include the role of obesity, the renin-angiotensin system, and dysregulation of fructose metabolism and lipogenesis in the development of both disorders. Further investigation of these pathways may lead to novel therapies that aim to target the NAFLD and CKD. However, more prospective studies that include information on both renal and liver histology will be necessary in order to understand the relationship between these diseases.

  17. Controversies in kidney paired donation.

    PubMed

    Gentry, Sommer E; Montgomery, Robert A; Segev, Dorry L

    2012-07-01

    Kidney paired donation represented 10% of living kidney donation in the United States in 2011. National registries around the world and several separate registries in the United States arrange paired donations, although with significant variations in their practices. Concerns about ethical considerations, clinical advisability, and the quantitative effectiveness of these approaches in paired donation result in these variations. For instance, although donor travel can be burdensome and might discourage paired donation, it was nearly universal until convincing analysis showed that living donor kidneys can sustain many hours of cold ischemia time without adverse consequences. Opinions also differ about whether the last donor in a chain of paired donation transplants initiated by a nondirected donor should donate immediately to someone on the deceased donor wait-list (a domino or closed chain) or should be asked to wait some length of time and donate to start another sequence of paired donations later (an open chain); some argue that asking the donor to donate later may be coercive, and others focus on balancing the probability that the waiting donor withdraws versus the number of additional transplants if the chain can be continued. Other controversies in paired donation include simultaneous versus nonsimultaneous donor operations, whether to enroll compatible pairs, and interactions with desensitization protocols. Efforts to expand public awareness of and participation in paired donation are needed to generate more transplant opportunities.

  18. [Carnosine, carnosinase and kidney diseases].

    PubMed

    Kiliś-Pstrusińska, Katarzyna

    2012-04-20

     Carnosine (beta-alanyl-L-histidine) is an endogenously synthesized dipeptide which is present in different human tissues, including the kidney. Carnosine is hydrolyzed by the enzyme carnosinase. There are two carnosinase homologues: serum secreted carnosinase and non-specific cytosolic dipeptidase, encoded by the genes CNDP1 and CNDP2 respectively and located on chromosome 18q22.3. Carnosine functions as a radical oxygen species scavenger and as a natural angiotensin converting enzyme inhibitor. Carnosine inhibits advanced glycation end product formation and reduces the synthesis of matrix proteins such as fibronectin and collagen type VI of podocytes and mesangial cells. In experimental studies it was shown that carnosine reduces the level of proinflammatory and profibrotic cytokines. It is suggested that carnosine is a naturally occurring anti-aging substance in human organisms with a beneficial effect on the cardiovascular system. This paper reports the results of studies concerning carnosine's role in kidney diseases, particularly in ischemia/reperfusion induced acute renal failure, diabetic nephropathy, gentamicin-induced nephrotoxicity and also in blood pressure regulation. The correlations between serum carnosine and serum carnosinase activity and polymorphism in the CNDP1 gene are analyzed. The role of CNDP1 gene polymorphism in the development of diabetic nephropathy and non-diabetic chronic kidney disease is discussed. Carnosine is engaged in different metabolic pathways. It has nephroprotective features. Further studies of carnosine metabolism and its biological properties, particularly those concerning the human organism, are required.

  19. Kidney transplantation in obese patients

    PubMed Central

    Tran, Minh-Ha; Foster, Clarence E; Kalantar-Zadeh, Kamyar; Ichii, Hirohito

    2016-01-01

    The World Health Organization estimated that in 2014, over 600 million people met criteria for obesity. In 2011, over 30% of individuals undergoing kidney transplant had a body mass index (BMI) 35 kg/m2 or greater. A number of recent studies have confirmed the relationship between overweight/obesity and important comorbidities in kidney transplant patients. As with non-transplant surgeries, the rate of wound and soft tissue complications are increased following transplant as is the incidence of delayed graft function. These two issues appear to contribute to longer length of stay compared to normal BMI. New onset diabetes after transplant and cardiac outcomes also appear to be increased in the obese population. The impact of obesity on patient survival after kidney transplantation remains controversial, but appears to mirror the impact of extremes of BMI in non-transplant populations. Early experience with (open and laparoscopic) Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy support excellent weight loss (in the range of 50%-60% excess weight lost at 1 year), but experts have recommended the need for further studies. Long term nutrient deficiencies remain a concern but in general, these procedures do not appear to adversely impact absorption of immunosuppressive medications. In this study, we review the literature to arrive at a better understanding of the risks related to renal transplantation among individuals with obesity. PMID:27011911

  20. [Left ventricular function in pulmonary arterial hypertension].

    PubMed

    Khomaziuk, V A

    1998-12-01

    Echocardiographic evaluation was done of left ventricular functional state in 90 patients with primary and secondary pulmonary arterial hypertension with and without intercavitary shunting. Changes in left ventricular function were identified in 86% cases; they reflected disturbances in both ventricles compensatory interaction. The degree of changes depended on the degree of dilatation of the right ventricle and level of interchamber shunting.

  1. Spinal cord ischemia and left atrial myxoma.

    PubMed

    Hirose, G; Kosoegawa, H; Takado, M; Shimazaki, K; Murakami, E

    1979-07-01

    A 62-year-old man had an acute, transient, flaccid paraplegia. Examination showed a primary cardiac tumor with emboli to major branches of the aorta. A myxoma was removed from the left atrium, and normal function returned. Left atrial myxoma should be suspected as a cause for embolism to the CNS.

  2. Two Rare Variants of Left Vertebral Artery.

    PubMed

    Singh, Rajani

    2017-02-15

    Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed. In 1 patient, the left vertebral artery arose aberrantly from arch of aorta between left common carotid artery and left subclavian artery. This artery then, following oblique course, abnormally entered into foramen transversarium of C4 vertebra. In the second patient, the left common stump emerged from arch of aorta in the left side of left common carotid artery and then instantly bifurcated into vertebral artery and subclavian artery. Then following the usual oblique course, the left vertebral artery anomalously entered into foramen transversarium of C3 vertebra at the level of upper border of thyroid cartilage. The knowledge of these rare variations in the origin of vertebral artery is of paramount importance to surgeons performing surgery in neck region, radiologist performing angiography to avoid misinterpretation of radiographs and to anatomists for rare variations in academics and research.

  3. Social Studies. Political Theory: Left to Right.

    ERIC Educational Resources Information Center

    Heggy, Joan

    The course outlined in this guide offers an in-depth look at the political left and right, including characteristics held by the extreme left and right, related social and economic theories, and the differences between theory and practice. The students will read and discuss viewpoints illustrative of a cross section of ideological positions and…

  4. A Conversation about No Child Left Behind

    ERIC Educational Resources Information Center

    Taylor, Brian

    2007-01-01

    This article presents an interview with J. Michael Ortiz, a member of the Aspen Institute's Commission on No Child Left Behind, on the issues concerning the No Child Left Behind Act (NCLB). Aspen Institute's Commission is an independent panel that was established in 2006 to conduct a high-level review of the federal government's signature…

  5. Time Components of the Left Ventricle.

    ERIC Educational Resources Information Center

    Franks, B. Don

    The purpose of this study was to examine the relationship of the time components of the left ventricle. Since one of the ways to investigate cardiac function is to analyze the time intervals between particular events of the cardiac cycle, various time intervals of systole and diastole of the left ventricle were measured from simultaneous…

  6. Pure Left Neglect for Arabic Numerals

    ERIC Educational Resources Information Center

    Priftis, Konstantinos; Albanese, Silvia; Meneghello, Francesca; Pitteri, Marco

    2013-01-01

    Arabic numerals are diffused and language-free representations of number magnitude. To be effectively processed, the digits composing Arabic numerals must be spatially arranged along a left-to-right axis. We studied one patient (AK) to show that left neglect, after right hemisphere damage, can selectively impair the computation of the spatial…

  7. Pregnancy and contraceptive counseling of women with chronic kidney disease and kidney transplants.

    PubMed

    Watnick, Suzanne

    2007-04-01

    Women with kidney disease of childbearing age should expect proactive counseling regarding pregnancy and contraception. Discussions should include the impact of pregnancy on their kidney disease and the impact of kidney disease on maternal and fetal outcomes. However, nephrologists rarely discuss sexual dysfunction, infertility, menstrual irregularities, and contraception with their premenopausal women patients. This review will consider pregnancy-related issues to discuss when counseling women with all stages of chronic kidney disease. Issues related to contraception in women on dialysis, women with functioning kidney transplants, and those with chronic kidney disease will also be reviewed.

  8. Metallothionein in rabbit kidneys preserved for transplantation.

    PubMed

    Elinder, C G; Lundgren, G; Nordberg, M; Palm, B; Piscator, M

    1984-03-01

    Thirteen rabbits were given repeated cadmium injections to achieve cadmium concentrations in kidney cortex ranging from 0.05 to 1 mmole Cd/kg wet weight. Another four animals served as controls. One kidney from each animal was frozen directly to -70 degrees C whereas the other kidney was kept for 24 hr at +4 degrees C in a preservative (Sachs' solution) to simulate conditions for preservation of human donor kidneys before transplantation. Protein binding of cadmium, zinc and copper in kidney homogenates and the concentration of metallothionein (MT) were measured in the kidney that was frozen directly and in the kidney that had been preserved. No gross differences in either the protein binding of cadmium, zinc and copper or in the MT content were seen between the directly frozen and preserved kidneys from the same animal. This indicates that MT is not rapidly broken down in rabbit kidneys which have been preserved similarly to human donor kidneys for 24 hr in a standard preservative solution prior to a transplantation.

  9. microRNAs in Diabetic Kidney Disease.

    PubMed

    Chung, Arthur C K

    2015-01-01

    Diabetes and diabetic kidney diseases have continually exerted a great burden on our society. Although the recent advances in medical research have led to a much better understanding of diabetic kidney diseases, there is still no successful strategy for effective treatments for diabetic kidney diseases. Recently, treatment of diabetic kidney diseases relies either on drugs that reduce the progression of renal injury or on renal replacement therapies, such as dialysis and kidney transplantation. On the other hand, searching for biomarkers for early diagnosis and effective therapy is also urgent. Discovery of microRNAs has opened to a novel field for posttranscriptional regulation of gene expression. Results from cell culture experiments, experimental animal models, and patients under diabetic conditions reveal the critical role of microRNAs during the progression of diabetic kidney diseases. Functional studies demonstrate not only the capability of microRNAs to regulate expression of target genes, but also their therapeutic potential to diabetic kidney diseases. The existence of microRNAs in plasma, serum, and urine suggests their possibility to be biomarkers in diabetic kidney diseases. Thus, identification of the functional role of microRNAs provides an essentially clinical impact in terms of prevention and treatment of progression in diabetic kidney diseases as it enables us to develop novel, specific therapies and diagnostic tools for diabetic kidney diseases.

  10. Partial left pericardial defect with herniation of the left atrial appendage

    PubMed Central

    Pernot, C.; Hoeffel, J C.; Henry, M.; Frisch, R.; Brauer, B.

    1972-01-01

    A case is reported of herniation of the left atrial appendage through a partial pericardial defect, probably congenital. The diagnosis was suggested by the history of chest pain and bulging of the middle segment of the left heart border on the plain chest film, without other signs. Angiography revealed a dilated left atrial appendage. An artificial left pneumothorax confirmed the presence of a pleuropericardial defect. The surgical procedure included excision of the appendage and closure of the defect. Images PMID:5034603

  11. TMS over the Left Angular Gyrus Impairs the Ability to Discriminate Left from Right

    ERIC Educational Resources Information Center

    Hirnstein, Marco; Bayer, Ulrike; Ellison, Amanda; Hausmann, Markus

    2011-01-01

    The underlying cognitive and neural mechanisms of the ability to discriminate left from right are hardly explored. Clinical studies from patients with impairments of left-right discrimination (LRD) and neuroimaging data suggest that the left angular gyrus is particularly involved in LRD. Moreover, it is argued that the often reported sex…

  12. Anti-fibrin antibody binding in valvular vegetations and kidney lesions during experimental endocarditis.

    PubMed

    Yokota, M; Basi, D L; Herzberg, M C; Meyer, M W

    2001-01-01

    In Streptococcus sanguinis (sanguis) induced experimental endocarditis, we sought evidence that the development of aortic valvular vegetation depends on the availability of fibrin. Endocarditis was induced in New Zealand white rabbits by catheter placement into the left ventricle and inoculation of the bacteria. Fibrin was localized in the developing vegetation with 99mTechnetium (Tc)-labeled anti-fibrin antibody one or three days later. When rabbit anti-fibrin antibody was given intravenously on day 1, the mass of aortic valvular vegetation was significantly reduced at day 3; infusion of non-specific rabbit IgG showed no effect. The 99mTc-labeled anti-fibrin antibody also labeled kidneys that showed macroscopic subcapsular hemorrhage. To learn if the deposition of fibrin in the kidneys was a consequence of endocarditis required a comparison of farm-bred and specific pathogen-free rabbits before and after the induction of endocarditis. Before induction, the kidneys of farm-bred rabbits were labeled, but specific pathogen-free rabbits were free of labeling and signs of macroscopic hemorrhage. After 3 days of endocarditis, kidneys of 10 of 14 specific pathogen-free rabbits labeled with 99mTc-labeled anti-fibrin antibody and showed hemorrhage. Kidney lesions were suggested to be a frequent sequellae of S. sanguinis infective endocarditis. For the first time, fibrin was shown to be required for the continued development of aortic valvular vegetations.

