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EN
The increasing prevalence of diabetic kidney disease (DKD), a common complication of type 1 and type 2 diabetes, is becoming a leading risk factor of developing end stage renal disease (ESRD). The multiple mechanisms involved in renal tissue damage are a challenge for effective targeted therapy. Urolithins are metabolites generated by gut microbiota upon dietary intake of plant-derived elagitannins. Multidirectional effects of these compounds include their anti-inflammatory, antioxidant, anti-proliferatory, anti-migratory and antiglycative properties that are mediated by modulation of signaling pathways and gene expression. Biochemical properties of urolithins indicate their capacity to regulate numerous mechanisms responsible for developing the hyperglycemia-induced tissue injury. The potentially beneficial effects of urolithins on podocytes, the most vulnerable renal cells should be particularly considered. The purpose of this review is to provide the evidence from the in vivo and in vitro studies showing that urolithin-based therapy could be a useful tool for protecting the kidneys from damage in diabetes.
EN
Renal artery pseudoaneurysms and arteriovenous fistulae most often occur as an iatrogenic complication. The article discusses a case of a patient diagnosed with an arteriovenous fistula and a pseudoaneurysm. A 64-year-old woman was admitted to the hospital due to nonspecific pain in the lumbar region. Imaging showed a typical picture of clear cell renal carcinoma. The patient was qualified for surgical treatment. After tumor resection, the patient developed microhematuria. Arteriovenous fistula and renal pseudoaneurysm were diagnosed using Doppler and computed tomography scans. The patient was qualified for arteriography with simultaneous embolization of the lesion. A follow-up evaluation confirmed the exclusion of aneurysm and fistula. Treatment outcomes were monitored using Doppler ultrasound. Doppler ultrasonography is the first method of choice in detecting and monitoring renal artery irregularities. Safety, non-invasiveness and easy access to this tool make it play a key role in the diagnosis of renal artery fistulas and pseudoaneurysms.
PL
Pseudotętniaki tętnic nerkowych i przetoki tętniczo-żylne nerek pojawiają się najczęściej jako powikłania jatrogenne. W pracy omówiono przypadek chorej, u której w badaniu ultrasonograficznym i tomografii komputerowej rozpoznano przetokę tętniczo-żylną i tętniaka rzekomego, zlokalizowane w nerce prawej, a następnie leczonej metodami wewnątrznaczyniowymi. Sześćdziesięcioczteroletnia kobieta została przyjęta do szpitala z powodu niespecyficznych dolegliwości bólowych w okolicy lędźwiowej. Badania obrazowe wykazały typowy obraz dla jasnokomórkowego raka nerki. Chorą zakwalifikowano do leczenia chirurgicznego. Po resekcji klinowej u pacjentki obserwowano okresowy krwinkomocz. Za pomocą badania dopplerowskiego i tomografii komputerowej zdiagnozowano przetokę tętniczo-żylną i tętniaka rzekomego nerki prawej. Chorą zakwalifikowano do arteriografii z równoczasową embolizacją. Po zabiegu embolizacji badania kontrolne potwierdziły wyłączenie tętniaka i przetoki z krążenia. Wyniki leczenia monitorowano za pomocą badań dopplerowskich. Ultrasonografia dopplerowska jest metodą z wyboru w wykrywaniu i monitorowaniu nieprawidłowości tętnic nerkowych. Bezpieczeństwo, nieinwazyjność i dostępność badania sprawiają, że odgrywa ono kluczową rolę w diagnozowaniu przetok tętnic nerkowych i pseudotętniaków.
PL
Zaproponowano sposób wyznaczania bezwzględnych i względnych zmian rezystancji w modelu elektrycznym krwiobiegu nerki. W oparciu o znane analogie między zjawiskami przepływu krwi w naczyniach i organach, a przepływem prądu w obwodach elektrycznych, zastosowano opisaną metodę do wyznaczenia zmian oporu naczyniowego nerki dla rzeczywistych danych medycznych. Przeprowadzono doświadczenie medyczne in vivo, polegające na zarejestrowaniu ciśnienia tętniczego i prędkości krwi w tętnicy nerki przeszczepionej, przed i po wysiłku fizycznym. Bezwzględne i względne zmiany oporu naczyniowego porównano ze zmianami współczynnika RI (indeks oporowy).
