Correlation between amyloid deposits affecting renal compartments and glomerular filtration rate during renal biopsy in a renal amyloidosis case series

Amyloidosis comprises a group of disorders that accumulate modified autologous proteins in organs, mainly the kidneys. Few studies have addressed the amyloid compartmental distribution and associated clinical outcomes. The aim of this study was to present a case series of renal amyloidosis correlating histopathological data with glomerular filtration rate (GFR) during kidney biopsy. We studied 53 cases reviewed by nephropathologists from 2000 to 2018 in a single kidney biopsy center in Brazil. GFR was estimated using the CKD-EPI formula. Cases were divided into Group A ≥60 and Group B <60 mL·min−1·(1.73 m2)−1 using the estimated GFR during kidney biopsy. Semiquantitative histopathological study was performed, including extension and distribution of amyloid deposits by compartments (glomeruli, tubulointerstitial tissue, and vessels). Statistical analyses were made to understand associations with lower GFR. No difference was seen for age, gender, proteinuria, hematuria, subtype of amyloid protein, arteriosclerosis, interstitial fibrosis/infiltrate, or glomerular and interstitial amyloid deposits. After a previous P value <0.1 in the descriptive analysis, the following variables were selected: globally sclerotic glomeruli, high blood pressure, and the extension of vascular amyloid deposition. A binary logistic regression model with GFR as the dependent variable showed history of hypertension and vascular amyloid to be robust and independent predictors of Group B <60 mL·min−1·(1.73 m2)−1. Beyond the histopathologic diagnosis of amyloidosis, a semiquantitative approach on renal biopsy could provide new insights. Vascular amyloid is an independent predictor of renal dysfunction in cases of renal amyloidosis.

Estudio histológico del tracto digestivo del neón cardenal paracheirodon axelrodi (Characidae) / Histological study of digestive tract of the neón cardenal paracheirodon axelrodi (Characidae)

Paracheirodon axelrodi es el pez ornamental que más se exporta en Colombia. Sin embargo, se desconocen varios aspectos de su biología básica. Se estudió la histología del tracto digestivo. Se sacrificaron 15 ejemplares (MS 222, 0,5 g/L), fijados en formaldehído al 4 por ciento y decalcificados con ácido nítrico 7 por ciento. Se siguió el procedimiento para H&E. El tracto digestivo de P. axelrodi presentó cuatro capas constitutivas: mucosa, submucosa, muscular y serosa. La mucosa de la boca presentó un epitelio escamoso estratificado no queratinizado con células caliciformes y sin botones gustativos, una submucosa de tejido conectivo laxo y una capa de músculo estriado esquelético. Los dientes son cónicos y abundantes. La capa serosa a lo largo del tracto digestivo es delgada compuesta de tejido conectivo laxo. La capa mucosa, submucosa y muscular del esófago posee la misma conformación tisular de la boca, sin embargo, la capa muscular presenta dos orientaciones. La mucosa del estómago está compuesta por epitelio cilíndrico simple con glándulas gástricas, submucosa de tejido conectivo laxo y una capa de músculo liso en dos orientaciones. Las capas del intestino exhi-bieron una composición tisular similar a la del estómago, sin glándulas gástricas. La mucosa presentó células caliciformes especialmente hacia la región posterior y un aumento en la longitud de los pliegues intestinales. La conformación tisular y morfológica del tracto digestivo de P. axelrodi lo ubica como un pez de hábitos alimenticios carnívoros pero de pequeñas presas.

