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Bol. latinoam. Caribe plantas med. aromát ; 20(4): 339-350, jul. 2021. ilus, tab
Article in English | LILACS | ID: biblio-1349507


This study was aimed to explore the comparative efficacy of cinnamon bark extract, cinnamaldehyde and kaempferol against acetaminophen (APAP)-induced oxidative stress. Cinnamon bark extract, cinnamaldehyde and kaempferol were utilized or in-vivo analysis. From the results of in-vitro screening tests, cinnamon ethanolic extract was selected for in-vivo study in mouse model. For this, Balb/c albino mice were treated with cinnamon ethanolic extract (200 mg/kg), cinnamaldehyde (10 mg/kg) and kaempferol (10 mg/kg) orally for 14 days followed by single intraperitoneal administration of APAP during 8 hours. Blood and organ samples were collected for biochemical and histopathological analysis. The results showed that cinnamon bark ethanolic extract, cinnamaldehyde and kaempferol ameliorated APAP-induced oxidative stress and organ toxicity in mice. In conclusion, cinnamaldehyde and kaempferol possess comparable antioxidant potential even at 20-times less dose as compared to cinnamon bark ethanolic extract suggesting therapeutic potential in oxidative stress-related disorders.

Este estudio tuvo como objetivo explorar la eficacia comparativa del extracto de corteza de canela, cinamaldehído y kaempferol contra el estrés oxidativo inducido por acetaminofén (APAP). Se utilizaron extracto de corteza de canela, cinamaldehído y kaempferol para el análisis in vivo. De los resultados de las pruebas de detección in vitro, se seleccionó el extracto etanólico de canela para estudio in vivo en modelo de ratón. Para ello, los ratones albinos Balb/c fueron tratados con extracto etanólico de canela (200 mg/kg), cinamaldehído (10 mg/kg) y kaempferol (10 mg/kg) por vía oral durante 14 días, seguido de la administración intraperitoneal única de APAP durante 8 horas. Se recogieron muestras de sangre y órganos para análisis bioquímicos e histopatológicos. Los resultados mostraron que el extracto etanólico de la corteza de canela, el cinamaldehído y el kaempferol mejoraron el estrés oxidativo inducido por APAP y la toxicidad orgánica en ratones. En conclusión, el cinamaldehído y el kaempferol poseen un potencial antioxidante comparable, incluso a una dosis 20 veces menor en comparación con el extracto etanólico de la corteza de canela, lo que sugiere un potencial terapéutico en los trastornos relacionados con el estrés oxidativo.

Animals , Mice , Acrolein/analogs & derivatives , Plant Extracts/administration & dosage , Cinnamomum zeylanicum/chemistry , Oxidative Stress/drug effects , Kaempferols/chemistry , Antioxidants/administration & dosage , Acrolein/chemistry , Chromatography, High Pressure Liquid , Disease Models, Animal , Phytochemicals , Kidney/drug effects , Kidney/pathology , Liver/drug effects , Liver/pathology , Acetaminophen/toxicity , Mice, Inbred BALB C
Clinics ; 76: e2096, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153992


OBJECTIVES To determine the role of the RBP4/PiC/SIRT3 signaling pathway in the opening of the mitochondria permeability transition pore (mPTP) in offspring rats with hypothyroidism during pregnancy. METHODS Sixty Sprague-Dawley (SD) rats were employed in this study. Pregnancy was deemed successful when a sperm was found in the uterus. After one week of pregnancy, offspring rats were divided into the following groups: overall hypothyroidism group (OH group), subclinical hypothyroidism group (SCH group), and normal control group (CON group). The establishment of the hypothyroidism model was confirmed when the serum thyroid stimulating hormone (TSH) levels were higher than normal value and TT4 level was within the normal range. The renal mitochondria of offspring rats were extracted on the 14th postnatal day (P14) and 35th postnatal day (P35). RESULTS At P14, no significant differences in the degree of mPTP opening and expression of phosphoric acid carrier vector (PiC) were detected between the rats in the OH group and the SCH group. However, the expression level of silent mating-type information regulation 3 homolog (SIRT3) was markedly reduced. Retinol-binding protein 4 (RBP4) expression increased in the rats from the OH group, relative to that in those from the SCH group. At P35, the degree of mPTP opening and the expression levels of PiC and RBP4 in the OH group were higher than those in the SCH group. However, SIRT3 expression in the OH group was lower than that observed in the SCH group. CONCLUSION RBP4 plays an important role in early renal mitochondrial damage and renal impairment in rats suffering from hypothyroidism during pregnancy. The RBP4/PiC/SIRT3 pathway is thus involved in the opening of the renal mPTP in offspring rats with hyperthyroidism.

Animals , Female , Pregnancy , Rats , Pregnancy Complications , Hypothyroidism/complications , Hypothyroidism/chemically induced , Kidney/metabolism , Kidney/pathology , Mitochondria , Permeability , Rats, Sprague-Dawley , Retinol-Binding Proteins, Plasma
Braz. j. med. biol. res ; 54(3): e9206, 2021. graf
Article in English | LILACS | ID: biblio-1153519


Renal fibrosis is one of the most significant pathological changes after ureteral obstruction. Transforming growth factor-β (TGF-β) signaling pathway plays essential roles in kidney fibrosis regulation. The aims of the present study were to investigate effects of microRNA-302b (miR-302b) on renal fibrosis, and interaction between miR-302b and TGF-β signaling pathway in murine unilateral ureteral obstruction (UUO) model. Microarray dataset GSE42716 was downloaded by retrieving Gene Expression Omnibus database. In accordance with bioinformatics analysis results, miR-302b was significantly down-regulated in UUO mouse kidney tissue and TGF-β1-treated HK-2 cells. Masson's trichrome staining showed that miR-302b mimics decreased renal fibrosis induced by UUO. The increased mRNA expression of collagen I and α-smooth muscle actin (α-SMA) and decreased expression of E-cadherin were reversed by miR-302b mimics. In addition, miR-302b up-regulation also inhibited TGF-β1-induced epithelial mesenchymal transition (EMT) of HK-2 cells by restoring E-cadherin expression and decreasing α-SMA expression. miR-302b mimics suppressed both luciferase activity and protein expression of TGF-βR2. However, miR-302b inhibitor increased TGF-βR2 luciferase activity and protein expression. Meanwhile, miR-302b mimics inhibited TGF-βR2 mRNA expression and decreased Smad2 and Smad3 phosphorylation in vivo and in vitro. Furthermore, over-expression of TGF-βR2 restored the miR-302b-induced decrease of collagen I and α-SMA expression. In conclusion, this study demonstrated that miR-302b attenuated renal fibrosis by targeting TGF-βR2 to suppress TGF-β/Smad signaling activation. Our findings showed that elevating renal miR-302b levels may be a novel therapeutic strategy for preventing renal fibrosis.

