scholarly journals Synergistic Impact of Diabetes and Hypertension on the Progression and Distribution of Glomerular Histopathological Lesions

2019 ◽  
Vol 32 (9) ◽  
pp. 900-908 ◽  
Author(s):  
Takaya Sasaki ◽  
Nobuo Tsuboi ◽  
Yusuke Okabayashi ◽  
Kotaro Haruhara ◽  
Go Kanzaki ◽  
...  
Keyword(s):  
Renal Cortex ◽  
Glomerular Hypertrophy ◽  
Zonal Distribution ◽  
Histopathological Lesions ◽  
Arterial Lesions ◽  
Glomerular Lesions ◽  
Medical Histories ◽  
Global Glomerulosclerosis ◽  
Arteriolar Hyalinosis ◽  
Different Parts

Abstract BACKGROUND Diabetes and hypertension share renal histopathological features, such as arterial lesions and glomerular hypertrophy, that have not been investigated in relation to the blood pressure status of diabetic subjects. The severity of glomerular lesions varies across locations of the renal cortex, which may be further affected by diabetes and/or hypertension. METHODS Histopathological lesions in different parts of the renal cortex of autopsy kidneys were evaluated and analyzed based on medical histories of diabetes and hypertension. RESULTS This study included a total of 82 Japanese autopsies composed of normotensive nondiabetics (n = 31), hypertensive nondiabetics (n = 28), normotensive diabetics (n = 14), and hypertensive diabetics (n = 9). There were no differences in age, sex, renal function, or body size among groups. In both the superficial and juxtamedullary cortices, increased glomerular volume (GV) was significantly associated with either diabetes or hypertension. In addition, diabetes and hypertension showed a significant interaction with GV regardless of the cortical location. Values for global glomerulosclerosis (GGS) and arteriolar hyalinosis (AH) were associated with diabetes but not with hypertension. Only values for GGS consistently showed cortical surface superiority. The zonal distribution of AH, GV, or other diabetic glomerular lesions differed among the lesions depending on the presence or absence of hypertension. CONCLUSIONS These results imply that diabetes and hypertension synergistically enhance glomerular hypertrophy across all layers of the human renal cortex. The process is closely associated with the severity of GGS and AH predominantly associated with diabetes.

scholarly journals Smoking-Related Glomerulopathy: Expanding the Morphologic Spectrum

2015 ◽  
Vol 41 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Steven P. Salvatore ◽  
Megan L. Troxell ◽  
Douglas Hecox ◽  
Kevin R. Sperling ◽  
Surya V. Seshan
Keyword(s):  
Interstitial Fibrosis ◽  
Smoking History ◽  
Nodule Formation ◽  
Diabetic Patients ◽  
Diffuse Mesangial Sclerosis ◽  
Cardiovascular Comorbidities ◽  
The Mean ◽  
Chronic Smoking ◽  
Global Glomerulosclerosis ◽  
Arteriolar Hyalinosis

Background: Chronic smoking and hypertension may lead to smoking-related nodular glomerulopathy (SRNG), a well-recognized entity that clinically and pathologically mimics nodular diabetic nephropathy (DN). However, like DN, diffuse mesangial sclerosis may occur in this setting without nodules. Methods: The clinicopathologic features of 10 non-diabetic patients with a long smoking history diagnosed from 2003-2012 showing diffuse mesangial glomerulosclerosis (6) or SRNG (4) were analyzed. Results: Nine of 10 patients were men, aged 58-80 with a 20-58 pack-year smoking history. None of the patients manifested diabetes, but all of them had hypertension. Numerous other cardiovascular comorbidities were present. At biopsy, the mean creatinine was 1.9 mg/dl (range 1.4-3) and the mean proteinuria was 3.9 g/24 h. The renal pathologic findings were similar in all patients except mesangial nodules in SRNG. Global glomerulosclerosis was seen in 6-72% of glomeruli (mean 31%), glomerulomegaly in all cases, and a range of interstitial fibrosis in 10-70% (mean 43%). Moderate (40%) and severe (50%) arteriosclerosis and arteriolar hyalinosis (80%) were also observed. Glomerular hilar or mesangial neovascularization was prominent. Endothelial swelling, subendothelial widening, and new basement membrane formation suggesting chronic healing thrombotic microangiopathy (TMA) was noted in 80%. No immune complexes were localized. Conclusions: Kidney biopsies from patients with proteinuria and chronic renal insufficiency in the setting of prolonged smoking and hypertension show either diffuse or nodular mesangial glomerulosclerosis. Chronic glomerular mesangial and endothelial injury associated with smoking leads to a chronic TMA appearance in the appropriate setting, even in the absence of mesangial nodule formation.

