Renal function after release of chronic unilateral hydronephrosis in man

Renal function after release of chronic unilateral hydronephrosis in man. Differential renal function studies performed on ten patients after release of unilateral hydronephrosis revealed that the previously obstructed kidney exhibits abnormalities in a number of physiological indexes. Many of the obstructed kidneys had an impairment of glomerular filtration rate, concentrating ability, acidification, sodium reabsorption and tubular maximal secretion of para-aminohippurate with normal urinary dilution. Despite impairment of sodium and water reabsorption, none of these patients, nor 20 additional patients, had a significant postobstructive diuresis from the previously obstructed kidney. All of the patients had normal total renal function. Thus, the changes observed were a result of the obstructive injury and were not related to azotemia or aberrations in water or sodium metabolism

The effect of nitric oxide on the pressure of the acutely obstructed ureter

Acute ureteral obstruction leads to changes in pressure inside the ureter, interrupting ureter function. The aim of our study is to explore the relationship between nitric oxide (NO) concentration and pressure in the ureter and to observe the effects of nitric oxide on the revival of renal function. We created the animal models by embedding balloons in the lower ureters of anesthetized dogs and expanding them to simulate acute ureteral obstruction. First, the test animals were pre-treated intravenously with different doses of L-NAME (non-selective nitric oxide synthase inhibitor) to inhibit nitric oxide synthase (NOS), and 10 min later, each subject was administered an intravenous dose of isoproterenol (10 μg/kg). We measured ureter pressure (UP), total and peak concentrations of NO (using an NO monitor, model inNO-T) in ureteral urine, and the volume of the urine (UFV) leaking from the balloon edge. After a certain amount of time had elapsed, it became clear that the dose of L-NAME was inversely related to the total and peak concentrations of NO, the rate of change in UP, and the volume of urine produced. We conclude that L-NAME prevents the NOS from inhibiting the release of NO, then inhibits the effect of isoproterenol reducing the pressure of the acute obstructive ureter. Inversely, we think that NO can reduce the pressure of the acute obstructive ureter and make the obstructive ureter recanalization. And when more the concentration of nitric oxide, the more the pressure will be reduced, and more urine will be collected

Enfermedades de las gl\ue1ndulas suprarrenales

Es un hecho afortunado que sea muy grande la capacidad de diagnosticar las entidades suprarrenales espec\uedficas que obligan a seguir una terap\ue9utica operatoria. La combinaci\uf3n de metodolog\ueda anal\uedtica para medir la producci\uf3n hormonal apropiada de corteza y m\ue9dula suprarrenales, s, las t\ue9cnicas radiogr\ue1ficas de localizaci\uf3n, han generado resultados excelentes. El tratamiento de estos trastornos suprarrenales por medio de t\ue9cnicas laparosc\uf3picas despu\ue9s de localizaci\uf3n satisfactoria ha hecho que haya una reversi\uf3n de las anormalidades metab\uf3licas y tambi\ue9n de la hipertensi\uf3n que suele acompa\uf1ar a estas entidades. Por lo expuesto, la historia comprende buenos resultados, gracias a la evoluci\uf3n de estas t\ue9cnicas diferentes en los \ufaltimos 50 a\uf1os

Page kidney as a complication of percutaneous antegrade endopyelotomy

A kidney with a compressive process that results in hyperreninemic hypertension is often referred to as a Page kidney. We present a case of Page kidney that resulted as a complication of percutaneous antegrade endopyelotomy. The patient had a typical presentation and classic radiologic signs of such a process. Surgical management consisted of nephrectomy, with resultant resolution of signs and symptoms. © 2005 Elsevier Inc

Chronic unilateral ureteral obstruction is associated with interstitial fibrosis and tubular expression of transforming growth factor-β

Chronic unilateral ureteral obstruction (UUO) results in interstitial fibrosis and nephron damage associated with irreversible loss of function. Collagen is increased in UUO, but detailed studies of rat renal extracellular matrix changes in UUO have not been carried out. Acute (3-day) obstruction results in increases in renal macrophages and the fibrogenic cytokine transforming growth factor-β (TGF-β), but their involvement in longer-term obstruction and fibrosis has not been studied. In the present experiments, kidneys of rats after UUO of 0, 1, 2, 3, 7, 14, 21, and 28 days\u27 duration were used. Trichrome staining, measurement of interstitial volume, and immunohistochemical studies localizing collagens I, III, and IV; laminin; fibronectin; TGF-β; and macrophages were carried out. We found increases in the interstitial space in both codex and medulla that (a) were significant by day 7 after UUO and (b) were accompanied by increased deposition of collagen I and collagen III. Collagen IV, laminin, and fibronectin, normally associated with the basement membrane, were found both in a thickened basement membrane and in the interstitial space. Macrophages, not found in sham-operated kidneys, were found in the interstitial space after UUO. TGF- β was found in sham cortical tubules, but not in medullary tubules. UUO was associated with little change in cortical TGF-β, whereas at 14 days, TGF-β was found in dilated medullary tubules. Immunohistochemical findings were confirmed with measurements of tissue TGF-β. In summary, UUO is associated with interstitial fibrosis. The increase in extracellular matrix is due both to increases in the interstitial collagens I and III and the basement membrane-associated collagen IV, laminin, and fibronectin. Macrophages are increased after UUO, but do not seem to be associated with the fibrogenic cytokine TGF-β. Medullary tubular synthesis of TGF-β may be a contributing factor in the fibrosis associated with UUO

Transforming growth factor-β receptor types I and II are expressed in renal tubules and are increased after chronic unilateral ureteral obstruction

Transforming growth factor-β (TGF-β) is a profibrotic cytokine which has been implicated in the renal fibrosis which follows unilateral ureteral obstruction (UUO) in the rat. TGF-β receptor types I (TGF-RI) and TGF-β. We sought to determine if TGF-Ri and TGF-RII are found in the kidney, and if their expression is changed as a result of UUO. Polymerase chain reaction (PCR) was used to determine expression of mRNA for TGF-RI and TGF-RII in the kidney. Immunoperoxidase was used to localize and quantify the expression of these receptors at 3, 7, 14, 21 and 28 days after UUO, and in sham-operated animals. Expression of mRNA for TGF-RI and TGF-RII was demonstrated in sham operated, obstructed ad contralateral unobstructed kidneys using PCR. Using immunoperoxidase, a uniform kidneys, whereas medullary tubules showed a patchy TGF-RI distribution and no TGF-RII staining. After UUO, an increased tubular expression of TGF-RI and TGF-RII was noted in both obstructed and contralateral kidneys compared to sham operated kidneys. No staining for either TGF-RI or TGF- RII was noted in glomeruli, vasculature or intestinal cells. TGF-β receptors I and II were found exclusively in renal tubules and were shown to increase in both the obstructed and contralateral kidneys relative to sham operated animals. Upregulation of TGF-β receptors in both kidneys suggest that TGF-β may contribute to the fibrotic response in the obstructed kidney and the hypertrophic response of the contralateral kidney