scholarly journals Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Hamid Tayebi Khosroshahi ◽  
Behzad Abedi ◽  
Sabalan Daneshvar ◽  
Yashar Sarbaz ◽  
Abolhassan Shakeri Bavil
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Diagnostic Methods ◽  
Renal Outcome ◽  
Renal Diseases ◽  
Pathological Findings ◽  
Renal Imaging ◽  
Pathological Conditions ◽  
Conventional Modality

At the present time, imaging guided renal biopsy is used to provide diagnoses in most types of primary and secondary renal diseases. It has been claimed that renal biopsy can provide a link between diagnosis of renal disease and its pathological conditions. However, sometimes there is a considerable mismatch between patient renal outcome and pathological findings in renal biopsy. This is the time to address some new diagnostic methods to resolve the insufficiency of conventional percutaneous guided renal biopsy. Nanotechnology is still in its infancy in renal imaging; however, it seems that it is the next step in renal biopsy, providing solutions to the limitations of conventional modalities.

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 287-296
Author(s):  
W. F. Dodge ◽  
C. W. Daeschner ◽  
J. C. Brennan ◽  
H. S. Rosenberg ◽  
L. B. Travis ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Importance ◽  
Renal Diseases ◽  
Renal Lesion ◽  
Bleeding Tendency ◽  
Percutaneous Renal Biopsy ◽  
The One ◽  
Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

scholarly journals P0114BENEFITS AND CHALLENGES OF A RENAL BIOPSY REGISTRY AND NETWORK - FCGG EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wim Laurens ◽  
Johan De Meester ◽  
Ben Sprangers ◽  
Steven Van Laecke ◽  
Dendooven Amélie ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Clinical Care ◽  
Adult Population ◽  
Age Groups ◽  
Time Frame ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Renal Biopsies

Abstract Background and Aims End December 2016, a renal biopsy network in the Flemish region (Belgium) was founded as a collaboration between the renal pathologists and nephrologists. This FCGG network introduced a uniform renal biopsy request form, a well-structured report form of the renal pathology examination and a comprehensive list of renal pathology diagnoses. Method Following informed consent [99.5%] and in compliance with GDPR, the registration of the renal biopsies consists of basic categorical renal data, structured renal pathology information and the final clinical renal disease. Results In 2017 and 2018, 1385 renal biopsies were registered – 10.5 per million inhabitants per year; in addition, 28 patients had a repeat biopsy in the same time frame (2%). Of the pediatric patients ( age < 18 years; N=92; 6.6%), 23 had IgA nephropathy, 20 a minimal change disease and 15 another type of glomerulonephritis. The biopsy was reported as normal or non-diagnostic in 15 patients (16%) – the majority was clinically considered as glomerulonephritis. The spectrum of the adult population was quite similar across gender and age groups: 56% glomerulonephritis [= IgA nephropathy [19%] + FSGS [8%] + pauci-immune glomerulonephritis [7%] + other GN [22%] ), 10% tubulo-interstitial nephritis, 7% acute tubular necrosis [ATN], 7% diabetes mellitus, and 7% nephroangiosclerosis. Exceptions are pauci-immune glomerulonephritis as the most important renal disease in women aged 65 years and older, and lupus nephritis as the second most important glomerulonephritis in women aged 18-44 years. Only a small percentage of adult renal biopsies yielded no result (7%), clinically interpreted as glomerulonephritis in 50% of the cases. Conclusion The FCGG network has provided a more intense collaboration between renal pathologists and nephrologists mainly by standardizing the renal biopsy reading and reporting across all centers. More precise estimates of the prevalent renal diseases were provided for the first time; however, in order to get full information, renal diseases diagnosed by other techniques ( serology, genetic analysis ) should also be collected in the future. Efforts will be done to coordinate the clinical care of renal diseases, particularly the more rare renal diseases, and to offer access to new therapeutic molecules or new schemes, through this super-regional network.

scholarly journals Pattern of glomerular disease in a tertiary care hospital in Nepal: A Shree Birendra Hospital experience

2012 ◽  
Vol 7 (4) ◽  
pp. 48-52
Author(s):  
A Sharma ◽  
RK Deo ◽  
RR Shahi
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Glomerular Disease ◽  
Renal Diseases ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Glomerular Diseases ◽  
Patient Profile ◽  
Nephritic Syndrome ◽  
Number Of Patients

