Increased levels of urinary interleukin-6 in Kawasaki disease

Kawasaki disease (KD) often presents with abnormal urinary findings, such as aseptic pyuria, mild proteinuria and microscopic haematuria. In this study, we measured urinary interleukin-6 (IL-6) by a sensitive sandwich ELISA assay using mouse monoclonal antibodies against recombinant IL-6 to elucidate the role of IL-6 in the pathogenesis of renal lesions in KD. Serum IL-6 levels were increased in acute KD as well as in febrile controls. Importantly, urinary IL-6 levels were consistently elevated in patients with acute KD, but much lower in febrile controls. Urinary IL-6 levels returned steadily to normal during the convalescent phase. In addition to IL-6, urinary levels ofN-acetyl--d-glucosaminidase (NAG) and ₂-microglobulin (₂-mg) were also elevated during the acute phase of this disease. Eosinophils and macrophages were identifiable in urinary sediments from these patients. The increased levels of urinary IL-6 in combination with increased NAG and ₂-mg seemed to suggest the presence of certain renal parenchymal lesions with cellular infiltration during the acute phase of the disease. IL-6 may serve as clinically useful parameter for the detection and monitoring of the renal involvement in KD.     

The effect of naringenin on the intestinal and renal transport of organic solutes

Summary Naringenin (4,5,7-trihydroxy-flavanone) inhibits the accumulation of glycine, -methyl-glucoside, p-amino-hippurate and N¹-methyl-nicotinamide in dog renal cortex slices. It also inhibits oxygen consumption by this tissue. Since the sensitivity of amino-acid uptake to the drug is less than the sensitivity of oxygen consumption, the inhibition of this transport might be secondary to an effect on intermediary metabolism. The inhibition of PAH uptake occurs at a lower concentration of the drug, and so naringenin may affect this process at the membrane level.Naringenin inhibits the transport of sugars and amino-acids by dog, guinea-pig and rat small intestine. Both steady-state accumulation and initial rates of entry are affected. Amino-acid uptake is depressed both in the presence or absence of sodium ions. The inhibition is reversible provided short contact times are employed. According to kinetic analysis, naringenin appeared to be a fully non-competitive inhibitor of phenylalanine influx. Examination of the unidirectional transmural fluxes of phenylalanine across guinea-pig intestine revealed that only the mucosal-serosal flux was affected, and then only if the flavanone was added to the solution bathing the mucosal face of the tissue. Naringenin does not inhibit mucosal Na⁺-K⁺-ATPase, but it does alter the intracellular ion concentrations.Although some of the results can be explained in terms of an effect of naringenin on metabolism, others can not. It is argued that naringenin has a direct action on cell membranes.Some of these results have been presented to the Physiological Society and a short report has appeared in their proceedings (Robinson, 1979)     

Changes in blood flow and vasculature of the dog kidney undergoing normothermic and hypothermic ischaemia

Summary In 11 mongrel dogs both kidneys have been subjected to a 2 h ischaemic period. One kidney was cooled by perfusing the renal artery at 4°C while the contralateral normothermic kidney was clamped for 2 h. Studying the renal blood flow using the Xenon wash out technique, sequential renal scanning and angiography, marked differences between hypo- and normothermic ischaemia kidneys were observed. One or two hours following hypothermic perfusion a marked decrease of blood flow in the first compartment and vasoconstriction was evident, while within this period following normothermic ischaemia an enhanced renal blood flow was observed. After 24 h renal blood flow and renal function tested by ¹³¹I-Hippuran clearance returned to normal values. Angiographic studies corresponded to the preoperative findings. In contrast, normothermic ischaemia kidneys showed a decreased renal blood flow, impairment of kidney function in isotope studies and pathological angiographic changes.Supported by Deutsche Forschungsgemeinschaft     

Action of the competitive angiotensin II antagonist saralasin during the initial phase of glycerol-induced acute renal failure of the rat

