肾小管上皮细胞损伤在慢性肾脏疾病进展中的作用

肾小管间质病变程度是决定各种肾脏疾病预后的重要因素 ,而肾小管上皮细胞的损伤和损伤反应可进一步加重肾间质病变。疾病状态时在缺氧、蛋白尿及多种炎症 /细胞因子作用下 ,肾小管上皮细胞可活化、增殖 ,并分泌多种炎症因子、趋化因子和血管活性因子进入肾间质 ,加重肾间质的炎症和纤维化进程。受损的肾小管上皮细胞除了发生坏死或凋亡外 ,还可能发生表型转化为肌纤维母细胞进入间质 ,直接参与肾间质纤维化。提示肾小管上皮细胞损伤和损伤后的反应是加重肾间质炎症、纤维化和慢性肾脏持续进展的重要因素     

红细胞生成素对单侧输尿管梗阻大鼠肾间质纤维化的保护作用

肾间质纤维化几乎是所有慢性肾脏疾病发展至终末期肾衰竭(ESRD)的共同通路.梗阻性肾病的病理变化主要表现为肾小管萎缩和间质纤维化,而肾小管上皮细胞凋亡是肾小管萎缩和肾实质丧失的主要原因[1,2].红细胞生成素(EPO)能调节红细胞生成以增加组织供氧,除此之外,EPO也是一种抗凋亡因子,介导多种细胞抗凋亡作用.Koury等[3]报道EPO调节红细胞生成的一种主要机制就是防止红系祖细胞凋亡.而EPO对肾间质纤维化的影响及其机制尚未见阐明.本研究旨在观察EPO对肾间质纤维化的影响并初步探讨其可能的作用机制.     

肾小管上皮细胞损伤在慢性肾脏疾病进展中的作用

肾小管间质病变程度是决定各种肾脏疾病预后的重要因素，而肾小管上皮细胞的损伤和损伤反应可进一步加重肾间质病变。疾病状态时在缺氧、蛋白尿及多种炎症／细胞因子作用下，肾小管上皮细胞可活化、增殖，并分泌多种炎症因子、趋化因子和血管活性因子进入肾间质，加重肾间质的炎症和纤维化进程。受损的肾小管上皮细胞除了发生坏死或凋亡外，还可能发生表型转化为肌纤维母细胞进入间质，直接参与肾间质纤维化。提示肾小管上皮细胞损伤和损伤后的反应是加重肾间质炎症、纤维化和慢性肾脏持续进展的重要因素。     

肾小管上皮细胞转分化在肾间质纤维化过程中的作用及其调控机制研究进展

肾小管上皮细胞转分化是肾间质纤维化的重要发病机制之一,TGF-β可促进肾小管上皮细胞转分化从而促进肾间质纤维化的形成,而BMP7则起抑制作用,最新发现的一种新型蛋白KCP可能通过增强BMP7与其受体的结合能力而发挥抗肾间质纤维化作用。     

肾小管上皮细胞转分化在肾间质纤维化过程中的作用及其调控机制研究进展

肾小管上皮细胞转分化是肾间质纤维化的重要发病机制之一,TGF-β可促进肾小管上皮细胞转分化从而促进肾间质纤维化的形成,而BMP7则起抑制作用,最新发现的一种新型蛋白KCP可能通过增强BMP7与其受体的结合能力而发挥抗肾间质纤维化作用.     

马兜铃酸肾病的发病机制

马兜铃酸诱导的肾小管上皮细胞转分化、坏死或凋亡等诸多因素在马兜铃酸肾病的肾间质纤维化过程中起重要作用,其确切机制尚待进一步研究。     

肝再生增强因子在肾间质纤维化中的研究进展

<正>肾纤维化,尤其是肾小管间质纤维化(RIF)是各种肾脏疾病发展致肾衰竭的共同途径[1],其病变的程度与肾功能的损害程度密切相关。肾间质纤维化是一个缓慢的动态过程,涉及到各种细胞因子的释放、炎症细胞的浸润、肾小管上皮细胞-间充质细胞转分化(EMT)、肾小管上皮细胞(RTEC)的凋亡、细胞外基质的过度积聚及降解失衡等因素。近年来,随着对肾间质纤维化的深入研究,发现ALR在抑制肾间质纤维化病理过程     