The incidence of renal diseases varies greatly in various parts of the world. Percutaneous renal biopsy is an important procedure for many patients with renal disease. This hospital based retrospective study evaluated the pattern of various glomerular diseases in Shree Birendra hospital. Hospital records were searched for all the patients undergoing renal biopsy for all indication and patient profile and histopathological examination record were obtained. All the patients undergoing renal biopsy for any cause from January 2007 to December 2010 were included in the study. A total of 46 patients underwent renal biopsy in the study period. The number of patients in the various age groups were - <16 years – 5 patients, 16-50 years – 34 patients and > 50 years – 7 patients. The number of male and female patients was 34 and 12 respectively. Major indication for undergoing renal biopsy in this study was Nephrotic Syndrome (n=29, 63%), followed by RPGN (n=8, 17%), Persistent proteinuria (n=6, 13%) and Nephritic syndrome (n=3, 7%). The most common histopathological diagnosis in the study was Membranous nephropathy (n=10, 22%), followed by Focal Segmental Glomerulosclerosis (n=9, 20%), Membranoproliferative glomerulonephritis (n=9, 20%) and Minimal change disease (n=6, 13%). USG guided renal biopsy is safe in adults and is a very useful tool for the diagnosis of renal disease. The pattern of glomerular disease varies in different settings. There is a need for further evaluation of glomerular disease with larger sample size to determine the pattern of glomerular disease in Nepal. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 48-52 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6742

MONOCLONAL ANTIBODY IDENTIFICATION OF FIBRIN DEPOSITS IN RENAL DISEASE

1987 ◽  
Author(s):  
A Bini ◽  
V D"Agati ◽  
C Pirani ◽  
B Kudryk ◽  
K L Kaplan
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Acute Interstitial Nephritis ◽  
Renal Diseases ◽  
Immunoperoxidase Technique ◽  
Intense Staining ◽  
Group I ◽  
Group Ii ◽  
Membranous Gn

Glomerular and vascular "fibrin" deposition has frequently been reported in human and experimental renal diseases. The biochemical form of this "fibrin" has not been well defined. We studied 16 renal biopsies (Bouin's fixed paraffin embedded) with the ABC-immunoperoxidase technique using monoclonal antibodies (MAbs); MAb I8C6 (Bβ1-42) to fibrinogen and fibrin I; MAb T2G1 (β15-42) to fibrin II; and MAb GC4 to fragment D or D-D. Polyclonal antisera to fibrinogen, albumin and IgG were used as controls. Renal biopsy specimens included 9 cases of microangiopathy (Group I: 6 hemolytic uremic syndrome (HUS), 1 sclerodero-ma, 2 acute humoral rejection) and 7 miscellaneous cases of other renal disease (Group II: 2 IgA nephropathy, 2 minimal change disease, 2 membranous GN, 1 acute interstitial nephritis). Fibrinogen and fibrin I were present on the glomerular (glom) endothelial cells in 8/9 Group I and 7/7 Group II cases, but was present in glom capillary lumens in Group I only. Staining of the endothelial aspect of interstitial capillaries, arterioles and arteries was also observed in both groups. Fibrin II was present in most glom and interstitial capillaries in both groups. However, intense staining for fibrin II was observed in arterioles and arteries in Group I only. Staining for fragments D and D-D was observed in glom capillaries in 6 Group I cases (6 HUS) and 3 Group II cases (2 IgA nephropathy, 1 membranous GN) but was most diffuse and intense in Group I. Traditional histochemical stains for fibrin (Lendrum and PTAH) were positive in 4 Group I cases only, indicating that the ABC technique is far more sensitive. Controls (14 needle biopsies of non-renal tissue) showed no vascular ractivity for fibrinogen, fibrin I, II and fragments D and D-D, suggesting that the vascular staining observed in renal biopsy tissue is not caused by the biopsy procedure itself. These findings indicate that 1) Fibrin formation and lysis occur in many renal diseases of both vascular and non—vascular origin. 2) Fibrinolytic activity is higher in the glom capillaries than in the larger vessels. 3) Damaged renal endothelium may be an active participant in these processes.

scholarly journals Predicting long-term renal and patient survival by clinicopathological features in elderly patients undergoing a renal biopsy in a UK cohort

2019 ◽  
Vol 12 (4) ◽  
pp. 512-520 ◽  
Author(s):  
Arunraj Navaratnarajah ◽  
Khrishanthne Sambasivan ◽  
Terry H Cook ◽  
Charles Pusey ◽  
Candice Roufosse ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Renal Disease ◽  
Renal Biopsy ◽  
Patient Survival ◽  
The Elderly ◽  
Acute Interstitial Nephritis ◽  
Histological Diagnosis ◽  
Renal Outcome ◽  
Prognostic Information