Cardinal neon, Paracheirodon axelrodi is the most exported ornamental fish in Colombia. However, many aspects of its biology are unknown. A histological study of the digestive tract was carried out and 15 specimens were sacrificed with MS 222, 0.5 g/L, fixed in 4 percent formaldehyde and decalcified with 7 percent nitric acid. H&E technique was followed. P. axelrodi digestive tract showed four constitutive layers: mucosae, submucosae, muscular, and serosa. Mouth mucosae presents a stratified nonkeratinized squamous epithelium with many goblet cells, and no taste buds, submucosae with areolar connective tissue, and skeletal muscular layer. Teeth were conical and abundant. Along the whole intestinal tract the serous was a very thin connective tissue layer. Esophagus mucosae, submucosae, and muscular layer were similar to those of the mouth. However, muscular layer presented two layers in different orientations. Stomach mucosae were made of simple cylindrical epithelium with gastric glands. Submucosa did present areolar connective tissue, and muscular layer exhibited smooth muscle in two different orientations. The intestinal layers were similar to those of the stomach, but without gastric glands. Mucosae presented goblet cells especially at the posterior region. Intestinal folds were also observed. Tisular and morphological structure of P. axelrodi digestive tract suggests a small prey carnivorous fish.

Effect of dietary linoleic acid on the progression of chronic renal failure in rats

The role of linoleic acid in chronic renal failure (CRF) is controversial. In the present study 21 male Wistar rats submitted to 5/6 renal mass reduction (R) and 16 normal controls (C) were fed a supplement (S) or normal (N) linoleic acid diet for 60 days starting 10 days after CRF. As expected, serum creatinine, cholesterol and triglycerides (mean SEM) were higher in the CRF groups compared to the C groups (P<0.05). The RS group presented lower cholesterol (84 4 vs 126 13 mg percent) and triglyceride (88 9 vs 132 19 mg percent) levels compared to the RN group. Proteinuria and kidney weight did not differ between CRF groups. Glomerular area increased 78 percent in RS and 100 percent in RN compared to control rats. Glomerular sclerosis index tended to be lower in RS (27 percent) compared to RN (38 percent), tubulointerstitial damage was similar between CRF groups (RS = 1.91 0.2 and RN = 2.14 0.3), and mesangial fractional volume increased to the same extent in both CRF groups. The data suggest that a linoleic acid-enriched diet did not protect against the progression of CRF after 60 days

Nefrite intersticial aguda apos tratamento com rifampicina. / Acute interstitial nephritis after treatment with refampicin

E relatado um caso de nefrite intersticial aguda, nao oligurica, em um paciente com mal de Hansen, em uso de rifampicina.O unico sinal de hipersensibilidade a droga correspondeu a eosinofilia no sangue periferico. A biopsia renal mostrou acentuado edema intersticial, infiltrado mononuclear e eosinofilico, alem de dano tubular focal, com ausencia de lesao glomerular ou vascular. Apos a suspensao da droga houve recuperacao da funcao renal.Os achados sugerem um mecanismo de hipersensibilidade como causa da lesao renal provavelmente induzida pela rifampicina

Correlacao anatomo-clinica em glomerulopatias. Estudo retrospectivo de 65 casos em adultos. / Anatomo-clinical correlation in glomerulopathies. Retrospective study of 65 cases in adults

O presente trabalho compreende estudo anatomo-clinico retrospectivo de 65 casos de glomerulopatias em adultos. Os casos foram classificados em tres sindromes clinicas: nefritica, nefrotica, nao nefritica - nao nefrotica. A intensidade das lesoes histologicas renais foi avaliada no material de biopsia e/ou autopsia atraves de metodo semiquantitativo (0 a 4 +) obtendo-se indices de lesao glomerular, tubular, intersticio-vascular e renal total. Para cada paciente, foram estabelecidas correlacoes entre estes indices com a apresentacao clinica, niveis pressoricos, funcao renal (creatinina serica) e evolucao. No conjunto, observou-se que lesoes historicas mais graves associam-se a agravamento da funcao renal e piora da evolucao dos pacientes.A analise estatistica de regressao linear simples demonstrou correlacao significante entre os diferentes indice de lesao com os niveis de creatinina serica, porem o indice de lesao intersticio-vascular foi o que melhor se correlacionou com a funcao renal (r2 = 0,53)