• Title/Summary/Keyword: Renal

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Ultrasonographic Resistive Index of the Interlobar Renal Artery in Renal Failure Induced by Ochratoxin A and Citrinin Toxicosis in Dogs (Ochratoxin-A 및 Citrinin 중독 신부전 개에서 신장엽간동맥 혈관저항지수에 대한 도플러초음파 평가)

  • Bae, Jun-Woo;Seong, Yun-Sang;Oh, Tae-Ho;Jang, Kwang-Ho;Lee, Keun-Woo;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.427-431
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    • 2006
  • Pulse Doppler ultrasonographic evaluation was performed to investigate the resistive index (RI) of the Interlobar renal artery in 17 dogs (32 kidneys) which were diagnosed with an acute renal failure caused by ochratoxin-A and citrinin contaminated commercial diet. RI was investigated in 7 normal beagle dogs and recovered patients. The mean of RI was resulted as $0.69{\pm}0.04$ in normal dog, however, significantly (p<0.001) increased as $0.76{\pm}0.05$ in renal failure dog. But RI had no relationship with the results of blood chemistry, urine analysis, and excretory urographic image quality. From these results, even though the results of the renal function test were within a normal reference range, it was considered that RI index is more reliable to represent a damaged renal parenchyma, and may have the potential to be a useful clinical tool in monitoring of the renal function.

Nephrotomy for Removal of Renal Calculi in Two Dog (개에서 신 절개를 통한 신 결석 제거 2례)

  • 김혜진;장화석;송영성;김성미;김순신;최치봉;김휘율
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.66-71
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    • 2004
  • 2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

Urine Cytology of Renal Cell Carcinoma - Analysis of 11 cases - (신세포암종의 요세포학적 소견 - 11예의 분석 -)

  • Chun, Yi-Kyeong;Cho, Hye-Jae;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.5 no.2
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    • pp.137-142
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    • 1994
  • Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of $0\sim80%$. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma. In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases(27%), suspicious in 2 cases(18%) and negative in 6 cases(55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7 cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early defection of renal cell carcinoma. However, careful examination of urinary smear could improve the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.

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A Novel Homozygous CLCNKB Mutation of Classic Bartter Syndrome Presenting with Renal Cysts in 6-year-Old Identical Twin Boys : A Case Report

  • Son, Min Hwa;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.25 no.1
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    • pp.35-39
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    • 2021
  • Bartter syndrome is an autosomal recessive hypokalemic salt-losing tubulopathy, and classic Bartter syndrome is associated with mutations in the CLCNKB gene. While chronic hypokalemia is known to induce renal cyst formation in different renal diseases, renal cyst formation in Bartter syndrome is rarely reported. Russian six-year-old identical male twins were referred to our hospital for the evaluation of renal cysts, which were incidentally detected on abdominal sonography due to diarrhea. Both twins had shown symptoms of polydipsia, polyuria, and nocturia since they were one year olds. Vital signs including blood pressure were normal in both twins. Renal sonography revealed nephromegaly, increased echogenicity of renal cortex, and various sized multiple cysts in both kidneys for both twins. Laboratory findings included hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis. Bartter syndrome with renal cysts were suspected. Genetic analysis for both twins confirmed a homozygous c.1614delC deletion on exon 15 of the CLCNKB gene, which was confirmed as a previously unreported variant to the best of our knowledge. They were managed with potassium chloride, nonsteroidal anti-inflammatory drugs, and angiotensin-converting-enzyme inhibitors. Metabolic alkalosis, hypokalemia, hypochloremia, and polyuria partially improved during the short course of treatment. This is the first report of a homozygous mutation in the CLCNKB gene in an identical twin, presenting with renal cysts.

Renal Biopsy (신장의 조직 검사)

  • Taek Min Kim;Jeong Yeon Cho;Sang Youn Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1198-1210
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    • 2023
  • The extent of renal biopsy indication is being widened because of the increasing incidence of incidental renal masses; the increasing treatment options for renal cell carcinoma, including ablation therapy and novel targeted treatment; and the increasing incidence of kidney transplantation. However, percutaneous renal biopsy is technically difficult, particularly for beginners, because the skin-to-organ distance is relatively longer than those associated with other organs. In the present review, we will discuss the indications, technical considerations, efficacy, and complications of renal biopsy. Furthermore, we share practical tips of renal biopsy through many examples to help radiologists perform renal biopsy safely and effectively in various situations.

