El riñón del niño prematuro: riesgos a largo plazo / The kidney of the premature child: long-term risks

Resumen: El recién nacido prematuro se enfrenta a las condiciones extrauterinas con sistemas aún inmaduros, tanto anatómica como fisiológicamente. El riñón termina de desarrollarse a finales del tercer trimes tre del embarazo, por lo que está especialmente expuesto a alterar su desarrollo normal en caso de nacer en forma prematura. Esta situación puede condicionar, entre otras consecuencias, una menor masa renal funcional y cambios microvasculares que representan un riesgo elevado de hipertensión arterial y daño renal crónico en el largo plazo. En el presente artículo se analiza la evidencia existente actual sobre estos riesgos en los prematuros y se ofrece un esquema de seguimiento de estos niños desde el punto de vista nefrológico.

Abstract: The premature newborn faces extrauterine conditions with some systems still immature, both ana tomically and physiologically. The kidney finishes developing at the end of the third trimester of pregnancy, so it is especially exposed to alter its normal development if preterm birth occurs. This si tuation may condition, among other consequences, a lower functional renal mass and microvascular changes comprising a high risk of chronic kidney disease in the long term and arterial hypertension. This article analyzes the current evidence on these risks in premature infants and offers a nephrology follow-up scheme of these children.

A study on the toxic effect of different doses of diclofenac sodium on the development of the kidney in the postnatal period / Estudio sobre el efecto tóxico de diferentes dosis de diclofenaco sódico en el desarrollo del riñón en el período postnatal

The toxic effects of different doses of diclofenac sodium (DS) on the kidney on the postnatal period (0-7 days) by morphometrical and immunohistochemical methods were investigated. For this purpose, 15 female adult wistar albino rats were used and divided into 5 main groups. Group Ia served as normal control, physiologic group Ib received normal saline, group II received low dose (3.9 mg/kg), group III received medium dose (9 mg/kg) and group IV received high dose (18 mg/kg). Male offspring's from 0-7 days after birth were used in this study. On the 8th day of postnatal life, all animals were anesthetized. Then, the kidney samples were analyzed. Haematoxylin and eosin staining showed degeneration and necrosis, apparent atrophy of the glomeruli, mononuclear cell infiltration, congested vessels, increased fibrous tissue and distortion of the proximal convoluted tubules with interruption of the brush margin of the DS treated group. Increased level of Caspase-3 and upregulation of TNF-α with different doses of DS. In light of our findings, DS may lead to adverse effects that are dose-dependent in the prenatal subjected kidney to this drug.

Se investigaron los efectos tóxicos de diferentes dosis de diclofenaco sódico (DS) en el riñón de ratas, durante su período postnatal (0-7 días), por métodos morfométricos e inmunohistoquímicos. Para este propósito, se utilizaron 20 crías macho, de ratas Wistar albinas, y se dividieron en 5 grupos principales. El grupo Ia sirvió como control normal, el grupo fisiológico Ib recibió solución salina normal, el grupo II recibió una dosis baja de DS (3,9 mg/kg), el grupo III recibió una dosis media de DS (9 mg/kg) y el grupo IV recibió una dosis alta de DS (18 mg/kg). Se administraron los medicamentos de 0 a 7 días después del nacimiento de las ratas. En el octavo día de vida postnatal, todos los animales fueron sacrificados. Luego, se analizaron las muestras de riñón. Mediante hematoxilina-eosina se evidenció degeneración y necrosis, aparente atrofia de los glomérulos, infiltración de células mononucleares, vasos congestionados, aumento del tejido fibroso y distorsión de los túbulos contorneados proximales, con interrupción del margen en cepillo del grupo tratado con DS. Se detectó un aumento del nivel de caspasa-3 y regulación al alza de TNF-α con diferentes dosis de DS. A la luz de nuestros hallazgos, la DS puede provocar efectos adversos en el riñón, que dependen de la dosis de este medicamento administrada en el período posnatal.

Presença de aglutininas anti-Leptospirasppem bovinos abatidos em frigorífico no extremo sul do estado da Bahia e fatores de risco associados / Presence of agglutinins anti-Leptospira in slaughtered bovine in the extreme south of Bahia and risk factors