Abstract Background Several publications have demonstrated the use of renal biopsy in elderly patients in establishing a diagnosis and enabling directed therapy. However, evidence on the long-term outcomes following biopsies is lacking. The aim of this study is to describe the renal and patient outcomes in elderly patients according to indication for biopsy, clinical parameters and the histological diagnosis. Methods We performed a retrospective cohort study of 463 patients >70 years old who underwent a renal biopsy at our centre between 2006 and 2015. Results The median age of the patients was 74.8 (range 70.0–89.6) years. The most frequent primary diagnoses were pauci-immune crescentic glomerulonephritis (GN; 12%), acute interstitial nephritis (10.8%) and membranous GN (7.1%). Death-censored renal survival at 1 and 5 years following the index biopsy was 85.2 and 75.9%, respectively, and patient survival at 1 and 5 years was 92.2 and 71.6%, respectively. Patients who progressed to end-stage renal disease (ESRD) were at higher risk of dying compared with patients who did not require dialysis [hazard ratio 2.41 (95% confidence interval 1.58–3.68; P < 0.001]. On multivariate analysis, factors associated with the risk of progression to ESRD were creatinine (P < 0.001), heavy proteinuria (P = 0.002) and a non-chronic kidney disease (CKD) biopsy indication (P = 0.006). A histological diagnosis of primary GN (P = 0.001) or tubulointerstitial nephritis (P = 0.008) was associated with a favourable renal outcome, while patients with vasculitis and paraprotein-related renal disease (PPRD) had the highest risk of requiring dialysis (P = 0.0002 and P = 0.003, respectively). PPRD was also an independent risk factor for death. Conclusions This study demonstrates that renal biopsies in the elderly not only enable directed therapy, but also provide prognostic information on renal and patient survival.

The Physician’s Task and the Problem of Documentation

1964 ◽  
Vol 03 (01) ◽  
pp. 11-19 ◽  
Author(s):  
A. Proppe
Keyword(s):  
Statistical Evaluation ◽  
Age Groups ◽  
Diagnostic Methods ◽  
Early Age ◽  
Case Histories ◽  
Lupus Vulgaris ◽  
Pathological Conditions ◽  
Clinical Methods ◽  
Corpus Hippocraticum ◽  
High Degree

SummaryCase histories suitable for statistical evaluation can be found even as far back as in the Corpus Hippocraticum. Such simple data as the patient’s age, body weight, size, the date of menarche, etc. are practically always included in the case records, and it is demonstrated that, when such data are recorded in a system of documentation suitable for mechanical sorting, it may enable us to draw conclusions of very great importance. Mechanical registration methods have revealed that, in the determination and recording of data as hitherto carried out. there has been a surprisingly large number of errors and a high degree of unreliability. This view has a considerable influence on modern clinical methods; it renders a more democratic relation between physician and patient necessary and makes clear the need for measures to enhance the reliability of diagnosis and treatment of pathological conditions. The author illustrates this view with reference to the mechanical falsification of the thesis of the proneness of early age groups to lupus vulgaris, furthermore with reference to the mechanical rationalization of modern routine diagnostic methods, to the constant surveillance of adverse effects on public health and to the protection against allergic reactions with the aid of recording systems of personal allergy and intolerance data with mechanical sorting and computer techniques.

scholarly journals Safety of Renal Biopsy by Physicians with Short Nephrology Experience

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 474
Author(s):  
Kenta Torigoe ◽  
Kumiko Muta ◽  
Kiyokazu Tsuji ◽  
Ayuko Yamashita ◽  
Shinichi Abe ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Biopsy ◽  
Renal Diseases ◽  
Complication Rates ◽  
Artery Embolization ◽  
Clinical Nephrology ◽  
Percutaneous Renal Biopsy ◽  
Artery Embolism ◽  
Renal Artery Embolization ◽  
Biopsy Complications

Percutaneous renal biopsy is an essential tool for diagnosing various renal diseases; however, little is known about whether renal biopsy performed by physicians with short nephrology experience is safe in Japan. This study included 238 patients who underwent percutaneous renal biopsy between April 2017 and September 2020. We retrospectively analyzed the frequency of post-renal biopsy complications (hemoglobin decrease of ≥10%, hypotension, blood transfusion, renal artery embolization, nephrectomy and death) and compared their incidence among physicians with varied experience in nephrology. After renal biopsy, a hemoglobin decrease of ≥10%, hypotension and transfusion occurred in 13.1%, 3.8% and 0.8% of patients, respectively. There were no cases of post-biopsy renal artery embolism, nephrectomy, or death. The composite complication rate was 16.0%. The incidence of post-biopsy complications was similar between physicians with ≥3 years and <3 years of clinical nephrology experience (12.5% vs. 16.8%, p = 0.64). Furthermore, the post-biopsy composite complication rates were similar between physicians with ≥6 months and <6 months of clinical nephrology experience (16.3% vs. 15.6%, p > 0.99). Under attending nephrologist supervision, a physician with short clinical nephrology experience can safely perform renal biopsy.

