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Folia Morphologica 2022Urinary system stones are frequently encountered in the community. Together with technological developments, introduction of new treatment procedures such as...
BACKGROUND
Urinary system stones are frequently encountered in the community. Together with technological developments, introduction of new treatment procedures such as extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery has further reduced morbidity, mortality and hospitalisation time of patients. In order to maximise success and to reduce complications of these procedures, it is necessary to evaluate anatomy and morphological differences of kidney collector system before the procedure. This study was conducted for the purpose of determining the morphology of the kidney collector system and the negative anatomic factors of the lower pole in autopsy cases performed in our institution.
MATERIALS AND METHODS
Eighty two kidney units obtained from 41 autopsy cases conducted in Faculty of Medicine Department of Forensic Medicine, Sivas Cumhuriyet University between September 2017 and September 2018 were included in the study. Percentages were found as 78% for intrarenal pelvis, 13.4% for borderline pelvis, 6.1% for extrarenal pelvis and 2.4% for pelvic nonexistence. When pelvicalyceal anatomy was evaluated, percentages were found as 32.9% for bicalyceal, 26.8% for tricalyceal, 20.7% for multicalyceal, and 19.5% for unclassified calyceality. When it was evaluated according to opening of calyces into the renal pelvis based on Sampaio classification, percentages were found as 30.5% for AI, 17.1% for type II, 28% for BI, 18.3% for BII, and 6.1% for unevaluated part. Infundibular lengths of kidney's lower pole were detected as under 3 cm in 39% and over 3 cm in 61% of all cases. Infundibulopelvic angles of kidney's lower pole were measured as under 70o in 42.7% and over 70o in 57.3% of all cases.
RESULTS
In our study, there was no statistically significant difference between the right and left kidneys in terms of collecting system morphology and lower pole's negative anatomical factors. Only infundibular length which is one of the collecting system morphology and lower pole's negative anatomical factors were statistically shorter in females than males. There was no difference in terms of other parameters.
CONCLUSIONS
In conclusion, the findings of this study are largely consistent with the results of similar studies. This reveals that renal collecting system morphology and negative anatomic factors in the lower pole collecting system in human are roughly similar. In clinical practice, pre-treatment computed tomography and, if necessary, magnetic resonance urography evaluation of the lower pole negative anatomic factors may contribute to gain preliminary information about both the clearance of stone fragments especially after shock wave lithotripsy and retrograde intrarenal surgery procedures and perioperative complications proactively.
Topics: Autopsy; Female; Humans; Kidney; Kidney Calculi; Lithotripsy; Male; Treatment Outcome
PubMed: 33899205
DOI: 10.5603/FM.a2021.0041 -
BMC Women's Health Apr 2023Endometriosis mainly occurs in female pelvic organs. Endometriosis in the kidney is extremely rare. (Review)
Review
BACKGROUND
Endometriosis mainly occurs in female pelvic organs. Endometriosis in the kidney is extremely rare.
CASE PRESENTATION
We herein describe a case of a 19-year-old girl with occasional mild abdominal pain associated with an ectopic left kidney. SPECT-CT showed no abnormal radioactive distribution in the left pelvis, suggesting loss of function of the ectopic kidney. Laparoscopic left ectopic kidney resection was subsequently performed. Histopathology revealed endometriosis of the ectopic left kidney.
CONCLUSIONS
In female patients with clinical manifestations of abdominal pain and gross hematuria, the possibility of renal endometriosis should be considered.
Topics: Humans; Female; Young Adult; Adult; Endometriosis; Kidney Diseases; Kidney; Laparoscopy; Abdominal Pain
PubMed: 37118742
DOI: 10.1186/s12905-023-02343-x -
Archivio Italiano Di Urologia,... Jun 2020Urolithiasis is one of the most frequent disease in the population and it represents one of the most frequent causes of access to emergency department. In addition.... (Review)
Review
Urolithiasis is one of the most frequent disease in the population and it represents one of the most frequent causes of access to emergency department. In addition. congenital anomalies occur more often in the kidney than in any other organ and the association of both renal abnormalities and stones is of clinical relevance. In this report, we discuss a case of a women with pelvic ectopic kidney affected by a large pyelic stone treated with ESWL (Extracorporeal Shockwave Lithotripsy).
