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Nutrition & Diabetes Jun 2024Vitamin D was shown to directly exert a protective effect on diabetic kidney disease (DKD) in our previous study. However, whether it has an effect on perirenal adipose...
BACKGROUND
Vitamin D was shown to directly exert a protective effect on diabetic kidney disease (DKD) in our previous study. However, whether it has an effect on perirenal adipose tissue (PRAT) or the intestinal flora and its metabolites (trimethylamine N-oxide, TMAO) is unclear.
METHODS
DKD mice were received different concentrations of 1,25-(OH)D for 2 weeks. Serum TNF-α levels and TMAO levels were detected. 16S rRNA sequencing was used to analyze gut microbiota. qPCR was used to detect the expression of TLR4, NF-Κb, PGC1α, and UCP-1 in kidney and adipose tissue. Histological changes in kidney and perirenal adipose tissue were observed using HE, PAS, Masson and oil red staining. Immunofluorescence and immunohistochemistry were used to detect the expression of VDR, PGC1α, podocin, and UCP-1 in kidney and adipose tissue. Electron microscopy was used to observe the pathological changes in the kidney. VDR knockout mice were constructed to observe the changes in the gut and adipose tissue, and immunofluorescence and immunohistochemistry were used to detect the expression of UCP-1 and collagen IV in the kidney.
RESULTS
1,25-(OH)D could improve the dysbiosis of the intestinal flora of mice with DKD, increase the abundance of beneficial bacteria, decrease the abundance of harmful bacteria, reduce the pathological changes in the kidney, reduce fat infiltration, and downregulate the expression of TLR4 and NF-κB in kidneys. The serum TMAO concentration in mice with DKD was significantly higher than that of the control group, and was significantly positively correlated with the urine ACR. In addition, vitamin D stimulated the expression of the surface markers PGC1α, UCP-1 and VDR in the PRAT in DKD mice, and TMAO downregulated the expression of PRAT and renal VDR.
CONCLUSIONS
The protective effect of 1,25-(OH)D in DKD mice may affect the intestinal flora and its related metabolite TMAO on perirenal fat and kidneys.
Topics: Animals; Gastrointestinal Microbiome; Mice; Kidney; Methylamines; Male; Receptors, Calcitriol; Mice, Knockout; Diabetic Nephropathies; Adipose Tissue; Mice, Inbred C57BL; Vitamin D; Calcitriol
PubMed: 38858392
DOI: 10.1038/s41387-024-00297-z -
Cureus Oct 2023Subcapsular hematoma (SRH) or perirenal hematoma (PRH) can be seen after trauma, interventional radiological procedures, urological procedures, anticoagulant...
Subcapsular hematoma (SRH) or perirenal hematoma (PRH) can be seen after trauma, interventional radiological procedures, urological procedures, anticoagulant medications, coagulation disorders, infections, and spontaneously in some patients. Within the urological procedures, PRH can occur after percutaneous nephrolithotomy and extracorporeal shortwave lithotripsy but has only been reported a few times after cystoscopy/ureteroscopy. Here, we present the case of PRH as a complication from cystoscopy with retrograde pyelography in a patient with underlying chronic kidney disease (CKD) and an extensive surgical history for nephrolithiasis. In addition to this, our patient had a further complication of sepsis by , of which the source is proven to be urinary, and it appears that the fungemia was triggered during the procedure as well. The diagnosis was confirmed by abdominal computed tomography (CT), and PRH was proven to resolve with conservative management on repeat imaging months later.
PubMed: 37933348
DOI: 10.7759/cureus.46602 -
The Journal of International Medical... Nov 2021To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB).
OBJECTIVE
To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB).
METHODS
This multivariate prospective study collected demographic and clinical data from all consecutive adult patients that underwent real-time ultrasound-guided PRB of native kidneys. All biopsies were performed by two well-trained ultrasound physicians using 16G biopsy needles. Routine renal ultrasounds were performed within 12-24 h after biopsies in order to observe post-biopsy perirenal haematoma formation. Patients were stratified based on the occurrence of post-biopsy haematoma development.
RESULTS
This prospective study enrolled 218 patients and stratified them into a haematoma group ( = 126) and a non-haematoma group ( = 92). Binary logistic regression analysis identified female patients (odds ratio [OR] 1.990; 95% confidence interval [CI] 1.125, 3.521), patients with a body mass index (BMI) ≥28 kg/m (OR 2.660; 95% CI 1.097, 6.449) and patients with immediate post-biopsy active bleeding (IPAB) (OR 2.572; 95% CI 1.422, 4.655) as being more likely to have perirenal haematoma after real-time ultrasound guided PRB of native kidneys.