Humans , Animals , Rats , Ureteral Obstruction/pathology , Signal Transduction , Transforming Growth Factor beta/metabolism , MicroRNAs/genetics , Smad Proteins , Kidney Diseases/genetics , Fibrosis , Cell Line , Epithelial-Mesenchymal Transition , Kidney/pathology , Kidney Diseases/pathology
Article in Chinese | WPRIM | ID: wpr-887960


The liver and kidney fibrosis model was established by thioacetamide(TAA) and unilateral ureteral obstruction(UUO) in SD rats. The rats were randomly divided into three groups: model group, low and high-dose groups of C21 steroidal glycosides of Cynanchum auriculatum. Another blank control group was set. Four weeks later, serum was taken to detect the biochemical indexes of liver and kidney function. Urine protein and urine creatinine were detected by kits. Liver and kidney tissue samples were stained with HE and Masson staining, and hydroxyproline content was detected. Western blot was used to detect expressions of fibrotic proteins, inflammatory factors and TLR4 signaling pathways, so as to observe the preventive and therapeutic effects of C21 steroidal glycosides from C. auriculatum on hepatic and renal fibrosis and explore its molecular mechanism. Four weeks later, serum biochemical results showed that liver and kidney functions were seriously damaged, and pathological sections showed that inflammatory cell infiltration, decrease of parenchymal cells, and increase of interstitial fibrosis in liver and kidney tissues. The results showed that low and high doses(150, 300 mg·kg~(-1)) of C21 steroidal glycosides could significantly reduce the collagen deposition and the pathological changes of liver and kidney fibrosis compared with the model group. At the same time, we found that the expression levels of TLR4 and MyD88 signaling pathway proteins were significantly increased in the liver and kidney tissues of the model group, and a large number of NF-κB signaling pathway proteins migrated into the nucleus. On the contrary, the expression levels of TLR4, MyD88 signaling pathway proteins and the nuclear migration of NF-κB were significantly inhibited in the low and high dose groups of C21 steroidal glycosides from C. auriculatum. Therefore, it was speculated that the mechanism of C21 steroidal glycoside for preventive and therapeutic effect on hepatic and renal fibrosis was related to inhibit TLR4/MYD88/NF-κB inflammatory pathway, thus preventing hepatic and renal fibrosis.

Animals , Cynanchum , Fibrosis , Glycosides , Kidney/pathology , Liver , NF-kappa B/genetics , Rats , Rats, Sprague-Dawley , Toll-Like Receptor 4/genetics
Int. j. morphol ; 38(2): 461-471, abr. 2020. graf
Article in English | LILACS | ID: biblio-1056463


This experiment was designed to study the administration of normal doses of one of recent antimalarial drug and coadministration of vitamin E on the kidney tissue. A total twenty-four adult male albino rats were used and divided into four groups: the first one served as a control, the second received artemether orally for three days consecutively. The rats of the third and fourth groups received the same dose of artemether concomitantly with 50 and 100 mg/kg vitamin E orally daily for 2 weeks. After the last dose, the rats were sacrificed and the kidney tissues with blood samples obtained and processed for light, electron microscopic and biochemical analysis. Histologically, artemether treated kidneys showed atrophied glomeruli with widened urinary space and kidney tubules were degenerated with disturbed contour and some vacuoles inside it. Ultrastructurally, the glomeruli of this group showed hypertrophic endothelial cells, irregularity of its basement membrane, disrupted foot processes and filtration slits. The kidney tubule cells showed loss of basal infoldings, cytoplasmic vacuolation, polymorphic damaged swollen mitochondria a loss of its microvilli towards its capillary lumen. Artemether plus vitamin E of the rat kidney groups showed improvement of morphological changes compared to the changes seen in artemether alone. These data were confirmed by biochemical findings with marked improvement of blood urea and creatinine levels and increase of anti-oxidant enzyme activities of glutathione peroxidase and superoxide dismutase in the vitamin E treated groups. The results of this study revealed that vitamins E can improve the adverse changes of artemether of rat renal tissue.

Este proyecto fue diseñado para estudiar la administración de dosis normales de uno de los medicamentos antipalúdicos y de la administración de vitamina E en el tejido renal. Se utilizaron 24 ratas albinas machos adultas divididas en cuatro grupos: el primero sirvió como control, el segundo recibió arteméter por vía oral durante tres días consecutivos. Las ratas del tercer y cuarto grupos recibieron la misma dosis de arteméter concomitantemente con 50 y 100 mg / kg de vitamina E por vía oral diariamente durante 2 semanas. Después de la última dosis, las ratas fueron sacrificadas y se obtuvo el tejido renal de cada muestra los cuales fueron procesados para análisis con microscopías de luz y electrónica, además de exámenes bioquímicos. Histológicamente, los riñones tratados con arteméter mostraron atrofia glomerular con espacio urinario ensanchado y túbulos renales degenerados con contorno alterado y algunas vacuolas en su interior. Ultraestructuralmente, los glomérulos de este grupo mostraron células endoteliales hipertróficas, irregularidad de su membrana basal, procesos alterados del pie y hendiduras de filtración. Las células del túbulo renal mostraron pérdida de inflexiones basales, vacuolación citoplasmática, mitocondrias dañadas y pérdida de sus microvellosidades hacia la luz capilar. Arteméter más vitamina E en los grupos de riñón de rata mostraron una mejora de los cambios morfológicos, en comparación con los cambios observados en arteméter solamente. Estos datos fueron confirmados por hallazgos bioquímicos con una marcada mejoría de los niveles de urea y creatinina en sangre y un aumento de las actividades enzimáticas antioxidantes de la glutatión peroxidasa y la superóxido dismutasa en los grupos tratados con vitamina E. Los resultados de este estudio revelaron que la vitamina E puede mejorar los cambios adversos del arteméter del tejido renal de la rata.