INTRODUÇÃO: A bovinocultura no Brasil é uma das principais atividades que compõem o agronegócio do país, sendo o segundo maior rebanho do mundo. O estado da Bahia tem papel importante neste setor, sendo o 10º estado em número de animais abatidos no Brasil em 2015 (4,4% dos animais abatidos no Brasil). Mesmo com índices animadores, a produtividade da pecuária baiana ainda é baixa, tendo as doenças infecciosas e parasitárias como principais entraves à sua melhora. Dentre essas doenças a leptospirose apresenta uma prevalência de 45,42% nos bovinos no estado da Bahia em prévio inquérito. OBJETIVOS: Assim, o presente projeto teve como objetivo: i) analisar a sororeatividade contra Leptospira de bovinos abatidos em estabelecimento com serviço de inspeção federal, no estado da Bahia, utilizando o teste microaglutinação (MAT), ii) avaliar qual o sorovar predominante na população animal pesquisada, iii) avaliar os rins dos animais abatidos em estabelecimento com serviço de inspeção federal, no estado da Bahia quanto a presença de lesões macroscópicas e a sua associação com as reações positivas ao MAT, vi) avaliar possíveis fatores de risco que poderão propiciar o desencadeamento da infecção por Leptospira. Foram analisados soros de 400 bovinos abatidos...

INTRODUCTION: cattle raising in Brazil is one of the activities that comprise the agribusiness of the country, the second largest herd in the world. The state of Bahia has an important role in this sector, being the 10th state in the number of animals slaughtered in Brazil in 2015 (4.4% of the animals slaughtered in Brazil). Despite encouraging rates, productivity of the Bahian livestock is still low, and infectious and parasitic diseases as major barriers to improvement. Among these diseases leptospirosis has a prevalence of 45.42% in cattle in the state of Bahia in a previous survey. OBJECTIVES: The present project aimed to: i) analyze the seroreactivity against Leptospira from bovine animals slaughtered in establishments with federal inspection service in the state of Bahia, using the microscopic agglutination test (MAT), ii) assess what the predominant serovar in animal population studied, iii) evaluate the kidneys of animals slaughtered in an establishment with federal inspection service in the state of Bahia and the presence of gross lesions and their association with the positive reactions to the MAT, vi) evaluate possible risk factors that may promote the onset of Leptospira infection. 400 slaughtered cattle sera were analyzed...

Sexual hormones modulate compensatory renal growth and function / Las hormonas sexuales modulan el crecimiento renal compensador (CRC) y la función renal en la uninefrectomía (uNx)

The role played by sexual hormones and vasoactive substances in the compensatory renal growth (CRG) that follows uninephrectomy (uNx) is still controversial. Intact and gonadectomized adult Wistar rats of both sexes, with and without uNx, performed at 90 days age, were studied at age 150 days. Daily urine volume, electrolyte excretion and kallikrein activity (UKa) were determined. Afterwards, glomerular filtration rate and blood pressure were measured, the kidneys weighed and DNA, protein and RNA studied to determine nuclei content and cell size. When the remnant kidney weight at age 150 days was compared with the weight of the kidney removed at the time of uNx, male uNx rats showed the greatest CRG (50%) while growth in the other uNx groups was 25%, 15% and 19% in orchidectomized, female and ovariectomized rats, respectively. The small CRG observed in the uNx female rats was accompanied by the lowest glomerular filtration value, 0.56 ± 0.02 ml/min/g kwt compared, with the other uNx groups, p < 0.05. Cell size (protein or RNA/DNA) was similar for all the groups except for uNx orchidectomized rats. In this group the cytoplasmatic protein or RNA content was lower than in the other groups while DNA (nuclei content) was similar. Some degree of hyperplasia was determined by DNA content in the uNx groups. Male sexual hormones positively influenced CRG and its absence modulated cell size. Female sexual hormones, instead, did not appear to stimulate CRG. The kallikrein kinin system may not be involved in CRG.

La importancia que pueden tener las hormonas sexuales y sustancias vasoactivas sobre el crecimiento renal compensador (CRC) que sigue a la uninefrectomía es aún materia de debate. Se estudiaron ratas Wistar de ambos sexos, a los 150 días de vida, intactas y gonadectomizadas con y sin uNx, realizada a los 90 días de vida. Se midió volumen urinario diario y excreción de electrolitos y actividad de kalikreína urinaria. Se midió filtrado glomerular y presión arterial media extrayéndose luego los riñones que fueron pesados y preparados para estudios histológicos y determinación de ADN, ARN y proteínas para estimar contenido nuclear y tamaño celular. El CRC fue calculado comparando el peso del riñón al momento de las uNx (90 dias de vida) con aquel obtenido a los 150 días de vida. En las ratas macho uNx se observó el mayor CRC (50%) mientras que, en los otros grupos uNx solo alcanzó un 25%, 15% y 19%. El filtrado glomerular acompañó los cambios morfológicos observándose el menor filtrado en las ratas hembras uNx respecto al resto de los grupos 0.56 ± 0.02, p < 0.05. El tamaño celular (proteína o ARN/ ADN) fue similar para todos los grupos excepto para los orquidectomizados uNx, cuyo contenido citoplasmático fue menor. El contenido nuclear (ADN) fue semejante en todos los grupos. Se observó que el CRC está influenciado positivamente por las hormonas sexuales masculinas y su ausencia modula el tamaño celular. La falta de hormonas sexuales femeninas, en cambio, afecta negativamente el CRC. El sistema kalikreína kinina no parecería estar involucrado en el CRC.