scholarly journals High Blood Pressure Is Associated with Tubulointerstitial Damage along with Glomerular Damage in Glomerulonephritis. A large Cohort Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1656
Author(s):  
Claudio Bazzi ◽  
Teresa M Seccia ◽  
Pietro Napodano ◽  
Cristina Campi ◽  
Brasilina Caroccia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Primary Glomerulonephritis ◽  
Hypertensive Patients ◽  
Tubulointerstitial Damage ◽  
Large Cohort Study ◽  
Global Glomerulosclerosis ◽  
Arteriolar Hyalinosis ◽  
Glomerular Damage

The key role of arterial hypertension in chonic kidney disease (CKD) progression is widely recognized, but its contribution to tubulointerstitial damage (TID) in glomerulonephritis (GN) remains uncertain. Hence, the objective of this study is to clarify whether TID is associated with glomerular damage, and whether the damage at the tubulointerstitial compartment is more severe in hypertensive patients. The study included retrospectively consecutive patients referred to the Nephrology Unit with diagnoses of primary glomerulonephritis, lupus nephritis (LN), and nephroangiosclerosis (NAS) at biopsy. At least six glomeruli per biopsy were analysed through light and immunofluorescence microscopy. Global glomerulosclerosis (GGS%), TID, and arteriolar hyalinosis (AH) were used as markers of CKD severity. Of the 448 patients of the cohort, 403 received a diagnosis of GN, with the remaining being diagnosed with NAS. Hypertension was found in 52% of the overall patients, with no significant differences among those with GN, and reaching 88.9% prevalence rate in NAS. The hypertensive patients with GN had more marked damage in glomerular and tubular compartments than normotensives independently of the amount of proteinuria. Moreover, hypertension and GGS% were found to be strongly associated with TID in GN. In GN patients, not only the severity of glomerular damage but also the extent of TID was associated with high blood pressure.

scholarly journals Renal Senescence, Telomere Shortening and Nitrosative Stress in Feline Chronic Kidney Disease

2021 ◽  
Vol 8 (12) ◽  
pp. 314
Author(s):  
Jessica Quimby ◽  
Andrea Erickson ◽  
Shannon Mcleland ◽  
Rachel Cianciolo ◽  
David Maranon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Inflammatory Infiltrate ◽  
Nitrosative Stress ◽  
Renal Cortex ◽  
Telomere Shortening ◽  
Corticomedullary Junction ◽  
Adult Cats ◽  
Global Glomerulosclerosis ◽  
Renal Senescence

Kidney tissues from cats with naturally occurring chronic kidney disease (CKD) and adult and senior cats without CKD were assessed to determine whether telomere shortening and nitrosative stress are associated with senescence in feline CKD. The histopathologic assessment of percent global glomerulosclerosis, inflammatory infiltrate, and fibrosis was performed. Senescence and nitrosative stress were evaluated utilizing p16 and iNOS immunohistochemistry, respectively. Renal telomere length was evaluated using telomere fluorescent in situ hybridization combined with immunohistochemistry. CKD cats were found to have significantly increased p16 staining in both the renal cortex and corticomedullary junction compared to adult and senior cats. Senior cats had significantly increased p16 staining in the corticomedullary junction compared to adult cats. p16 staining in both the renal cortex and corticomedullary junction were found to be significantly correlated with percent global glomerulosclerosis, cortical inflammatory infiltrate, and fibrosis scores. p16 staining also correlated with age in non-CKD cats. Average telomere length was significantly decreased in CKD cats compared to adult and senior cats. CKD cats had significantly increased iNOS staining compared to adult cats. Our results demonstrate increased renal senescence, telomere shortening, and nitrosative stress in feline CKD, identifying these patients as potential candidates for senolytic therapy with translational potential.

