Renal primary cilia lengthen after acute tubular necrosis.

Renal primary cilia are sensory antennas required for the maintenance of normal epithelial differentiation and proliferation in the kidney, but they also have a potential role in epithelial differentiation during renal injury and repair. In mice, tubular damage causes an increase in the length of renal cilia, which may modify their sensory sensitivity during repair. Here, we investigated whether the alteration of renal cilium length during renal injury is clinically relevant. Using biopsies of human renal transplants that suffered acute tubular necrosis during transplantation, we compared the length of renal primary cilia with renal function. Serial biopsies showed that acute tubular necrosis resulted in more than a doubling of cilium length throughout the nephron and collecting duct approximately 1 wk after injury. Allografts displayed a trend toward normalization of cilium length in later biopsies, and this correlated with functional recovery. A mouse model of renal ischemia-reperfusion confirmed the increase and subsequent regression of cilium length during renal repair, displaying complete normalization of cilium length within 6 wk of injury. These findings demonstrate that the length of renal cilia is a clinically relevant indicator of renal injury and repair.

Alterations in renal cilium length during transient complete ureteral obstruction in the mouse.

The renal cilium is a non-motile sensory organelle that has been implicated in the control of epithelial phenotype in the kidney. The contribution of renal cilium defects to cystic kidney disease has been the subject of intense study. However, very little is known of the behaviour of this organelle during renal injury and repair. Here we investigate the distribution and dimensions of renal cilia in a mouse model of unilateral ureteral obstruction and reversal of ureteral obstruction. An approximate doubling in the length of renal cilia was observed throughout the nephron and collecting duct of the kidney after 10 days of unilateral ureteral obstruction. A normalization of cilium length was observed during the resolution of renal injury that occurs following the release of ureteral obstruction. Thus variations in the length of the renal cilium appear to be a previously unappreciated indicator of the status of renal injury and repair. Furthermore, increased cilium length following renal injury has implications for the specification of epithelial phenotype during repair of the renal tubule and duct.

Renal cilia display length alterations following tubular injury and are present early in epithelial repair.

BACKGROUND: Renal cilia are flow sensors that are required for the maintenance of normal kidney architecture. Defects in this organelle are frequently associated with polycystic kidney disease, but the role of renal cilia during acute tubular injury has not been investigated. METHODS: We have analysed the presence and dimensions of renal cilia following renal ischaemia-reperfusion and ureteral obstruction injury in the mouse, and related these results to injury and repair of the renal tubule. The expression of genes encoding cilium-localized proteins was measured following ischaemia-reperfusion injury. RESULTS: Ischaemia-reperfusion injury was demonstrated to affect the length of cilia in the renal tubule and duct. The average length of renal cilia in the proximal tubule decreases 1 day (2.8 +/- 0.4 microm) and 2 days (3.0 +/- 0.2 microm) after injury, as compared to the control uninjured proximal tubule (4.2 +/- 0.3 microm). Later in the injury and repair process at 4 and 7 days, the average length of cilia increases in both the proximal (7 days = 6.2 +/- 0.3 microm) and distal tubule/collecting duct (4 days = 4.4 +/- 0.3 microm; 7 days = 5.5 +/- 0.4 microm; control 2.5 +/- 0.1 microm). The expression level of genes encoding cilium-localized products did not correlate with the increase in cilium length following ischaemia-reperfusion injury. Ureteral obstruction for 8 days also caused lengthening (8 days UUO = 5.8 +/- 0.3 microm; control 2.5 +/- 0.1 microm) of renal cilia in the distal tubule/collecting duct. During the repair process that follows ischaemia-reperfusion injury, cilia were present on the dedifferentiated cells that proliferate and adopt an epithelial phenotype to facilitate the repair of the ischaemic renal tubule. CONCLUSIONS: We propose roles for the renal cilium in responding to changes in the renal environment caused by injury, and in the repair process that re-establishes the epithelial layer of the damaged renal tubule.