  13. Effects of maternal subtotal nephrectomy on the development of the fetal kidney: A morphometric study.

    PubMed

    Kondo, Tomohiro; Kitano-Amahori, Yoko; Nagai, Hiroaki; Mino, Masaki; Takeshita, Ai; Kusakabe, Ken Takeshi; Okada, Toshiya

    2015-11-01

    The present study was designed to explore if maternal subtotal (5/6) nephrectomy affects the development of fetal rat kidneys using morphometric methods and examining whether there are any apoptotic changes in the fetal kidney. To generate 5/6 nephrectomized model rats, animals underwent 2/3 left nephrectomy on gestation day (GD) 5 and total right nephrectomy on GD 12. The fetal kidneys were examined on GDs 16 and 22. A significant decrease in fetal body weight resulting from maternal 5/6 nephrectomy was observed on GD 16, and a significant decrease in fetal renal weight and fetal body weight caused by maternal nephrectomy was observed on GD 22. Maternal 5/6 nephrectomy induced a significant increase in glomerular number, proximal tubular length, and total proximal tubular volume of fetuses on GD 22. Maternal 5/6 nephrectomy resulted in an increase in the number of apoptotic cells in the metanephric mesenchyme of the kidney on GD 16, and in the collecting tubules on GD 22. These findings suggest that maternal 5/6 nephrectomy stimulates the development of the fetal kidney while suppressing fetal growth.

  14. PPAR-γ agonists in polycystic kidney disease with frequent development of cardiovascular disorders.

    PubMed

    Nagao, Shizuko; Yamaguchi, Tamio

    2012-06-01

    Autosomal dominant polycystic kidney disease (ADPKD) is the most common of the monogenic disorders and is characterized by bilateral renal cysts; cysts in other organs including liver, pancreas, spleen, testis and ovary; vascular abnormalities including intracranial aneurysms and subarachnoid hemorrhage; and cardiac disorders such as left ventricular hypertrophy (LVH), mitral valve regurgitation, mitral valve prolapse and aortic regurgitation. Autosomal recessive polycystic kidney disease (ARPKD) is an early-onset multisystem disorder characterized by polycysts divided from the renal collecting ducts, congenital hepatic fibrosis, and ductal plate malformation complicated by pulmonary hyperplasia and systemic hypertension. In these polycystic kidney diseases (PKD), progressive enlargement of the cysts results from the aberrant proliferation of tubule epithelial cells and trans-epithelial fluid secretion leading to extensive nephron loss and interstitial fibrosis. Peroxisome proliferator-activated receptor-γ (PPAR-γ), a member of the ligand-dependent nuclear receptor superfamily, is expressed in a variety of tissues, including kidneys and liver, and plays important roles in cell proliferation, fibrosis, and inflammation. PPAR-γ agonists ameliorate polycystic kidney, polycystic liver and cardiac defects through β-catenin, c-Myc, CFTR, MCP-1, S6, ERK, and TGF-β signaling pathways in animal models of PKD. In this review, we describe the possible therapeutic value of PPAR-γ agonists in the treatment of renal and hepatic manifestations, and cardiac defects in progressive PKD.

  15. [Recent developments in genetic kidney diseases].

    PubMed

    Liebau, M C; Benzing, T

    2011-05-01

    The improved understanding of genetic kidney diseases has given rise to a more detailed understanding of kidney function within the last decade. Insights into the pathophysiological principles of frequent kidney diseases - partly inherited, partly acquired - have been obtained by the investigation of rare genetic disorders and can now serve as a starting point for the development of novel therapeutic strategies. In this way various clinical multicenter trials, which are based on the observations made in basic science have been established for the very common autosomal dominant polycystic kidney disease. Furthermore, the influence of genetic aspects on frequent kidney diseases, e. g. diabetic nephropathy, is becoming more obvious. This article aims to give an overview over essential recent development in the field of genetic kidney diseases.

  16. Cyclosporine increases calcium in kidney medulla

    SciTech Connect

    Borowitz, J.L.

    1988-01-01

    Treatment of rats with 20, 50, or 100 mg/kg of cyclosporine p.o. markedly increased /sup 45/Ca accumulation in kidney slices especially in medulla. The effect was related to dose and duration of treatment, and was also observed in slices of kidney medulla from cyclosporine-treated mice. Total calcium was elevated in kidney medulla of cyclosporine-treated rats so that the effect is not merely an increased exchange but a build-up of calcium in the tissue. No histopathologic evidence of cyclosporine-related cell necrosis was present in mouse kidney, showing that calcium accumulation is not dystrophic in character. Accumulation of /sup 45/Ca in slices of rat heart, liver, or brain was not affected by cyclosporine pretreatment of the animals. It is suggested that cyclosporine-induced changes in calcium metabolism in kidney medulla may influence kidney function.

  17. Wilms tumor in horseshoe kidneys: radiologic diagnosis

    SciTech Connect

    Gay, B.B. Jr.; Dawes, R.K.; Atkinson, G.O. Jr.; Ball, T.I. Jr.

    1983-03-01

    Two cases of nephroblastoma occurring in a horseshoe kidney are reported, and 32 cases from the literature are reviewed. The radiologic signs of horseshoe kidney may be difficult to evaluate with excretory urography when the mass is large. Rotational abnormalities of the opposite kidney that is not involved by tumor should suggest the possibility of an associated horseshoe kidney. Real-time ultrasonography and computed tomography are helpful in identifying the isthmus of the horseshoe kidney. Aortography confirms the presence of the horseshoe kidney and demonstrates the arterial supply to the isthmus and the tumor. Radionuclide scans demonstrate the isthmus when the tumor arises from an upper pole, but may not be diagnostic if the tumor arises from the isthmus.

  18. The kidney and hypertension: causes and treatment.

    PubMed

    Sica, Domenic A

    2008-07-01

    Chronic kidney disease is both a cause and a consequence of hypertension. Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Beyond volume expansion, chronic kidney disease-related hypertension is without truly defining characteristics. Consequently, the sequencing of antihypertensive medications for the patient with chronic kidney disease and hypertension becomes arbitrary. Prescription practice in such patients should be mindful of the need for multiple drug classes with at least one of them being a diuretic. Blood pressure goals in the patient with chronic kidney disease and hypertension are set at lower levels than those for patients with essential hypertension alone. It remains to be determined to what level blood pressure should be lowered in the patient with chronic kidney disease, however.

  19. Successful treatment of a continuous flow left ventricular assist device thrombosis with eptifibatide.

    PubMed

    Jennings, Douglas L; Cabrera, Rafael; Wang, Dee Dee; Tita, Cristina

    2012-01-01

    Left ventricular assist device thrombosis is a rare but potentially lethal complication of mechanical circulatory support. Here, we present a case of successful treatment of a suspected HeartMate II thrombosis with the glycoprotein IIb/IIIa inhibitor, eptifibatide. The patient presented with signs and symptoms of heart failure, along with acute kidney injury and hemolytic anemia that did not respond to diuresis, inotrope support, or anticoagulation. Treatment with eptifibatide resulted in marked clinical and hemodynamic improvement within 24 hrs. The patient was transitioned to clopidogrel and discharged without further incident. Eptifibatide may represent a potential therapeutic option for patients with device thrombosis.

  20. [Social aspects of left-handedness].

    PubMed

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Throughout human history left-handedness has been considered as sinful. It has been associated with the devil, weakness, female gender, unhealthiness, evil, something that has to be turned to a "good"--right side by force. Left-handedness is being more and more acceptable at rational level, but in everyday life it is still considered to be unusual if someone writes with the left hand. Lessening of the number of lefthanders is associated with ageing. There are about 13% lefthanders among people in twenties and less than 1% lefthanders among those in eighties. This finding may be explaned with more pronounced socio-cultural pressure on left-handed people in the past, compared to nowadays. On the other hand, this may also support the hypothesis about a reduced life span of lefthanded people. With cross-exercising of left-handedness, certain typical characteristics and behavioural patterns appear in these people. This was a sort of provoked behaviour and an attack on the integrity of an emotional attitude toward oneself. Stuttering may also appear as a consequence of unsuccessful cross-exercising of left-handedness. The hypothesis about left-handedness as an advantage is supported with the reports about relatively more lefthanders in some specific groups such as: mathematicians, sculptors, architects, painters, musicians, actors, tennis players, as well as famous army commanders and rulers.

  1. Surgical Treatment of Left Ventricular Pseudoaneurysm

    PubMed Central

    Mujanovic, Emir; Bergsland, Jacob; Avdic, Sevleta; Stanimirovic-Mujanovic, Sanja; Kovacevic-Preradovic, Tamara; Kabil, Emir

    2014-01-01

    Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata­strophic complication of myocardial infarction, occurring in approximately 4% of pa­tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm. The left ventricular pseudoaneurysm contains only pericardial and fibrous elements in its wall-no myocardial tissue. Because such aneurysms have a strong tendency to rupture, this disorder may lead to death if it is left surgically untreated. Case report: In this case report, we present a patient who underwent successful repair of a left ventricular pseudoaneurysm, which followed a myocardial infarction that was caused by occlusion of the left circumflex coronary artery. Although repair of left ventricular pseudoaneurysm is still a surgical challenge, it can be performed with acceptable results in most patients. PMID:25568538

  2. [Gigantic coronary aneurysm arisen from coronary fistula between the left circumflex artery and the left ventricle].

    PubMed

    Uchida, T; Andou, H; Yasutsune, T; Iwai, T; Fukumura, F; Tanaka, J

    2008-12-01

    A 71-year-old male was referred to our hospital due to abnormality detected by a chest roentgenogram. He had no symptoms except for slight chest oppression. He was found to have a giant coronary aneurysm. It was originated from a coronary artery (left circum flex branch) left ventricular fistula. The orifice of this fistula to the left ventricle was also dilated and formed diverticulum. Ligation of the feeding coronary branch, closure of the aneurysmal fistula in the left ventricular wall and aneurysmectomy were performed under cardiopulmonary bypass. Postoperative course was uneventful. A giant aneurysm originated from a coronary-left ventricular fistula was considered to be very rare.

  3. Phosphatidylinositol 3-kinase signaling determines kidney size.

    PubMed

    Chen, Jian-Kang; Nagai, Kojiro; Chen, Jianchun; Plieth, David; Hino, Masayo; Xu, Jinxian; Sha, Feng; Ikizler, T Alp; Quarles, C Chad; Threadgill, David W; Neilson, Eric G; Harris, Raymond C

    2015-06-01

    Kidney size adaptively increases as mammals grow and in response to the loss of 1 kidney. It is not clear how kidneys size themselves or if the processes that adapt kidney mass to lean body mass also mediate renal hypertrophy following unilateral nephrectomy (UNX). Here, we demonstrated that mice harboring a proximal tubule-specific deletion of Pten (Pten(ptKO)) have greatly enlarged kidneys as the result of persistent activation of the class I PI3K/mTORC2/AKT pathway and an increase of the antiproliferative signals p21(Cip1/WAF) and p27(Kip1). Administration of rapamycin to Pten(ptKO) mice diminished hypertrophy. Proximal tubule-specific deletion of Egfr in Pten(ptKO) mice also attenuated class I PI3K/mTORC2/AKT signaling and reduced the size of enlarged kidneys. In Pten(ptKO) mice, UNX further increased mTORC1 activation and hypertrophy in the remaining kidney; however, mTORC2-dependent AKT phosphorylation did not increase further in the remaining kidney of Pten(ptKO) mice, nor was it induced in the remaining kidney of WT mice. After UNX, renal blood flow and amino acid delivery to the remaining kidney rose abruptly, followed by increased amino acid content and activation of a class III PI3K/mTORC1/S6K1 pathway. Thus, our findings demonstrate context-dependent roles for EGFR-modulated class I PI3K/mTORC2/AKT signaling in the normal adaptation of kidney size and PTEN-independent, nutrient-dependent class III PI3K/mTORC1/S6K1 signaling in the compensatory enlargement of the remaining kidney following UNX.

  4. CT of trauma to the abnormal kidney

    SciTech Connect

    Rhyner, P.; Federle, M.P.; Jeffrey, R.B.

    1984-04-01

    Traumatic injuries to already abnormal kidneys are difficult to assess by excretory urography and clinical evaluation. Bleeding and urinary extravasation may accompany minor trauma; conversely, underlying tumors, perirenal hemorrhage, and extravasation may be missed on urography. Computed tomography (CT) was performed in eight cases including three neoplasms, one adult polycystic disease, one simple renal cyst, two hydronephrotic kidneys, and one horseshoe kidney. CT provided specific and clinically useful information in each case that was not apparent on excretory urography.