CONCLUSION
Female sex, a BMI ≥28 kg/m and IPAB were risk factors for perirenal haematoma after real-time ultrasound-guided PRB of native kidneys.
Topics: Adult; Biopsy; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Image-Guided Biopsy; Kidney; Prospective Studies; Ultrasonography, Interventional
PubMed: 34786995
DOI: 10.1177/03000605211058377 -
Journal of Surgical Case Reports Mar 2015Liposarcomas are neoplasms of mesodermic origin, are derived from adipose tissue and represent <1% of all malignant tumours. Primary liposarcomas of the kidney are very...
Liposarcomas are neoplasms of mesodermic origin, are derived from adipose tissue and represent <1% of all malignant tumours. Primary liposarcomas of the kidney are very rare. Here, we present the cases of two patients diagnosed with retroperitoneal perirenal myxoid liposarcoma. The patients were diagnosed via imaging, which in both cases revealed a huge right retroperitoneal tumour mass compressing the abdominal organs and large blood vessels. Surgical intervention consisting of en bloc resection of the tumour and the right kidney was performed using a transperitoneal approach. Three years after the surgery, both patients presented local recurrence, for which they underwent chemotherapy. Liposarcomas with renal origin are rare clinical entities with a high rate of malignancy and a poor prognosis. Because the use of chemotherapy and radiotherapy in the treatment of such liposarcomas is controversial, the treatment of choice is wide surgical resection with clean margins.
PubMed: 25750026
DOI: 10.1093/jscr/rju127 -
Iranian Journal of Kidney Diseases Jul 2022Bleeding events are the most common complications after kidney biopsy. This study aims to evaluate the effect of desmopressin administration on bleeding complication, in... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Bleeding events are the most common complications after kidney biopsy. This study aims to evaluate the effect of desmopressin administration on bleeding complication, in native kidney biopsy candidates with reduced kidney function.
METHODS
This double-blind randomized clinical trial enrolled 18 to 80 years old patients with 15 < eGFR < 90 mL/min/ 1.73m² from July 2017 to August 2020. Patients were randomly assigned to receive either 3 µg/kg of intranasal desmopressin acetate or 1 mL/kg of intranasal sodium chloride 0.65%, one hour before ultrasound-guided, percutaneous native kidney biopsy. The primary outcome was the post-biopsy bleeding complications, and secondary outcomes were the volume of perirenal hematoma, and changes of post-biopsy hemoglobin and hematocrit level, plasma sodium and blood pressure (Clinical Trial Registration ID: IRCT20090701002112N3).
RESULTS
A total of 120 patients (58 men and 62 women), 60 patients in each group, were analyzed. The mean age and eGFR of the patients were 45.29 ± 15.95 years and 51.77 ± 18.02 ml/min/ 1.73m², respectively. Desmopressin administration significantly decreased post-biopsy perirenal hematoma compared to placebo (7/60 [11.6%]) vs. 33/60 [40%]; P < .05), and the hematoma volume was significantly smaller in the desmopressin group, in case of hematoma formation (2.31 ± 1.17 vs. 7.72 ± 5.45 mm³, P < .05).
CONCLUSION
Desmopressin administration before kidney biopsy is a safe and effective strategy to prevent bleeding complications. Considering absolute risk reduction of about 28%, the number needed to treat is about 4 procedures. We recommend considering desmopressin administration before percutaneous native kidney biopsy. DOI: 10.52547/ijkd.6966.
Topics: Adult; Biopsy; Deamino Arginine Vasopressin; Double-Blind Method; Female; Hematoma; Humans; Kidney; Kidney Diseases; Male; Middle Aged; Ultrasonography, Interventional; Young Adult
PubMed: 35962638
DOI: No ID Found -
Communications Biology Oct 2021Reindeer (Rangifer tarandus) are semi-domesticated animals adapted to the challenging conditions of northern Eurasia. Adipose tissues play a crucial role in northern...