scholarly journals GLOMERULAR CAPILLARY GROWTH AND CELLULAR HYPERPLASIA IN A MODEL OF FOCAL AND SEGMENTAL GLOMERULOSCLEROSIS

2011 ◽  
Vol 19 (2) ◽  
pp. 109
Author(s):  
John F Bertram ◽  
Meroe M Cahill
Keyword(s):  
Glomerular Hypertrophy ◽  
Focal And Segmental Glomerulosclerosis ◽  
Cell Hyperplasia ◽  
Renal Disorder ◽  
Glomerular Cell ◽  
Capillary Growth ◽  
Glomerular Capillary ◽  
Segmental Glomerulosclerosis ◽  
Glomerular Lesions ◽  
Foot Process

Focal and segmental glomerulosclerosis (FSGS) is a chronic renal disorder characterized by segmental glomerular lesions and widespread podocyte foot process effacement. We have previously shown that glomerular enlargement (hypertrophy) precedes the development of FSGS in an animal model not previously thought to involve glomerular hypertrophy. This hypertrophy involved growth of glomerular capillaries. The aim of the present study was to determine whether the capillary growth involved an increase in the number of capillaries per glomerulus, or lengthening of existing capillaries. In addition, we examined the contribution of glomerular cell hyperplasia to the hypertrophy. We found that glomerular capillary growth in this model appears to primarily involve lengthening of existing capillaries rather that sprouting of new capillaries, and that glomerular cell proliferation contributes to the glomerular hypertrophy.

Hemoglobin crystals of the red blood cells in the human renal cortex: electron microscopic observations of the renal lithiasis

1978 ◽  
Vol 36 (2) ◽  
pp. 480-481
Author(s):  
Kosuke Ueda ◽  
Hiroto Washida ◽  
Nakazo Watari
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Renal Cortex ◽  
Uranyl Acetate ◽  
Osmic Acid ◽  
Renal Lithiasis ◽  
Electron Microscopic ◽  
Hemoglobin C ◽  
First Case ◽  
Ultrathin Sections

IntroductionHemoglobin crystals in the red blood cells were electronmicroscopically reported by Fawcett in the cat myocardium. In the human, Lessin revealed crystal-containing cells in the periphral blood of hemoglobin C disease patients. We found the hemoglobin crystals and its agglutination in the erythrocytes in the renal cortex of the human renal lithiasis, and these patients had no hematological abnormalities or other diseases out of the renal lithiasis. Hemoglobin crystals in the human erythrocytes were confirmed to be the first case in the kidney.Material and MethodsTen cases of the human renal biopsies were performed on the operations of the seven pyelolithotomies and three ureterolithotomies. The each specimens were primarily fixed in cacodylate buffered 3. 0% glutaraldehyde and post fixed in osmic acid, dehydrated in graded concentrations of ethanol, and then embedded in Epon 812. Ultrathin sections, cut on LKB microtome, were doubly stained with uranyl acetate and lead citrate.

Organized Intraglomerular Deposits in NZB Mouse Disease

1971 ◽  
Vol 29 ◽  
pp. 544-545
Author(s):  
Francis R. Comerford ◽  
Alan S. Cohen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Antinuclear Antibodies ◽  
Human Systemic Lupus Erythematosus ◽  
Systemic Lupus ◽  
Glomerular Lesion ◽  
Ultrastructural Studies ◽  
Dense Deposits ◽  
Experimental Nephritis ◽  
Glomerular Lesions

Mice of the inbred NZB strain develop a spontaneous disease characterized by autoimmune hemolytic anemia, positive lupus erythematosus cell tests and antinuclear antibodies and nephritis. This disease is analogous to human systemic lupus erythematosus. In ultrastructural studies of the glomerular lesion in NZB mice, intraglomerular dense deposits in mesangial, subepithelial and subendothelial locations were described. In common with the findings in many examples of human and experimental nephritis, including many cases of human lupus nephritis, these deposits were amorphous or slightly granular in appearance with no definable substructure.We have recently observed structured deposits in the glomeruli of NZB mice. They were uncommon and were found in older animals with severe glomerular lesions by morphologic criteria. They were seen most commonly as extracellular elements in subendothelial and mesangial regions. The deposits ranged up to 3 microns in greatest dimension and were often adjacent to deposits of lipid-like round particles of 30 to 250 millimicrons in diameter and with amorphous dense deposits.