  5. Role of Grainyhead in Kidney Cancer

    DTIC Science & Technology

    2014-12-01

    AD______________ Award Number: W81XWH-12-1-0428 TITLE: Role of Grainyhead in Kidney Cancer PRINCIPAL INVESTIGATOR: Steven Frisch CONTRACTING...SUBTITLE Role of Grainyhead in Kidney Cancer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0428 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Steven...metastatic gene expression in RCC. 15. SUBJECT TERMS Grainyhead-like-2/ kidney /collecting ducts/proximal tubules/distal tubules/clear cell renal

  6. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    MedlinePlus

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

  7. Kidney biomimicry--a rediscovered scientific field that could provide hope to patients with kidney disease.

    PubMed

    Stenvinkel, Peter; Johnson, Richard J

    2013-11-01

    Most studies on kidney disease have relied on classic experimental studies in mice and rats or clinical studies in humans. From such studies much understanding of the physiology and pathophysiology of kidney disease has been obtained. However, breakthroughs in the prevention and treatment of kidney diseases have been relatively few, and new approaches to fight kidney disease are needed. Here we discuss kidney biomimicry as a new approach to understand kidney disease. Examples are given of how various animals have developed ways to prevent or respond to kidney failure, how to protect themselves from hypoxia or oxidative stress and from the scourge of hyperglycemia. We suggest that investigation of evolutionary biology and comparative physiology might provide new insights for the prevention and treatment of kidney disease.

  8. Left ventricular mechanics of counterpulsation and left heart bypass, individually and in combination.

    PubMed

    Rose, E A; Marrin, C A; Bregman, D; Spotnitz, H M

    1979-01-01

    Counterpulsation and left heart bypass devices have been successfully used to salvage patients with severe left ventricular power failure following cardiopulmonary bypass. Each of these techniques is believed to reduce or minimize myocardial work, yet the effects of these devices on the force of myocardial contraction have not been defined. In the present investigation the effects of counterpulsation produced by intravascular (intra-aortic balloon pumping) and extravascular (pulsatile assist device) balloon devices, partial left atrial-aortic bypass, and total bypass on left ventricular mechanics were examined. The devices were studied individually and in combination in 10 anesthetized open-chest dogs. Left ventricular wall stress, external work, and contractility indices were calculated by computer using a changing volume spherical model of the left ventricle. Results indicate that although all currently available circulatory assist devices reduced peak left ventricular wall stress, a spectrum of relative effectiveness progressed from intra-aortic balloon pumping or pulsatile assist device alone through the combination intra-aortic balloon pumping plus the pulsatile assist device. Partial left heart bypass was more effective than intra-aortic balloon pumping plus the pulsatile assist device in reducing peak wall stress, but the difference was small. Total left heart bypass was vastly superior to any of the other modalities tested in its effects on peak wall stress as well as external work. The addition of counterpulsation to partial or total left heart bypass produced minimal changes in left ventricular systolic mechanics.

  9. Gelastic seizures involving the left parietal lobe.

    PubMed

    Machado, René Andrade; Astencio, Adriana Goicoechea

    2012-01-01

    Gelastic seizures have been described in various epilepsies arising from the temporal or frontal lobes, although the most commonly encountered form is related to the presence of a hypothalamic hamartoma. We describe a patient with gelastic seizures involving the left parietal lobe. Our patient, an 8-year-old girl, underwent interictal video/EEG monitoring and MRI. The seizures consisted of brief staring followed by smiling and laughing. Electroencephalography during the gelastic seizures showed rhythmic spikes and waves in the left parietal lobe. MRI revealed the characteristic features of focal cortical dysplasia. Our findings suggest that the left parietal lobe may actively participate in the particular epileptogenic network generating gelastic seizures.

  10. What Lies Ahead (left-eye)

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This is the left-eye version of the 3-D cylindrical-perspective mosaic showing the view south of the martian crater dubbed 'Bonneville.' The image was taken by the navigation camera on the Mars Exploration Rover Spirit. The rover will travel toward the Columbia Hills, seen here at the upper left. The rock dubbed 'Mazatzal' and the hole the rover drilled in to it can be seen at the lower left. The rover's position is referred to as 'Site 22, Position 32.' This image was geometrically corrected to make the horizon appear flat.

  11. Basics of kidney biopsy: A nephrologist's perspective

    PubMed Central

    Agarwal, S. K.; Sethi, S.; Dinda, A. K.

    2013-01-01

    The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from Vim–Silverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM) is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations. PMID:23960337

  12. A Nationwide Analysis of Kidney Autotransplantation.

    PubMed

    Moghadamyeghaneh, Zhobin; Hanna, Mark H; Fazlalizadeh, Reza; Obi, Yoshitsugu; Foster, Clarence E; Stamos, Michael J; Ichii, Hirohito

    2017-02-01

    There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22.7%) followed by ureter pathology (17%). Overall, 97.7 per cent of operations were performed in urban teaching hospitals. The number of procedures from 2008 to 2012 were significantly higher compared with the number of them from 2002 to 2007 (473 vs 345, P < 0.01). The overall mortality and morbidity of patients were 1.3 and 46.2 per cent, respectively. The most common postoperative complications were transplanted kidney failure (10.7%) followed by hemorrhagic complications (9.7%). Obesity [adjusted odds ratio (AOR): 9.62, P < 0.01], fluid and electrolyte disorders (AOR: 3.67, P < 0.01), and preoperative chronic kidney disease (AOR: 1.80, P = 0.03) were predictors of morbidity in patients. In conclusion, Kidney autotransplantation is associated with low mortality but a high morbidity rate. The most common indications of kidney autotransplantation are renal artery and ureter pathologies, respectively. A kidney transplant failure rate of 10.7 per cent was observed in patients with kidney autotransplantation. The most common postoperative complication was hemorrhagic in nature.

  13. Nutritional Management of Kidney Stones (Nephrolithiasis)

    PubMed Central

    Segal, Adam M.; Seifter, Julian L.; Dwyer, Johanna T.

    2015-01-01

    The incidence of kidney stones is common in the United States and treatments for them are very costly. This review article provides information about epidemiology, mechanism, diagnosis, and pathophysiology of kidney stone formation, and methods for the evaluation of stone risks for new and follow-up patients. Adequate evaluation and management can prevent recurrence of stones. Kidney stone prevention should be individualized in both its medical and dietary management, keeping in mind the specific risks involved for each type of stones. Recognition of these risk factors and development of long-term management strategies for dealing with them are the most effective ways to prevent recurrence of kidney stones. PMID:26251832

  14. Optical Coherence Tomography in Kidney Transplantation

    NASA Astrophysics Data System (ADS)

    Andrews, Peter M.; Wierwille, Jeremiah; Chen, Yu

    End-stage renal disease (ESRD) is associated with both high mortality rates and an enormous economic burden [1]. The preferred treatment option for ESRD that can extend patients' lives and improve their quality of life is kidney transplantation. However, organ shortages continue to pose a major problem in kidney transplantation. Most kidneys for transplantation come from heart-beating cadavers. Although non-heart-beating cadavers represent a potentially large pool of donor kidneys, these kidneys are not often used due to the unknown extent of damage to the renal tubules (i.e., acute tubular necrosis or "ATN") induced by ischemia (i.e., lack of blood flow). Also, ischemic insult suffered by kidneys awaiting transplantation frequently causes ATN that leads to varying degrees of delayed graft function (DGF) after transplantation. Finally, ATN represents a significant risk for eventual graft and patient survival [2, 3] and can be difficult to discern from rejection. In present clinical practice, there is no reliable real-time test to determine the viability of donor kidneys and whether or not donor kidneys might exhibit ATN. Therefore, there is a critical need for an objective and reliable real-time test to predict ATN to use these organs safely and utilize the donor pool optimally. In this review, we provided preliminary data indicating that OCT can be used to predict the post-transplant function of kidneys used in transplantation.

  15. Huge abdominal cyst occurred after kidney transplantation.

    PubMed

    Hwang, H P; Yu, H C; Park, H S; Song, J S; Kang, K P; Kim, W; Park, S K; Lee, S

    2014-01-01

    This case demonstrates continuous ambulatory peritoneal dialysis-related endometrial tissue migration and occurrence of huge cystic endometriosis by the recovery of menstrual period after kidney transplantation.

  16. Imaging Leukocyte Responses in the Kidney.

    PubMed

    Finsterbusch, Michaela; Kitching, A Richard; Hickey, Michael J

    2017-03-01

    The kidney can be negatively affected by a range of innate and adaptive immune responses, resulting in alterations in the functions of the kidney and, in some cases, progression to renal failure. In many of these responses, infiltration of blood-borne leukocytes into the kidney is central to the response. In addition, a large population of mononuclear phagocytes resident in the kidney can modulate these responses. A great deal of research has investigated both the mechanisms of leukocyte recruitment to the kidney and the actions of immune cells resident within the kidney. Because of the dynamic nature of the processes whereby leukocytes enter sites of inflammation, in vivo imaging has been one of the key approaches used for understanding leukocyte recruitment as it occurs throughout the body, and this is also true for kidney. However, imaging this organ and its complicated microvasculature during different forms of renal pathology presents a unique set of challenges. In this review, we examine the approaches used for intravital imaging of the kidney and summarize the insights gained from these studies regarding the mechanisms of leukocyte entry into the kidney during inflammation and the actions of immune cells within this organ.

  17. Obesity and kidney disease: Beyond the hyperfiltration.

    PubMed

    Mascali, A; Franzese, O; Nisticò, S; Campia, U; Lauro, D; Cardillo, C; Di Daniele, N; Tesauro, M

    2016-09-01

    In industrialized countries, overweight and obesity account for approximately 13.8% and 24.9% of the kidney disease observed in men and women, respectively. Moreover, obesity-associated glomerulopathy is now considered as "an emerging epidemic." Kidney function can be negatively impacted by obesity through several mechanisms, either direct or indirect. While it is well established that obesity represents the leading risk factor for type 2 diabetes and hypertension, awareness that obesity is associated with direct kidney damage independently of hypertension and diabetes is still not widespread. In this paper we will discuss the emerging role of adipose tissue, particularly in the visceral depot, in obesity-induced chronic kidney damage.

  18. Statins in chronic kidney disease and kidney transplantation.

    PubMed

    Kassimatis, Theodoros I; Goldsmith, David J A

    2014-10-01

    HMG-CoA reductase inhibitors (statins) have been shown to improve cardiovascular (CV) outcomes in the general population as well as in patients with cardiovascular disease (CVD). Statins' beneficial effects have been attributed to both cholesterol-lowering and cholesterol-independent "pleiotropic" properties. By their pleiotropic effects statins have been shown to reduce inflammation, alleviate oxidative stress, modify the immunologic responses, improve endothelial function and suppress platelet aggregation. Patients with chronic kidney disease (CKD) exhibit an enormous increase in CVD rates even from early CKD stages. As considerable differences exist in dyslipidemia characteristics and the pathogenesis of CVD in CKD, statins' CV benefits in CKD patients (including those with a kidney graft) should not be considered unequivocal. Indeed, accumulating clinical evidence suggests that statins exert diverse effects on dialysis and non-dialysis CKD patients. Therefore, it seems that statins improve CV outcomes in non-dialysis patients whereas exert little (if any) benefit in the dialysis population. It has also been proposed that dyslipidemia might play a causative role or even accelerate renal injury. Moreover, ample experimental evidence suggests that statins ameliorate renal damage. However, a high quality randomized controlled trial (RCT) and metaanalyses do not support a beneficial role of statins in renal outcomes in terms of proteinuria reduction or retardation of glomerular filtration rate (GFR) decline.

  19. [Kidney grafts from elderly donors].

    PubMed

    Hiesse, Christian; Pessione, Fabienne; Cohen, Sophie

    2003-06-07

    FROM AN EPIDEMIOLOGICAL POINT OF VIEW: The epidemiology of renal transplantation had greatly changed over the past 10 years. The increasing number of patients with renal failure and candidates for transplantation increases the demand for grafts, whereas the sampling rate of organs remains stable. The mean age of the donors is rising, hence underlining the question of the use of organs of so-called "borderline" quality. THE WEAK POINTS OF ELDERLY GRAFTS: Aging of the kidneys affects the structure of the parenchyma and renal function, which decreases, notably in hypertensive persons. The elderly graft exhibits a critical mass of nephrons that is insufficient to fulfil the functional requirements of a poorly equipped recipient. The recipient is more sensitive to the added agressions: prolonged ischemia and immunological and medicinal agressions. THE RESULTS OF RENAL GRAFT FROM ELDERLY DONORS: They are quantitatively and qualitatively inferior to those of renal transplants from "ideal" donors. The donor's age is a significant factor influencing negatively influences the survival of the transplanted kidney, but dependent on past vascular history. Good results regarding the maintenance of dialysis are obtained by selecting the donors and by avoiding added risk factors. THE ASSESSMENT OF A GRAFT FROM AN ELDERLY DONOR: This, basically, relies on clinical criteria: donor's history, cause of death and accurate measurement of the renal function. A biopsy of the graft, at the time of sampling, provides useful information. TRANSPLANTATION STRATEGY OF A GRAFT FROM AN ELDERLY DONOR: Donor-recipient matching by age is a common approach. Grafting of both kidneys in the same recipient is a method presently under assessment. The episode of ischemia must be reduced and the immunosuppressive therapy adapted.