Topics: Female; Humans; Kidney; Kidney Calculi; Lithotripsy; Middle Aged; Pelvis
PubMed: 32597111
DOI: 10.4081/aiua.2020.2.109 -
Experimental and Clinical... Sep 2021We describe a case of a 55-year-old woman with polycystic kidney disease who received a living donor kidney transplant 16 years earlier and was on immunosuppressive...
We describe a case of a 55-year-old woman with polycystic kidney disease who received a living donor kidney transplant 16 years earlier and was on immunosuppressive therapy with satisfactory renal function. The donor was her mother. The patient presented with flank pain on the right side and macrohematuria, and noncontrast computed tomography and magnetic resonance imaging led to the diagnosis of tumors in the remaining right native polycystic kidney and ureter, as well as secondary retroperitoneal dissemination. We performed right radical nephrectomy and ureterectomy with extirpation of 2 metastases; the left native kidney remained intact. Histology showed squamous metaplastic changes and invasive epithelial neoplasm in the lumen of the renal pelvis and ureter with extensive squamous differentiation positive for nuclear p63 as squamous cell immunohistochemical marker. After surgery, an immunosuppressive therapy with methylprednisolone was administered, without calcineurin inhibitors and mycophenolate mofetil. Twelve months later the patient was still alive, with a glomerular filtration rate of 29 mL/min. Needs remain for further treatment modalities in patients with primary squamous cell carcinoma in nonfunctioning kidneys and improvements in imaging technique accuracy.
Topics: Carcinoma, Renal Cell; Carcinoma, Squamous Cell; Female; Humans; Kidney; Kidney Neoplasms; Kidney Transplantation; Living Donors; Male; Middle Aged; Nephrectomy; Polycystic Kidney Diseases; Treatment Outcome; Ureter
PubMed: 34269650
DOI: 10.6002/ect.2021.0094 -
Kidney International Jan 1997The aim of the present study was to determine the applicability of magnetic resonance imaging (MRI) as a non-invasive measure of kidney volume in vivo in diabetic and...
The aim of the present study was to determine the applicability of magnetic resonance imaging (MRI) as a non-invasive measure of kidney volume in vivo in diabetic and non-diabetic rats. Magnetic resonance, T1 weighted Spin Echo, images were obtained after injection of contrast in anesthetized control (N = 14) and hyperglycemic streptozotocin (STZ)-diabetic rats (N = 14). On MRI imaging the total kidney, cortex, medullary and pelvic volumes were calculated. Immediately after MRI measurements the left kidneys were removed before weighing either as a clamped kidney weight (that is, the kidney containing blood and urine) or as a wet kidney weight (the kidney drained of blood and urine), while the right kidneys were perfusion-fixed for morphometric measurements. On thin kidney slices obtained from perfusion-fixed kidneys the cortex, medullary and pelvic fractions were measured and subsequently the cortex, medulla and pelvic volumes were calculated. The cortical volume was measured according to three different approaches. The corticomedullary boundary was defined either to the arcuate arteries, to a curved line following the glomeruli, or to a line at the top of the medullary rays. Both in control and diabetic rats, MRI measured kidney volumes were similar to the volume of perfusion-fixed kidneys, while the clamped kidney weight, and in particular the wet kidney weights, were smaller than the MRI obtained volumes. Good agreement was found between the MRI measured cortex and medulla volumes when the cortex was defined to the top of the medullary rays in the morphometric analysis. In conclusion, the present study demonstrates that MRI allows a reliable non-invasive estimate of renal morphology at a macroscopic level in both diabetic and non-diabetic rats.
Topics: Animals; Diabetes Mellitus, Experimental; Diabetic Nephropathies; Female; Hypertrophy; Kidney Cortex; Kidney Medulla; Kidney Pelvis; Ligation; Magnetic Resonance Imaging; Perfusion; Rats; Rats, Wistar
PubMed: 8995717
DOI: 10.1038/ki.1997.7 -
Journal of Feline Medicine and Surgery Oct 2023A retrospective multicenter case series of renal fusion anomalies in cats was investigated. The aim of this study was to describe the imaging characteristics...
