Effect of vitamin D3 overdose and calcium supplementation in experimental nephrolithiasis model

Introduction:There is little information in the literature relating supplementary oral usage of vitamin D and calcium to the development of kidney stones. Objective:To evaluate the effect of high dose, 200 IU of vitamin D3 (V) with calcium supplementation (Ca). Methods:Experimental model consists of insertion of pellets into the bladder of rats. V was administered for 30 days with or without Ca. The rats were divided in 6 groups: 1. Sham, 2. Pellets control; 3. V control; 4. Pellets + V; 5. Pellets + Ca and 6. Pellets + Ca + V. Results:50% and 17% decreases bladder stones formation in groups 5 and 6, p < 0.005 comparing with the group 2 were observed. There was no hypercalcemia or hypercalciuria in all groups. We observed a significant decrease in calciuria in group 6 (p = 0.03). Conclusion:The administration of the V associated with Ca significantly decreased the formation of stones and caused a significant reduction in urinary calcium, suggesting a protection in the lithogenic pathophysiology.Introdução:Há poucos dados na literatura sobre a suplementação de vitamina D e cálcio e o desenvolvimento de cálculos renais. Objetivo:Avaliar o efeito de doses elevadas de vitamina D3 (V), com suplemento de cálcio (Ca) no desenvolvimento de litíase em modelo experimental. Métodos:Pastilhas foram inseridas na bexiga de ratos, que receberam V com ou sem Ca. Ratos foram divididos em seis grupos: 1. Sham; 2. Controle com pastilha, 3. Controle com V, 4. Pastilha + V, 5. Pastilha + Ca e 6. Pastilha + Ca + V. Resultados:Observou-se 50% e 17% de redução na formação de cálculos, respectivamente nos grupos 5 e 6 em comparação ao grupo 2 (p < 0,005). Não foram observadas hipercalcemia ou hipercalciúria em todos os grupos. Encontramos no grupo 6 (p = 0,03) uma redução significativa na calciúria. Conclusão:A administração de V associada com Ca diminuiu significantemente a formação de cálculos e reduziu significantemente a calciúria, sugerindo uma interferência benéfica na fisiopatologia litogênica.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Detection of podocyturia in patients with lupus nephritis

INTRODUCTION: The podocyturia has been detected in glomerular diseases, such as lupus nephritis (LN), in which proteinuria is an important manifestation, and its occurrence seems to be limited to the active phase of the disease. OBJECTIVE: To evaluate podocyturia in LN patients, and the possible association with clinical disease activity. METHODS: We evaluated 56 patients with LN, that were classified in three groups according to the degree of clinical activity: Group B, no activity (n = 17), Group C with mild (n = 29) and Group D, moderate to severe activity (n = 10). The control group was composed by 29 healthy subjects (Group A). The podocyturia was studied by indirect immunofluorescence using primary antibodies to podocyte: anti-podocin, nephrin and synaptopodin, and a secondary antibody conjugated with FITC. We also evaluated serum creatinine levels, urinary protein/creatinine (P/C) ratio, hematuria and leucocituria. RESULTS: The podocyturia with anti-podocin and anti-sinaptopodin correlated statistically with the P/C ratio (p = 0.001 and p = 0.013, respectively). The podocyturia with anti-podocin, as well as the P/C ratio showed significant correlation (p < 0.001) with the degree of lupus disease activity, unlike the other two antibodies, anti-nephrin and anti-synaptopodin. CONCLUSION: Our findings show that podocyturia with anti-podocin could be useful in monitoring disease activity in LN patients.INTRODUÇÃO: A podocitúria tem sido detectada em doenças glomerulares, tais como em nefrite lúpica (NL), em que a proteinúria é uma manifestação importante, e sua ocorrência parece limitar-se à fase ativa da doença. OBJETIVO: Avaliar a podocitúria por imunofluorescência em pacientes portadores de NL e verificar possível associação com atividade clínica da doença. MÉTODOS: Foram avaliados 56 pacientes com NL. Os pacientes foram divididos em três grupos de acordo com o grau de atividade clínica: Grupo B, sem atividade (n = 17); Grupo C, com atividade discreta (n = 29) e Grupo D, moderada a grave (n = 10). Como grupo controle, foram incluídos 29 indivíduos saudáveis (Grupo A). A podocitúria foi estudada por meio de imunofluorescência indireta, usando-se anticorpos primários antipodocina, nefrina e sinaptopodina, e anticorpo secundário conjugado à FITC. Também foram avaliados os níveis de creatinina sérica e da relação proteína/creatinina (P/C) urinária, assim como a presença de hematúria e leucocitúria. RESULTADOS: A podocitúria com antipodocina e com antissinaptopodina correlacionou-se estatisticamente com a relação P/C (p = 0,001 e p = 0,013, respectivamente). Tanto a podocitúria com antipodocina, quanto a relação P/C, apresentaram correlação significante (p < 0,001) com a graduação de atividade da doença na NL, diferentemente do que se observou com os outros dois anticorpos, antinefrina e antissinaptopodina. CONCLUSÃO: Nossos achados sugerem que a pesquisa de podocitúria com anticorpos antipodocina poderia ser útil no acompanhamento de pacientes com NL, fornecendo dados relevantes quanto à atividade da doença.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Electroacupuncture and Moxibustion Decrease Renal Sympathetic Nerve Activity and Retard Progression of Renal Disease in Rats