Animals , Male , Rats , Vitamin E/pharmacology , Acute Kidney Injury/chemically induced , Artemether/toxicity , Vitamin E/administration & dosage , Microscopy, Electron , Biomarkers/analysis , Rats, Wistar , Kidney/drug effects , Kidney/pathology , Kidney/ultrastructure , Antimalarials/toxicity
Einstein (Säo Paulo) ; 18: eAO5576, 2020. tab
Article in English | LILACS | ID: biblio-1133778


ABSTRACT Objective: To evaluate anatomic factors and radiologist's experience in the detection of solid renal masses on ultrasonography. Methods: We searched for solid renal masses diagnosed on cross-sectional imaging from 2007 to 2017 that also had previous ultrasonography from the past 6 months. The following features were evaluated: nodule size, laterality, location and growth pattern, patient body mass index and radiologist's experience in ultrasound. In surgically resected cases, pathologic reports were evaluated. Unpaired t test and χ2 test were used to evaluate differences among subgroups, using R-statistics. Statistical significance was set at p<0.05. Results: The initial search of renal nodules on cross-sectional imaging resulted in 428 lesions and 266 lesions were excluded. Final cohort included 162 lesions and, of those, 108 (67%) were correctly detected on ultrasonography (Group 1) and 54 (33%) were missed (Group 2). Comparison of Groups 1 and 2 were as follows, respectively: body mass index (27.7 versus 27.1; p=0.496), size (2.58cm versus 1.74cm; p=0.003), laterality (54% versus 59% right sided; p=0.832), location (27% versus 22% upper pole; p=0.869), growth pattern (25% versus 28% endophytic; p=0.131) and radiologist's experience (p=0.300). From surgically resected cases, histology available for Group 1 was clear cell (n=11), papillary (n=15), chromophobe (n=2) renal cell carcinoma, oncocytoma (n=1), and, for Group 2, clear cell (n=7), papillary (n=5) renal cell carcinoma, oncocytoma (n=2), angiomyolipoma, chromophobe renal cell carcinoma, and interstitial pyelonephritis (n=1, each). Conclusion: Size was the only significant parameter related to renal nodule detection on ultrasound.

RESUMO Objetivo: Avaliar os fatores anatômicos e a experiência do radiologista na detecção de massas renais sólidas na ultrassonografia. Métodos: Buscamos massas renais sólidas diagnosticadas em imagens seccionais, de 2007 a 2017, que também tivessem ultrassonografia prévia nos últimos 6 meses. As seguintes características foram avaliadas: tamanho do nódulo, lateralidade, localização e padrão de crescimento, índice de massa corporal do paciente e experiência do radiologista em ultrassonografia. Nos casos com ressecção cirúrgica, os laudos de patologia foram analisados. O teste t não pareado e o teste χ2 foram utilizados para avaliar as diferenças entre os subgrupos, usando R-statistics. A significância estatística foi estabelecida em p<0,05. Resultados: A pesquisa inicial de nódulos renais achados em imagens seccionais resultou em 428 lesões, com 266 exclusões. A coorte final incluiu 162 lesões e, destas, 108 (67%) foram detectadas corretamente na ultrassonografia (Grupo 1), e 54 (33%) não foram identificadas (Grupo 2). A comparação dos Grupos 1 e 2 mostrou índice de massa corporal (27,7 versus 27,1; p=0,496), tamanho (2,58cm versus 1,74cm; p=0,003), lateralidade (54% versus 59% no lado direito; p=0,832), localização (27% versus 22% no polo superior; p=0,869), padrão de crescimento (25% versus 28% endofítico; p=0,131) e experiência do radiologista (p=0,300). A histologia disponível para o Grupo 1 foi carcinoma renal de células claras (n=11), papilar (n=15), cromófobo (n=2), oncocitoma (n=1), e, para o Grupo 2, carcinoma renal de células claras (n=7), papilar (n=5), oncocitoma (n=2), angiomiolipoma, cromófobo e pielonefrite intersticial (n=1, cada). Conclusão: O tamanho foi o único parâmetro significativo relacionado à detecção de nódulos renais no ultrassom.

Humans , Carcinoma, Renal Cell/diagnostic imaging , Ultrasonography , Kidney/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Diagnosis, Differential , Radiologists , Kidney/pathology
Article in Spanish | LILACS | ID: biblio-1292488