CASE SERIES SUMMARY
A retrospective multicenter case series of renal fusion anomalies in cats was investigated. The aim of this study was to describe the imaging characteristics (radiography, ultrasonography and CT) of renal ectopia and fusion in cats. A total of 13 feline patients (median age 9 years) were included in this multicentric retrospective study. Ultrasound was available in 12/13 cases, radiographs in 4/13 cases and CT in 3/13 cases. Of the 13 cases, seven were left to right fusions, four were right to left fusions, one was on the midline and one was in the pelvic inlet. Adopting a human classification system, there were five lump kidneys, four disc kidneys, one horseshoe kidney, one caudal ectopia, one L-shaped kidney and one pelvic kidney. In 2/13 cases, additional congenital malformations were noted, including an azygous continuation of the caudal vena cava and a peritoneal-pericardial diaphragmatic hernia.
RELEVANCE AND NOVEL INFORMATION
This study provides further description of the imaging findings in feline patients with fused renal ectopia. The morphologic characteristics of the fused kidneys in cats appear similar to what is published in the human literature. Renal fusion might be an incidental finding in cats, but further investigations are necessary to determine their clinical relevance.
Topics: Humans; Cats; Animals; Fused Kidney; Retrospective Studies; Kidney Diseases; Kidney; Radiography; Cat Diseases
PubMed: 37791875
DOI: 10.1177/1098612X231196810 -
International Braz J Urol : Official... 2020
Editorial Comment: The significance of in-traoperative renal pelvic urine and stone cul-tures for patients at a high risk of post-ureteroscopy systemic inflammatory res-ponse syndrome.
Topics: Humans; Kidney Pelvis; Lithotripsy, Laser; Syndrome; Ureteroscopy
PubMed: 32648426
DOI: 10.1590/S1677-5538.IBJU.2020.05.06 -
Gynecologie, Obstetrique, Fertilite &... Mar 2018Diagnostic performance of MR imaging for the diagnosis of pelvic endometriosis are good. Even if some differences of performances exists according the location... (Review)
Review
Diagnostic performance of MR imaging for the diagnosis of pelvic endometriosis are good. Even if some differences of performances exists according the location considered, the risk of misdiagnosis is lower than 10% for trained teams (NP2). The performance of pelvic MR imaging and surgery are quite similar to diagnose endometrioma (sensitivity and specificity>90%). A negative pelvic MR imaging allows to exclude deep pelvic endometriosis with a performance similar to surgery but a positive MR imaging is less accurate than surgery because of a high number of false positives (23%). Pelvic MR imaging is more sensitive and less specific than ultrasonography for the diagnosis of uterosacral ligament, vagina or recto vaginal septum (NP2). Pelvic ultrasonography is more sensitive than pelvic MR imaging for the diagnosis of colorectal location (NP3). Pelvic MR imaging is a reproducible technique for the diagnosis of pelvic endometriosis (NP3). Regarding, quality criteria of pelvic MR imaging, no data are enough to recommend a specific MR unit, digestive preparation, or a specific moment during the menstrual cycle to realize the examination. Vaginal and/or rectal opacification are options. Most of studies are based a protocol including 3D T2W and 3DT1W sequences. Gadolinium injection is useful to characterize a complex adnexal mass. In clinical routine, slices crossing the kidneys are useful to evaluate the presence of pyelo calic distension. ColoCT is an accurate technique to diagnose pelvic digestive endometriosis (rectosigmoide and iléocaecal) (NP3).
Topics: Diagnostic Imaging; Endometriosis; Female; Genitalia, Female; Humans; Pelvis; Rectum
PubMed: 29540333
DOI: 10.1016/j.gofs.2018.02.023 -
European Review For Medical and... May 2022Acyl-CoA-binding protein (ACBP), also known as diazepam binding inhibitor (DBI), is a small phylogenetically conserved protein. This ancestral peptide is...
OBJECTIVE
Acyl-CoA-binding protein (ACBP), also known as diazepam binding inhibitor (DBI), is a small phylogenetically conserved protein. This ancestral peptide is multifunctional, performing intracellular activities as ACBP protein or extracellular roles as DBI. Several studies showed its endless facets, including a relevant activity as appetite stimulator and as anabolic factor. High levels of ACBP have been described in erythrocytes, liver, kidney, and gut cells. The aim of this study was to analyze, at immunohistochemical level, the expression of ACBP in fetal human tissues during development, focusing on the developing kidney.