EN
The trend analysis of changes in parameters of the electric analogue of the kidney blood circulation will facilitate after transplantation the recognition of the clinical state of the kidney and the easier recognition of potential pathologies will make possible. In research was compared: the resistance index (RI), average value of blood flow in renal artery and the vascular resistance of kidney before and after effort. An equivalent electric circuit of kidney blood vessels was created for analysis of blood flow in the renal artery. An arterial system pressure and a waveform of the blood velocity and RI were recorded in the renal artery with using the ultrasound scanner of Doppler at woman with transplant's kidney. On the base of the calculated amplitude spectrum the parameters of the equivalent electric circuit of the kidney blood circulation were appointed. In conducted research, value RI increased about 8% after effort. After effort the average value of blood flow dropped about 28%, however vascular resistance increase about 54%. The evaluation of state of transplanted kidney on the base the change of vascular resistance is more accurate than appointing RI. The method seems be useful for hemodynamic evaluation and after clinical tests for diagnostic of the transplanted kidney.
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EN
The presence of surfactant proteins was investigated in the human organ of Corti, Eustachian tube and kidney tissues. It has previously been shown that lamellar bodies are present in hairy cells of organ of Corti, in the cytoplasm of secretory and lumen of tubal glands of Eustachian tube and kidney renal basement membrane. No evidence for the presence of surfactant proteins in the organ of Corti and kidney has been presented until now. The aim of this study was to find out if surfactant proteins were expressed in other epithelia such as organ of Corti, Eustachian tube and kidney. Surfactant proteins were identified using one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting. On one-dimensional Western blots, bands for surfactant protein A in human Eustachian tube (SP-A, 34 kDa) and in kidney extracts, and for surfactant protein D (SP-D, 43 kDa) in Eustachian tube and in kidney extracts (SP-D, 86 kDa), and for surfactant protein B (SP-B, 8 kDa) in human Eustachian tubeand organ of Corti extracts were detected. Bands corresponded to monomeric forms of lung surfactant proteins. These results indicate the presence of SP-A and SP-D in kidney epithelium, SP-A, SP-B and SP-D in Eustachian tube and SP-B in the organ of Corti.
EN
Autosomal dominant polycystic kidney disease is the most common genetic cause of renal failure. Apart from kidney involvement, patients are at risk of extra-renal manifestations, including vascular lesions. The etiology of vascular changes is diverse and depends, among other factors, on polycystin gene mutation, increased activity of the renin-angiotensin-aldosterone system and the occurrence of hypertension. The observed vascular system complications include cerebral artery aneurysms, cervico-encephalic arteries' dissection, aortic aneurysm and dissection and intracranial arterial dolichoectasia. This article discusses the etiopathogenesis, symptomatology, principles of prevention and treatment of the aforementioned diseases of the vascular system accompanying polycystic kidney disease.
EN
2-oxoglutarate dehydrogenase (2-OGDH) is the key regulatory enzyme of cell metabolism. It has been previously demonstrated that in rats subjected to protein restriction low, clinically relevant doses of fibrates up-regulate liver 2-OGDH and promote 2-oxoglutarate catabolism. The aim of the present study was to evaluate the effect of low doses of fenofibrate and bezafibrate on renal 2-OGDH complex in rats fed low-protein chow. Fibrates were administrated for 14 days to Wistar male rats at one daily doses of 5, 10 and 20 mg/kg b.wt./day. The 2-OGDH activity was assayed spectrophotometrically. The mRNA levels for 2-OGDH catalytic subunits (E1 and E2) and PPARα were quantified by means of semi-quantitative reverse-transcription-PCR. 2-OGDH activity increased in response to administration of fenofibrate and bezafibrate (by 11, 24, 32% and 9, 12, 21%, respectively). The difference was statistically significant for the doses of 10 and 20 mg/kg b.wt of fenofibrate (p<0.001) and the highest dose of bezafibrate (p<0.05). Stimulation of 2-OGDH was not accompanied by changes in mRNA levels for E1 and E2. In addition, mRNA level for PPARα did not change. It is conceivable that fibrate-induced stimulation of 2-OGDH activity can affect renal metabolism and contribute to changes in kidney functions.