INTRODUCCIÓN: En 6 meses se notificaron más de 400 mil fallecidos por COVID-19. Han surgido múltiples investigaciones para comprender su etiopatogenia, siendo la autopsia médica uno de los mejores procedimientos para obtener información. Presentamos una revisión respecto a hallazgos post mortem publicados hasta mayo, 2020. RESULTADOS: Se recolectaron 12 estudios, de un total de 109 pacientes cuyo deceso fue por complicación respiratoria, predominó el sexo masculino, edad avanzada y con múltiples comorbilidades. El estudio PCR se realizó principalmente para diagnóstico. Se demostró ARN viral en riñón, hígado, corazón, cerebro y otros órganos. Los autores relataron presencia de micro y/o macro trombosis, en 50 de 109 casos, sobre todo a nivel pulmonar y renal, de tipo microscópica y relacionados a signos de shock. Desde la perspectiva anatomopatológica, se centra en alteraciones pulmonares y renales: daño alveolar difuso, injuria tubular aguda, microtrombos y otros signos de alteración microcirculatoria. Los estudios inmunohistoquímicos, de inmunofluoresencia y microscopía electrónica sugieren tropismo del virus por células epiteliales y estromales a nivel pulmonar y renal. En otros órganos se encuentran elementos morfológicos inespecíficos, atribuibles a patologías de base o shock. CONCLUSIÓN: El patrón histopatológico de daño alveolar difuso es frecuente, principalmente en fase exudativa o temprana. En el tejido renal destaca la injuria tubular aguda y daño microcirculatorio. El número y la descripción de muestras en otros órganos es reducida, siendo necesaria mayor casuística. La trombosis, es un trastorno prevalente en pulmones y riñones de pacientes con signos de shock. El tipo de trombo con más frecuencia descrito, es el microtrombo. Si bien se puede explicar como gatillante del fenómeno trombótico la interacción entre agente y huésped, otros factores deben ser estudiados para dilucidar la patogenia.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Thrombosis/pathology , COVID-19/pathology , Autopsy , Thrombosis/diagnosis , RNA, Viral/analysis , Polymerase Chain Reaction , COVID-19/diagnosis , COVID-19/mortality , Kidney/pathology , Kidney/virology , Liver/pathology , Liver/virology , Lung/pathology , Lung/virology
Braz. j. med. biol. res ; 53(4): e9220, 2020. graf
Article in English | LILACS | ID: biblio-1089355


Rab7, an important member of the Rab family, is closely related to autophagy, endocytosis, apoptosis, and tumor suppression but few studies have described its association with renal fibrosis. In the early stage, our group studied the effects of Rab7 on production and degradation of extracellular matrix in hypoxic renal tubular epithelial cells. Because cell culture in vitro is different from the environment in vivo, it is urgent to understand the effects in vivo. In our current study, we established a renal fibrosis model in Rab7-knock-in mice (prepared by CRISPR/Cas9 technology) and wild type (WT) C57BL/6 mice using unilateral ureteral obstruction (UUO). Seven and 14 days after UUO, the expression of the Rab7 protein in WT mice, as well as the autophagic activity, renal function, and the degree of renal fibrosis in WT and Rab7-knock-in mice were examined by blood biochemical assay, hematoxylin-eosin and Masson staining, immunohistochemistry, and western blotting. We found that the Rab7 expression in WT mice increased over time. Furthermore, the autophagic activity constantly increased in both groups, although it was higher in the Rab7-knock-in mice than in the WT mice at the same time point. Seven days after UUO, the degree of renal fibrosis was milder in the Rab7-knock-in mice than in the WT mice, but it became more severe 14 days after surgery. Similar results were found for renal function. Therefore, Rab7 suppressed renal fibrosis in mice initially, but eventually it aggravated fibrosis with the activation of autophagy.

Animals , Male , Female , Rabbits , Autophagy/physiology , Ureteral Obstruction/complications , rab GTP-Binding Proteins/genetics , Kidney/pathology , Kidney Diseases/etiology , Fibrosis , RNA/isolation & purification , Signal Transduction , Up-Regulation , Mice, Knockout , Reverse Transcriptase Polymerase Chain Reaction , rab GTP-Binding Proteins/metabolism
Rev. Assoc. Med. Bras. (1992) ; 66(supl.1): s10-s16, 2020. graf
Article in English | LILACS | ID: biblio-1057106


SUMMARY Fabry disease (FD) is a recessive monogenic inheritance disease linked to chromosome X, secondary to mutations in the GLA gene. Its prevalence is estimated between 1:8,454 and 1:117,000 among males and is probably underdiagnosed. Mutations in the GLA gene lead to the progressive accumulation of globotriaosylceramide (Gb3). Gb3 accumulates in lysosomes of different types of cells of the heart, kidneys, skin, eyes, central nervous system, and gastrointestinal system, and may lead to different clinical scenarios. The onset of symptoms occurs during childhood, with acroparesthesia, heat intolerance, and gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, and neuropathic pain. Subsequently, symptoms related to progressive impairment appear, such as angiokeratomas, cornea verticillata, left ventricular hypertrophy, myocardial fibrosis, proteinuria, and renal insufficiency. The latter being the main cause of death in FD. The gold standard for diagnosis is the genetic analysis in search of mutation, in addition to family history. In homozygous patients, the enzyme activity can also be used. Once the diagnosis is confirmed, the patient and their family should receive genetic counseling. The treatment, in turn, currently focuses mainly on replacing the enzyme that is absent or deficient by means of enzyme replacement therapy, with the purpose of avoiding or removing deposits of Gb3. Chaperones can also be used for the treatment of some cases. It is considered that the specific treatment should be initiated as soon as a diagnosis is obtained, which can change the prognosis of the disease.

Humans , Male , Female , Fabry Disease/pathology , Renal Insufficiency, Chronic/pathology , Enzyme Replacement Therapy , Kidney/pathology , Trihexosylceramides , Fabry Disease/complications , Fabry Disease/genetics , Fabry Disease/therapy , Renal Insufficiency, Chronic/etiology
Rev. Assoc. Med. Bras. (1992) ; 66(supl.1): s75-s81, 2020. graf
Article in English | LILACS | ID: biblio-1057102


SUMMARY The scenario of infection by the human immunodeficiency virus (HIV) has been undergoing changes in recent years, both in relation to the understanding of HIV infection and regarding the treatments available. As a result, the disease, which before was associated with high morbidity and mortality, is now seen as a chronic disease that can be controlled, regarding both transmission and symptoms. However, even when the virus replication is well controlled, the infected patient remains at high risk of developing renal involvement, either by acute kidney injury not associated with HIV, nephrotoxicity due to antiretroviral drugs, chronic diseases associated with increased survival, or glomerular disease associated to HIV. This review will cover the main aspects of kidney failure associated with HIV.

