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Multiple renal veins clogging the hilum of the right kidney

  • Satheesha B Nayak;Narendra Pamidi;Vasanthakumar Packirisamy;Soumya Kodimajalu Vasudeva
    • Anatomy and Cell Biology
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    • v.56 no.1
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    • pp.141-144
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    • 2023
  • Knowledge of variations of renal vessels is of utmost importance in retroperitoneal surgeries and kidney transplant surgeries. We report concurrent variations of the right renal vessels, observed in an adult male cadaver during dissection classes. The right kidney was supplied by three renal arteries, out of which two entered the kidney through the hilum and the other one entered through the lower pole of the kidney. There were five renal veins, emerging independently from the hilum and opening separately through five openings into the inferior vena cava. Among the veins, only one emerged anterior to the renal pelvis and the other four emerged behind it. Four of them terminated into the posterolateral aspect of the inferior vena cava, whereas one terminated into its anterior aspect. Fourth vein from above, received the right testicular vein. The renal hilum was clogged with the presence of seven vessels and renal pelvis.

Differentiation of Chromophobe Renal Cell Carcinoma and Clear Cell Renal Cell Carcinoma by Using Helical CT (나선식 CT를 이용한 혐색소형 신세포암과 투명세포형 신세포암의 감별)

  • Kim, Hong-Chul;Cho, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.14-18
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    • 2012
  • Background: The purpose of this study was to differentiate chromophobe renal cell carcinoma and clear cell renal cell carcinoma on helical CT. Methods: The CT images of 9 patients histopathologically proven to have chromophobe renal cell carcinoma and 20 patients with clear cell renal cell carcinoma were reviewed. The tumor sizes, margins, enhancement degrees and patterns, presence or absence of calcification, and tumor spread patterns (including perinephric changes, venous invasion, lymphadenopathy, and distant metastasis) were compared. Results: All the chromophobe renal cell carcinomas showed well-demarcated margins. Thechromophobe renal cell carcinomas showed milder enhancements than the clear cell renal cell carcinomas. The sensitivity and specificity for differentiating the chromophobe renal cell carcinoma from the clear cell renal cell carcinoma were 100 and 88%, respectively, when 101 Hounsfield units was used as the cut-off value in the corticomedullary phase, and 95 and 100% when a less-than-three-time enhancement change was used as a cut-off value in the corticomedullary phase (p<0.05). The chromophobe renal cell carcinomas (67%) tended to show a homogeneous enhancement whereas the clear cell renal cell carcinomas (85%) usually showed a heterogeneous enhancement (p<0.05). Statistical analysis revealed that the frequencies of the tumor spread pattern and calcification in the two subtypes didnot differ significantly (p>0.05). Conclusion: The CT findings of the chromophobe renal cell carcinomascompared to those of the clear cell renal cell carcinomas showed that there were mild enhancements in the corticomedullary phase, homogeneous enhancements, and well-demarcated margins.

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Renal Precursor Cell Transplantation Using Biodegradable Polymer Scaffolds

  • KIM , SANG-SOO;PARK, HEUNG-JAE;HAN, JOUNG-HO;PARK, MIN-SUN;PARK, MOON-HYANG;SONG, KANG-WON;JOO, KWAN-JOONG;CHOI, CHA-YONG;KIM, BYUNG-SOO
    • Journal of Microbiology and Biotechnology
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    • v.15 no.1
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    • pp.105-111
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    • 2005
  • End-stage renal disease is a fatal and devastating disease that is caused by progressive and irreversible loss of functioning nephrons in the kidney. Dialysis and renal transplantation are the common treatments at present, but these treatments have severe limitations. The present study investigated the possibility of reconstructing renal tissues by transplantation of renal precursor cells to replace the current treatments for end-stage renal disease. Embryonic renal precursor cells, freshly isolated from metanephroi of rat fetus at day 15 post-gestation, were seeded on biodegradable polymer scaffolds and transplanted into peritoneal cavities of athymic mice for three weeks. Histologic sections stained with hematoxylin & eosin and periodic acid-Schiff revealed the formation of primitive glomeruli, tubules, and blood vessels, suggesting the potential of embryonic renal precursor cells to reconstitute renal tissues. Immunohistochemical staining for proliferating cell nuclear antigen, a marker of proliferating cells, showed intensive nuclear expression in the regenerated renal structures, suggesting renal tissue reconstitution by transplanted embryonic renal precursor cells. This study demonstrates the reconstitution of renal tissue in vivo by transplanting renal precursor cells with biodegradable polymer scaffolds, which could be utilized as a new method for partial or full restoration of renal structure and function in the treatment of end-stage renal disease.

