• Title/Summary/Keyword: renal pathology

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Two pediatric cases with hematuria, normal renal function and positive antineutrophil cytoplasmic antibodies

  • Ji Hyeon Lim;Ji Won Jung;Heoun Jeong Go;Joo Hoon Lee;Young Seo Park
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.86-90
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    • 2022
  • Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis requires prompt diagnosis and treatment, since renal function at the time of diagnosis is significantly associated with renal outcomes. Here, we report two pediatric patients with ANCA-positive glomerulonephritis initially presenting with hematuria, mild proteinuria, and normal renal function. The first patient with a high myeloperoxidase-ANCA titer (>134 IU/mL) was diagnosed with rapidly progressive glomerulonephritis based on renal biopsy and treated with immunosuppressive therapy after 10 months of follow-up. The second patient with a low myeloperoxidase-ANCA titer (11 IU/mL) maintained normal kidney function without medication. Two cases showed different clinical course according to ANCA titer.

Two cases of Familial Juvenile Hyperuricemic Nephropathy (Familial Juvenile Hyperuricemic Nephropathy 2례)

  • Park Jin-Ho;Choi Bo-Hwa;Lee So-Young;Yoo Eun-Sil;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.183-188
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    • 1997
  • Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

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Water Extract of Hovenia dulcis Suppressed Lipid Peroxidation and Improved Renal Function in $CCl_4$ Intoxicated Rats ($CCl_4$를 투여한 랫드에서 헛개나무 열수추출물의 지질과산화 억제와 신기능 개선 작용)

  • park Yeun Woo;Yang Si Yang;Lee Min Kyung;Jin Ju Young;Cho Jung Hee;Kim Ki Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.868-873
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    • 2004
  • Renal dysfunction could be developed as the secondary disease of liver cirrhosis. Delayed or suppresed lipid peroxidation by the treatment with physiological active substances could be explained as the antioxidative and protective effect in tissue damage. In this study, we investigated an antioxidative effect and renal function improvement of Hovenia dulcis in liver fibrosis(cirrhosis) induced rats. The female Sprague-Dawley rats (180∼210 g) were divided into 3 groups (Normal, AC: CCl₄ mixture treated group, AC-HV: CCl₄ mixture+ Hovenia dulcis treated group) and renal damage was developed by CCl₄ mixture administration in 4 weeks (0.8 ㎖/rat). The tissue of kidney and liver and sera were used for quantitative measurement of enzyme activity, MDA and Hyp. The histological change and gene expression of collagen α1(III) mRNA and a1(IV) mRNA were observed by Masson's trichrome staining and RT-PCR. As a result, the clinical biochemical parameters of liver function (AST and ALT) in sera of AC-HV group showed significantly 46.4% and 104.8% lower (p<0.005), and the level of ALP and BUN as the parameter of protein urine and azotemia showed 17.8 % and 25.8 % lower than in AC group. In AC-HV group, the concentration of MDA in kidney and liver was decreased significantly 15.8% and 21.3% when compared with AC group (p<0.01 -0.005). The content of Hyp in kidney of AC-HV group is merely higher than in AC group, in contrast to liver tissue. The expression of collagen α1(III) mRNA and collagen α1(IV) mRNA was decreased in AC, but both of collagen mRNA in normal and AC-HV group expressed fast similar. More massive lipid droplets, thicker collagen fiber bundles in portal triads and more formation of portal central septum were observed in the liver of AC group than in AC-HV group. In conclusion, CCl₄ mixture intoxication could be developed not only liver fibrosis(cirrhosis) but also renal dysfunction by the massive lipid peroxidation and suppression of interstitial collagen and basement membrane collagen synthesis. And the water extract of Hovenia dulcis may be possessed the antioxidative and protective effect and improvement of kidney function in renal dysfunction induced rats.

Vanadate-Induced Renal cAMP and Malondialdehyde Accumulation Suppresses Alpha 1 Sodium Potassium Adenosine Triphosphatase Protein Levels

  • Eiam-Ong, Somchit;Nakchui, Yuyen;Chaipipat, Mookda;Eiam-Ong, Somchai
    • Toxicological Research
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    • v.34 no.2
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    • pp.143-150
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    • 2018
  • It has been demonstrated that vanadate causes nephrotoxicity. Vanadate inhibits renal sodium potassium adenosine triphosphatase (Na, K-ATPase) activity and this is more pronounced in injured renal tissues. Cardiac cyclic adenosine monophosphate (cAMP) is enhanced by vanadate, while increased cAMP suppresses Na, K-ATPase action in renal tubular cells. There are no in vivo data collectively demonstrating the effect of vanadate on renal cAMP levels; on the abundance of the alpha 1 isoform (${\alpha}_1$) of the Na, K-ATPase protein or its cellular localization; or on renal tissue injury. In this study, rats received a normal saline solution or vanadate (5 mg/kg BW) by intraperitoneal injection for 10 days. Levels of vanadium, cAMP, and malondialdehyde (MDA), a marker of lipid peroxidation were measured in renal tissues. Protein abundance and the localization of renal ${\alpha}_1-Na$, K-ATPase was determined by Western blot and immunohistochemistry, respectively. Renal tissue injury was examined by histological evaluation and renal function was assessed by blood biochemical parameters. Rats treated with vanadate had markedly increased vanadium levels in their plasma, urine, and renal tissues. Vanadate significantly induced renal cAMP and MDA accumulation, whereas the protein level of ${\alpha}_1-Na$, K-ATPase was suppressed. Vanadate caused renal damage, azotemia, hypokalemia, and hypophosphatemia. Fractional excretions of all studied electrolytes were increased with vanadate administration. These in vivo findings demonstrate that vanadate might suppress renal ${\alpha}_1-Na$, K-ATPase protein functionally by enhancing cAMP and structurally by augmenting lipid peroxidation.