Clinical Analysis of Postoperative Acute Renal Failure in the Patients undergoing Cardiovascular Operation with CPB (개심술 후 발생한 급성 신부전의 임상적 고찰)

  • 편승환;노재욱;방정희;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.494-501
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    • 1998
  • From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass(CPB). Because we were interested in new development of ARF(prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation(serum creatinine level less than 1.5 mg/dL) was registered in 198(74%) patients. Of these, 27(14%) patients showed postoperative renal complication, including 20(10%) patients classified as renal dysfunction(serum creatinine level between 1.5 and 2.5 mg/dL) and 7(4%) patients as acute renal failure(serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed(p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality(odd ratio 2.52∼11.25), along with cardiovascular(odd ratio 4.20) and respiratory(odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age(odd ratio 1), need for emergency operation(odd ratio 3.78), low-output syndrome(odd ratio 3.66), respiratory complication(odd ratio 1.30), need for deep hypothermic circulatory arrest(odd ratio 1.4). The 13 patients(7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.

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The Effects of Gypsum Fibrosum on Renal Functional and Histopathological Disorder in Chronic Renal Failure Rat Model (석고(石膏)가 만성 신부전 Rat의 신기능 보호 및 조직학적 변화에 미치는 영향)

  • Byun, Sang-Hyuk
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.871-886
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    • 2008
  • Objective : Gypsum fibrosum has been traditionally used in treatment of febrile diseases and recently been shown to have anti-inflammatory effect. Chronic renal failure has a serious clinical symptoms including proteinuria, azotemia, anemia, and hyperlipidemia and has characteristic histopathological changes, glomerular hypertrophy, infiltration of inflammatory cells, and crescentic sclerosis, We investigated the effects of gypsum fibrosum on renal functional and histopathological disorder in chronic renal failure rat model induced 5/6 nephrectomy. Methods : Using Sprague-Dawley rats, CRF was induced by 5/6 nephrectomy. The rats were divided into 3 groups, normal, conrol, and gypsum administered orally with gypsum fibrosum 500mg/kg/day. Body weight, 24 hr proteinuria, hematologic analysis, and histological morphologic changes were followed up after 8 weeks. The glomerular macrophage/monocyte infiltration, $TGF-{\beta}_1$, type IV collagen, and angiotensin II type1 receptor($AT_1$) were evaluated by immunohistochemistry. Resuls : In the CRF control group, functional parameters and histopathologic changes clearly indicated the development of CRF. 24 hr proteinuria significantly increased in the CRF control group over the normal group, and serum creatinine level was lower in the gypsum group than in the control group, LDL-cholesterol was significantly lower in the gypsum group than in the control group. Morphological investigations showed a variety of characteristic features of CRF, glomerular hypertrophy, increasing cellular density of glomerulus, deposition of extra-cellular matrix, fibrotic change, and glomerular sclerosis in the control group, but in the gypsum group, these features diminished significantly. In observation of renal type IV collagen and $AT_1$ expression, positive area significantly increased in the control group over the normal group, and it significantly decreased in the gypsum group compared to the control group. Conclusions : Our findings suggest that gypsum fibrosum inhibits $AT_1$ and type IV collagen expression in renal tissues and attenuates progression of glomerulosclerosis and interstitial fibrosis in chronic renal failure rats, which lead to amelioration of renal function. From these results, we suggest that gypsum fibrosum may have renoprotective effects and could be a useful remedy agent for treating chronic renal failure.

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Effect of Adenosine Receptor Antagonists on the Renal Function and Renin Release in Rabbits (가토의 신장기능과 Renin 분비에 미치는 Adenosine수용체 차단제의 영향)

  • Rhee, Keon-Su;Kim, Young-Jin;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.23 no.2
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    • pp.377-391
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    • 1989
  • Recently it was suggested that the endogenous adenosine might be the mediator for the intercellular communication in the regulation of tubuloglomerular feedback control and renin release. Even though the previous data showed more important regulatory roles in the renal hemodynamics and renin release for the A1 adenosine receptor, it has not yet been settled down about the functional subclassification of renal adenosine receptors. The purpose of the present experiment was to clarify the importance of the renal adenosine receptors for the regulations of the hemodynamic, excretory and secretory functions. Experiments have been done in unanesthetized rabbits. Intrarenal arterial infusion of A1 adenosine antagonist, 8-phenyltheophylline, $3{\sim}30\;nmole/min$, increased urine flow, renal hemodynamics and urinary excretion of sodium. Intrarenal arterial infusion of Al antagonist, 1-3-diethyl-8-phenylxanthine (DPX), $10{\sim}100\;nmole/min$, increased renal hemodynamics and excretory functions. Non-specific adenosine antagonist, theophylline, $30{\sim}300\;nmole/min$, resulted in dose dependent increases in renal hemodynamics and excretory function. All of the three adenosine antagonists for the increases in renal hemodynamics, excretory and secretory functions was 8-phenyltheophylline > DPX > theophylline. These results suggest that the endogenous adenosine is important for the intrinsic regulatory roles for the renal functions through the adenosine receptors, and that the A1 adenosine receptor is more important than the A2 receptor in the regulation of renal hemodynamics, excretory and renin secretory functions.