Summary The effects of the competitive angiotensin II antagonist saralasin (1-sarcosine-8-alanine-5-isoleucine-angiotensin II) on renal function in healthy rats and in rats with myohemoglobinuric acute renal failure were studied. Acute renal failure was induced by an intramuscular injection of 50% glycerol (10 ml ·kg^–1). Functional impairment of the glycerol treated animals consisted in a decrease of renal blood flow (electromagnetic flowmeter) and GFR and in an increase of urine volume and arterial blood pressure.In healthy rats saralasin (6 g·kg^–1·min^–1 i.v.) had no renal effects by itself but antagonized the angiotensin II (200 ng·kg^–1·min i.v.) induced fall of renal blood flow and GFR and the increase of arterial blood pressure. Given to glycerol treated animals saralasin did not induce any change of arterial blood pressure, renal blood flow, GFR or the urinary excretion of fluid and sodium.Supported by Deutsche Forschungsgemeinschaft     

补肾益骨膏对大鼠肝肾的损害作用

目的:观察连续给予补肾益骨膏对大鼠肝、肾的损害作用及其损害的可逆性.方法:将144只大鼠分成对照组,补肾益骨膏高、低剂量组,各组动物按1.5 mL•kg 1等体积分别灌胃,高、低剂量组分别按60.0,15.0 g•kg 1给予补肾益骨膏,对照组给予等体积的纯化水,每天连续灌服给药,周日休息,共180 d;用药90,180 d及停药30 d,分3批处死动物,采血进行与肝、肾功能相关的血清生化检测及其病理组织学检查.结果:补肾益骨膏长期给药对肾脏有可疑损害作用,对肝脏有轻度可逆性损害作用.结论:临床长期大剂量使用补肾益骨膏应注意肝、肾功能的检查.     

Calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation.

OBJECTIVE: The aim of the study was the assessment of calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation. METHODS: The study covered 64 pregnant women in the third trimester of gestation including: 33 women after renal transplantation (the study group) and 31 healthy pregnant women (the control group). Women from both groups were at the similar age: 30.8+/-4.7 vs. 31.3+/-5.0 years (NS) and at the same gestational age 34.8+/-2.4 vs. 35.3+/-2.6 weeks (NS). The mean body mass index (BMI) in the women from the study group before pregnancy was 21.49+/-2.81 vs. 22.1+/-3.02 in the control group (NS), BMI before delivery was 25.43+/-3.05 vs. 26.0+/-3.35 (NS), the percentage of the BMI increase during pregnancy was 18.7+/-7.68 vs. 17.65+/-7.13 (NS) and BMI increase during gestation was 3.93+/-1.56 vs. 3.90+/-1.54, respectively (NS). Arterial blood pressure at the time of blood samples collection for biochemical tests was 151.4+/-26.8/92.5+/-16.9 in women from the study group comparing to 115.0+/-6.0/68.0+/-7.0 mmHg (P<0.001) in the patients from the control group. The maximal blood pressure during pregnancy was 169.2+/-20.7/102.7+/-14.0 vs. 118.0+/-7.0/70.0+/-8.0 mmHg (P<0.001), respectively. We estimated serum levels of: total Ca, ionized Ca(2+), inorganic phosphorus (P(i)), Mg, total protein, albumin and blood morphology. Moreover, urine levels of Ca, P(i), Mg and protein were assessed. RESULTS: The pregnant women after renal transplantation presented increases in serum concentrations of total Ca (2.54+/-0.20 vs. 2.16+/-0.10 mmol/l; P<0.001) and ionized Ca(2+) (1.322+/-0.104 vs. 1.12+/-0.07 mmol/l; P<0.001) and the decrease in P(i) level (1.013+/-0.211 vs. 1.10+/-0.16 mmol/l; P<0.05), total protein (59.3+/-7.0 vs. 65+/-5 g/l; P<0.001) and albumin (461.6+/-65.65 vs. 493.2+/-59 micromol/l; P<0.05). Moreover, in the study group drop in red blood cells count to 3.71+/-0.56 vs. 4.01+/-0.35 x 10(12)/l (P<0.02) in the control group was detected. Despite increased volume of 24-h urine collection in the kidney recipients we observed significantly decreased urine 24-h calcium excretion 2.47+/-0.92 vs. 6.72+/-3.49 mmol (P<0.001) and simultaneous increase in urine Mg excretion 3.422+/-1.025 vs. 2.18+/-0.52 mmol/24 h (P<0.001). There was no difference in urine 24-h P(i) excretion between the study and the control group. The pregnant renal transplant recipients presented proteinuria of 1.19+/-1.9 g/24 h. CONCLUSIONS: Women after kidney grafting present vital aberrations in calcium-phosphorus-magnesium homeostasis during pregnancy. The most significant changes are associated with calcium metabolism (high increase in serum Ca levels and impairment of renal elimination of calcium). The observed changes may be influenced by the doses of immunosuppressive agents and disturbed renal function.     