Sonographic renal length and volume of normal Thai children versus their Chinese and Western counterparts

  • Rongviriyapanich, Chantima;Sakunchit, Thanarat;Sudla, Chirawat;Mungkung, Supamas;Pongnapang, Napapong;Yeong, Chai Hong
    • Clinical and Experimental Pediatrics
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    • v.63 no.12
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    • pp.491-498
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    • 2020
  • Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.

Effects of Renal Arterial Trifluoperazine on the Renal Function in Conscious Rabbit (무마취가토 신동맥내 투여에 의한 Trifluoperazine의 신장기능에 미치는 영향)

  • Koh, Gou Y.;Cho, Kyung W.
    • The Korean Journal of Physiology
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    • v.19 no.1
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    • pp.25-33
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    • 1985
  • Renal arterial infusion of renotropic agents has been a very useful technique in the renal function studies. This type of experiments have usually been conducted in the large animals such as dogs and sheep. In these animals a catheter can be placed in the site without much disturbances of renal blood flow. Rabbits as an experimental model, however, caused a disturbances of renal blood flow by a catheterization of renal artery by its properties. Therefore we have developed a new technique that allows a simple and selective access to one side of renal arteries and the other as a control, without any disturbances of renal function. The distance between the both bifurcations of renal arteries on abdominal aorta is about 7 mm. To locate the tip of catheter on one side renal artery, ascending cannulation performed via femoral artery was done. We did an experiment with the technique to clarify the effect of calmodulin inhibitor on the renal function. One of the phenothiazine derivatives, trifluoperazine known as a powerful calmodulin inhibitor. Trifluoperazine, actual dose ranges of $2.76-5.20\;ug\;{\cdot}\;kg^{-1}\;{\cdot}\;min^{-1}$, increased urine volume and glomerular filtration rate significantly. Significant increases in urinary excretion of sodium, chloride and potassium were found. Fractional excretion of sodium and free water clearance increased significantly. These data suggest that this new technique is very useful in field of renal physiology and that striking effect of trifluoperazine on the renal function may be caused by increasing the renal hemodynamics, and by the inhibition of sodium, chloride and potassium reabsorption in the renal tubules.

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Hesperidin improves warm ischemia/reperfusion-induced oxidative renal injury in rats

  • Gandhi, Chintan;Zalawadia, Rishit;Balaraman, R.
    • Advances in Traditional Medicine
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    • v.9 no.4
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    • pp.292-302
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    • 2009
  • Ischemia/reperfusion injury, which is commonly seen in the field of renal surgery or transplantation, is a major cause of acute renal failure. Previous studies showed that antioxidant treatments attenuated renal ischemia/reperfusion injury. The objective of this study was to examine the role of hesperidin in modulating reactive oxygen species induced inflammation and apoptosis after renal ischemia/reperfusion injury. Rats were subjected to right nephrectomy, 15 days later 45 min of renal ischemia and 24 h reperfusion with or without treatment with hesperidin. Renal function, inflammation and apoptosis were compared at 24 h after reperfusion injury. Hesperidin improved the renal dysfunction and reduced inflammation and apoptosis after ischemia/reperfusion injury. In conclusion, hesperidin shows potent anti-apoptotic and antiinflammatory properties due to antioxidant property. These findings may have major implications in the treatment of human ischemic acute renal failure.