Observer variability in sonographic measurement of kidney sizes among children in Benin City, Nigeria / Variabilidad del observador en las mediciones sonográficas del tamaño del riñón entre los niños en Benin City, Nigeria

AIM: To assess the level of inconsistency in replicating sonographic kidney size measurements in a population of healthy Nigerian children. SUBJECTS AND METHODS: In this prospective cross-sectional study, convenience sampling technique was used to select a sample of Nigerian children. Both consent from participants and ethical approval from the local authority were obtained before the study commenced. Three radiologists carried out the replicate sonographic measurements using a DP-1100 mechanical sector scanner with a 3.5 MHz convex probe. All examinations were done with subjects in the supine oblique position. Longitudinal and transverse scans were performed. Renal lengths and widths were measured from the longitudinal scans while thickness was measured from the transverse scans. Renal volumes were calculated with the ellipsoid formula. Analysis of variance, Student's t-test, Pearson's correlation coefficient and z-test were used to test the statistical significance of results. SPSS version 17.0 was used in the analysis of results while statistical significance of all results was tested at p < 0.05. RESULTS: Mean intra-observer measurement errors in replicate sonographic measurements of kidney sizes ranged from 0.36-0.43 cm, 0.22-0.63 cm, 0.37-0.52 cm and 5.93-9.62 ml for kidney length, width, thickness and volume, respectively. Mean inter-observer measurement errors were in the range of 0.29 0.48 cm, 0.18-0.23 cm, 0.34-1.82 cm and 5.92-7.28 ml for length, width, thickness and volume, respectively. Mean intra-observer errors were not statistically significant (p > 0.05) but mean interobserver errors were (p < 0.05). Differences in all measurement errors of right and left kidney length, width, thickness and volume were not statistically significant (p > 0.05). Measurement errors correlated weakly with kidney sizes. Observer errors in renal length were not significantly different from what was reported among Caucasians (p > 0.05) whereas that of volume was (p < 0.05). CONCLUSION: Errors in replicate sonographic kidney size measurements obtained by a single observer were less than errors in the same measurements by different observers; therefore, replicate sonographic measurements by a single observer were more consistent in this population.

OBJETIVO: Evaluar el nivel de inconsistencia cuando se repiten las mediciones sonográficas del tamaño del riñón en una población de niños nigerianos saludables. SUJETOS Y MÉTODOS: En este estudio prospectivo transversal, se utilizó la técnica de muestreo por conveniencia para seleccionar una muestra de niños nigerianos. Antes de comenzar el estudio, se obtuvo tanto el consentimiento de los participantes como la aprobación ética de la autoridad local. Tres radiólogos llevaron a cabo la repetición de las mediciones sonográficas mediante un escáner de sector mecánico DP-1100 con una sonda convexa de 3.5 MHz. Todos los exámenes se realizaron con sujetos en posición supina oblicua. Se realizaron escaneos longitudinales y transversales. La longitud y el ancho renales fueron medidos a partir de los escaneos longitudinales, mientras que el espesor se midió a partir de los escaneos transversales. Los volúmenes renales se calcularon con fórmula elipsoide. El análisis de varianza, la prueba t de Student, el coeficiente de correlación de Pearson, y la prueba Z, fueron utilizados para probar la significación estadística de los resultados. El programa SPSS versión 17.0 fue utilizado en el análisis de los resultados mientras que la significación estadística de los resultados fue probada en p < 0.05. RESULTADOS: Los errores intraobservadores promedio en la repetición de las mediciones sonográficas de los tamaños de riñón variaron de 0.36-0.43 cm, 0.22-0.63 cm, 0.37-0.52 cm, 5.93-9.62 mL en cuanto a longitud, ancho, espesor y volumen, respectivamente. Los errores interobservadores promedio de medición estuvieron en un rango de 0.29-0.48 cm, 0.18-0.23 cm, 0.34-1.82 cm y 5.92-7.28 mL de longitud, ancho, espesor y volumen, respectivamente. Los errores intraobservadores promedio no fueron estadísticamente significativos (p > 0.05) pero los errores interobservadores fueron (p < 0.05). Las diferencias en todos los errores de medición del riñón derecho e izquierdo en relación con la longitud, ancho, espesor y volumen, no fueron estadísticamente significativos (p > 0.05). Los errores de medición guardaron una débil correlación con los tamaños del riñón. Los errores de observador en relación con la longitud renal no fueron significativamente diferentes de lo que se informó entre los caucásicos (p > 0.05), mientras que el resultado para el volumen fue (p < 0.05). CONCLUSIÓN: Los errores en la repetición de las mediciones sonográficas del tamaño del riñón obtenidas por un solo observador, son menos que los errores en las mismas mediciones por diferentes observadores. Por lo tanto, las mediciones sonográficas repetidas por un único observador eran más consistentes entre esta población.