RESUMO O panorama da infecção pelo vírus da imunodeficiência humana (HIV) vem sofrendo alterações nos últimos anos, tanto em relação ao entendimento da infecção pelo HIV quanto aos tratamentos disponíveis. Como resultado, a doença, que antes estava associada a alta morbimortalidade, é agora considerada uma doença crônica que pode ser controlada, tanto em relação à transmissão quanto aos sintomas. No entanto, mesmo quando a replicação viral é bem controlada, o paciente infectado tem um alto risco de desenvolver complicações renais, seja através de lesão renal aguda não relacionada ao HIV, por nefrotoxicidade causada por drogas antirretrovirais, por doenças crônicas associadas com o aumento da sobrevida ou por doença glomerular associada ao HIV. Esta revisão abordará os principais aspectos da insuficiência renal associada ao HIV.

Humans , HIV Infections/complications , AIDS-Associated Nephropathy/etiology , Acute Kidney Injury/etiology , HIV Infections/drug therapy , Chronic Disease , Risk Factors , AIDS-Associated Nephropathy/pathology , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active/adverse effects , Acute Kidney Injury/pathology , Tenofovir/adverse effects , Atazanavir Sulfate/adverse effects , Kidney/pathology
Braz. j. med. biol. res ; 53(6): e8625, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1132515


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.

Humans , Male , Female , Adult , Middle Aged , Aged , Glomerular Filtration Rate , Amyloid/physiology , Amyloidosis/pathology , Kidney/pathology , Kidney Diseases/pathology , Biopsy , Retrospective Studies , Amyloidosis/physiopathology , Kidney/physiopathology , Kidney Diseases/physiopathology
Int. j. morphol ; 37(4): 1335-1341, Dec. 2019. graf
Article in English | LILACS | ID: biblio-1040134


Food additives and flavour enhancers used in the food industry are potential health risks. We tested the hypothesis that the food additive and flavour enhancer, monosodium glutamate (MSG), which is the sodium salt of glutamic acid can induce ultrastructural alterations to the kidney, and the antioxidant vitamin E can protect against acute kidney injuries induced by a toxic dose of MSG in a rat model of the disease. The model group of rats received a daily dose of MSG (4 gm/kg) for 7 days, whereas the protective groups were either received a 100 mg/kg vitamin E plus MSG or 300 mg/kg vitamin E plus MSG for 7 days. Rats were then sacrificed on day 8. Transmission and light microscopy images revealed substantial kidney damage induced by MSG in the model group as demonstrated by degenerated epithelial cells with Pyknotic nuclei, swollen mitochondria, damaged brush margins, dilated tubules, and widening of Bowman's space with shrinkage and deformity of some glomeruli. Treatment of the model group with vitamin E showed a substantial protection of kidney tissue and renal ultrastructure by 300 mg/kg vitamin E compared to a partial protection by 100 mg/kg vitamin E. In addition, MSG significantly (p<0.05) increased serum levels of urea and creatinine, which were significantly (p<0.05) decreased with vitamin E. However, for serum creatinine, high doses of vitamin E (300 mg/kg) were more effective than lower doses (100 mg/kg) of vitamin E. These results indicate that vitamin E at 300 mg/kg effectively protects against MSG-induced acute kidney injury in rats.

Los aditivos alimentarios y los potenciadores del sabor utilizados en la industria alimentaria son riesgos potenciales para la salud. Probamos la hipótesis de que el aditivo alimentario y el potenciador del sabor, glutamato monosódico (MSG), la sal sódica del ácido glutámico, puede inducir alteraciones ultraestructurales del riñón, y que las propiedades antioxidantes de la vitamina E, pueden proteger contra las lesiones renales inducidas por una dosis tóxica de MSG en un modelo de rata. El grupo modelo de ratas recibió una dosis diaria de MSG (4 g / kg) durante 7 días, mientras que los grupos protectores recibieron una dosis de 100 mg / kg de vitamina E más MSG o 300 mg / kg de vitamina E más MSG durante 7 días. Las ratas se sacrificaron el día 8. Las imágenes de microscopía óptica y de transmisión revelaron un daño renal sustancial inducido por el MSG en el grupo modelo, como lo demuestran las células epiteliales degeneradas con núcleos picnóticos, mitocondrias hinchadas, bordes dañados, túbulos dilatados y ensanchamiento del espacio de Bowman, además de la deformidad de algunos glomérulos. El tratamiento del grupo modelo con vitamina E mostró una protección sustancial del tejido renal y la ultraestructura renal de 300 mg / kg de vitamina E en comparación con una protección parcial de 100 mg / kg de vitamina E. Además, el MSG aumentó significativamente (p <0,05) en el suero los niveles de urea y creatinina, disminuyeron significativamente (p <0,05) con la vitamina E. Sin embargo, para la creatinina sérica, las dosis altas de vitamina E (300 mg / kg) fueron más efectivas que las dosis más bajas (100 mg / kg) de vitamina E. Estos resultados indican que la vitamina E a 300 mg / kg protege eficazmente contra la lesión renal aguda inducida por MSG en ratas.

Animals , Rats , Sodium Glutamate/toxicity , Vitamin E/therapeutic use , Acute Kidney Injury/drug therapy , Vitamin E/pharmacology , Rats, Sprague-Dawley , Microscopy, Electron, Transmission , Disease Models, Animal , Acute Kidney Injury/chemically induced , Acute Kidney Injury/pathology , Kidney/pathology , Kidney/ultrastructure
Rev. méd. Chile ; 147(12): 1510-1517, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1094184


Background Lupus nephritis (LN) is a complication of systemic lupus erythematosus that requires renal biopsy (RB). Proliferative classes III, IV-S, IV-G have especial clinical and pathological characteristics. Aim To determine the association between pathological features in RB with serum creatinine and urine protein levels. Material and Methods We analyzed 186 RB performed in adults aged 18 to 73 years, from a renal pathology reference center. Histopathological variables such as class and subclass of proliferative LN, endocapillary and extracapillary proliferation, activity and chronicity indexes, and vascular sclerosis were correlated with serum creatinine and urine protein levels, at the time of diagnosis. Results As compared with LN III, all the morphological and laboratory values were significantly more deteriorated in LN IV, with special focus on vascular sclerosis. Serum creatinine was the only variable that significantly differentiated LN IV-S from LN IV-G. Proteinuria was non-significantly higher in LN IV-G compared to LN IV-S. However, the difference became significant when proteinuria was compared between LN IV-G and LN III. Conclusions The significant difference in serum creatinine between LN IV-S and LN IV-G supports the concept that they are different subclasses. Proteinuria is a variable that differentiates classes III from IV-G, being significantly higher in the second. Severe arteriosclerosis is a constant and significant finding that differentiates LN III from LN IV. Thus, we propose its usefulness for distinguishing LN classes, and eventually, to be considered in the chronicity index.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Lupus Nephritis/pathology , Kidney/pathology , Proteinuria/pathology , Biopsy , Severity of Illness Index , Retrospective Studies , Creatinine/blood
J. bras. nefrol ; 41(4): 580-584, Out.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1056602


