Pathology of severe urolithiasis in a flock of egg-laying hens

Fourteen, 31-week-old Lohmann white layers from a flock of 30,000 chickens had a history of apathy, and a drop in egg production. Clinical signs were observed in approximately 40% of the flock, and lasted for three months. Fourteen hens were euthanized for post-mortem examinations. Macroscopic findings included marked atrophy and loss of renal lobes along with compensatory renal hypertrophy of the contralateral lobe. Ureters were markedly dilated and filled with mucus and/or with molded white to yellow-grey uroliths that obliterated the lumen. At histopathology, the uroliths inside ureters and tubules were composed of concentrically arranged mineralized concretions, as well as urates associated with heterophilic infiltrations and epithelial hyperplasia. Renal parenchyma adjacent to obstructed ureters was compressed with tubules replaced by fibrous tissue. Multifocal interstitial lymphocytic nephritis, proteinuria and membranoproliferative glomerulonephritis were also found. Heterophilic and caseous ureteritis associated with numerous Gram-positive coccoid bacteria occurred in three chickens. Immunohistochemistry for avian coronavirus was negative. This negative result along with the case history indicated that water restriction was the most likely cause of mortality. This condition resulted in significant economic loss for this farmer.

Compensatory renal hypertrophy in reflux nephropathy presenting as hypertensive emergency

ABSTRACT Hypertensive emergency in the paediatric population is not uncommon. However, due to its numerous etiologies, care should be taken in determining the approach of management. We report a case of a child who presented with double vision, giddiness and elevated blood pressure. Blood investigations were normal. Renal ultrasound and magnetic resonance imaging of the abdomen were performed which both showed findings suspicious of a large heterogeneous mass at the lower pole of the left kidney with dysplastic right kidney. A final diagnosis of bilateral vesicoureteric reflux with left compensatory hypertrophy was made based upon micturating cystourethrography findings and was later confirmed by 99mTc-dimercaptosuccinic acid (DMSA) study. The objective of this case is to share the importance of the appropriate choice of radiological examinations, not only in achieving an accurate diagnosis but to ensure that unnecessary investigations are avoided.

Cross-Sectional Investigations of Pre- and Post-Operative Renal Global Function and Renal Parenchymal Volumetry in Both Partial and Radical Nephrectomy Utilizing Film-Based Technology

Objectives: To investigate pre- and post-operative renal global function and renal parenchymal volume (RPV) in both partial nephrectomy (PN) and radical nephrectomy (RN) utilizing film-based technology. Patients and Methods: The patient cohort consisted of 81 and 82 cases with T1 tumors (≤ 7 cm) treated by PN and RN, respectively. Renal global function was assessed using the estimated glomerular filtration rate (eGFR), and RPV was measured using a Synapse Vincent volumetric analyzer which creates a reconstructed image from a computed tomography scan. Renal global function and RPV were evaluated pre-operatively and 6 months post-operatively. Results: The percent eGFR decline of PN cases was significantly reduced compared with RN cases (p < 0.0001). Post-operative RPV of the contralateral side was significantly increased compared with pre-operative RPV (p < 0.0001) in RN cases. The percent change of the contralat-eral side RPV was slightly increased in RN compared with PN cases (p = 0.1881). A strong positive correlation was noted between post-operative eGFR and post-operative total RPV (r = 0.69, p < 0.0001), and a strong negative correlation was noted between percent eGFR decline and post-operative total RPV (r = -0.63, p < 0.0001). Conclusions: Prominent compensatory renal hypertrophy occurred within 6 months after RN. Post-operative renal functional outcome was closely correlated with the post-operative total RPV. In addition to RPV, further studies to unravel post-operative renal function from multifactorial aspects including surgical factors and intrinsic medical disease should be performed in the future.