Background/Aim: Chronic kidney disease (CKD) is an increasing major public health problem worldwide. the sympathetic nervous system and nitric oxide play an important role in the pathogenesis of CKD. Traditional Chinese medicine has accumulated thousands of years of therapeutic experiences. Electroacupuncture (EA) and moxibustion (MO) are two such therapeutic strategies. the aim of this study was to investigate the renal and hemodynamic effects of EA-MO in an experimental model of a CKD. Methods: Male Wistar rats submitted to 5/6th nephrectomy (5/6 NX) were studied for 8 weeks. There were four groups: (1) control, normal rats; (2) NX, 5/6 NX only; (3) NX-AS, 5/6 NX and EA-MO session using sham points, and (4) NX-AM, 5/6 NX and EA-MO session using real acupoints. Biochemical and blood pressure studies, renal sympathetic nerve activity measurements, nitric oxide levels and the histopathological indices were assessed. Results:The EA- and MO-treated group presented significant improvement in all measured functional and histopathological parameters. Conclusion: These findings suggest that EA-MO had beneficial effects on CKD. This effect was probably achieved by the modulation of the renal sympathetic nerve activity and nitric oxide levels, leading to decreased blood pressure, which is associated with less proteinuria. Copyright (c) 2012 S. Karger AG, BaselConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fed Univ São Paulo UNIFESP, Dept Med, Div Nephrol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Physiol, Cardiovasc Physiol Div, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Pathol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Chinese Med & Acupuncture Div, Dept Orthoped & Traumatol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Med, Div Nephrol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Physiol, Cardiovasc Physiol Div, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Pathol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Chinese Med & Acupuncture Div, Dept Orthoped & Traumatol, São Paulo, BrazilWeb of Scienc

Pré-dimensionamento de válvulas de alívio a partir do cálculo de volume expulso de água durante transitório hidráulico

Este trabalho tem por objetivo verificar a viabilidade da adoção de determinados diâmetros de válvula de alívio para algumas configurações de adutora durante eventos de parada de bomba e posterior golpe de aríete. Para isso, adotou-se a modelagem computacional do transiente hidráulico a partir do UFC 7, que utiliza o Método das Características e o modelo de Cavidade de Gás Livre Discreto com celeridade variável, e da válvula de alívio por meio do uso da equação da vazão através do orifício e das curvas de abertura e fechamento da válvula proposta por Bell et al. (2020), com adaptações para evitar sobrepressões secundárias. Os resultados obtidos foram ilustrados por meio de três configurações distintas de adutoras, em que foram exibidas as envoltórias de pressão e os gráficos de volume disponível nas tubulações ao longo do tempo. A partir destes, verificou-se que diâmetros elevados de válvula de alívio promovem o esvaziamento total da água existente na adutora, o que na prática é impossível de ocorrer. Assim, pode-se propor a adoção de diâmetros ideais para cada caso, também sendo observado o critério de geração de sobrepressões secundárias. Ademais, foram testados mais oito casos e, a partir de algumas combinações dos dados de entrada destas adutoras, foi proposta uma equação para pré-dimensionamento da válvula de alívio. Sugere-se, então, que essa equação seja testada em casos distintos para averiguar se, de fato, cumpre a função pretendida

Previous Exercise Training Has a Beneficial Effect on Renal and Cardiovascular Function in a Model of Diabetes