Abstract In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA. On fundus examination, a severe acute hypertensive retinopathy was found. The kidney biopsy showed severe endothelial damage with widening of mucoid cells at the level of the intima, focal concentric proliferation on most small arterioles, and C3, C4d, and IgM deposits along the capillary walls. The genetic study of complement only showed the presence of membrane cofactor protein (MCP) risk haplotypes, without other genetic complement disorders. We understand that in a patient with TMA and SSc, the kidney damage would be fundamentally endothelial and of an acute type; moreover, we would observe clear evidence of complement activation. Once further studies correlate clinical-analytical data with anatomopathological studies, it is likely that we will be forced to redefine the SRC concept, focusing on the relationship between acute endothelial damage and complement activation.

Resumo Nas revisões de biópsias renais, a crise renal esclerodérmica (CRE) é caracterizada por lesões endoteliais vasculares, depósitos de C4d em vasos peritubulares e lesões agudas e crônicas que coexistem na mesma biópsia. Os sinais clínicos de microangiopatia trombótica (MAT) são descritos na esclerose sistêmica (ES); no entanto, não foram relacionados às lesões agudas descritas nas biópsias renais. Relatamos um caso de CRE em um paciente com síndrome de superposição de esclerodermia-dermatomiosite, que também apresentou dados clínicos e histopatológicos de MAT. No exame de fundo do olho, foi encontrada uma retinopatia hipertensiva aguda grave. A biópsia renal mostrou lesão endotelial grave com alargamento das células mucoides ao nível da íntima, proliferação concêntrica focal na maioria das pequenas arteríolas e depósitos de C3, C4d e IgM ao longo das paredes dos capilares. O estudo genético do complemento mostrou apenas a presença de haplótipos de risco da proteína cofator de membrana (PCM), sem outros distúrbios genéticos do complemento. Entendemos que em um paciente com MAT e ES, o dano renal seria fundamentalmente endotelial e do tipo agudo; além disso, observaríamos evidências claras de ativação do complemento. Uma vez que novos estudos correlacionam dados clínico-analíticos com estudos anatomopatológicos, é provável que sejamos forçados a redefinir o conceito de CRE, enfocando a relação entre dano endotelial agudo e ativação do complemento.

Humans , Male , Middle Aged , Raynaud Disease/complications , Vision Disorders/etiology , Acute Kidney Injury/etiology , Kidney/blood supply , Capillaries/metabolism , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Immunohistochemistry , Papilledema/pathology , Dermatomyositis/complications , Dermatomyositis/immunology , Hypertensive Retinopathy/diagnosis , Hypertensive Retinopathy/pathology , Hypertensive Retinopathy/drug therapy , Acute Kidney Injury/diagnosis , Anemia, Hemolytic/diagnosis , Anemia, Hemolytic/etiology , Kidney/pathology , Kidney/diagnostic imaging
Pesqui. vet. bras ; 39(10): 780-788, Oct. 2019. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1056909


The objective of the present study was to characterize the biochemical, hormonal, and mineral profile, and histopathology of the liver and kidneys, related to the severity of natural cases of pregnancy toxemia (PT) in sheep. A total of 45 sheep with PT were analyzed at the "Clínica de Bovinos", Campus Garanhuns-UFRPE. The animals were submitted to clinical examination, followed by the collection of blood and urine. A necropsy was performed on thirteen animals that died and a histopathological examination was performed on samples of liver and kidneys. Increased creatinine, urea, glucose, fructosamine, non-esterified fatty acids, β-hydroxybutyrate, cortisol, chlorine, amylase, aspartate aminotransferase, gamma-glutamyltransferase, and folic acid were found, whereas insulin, potassium, and total and ionizable calcium presented low values for the species. Total protein, albumin, globulin, sodium, magnesium, and vitamin B12 remained within the normal range. In the macroscopic analysis of the liver, it was possible to observe an increase in organ and border size, yellowish coloration and parenchyma that varied from firm to friable. Vacuolation of the hepatocytes and renal tubular cells was observed. Metabolic disorders in sheep associated with hepatic and renal lesions are more apparent in overweight animals. With the greater impairment in hepatic and renal function, the clinical prognosis of animals with a high body score should be considered reserved.(AU)

Objetivou-se caracterizar o perfil bioquímico, hormonal, mineral e a histopatologia hepática e renal, relacionando com a severidade de casos naturais de toxemia da prenhez (TP) em ovelhas. Analisou-se 45 ovelhas na Clínica de Bovinos, Campus Garanhuns-UFRPE, com TP. Foram submetidas ao exame clínico, seguido de coleta de sangue e urina. Treze animais que vieram a óbito foram necropsiados, nas amostras de fígado e rins realizou-se exame histopatológico. Revelou-se elevação de creatinina, ureia, glicose, frutosamina, ácidos graxos não esterificados, β-hidroxibutirato, cortisol, cloro, amilase, aspartato aminotransferase, gama glutamiltransferase e ácido fólico, enquanto insulina, potássio, cálcio total e ionizável apresentaram valores abaixo para os da espécie. A proteína total, albumina, globulina, sódio, magnésio e vitamina B12 mantiveram-se dentro da normalidade. Na análise macroscópica do fígado, pôde-se observar aumento de tamanho do órgão e dos bordos, coloração amarelada e parênquima que variava de firme a friável. Observou-se vacuolização dos hepatócitos e das células tubulares renais. Os transtornos metabólicos nas ovelhas associados às lesões hepáticas e renais são mais aparentes nos animais com sobrepeso. Com o maior comprometimento da função hepática e renal, o prognóstico clínico dos animais com escore corporal elevado há de ser considerado reservado.(AU)