  20. The Kidney in Lead Poisoning

    PubMed Central

    Radošević, Zdenko; Šarić, Marko; Beritić, Tihomil; Knežević, Jelica

    1961-01-01

    Kidney damage due to lead is still an interesting problem of industrial toxicology. In spite of abundant literature data, much still remains to be explained. There are controversial opinions, not only on the type of renal lesions due to lead, but also on whether lead affects the kidney at all. In this paper our clinical observations on the effect of lead upon the kidney in 53 patients suffering from lead poisoning are presented. In 44 patients (40 men and four women) lead poisoning was due to occupation, and in nine (five men and four women) to the use of lead-glazed pottery. The length of exposure varied from two months to 35 years. In all cases the diagnosis of lead poisoning was made clinically and confirmed by laboratory tests. Permanent changes in the form of chronic nephropathy were observed in only two patients. These were the two cases in which exposure to lead was the longest and most intense. Twenty-three patients showed functional renal lesions tending to normalize. In addition to the cases of organic nephropathy, blood pressure was persistently raised in one further patient; in two patients a raised blood pressure was observed only in the acute stage of poisoning. On the basis of these findings we consider that lead intoxication can cause renal lesions. These lesions are for the most part functional and temporary. In cases of long and severe exposure and repeated lead intoxication, organic renal lesions seem possible. The disturbances of renal function observed in this study may be ascribed to disordered intrarenal circulation, due to the spastic effect of lead on intrarenal blood vessels, and to a direct toxic or indirect hypoxic effect of lead on the tubules. When investigating renal function, we have observed that the timing of individual tests is of paramount importance. Some lesions are subject to changes in the natural course of lead poisoning, and unless this is borne in mind, apparently contradictory results may be obtained. PMID:13739013

  1. Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Grantham, Jared J.

    2010-01-01

    Shortly after being elbowed in the flank during a pickup basketball game, a 35-year-old healthy man has severe, colicky abdominal pain followed by gross hematuria. He is hospitalized, and a renal ultrasound scan reveals bilateral polycystic kidneys and liver cysts, previously unknown to the patient. The blood pressure is 160/100 mm Hg. The serum creatinine concentration is 0.9 mg per deciliter (80 μmol per liter). The pain subsides in 2 days with analgesics, rest, and fluids; the gross hematuria resolves in 4 days, although microscopic hematuria persists. How should his case be further evaluated and managed? PMID:20009161

  2. [Isolated giant hydatid in kidney].

    PubMed

    Ozgör, Faruk; Erbin, Akif; Berberoğlu, Ahmet Yalçın; Binbay, Murat; Sarılar, Omer; Müslümanoğlu, Ahmet Yaser

    2014-06-01

    Cyst hydatid of the kidney is parasitic condition caused by Echinococcus granulosus and identified in many countries, especially associated with sheep farming. Echinococcal larvae enter the bloodstream using the digestive system and invade any organs in the human body. The urinary system is the third most common area affected by parasitic infection after liver and lungs, but isolated renal involvement is a very rare situation, even in endemic areas. İn our case, we aimed to report a 57-year-old female patient with an 18-centimeter isolated renal cyst hydatid treated by retroperitoneal nephrectomy. The diagnosis was based on imaging findings and confirmed by histopathologically.

  3. Chronic kidney disease in pregnancy.

    PubMed

    Chinnappa, V; Ankichetty, S; Angle, P; Halpern, S H

    2013-07-01

    Parturients with renal insufficiency or failure present a significant challenge for the anesthesiologist. Impaired renal function compromises fertility and increases both maternal and fetal morbidity and mortality. Close communication amongst medical specialists, including nephrologists, obstetricians, neonatologists and anesthesiologists is required to ensure the safety of mother and child. Pre-existing diseases should be optimized and close surveillance of maternal and fetal condition is required. Kidney function may deteriorate during pregnancy, necessitating early intervention. The goal is to maintain hemodynamic and physiologic stability while the demands of the pregnancy change. Drugs that may adversely affect the fetus, are nephrotoxic or are dependent on renal elimination should be avoided.

  4. Medullary sponge kidney in childhood

    SciTech Connect

    Patriquin, H.B.; O'Regan, S.

    1985-08-01

    Medullary sponge kidney is reported in six children aged 2-18 years. One child was asymptomatic; the others had hematuria or a urine-concentrating defect. Renal function and size were otherwise normal, as was liver function. The diagnosis was made at excretory urography according to criteria established in adults. Sonography revealed hyperechogenic pyramids, at first at the periphery, later generalized. Computed tomography is very sensitive to the pyramidal nephrocalcinosis that complicates this disease and explains the frequent presenting symptom of hematuria in these children.

  5. Stem cells in kidney diseases.

    PubMed

    Soler, María José; José Tomas, Ortiz-Pérez

    2012-01-01

    Circulating bone marrow-derived endothelial progenitor cells (EPCs) seem to play a crucial role in both vasculogenesis and vascular homeostasis. Chronic kidney disease is a state of endothelial dysfunction, accelerated progression of atherosclerosis and high cardiovascular risk. As a consequence, cardiovascular disorders are the main cause of death in end-stage renal disease (ESRD). It has been shown that patients with advanced renal failure have decreased number of bone marrow-derived endothelial progenitor cells and impaired EPCs function. Moreover, in kidney transplant patients, renal graft function significantly correlated with EPC number. The reduced number of EPCs in patients with ESRD has been ascribed to the uremia. Therefore, therapies that improve the uremic status in dialysis patients such as nocturnal hemodialysis are associated with restoration of impaired EPCs number and migratory function. In fact, some of the common treatments for patients with chronic kidney disease such as erythropoietin, statins and angiotensin II receptor antagonist increase the number of EPCs. Nowadays, there is growing evidence indicating that, under pathophysiological conditions, stem cells (SCs) derived from bone marrow are able to migrate in the injured kidney, and they seem to play a role in glomerular and tubular regeneration. After acute tubular renal injury, surviving tubular epithelial cells and putative renal stem cells proliferate and differentiate into tubular epithelial cells to promote structural and functional repair. Moreover, bone marrow stem cells, including hematopoietic stem cells and mesenchymal stem cells can also participate in the repair process by proliferation and differentiation into renal lineages. For instance, mesenchymal SCs have been shown to decrease inflammation and enhance renal regeneration. The administration of ex vivo expanded bone marrow-derived mesenchymal SCs have been proved to be beneficial in various experimental models of acute

  6. Transplantation of kidneys with tumors.

    PubMed

    Frascà, Giovanni M; D'Errico, Antonia; Malvi, Deborah; Porta, Camillo; Cosmai, Laura; Santoni, Matteo; Sandrini, Silvio; Salviani, Chiara; Gallieni, Maurizio; Balestra, Emilio

    2016-04-01

    The shortage of donors in the face of the increasing number of patients wait-listed for renal transplantation has prompted several strategies including the use of kidneys with a tumor, whether found by chance on harvesting from a deceased donor or intentionally removed from a living donor and transplanted after excision of the lesion. Current evidence suggests that a solitary well-differentiated renal cell carcinoma, Fuhrman nuclear grade I-II, less than 1 cm in diameter and resected before grafting may be considered at minimal risk of recurrence in the recipient who, however, should be informed of the possible risk and consent to receive such a graft.

  7. The relationship between chemical-induced kidney weight increases and kidney histopathology in rats.

    PubMed

    Craig, Evisabel A; Yan, Zhongyu; Zhao, Q Jay

    2015-07-01

    The kidney is a major site of chemical excretion, which results in its propensity to exhibit chemically-induced toxicological effects at a higher rate than most other organs. Although the kidneys are often weighed in animal toxicity studies, the manner in which these kidney weight measurements are interpreted and the value of this information in predicting renal damage remains controversial. In this study we sought to determine whether a relationship exists between chemically-induced kidney weight changes and renal histopathological alterations. We also examined the relative utility of absolute and relative (kidney-to-body weight ratio) kidney weight in the prediction of renal toxicity. For this, data extracted from oral chemical exposure studies in rats performed by the National Toxicology Program were qualitatively and quantitatively evaluated. Our analysis showed a statistically significant correlation between absolute, but not relative, kidney weight and renal histopathology in chemically-treated rats. This positive correlation between absolute kidney weight and histopathology was observed even with compounds that statistically decreased terminal body weight. Also, changes in absolute kidney weight, which occurred at subchronic exposures, were able to predict the presence or absence of kidney histopathology at both subchronic and chronic exposures. Furthermore, most increases in absolute kidney weight reaching statistical significance (irrespective of the magnitude of change) were found to be relevant for the prediction of histopathological changes. Hence, our findings demonstrate that the evaluation of absolute kidney weight is a useful method for identifying potential renal toxicants.

  8. Angiotensin II type 2 receptors and nitric oxide sustain oxygenation in the clipped kidney of early Goldblatt hypertensive rats.

    PubMed

    Palm, Fredrik; Connors, Stephanie G; Mendonca, Margarida; Welch, William J; Wilcox, Christopher S

    2008-02-01

    Angiotensin-converting enzyme inhibitors (ACEIs) decrease the glomerular filtration rate and renal blood flow in the clipped kidneys of early 2-kidney, 1-clip Goldblatt hypertensive rats, but the consequences for oxygenation are unclear. We investigated the hypothesis that angiotensin II type 1 or angiotensin II type 2 receptors or NO synthase mediate renal oxygenation responses to ACEI. Three weeks after left renal artery clipping, kidney function, oxygen (O(2)) use, renal blood flow, renal cortical blood flow, and renal cortical oxygen tension (Po(2)) were measured after acute administration of an ACEI (enalaprilat) and after acute administration of ACEI following acute administration of an angiotensin II type 1 or angiotensin II type 2 receptor blocker (candesartan or PD-123,319) or an NO synthase blocker (N(G)-nitro-L-arginine methyl ester with control of renal perfusion pressure) and compared with mechanical reduction in renal perfusion pressure to the levels after ACEI. The basal renal cortical Po(2) of clipped kidneys was significantly lower than contralateral kidneys (35+/-1 versus 51+/-1 mm Hg; n=40 each). ACEI lowered renal venous Po(2), cortical Po(2), renal blood flow, glomerular filtration rate, and cortical blood flow and increased the renal vascular resistance in the clipped kidney, whereas mechanical reduction in renal perfusion pressure was ineffective. PD-123,319 and N(G)-nitro-L-arginine methyl ester, but not candesartan, reduced the Po(2) of clipped kidneys and blocked the fall in Po(2) with acute ACEI administration. In conclusion, oxygen availability in the clipped kidney is maintained by angiotensin II generation, angiotensin II type 2 receptors, and NO synthase. This discloses a novel mechanism whereby angiotensin can prevent hypoxia in a kidney challenged with a reduced perfusion pressure.

  9. Hydrallazine alone in acute left ventricular failure

    PubMed Central

    Clark, A. J. L.; McMichael, H. B.