Kidney reconstruction using kidney cell transplantation in kidney failure animal model

  • Kim, Sang-Soo;Park, Heung-Jae;Han, Joung-Ho;Choi, Cha-Yong;Kim, Byung-Soo
    • 한국생물공학회:학술대회논문집
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    • 2003.10a
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    • pp.347-350
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    • 2003
  • Dialysis and renal transplantation, the current therapies for end-stage renal disease (ESRD), have many limitations including severe complications, organ shortage, and graft failure. To overcome the limitations, the present study investigated the reconstruction of renal tissue in vivo by transplanting isolated fetal renal cells using fibrin gel to the kidney of renal failure rat model. After 4 weeks from the transplantation, blood urea nitrogen(BUN) and creatinine were examined from blood samples and histological examination of the implanted tissues revealed formation of renal-like structures and restoration of renal function.

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Preventive Effect of Puerariae Radix and Rehmanniae Radix Preparata on Cisplatin-induced Rat Mesangial Cell Apoptosis (갈근(葛根)과 숙지황(熟地黃) 추출물의 cisplatin에 의한 rat mesangial cell의 apoptosis에 대한 보호효과)

  • Ju, Sung-Min;Park, Jin-Mo;Jeon, Byung-Jae;Yang, Hyun-Mo;Hong, Jae-Eui;Kim, In-Gyu;Kim, Won-Sin;Jeon, Byung-Hun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.5
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    • pp.1140-1146
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    • 2008
  • One of the major side effects of cisplatin is nephrotoxicity, leading to acute renal failure. Recent study has suggested a role of hydroxyl radicals and p53 in renal cell injury by cisplatin. This study determined the possible involvement of oxidative stress in p53 activation. In rat mesangial cells, cisplatin treatment induced apoptosis and p53 activation. Pifithrin-$\alpha$, a pharmacological inhibitor of p53, suppressed cisplatin-induced apoptosis. Cisplatin also induced reactive oxidative species (ROS) generation. Of interest, cisplatin-induced apoptosis was prevented by N-acetyl-cysteine (NAC), a general antioxidant. NAC diminished p53 activation during cisplatin treatment. Puerariae Radix and Rehmanniae Radix Preparata with antioxidative activity were reduced the cisplatin-induced ROS generation, caspase-3 activity and p53 activation. In conclusion, ROS may contribute to p53 activation to initiate cisplatin-induced apoptosis in rat mesangial cells. In result, antioxidative effect of Puerariae Radix and Rehmanniae Radix Preparata prevented cisplatin-induced apoptosis through inhibition of p53 activation.

A Case of Juvenile Glomerulonephropathy in a Cocker Spaniel Dog (어린 cocker spaniel 종에서 발생한 신부전증)

  • Kwon, O-Serng;Yi, Jung-Yeon;Kwak, Ho-Hyun;Woo, Heung-Myung;Han, Jeong-Hee;Yoon, Byung-Il
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.647-652
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    • 2007
  • In the present study, we address systemically a case of renal disease developed in a 1 year-old male cocker spaniel dog in terms of clinical signs, clinical pathology and pathological examinations. The animal has been suffered from renal dysfunction signs such as polyuria, anorexia, vomiting, diarrhea and weight loss. The dog was very weak and emaciated and had foamy contents with foul-smell in oral cavity. The animals showed notable decrease in the number of red blood cells and severe decreases of hemoglobin and hematocrit with or without changes of mean corpuscular volume and mean corpuscular hemoglobin concentration values, indicating microcytic or normocytic hypochromatic anemia. In serum chemistry, blood urea nitrogen, creatinine, phosphorous, Na and Cl, which are associated with renal function, were dramatically increased. In addition, alanine aminotransferase, aspartate transferase, alkaline phosphatase, cholesterol, lipase and amylase were also significantly elevated, while K concentration was notably decreased. Urinalysis indicated prominent proteinuria with increase of bilirubin. Despite of symptomatic treatments, the dog was getting worse in healthy condition and dead in the end. At necropsy, both kidneys were brownish, pale, slightly small, and have diffuse, firm and subcapsular pits. Histologically, the kidneys indicated prominent segmental or diffuse interstitial fibrosis in cortex and medulla as well as glomerulonephritis. The clinical signs, clinical pathology and histopathological abnormalities of the young dog presented were consistent with chronic glomerulonephropathy, which was suspected to be a case of familial renal disease in the juvenile cocker spaniel dog.