Reindeer (Rangifer tarandus) are semi-domesticated animals adapted to the challenging conditions of northern Eurasia. Adipose tissues play a crucial role in northern animals by altering gene expression in their tissues to regulate energy homoeostasis and thermogenic activity. Here, we perform transcriptome profiling by RNA sequencing of adipose tissues from three different anatomical depots: metacarpal (bone marrow), perirenal, and prescapular fat in Finnish and Even reindeer (in Sakha) during spring and winter. A total of 16,212 genes are expressed in our data. Gene expression profiles in metacarpal tissue are distinct from perirenal and prescapular adipose tissues. Notably, metacarpal adipose tissue appears to have a significant role in the regulation of the energy metabolism of reindeer in spring when their nutritional condition is poor after winter. During spring, genes associated with the immune system are upregulated in the perirenal and prescapular adipose tissue. Blood and tissue parameters reflecting general physiological and metabolic status show less seasonal variation in Even reindeer than in Finnish reindeer. This study identifies candidate genes potentially involved in immune response, fat deposition, and energy metabolism and provides new information on the mechanisms by which reindeer adapt to harsh arctic conditions.
Topics: Adaptation, Biological; Adipose Tissue; Animals; Arctic Regions; Finland; Reindeer; Seasons; Siberia; Transcriptome
PubMed: 34620965
DOI: 10.1038/s42003-021-02703-z -
BMC Cardiovascular Disorders Sep 2015Renal sinus fat (RSF) has been recognized as a risk factor for arterial hypertension. This study was addressed to examine whether also para- and perirenal fat...
BACKGROUND
Renal sinus fat (RSF) has been recognized as a risk factor for arterial hypertension. This study was addressed to examine whether also para- and perirenal fat accumulation is associated to higher 24-h mean systolic (SBP) and/or diastolic blood pressure (DBP) levels in overweight and obese subjects.
METHODS
A cohort of 42 overweight and obese patients, 29 women and 13 men, aged 25-55 years, not treated with any kind of drug, was examined. Body mass index (BMI), waist circumference (WC), fasting insulin and glucose serum levels, insulin resistance (assessed by using the homeostasis model assessment [HOMAIR]), and 24-h aldosterone urine levels were measured. Ambulatory blood pressure monitoring (ABPM) was measured with 15 min intervals from 7.0 a.m. to 11.0 a.m. and with 30 min intervals from 23.0 to 7.0 for consecutive 24 h, starting from 8:30 AM. Measurement of para- and perirenal fat thickness was performed by ultrasounds by a duplex Doppler apparatus.
RESULTS
Para- and perirenal ultrasonographic fat thickness (PUFT) was significantly and positively correlated with WC (p < 0.01), insulin (p < 0.01), HOMAIR (p < 0.01), and 24-h mean DBP levels (p < 0.05). 24-h mean DBP was also significantly and positively correlated with 24-h aldosterone urine concentrations (p < 0.001). A multivariate analysis by multiple linear regression was performed; the final model showed that the association of 24-h mean DBP as dependent variable with PUFT (multiple R = 0.34; p = 0.026) and daily aldosterone production (multiple R = 0.59; p = 0.001) was independent of other anthropometric, hormone and metabolic parameters.
DISCUSSION AND CONCLUSIONS
This study shows a positive independent association between PUFT and mean 24-h diastolic blood pressure levels in overweight and obese subjects, suggesting a possible direct role of PUFT in increasing daily diastolic blood pressure.
Topics: Adipose Tissue; Adult; Aldosterone; Blood Glucose; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Body Mass Index; Female; Humans; Insulin; Insulin Resistance; Kidney; Male; Middle Aged; Obesity; Overweight; Risk Factors; Ultrasonography; Waist Circumference
PubMed: 26419359
DOI: 10.1186/s12872-015-0101-6 -
Prognostic impact of perirenal fat stranding on oncologic outcomes in ureteral urothelial carcinoma.Investigative and Clinical Urology Jan 2021Perirenal fat stranding (PRFS) is defined as linear areas of soft-tissue attenuation in the perirenal space that can result from ureteral obstruction. We analyzed the...
PURPOSE
Perirenal fat stranding (PRFS) is defined as linear areas of soft-tissue attenuation in the perirenal space that can result from ureteral obstruction. We analyzed the prognostic impact of PRFS on outcomes in patients with ureteral urothelial carcinoma (UC).
MATERIALS AND METHODS
Overall, 126 patients evaluated preoperatively by computerized tomography (CT) scan and diagnosed with ureteral UC following nephroureterectomy between January 2001 and May 2018 were included. We analyzed associations between oncologic outcomes and secondary signs such as hydronephrosis and PRFS.