Animals , Female , Pregnancy , Pre-Eclampsia/physiopathology , Pre-Eclampsia/blood , Pre-Eclampsia/veterinary , Sheep, Domestic , Kidney/pathology , Liver/pathology
Int. j. morphol ; 37(3): 1049-1057, Sept. 2019. graf
Article in English | LILACS | ID: biblio-1012395


SUMMARY: Titanium dioxide nanoparticles (TiO2 NPs) are widely used in many commercial products, nanomedicine, agriculture, personal care products, different industries and pharmaceutical preparations with potential risk in human health and the environment. The current work was conducted to investigate the renal damage that might be induced by the acute toxicity TiO2 NPs. A total of 40 healthy male adult Wistar albino rats (Rattus norvegicus) were exposed to TiO2 NPs (126, 252, 378 mg/kg bw) for 24 and 48 h. Fresh portions of the kidneys from each rat were processed for histological and histochemical alterations. In comparison with respective control rats, exposure to TiO2 NPs has marked the following glomerular, tubular and interstitial alterations including the followings: glomerular congestion, Bowman's capsule swelling and dilatation, inflamed glomeruli, renal tubules cloudy swelling, karyorrhexis, karyolysis, infiltration of inflammatory cells, congestion, necrosis, hydropic degeneration, dilatation and congestion of blood vessels, hyaline droplets and hyaline casts precipitation, interstitial edema and fibrosis. From the findings of the current work one may conclude that TiO2 NPs are capable of inducing kidney damage with more insulation in the cortex and the proximal convoluted tubules than the medulla and the distal ones respectively. In addition, it might be concluded that renal damage induced by these nanomaterials is dose and duration of exposure dependent. Further hematological, biochemical, immunohistochemical, and ultra-structural studies are recommended.

RESUMEN: Las nanopartículas de dióxido de titanio (TiO2 NP) se usan ampliamente en muchos productos comerciales, nanomedicina, agricultura, productos para el cuidado personal, diferentes industrias y preparaciones farmacéuticas con riesgo potencial para la salud humana y el medio ambiente. El trabajo actual se realizó para investigar el daño renal que podría ser inducido por la toxicidad aguda NP de TiO2. Un total de 40 ratas Wistar albinas adultas sanas (Rattus norvegicus) fueron expuestas a TiO2 NP (126, 252, 378 mg / kg de peso corporal) durante 24 y 48 h. Las muestras de los riñones de las ratas se procesaron para estudios histológicos e histoquímicos. En comparación con las ratas control, la exposición de las ratas a TiO2 NP presentaron las siguientes alteraciones glomerulares, tubulares e intersticiales: congestión glomerular, dilatación de la cápsula de Bowman, inflamación glomerular, túbulos renales aumentados, cariorrexis, cariólisis, infiltración de células inflamatorias, congestión, necrosis, degeneración hidrópica, dilatación y congestión de vasos sanguíneos, gotas y precipitaciones hialina, edema intersticial y fibrosis. A partir de los hallazgos del trabajo actual, se puede concluir que las NP de TiO 2 son capaces de inducir daño renal con más aislamiento en la corteza y en los túbulos contorneados proximales que en la médula y los túbulos contorneados distales, respectivamente. Además, se podría concluir que el daño renal inducido por estos nanomateriales depende de la dosis y la duración de la exposición. Se recomiendan estudios adicionales hematológicos, bioquímicos, inmunohistoquímicos y ultraestructurales.

Animals , Rats , Titanium/toxicity , Nanoparticles/toxicity , Kidney/drug effects , Rats, Wistar , Kidney/pathology , Kidney Glomerulus/drug effects , Kidney Glomerulus/pathology , Kidney Tubules/drug effects , Kidney Tubules/pathology , Necrosis/chemically induced
J. bras. nefrol ; 41(3): 315-322, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040245


Abstract Introduction: It is hypothesized that increased macrophage migration inhibitory factor (MIF) expression may contribute to diabetic nephropathy (DN) pathogenesis. The aim of the present study was to investigate the renal effects of MIF inhibition in a diabetic experimental model. Methods: Eighteen male Wistar rats (230 ± 20 g) were divided into three groups: 1) control, 2) diabetic (STZ, 50 mg/kg, dissolved in saline, ip), 3) diabetic + MIF antagonist (p425, 1 mg/kg per day, ip, on the 21th day, for 21 consecutive days). The treatment started since we founwd a significant increase in urine albumin excretion (UAE) rate in the diabetic rats in comparison with the control rats. The rats were kept individually in metabolic cages (8 AM-2 PM) and urine samples were collected in the 21 and 42th day. At the end, blood and tissue samples were collected for biochemical (BS, UPE, urine GAG, BUN, Cr, Na, and K) and histological analyses. Results: The results of this study showed that MIF antagonist (p425) significantly decreased urine protein and GAG excretion, urine protein/creatinine ratio, and serum BUN and Cr in the streptozotocin-induced DN in the rats. Pathological changes were significantly alleviated in the MIF antagonist (p425)-administered DN rats. Conclusion: Collectively, these data suggested that MIF antagonist (p425) was able to protect against functional and histopathological injury in the DN.