scholarly journals SAT0211 RENAL INJURY IN SYSTEMIC LUPUS ERYTHEMATOSUS CHARACTERIZED BY THROMBOTIC MICROANGIOPATHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1048.1-1048
Author(s):  
W. Hu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Renal Biopsy ◽  
Lupus Erythematosus ◽  
Thrombotic Microangiopathy ◽  
Renal Injury ◽  
Renal Outcome ◽  
Pathological Examination ◽  
Systemic Lupus ◽  
Tubulointerstitial Lesions

Background:Classical lupus nephritis (LN) is characterized by glomerular immune complex(IC) deposition with glomerular proliferation, basement membrane destruction and cell infiltration. Non-IC mediated renal injury with thrombotic microangiopathy (TMA) was also reported in patients with systemic lupus erythematosus (SLE-renal TMA), but most studies were reported in patients with both LN and renal TMA.Objectives:In this study, clinical features and outcomes of SLE-renal TMA in absence of obvious IC in SLE patients were analyzed.Methods:Patients with glomerular TMA and/or vascular TMA in the absence of obvious subendothelial or epithelial immune deposits were screened out from 2332 biopsied in SLE patients who underwent first renal biopsy from January 2005 to August 2016. Their clinical, histological features and outcomes were retrospectively analyzed.Results:In 2332 renal biopsies obtained from SLE patients, 257 (11.0%) showed renal TMA, of which 237 showed both renal TMA and LN, and 20 biopsies had only renal TMA (SLE-renal TMA). There were 2 males and 18 females with an average age of (25 ± 10) years. The median course of SLE and LN were 3.0(1.0, 6.0) and 0.8(0.5, 1.9) months. All 20 patients deserved acute kidney injury, of which 11 (55%) needed renal replacement therapy (RRT) and 12 (60%) were nephrotic syndrome. Blood system involvement was found in all cases, including 13 cases (65.0%) with TMA triad (microvascular hemolytic anemia, thrombocytopenia and elevated lactate dehydrogenase).Pathological examination showed that 17 cases (85.0%) had both glomerular TMA and vascular TMA. Immunofluorescence and electron microscopy showed that 8 cases (40%) had no IC deposition in glomerulus and 12 cases (60%) had only IC deposition in mesangium. Acute tubulointerstitial lesions in patients requiring RRT were more serious than those no needing for RRT((43.6±24.9) %vs(21.7±20.1) %,P=0.047). The fusion range of foot process was positively correlated with proteinuria (r2= 0.347,P=0.006).All patients received high-dose methylprednisolone pulse therapy. Four patients received plasma exchange and three patients received gamma globulin, respectively. Eleven patients requiring RRT all stop RRT in a median time of 16.0 (9.0, 30.0) days. During a median follow-up of 58.0 (36.0, 92.3) months, complete remission (CR) was obtained in 15 cases, partial remission in 4 cases and no remission in 1 case. Six cases (30%) relapsed. No case died or progressed to end stage renal disease.Conclusion:Renal injury characterized by TMA is not uncommon in SLE renal biopsy cases. The clinical manifestation is special and the renal injury is serious. The renal outcome is good by intensive immunosuppressive therapy. It should be considered as a unique type of renal injury in SLE.References:[1]Moake JL. Thrombotic microangiopathies. N Engl J Med. 2002. 347(8): 589-600.[2]Anders HJ, Weening JJ. Kidney disease in lupus is not always ‘lupus nephritis’. Arthritis Res Ther. 2013. 15(2): 108.[3]Song D, Wu LH, Wang FM, et al. The spectrum of renal thrombotic microangiopathy in lupus nephritis. Arthritis Res Ther. 2013. 15(1): R12.[4]Hu WX, Liu ZZ, Chen HP, Zhang HT, Li LS, Liu ZH. Clinical characteristics and prognosis of diffuse proliferative lupus nephritis with thrombotic microangiopathy. Lupus. 2010. 19(14): 1591-8.[5]Tomov S, Lazarchick J, Self SE, Bruner ET, Budisavljevic MN. Kidney-limited thrombotic microangiopathy in patients with SLE treated with romiplostim. Lupus. 2013. 22(5): 504-9.[6]Li C, Yap D, Chan G, et al. Clinical Outcomes and Clinico-pathological Correlations in Lupus Nephritis with Kidney Biopsy Showing Thrombotic Microangiopathy. J Rheumatol. 2019 .[7]Chen MH, Chen MH, Chen WS, et al. Thrombotic microangiopathy in systemic lupus erythematosus: a cohort study in North Taiwan. Rheumatology (Oxford). 2011. 50(4): 768-75.[8]Park MH, AUID- Oho, Caselman N, Ulmer S, Weitz IC, AUID- Oho. Complement-mediated thrombotic microangiopathy associated with lupus nephritis. Blood Adv. 2018. 2(16): 2090-2094.Disclosure of Interests:None declared