Length and Volume of Morphologically Normal Kidneys in Korean Children: Ultrasound Measurement and Estimation Using Body Size

OBJECTIVE: To evaluate the relationship between anthropometric measurements and renal length and volume measured with ultrasound in Korean children who have morphologically normal kidneys, and to create simple equations to estimate the renal sizes using the anthropometric measurements. MATERIALS AND METHODS: We examined 794 Korean children under 18 years of age including a total of 394 boys and 400 girls without renal problems. The maximum renal length (L) (cm), orthogonal anterior-posterior diameter (D) (cm) and width (W) (cm) of each kidney were measured on ultrasound. Kidney volume was calculated as 0.523 x L x D x W (cm3). Anthropometric indices including height (cm), weight (kg) and body mass index (m2/kg) were collected through a medical record review. We used linear regression analysis to create simple equations to estimate the renal length and the volume with those anthropometric indices that were mostly correlated with the US-measured renal sizes. RESULTS: Renal length showed the strongest significant correlation with patient height (R2, 0.874 and 0.875 for the right and left kidneys, respectively, p < 0.001). Renal volume showed the strongest significant correlation with patient weight (R2, 0.842 and 0.854 for the right and left kidneys, respectively, p < 0.001). The following equations were developed to describe these relationships with an estimated 95% range of renal length and volume (R2, 0.826-0.884, p < 0.001): renal length = 2.383 + 0.045 x Height (+/- 1.135) and = 2.374 + 0.047 x Height (+/- 1.173) for the right and left kidneys, respectively; and renal volume = 7.941 + 1.246 x Weight (+/- 15.920) and = 7.303 + 1.532 x Weight (+/- 18.704) for the right and left kidneys, respectively. CONCLUSION: Scatter plots between height and renal length and between weight and renal volume have been established from Korean children and simple equations between them have been developed for use in clinical practice.

Órgãos internos e trato digestório de novilhos superprecoces não castrados ou castrados, de dois grupos genéticos / Internal organs and digestive tract of non-castrated or castrate young steers of two genotypes

Avaliaram-se as características dos órgãos e do trato gastrintestinal de novilhos com duas condições sexuais - castrados e não castrados -, com predomínio genético Charolês ou Nelore com idade e peso médios iniciais de 12 meses e 267kg, respectivamente. Os novilhos foram confinados até o peso de abate médio preestabelecido de 400kg. A dieta alimentar continha relação volumoso:concentrado de 50:50 (base na matéria seca), com 10 por cento de proteína bruta. O delineamento experimental utilizado foi o inteiramente ao acaso, em arranjo fatorial de 2x2 (duas condições sexuais x dois predomínios genéticos). Para o peso absoluto do omaso, observou-se interação significativa de genótipo versus condição sexual dos novilhos. Animais não castrados apresentaram maiores pesos absolutos dos rins (0,81 versus 0,66kg), do abomaso (1,20 versus 1,00kg) e dos intestinos, nas diferentes formas de expressão, em comparação aos castrados. Os animais com predomínio Charolês apresentaram maiores pesos absolutos do omaso (4,24 versus 3,46kg), dos intestinos (8,18 versus 6,84kg) e do total do trato digestório (16,88 versus 14,90kg) em relação aos animais com predominância Nelore. Não houve correlação entre o rendimento de carcaça e os componentes não integrantes da carcaça.

The characteristics of non-integrant parts of carcass of steers with two sexual conditions - castrated and non-castrated - with Charolais or Nellore genetic predominance were evaluated. The average age and inicial weight were 12 months old and 267kg, respectively. The steers were feedlot finished until slaughter weight of 400kg. The experimental diet was formulated in a roughage:concentrate ratio 50:50 (dry matter basis), with 10 percent crude protein. A completely randomized experimental design in a 2x2 factorial arrangement (two sexual conditions and two genetic groups) was used. Significant interaction between genotypes and sexual conditions of steers was observed for the omasum absolute weight. The non-castrated animals showed heavier kidneys (0.81 versus 0.66kg) and abomasums (1.20 versus 1.00kg) and intestines in comparisson to castrated animals. Genotypes with Charolais predominance showed heavier omasums (4.24 versus 3.46kg), intestines (8.18 versus 6.84kg), and the total digestive tract (16.88 versus 14.90kg) in relation to animals with Nellore predominance. No significant correlation between carcass dressing percentage and non-integrant parts of carcass was observed.