Resumo Introdução: Supõe-se que elevações da expressão do fator de inibição da migração de macrófagos (MIF) possam contribuir para a patogênese da nefropatia diabética (ND). O objetivo do presente estudo foi investigar os efeitos renais da inibição do MIF em um modelo experimental diabético. Métodos: Dezoito ratos Wistar machos (230 ± 20g) foram divididos em três grupos: 1) controle, 2) diabético (STZ 50 mg/kg dissolvida em soro fisiológico, IP), 3) diabético + antagonista do MIF (p425 1 mg/kg por dia IP no 21o dia por 21 dias consecutivos). O tratamento começou após a identificação de aumento significativo na albuminúria nos ratos diabéticos em relação aos controles. Os ratos foram mantidos individualmente em gaiolas metabólicas (8h-14h) e amostras de urina foram colhidas no 21o e no 42o dia. Ao final do estudo, amostras de sangue e tecido foram colhidas para análises bioquímicas (BS, excreção urinária de proteína, excreção urinária de GAGs, BUN, Cr, Na e K) e histológicas. Resultados: O presente estudo demonstrou que o antagonista do MIF (p425) diminuiu significativamente proteinúria, excreção urinária de GAGs , relação proteína/creatinina na urina, BUN e Cr no grupo com ND induzida por estreptozotocina. As alterações patológicas foram significativamente abrandadas nos ratos com ND que receberam antagonista do MIF (p425). Conclusão: Coletivamente, os dados sugerem que o antagonista do MIF (p425) teve efeito protetor contra lesões funcionais e histopatológicas da ND.

Animals , Male , Rats , Macrophage Migration-Inhibitory Factors/antagonists & inhibitors , Intramolecular Oxidoreductases/antagonists & inhibitors , Protective Agents/therapeutic use , Protective Agents/pharmacology , Diabetes Mellitus, Experimental/pathology , Diabetic Nephropathies/therapy , Blood Glucose , Rats, Wistar , Streptozocin/pharmacology , Creatinine/urine , Creatinine/blood , Diabetes Mellitus, Experimental/chemically induced , Diabetes Mellitus, Experimental/urine , Diabetes Mellitus, Experimental/blood , Diabetic Nephropathies/urine , Diabetic Nephropathies/pathology , Diabetic Nephropathies/blood , Albuminuria/drug therapy , Disease Models, Animal , Glycosaminoglycans/urine , Kidney/pathology , Macrophage Activation
J. bras. nefrol ; 41(3): 423-426, July-Sept. 2019. graf
Article in English | LILACS | ID: biblio-1040256


ABSTRACT Introduction: Vascular access and renal biopsy are common procedures in nephrology. In this study, two artisanal simulators of very low cost and excelent image quality are (prented) presented to guide, by ultrasound, the venous access and renal biopsy. Methods: The simulators are constructed using chicken breast slices, Penrose drain, plastic milk shake straw and pig kidney. Results: Both simulators enable immediate identification of the anatomical structures of interest, vessels and kidney, and enable spatial orientation and hand-eye coordination, essential for the development of the necessary skills to safely carry out invasive procedures. Conclusion: The simulators described, were extremely useful for simulating venous access and renal biopsy guided by ultrasonography, enabling training to reduce the failure rate in punctures and the potential complications associated with the described procedures.

RESUMO Introdução: O acesso vascular e a biópsia renal são procedimentos comuns na prática nefrológica. Neste estudo, são apresentados dois simuladores artesanais de baixo custo e excelente qualidade de imagem para guiar, ultrassonograficamente, o acesso venoso e a biópsia renal. Métodos: Os simuladores são construídos utilizando fatias de peito de frango, dreno de Penrose, canudo plástico milk shake e rim de porco. Resultados: Ambos os simuladores permitem a identificação imediata das estruturas anatômicas de interesse, vasos e rim, e possibilitam a orientação espacial e coordenação olho-mão, essenciais para o desenvolvimento das habilidades necessárias para realizar seguramente procedimentos invasivos. Conclusão: Os simuladores descritos, extremamente úteis para as simulações do acesso venoso e a biópsia renal guiados por ultrassonografia, possibilitam o treinamento objetivando a redução do insucesso das punções e das complicações potenciais associadas aos procedimentos descritos.

Animals , Ultrasonography/methods , Simulation Training/methods , Nephrologists/education , Kidney/pathology , Nephrology/education , Swine , Blood Vessels , Punctures , Chickens , Clinical Competence , Muscle, Skeletal , Image-Guided Biopsy
Int. braz. j. urol ; 45(4): 754-762, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019881


ABSTRACT Purpose This study aimed to study morphological and renal structural changes in relation to different ischemic times and types of renal vascular pedicle clamping. Methods Sixteen pigs were divided into two groups (n = 8): Group AV - unilateral clamping of the renal artery and vein and Group A - unilateral clamping of the renal artery only, both with the contralateral kidney used as control. Serial biopsies were performed at 0, 10, 20, 30, 40, 50, 60, 70, 80, and 90 minutes after clamping. Results there is a correlation between the occurrence of renal damage as a function of time (p <0.001), with a higher frequency of Group A lesions for cellular alterations (vascular congestion and edema, interstitial inflammatory infiltrate, interstitial hemorrhage and cell degeneration), with the exception of in the formation of pigmented cylinders that were evidenced only in the AV Group. Conclusion the number of lesions derived from ischemia is associated with the duration of the insult, there is a significant difference between the types of clamping, and the AV Group presented a lower frequency of injuries than Group A. The safety time found for Group A was 10 minutes and for Group AV 20 minutes.

Animals , Female , Renal Artery/pathology , Renal Veins/pathology , Ischemia/pathology , Kidney/blood supply , Kidney/pathology , Nephrectomy/methods , Reference Values , Swine , Time Factors , Biopsy , Reproducibility of Results , Constriction
Rev. méd. Chile ; 147(7): 891-900, jul. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058619


Background: Renal infarction is a rare and usually underdiagnosed entity. Aim: To study the etiology of renal infarction in published series. Material and Methods: A systematic review was carried out selecting 28 series that included 1582 patients. Results: The proposed cause was cardiac or aortic embolism in 718 cases (45%), an arterial injury in 253 (16%), prothrombotic factors in 146 (9%) and other causes in 79 (5%). 291 cases were classified as idiopathic (18.4%). Atrial fibrillation was present in 542 of the 718 patients with cardiac or aortic embolism. Conclusions: The main cause of renal infarction is cardiac or aortic embolism and among this group, most cases are due to atrial fibrillation. One out of five cases is labeled as idiopathic.

Humans , Infarction/etiology , Kidney/blood supply , Kidney Diseases/etiology , Kidney/pathology