Exercise training (ET) is an important intervention for chronic diseases such as diabetes mellitus (DM). However, it is not known whether previous exercise training intervention alters the physiological and medical complications of these diseases. We investigated the effects of previous ET on the progression of renal disease and cardiovascular autonomic control in rats with streptozotocin (STZ)-induced DM. Male Wistar rats were divided into five groups. All groups were followed for 15 weeks. Trained control and trained diabetic rats underwent 10 weeks of exercise training, whereas previously trained diabetic rats underwent 14 weeks of exercise training. Renal function, proteinuria, renal sympathetic nerve activity (RSNA) and the echocardiographic parameters autonomic modulation and baroreflex sensitivity (BRS) were evaluated. In the previously trained group, the urinary albumin/creatinine ratio was reduced compared with the sedentary diabetic and trained diabetic groups (p &lt; 0.05). Additionally, RSNA was normalized in the trained diabetic and previously trained diabetic animals (p &lt; 0.05). The ejection fraction was increased in the previously trained diabetic animals compared with the diabetic and trained diabetic groups (p &lt; 0.05), and the myocardial performance index was improved in the previously trained diabetic group compared with the diabetic and trained diabetic groups (p &lt; 0.05). In addition, the previously trained rats had improved heart rate variability and BRS in the tachycardic response and bradycardic response in relation to the diabetic group (p &lt; 0.05). This study demonstrates that previous ET improves the functional damage that affects DM. Additionally, our findings suggest that the development of renal and cardiac dysfunction can be minimized by 4 weeks of ET before the induction of DM by STZ.Fundacao de Amparo a Pesquisa do Estado de Sao PauloFundacao de Amparo a Pesquisa do Estado de Sao PauloConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao Oswaldo RamosFundacao Oswaldo RamosCNPq-Bolsa de Produtividade em pesquisa (BPQ)CNPqBolsa de Produtividade em pesquisa (BPQ

Relative Contribution of Morphometric and Functional Indicators of Tubulointerstitial Lesion to Glomerular Diseases Prognosis

Background: Early diagnosis of proximal tubular lesions can be achieved by detecting abnormal levels of low molecular weight proteins in urine. Material and Methods: 100 cases of glomerulopathies were retrospectively studied to establish the profile of urinary levels of retinol-binding protein (urRBP) and their correlation with histological markers of tubulointerstitial lesions in renal biopsies. the histological study included staining with picrosirius red. Results: Non-proliferative glomerulopathies, male sex, white race and young adults were predominant. the chance of abnormal urRBP occurring was higher among patients with a predominant proliferative component, baseline serum creatinine >1.2 mg/dl (p = 0.008), creatinine clearance <70 ml/min (p = 0.006), and severe interstitial fibrosis (p = 0.042). in multivariate analysis, only serum creatinine and creatinine clearance were independently associated to urRBP, and only urRBP was a time-independent prognostic factor for survival without renal failure ( risk of renal failure: 9 !). Conclusion: Our study suggests that urRBP determination is prognostically relevant in the progression of glomerulopathies; on the other hand, the evaluated morphometric markers correlated poorly with the clinical outcome of these patients. Consequently, urRBP determination, as a functional marker of tubulointerstitial damage, was more appropriate for determining the prognosis of glomerular diseases than the morphometric analysis of renal biopsies. Copyright (C) 2008 S. Karger AG, BaselConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Serv Nephrol, EPM, Div Nephrol,Glomerulopathy & Renal Immunopathy Se, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Serv Nephrol, EPM, Div Nephrol,Glomerulopathy & Renal Immunopathy Se, BR-04023900 São Paulo, BrazilWeb of Scienc

Renal tuberculosis in adult polycystic kidney disease: Report of 2 cases and review of the literature

Adult polycystic kidney disease (APKD) is a common and potentially fatal disease, leading to end-stage renal failure in 50% of cases. the disease is frequently complicated by arterial hypertension, bacterial pyelonephritis, and hematuria. the association between APKD and tuberculosis has rarely been reported and is related to a more unfavorable course since the infection becomes refractory to specific treatment. the authors report 2 cases of renal tuberculosis diagnosed in the native nephrectomy specimens of 2 patients with APKD after renal transplantation. Tuberculosis, although not common, must be recognized as a potential source of infection of native polycystic kidneys in immunocompromised transplant recipients.Universidade Federal de São Paulo, Paulista Sch Med, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Nephrol Discipline, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Nephrol Discipline, São Paulo, BrazilWeb of Scienc