Estado del funcionamiento renal de pacientes con osteoporosis primaria (tipo 2) / Renal function status in patients with primary osteoporosis (type 2)

Introducción: Diversos estudios han corroborado la relación entre la insuficiencia renal crónica y la disminución de la densidad mineral ósea; sin embargo, no se ha determinado la misma en presencia de función renal levemente disminuida. El objetivo de esta investigación fue valuar el estado de la función renal en pacientes con osteoporosis primaria y su relación con la densidad mineral ósea. Material y métodos: Estudio prospectivo, transversal, descriptivo, en pacientes con osteoporosis primaria determinada mediante densitometría central (cadera y columna). Se calculó la función renal con la fórmula MRDR (modification of diet in renal disease) en base a la creatinina sérica. Los resultados se clasificaron utilizando las categorías recomendadas por The National Kidney Foundation. Se analizó la relación entre el grado de alteración del funcionamiento renal y la densidad mineral ósea. Resultados: 120 mujeres con edad promedio de 67.9 ± 6.56 años. Se encontró correlación entre valores menores de densidad mineral ósea de columna (T score) y afección moderada de la función renal (F = 4.860, p = 0.009). No hubo relación entre la densitometría de cadera con la función renal ni entre la función renal y el antecedente de fractura (p = 0.223). Conclusiones: Existe relación significativa entre la disminución de la densidad mineral ósea de columna y el deterioro de la función renal de las pacientes con osteoporosis primaria. No fue significativa la relación de la función renal con la incidencia de fracturas en esta población.

BACKGROUND: Several studies correlate renal function with lower bone mineral density (BMD); however, the relationship between early stages of renal dysfunction and BMD has not been clearly defined. Our objective was to determine renal function in patients with primary osteoporosis (type 2) and its relationship with BMD. METHODS: Patients with primary osteoporosis diagnosed using DEXA were evaluated in this cross-sectional analysis. Renal function was estimated according to the modification of diet in renal disease (MDRD) equation and classified according to the National Kidney Foundation for chronic kidney disease (CKD). The relationship between renal function and BMD was analyzed. RESULTS: Included in the study were 120 women with a mean age 67.9 + or - 6.56 years. There was a positive relationship between spine BMD and moderate affection of renal function (F = 4.860, p = 0.009). No relationship was found between hip BMD or fracture with renal function (p = 0.223). CONCLUSIONS: Although women with poor renal function have significantly lower spine BMD, no relationship between early stages of CKD and low BMD has been demonstrated.

Aluminium induced microscopic changes in the kidney.

Reports of aluminium toxicity on kidneys through dietary source is less reported even though it’s adverse effects such as encephalopathy, dementia, osteomalacia and fractures have been reported in renal failure cases after ingestion of aluminium gel. As Majority of Indian population is exposed to aluminium through dietary source, therefore, the effects of alumuinium toxiciy was studied in albino rats after oral administration of Aluminium salts. The present study was carried out on 40 albino rats divided into two equal group: control and experimental. Each of twenty animals of experimental group were given 37.5 mg of aluminium chloride per day orally for 3 weeks. All the animals were sacrificed on 22nd day. Small pieces of kidney were procured, fixed in 10% neutral buffered formaline and embedded in paraffin. Sections of 7µ thickness were cut and stained with Haematoxylin and Eosin for general morphology and PAS for basement membrane. Significant histopathological changes were observed. Breakdown of general architectural pattern with degenerative changes were seen more in cortex as compared to medulla. Haemorrhage and inflammatory cell reaction was also observed in cortex.

Sonographic assessment of renal growth in patients with Beckwith-Wiedemann syndrome: the Beckwith-Wiedemann syndrome renal nomogram

