Journal of nephropathology
Volume:9 Issue: 2, Apr 2020

Contrast-induced nephropathy (CIN) is an iatrogenic disease caused by the parenteral administration of iodinated contrast media (CM). A number of agents are currently being assessed to minimise or prevent CIN. Such agents are typically assessed using rat models. The aim of this study was to provide a comprehensive review of the rat models of CIN used in pre-clinical research. The MEDLINE, EMBASE, Web of Science and Cochrane databases were systematically searched. Articles reporting rat models of CIN were included for assessment. Study designs, contrast agents and outcome measures were assessed. Of the assessed studies, a majority report a requirement for pre-existing renal impairment prior to the administration of CM. Outcome measures are heterogenous between studies, but typically include assessment and quantification of serum biochemical markers, cellular oxidative stress and histopathological changes. The significant variation in methodology reported in the current literature highlights the lack of consensus. The use of a reliable pre-contrast insult appears critical to result in the development of contrast nephropathy. The use of acceptable outcome measures appears to include serum laboratory markers, quantification of reactive oxygen species (ROS) and objective histopathological outcomes.

Sirolimus is a macrolide and a type of immunosuppressant drug to prevent rejection of transplanted organs. This drug inhibits the activation of T and B lymphocytes and reduces the production of interleukin-2 (IL-2).

This study aimed to review the effect of sirolimus in kidney transplantation in patients with diabetes mellitus as a systematic review.

International databases including PubMed, Web of Science and Scopus were considered for search of English articles by 29 June 2019. Twenty-one published articles were finally entered into the study. Keywords were sirolimus, rapamune, rapamycin, diabetes mellitus and kidney transplantation or a combination of them in the title/abstracts. Treatment using a combination of sirolimus and tacrolimus were excluded.

There were more than 3244 subjects reviewed in this systematic review including 21 published articles (Total population of 21 articles: 3244 people).

According to the results, sirolimus-based immunosuppression for preventing kidney transplantation is effective and has a low-risk in diabetic patients resulting in suitable glucose control.

Lupus nephritis (LN) is a substantial manifestation of systemic lupus erythematosus (SLE). HDAC6 is overexpressed in various kidney diseases, and its inhibition slows kidney injury progression. Urinary TFF3 increases in chronic kidney diseases (CKDs) and may be associated with patient’s outcome.

This study aimed to examine the relationship between renal HDAC6 and TFF3 proteins expression and with clinicopathologic characteristics and outcome of LN. Patients and

HDAC6 and TFF3 proteins’ expression was immunohistochemically detected in 56 cases of LN. They were correlated to patients’ age, gender, urinary 24 hours protein and serum creatinine levels at baseline and during follow up. Additionally, they were correlated to LN classes, activity index (AI) and chronicity index (CI) and relapse free survival (RFS).

HDAC6 overexpression was significantly associated with serum creatinine and 24 hours proteinuria levels at baseline (P = 0.041 and P =0.026 respectively) and during follow up (P < 0.001). It was associated with AI and CI of class III and IV LN (P = 0.047 and 0.003 respectively). TFF3 overexpression was associated with higher serum creatinine and more proteinuria at baseline (P = 0.015 and 0.001 respectively) and during follow up (P < 0.001). It was significantly associated with higher CI (P = 0.001). Both markers were associated with shorter RFS (P < 0.001).

HDAC6 and TFF3 proteins are associated with clinicopathologic features of renal damage in LN. They are reliable predictors of patients’ RFS, which makes them good candidates for risk stratification of patients and targeted therapy.

The frequency that idiopathic focal segmental glomerulosclerosis (FSGS) recurs in renal allografts is reportedly 20-50%, but the epidemiology of secondary FSGS in this setting has scarcely been addressed.

The aim of this study was to examine the incidence, etiology, and subtypes of FSGS in renal allograft recipients and allograft survival in recipients with FSGS. Patients and

As a retrospective review, we examined medical records of 359 consecutive renal allograft recipients (living donors, 329; cadaveric donors, 30). In 121 of these patients, allograft dysfunction or proteinuria prompted biopsies. We compared allograft survival in recipients with and without FSGS. We then determined histologic subtypes of FSGS using the Columbia classification and categorized FSGS as recurrent or de novo, and idiopathic or secondary.

Of 121 subjects who were biopsied, six with inadequate specimens (<10 glomeruli) were excluded. Only 17 of those remaining (n=115) were diagnosed as secondary FSGS. Renal allograft survival did not differ significantly in patients with or without FSGS (P=0.953). Subtypes of FSGS were as follows; not otherwise specified (NOS; n=8), collapsing (n=5), cellular (n=2), and perihilar (n=2).

Secondary FSGS was observed in 14.5% of biopsies of renal allograft recipients and seemed no significant impact on allograft survival.

Febrile convulsion (FC) is the most common seizure disorder in childhood. Few studies focused on epidemiologic characteristics of urinary tract infections accompanied by FC.

To evaluate prevalence and incidence rates of FC among children with urinary tract infection. Patients and

An observational study in epidemiology was performed in nephrology clinic of a tertiary children hospital from June 2002 to 2016. Totally 1242 cases were followed and those aged 6-60 months enrolled in the study. Demographic characteristics were compared between patients with and without FC.