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Influence of Intracerebroventricular Thiopental Sodium on the Renal Function in Conscious Rabbit (측뇌실내로 투여한 Thiopental Sodium의 가토 신장기능에 미치는 영향)

  • Hong, Ki B.;Cho, Kyung W.
    • The Korean Journal of Physiology
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    • v.19 no.1
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    • pp.35-48
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    • 1985
  • One of most frequently used anesthetic agents is barbiturate derivatives. Pentobarbital or thiopental sodium have been used most frequently in the laboratory or clinical practice. There have been reports on the renal effects of barbiturate anesthesia in human and laboartory animals. Renal effects of thiopental sodium anesthesia, however, are still controversial. One of the discrepancies may be derived from the doses used. It has been reported that subanesthetic small dose of thiopental sodium influences the renal function directly. To clarify possible central effects of very small amounts of thiopental sodium on the renal function, experiments have been done in conscious rabbits. Thiopental sodium was infused into the lateral cerebroventricle for 10 minutes. Intracerebroventricular thiopental sodium induced increased urinary volume, glomerular filtration rate and renal plasma flow by doses of $0.1{\sim}1.0\;mg/10 min/rabbit$. Filtration fractions were not changed. Sodium, chloride and potassium excretions were increased by 0.065 mg/10 min/rabbit of thiopental sodium without significant changes of renal hemodynamics. Higher doses of thiopental sodium $(0.1{\sim}1.0\;mg/10 min/rabbit)$ induced greater increases of electrolytes excretion and renal hemodynamics. Free water clearance was not changed by thiopental sodium, but the fractional excretion of free water showed a tendency of decrease. Fractional excretion of sodium was increased by doses of 0.065 to 1.0 mg of thiopental sodium . Highly significant correlation between the changes of glomerular filtration rate and the changes of sodium excretion were found in the higher doses. Plasma renin concentration (activity) was not changed by the centrally administered thiopental sodium. Intravenous thiopental sodium, 1.0 mg/rabbit, induced no changes of renal function in conscious rabbit. These data suggest that intracerebroyentricular thiopental sodium can increase urinary sodium excretion directly by inhibition of sodium reabsorption in the renal tubules and/or indirectly by increasing the renal hemodynamics.

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Effect of Adenosine Analogues on the Renal Function and Renin Release (가토의 신장기능과 Renin분비에 미치는 Adenosine Analogues의 영향)

  • Song, Yun-Sik;Choi, Byung-Soo;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.22 no.2
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    • pp.319-332
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    • 1988
  • The regulations of renal function and renin release are influenced by neural, humoral and physical factors. During the last decade, considerable progress has been made in the identification and characterization of these extrinsic renal control systems. Mechanisms intrinsic to the kidney are also important for renal function. These include the autoregulation of blood flow, and the local control of renin secretion. Fundamental questions regarding the mechanism of these intrinsic controls remain unanswered. Recently, endogenous renal adenosine has been claimed to influence the tubuloglomerular feedback control and renin release. Two subclasses of adenosine receptors $A_1{\;}and{\;}A_2$ have been described. The present experiment was carried out to evaluate the effects of $N_6-cyclohexyladenosine$ $(CHA,{\;}A_1{\;}selective)$ and 5'-N-ethylcarbox-amide adenosine $(NECA,{\;}A_2{\;}selective)$ on the renal function and renin release in the unanesthetized rabbit. Intra-renal arterial infusion of NECA $(0.3{\sim}10.0n{\;}mole/min/rabbit)$ or CHA $(0.03{\sim}10.0n{\;}mole/min/rabbit)$ caused a prompt and dose-dependent decrease in urine volume, glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), electrolyte excretion and free water clearance $(CH_2O)$, the effect being much more profound with CHA than with NECA. The NECA infusion resulted in a profound decrease of systemic blood pressure, but the CHA infusion did not. Both NECA and GHA infusions caused a prompt and dose-dependent decrease in renin secretion rate, again the effect being greater with CHA than with NEGA. These results suggest that both $A_1{\;}and{\;}A_2$ adenosine receptors may be involved in the intrinsic control of renal function and renin release, and that the $A_1$ receptors plays a more important role than the $A_2$ receptor in the regulation of renal fnction.

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