大鼠肾小管间质纤维化中肾小管上皮细胞表型转化的研究

目的观察大鼠肾小管间质纤维化过程中,肾小管上皮细胞是否发生表型转化。方法以腺嘌呤150 mg·kg-1·d-1灌胃,连续17周,制作大鼠肾小管间质纤维化模型。采用光镜、透射电镜、偏振光显微镜及免疫组织化学等方法,观察病变肾组织的病理变化以及肾小管上皮细胞的表型转化情况。结果病变肾组织出现肾小管变性、萎缩和再生,肾间质淋巴和单核细胞浸润以及进行性肾间质纤维化等肾小管间质纤维化的典型的病变。偏振光显微镜观察发现,随着病变的进展,间质中以Ⅲ型和Ⅰ型胶原为主的大量胶原纤维增生,并逐渐加重。免疫组化结果显示,损伤的肾小管上皮细胞处于萎缩和再生状态,随着病变的进展,小管上皮细胞内逐渐出现d平滑肌肌动蛋白(α-SMA)和波形蛋白(vimentin)的阳性表达。透射电镜下可见肾小管上皮细胞内原纤维出现以及突破基底膜游离到肾间质中,并与肾间质中的间质细胞、胶原纤维相混合存在。结论在大鼠肾间质纤维化的发生过程中,受损并处于再生状态的肾小管上皮细胞有向肌成纤维细胞等间胚叶细胞转化并产生细胞外基质的功能。     

神经胶质瘤相关蛋白-2与肾小管间质纤维化的关系

神经胶质瘤相关蛋白-2（glioma pathogenesis-related protein 2,GLIPR-2）是新近发现的一种蛋白质,属于CAP蛋白超家族成员之一.研究发现,它能诱导肾小管上皮细胞发生上皮细胞间充质转分化（Epithelial-to-Mesenchymal Transition,EMT）,从而参与肾小管间质纤维化的发生发展.本文就GLIPR-2的生理及病理机制、在肾间质纤维化中的作用作一综述,以期丰富肾间质纤维化的发病机制,为肾间质纤维化治疗的研究提供新的思路.     

肾小管上皮细胞转分化在肾间质纤维化中的研究进展

肾小管上皮细胞转分化在肾间质纤维化发生中起到重要作用,其转化条件和机制已成为当今学者研究的热点。本文就肾小管上皮细胞转分化的概念、标志、发生机制、步骤及药物对其影响进行综述。     

Continuous renal replacement therapy improves renal recovery from acute renal failure

BACKGROUND: Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery. METHODS: We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate. RESULTS: 116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial. CONCLUSIONS: Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.     

Influences of renal stone surgeries on renal function--evaluation of renal function with 99mTc-DMSA renal scintigraphy]

From 1984 to 1990, 99mTc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94 +/- 5.60%) was significantly lower than that of PNL (-0.06 +/- 3.92%), pyelolithotomy (-4.08 +/- 4.79%) (p less than 0.01) and ESWL (-7.72 +/- 3.87%) (p less than 0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80 +/- 4.21% nephrolithotomy 4.67 +/- 4.73%, pyelolithotomy -1.46 +/- 5.39% and ESWL -2.02 +/- 4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possivility of deterioration of renal function after ESWL was suggested.     

Abnormal renal arteriography after renal trauma.

Angiograms following renal trauma in a ten-year-old girl were highly suggestive of renal neoplasm, especially Wilms' tumor. There are striking similarities between arteriograms after renal trauma and those showing neovascularity.     

Reversible renal hypertension due to renal hygroma

A hygroma of the left kidney was found at surgery in a thirty-five-year-old woman, who presented with anemia, hypertension, and a left abdominal mass. There was a very high sedimentation rate and fine needle aspiration yielded bizarre cells which raised the possibility of malignancy. Compression of the kidney by the cystic structure probably interfered with renal blood flow and was responsible for the elevated blood pressure which receded to normal after removal of the cyst and the left kidney.     

Extensive renal involvement by renal cell carcinoma

Experience with the management of 3 cases of bilateral renal adenocarcinoma and 1 case of unilateral carcinoma in the solitary kidney is presented. Two patients died of metastases six and thirteen months postoperatively, while one is alive with metastases at fourteen months and another is alive without metastases at four months. The literature is reviewed, and the various treatments are discussed.