7
Content available remote Laparoscopic Live-Donor Nephrectomy With Retroperitoneoscopic Access
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EN
Live donation remains the single most consistent factor affecting long-term results of the transplantation. Open live donor nephrectomy is associated with high traumatization and possibility of complications due to large skin incision. The alternative is laparoscopic live donor nephrectomy (LDN) which is widely used in many countries. We present the case of LDN. The retroperitoneal approach was applied and time of operation was 210 min. The immediate function of transplanted kidney was observed. Authors hope that the offering this minimally invasive procedure to the potential donors may popularize the idea of live donation in Poland.
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EN
Summary: The aim of the study was to determine the incidence of renal venous system congenital anomalies in the Polish population. Material and method: Vascular kidney samples were investigated by means of preparations and X-ray contrasting. The study the group comprised 281 male and 269 female specimens. Results: Congenital anomalies were diagnosed in 186 patients (33 8% of all cases), and they were more frequent in men than in women, albeit that difference was non-significant. The following anomalies were most commonly observed: multiple venous variations on the right side (20.4%), retroaortic course of the left renal vein (4.2%), and circumaortic venous ring of the left renal vein (3.8%). Other anomalies were diagnosed in 1%-2% of cases. Conclusions: Awareness and preoperative assessment of the venous system before abdominal aortic surgery, isolated collection of renal venous blood samples, and urological or kidney transplantation procedures is essential.
EN
This study aimed to assess levels of silver nanoparticle residues in eggshells and tissues as well as the levels of selected biochemical parameters and oxidative stress indices in chickens hatched from nanosilver disinfected eggs. The samples included 40 Greenleg Partridge chicks allocated into two groups. The experimental group (group D) consisted of chickens hatched from eggs disinfected with a nanosilver preparation prior to incubation, while the control group (group C) included chickens whose eggs were exposed to UV radiation for disinfection. The eggshells and kidney sections obtained from group D chickens showed a significantly higher silver level compared to group C. For the biochemical parameters, only the uric acid content was higher in group D compared to group C. Analysis of the antioxidative stress biomarkers (superoxide dismutase and catalase), showed a significant increase in group D in relation to group C.
EN
Thoracic kidney is the rarest, usually asymptomatic type of kidney ectopia. 2 cases of thoracic kidney discovered incidentally through chest radiography are reported. In both patients renal function tests were normal and no further treatment was necessary. Ultrasonography and computed tomography studies performed for confirmation of the diagnosis are presented. An embryonic background of this abnormality is discussed.
EN
Purpose: To evaluate whether advanced glycation end products (AGE) levels are increased in the plasma and renal tissues of rats after unilateral renal artery stenosis (RAS). Materials and methods: AGE levels were measured using commercially available ELISA kit in plasma and renal tissue samples obtained from 16 rats with experimental induced RAS for 3 and 28 days and from 6 respective sham-operated control rats. We also analyzed by HPLC the concentration of 4-hydroxynonenal (4-HNE), a known inducer of AGE formation and accumulation. Results: Plasma concentrations of 4-HNE and AGE were significantly increased (p<0.05) after 28 days of RAS. At this time point, the concentration of AGE was markedly increased in the clipped atrophic kidney (by about 10-fold; p<0.05), but it was unchanged in the contralateral kidney of the same rats. No differences in plasma and renal AGE levels were detected at day 3 of RAS. Sham operation did not affect the levels of AGE and 4-HNE at each time point. Conclusions: Increased accumulation of AGE both in the plasma and in the ischemic atrophic kidney suggest that AGE levels can be used as a reliable biomarker for monitoring the development of ischemic nephropathy caused by renal artery stenosis.
EN
With development of medical diagnostic and imaging techniques the sparing surgeries are facilitated. Renal cancer is one of examples. In order to minimize the amount of healthy kidney removed during the treatment procedure, it is essential to design a system that provides three-dimensional visualization prior to the surgery. The information about location of crucial structures (e.g. kidney, renal ureter and arteries) and their mutual spatial arrangement should be delivered to the operator. The introduction of such a system meets both the requirements and expectations of oncological surgeons. In this paper, we present one of the most important steps towards building such a system: a new approach to kidney segmentation from Computed Tomography data. The segmentation is based on the Active Contour Method using the Level Set (LS) framework. During the segmentation process the energy functional describing an image is the subject to minimize. The functional proposed in this paper consists of four terms. In contrast to the original approach containing solely the region and boundary terms, the ellipsoidal shape constraint was also introduced. This additional limitation imposed on evolution of the function prevents from leakage to undesired regions. The proposed methodology was tested on 10 Computed Tomography scans from patients diagnosed with renal cancer. The database contained the results of studies performed in several medical centers and on different devices. The average effectiveness of the proposed solution regarding the Dice Coefficient and average Hausdorff distance was equal to 0.862 and 2.37 mm, respectively. Both the qualitative and quantitative evaluations confirm effectiveness of the proposed solution.