BACKGROUND: Beckwith-Wiedemann syndrome is a disorder of somatic overgrowth. Evidence of kidney overgrowth is a diagnostic criterion that may be used to help identify those patients who are at the greatest risk of developing Wilms tumors. In such subjects, kidney size is typically larger than that of age-matched normal controls. OBJECTIVE: The purpose of our study was to generate a nomogram that could be used to measure renal dimensions in children with Beckwith-Wiedemann syndrome in a clinical setting. MATERIALS & METHODS: All of the Beckwith-Wiedemann syndrome patients followed at our institution from 1996 to 2004 were eligible for inclusion in our study. Renal length was measured with a curvilinear transducer and with the patient supine. Renal lengths were measured for both kidneys using real-time ultrasound for all patients. Their data were compared with those of age-matched controls reported in the 1984 study by Rosenbaum et al. RESULTS: Ninety-six children with Beckwith-Wiedemann syndrome were followed from 1996 to 2004. Forty-three of these patients met our criteria for inclusion in the study: 28 girls (65 percent) and 15 boys (35 percent). We identified a linear relationship between kidney length and patient age. No statistically significant differences in renal length were found between boys and girls (p=0.2153) or between the kidneys on either side of the body (p=0.9613). CONCLUSION: Our study provides a practical, simple renal growth chart that offers a reasonable, sensitive method for evaluating kidney size in children with Beckwith-Wiedemann syndrome.

Compensatory renal growth and mitochondrial function: the influence of warm ischemia and reperfusion / Hipertrofia renal compensatória e função mitocondrial: influência da isquemia quente e reperfusão

PURPOSE: To evaluate the influence of ischemia/reperfusion injury on renal compensatory growth (CGR) and mitochondrial function. METHODS: Forty five Wistar rats were divided in 3 groups: Control Group (GC) - 21 rats were submitted to a sham laparotomy and sacrificed at 1st (6 rats) and 7th (15 rats) postoperative days to evaluate the dry weight of both kidneys and their growth during 1 week (6 rats) and to quantify mitochondrial respiration (9 rats); Group 1 (G1) - 12 rats underwent right nephrectomy and were sacrificed 7 days later for analysis of renal mitochondrial function (6 rats) and dry weight (6 rats). Group 2 (G2) - renal warm ischemia for 60 minutes followed by right nephrectomy was performed in 12 rats; they were sacrificed 7 days later to evaluate renal mitochondrial function (6 rats) and dry weight (6 rats). RESULTS: Dry weight (mg) of left kidneys at 7th day: GC - 219±18, G1 - 281±23 and G2 - 338±39 (GCxG1 p<0.01; GCxG2 p<0.001; G1xG2 p<0.01). State 4 mitochondrial respiration rate and respiratory control ratio (RCR) were similar in all groups (p>0.05). State 3 respirations (mM/min/mg) in GC, G1 and G2 was respectively: 99±23, 132±22 and 82±44 (p<0.02; the only statistical difference noted was between groups G1xG2 - p<0.05). CONCLUSIONS: Following unilateral nephrectomy CRG is associated with an increase in state 3 of mitochondrial respiration. Renal ischemia/reperfusion injury enhances the CRG provoked by unilateral nephrectomy but such enhancement seems independent on mitochondrial respiration.

OBJETIVO: Avaliar a influência da lesão de isquemia/reperfusão na hipertrofia renal compensatória (HRC) e na função mitocondrial. MÉTODOS: 45 ratos Wistar foram divididos em três grupos: Grupo Controle (GC) - 21 ratos submetidos apenas à laparotomia e sacrificados no 1º dia (6 ratos) e 7º dia pós-operatório (15 ratos) para avaliar o peso seco de ambos os rins e seu crescimento durante uma semana (6 ratos) e quantificar a função mitocondrial (9 ratos); Grupo 1 (G1) - 12 ratos submetidos à nefrectomia direita e sacrificados após 7 dias para análise da função mitocondrial renal (6 ratos) e peso renal seco (6 ratos); Grupo 2 (G2) - isquemia renal quente durante 60 minutos no rim esquerdo seguida da nefrectomia direita foi realizada em 12 ratos, que foram sacrificados após 7 dias para avaliação da função mitocondrial (6 ratos) e peso seco (6 ratos). RESULTADOS: peso seco (mg) do rim esquerdo no 7º dia: GC= 219±18; G1=281±23 e G2=338±39 (GCxG1 p<0,01; GCxG2 p<0,001; G1xG2 p<0,01). O estado 4 da função mitocondrial e a Razão de Controle Respiratório (RCR) foram semelhantes em todos os grupos (p>0,05). O estado 3 da respiração mitocondrial (mMO2/min/mg) no GC, G1 e G2 foi, respectivamente: 99±23, 132±22 e 88±44 (p<0,02; a única diferença estatística foi observada entre os grupos G1xG2 - p<0,05). CONCLUSÕES: após nefrectomia unilateral a HRC está associada ao aumento do estado 3 da respiração mitocondrial. A lesão de isquemia/reperfusão renal aumenta a HRC estimulada pela nefrectomia unilateral, mas este aumento parece independer da respiração mitocondrial.