Vesicoureteral Reflux and Renal Scar (방광요관역류와 신반흔)

  • Nam, Hee-Young;Shin, Joon-Heon;Lee, Jun-Ho;Choi, Eun-Na;Park, Hye-Won
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.201-212
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    • 2006
  • Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.

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Renal Problems in Early Adult Patients with Turner Syndrome

  • Yu, Dong Uk;Ku, Jae Kyun;Chung, Woo Yeong
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.154-158
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    • 2015
  • Purpose: This study aimed to evaluate the status of renal function and the presence of urinary abnormalities in early adult patients with Turner syndrome (TS). Methods: Sixty-three girls with TS, who are attending pediatric endocrine clinics in Busan Paik Hosp., were studied. Urine and blood chemistry tests were performed in every visiting times. Renal ultrasonography was performed in all patients at the initial diagnosis, and intravenous pyelography, DMSA renal scan and renal CT were also performed, if necessary. Results: Of the 63 patients, the karyotype showed 45,X in 32 (50.8%), mosaicism in 22 (34.9%) and structural aberration in 9 (14.3%). The renal function at the latest visit was shown as normal in all patients. Nephrotic syndrome had developed in one patient. Hematuria was observed in seven patients. Renal anomalies were observed in 20 of the 63 TS (31.7%). Of the 32 TS patients with 45,X karyotype, 13 (40.6%) had renal anomalies, while these were found in 7 (22.6%) of 31 TS patients with mosaicism/structural aberration. But there was no significant statistical difference between two karyotype groups. Conclusion: Based on this study, most of the patients with TS do not have any significant problems related to renal function until early adulthood, regardless of renal malformation or hematuria.

Infarction of Renal Transplant with Extrarenal Excretion of Tc-99m $MAG_3$ Demonstrated by Renal Scintigraphy (Tc-99m $MAG_3$ 신장스캔에서 신외 배설과 함께 발견된 이식신 경색)

  • Lim, Seok-Tae;Kim, Min-Woo;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.199-201
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    • 2003
  • A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later Tc-99m $MAG_3$ renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m $MAG_3$ caused by acute renal artery thrombosis.

Effects of Acute Renal Ischemia on Aerobic Metabolism of Rabbit Kidney Homogenates (급성 신장 빈혈이 신장의 유기성 대사에 미치는 영향)

  • Kang, Suk-Won
    • The Korean Journal of Physiology
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    • v.6 no.2
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    • pp.9-17
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    • 1972
  • This experiment was carried out to investigate systematically how the aerobic metabolic capacity of renal tissue reduced by the effects of a period of induced ischemia. Aerobic metabolic studies were performed on homogenates of cortex and medulla of rabbits. Ischemia was induced by occluding the renal vein or renal artery of the left kidney for an hour. The right kidney used as a paired control. Aerobic metabolism was asesssed by measuring the oxygen consumption using the Warburg's manometric apparatus. The results are summarized as follows: 1. One hour of occlusive ischemia does not increase in the kidney weight in the renal arterial occlusion but increase in the renal venous occlusion. 2. Occlusion of either the renal vein or renal artery for an hour did not reduce to any significant degree the level of endogenous substrate in cortical homogenates as measured the rates of $0_2$ consumption. 3. A significant reduction in the rate of $C_2$ consumption was noted in the medullary homogenates of renal venous occluded kidneys while renal arterial occlusion had less of an effect. 4. The capaciy of homogenates for aerobic metabolism is not reduced by acute ischemia, because of the higher rate of oxygen consumption induced by exogenous glucose in renal vein occlusion. 5. The oxygen consumption of medullary homogenate more decreased to acute ischemia than cortical homogenates. The results of this investigation suggest that one hour circulatory stasis does not reduce major potential capacity of renal cortical tissue at the subcellular level to produce energy. In contrast, the aerobic metabolism of medullary tissue is reduced by renal ischemia. Further, both cortex and medulla appear to be more sensitive to ischemia induced by renal venous occlusion than by renal arterial occlusion.

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