    1981-01-01

    A patient presented with severe acute left ventricular failure and was treated with hydrallazine and oxygen alone. He made a rapid and full recovery as judged by clinical, radiological and blood gas evidence. ImagesFig. 1 PMID:7329902

  10. Left ventricular myxoma: a case report

    PubMed Central

    Qin, Wei; Wang, Liming; Chen, Xin; Liu, Peisheng; Wang, Rui

    2014-01-01

    Cardiac myxoma, the most common primary heart tumor, is located mainly in the left atrium. We reported a rare case of left ventricular myxoma incidentally found on echocardiography in an asymptomatic 60-year-old male. The tumor was carefully resected without fragmentation. The patient had an uneventful recovery and was discharged home on the 4th postoperative day. Surgical resection of this type of cardiac myxoma is recommended due to the rarity of tumor location. PMID:25469121

  11. Traumatic avulsion of kidney and spleen into the chest through a ruptured diaphragm in a young worker: a case report

    PubMed Central

    Konstantinos, Stamatiou; Georgios, Ilias; Christos, Chlopsios; Vasilissa, Karanasiou; Nikolaos, Kavouras; Fred, Lebrun; John, Heretis; Frank, Sofras

    2007-01-01

    Introduction Rupture of the diaphragm is almost always due to major trauma. Diaphragmatic injuries are rare (5–7%), usually secondary to blunt, or more rarely to penetrating, thoracic or abdominal trauma. No single investigation provides a reliable diagnosis of diaphragmatic rupture when a patient first arrives at hospital. Almost 33% are suspected on initial chest x-ray, but the percentage is lower in patients who are immediately intubated. Mortality in patients with diaphragmatic rupture following blunt abdominal trauma is generally associated with coexistent vascular and visceral injuries that could be rapidly fatal. It's mandatory that the right diagnosis is reached as soon as possible given that mortality is influenced by the time elapsing between trauma and diagnosis. Case presentation A 35-year-old worker was hit by a heavy object while working in the factory. He was transferred immediately to our emergency room. Chest x-ray showed massive left hemothorax without any additional signs to suggest diaphragmatic injury. It was decided to perform immediate surgical exploration before further radiological examination. During surgery, the right kidney and liver appeared normal, but the left kidney and spleen were not found in their anatomical position. The left hemidiaphragm had a10-cm oblique posterior tear. The left kidney was found lacerated in the left side of the chest, separated completely from its vascular pedicle and ureter, along with the entire spleen which was also separated from its vascular tree. Conclusion The avulsion of both kidney and spleen following abdominal trauma is uncommon and survival depends on prompt diagnosis and treatment. PMID:18076752

  12. Inhibitors of pig kidney trehalase.

    PubMed

    Kyosseva, S V; Kyossev, Z N; Elbein, A D

    1995-02-01

    Trehazolin, a new trehalase inhibitor isolated from the culture broth of Micromonospora, was reported to be a highly specific inhibitor for porcine and silk worm trehalases with IC50 values of 5.5 x 10(-9) and 3.7 x 10(-9) M, respectively (O. Ando, H. Satake, K. Itoi, A. Sato, M. Nakajima, S. Takashi, H. Haruyama, Y. Ohkuma, T. Kinoshita, and R. Enokita (1991) J. Antibiot. 44, 1165-1168). We also found that trehazolin is a very powerful and quite specific inhibitor against purified pig kidney trehalase, giving an IC50 value of 1.9 x 10(-8) M. Lineweaver-Burk plots showed that this compound was a competitive inhibitor of the trehalase. However, even at concentrations of 200 micrograms/ml, trehazolin did not inhibit the rat intestinal maltase or sucrase, yeast alpha-glucosidase or almond beta-glucosidase. Validoxylamine A and validamycin A, two other trehalase inhibitors, showed potent competitive inhibition against purified pig kidney trehalase, with IC50 values of 2.4 x 10(-9) and 2.5 x 10(-4) M, respectively. On the other hand, validoxylamine A was almost inactive against rat intestinal sucrase and maltase, with some inhibition being observed at millimolar concentration. A number of other glucosidase inhibitors, such as MDL 25637, castanospermine, and deoxynojirimycin were also tested against the purified trehalase and showed reasonable inhibitory activity.

  13. Myeloperoxidase in chronic kidney disease.

    PubMed

    Madhusudhana Rao, A; Anand, Usha; Anand, C V

    2011-01-01

    Numerous lines of evidence implicate a role of myeloperoxidase (MPO) in the pathogenesis of cardiovascular disease (CVD). It is a well accepted fact that patients with chronic kidney disease (CKD) are at an increased risk for CVD. MPO is a pro-oxidant enzyme which could be involved in the increased susceptibility of these patients to CVD. Hence, the levels of plasma MPO was determined in healthy controls as well as in patients with CKD [stratified with the level of their kidney failure as CKD stages II-V (end stage renal disease)]. Plasma MPO was assayed by a spectrophotometric method. Serum urea and creatinine were estimated on a clinical chemistry analyzer using standard laboratory procedures. The mean plasma MPO levels were significantly lower with advancing stages of renal failure (P < 0.001). There was a positive correlation between MPO and GFR (r = +0.89, P < 0.001) and a negative correlation with urea (r = -0.85, P < 0.001) and creatinine (r = -0.82, P < 0.001). While an inverse association was observed between plasma MPO and urea in CKD patients, such an association was not observed in control subjects (P = 0.43). In conclusion, the decline in plasma MPO levels may be due to the inhibitory effect of uraemic toxins on the enzyme.

  14. Ultrasonic propulsion of kidney stones

    PubMed Central

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

    2016-01-01

    Purpose of review Ultrasonic propulsion is a novel technique that uses short bursts of focused ultrasonic pulses to reposition stones transcutaneously within the renal collecting system and ureter. The purpose of this review is to discuss the initial testing of effectiveness and safety, directions for refinement of technique and technology, and opinions on clinical application. Recent findings Preclinical studies with a range of probes, interfaces, and outputs have demonstrated feasibility and consistent safety of ultrasonic propulsion with room for increased outputs and refinement toward specific applications. Ultrasonic propulsion was used painlessly and without adverse events to reposition stones in 14 of 15 human study participants without restrictions on patient size, stone size, or stone location. The initial feasibility study showed applicability in a range of clinically relevant situations, including facilitating passage of residual fragments following ureteroscopy or shock wave lithotripsy, moving a large stone at the UPJ with relief of pain, and differentiating large stones from a collection of small fragments. Summary Ultrasonic propulsion shows promise as an office-based system for transcutaneously repositioning kidney stones. Potential applications include facilitating expulsion of residual fragments following ureteroscopy or shock wave lithotripsy, repositioning stones prior to treatment, and repositioning obstructing UPJ stones into the kidney to alleviate acute renal colic. PMID:26845428

  15. Lithium-associated kidney microcysts.

    PubMed

    Tuazon, Jennifer; Casalino, David; Syed, Ehteshamuddin; Batlle, Daniel

    2008-08-31

    Long-term lithium therapy is associated with impairment in concentrating ability and, occasionally, progression to advanced chronic kidney disease from tubulointerstitial nephropathy. Biopsy findings in patients with lithium-induced chronic tubulointerstitial nephropathy include tubular atrophy and interstitial fibrosis interspersed with tubular cysts and dilatations. Recent studies have shown that cysts are seen in 33-62.5% of the patients undergoing lithium therapy. MR imaging is highly capable of defining renal morphological features and has been demonstrated to be superior to US and CT scan for the visualization of small renal cysts. The microcysts are found in both cortex and medulla, particularly in the regions with extensive atrophy and fibrosis, and can be multiple and bilateral. They tend to be sparse and do not normally exceed 1-2 mm in diameter. The renal microcysts in the image here reported are subtle, but consistent with lithium-induced chronic nephropathy. An MRI of the kidneys provides noninvasive evidence that strengthens the diagnosis of lithium-induced nephropathy.

  16. Sleep disorders in kidney disease.

    PubMed

    De Santo, R M; Perna, A; Di Iorio, B R; Cirillo, M

    2010-03-01

    Sleep disorders are common in patients with end stage renal disease receiving hemodialysis or peritoneal dialysis. However also a well functioning renal graft does not cure the poor sleep pattern which now emerges as a problem even in early chronic kidney disease (CKD). When patients are made aware for the first time of a disease such as CKD, which may brink to dialysis or at the best to a renal transplant patients begin to experience a disordered sleep. Sleeping disorders include insomnia (I), sleep apnoea (SAS), restless legs syndrome (RLS), periodic limb movement disorder (PLMD), excessive daily sleeping (EDS), sleepwalking, nightmares, and narcolepsy. Disordered sleep did not meet the clinical and scientific interest it deserves, in addition and we do not have a well defined solution for sleeping complaints. However, awareness that a poor sleep is associated with poor quality of life and carries an increase in mortality risk has recently stimulated interest in the field. There are many putative causes for a disordered sleep in chronic kidney disease and in end-stage renal disease. For a unifying hypothesis demographic factors, lifestyles, disease related factors, psychological factors, treatment related factors, and social factor must be taken into consideration.

  17. Chromium-induced kidney disease

    SciTech Connect

    Wedeen, R.P. ); Qian, Lifen )

    1991-05-01

    Kidney disease is often cited as one of the adverse effects of chromium, yet chronic renal disease due to occupational or environmental exposure to chromium has not been reported. Occasional cases of acute tubular necrosis (ATN) following massive absorption of chromate have been described. Chromate-induced ATN has been extensively studied in experimental animals following parenteral administration of large doses of potassium chromate (hexavalent). The chromate is selectively accumulated in the convoluted proximal tubule where necrosis occurs. An adverse long-term effect of low-dose chromium exposure on the kidneys is suggested by reports of low molecular weight (LMW) proteinuria in chromium workers. Excessive urinary excretion of {beta}{sub 2}-microglobulin, a specific proximal tubule brush border protein, and retinol-binding protein has been reported among chrome palters and welders. However, LMW proteinuria occurs after a variety of physiologic stresses, is usually reversible, and cannot by itself be considered evidence of chromic renal disease. Chromate-induced ATN and LMW proteinuria in chromium workers, nevertheless, raise the possibility that low-level, long-term exposure may produce persistent renal injury. The absence of evidence of chromate-induced chromic renal disease cannot be interpreted as evidence of the absence of such injury.

  18. [Anemia in chronic kidney disease].

    PubMed

    Amador-Medina, Lauro Fabián

    2014-01-01

    Anemia is almost unavoidable in the last stages of chronic kidney disease. It is defined as a condition where hemoglobin concentration is below 2 standard deviations from the mean hemoglobin level of the general population, corrected for age and sex (typically, hemoglobin < 13 g/dL in adults and 12 g/dL in women). Although the cause is multi-factorial, the most known is inadequate erythropoietin production. Anemia has been associated with poor prognosis in patients with several conditions such as cancer, chronic kidney disease and congestive heart failure. Treatment with erythropoiesis-stimulating agents, such as erythropoietin, is a logical strategy that has enabled clinical improvement and reduced transfusion requirements for the patients; however, total correction of anemia with erythropoiesis-stimulating agents has demonstrated an increase in the risk of mortality or cardiovascular complications associated with these agents. In randomized trials, the achievement of normal or nearly normal hemoglobin levels is not associated with improved survival and reduced cardiovascular risk; however the ideal hemoglobin level with the use of erythropoiesis-stimulating agents seems to be problematic. More information is needed in order to obtain definite conclusions; in the meantime, using the lowest possible dose of erythropoietin seems to be the most prudent approach.

  19. Pathophysiology of Acute Kidney Injury

    PubMed Central

    Basile, David P.; Anderson, Melissa D.; Sutton, Timothy A.

    2014-01-01

    Acute kidney injury (AKI) is the leading cause of nephrology consultation and is associated with high mortality rates. The primary causes of AKI include ischemia, hypoxia or nephrotoxicity. An underlying feature is a rapid decline in GFR usually associated with decreases in renal blood flow. Inflammation represents an important additional component of AKI leading to the extension phase of injury, which may be associated with insensitivity to vasodilator therapy. It is suggested that targeting the extension phase represents an area potential of treatment with the greatest possible impact. The underlying basis of renal injury appears to be impaired energetics of the highly metabolically active nephron segments (i.e., proximal tubules and thick ascending limb) in the renal outer medulla, which can trigger conversion from transient hypoxia to intrinsic renal failure. Injury to kidney cells can be lethal or sublethal. Sublethal injury represents an important component in AKI, as it may profoundly influence GFR and renal blood flow. The nature of the recovery response is mediated by the degree to which sublethal cells can restore normal function and promote regeneration. The successful recovery from AKI depends on the degree to which these repair processes ensue and these may be compromised in elderly or CKD patients. Recent data suggest that AKI represents a potential link to CKD in surviving patients. Finally, earlier diagnosis of AKI represents an important area in treating patients with AKI that has spawned increased awareness of the potential that biomarkers of AKI may play in the future. PMID:23798302

  20. Treating stones in transplanted kidneys.

    PubMed

    Saxena, S; Sadideen, H; Goldsmith, D

    2013-02-01

    The formation of calculi in renal allografts is an uncommon complication in renal transplant recipients, with a reported incidence of 0.2-1.7% according to retrospective studies. Although the majority of these stones appear to form de novo following renal transplantation (RTX), there is a growing body of evidence suggesting that more often than previously thought they may be transplanted with the donor graft itself. The etiology and pathophysiology of renal graft stones is multifactorial. A combination of metabolic and urodynamic factors predispose to stone formation and these are generally found more frequently in allograft rather than native kidneys. In addition tertiary hyperparathyroidism (following RTX) plays an important role. Renal allograft stones can pose significant challenges for the clinician. The diagnosis requires a high index of suspicion and must be prompt, as these patients' reliance on a solitary kidney for their renal function leaves them susceptible to significant morbidity. However, reports in the literature come largely from anecdotal experience and case reports, meaning that there is a limited consensus regarding how best to manage the condition. We suggest that interventional treatment should be guided primarily by stone size and individual patient presentation. Good outcomes have been reported with shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL) and ureteroscopy, but optimal management of the risk factors leading to calculi formation (i.e., prevention) will remain the most cost-effective management.

  1. Effects of a left ventricular assist device with a centrifugal pump on left ventricular diastolic hemodynamics.

    PubMed

    Saito, Akira

    2002-10-01

    The purpose of this investigation was to analyze how left ventricular assist device (LVAD) with a centrifugal pump alters left ventricular diastolic hemodynamics and energy by means of a left ventricular pressure volume relationship. Fifteen anesthetized normal pig hearts were studied after placement of an apical drainage LVAD with a centrifugal pump. Indices of the left ventricular isovolumic relaxation phase, left ventricular filling phase and general hemodynamic data were recorded with the LVAD in on and off situations. The pump assist rate was adjusted to 25%, 50% and 75%. Left ventricular stroke work, with a high correlation with oxygen consumption, decreased as the assist rate increased. Left ventricular relaxation delayed as the assist rate increased, but the atrioventricular pressure gradient increased in the left ventricular rapid filling phase. This finding clarifies left ventricular rapid filling. In this study, it was suggested that although left ventricular isovolumic relaxation was affected, 75% assistance is the most effective for the pump flow in terms of circulation support and restoration of cardiac function.