EN
Background. There is evidence that dyslipidemia is associated with chronic kidney disease (CKD) and it has been implicated in the progression of renal damage. Optimal management of dyslipidemia should therefore lead to renal benefits. A number of experimental models demonstrate a beneficial effect of statins in ameliorating renal damage. However, the exact mechanism by which statins protect against renal damage remains unclear. Methods. In a placebo-controlled, randomized, cross-over study we evaluated the influence of atorvastatin (ATO) 40 mg/day added to the renin-angiotensin-aldosterone systeme (RAAS) blockade on proteinuria and surrogate biomarkers of tubular damage or injury in 14 non-diabetic patients with proteinuria (0.4-1.8 g per 24 h) with normal or declined kidney function (eGFR 55-153 ml/min). In the eight-week run-in period, therapy using angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II subtype 1 receptor antagonists (ARB) was adjusted to achieve a blood pressure below 130/80 mm Hg. Next, patients were randomly assigned to one of two treatment sequences: ATO/washout/placebo or placebo/washout/ATO. Clinical evaluation and laboratory tests were performed at the randomization point and after each period of the study. The primary end point of this study was a change in proteinuria measured as 24-h urine protein excretion (DPE). Secondary end points included urine N-acetyl-β-d-glucosaminidase (NAG) and α1-microglobulin (α1m) excretion. Results. The ATO therapy significantly reduced urine excretion of α1m (p=0.033) and NAG (p=0.038) as compared to placebo. There were no differences in proteinuria, blood pressure, eGFR and serum creatinine between the ATO and placebo groups. Conclusion. Atorvastatin treatment is safe and improves biomarkers of tubular damage or injury in non-diabetic patients with CKD.
EN
Amyloidosis is a disease caused by the deposition of amorphous extracellular protein, leading to impaired kidney function. Canine and feline amyloidosis is associated with the deposition of AA protein. The disease is hereditary and is related to breed but not sex. Predisposed breeds include the Shar Pei dog and Abyssinian cat. Proteinuria resulting in hypoalbuminemia due to changes in renal glomeruli is the first clinical sign. In addition, a decreased appetite, anorexia, vomiting, lethargy, polyuria and polydipsia may be observed. In order to diagnose the disease, serum amyloid A levels may be measured. However, a definitive diagnosis is made on the basis of an intravital renal biopsy and the presence of amyloid in the histopathological examination. The main goal of treatment is to reduce inflammation and proteinuria. If nephrotic syndrome occurs, the prognosis is guarded to poor, and the majority of patients do not survive one year. The definitive diagnosis is based on the post-mortem examination, in which the presence of amyloid deposits is confirmed in the kidney tissue. We present the case of a 7-year-old female Shar Pei diagnosed with kidney amyloidosis, on the basis of which we have developed a prevention scheme for clinical practice.
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EN
Relatively successful elsewhere, gene delivery aimed at the vasculature and kidney has made very little progress. In the kidney, the hurdles are related to the unique structure–function relationships of this organ and in the blood vessels to a variety of, mostly endothelial, factors making the delivery of transgenes very difficult. Among gene-therapeutic approaches, most viral gene delivery systems utilized to date have shown significant practical and safety-related limitations due to the level and duration of recombinant transgene expression as well as their induction of a significant host immune response to vector proteins. Recombinant adeno-associated virus (rAAV) vectors appear to offer a vehicle for safe, long-term transgene expression. rAAV-based vectors are characterized by a relative non-immunogenicity and the absence of viral coding sequences. Furthermore, they allow for establishment of long-term latency without deleterious effects on the host cell. This brief review addresses problems related to transgene-delivery to kidney and vasculature with particular attention given to rAAV vectors. The potential for gene therapy as a strategy for selected renal and vascular diseases is also discussed.
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