Effects of prenatal alcohol exposure on the developing kidneys

Clinical and experimental studies strongly suggest that prenatal alcohol exposure is associated with zinc deficiency and impaired renal tubular function. Whether maternal alcohol consumption during pregnancy causes renal tubular cell injury is unknown. Renal function was studied in 8 infants with fetal alcohol syndrome [FAS] and 8 healthy age-matched infants. Renal function and structure were also examined in 11 offspring of rats exposed to alcohol during gestation. Infants with FAS had limited ability to concentrate urine after water restriction [P<0.001] and impaired acidification after acute acid loading [P<0.001] compared to control group. Plasma zinc levels were lower [P<0.001] and urinary zinc excretion was higher [P<0.001] in infants with FAS compared to control infants. Scanning electron microscopic studies revealed cytoplasmic mitochondrial hypertrophy and vacuolar structures of the epithelial cells of the cortical collecting ducts in the rat kidney following fetal exposure to alcohol. These findings suggest that offspring of rats exposed to alcohol during fetal life have renal functional and structural abnormalities that may be responsible in the genesis of renal functional abnormalities as described in infants with FAS

Hallazgos en la ecosonografía renal de niños portadores de reflujo vesicoureteral / Ultrasound image examination in children with vesicouretral reflux

Ciento veinte (120) pacientes con infección urinaria, fueron evaluados mediante cistografía miccional en el Servicio de Radiología del Hospital Universitario Dr. "Antonio María Pineda". Quince (15) pacientes presentaron RVU, a los cuales se les practicó ecosonograma renal. Se observó mayor frecuencia de RVU en el sexo femenino, 66,7 por ciento. El reflujo grado V ocupó el 33,3 por ciento, seguido de reflujo grado III con un 26,7 por ciento, con una importante frecuencia de reflujo pasivo de 93,3 por ciento. El crecimiento renal y el espesor del parénquima renal se afecta en forma inversamente proporcional al grado de reflujo, presentando el 53,3 por ciento de los pacientes en estudio, riñones pequeños para la edad y el 46,7 por ciento adelgazamiento del parénquima renal. La presencia de cicatriz renal ocupó un porcentaje de 33,3 por ciento. Los avances en la ultrasonografía han resultado en la reevaluación de los métodos tradicionales. La ecografía tiene un valor potencial en el seguimiento del niño con RVU, ya que permite la evaluación de las consecuencias del daño renal por el reflujo vésicoureteral y la infección

Effect of plant growth promoting substance [2,4 - dichlorophenoxy acetic acid] on the structure of the rat kidney at different postnatal ages

Thirty adult mated females albino rats were used in this study. The animals were divided into two groups: One served as a control and the other received a daily dose of 15 mg/kg of 2, 4-D starting form the sixth day of pregnancy till delivery. At one week, proximal and distal tubules exhibited degenerative alterations which varied in severity and extent. The lining epithelium showed an increase in number and size of lysosomes and the mitochondria became swollen with destructed cristae. The renal corpuscle showed marked reduction of the urinary space with fusion of the podocytic feet processes. With progress of development, there was more degenerative changes in the convoluted tubules. Some cells of the proximal convoluted tubules showed marked reduction in most of the cell organelles. Other cells showed large bodies of moderate electron density and numerous lysosomes. The cells of the distal tubules showed numerous vacuoles of variable sizes and shapes, some of them contained myelin-like figures. The urinary space of the renal corpuscles was no longer obliterated and the podocytic feet processes were regularly spaced

Embriogênese renal de ratos: participação das catepsinas S e H, correlação com fatores de crescimento / Embryonic kidneys of rats: participation of cathepsins S and H, correlation with growth factors

Durante o desenvolvimento renal muitas proteases são secretadas nos ambientes intra e extracelular para participarem da remodelação da matriz extracelular (MEC). A proteólise tem sido também relacionada a eventos estimulatórios e inibitórios determinados por fatores de crescimento durante a nefrogênese. Foram utilizados neste estudo técnicas de cultura de rim embrionário, identificação gênica atravésdo método de PCR pela reverse transcriptase (rtPCR) e a cultura tridimensional de células em gel de colágeno I. Observou-se que o desenvolvimento embrionário renal é fortemente afetado pelas catepsinas S e H que funcionam como mediadores da atividade de fatores de crescimento com o HGF, NGF e o TGF-b em mecanismo variável do ponto de vista de dose e local de ação, assegurando alta especificidade destes polipeptídeos durante os eventos de crescimento e diferenciação. A expressão das catepsinas S e H durante o crescimento do rim embrionário varia de acordo com a idade gestacional do órgão, de tal forma que se observa expressão mais evidente destas enzimas em idades mais tardias para a catepsina S e mais precoce para a catepsina H, dando espaço para atuação de outras mol[éculas estimuladoras de crescimento nas idades em que eslas estão ausentes. Os inibidores de cisteíno-proteases E-64 e Leupeptin adicionados ao meio de cultura de rins embrionários em cultivo determinou alterações significativas de crescimento naqueles órgãos. A aplicação de modelos já bem estabelecidos de tubulogênese, como a cultura de células MDCK e IMCD em gel de colágeno tipo I, com meios tratados com os fatores de crescimento EGF e HGH isoladamente ou em associação aos inibidores E-64 e Leupeptin foi providente na medida em se observou redução significante na ramificação induzida pelo HGF nos ensaios com o E-64 em ambas linhagens celulares. Diferentemente, o Leupeptin causou alteração apenas na complexidade da ramificação por provável inibição dos processos celulares. Este estudo sugere que, através das técnicas de rtPCR, cultivo de órgão embrionário e modelo de nefrogênese com cultura tridimensional de células MDCK e IMCD, as catepsinas S e H estão fortemente envolvidas no evento de tubulogênese induzido por fatores de crecimento específicos

