Relation of peritubular capillary features to class of lupus nephritis.

BACKGROUND: Experimental studies have linked peritubular capillary (PTC) loss with progression of chronic kidney disease. Minimal information on PTC in lupus nephritis (LN) has been reported. We therefore evaluated the PTC area in different classes of LN and determined if specific clinical characteristics correlated with PTC changes. METHODS: Renal biopsies of 253 subjects with LN (categorized using the ISN/RPS 2003 classification) and 13 normal renal donors (the controls) were retrospectively evaluated for PTC morphology by staining for CD31 with immunohistochemistry method. The percent positive area of PTC (% PTC) was correlated with serum and urinary measures of renal function and renal pathology. RESULTS: Significant PTC loss was observed in all classes of LN compared to controls. The % PTC area was highest in controls (7.64±1.48 %) with levels of 1.95±1.50, 4.16±3.85, 4.19±4.45, 5.02±1.79, and 4.45±3.75 in classes II, III, IV, IV combined with V and V, respectively (all p values < 0.05). The lowest PTC density was observed in class II LN, but this may be because some cases with worse classes of LN showed increased PTC density due to abnormally dilated capillaries associated with acute inflammation and angiogenesis. %PTC was increased in those with hematuria (5.8±5.2 vs. 3.6±3.4 %, red blood cells 3-10 vs. < 3 cells/high power field, p < 0.05) and was reduced in those with a moderately declined renal function (3.29±3.40 vs. 4.42±4.12, eGFR 15-59 vs. ≥ 60 ml/min/1.73 m2, p < 0.05). Nephrotic-range proteinuria also trended to be associated with lower PTC density although it did not reach statistical significance (3.1±2.6 vs. 4.9±4.5, p= 0.067). CONCLUSIONS: LN is associated with PTC loss and the severity correlates with reduced renal function. Further studies are needed to investigate whether a loss of PTC can predict long term renal outcomes in LN.

Monosodium glutamate (MSG) consumption is associated with urolithiasis and urinary tract obstruction in rats.

BACKGROUND: The peritoneal injection of monosodium glutamate (MSG) can induce kidney injury in adult rats but the effects of long-term oral intake have not been determined. METHODS: We investigated the kidney histology and function in adult male Wistar rats that were fed ad libitum with a standard rat chow pellet and water with or without the addition of 2 mg/g body weight MSG/day in drinking water (n=10 per group). Both MSG-treated and control animals were sacrificed after 9 months when renal function parameters, blood and urine electrolytes, and tissue histopathology were determined. RESULTS: MSG-treated rats were more prone to kidney stone formation, as represented by the alkaline urine and significantly higher activity product of calcium phosphate. Accordingly, 3/10 MSG-treated rats developed kidney stones over 9 months versus none of the control animals. Further, 2/10 MSG-treated rats but none (0/10) of the controls manifested hydronephrosis. MSG-treated rats had significantly higher levels of serum creatinine and potassium including urine output volume, urinary excretion sodium and citrate compared to controls. In contrast, MSG-treated rats had significantly lower ammonium and magnesium urinary excretion. CONCLUSION: Oral MSG consumption appears to cause alkaline urine and may increase the risks of kidney stones with hydronephrosis in rats. Similar effects in humans must be verified by dedicated studies.

High expression of ABCC1 indicates poor prognosis in intrahepatic cholangiocarcinoma.

Intrahepatic cholangiocarcinoma (ICC) is a serious health problem in Thailand. To reach a cure, radical resection is the gold standard but most patients are not candidates because of delayed first presentation. Palliative surgery and/or combined chemotherapy are alternatives; however, outcomes are still unsatisfactory. A low response to multiple anticancer drugs might be due to a multidrug resistance (MDR) phenotype of ICC. In this study, we investigated the expression profile of selected adenosine triphosphate binding cassette (ABC) transporter superfamily members, the major contributors to cancer MDR, and determined the clinical significance of certain examples in ICC. Expression of 9 ABC transporters; ABCB1, ABCB11, ABCC1, ABCC2, ABCC3, ABCC4, ABCC6, ABCC11 and ABCG2, was determined in 55 ICC tissues using real-time RT-PCR. The results showed that ABCC1, ABCC2, ABCC3 and ABCC4 were differentially expressed in ICC tissues. Only ABCC1 expression was significantly higher in ICC tissues than those of the corresponding non-tumor tissues (P<0.001), significantly correlating with shortened overall survival time (P<0.05). Multivariate analysis indicated that expression is an independent clinicopathological factor (adjusted HR=5.689; 95%CI=1.042-31.076; P<0.05). These results suggested that ABCC1 is a candidate prognostic marker for ICC.