Urogenital injuries in childhood: A strong association of bladder trauma to bowel injuries

We analysed the inter-relationships of the cause and the type of trauma, the presence of pelvic fracture, the associated intraabdominal organ injuries,and the morbidity and mortality rates in 154 patients presenting and being treated for UGT between 1983 and 1997.The cause of injury was blunt in 77% of cases and penetrating in 13%. The most frequently injured organs were kidney followed by urethra and bladder. Bowels, liver and spleen were the most frequently associated injured organs. Moreover, bladder injuries were strongly associated with bowel injuries (p < 0.0001). Hemodynamically normal 49 children with minor or major kidney injuries were managed conservatively. Hemodynamically non-stable 11 patients were explored.The majority of urogenital injuries can be managed conservatively evenwhen associated with intraabdominal organ injuries. Solid genitourinary organ injuries may accompany more frequently to intraperitoneal solidorgan injury. Whereas, non-solid genitourinary organ injuries may more frequently associated with injuries of intraperitoneal hollow viscus. This revised version was published online in August 2006 with corrections to the Cover Date.     

Kinetic versus thermodynamic factors in calcium renal lithiasis

Calcium renal lithiasis formation depends on the balance between thermodynamic (supersaturation) and kinetic (inhibitors, nucleants)factors. In this paper, the importance of both groups was evaluated using(a) the complete urine analysis data obtained from 32 healthy volunteers and 141 active stone-formers, and (b) a comprehensive computer model to calculate the supersaturation values of calcium oxalate monohydrate,hydroxyapatite and brushite in each urine sample. The results of this evaluation were used to assess the possible effectiveness of a given pharmacological treatment. This revised version was published online in August 2006 with corrections to the Cover Date.     

Giant angiomyolipoma associated with marked pulmonary lesions suggesting lymphangioleiomyomatosis in a patient with tuberous sclerosis

The association between Tuberous Sclerosis (TS) and Angiomyolipoma (AML) is well known. A patient with TS and giant AML mimicking Renal Cell Carcinoma (RCC), measuring 29 × 18 × 11 cm, weighing 4700 gr is presented. Imaging studies revealed coexistent pulmonary lymphangioleiomyomatosis and concurrent renal and pulmonary involvement is extremely rare in patients in TS. We believe that the growth potential of this hamartomatous lesion may reach to a life threatening size. This revised version was published online in August 2006 with corrections to the Cover Date.     

Concomitment spread of a renal cell carcinoma beyond the kidney and a transitional cell carcinoma beyond the bladder

We report the case of a 61-year-old man, with a rare combination of two advanced urological tumors: a concomitant spread of an adenocarcinomabeyond the kidney and a urothelial carcinoma beyond the bladder. Wesimultaneously performed a primary curative prostatovesiculectomy anda nephroureterectomy on the right with ileal neobladder. To ourknowledge, a case report of concomitant spread of an adenocarcinomabeyond the kidney (pT3 pN0 M0 G3) and a urothelial carcinoma beyondthe bladder (pT3a pN0 M0 G3) with subsequent curative therapy hasthus far not been published. A combination of the two diseasesdescribed here is obviously a remarkable rarity. This revised version was published online in August 2006 with corrections to the Cover Date.