Effects of Bojungchiseup-tang on Renal Expression of Water Channels, Na, K-ATPase and Nitric Oxide Synthase in Rats (보중치습탕의 백서 신장 수분채널, Na, K-ATPase, 산화질소 합성효소 발현에 미치는 영향)

  • Kang Dae Gill;Kim Jang Giun;Kim Bok Hae;Cho Dong Ki;Sohn Eun Jin;Ryu Do Gon;Lee Ho Sub
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.1
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    • pp.72-77
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    • 2002
  • The present study was examined the effects of Bojungchiseup-tang water extract on the renal expression of renal function regulatory proteins including aquaporin 2 (AQP 2), aquaporin 3 (AQP 3), Na, K-ATPase α1 subunit, endothelial nitric oxide synthase (ecNOS), and inducible nitric oxide synthase (iNOS) in rats. The renal expression of AQP 3 was attenuated in rats administered with Bojungchiseup-tang water extract without altered expression of AQP 2, while ecNOS was up-regualted. Oral administration of Bojungchiseup-tang water extract (40 ㎕/100 g) also attenuated the renal expression of Na, K-ATPase α1-subunit and iNOS protein. These results suggest that the diuretic and natriuretic effects of Bojungchiseup-tang maybe causely related with a decreased expression of AQP 3 and increased expression of ecNOS.

Clinical Study of Gamdutang Complex Formula on Patients of Acute Renal Failure due to Paraquat Intoxication

  • Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.588-593
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    • 2002
  • Paraquat, one of the potent herbicides, causes fatal damage to many vital organs, when orally ingested, resulting in circulatory failure, respiratory distress syndrome, and a few other serious problems, but there is no known specific antidote against it. Of the possible problems related to paraquat intoxication, oliguric acute renal failure, which has been known to develop within 24 or 48 hours after intoxication, are notoriously life-threatening. So we attempted to investigate the clinical characteristics and progress of paraquat-induced acute renal failure and the therapeutic possibilities of herbal medicines. All of the fifteen subjects were treated with intravenous fluid injection of 5% dextrose saline or 10% dextrose water in conjunction with herbal medicines which were used for oral administration or gargling. Gamdutang, a decoction of Semen Glycin(黑豆 200g) and Radix Glycyrrhizae(甘草 100g) with addition of other herbs when necessary, was administered orally. At the same time, gargling fluid, consisted of Chinese ink(墨汁), char-frying powder of Rhei Rhizoma(大黃炒炭末), Succus phyllostachyos(竹瀝), was used to detoxify the oral cavity. Serum levels of Blood Urea Nitrogen(BUN) and Creatinine reached its peak on the third day of hospitalization, but then decreased and fell within the normal range on the 7th day and remained there. Serum levels of Na+ and K+ decreased down below the lower limits of normal range on the 7th day and on the 3rd day, respectively. Then they returned back within normal limits. Mean urine output on the 1st day of hospitalization was 1,050ml and it continuously increased to reach more than 2,000ml on the 14th day. From that day on, it stayed over 2,000ml. Fifteen cases of acute renal failure caused by paraquat intoxication were treated with combined treatments of oriental and western medicine in our hospital. However, we think that it is necessary to study further about the way to combine oriental and western medicine, to find out a more effective treatment method.

Clinical Characteristics and Long-Term Prognosis of Alport Syndrome: A Retrospective Single-Center Study

  • Jang, Hea Min;Baek, Hee Sun;Park, Sun-Hee;Kim, Yong-Lim;Kim, Chan-Duck;Jung, Hee-Yeon;Cho, Jang-Hee;Han, Man Hoon;Kim, Yong Jin;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.24 no.2
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    • pp.91-97
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    • 2020
  • Purpose: Alport syndrome (AS) is one of the most common inherited renal diseases caused due to mutations of genes encoding specific proteins of the type IV collagen family, and its major clinical manifestations include progressive renal failure, sensorineural deafness, and ocular abnormalities. We investigated the clinical characteristics and long-term prognosis of AS in Korean pediatric and adult populations. Methods: We conducted a retrospective review of medical records of 33 children and adults who had been diagnosed or treated with AS from 1985 to 2019. Results: The mean age of the 33 patients diagnosed with AS was 16.2±13.6 years, and the male-to-female ratio was 2:1. At the first visit, recurrent gross hematuria was the most common initial symptom. In 10 of 33 patients (30.3%), sensorineural hearing loss (SNHL) was diagnosed, but none had ophthalmic problems. Moreover, 11 of 33 patients (33.3%) had advanced to end-stage renal disease (ESRD), and a significant difference was observed in the age of the patients who progressed to ESRD based on the presence or absence of SNHL (P=0.035). Conclusion: SNHL in AS can be an important prognostic factor for long-term deterioration of renal function. Further investigation is required to confirm the clinical course and the genetic characteristics of AS in Korea through prospective national cohort studies.