Aspectos celulares e moleculares da nefrogênese / Cellular and molecular aspects of nephrogenese

A ramificaçao/tubulogênese do broto ureteral é fundamental para o desenvolvimento renal. O sistema de cultura de células em gel de três dimensoes tem trazido grandes avanços ao entendimento dos mecanismos envolvidos na arborizaçao. Nesta tese procura-se unificar estes achados com os obtidos através de técnicas genéticas e de cultura de órgaos. Os dados sugerem a existência de um balanço entre fatores facilitadores da tubulogênese, como o fator de crescimento hepático (HGF) e componentes da matriz extracelular (MEC), como laminina, entactina e flbronectina, e fatores inibidores de crescimento, como o fator de crescimento transformador beta (TGF-b) e outras proteínas da MEC (vitronectina, colágeno IV e heparan sulfato). Possivelmente, fatores distais ao acoplamento entre os ligantes (fatores de crescimento) e seus receptores (frequemtemente tirosina-quinase, PTK) agem como reguladores desta arborizaçao. Assim, múltiplas vias de fosforilaçao mediadas por proteínas quinases (PKC, PKA e PTK), proteases extracelulares e intracelulares (especialmente as catepsinas), seus inibidores e integrinas, modulam a morfogênese do túbulo renal. Sao discutidos os aspectos relevantes deste conjunto de instrumentos celulares, abrindo a oportunidade de, na medida em que se conheça os mecanismos de diferenciaçao/formaçao, aplicá-los futuramente na compreensao de alguns estados flsiopatológicos, como a doença cística renal e a regeneraçao após um insulto isquêmico

Sonographic renal length in Indian children.

For the purpose of making norms of ultrasonographic renal length in Indian children, 240 children (137 boys and 103 girls) below 5 years of age were subjected to sonographic evaluation in supine position. Left renal length increased from 59.18 mm, in infancy to 81.89 mm between 4-5 years age in female children. Similar increase was observed in male children. There was no statistically significant difference in renal length in boys and girls in various age groups (p 0.05 to 0.1). Right renal length measured 1-3.5 mm than less than the left renal length, and this difference was statistically significant (p 0.05 to 0.0002) in both sexes. Renal length positively correlated to subject's age, length/height, body weight and body surface area in that order.

Postnatal changes in kidney glucocorticoid receptor of mice.

The specific binding of [3H]dexamethasone to its receptor and the activation of the hormone-receptor complexes from the kidney of mice at various postnatal ages were investigated. The results indicated that the level (fmol/mg protein) of glucocorticoid receptors remained unaltered at 10-, 15- and 30-day, increased significantly at 45-day and thereafter declined to its earlier level in 60-day old mice. Scatchard analysis of binding data confirmed the increased level of receptors at 45-day compared to day 15, without any change in the hormone affinity to its receptor at these two ages. The extent of temperature- and salt-dependent activation of the receptor showed no marked differences in 10- and 60-day old mice, as determined by DNA-cellulose binding assays. However, the nuclear binding of temperature- and salt-activated glucocorticoid-receptor complexes was significantly higher in 10-day old mice. Cross-mixing experiments showed nuclear specificity in higher binding of thermally activated receptor at day 10 of postnatal age. Molybdate, tungstate and N-ethylmaleimide inhibited the temperature- and salt-dependent activation of glucocorticoid-receptor complexes similarly at both the ages studied. DNase I extraction of bound hormone-receptor complexes from nuclei showed higher extractability at day 10 (63%) compared to day 60 (43%). These findings indicated changes in glucocorticoid receptor concentration together with chromatin organization that might play an important role in glucocorticoid-mediated responses during postnatal development of mice.