MATERIALS AND METHODS
Immunohistochemistry for ACBP was performed on 30 human fetal kidneys, from 15 fetuses of gestational age ranging from 13 to 19 weeks. At autopsy, all kidney samples were 10% formalin-fixed, routinely processed and paraffin-embedded. Five micron-thick paraffin sections were stained with Hematoxylin and Eosin and PAS stain for a morphological examination.
RESULTS
ACBP was detected in all 30 kidneys analyzed in this study. No significant changes in ACBP expression were observed at different gestational ages. Immunostaining for ACBP was restricted to the epithelium covering the renal pelvis, the papillae, the collecting tubules, and the proximal and distal tubules. On the other hand, medullary regions and in the metanephric mesenchymal stem/progenitor cells did not show any reactivity for ACBP.
CONCLUSIONS
According to our findings, ACBP should be considered as a new player in the complex field of human nephrogenesis, given that it was detected in all fetal kidneys immunostained. Its preferential localization in the renal structures derived from the Wolf duct, such as pelvis epithelium and collecting ducts, suggests a major role for ACBP in the induction of the metanephric mesenchymal cells toward the differentiation into glomerular structures. ACBP expression in proximal and distal tubules, two structures originating from the metanephric mesenchyme, indicates a further role of this protein in nephron development. In conclusion, ACBP should be added to the multiple molecules involved in human nephrogenesis.
Topics: Coenzyme A; Diazepam Binding Inhibitor; Humans; Kidney
PubMed: 35587082
DOI: 10.26355/eurrev_202205_28749 -
BMC Nephrology Aug 2016Transcription factor Nrf2 protects from experimental acute kidney injury (AKI) and is promising to limit progression in human chronic kidney disease (CKD) by...
BACKGROUND
Transcription factor Nrf2 protects from experimental acute kidney injury (AKI) and is promising to limit progression in human chronic kidney disease (CKD) by upregulating multiple antioxidant genes. We recently demonstrated that deletion of Keap1, the endogenous inhibitor of Nrf2, in T lymphocytes significantly protects from AKI. In this study, we investigated the effect of Keap1 deletion on Nrf2 mediated antioxidant response in the renal tubular epithelial cells.
METHODS
We deleted Keap1 exon 2 and 3 in the renal tubular epithelial cells by crossing Ksp-Cre mice with Keap1 floxed (Keap1 (f/f)) mice. Deletion of Keap1 gene in the kidney epithelial cells of Ksp-Keap1 (-/-) mice and its effect on Nrf2 target gene expression was performed using PCR and real-time PCR respectively. Histological evaluation was performed on H&E stained sections. Complete blood count, serum and urine analysis were performed to assess systemic effects of defective kidney development. Student's T test was used to determine statistical difference between the groups.
RESULTS
Ksp-Cre resulted in the deletion of Keap1 exon 2 and 3 and subsequent upregulation of Nrf2 target genes, Nqo1, Gclm and Gclc in the kidney epithelial cells of Ksp-Keap1 (-/-) mice at baseline. Renal epithelial cell specific deletion of Keap1 in Ksp-Keap1 (-/-) mice caused marked renal pelvic expansion and significant compression of medullary parenchyma consistent with hydronephrosis in both (3 month-old) males and females. Kidneys from 6 month-old Ksp-Keap1 (-/-) mice showed progressive hydronephrosis. Hematological, biochemical and urinary analysis showed significantly higher red blood cell count (p = 0.04), hemoglobin (p = 0.01), hematocrit (p = 0.02), mean cell volume (p = 0.02) and mean cell hemoglobin concentration (p = 0.003) in Ksp-Keap1 (-/-) mice in comparison to Keap1 (f/f) mice.
CONCLUSIONS
These unexpected findings demonstrate that Keap1 deletion in renal tubular epithelial cells results in an abnormal kidney development consistent with hydronephrosis and reveals a novel Keap1 mediated signaling pathway in renal development.
Topics: Animals; Epithelium; Gene Deletion; Hydronephrosis; Kelch-Like ECH-Associated Protein 1; Kidney; Male; Mice; Mice, Knockout; Mice, Transgenic
PubMed: 27484495
DOI: 10.1186/s12882-016-0310-y