Morphometric analysis of cellular interactions with the endothelium during the development of arterial lesions using Scanning Electron Microscopy and digital image analysis

1987 ◽  
Vol 45 ◽  
pp. 918-919
Author(s):  
M.E. Rosenfeld ◽  
C. Karboski ◽  
M.F. Prescott ◽  
P. Goodwin ◽  
R. Ross
Keyword(s):  
Electron Microscopy ◽  
Image Analysis ◽  
Quantitative Data ◽  
Digital Image Analysis ◽  
Lower Cost ◽  
Matched Control ◽  
Digital Analysis ◽  
Cellular Interactions ◽  
Arterial Lesions ◽  
Scanning Electron

Previous research documenting the chronology of the cellular interactions that occur on or below the surface of the endothelium during the initiation and progression of arterial lesions, primarily consisted of descriptive studies. The recent development of lower cost image analysis hardware and software has facilitated the collection of high resolution quantitative data from microscopic images. In this report we present preliminary quantitative data on the sequence of cellular interactions that occur on the endothelium during the initiation of atherosclerosis or vasculitis utilizing digital analysis of images obtained directly from the scanning electron microscope. Segments of both atherosclerotic and normal arteries were obtained from either diet-induced or endogenously (WHHL) hypercholesterolemic rabbits following 1-4 months duration of hypercholesterolemia and age matched control rabbits. Vasculitis was induced in rats following placement of an endotoxin soaked thread adjacent to the adventitial surface of arteries.

Comparative Chemical, Biological and Clinical Studies of 99mTc-Glucoheptonate and 99mTc-Dimercaptosucci- nate as Used in Renal Scintigraphy

1979 ◽  
Vol 18 (01) ◽  
pp. 40-45 ◽  
Author(s):  
M. Malešević ◽  
Lj. Stefanović ◽  
N. Vanlić-Razumenić
Keyword(s):  
Clinical Studies ◽  
Gamma Camera ◽  
Radiochemical Purity ◽  
Renal Cortex ◽  
Renal Scintigraphy ◽  
Time Intervals ◽  
Experimental Animals ◽  
Dynamic Studies

The renal radiopharmaceutical preparations 99mTc-DMS and 99mTc-GH were examined chemically, biologically and clinically. Both preparations are of high radiochemical purity. The biodistribution of both preparations was examined in experimental animals at different time intervals, from 15 min to 4 hr; the percentage of incorporation of 99mTc-DMS into kidneys is much higher (29.4% to 52.0%) than that of 99mTc-GH (12.80% to 22.20%). Both preparations accumulate to a greater extent in the renal cortex than in the medulla.The most suitable time for renal scintigraphy for "mTc-DMS is 90-150 min while for 99mTc-GH it is 60-90 min. It is concluded that 99mTc-DMS is more suitable for static scintigrams on the scanner and 99mTc-GH for dynamic studies with the gamma camera.

The Employment of 197Hg EDTA in Kidney Scanning

1965 ◽  
Vol 05 (01) ◽  
pp. 56-67
Author(s):  
I. Pál ◽  
J. Földes ◽  
I. Krasznai
Keyword(s):  
Radiation Dose ◽  
Renal Cortex ◽  
Radiation Doses ◽  
Intravenous Pyelography ◽  
Edta Complex

SummaryThe authors investigated the use of 197Hg EDTA complex for kidney scanning. They describe the physical, biological and toxicological properties of the compound; its distribution within the organism, its excretion with urine and faeces and its uptake by the kidneys. The authors have established that the renal cortex selectively secretes the material which makes it suitable for kidney scanning. Some scintigrams of both normal and pathologic kidneys are presented.Finally a detailed discussion of the dosimetry is included. The radiation doses due to 197Hg EDTA are compared with those due to 203Hg-neohydrin and to intravenous pyelography. This comparison shows clearly that the use of 197Hg EDTA considerably decreases the radiation dose to the patient.

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