Interference of enalaprilat on glomerular permeability to macromolecules (IGG) in acute unilateral ureteral obstruction in rats

INTRODUCTION: Unilateral ureteral obstruction breaks out events that cause the transitory increase of glomerular permeability to macromolecules, both in the obstructed kidney and in the contralateral kidney, suggesting the presence of some factor, with a systemic action, liberated as a response to the obstruction. We know that the rennin-angiotensin system is activated by acute ureteral obstruction. We have developed an experiment to assess the role of angiotensin II on the glomerular permeability to IgG due to acute ureteral obstruction, using enalaprilat, an angiotensin enzyme conversion inhibitor, to block the effects of the activation of the rennin-angiotensin system. MATERIALS AND METHODS: We have used 45 adult Wistar female rats, distributed into 3 main groups: a control group with 5 animals and 2 experiment groups each one with 10 animals submitted to unilateral ureteral obstruction and nephrectomy at 60 and 120 minutes. Each experiment group had its simulation correspondent (sham). We have studied both kidneys through the direct immunofluorescence method. RESULTS: We have found positive permeation in animals without enalaprilat in both kidneys and negative permeation in those in which the drug was used. CONCLUSION: We have concluded that enalaprilat interferes in this alteration of permeability, suggesting that angiotensin II is involved in the loss of selectivity of the glomerular membrane.

Assessment of lymphocele incidence following 450 renal transplantations

OBJECTIVE: To determine the incidence of lymphocele in the follow-up of patients who underwent renal transplantation, as well as potential factors responsible or associated to its development. MATERIALS AND METHODS: All records from patients who were treated for lymphocele in our institution between May 1989 and December 2002 were reviewed, as well as their clinical outcome following treatment. RESULTS: Among 450 patients who underwent renal transplantation in the period, only 3 required treatment, with 2 of them treated due to the collection volume, and the other due to symptoms (pain), representing an incidence of only 0.6 percent. COMMENTS: The occurrence of perirenal fluid collections following renal transplantation is frequent. In cases where treatment is required, this can generate an excessive morbidity for the patient, which motivates the development of preventive methods, such as minimally invasive therapy, for such cases. CONCLUSION: Careful ligation of lymphatic vessels both during graft preparation and during its implantation, added to post-operative drainage can significantly contribute to reducing the incidence of lymphocele following renal transplantation.