RESULTS
Overall, 68 patients (54.0%) showed PRFS on preoperative CT scans. The patients' mean age was 66.33±9.49 years. A high pT stage (≥T3) was seen in 47 patients (37.3%) and high-grade tumors were seen in 90 patients (71.4%). Lymphovascular invasion (LVI) was seen in 15 patients (11.9%), and 5 (4.0%) were at the pN1 stage. Multivariate Cox analysis showed that cT stage≥3, PRFS, pT stage≥3, tumor grade, LVI, and pN1 stage were independent prognostic factors of recurrence-free survival (RFS) and cancer-specific survival (CSS) (all p<0.05).
CONCLUSIONS
PRFS was found to be an independent prognostic factor for RFS and CSS. PRFS is easily detectable in preoperative CT imaging and may be useful for improving the prediction of oncologic outcomes of ureteral UC. Therefore, PRFS along with other important preoperative CT findings can help urologists give preoperative advice to patients with ureteral UC before surgical management.
Topics: Aged; Blood Vessels; Carcinoma, Transitional Cell; Female; Humans; Intra-Abdominal Fat; Kidney; Lymphatic Vessels; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Nephrectomy; Prognosis; Survival Rate; Tomography, X-Ray Computed; Ureteral Neoplasms; Ureteral Obstruction
PubMed: 33314805
DOI: 10.4111/icu.20200125 -
Oncology Letters Sep 2022Primary retroperitoneal perirenal CIC rearrangement sarcoma is rare. The current case report presents a 69-year-old male patient with this pathology, including the...
Primary retroperitoneal perirenal CIC rearrangement sarcoma is rare. The current case report presents a 69-year-old male patient with this pathology, including the clinical features, pathomorphology and immunohistochemistry, and CIC gene rupture detected by fluorescence hybridization (FISH). Furthermore, the relevant literature was reviewed. Histologically, the tumor was composed of diffuse nests of small- to medium-sized juvenile round blue cells with hyperchromatic nuclei, prominent nucleoli and occasional mitotic signs. The tumor involved adipose tissue with no obvious hemorrhagic necrotic foci. Immunohistochemistry indicated scattered expression of CD99 in tumor cells. FISH examination suggested that the CIC gene was fragmented and translocated.
PubMed: 35949589
DOI: 10.3892/ol.2022.13442 -
International Journal of Surgery Case... Oct 2021Emphysematous pyelonephritis (EPN) is an uncommon suppurative infection of renal parenchyma and perirenal tissue characterized by production of gas within renal...
INTRODUCTION
Emphysematous pyelonephritis (EPN) is an uncommon suppurative infection of renal parenchyma and perirenal tissue characterized by production of gas within renal parenchyma, collecting system or perinephric tissue.
CASE PRESENTATION
We report a case of young non diabetic female with past history of extracorporeal shock wave lithotripsy (ESWL) who presented with intermittent lower abdominal pain, dysuria and left lower limb swelling. Abdomen examination was notable for tenderness at left iliac fossa and fullness at left renal angle. Blood investigation showed leukocytosis and deranged creatinine levels. Urine analysis showed pyuria. Transabdominal ultrasound revealed left nephrolithiasis with moderate hydronephrosis, vesical calculus and double J (DJ) stent in situ. Patient was diagnosed as acute pyelonephritis and started on intravenous antibiotics. Despite on medical management, the condition deteriorated and progressed to septic shock. Computed tomography of kidneys, ureters and bladder (CT KUB) showed air fluid level in calyceal system with perinephric collection and confirmed diagnosis as emphysematous pyelonephritis. Patient underwent surgical drainage to control the sepsis. Few days later after control of sepsis and optimization, left nephrectomy and removal of retained DJ stent was done.
CLINICAL DISCUSSION
This case report highlights the need to consider emphysematous pyelonephritis as a possible diagnosis in patients harbouring DJ stents even in young non diabetics. Early aggressive medical management coupled with urological intervention is a valuable alternative to upfront emergent nephrectomy. However, surgery should not be delayed in patient with fulminant infection at presentation or who failed on conservative management.
CONCLUSION
Emphysematous pyelonephritis warrants high index of suspicion for timely diagnosis and can be fatal if not recognized early and promptly treated.
PubMed: 34534814
DOI: 10.1016/j.ijscr.2021.106405