  2. The left side of motor resonance

    PubMed Central

    Sartori, Luisa; Begliomini, Chiara; Panozzo, Giulia; Garolla, Alice; Castiello, Umberto

    2014-01-01

    Motor resonance is defined as the internal activation of an observer's motor system, specifically attuned to the perceived movement. In social contexts, however, different patterns of observed and executed muscular activation are frequently required. This is the case, for instance, of seeing a key offered with a precision grip and received by opening the hand. Novel evidence suggests that compatibility effects in motor resonance can be altered by social response preparation. What is not known is how handedness modulates this effect. The present study aimed at determining how a left- and a right-handed actor grasping an object and then asking for a complementary response influences corticospinal activation in left- and right-handers instructed to observe the scene. Transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs) were thus recorded from the dominant hands of left- and right-handers. Interestingly, requests posed by the right-handed actor induced a motor activation in the participants' respective dominant hands, suggesting that left-handers tend to mirror right-handers with their most efficient hand. Whereas requests posed by the left-handed actor activated the anatomically corresponding muscles (i.e., left hand) in all the participants, right-handers included. Motor resonance effects classically reported in the literature were confirmed when observing simple grasping actions performed by the right-handed actor. These findings indicate that handedness influences both congruent motor resonance and complementary motor preparation to observed actions. PMID:25249966

  3. Incidental renocolic fistula with xanthogranulomatous pyelonephritis

    PubMed Central

    McDermott, R.L.; Dowling, C.M.; Alsinnawi, M.; Grainger, R.

    2012-01-01

    INTRODUCTION We report the case of a 66-year-old female undergoing elective nephrectomy for a non-functioning kidney in whom an incidental renocolic fistula was detected. PRESENTATION OF CASE She presented with recurrent urinary tract infections and left flank pain. Investigations revealed a nonfunctioning left kidney with a large staghorn calculus and features suggestive of xanthogranulomatous pyelonephritis (XPG). At nephrectomy, an incidental renocolic fistula was found and excised. DISCUSSION XGP is a rare, chronic inflammatory disorder of the kidney characterized by a destructive mass invading the renal parenchyma. Renocolic fistulae complicating XGP are uncommon and not widely reported in the literature. CONCLUSION Herein, we describe a case of XGP with renocolic fistula formation, its management and a review of the literature. PMID:23291328

  4. Studying the Genetic Basis of Kidney Cancer - TCGA

    Cancer.gov

    Dr. Marston Linehan, NCI's Chief of Urologic Surgery, has spent the last several decades studying kidney cancer genes and treating kidney cancer patients. Learn more about his experience as a kidney cancer physician scientist and TCGA contributor in this

  5. What's New in Kidney Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Kidney Cancer About Kidney Cancer What’s New in Kidney Cancer Research and Treatment? Research on ... can also be used to develop new treatments. New approaches to local treatment High-intensity focused ultrasound ( ...

  6. Marathon Running May Cause Short-Term Kidney Injury

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_164324.html Marathon Running May Cause Short-Term Kidney Injury But ... of endurance are also tough on the kidneys. "Marathon runners demonstrate transient or reverse short-term kidney ...

  7. What You Need to Know about Kidney Cancer

    MedlinePlus

    ... Publications Reports What You Need To Know About™ Kidney Cancer This booklet is about cancer that starts in ... choices about your care. This booklet covers: How kidney cancer is diagnosed Common symptoms for kidney cancer Treatments ...

  8. Greater trochanteric pain syndrome due to tumoral calcinosis in a patient with chronic kidney disease.

    PubMed

    Baek, Dongjin; Lee, Sang Eun; Kim, Woo-Jin; Jeon, Sanghoon; Lee, Kihwa; Jung, Jaewook; Joo, Hyunchul; Park, Jaehong; Kim, Yonghan; Choi, Young-gyun

    2014-01-01

    Tumoral calcinosis is a rare syndrome characterized by massive subcutaneous soft tissue deposits of calcium phosphate near the large joints. It is more prevalent in patients with chronic kidney disease undergoing dialysis. A 57-year-old woman was referred to our pain clinic with the complaint of severe pain in the left buttock and lateral hip. The patient had been suffering from chronic kidney disease for 10 years and had been undergoing peritoneal dialysis over the past 5 years. The patient's symptom was initially suspected to be of lumbar origin at the L5 level and a left L5 transforaminal epidural block was performed, but without success. Re-evaluation of the physical examination revealed severe tenderness over the left greater trochanter and piriformis muscle. On ultrasonographic evaluation, multiple mass-like lesions in the left buttock were observed. About 30 mL of fluid was aspirated from the cystic lesions, followed by 30 mL mixture of 0.08% levobupivacaine and triamcinolone 40 mg injected into the bursa under ultrasound guidance, which brought pain relief. Trochanteric bursitis was thought of as the cause of the symptoms. The patient was diagnosed with tumoral calcinosis based on the past medical history, simple plain radiographs, and hip magnetic resonance imaging (MRI). We diagnosed a case of greater trochanteric pain syndrome due to tumoral calcinosis related to chronic kidney disease in a patient whose symptoms had initially been considered to be radiating leg pain caused by lumbar spinal disease. We report our experience of symptomatic improvement following the repeated ultrasound-guided aspiration of calcific fluid and the injection of a mixture of local anesthetic and steroid.

  9. Kidney Transplantation in the Diabetic Patient

    PubMed Central

    Pérez-Sáez, María José; Pascual, Julio

    2015-01-01

    Diabetes mellitus is one of the most important causes of chronic kidney disease (CKD). In patients with advanced diabetic kidney disease, kidney transplantation (KT) with or without a pancreas transplant is the treatment of choice. We aimed to review current data regarding kidney and pancreas transplant options in patients with both type 1 and 2 diabetes and the outcomes of different treatment modalities. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This applies to simultaneous pancreas kidney transplantation or pancreas after KT compared to KT alone (either living donor or deceased). Other factors as living donor availability, comorbidities, and expected waiting time have to be considered whens electing one transplant modality, rather than a clear benefit in survival of one strategy vs. others. In selected type 2 diabetic patients, data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor is not an option. Pancreas and kidney transplantation seems to be the treatment of choice for most type 1 diabetic and selected type 2 diabetic patients. PMID:26239558

  10. Nocturnal Hypoxia and Loss of Kidney Function

    PubMed Central

    Ahmed, Sofia B.; Ronksley, Paul E.; Hemmelgarn, Brenda R.; Tsai, Willis H.; Manns, Braden J.; Tonelli, Marcello; Klarenbach, Scott W.; Chin, Rick; Clement, Fiona M.; Hanly, Patrick J.

    2011-01-01

    Background Although obstructive sleep apnea (OSA) is more common in patients with kidney disease, whether nocturnal hypoxia affects kidney function is unknown. Methods We studied all adult subjects referred for diagnostic testing of sleep apnea between July 2005 and December 31 2007 who had serial measurement of their kidney function. Nocturnal hypoxia was defined as oxygen saturation (SaO2) below 90% for ≥12% of the nocturnal monitoring time. The primary outcome, accelerated loss of kidney function, was defined as a decline in estimated glomerular filtration rate (eGFR) ≥4 ml/min/1.73 m2 per year. Results 858 participants were included and followed for a mean study period of 2.1 years. Overall 374 (44%) had nocturnal hypoxia, and 49 (5.7%) had accelerated loss of kidney function. Compared to controls without hypoxia, patients with nocturnal hypoxia had a significant increase in the adjusted risk of accelerated kidney function loss (odds ratio (OR) 2.89, 95% confidence interval [CI] 1.25, 6.67). Conclusion Nocturnal hypoxia was independently associated with an increased risk of accelerated kidney function loss. Further studies are required to determine whether treatment and correction of nocturnal hypoxia reduces loss of kidney function. PMID:21559506

  11. High Blood Pressure and Kidney Disease

    MedlinePlus

    ... Kidney disease is diagnosed with urine and blood tests. Health care providers measure blood pressure with a blood pressure ... the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood the kidneys filter ...

  12. The Experience of Living Kidney Donors

    ERIC Educational Resources Information Center

    Brown, Judith Belle; Karley, Mary Lou; Boudville, Neil; Bullas, Ruth; Garg, Amit X.; Muirhead, Norman

    2008-01-01

    This article describes the experiences, feelings, and ideas of living kidney donors. Using a phenomenological, qualitative research approach, the authors interviewed 12 purposefully selected living kidney donors (eight men and four women), who were between four and 29 years since donation. Interviews were audiotaped, and transcribed verbatim, and…

  13. Study of Kidney Tumors in Younger Patients

    ClinicalTrials.gov

    2016-11-18

    Clear Cell Sarcoma of the Kidney; Congenital Mesoblastic Nephroma; Diffuse Hyperplastic Perilobar Nephroblastomatosis; Rhabdoid Tumor of the Kidney; Stage I Renal Cell Cancer; Stage I Wilms Tumor; Stage II Renal Cell Cancer; Stage II Wilms Tumor; Stage III Renal Cell Cancer; Stage III Wilms Tumor; Stage IV Renal Cell Cancer; Stage IV Wilms Tumor; Stage V Wilms Tumor

  14. T cells and autoimmune kidney disease.

    PubMed

    Suárez-Fueyo, Abel; Bradley, Sean J; Klatzmann, David; Tsokos, George C

    2017-03-13

    Glomerulonephritis is traditionally considered to result from the invasion of the kidney by autoantibodies and immune complexes from the circulation or following their formation in situ, and by cells of the innate and the adaptive immune system. The inflammatory response leads to the proliferation and dysfunction of cells of the glomerulus, and invasion of the interstitial space with immune cells, resulting in tubular cell malfunction and fibrosis. T cells are critical drivers of autoimmunity and related organ damage, by supporting B-cell differentiation and antibody production or by directly promoting inflammation and cytotoxicity against kidney resident cells. T cells might become activated by autoantigens in the periphery and become polarized to secrete inflammatory cytokines before entering the kidney where they have the opportunity to expand owing to the presence of costimulatory molecules and activating cytokines. Alternatively, naive T cells could enter the kidney where they become activated after encountering autoantigen and expand locally. As not all individuals with a peripheral autoimmune response to kidney antigens develop glomerulonephritis, the contribution of local kidney factors expressed or produced by kidney cells is probably of crucial importance. Improved understanding of the biochemistry and molecular biology of T cells in patients with glomerulonephritis offers unique opportunities for the recognition of treatment targets for autoimmune kidney disease.

  15. The Mouse Isolated Perfused Kidney Technique.

    PubMed

    Czogalla, Jan; Schweda, Frank; Loffing, Johannes

    2016-11-17

    The mouse isolated perfused kidney (MIPK) is a technique for keeping a mouse kidney under ex vivo conditions perfused and functional for 1 hr. This is a prerequisite for studying the physiology of the isolated organ and for many innovative applications that may be possible in the future, including perfusion decellularization for kidney bioengineering or the administration of anti-rejection or genome-editing drugs in high doses to prime the kidney for transplantation. During the time of the perfusion, the kidney can be manipulated, renal function can be assessed, and various pharmaceuticals administered. After the procedure, the kidney can be transplanted or processed for molecular biology, biochemical analysis, or microscopy. This paper describes the perfusate and the surgical technique needed for the ex vivo perfusion of mouse kidneys. Details of the perfusion apparatus are given and data are presented showing the viability of the kidney's preparation: renal blood flow, vascular resistance, and urine data as functional, transmission electron micrographs of different nephron segments as morphological readouts, and western blots of transport proteins of different nephron segments as molecular readout.

  16. Kidney Failure - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Arabic) الفشل الكلوي - العربية Bilingual PDF Health Information Translations Bosnian (Bosanski) Kidney Failure Otkazivanje rada bubrega - Bosanski (Bosnian) Bilingual PDF Health Information Translations Chinese - Simplified (简体中文) Kidney Failure 肾衰 - 简体中文 (Chinese - ...

  17. Medullary sponge kidney associated with congenital hemihypertrophy.

    PubMed

    Indridason, O S; Thomas, L; Berkoben, M

    1996-08-01

    Medullary sponge kidney is a developmental disorder characterized by ectatic and cystic malformation of the collecting ducts and tubules. Clinical manifestations include urinary tract infections, renal stones, and hematuria. It can be associated with other developmental disorders. A case of medullary sponge kidney associated with congenital hemihypertrophy, complicated by nephrocalcinosis and nephrolithiasis, is reported here.