scholarly journals Lifetime risk of cardiovascular-renal disease in type 2 diabetes: a population-based study in 473399 individuals

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Zhang ◽  
J Mamza ◽  
T Morris ◽  
G Godfrey ◽  
F Asselbergs ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Disease ◽  
Population Based ◽  
Lifetime Risk ◽  
Disease Stage ◽  
Renal Diseases ◽  
Funding Source ◽  
Private Company ◽  
Risk Of Death

Abstract Background Lifetime risks of cardiovascular (CV) and renal diseases are high, particularly in type 2 diabetes (T2D), but rarely studied together, and relative disease contributions are unknown. Knowledge of lifetime risk of cardiovascular-renal disease (CVRD) will better reflect disease burden in T2D. Purpose To investigate the lifetime risks (LTRs) of composite and individual components of major adverse reno-cardiovascular events, MARCE in T2D patients. Method In a population-based cohort study using national electronic health records, we studied 473399 individuals aged 45–99 years with T2D in England 2007–2018. The LTR of composite and individual components of MARCE (including CV death and CVRD: heart failure, HF; chronic kidney disease stage 3 and above, CKD; myocardial infarction, MI; stroke or peripheral artery disease, PAD) were estimated. LTRs by baseline CVRD comorbidity status were compared with individuals free from CVRD at baseline, accounting for the competing risk of death. Results Among T2D patients aged ≥45 years, the LTR of MARCE was 80% for individuals free from CVRD at baseline. LTR of MARCE was 97%, 93%, 98%, 89% and 91% for individuals with specific CVRD comorbidities for HF, CKD, MI, stroke and PAD, respectively at baseline. Within the CVRD-free cohort, LTR of CKD was highest at 54%, followed by CV death (41%), HF (29%), stroke (20%), MI (19%) and PAD (9%). Compared to CVRD-free, HF, MI and CKD at baseline were associated with the highest LTR of MARCE and its component diseases (Table). Conclusion The lifetime risk of CV disease and CKD in T2D patients is estimated to be over 60% and 50% respectively (1–3). When considered together, the LTR of MARCE is 80% in CVRD-free T2D patients, while nearly all those with T2D and HF will develop MARCE over their lifetime. Of the individual components of MARCE, LTR of CKD and HF were the highest among CVRD-free T2D patients. Preventive measures in T2D patients should be a priority in clinical practice to mitigate the burden of these complications. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): AstraZeneca

Obstructive nephropathy and renal fibrosis

2002 ◽  
Vol 283 (5) ◽  
pp. F861-F875 ◽  
Author(s):  
Saulo Klahr ◽  
Jeremiah Morrissey
Keyword(s):  
Renal Disease ◽  
Renal Fibrosis ◽  
Interstitial Fibrosis ◽  
Rodent Model ◽  
Renal Diseases ◽  
Obstructive Nephropathy ◽  
Therapeutic Approaches ◽  
Cellular Events ◽  
The Impact ◽  
Made In

Interstitial fibrosis has a major role in the progression of renal diseases. Several animal models are available for the study of renal fibrosis. The models of aminonucleoside-induced nephrotic syndrome, cyclosporin nephrotoxicity, and passive Heyman nephritis are characterized by molecular and cellular events similar to those that occur in obstructive nephropathy. Additionally, inhibition of angiotensin-converting enzyme exerts salutary effects on the progression of renal fibrosis in obstructive nephropathy. Unilateral ureteral obstruction (UUO) has emerged as an important model for the study of the mechanisms of renal fibrosis and also for the evaluation of the impact of potential therapeutic approaches to ameliorate renal disease. Many quantifiable pathophysiological events occur over the span of 1 wk of UUO, making this an attractive model for study. This paper reviews some of the ongoing studies that utilized a rodent model of UUO. Some of the findings of the animal model have been compared with observations made in patients with obstructive nephropathy. Most of the evidence suggests that the rodent model of UUO is reflective of human renal disease processes.

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