784 cases including 704 girls (89.8%) and 80 boys (10.2%) enrolled. Twenty-five patients (3.18%) presented with FC. FC occurred in 25 of 503 cases (5%) with febrile urinary tract infection. Twenty girls and 5 boys were in FC and 684 girls and 75 boys were in non-FC groups (P= 0.1). The average age in FC and non-FC groups were 15.52±8.4 and 25.16± 16 months respectively (P=0.004). Patients were divided into 2 age sub-groups: 6-24 and 26-60 months. A significantly higher number of cases in FC compared with non-FC group were in age subgroup of 6-24 months (P=0.028).

Our study revealed a prevalence rate of 3.18% and an incidence rate of 5% for FC among children with urinary tract infection. Also FC subjects had a significantly younger age at presentation than non-FC cases. We found that FC as presentation of urinary tract infection occurred up to 3 years old, and there is no significant gender difference between FC and non-FC cases.

High prevalence of pulmonary hypertension has been reported in patients with chronic renal failure, especially those undergoing hemodialysis.

Considering the high prevalence of pulmonary hypertension in hemodialysis patients and uncertainty about the causes, the present study planned to investigate the role of parathyroid hormone (PTH) and cardiac ejection fraction (EF %) in development of pulmonary hypertension. Patients and

By simple census sampling, all patients on hemodialysis in the hemodialysis center of Birjand University of Medical Sciences were enrolled. After obtaining written consent, the EF% and systolic pulmonary artery pressure (sPAP) were determined using echocardiography (MEDISON V10 model, Korea). The cut-point of less than 35 mm Hg was considered for normal sPAP. The blood sample was prepared to assay PTH using COBAS411 and ROCH kit. Independent t test or Man-Whitney test were used to compare means. P value <0.05 was considered significant.

A totsl of 114 patients were enrolled in the study. Finally 89 patients, including 49 (55.1%) male and 40 (44.9%) female completed the study. The mean age and mean sPAP of the studied patients were 55.14 ± 15.68 years and 30.65 ± 12.10 mm Hg respectively. Among the studied patients, normal and high sPAP were reported in 60 (67.4%) and 29 (32.6%) cases respectively. Cardiac EF% in patients with normal and high sPAP was 59.08 ± 2.83 versus 56.37 ± 4.79 respectively (P = 0.01). PTH was determined 275.12 ± 218.44 versus 395.67 ± 332.05(pg/mL) (P = 0.03), in patients with normal and high sPAP respectively.

The prevalence of pulmonary hypertension in the studied patients was 32.6%. Patients in the pulmonary hypertension group had higher levels of PTH and lower cardiac EF%.

Benign prostate hyperplasia, pathophysiology contributes to bladder outlet obstruction due to functional obstruction caused by gland size enlargement resulting in the lower urinary tract symptoms (LUTS).

To determine the correlation of the prostate volume with surgical outcomes and postoperative LUTS in patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Patients and

Patients with BPH who were refractory for medical treatment enrolled in the study. Patients divided into three groups with attention to their prostate volume conducted by transabdominal ultrasonography. To evaluate patients’ LUTS, the International Prostate Symptom Score (IPSS) questionnaire was filled for all patients preoperatively and during the first and third months follow up sessions.

In the current study, mean age of the patients was 66.92 ± 1.08 years. Of 111 patients, eight patients (7.2%) had prostate volume less than 30 cc, 59 patients (53.2%) had prostate volume between 30-60 cc, and 44 patients (39.6%) had prostate volume more than 60 cc. During first month postoperative, mean decrease in IPSS scores in patients with prostate volume less than 30 cc, prostate volume between 30–60 cc and prostate volume more than 30 cc were 27.72 ± 3.53, 27.32 ± 3.37 and 27.45 ± 2.87, respectively. The ANOVA test showed no significant difference between the groups (P= 0.93). Mean decrease in IPSS score during third month postoperative, had no significant difference between the three groups, too (P=0.71). Symptoms alleviation observed in 94.6% and 95.5% of the patients, during first and third months follow-up, respectively.

There was no correlation between the IPSS scores decrease and patients’ symptoms recovery and preoperative prostate volume in patients with BPH who underwent TRUP.

Immune checkpoint inhibitors (CPIs) represent novel new cancer immunotherapy agents. The use of nivolumab has been linked with immune mediated acute interstitial nephritis (AIN).

We present the case of a patients with recurrent hepatocellular carcinoma who developed severe Fanconi syndrome, as evidenced by hyperchloremic metabolic acidosis, hypokalemia, hypophosphatemia, glucosuria, aminoaciduria, 8 months after initiating treatment with nivolumab, without any evidence of acute renal insufficiency.

Clinicians need to be aware of the renal side effects of new novel cancer immunotherapy agents, such as, immune CPIs

There exist few reports of de novo tumors involving an allograft kidney, and to the best of our knowledge there are only two previous reports of angiomyxoma

A 53-year-old Caucasian male with end-stage renal disease (ESRD) on hemodialysis (HD) secondary to malakoplakia with three failed prior renal transplants presented for repeat transplant evaluation. Imaging demonstrated a mass of the transplanted kidney suggestive of posttransplant lymphoproliferative disease (PTLPD). A biopsy was obtained revealing a predominance of myxoid material. The patient became increasingly symptomatic from the mass and underwent a palliative right transplant nephrectomy. Final pathology revealed angiomyxoid tumor.

Angiomyxomas are asymptomatic, appear as PTLD on imaging and should be considered in the differential diagnosis of masses occurring in renal transplant allografts