  18. Allopurinol and kidney function: An update.

    PubMed

    Stamp, Lisa K; Chapman, Peter T; Palmer, Suetonia C

    2016-01-01

    Allopurinol is the most commonly used urate lowering therapy in the management of gout. Despite the fact that it has been available for over 40 years there is ongoing debate about optimal allopurinol dosing in gout patients with chronic kidney disease. Given that gout is common in patients with renal impairment, clinicians need to be aware of the relationships between serum urate and kidney function as well as the effects of allopurinol on kidney function and vice versa. The use of allopurinol in patients on dialysis is an understudied area. Dialysis reduces plasma oxypurinol concentrations, therefore the dose and time of administration in relationship to dialysis need to be carefully considered. Recently, it has been suggested that there may be a role for allopurinol in patients with chronic kidney disease without gout. Observational studies have reported an association between serum urate and chronic kidney disease and end stage renal failure. The effect of urate lowering therapy with allopurinol on progression of kidney disease has been examined in small studies with varying results. Larger clinical trials are currently underway. This review will examine the relationships between allopurinol and kidney function in adults with and without renal disease and address allopurinol dosing in gout patients with impaired kidney function.

  19. Kidneys at higher risk of discard: expanding the role of dual kidney transplantation.

    PubMed

    Tanriover, B; Mohan, S; Cohen, D J; Radhakrishnan, J; Nickolas, T L; Stone, P W; Tsapepas, D S; Crew, R J; Dube, G K; Sandoval, P R; Samstein, B; Dogan, E; Gaston, R S; Tanriover, J N; Ratner, L E; Hardy, M A

    2014-02-01

    Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI)>85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (<80%, 80-90% and >90%). Kidneys with KDPI>90% were associated with increased odds of discard (OR=1.99, 95% CI 1.74-2.29) compared to ones with KDPI<80%. DKTs of KDPI>90% were associated with lower overall allograft failure (HR=0.74, 95% CI 0.62-0.89) and better patient survival (HR=0.79, 95% CI 0.64-0.98) compared to single ECD kidneys with KDPI>90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile.

  20. World Kidney Day 2016: averting the legacy of kidney disease-focus on childhood.

    PubMed

    Ingelfinger, Julie R; Kalantar-Zadeh, Kamyar; Schaefer, Franz

    2016-04-01

    World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood.

  1. Using Xenopus to study genetic kidney diseases.

    PubMed

    Lienkamp, Soeren S

    2016-03-01

    Modern sequencing technology is revolutionizing our knowledge of inherited kidney disease. However, the molecular role of genes affected by the rapidly rising number of identified mutations is lagging behind. Xenopus is a highly useful, but underutilized model organism with unique properties excellently suited to decipher the molecular mechanisms of kidney development and disease. The embryonic kidney (pronephros) can be manipulated on only one side of the animal and its formation observed directly through the translucent skin. The moderate evolutionary distance between Xenopus and humans is a huge advantage for studying basic principles of kidney development, but still allows us to analyze the function of disease related genes. Optogenetic manipulations and genome editing by CRISPR/Cas are exciting additions to the toolbox for disease modelling and will facilitate the use of Xenopus in translational research. Therefore, the future of Xenopus in kidney research is bright.

  2. Planar cell polarity of the kidney.

    PubMed

    Schnell, Ulrike; Carroll, Thomas J

    2016-05-01

    Planar cell polarity (PCP) or tissue polarity refers to the polarization of tissues perpendicular to the apical-basal axis. Most epithelia, including the vertebrate kidney, show signs of planar polarity. In the kidney, defects in planar polarity are attributed to several disease states including multiple forms of cystic kidney disease. Indeed, planar cell polarity has been shown to be essential for several cellular processes that appear to be necessary for establishing and maintaining tubule diameter. However, uncovering the genetic mechanisms underlying PCP in the kidney has been complicated as the roles of many of the main players are not conserved in flies and vice versa. Here, we review a number of cellular and molecular processes that can affect PCP of the kidney with a particular emphasis on the mechanisms that do not appear to be conserved in flies or that are not part of canonical determinants.

  3. De Novo Kidney Regeneration with Stem Cells

    PubMed Central

    Yokote, Shinya; Yamanaka, Shuichiro; Yokoo, Takashi

    2012-01-01

    Recent studies have reported on techniques to mobilize and activate endogenous stem-cells in injured kidneys or to introduce exogenous stem cells for tissue repair. Despite many recent advantages in renal regenerative therapy, chronic kidney disease (CKD) remains a major cause of morbidity and mortality and the number of CKD patients has been increasing. When the sophisticated structure of the kidneys is totally disrupted by end stage renal disease (ESRD), traditional stem cell-based therapy is unable to completely regenerate the damaged tissue. This suggests that whole organ regeneration may be a promising therapeutic approach to alleviate patients with uncured CKD. We summarize here the potential of stem-cell-based therapy for injured tissue repair and de novo whole kidney regeneration. In addition, we describe the hurdles that must be overcome and possible applications of this approach in kidney regeneration. PMID:23251079

  4. Negative participation of the left posterior fascicle in the reentry circuit of verapamil-sensitive idiopathic left ventricular tachycardia.

    PubMed

    Morishima, Itsuro; Nogami, Akihiko; Tsuboi, Hideyuki; Sone, Takahito

    2012-05-01

    Left posterior fascicle and idiopathic Left VT. The left posterior fascicle may be a bystander of the circuit of verapamil-sensitive idiopathic left ventricular tachycardia. During ventricular tachycardia (VT), 3 sequences of potentials were seen at the left posterior septum: diastolic Purkinje potentials propagating from base to apex and presystolic left posterior fascicular potentials and systolic left ventricular (LV) myocardial potentials propagating in the reverse direction. Selective capture of the left posterior fascicle by the sinus beat did not affect the VT cycle length. Entrainment pacing revealed that the retrograde limb of the circuit was not the left posterior fascicle, but the LV myocardium.

  5. Renoprotective effect of yohimbine on ischaemia/reperfusion-induced acute kidney injury through α2C-adrenoceptors in rats.

    PubMed

    Shimokawa, Takaomi; Tsutsui, Hidenobu; Miura, Takeshi; Nishinaka, Toru; Terada, Tomoyuki; Takama, Masashi; Yoshida, Shuhei; Tanba, Takao; Tojo, Ayumi; Yamagata, Masayo; Yukimura, Tokihito

    2016-06-15

    Excitation of renal sympathetic nervous activity and the resulting increased levels of renal venous norepinephrine play important roles in renal ischaemia/reperfusion injury in rats. This study examined the effects of yohimbine, a non-selective α2-adrenoceptor antagonist, on renal venous norepinephrine levels and kidney function in acute kidney injury. Acute ischaemia/reperfusion-induced kidney injury was induced in rats by clamping the left renal artery and vein for 45min, followed by reperfusion, 2 weeks after a contralateral nephrectomy. Intravenous injection of yohimbine (0.1mg/kg) 5min prior to ischaemia significantly attenuated kidney injury and decreased the renal venous norepinephrine levels, as compared with vehicle-treated rats. To investigate the involvement of α2-adrenoceptor subtypes, we pre-treated with JP-1302, a selective α2C-adrenoceptor antagonist (1mg/kg). This suppressed renal venous norepinephrine levels and tumour necrosis factor-α and monocyte chemoattractant protein-1 mRNA levels after reperfusion and improved kidney function. Pre-treatment with BRL44408, a selective α2A-adrenoceptor antagonist (1mg/kg), or imiloxan, a selective α2B-adrenoceptor antagonist (1mg/kg) had no effect on renal function or tissue injury. These results suggest that yohimbine prevented ischaemia/reperfusion-induced kidney injury by inhibiting α2C-adrenoceptors and suppressing pro-inflammatory cytokine expression.

  6. APICAL LEFT VENTRICULAR-ABDOMINAL AORTIC COMPOSITE CONDUITS FOR LEFT VENTRICULAR OUTFLOW OBSTRUCTIONS

    PubMed Central

    Cooley, Denton A.; Norman, John C.

    1978-01-01

    Certain problems related to the left ventricular outflow tract are not amenable to conventional surgical methods, but may be solved with the creation of a double outlet left ventricle by using a composite rigid pyrolite left ventricular apex outlet prosthesis and a fabric valve-containing conduit. Low porosity woven Dacron tube grafts are used for the conduit. Twenty-three patients who have undergone apico-aortic bypass with this conduit are reported here, with gratifying results in eighteen. PMID:15216062

  7. The solitary kidney--a nephrological perspective.

    PubMed

    Gluhovschi, Gh; Gadalean, Florica; Gluhovschi, Cristina; Petrica, Ligia; Velciov, Silvia; Gluhovschi, A; Timar, R

    2013-01-01

    The solitary kidney (SK) is of special interest for practitioners because of the reduced number of nephrons as compared to persons who have 2 kidneys. It undergoes adaptive phenomena of hypertrophy and hyperfiltration that allow long-term evolution, but pathological situations might occur in the remnant kidney. In some persons with a SK, the adaptive phenomena can be associated with proteinuria, arterial hypertension (AH) and diminished Glomerular Filtration Rate (GFR). In very rare situations, diminution of renal function in patients with a SK can progress to end-stage renal disease (ESRD) and, totally exceptionally, it requires renal replacement therapy. The SK can be congenital or acquired. At present patients with a SK address themselves more and more frequently to nephrology services which monitor the evolution of both the congenital and the surgically acquired SK. The congenital SK possesses a higher number of nephrons (75%, as compared to 2 functional kidneys in a healthy person) than the surgically acquired SK - 50% nephrons. This makes adaptive phenomena differ. Secondary lesions sometimes appear later in case of the congenital SK. In other situations, no significant differences between the evolution of the congenital or acquired SK are registered. The congenital solitary kidney is often associated with congenital abnormalities of the kidney and of the urinary tract (CAKUT). This association increases the risk for chronic kidney disease and for evolution towards chronic renal failure. The congenital SK is also often associated with gynaecological and other abnormalities. The acquired solitary kidney can be due to nephrectomy on a pathological kidney which could not be conservatively treated or due to donation of a kidney for renal transplantation. The SK itself sometimes requires partial nephrectomy intervention, for example sparing surgery. Although the evolution is in most cases favorable, it requires attentive monitoring.

  8. Cardiovascular abnormalities in autosomal-dominant polycystic kidney disease

    PubMed Central

    Ecder, Tevfik; Schrier, Robert W.

    2009-01-01

    Cardiovascular problems are a major cause of morbidity and mortality in patients with autosomal-dominant polycystic kidney disease (ADPKD). Hypertension is a common early symptom of ADPKD, and occurs in approximately 60% of patients before renal function has become impaired. Hypertension is associated with an increased rate of progression to end-stage renal disease and is the most important potentially treatable variable in ADPKD. Left ventricular hypertrophy, which is a powerful, independent risk factor for cardiovascular morbidity and mortality, also occurs frequently in patients with ADPKD. Both hypertension and left ventricular hypertrophy have important roles in cardiovascular complications in these individuals. Moreover, biventricular diastolic dysfunction, endothelial dysfunction, increased carotid intima-media thickness, and impaired coronary flow velocity reserve are present even in young patients with ADPKD who have normal blood pressure and well-preserved renal function. These findings suggest that cardiovascular involvement starts very early in the course of ADPKD. Intracranial and extracranial aneurysms and cardiac valvular defects are other potential cardiovascular problems in patients with ADPKD. Early diagnosis and treatment of hypertension, with drugs that block the renin-angiotensin-aldosterone system, has the potential to decrease the cardiovascular complications and slow the progression of renal disease in ADPKD. PMID:19322187

  9. An unusual coincidence of multiple synchronous kidney tumors with a metachronous rectal adenocarcinoma.

    PubMed

    Böor, Andrej; Jurkovic, Ivan; Dudríková, Katarína

    2003-01-01

    In synchronous surgery specimens (right-sided nephrectomy and left-sided partial nephrectomy), a unique combination of a papillary (chromophil) renal cell carcinoma (4 x 3.7 x 3.5 cm) and a renal oncocytoma (11 x 10 x 9 mm) in the right kidney and a renal carcinoid (2.5 x 2.3 x 1.1 cm) in the resected part of the left kidney has been found. This multiplicity and bilaterality, based on the findings of three distinct histogenetic types of kidney tumors, was accompanied by a metachronous rectal adenocarcinoma discovered 14 months later. After surgery, no radiation or other oncologic therapy was given. At present, our patient is well without any evidence of neoplastic disease three years after primary diagnosis. To the best of our knowledge, this is the first case of a combination of three distinct histogenetic types of synchronous renal tumors associated with a metachronous rectal adenocarcinoma treated with simple surgery. In the absence of cytogenetic studies, the possibility of a the presence of a hereditary renal cancer syndrome must be considered.

  10. Classical and remote post-conditioning effects on ischemia/reperfusion-induced acute oxidant kidney injury.

    PubMed

    Kadkhodaee, Mehri; Najafi, Atefeh; Seifi, Behjat

    2014-11-01

    The present study aimed to analyze and compare the effects of classical and remote ischemic postconditioning (POC) on rat renal ischemia/reperfusion (IR)-induced acute kidney injury. After right nephrectomy, male rats were randomly assigned into four groups (n = 8). In the IR group, 45 min of left renal artery occlusion was induced followed by 24 h of reperfusion. In the classical POC group, after induction of 45 min ischemia, 4 cycles of 10 s of intermittent ischemia and reperfusion were applied to the kidney before complete restoring of renal blood. In the remote POC group, 4 cycles of 5 min ischemia and reperfusion of left femoral artery were applied after 45 min renal ischemia and right at the time of renal reperfusion. There was a reduction in renal function (increase in blood urea and creatinine) in the IR group. Application of both forms of POC prevented the IR-induced reduction in renal function and histology. There were also significant improvements in kidney oxidative stress status in both POC groups demonstrated by a reduction in malondialdehyde (MDA) formation and preservation of antioxidant levels comparing to the IR group. We concluded that both methods of POC have protective effects on renal function and histology possibly by a reduction in IR-induced oxidative stress.

  11. [MALT B cell lymphoma with kidney damage and monoclonal gammopathy: a case study and literature review].

    PubMed

    Peces, R; Vega-Cabrera, C; Peces, C; Pobes, A; Fresno, M F

    2010-01-01

    We report a case of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) involving the left kidney and simultaneous onset of a monoclonal gammopathy IgM kappa. No predisposing local inflammatory condition was identified. Following left nephrectomy, the renal specimen showed the centrocyte like cells and lymphoid cells in the lymphoepithelial lesions were positive for CD20 and CD79α. The neoplastic cells expressed monotypic cytoplasmic IgM kappa. The demonstration of bone marrow cells of B-lineage expressing the same monoclonal protein as the tumor suggested bone marrow involvement, even in the absence of identical morphology. Despite chemotherapy and rituximab treatment, clinical follow-up showed right kidney extension with high-grade transformation, and finally systemic dissemination. This case illustrates that the kidney is among the sites that may be involved by MALT B-cell lymphomas in a primary or secondary fashion, and the need for expanded investigation of the possible dissemination. We review the literature on this unusual extranodal lymphoma.

  12. [Effect of berberine on left ventricular remodeling in renovascular hypertensive rats].

    PubMed

    Zhao, Hai-Ping; Hong, Ying; Xie, Jun-Da; Xie, Xin-Ran; Wang, Jing; Fan, Jiang-Bo

    2007-03-01

    The purpose of this study is to evaluate the effects and the underline mechanisms of berberine on the cardiac function and left ventricular remodeling in rats with renovascular hypertension. The renovascular hypertensive model was established by the two-kidney, two-clip (2K2C) method in Sprague-Dawley (SD) rats. Two weeks after surgery, all the operated SD rats were randomly assigned into four groups: (1) renovascular hypertensive model group; (2) berberine 5 mg x kg(-1) group; (3) berberine 10 mg x kg(-1) group; (4) captopril 45 mg x kg(-1) group; and the sham operated rats were used as control. Four weeks after the drugs were administered, the cardiac function was assessed. The ratios of heart weight to body weight (HW/BW), left ventricular weight to body weight (LVW/BW) and right ventricular weight to body weight (RVW/BW) were compared between groups. Coronal sections of the left ventricular tissue (LV) were prepared for paraffin sections, picrosirius red and HE staining was performed. The left ventricular wall thickness (LVWT), interventricular septal thickness (IVST), the parameters of myocardial fibrosis indicated by interstitial collagen volume fraction (ICVF) and perivascular collagen area (PVCA) were assessed. Nitric oxide (NO), adenosine cyclophosphate (cAMP) and guanosine cyclophosphate (cGMP) concentrations of left ventricular tissue were measured. Berberine 5 mg x kg(-1) and 10 mg x kg(-1) increased the left ventricular +/- dp/dt(max) and HR. Berberine 10 mg x kg(-1) decreased HW/BW and LVW/BW. The image analysis showed that both 5 and 10 mg x kg(-1) of berberine decreased LVWT, ICVF and PVCA, while increased the NO and cAMP contents in left ventricular tissue. Berberine could improve cardiac contractility of 2K2C model rats, and inhibit left ventricular remodeling especially myocardial fibrosis in renovascular hypertension rats. And such effects may partially associate with the increased NO and cAMP content in left ventricular tissue.

  13. Apparatus for disintegrating kidney stones

    NASA Technical Reports Server (NTRS)

    Angulo, E. D. (Inventor)

    1984-01-01

    The useful life of the wire probe in an ultrasonic kidney stone disintegration instrument is enhanced and prolonged by attaching the wire of the wire probe to the tip of an ultrasonic transducer by means of a clamping arrangement. Additionally, damping material is applied to the wire probe in the form of a damper tube through which the wire probe passes in the region adjacent the transducer tip. The damper tube extends outwardly from the transducer tip a predetermined distance, terminating in a resilient soft rubber joint. Also, the damper tube is supported intermediate its length by a support member. The damper system thus acts to inhibit lateral vibrations of the wire in the region of the transducer tip while providing little or no damping to the linear vibrations imparted to the wire by the transducer.

  14. Kidney cell electrophoresis, continuing task

    NASA Technical Reports Server (NTRS)

    Todd, P. W.

    1985-01-01

    Materials and procedures for microgravity electrophoresis of living human embryonic kidney cells were evaluated to provide ground support in the form of analytical cell electrophoresis and flow cytometry. Preflight culture media, electrophoresis buffer, fraction collection media, temperature profiles, and urokinase assay procedures were tested prior to flight. Electrophoretic mobility distributions of aliquots of the cell population to be fractionated in flight were obtained. Cells were prepared in suspension prior to flight in electrophoresis buffer and 10% calf serum. Electrophoretic separation proceeded in electrophoresis buffer without serum in the Continuous Flow Electrophoretic Separator, and fractions were collected into sample bags containing culture medium and concentrated serum. Fractions that yielded enough progeny cells were analyzed for morphology and electrophoretic mobility distributions. It is noted that the lowest mobility fraction studied produced higher mobility progeny while the other fractions produced progeny cells with mobilities related to the fractions from which they were collected.

  15. Managing the kidney waiting list.

    PubMed

    Zarifian, April; O'Rourke, Marian

    2006-09-01

    Candidates on the kidney transplant list wait for longer periods and have increasing numbers of comorbid conditions. To ensure that these candidates are acceptable for transplantation when an organ becomes available, physical, psychosocial, and financial strategies are essential. The authors surveyed 68 transplant centers to determine current practices. Eighteen percent of centers did not reevaluate candidates. Other programs used time on the list, disease, age, or a combination of these factors as evaluation criteria. Initial cardiac evaluation was relied upon by 51.4% of centers, with varying criteria used to determine status. Social work evaluation was done by 42.6% of centers, usually annually. Annual financial reevaluation was performed in 57.4%. Data support reviewing candidates, especially those with diabetes, those who have been receiving dialysis for a long time, and those older than 60 years. The dedication of one coordinator to manage waitlisted candidates using age, diagnosis, and time receiving dialysis was effective in this study.

  16. Chronic kidney disease in children

    PubMed Central

    Becherucci, Francesca; Roperto, Rosa Maria; Materassi, Marco; Romagnani, Paola

    2016-01-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Although relatively uncommon in children, it can be a devastating illness with many long-term consequences. CKD presents unique features in childhood and may be considered, at least in part, as a stand-alone nosologic entity. Moreover, some typical features of paediatric CKD, such as the disease aetiology or cardiovascular complications, will not only influence the child's health, but also have long-term impact on the life of the adult that they will become. In this review we will focus on the unique issues of paediatric CKD, in terms of aetiology, clinical features and treatment. In addition, we will discuss factors related to CKD that start during childhood and require appropriate treatments in order to optimize health outcomes and transition to nephrologist management in adult life. PMID:27478602

  17. Deformity of Ears and Kidneys

    PubMed Central

    Taylor, W. C.

    1965-01-01

    Ten children with gross deformity of the external ear were observed. In six the facial bones were underdeveloped on the same side as the deformed ear. In all six there was a congenital abnormality of the kidney or upper urinary tract, usually on the same side as the deformed ear. In addition there were usually other associated congenital defects in each case. In the remaining four children the facial bones appeared normal, and pyelography showed no abnormality of the urinary tract. In these four children there were no other associated defects. These observations emphasize the importance of investigating the urinary tract in children with gross deformity of the external ear, especially where there is an associated underdevelopment of the facial bones. PMID:14317453

  18. Kidney injuries related to ipilimumab.

    PubMed

    Izzedine, Hassane; Gueutin, Victor; Gharbi, Chems; Mateus, Christine; Robert, Caroline; Routier, Emilie; Thomas, Marina; Baumelou, Alain; Rouvier, Philippe

    2014-08-01

    Monoclonal antibodies directed against the immune checkpoint protein cytotoxic T-lymphocyte antigen-4 (CTLA-4; CD152) have been investigated in metastatic melanoma and other cancers and have shown promising results. Inhibition of CTLA-4 characteristically induces well-known side effects called "immune-related adverse events" (irAEs). IrAEs mainly include colitis, dermatitis, hepatitis, endocrinopathies; uveitis, iridocyclitis, neuropathies, and inflammatory myopathy have occasionally been reported. Kidney involvement is rare. We report 2 cases of acute granulomatous interstitial nephritis and present, based on literature review, renal disorders related to Ipilimumab therapy. Autoimmune symptoms have to be carefully checked for patients treated with CTLA-4 inhibitors. In order to reduce the risk of sequelae, early recognition of irAEs and treatment initiation are crucial.

  19. Loss of Prolyl Carboxypeptidase in Two-Kidney, One-Clip Goldblatt Hypertensive Mice

    PubMed Central

    Grobe, Nadja; Leiva, Orly; Morris, Mariana; Elased, Khalid M.

    2015-01-01

    It is well documented that angiotensin (Ang) II contributes to kidney disease progression. The protease prolyl carboxypeptidase (PRCP) is highly expressed in the kidney and may be renoprotective by degrading Ang II to Ang-(1-7). The aim of the study was to investigate whether renal PRCP protein expression and activity are altered in two-kidney, one-clip (2K1C) Goldblatt hypertensive mice. Left renal artery was constricted by using 0.12 mm silver clips. Blood pressure was measured using telemetry over the eleven weeks of study period and revealed an immediate increase in 2K1C animals during the first week of clip placement which was followed by a gradual decrease to baseline blood pressure. Similarly, urinary albumin excretion was significantly increased one week after 2K1C and returned to baseline levels during the following weeks. At 2 weeks and at the end of the study, renal pathologies were exacerbated in the 2K1C model as revealed by a significant increase in mesangial expansion and renal fibrosis. Renal PRCP expression and activity were significantly reduced in clipped kidneys. Immunofluorescence revealed the loss of renal tubular PRCP but not glomerular PRCP. In contrast, expression of prolyl endopeptidase, another enzyme capable of converting Ang II into Ang-(1-7), was not affected, while angiotensin converting enzyme was elevated in unclipped kidneys and renin was increased in clipped kidneys. Results suggest that PRCP is suppressed in 2K1C and that this downregulation may attenuate renoprotective effects via impaired Ang II degradation by PRCP. PMID:25706121

  20. Temporal Trends in the Histology of the Rabbit Kidney after Cavitational Tissue Ablation

    NASA Astrophysics Data System (ADS)

    Hall, Timothy L.; Kieran, Kathleen; Fowlkes, J. Brian; Cain, Charles A.; Roberts, William W.

    2007-05-01

    Tissue can be mechanically ablated through inertial cavitation generated by high intensity pulsed ultrasound. The ablation appears acutely as a fine slurry with absent cellular structure. Long-term effects and the evolution of histologic changes in disrupted tissue remain poorly understood. This study aimed to characterize the 0-60 day histology of cavitational ablation in a rabbit model. 29 New Zealand White rabbits were anesthetized and exposed to high intensity pulses of ultrasound (60000 pulses, 20 usec duration, 750 kHz, 1 kHz PRF, 18 MPa peak rarefactional pressure, lower pole, left kidney). Kidneys were harvested immediately from five rabbits. The others were recovered and the kidneys were harvested 1, 2, 7, 20, or 60 days after treatment. Grossly, kidneys from 0-2 days displayed subcapsular bruising near the exposure site and some hemorrhage in the adjacent perirenal fat; microscopically, a disrupted, acellular zone measuring 3-5 mm by 5-10 mm accompanied by local infiltration of neutrophils (acute inflammation) was seen. Kidneys harvested after 7 days displayed tubular dilatation adjacent to the targeted area and collagen deposition consistent with scar formation. Decreased collagen deposition, decreased size of the disrupted zone, and regeneration of the tubular basal cell layer of dilated tubules was evident by day 20. Kidneys harvested at 20 and 60 days had contour defects near the exposure site with an apparent volume loss. Cavitation causes orderly and predictable histologic changes. Local renal damage induced during histotripsy may be partially reversible. Further research is needed to identify the clinical correlates of the observed histologic findings.