Chronic Renal Disorder Research Articles

Effects of vitamin D supplementation (oily form) in patients with thalassemia

Background. Thalassemia is congenital disease case by mutation effect to synthesis of beta globin chain of hemoglobin result in combination of metabolic and endocrine disorder. Bone disease is a not rare complication in thalassemia due to malabsorption of calcium, the secondary chronic renal disorder with low vitamin D (VD), as well as many endocrine risk factors. Aim. Evaluation of vitamin D treatment (oily form) in patients with thalassemia. Method. Post Marketing Surveillance (PMS) in 26 patients with Thalassemia in Ibn Al-Atheer Hospital. All patient take vitamin D oral vial oily form with dose 50000 IU, this PMS continued in 4 weeks, every week the patient take one vial. The Parameter for the level of VD. Result. The total number of patients was 26; mean age was 13.5 years, between 3-41 years, with 53.8% were males and 46.2% were females. mean serum level of vitamin D was statically significantly very lower in thalassemia patients than in than normal level; (89%) of cases had deficient VD (≤ 20 ng/ml), (7%) of cases had insufficient vitamin D (21–29 ng/ml), and (4%) of cases had deficient VD optimal vitamin D (more than 30 ng/ml), our study showed that 4 weeks of VD supplementation significantly increased the serum level of VD. Conclusion. VD (Oily based oral vial) “High D” significantly raise the VD level in serum in majority of thalassemia patients, the result was sustained regardless of age, gender and existence of other comorbidities.

Coexistence of Neonatal Bartter Syndrome and Congenital Cutis Laxa, in which a new mutation in SLC12A1 was identified

Introduction: Neonatal Bartter Syndrome (NBS) is an extremely rare congenital chronic renal tubular transport disorder characterized by preterm birth, polyhydramnios, polyuria, salt wasting, and severe dehydration. Congenital Cutis Laxa (CCL) is a rare disease characterized by loss of skin flexibility and laxity, and atypical facial appearance.
 Case Presentation: A 1290-gram female baby at 30+6 weeks of gestation was hospitalized due to premature birth and respiratory distress. During physical examination, an atypical facial appearance, wrinkles on the forehead, skin laxity, and philtrum were visible as well as a small chin and arachnodactyly in the fingers and toes. The patient displayed metabolic alkalosis in her blood gases. The patient, with an atypical face and current findings submitted her exome for genetic diagnosis. Genetic analysis revealed the presence of homozygous NM_001184832.2:c.2485+5G>A (rs749269268) in SLC12A1, and NBS Type 1 was diagnosed. A novel heterozygous NM_000501.4:c.352G>T, p.Val118Phe (rs781922544) variant was detected in ELN, and CCL syndrome with autosomal dominant inheritance was diagnosed.
 Conclusions: The rare co-occurrence of NBS and CCL syndrome in our patient was seen as a mere coincidence. Since this is the first reported case in the literature, it was deemed appropriate to present this case.

Butyrate alleviates renal inflammation and fibrosis in a rat model of polycystic ovarian syndrome by suppression of SDF-1

BackgroundPolycystic ovarian syndrome (PCOS) is a multifactorial condition with metabolic-related complications, such as diabetic nephropathy and chronic renal disorder, which are the leading cause of renal transplant globally. Protective effects of histone deacetylase (HDAC) inhibitors (HDACi) have been documented in metabolic-linked pathologies. Nonetheless, the current study investigated the restorative role of HDACi, butyrate in experimental PCOS-induced renal disorder.Materials and methodsFemale Wistar rats (8-week-old) were divided into groups; control, butyrate-treated, letrozole and letrozole + butyrate-treated groups. To induce PCOS, 1 mg/kg of letrozole was given (oral gavage) for 21 days. After confirmation of PCOS, 200 mg/kg of butyrate (oral gavage) was administered for 6 weeks.ResultsRats with PCOS revealed disruption in glucose homeostasis (hyperinsulinemia and impaired glucose tolerance and insulin resistance) and presented with the phenotypes of PCOS (hyperandrogenism, multiple ovarian cysts and elevated LH/FSH ratio). Increased plasma and renal triglycerides and inflammatory (TNF-α/SDF-1/NF-κB) markers were observed with elevated levels of TGFβ-1, renal lipid peroxidation and redox imbalance (GGT, GSH, HIF-1α). Interestingly, animals with PCOS reported increased body weight as well as renal mass. Whereas, heightened levels of plasma urea, creatinine and creatine kinase indicating renal dysfunction, characterized by renal apoptosis (Caspase-6) and increased HDAC2 levels. Notwithstanding, administration of butyrate averted the alterations.ConclusionThe present investigation demonstrates that PCOS declines renal function, which is accompanied by renal inflammation, apoptosis and fibrosis. The study further suggests that butyrate, an HDAC2i restores renal function by suppressing renal SDF-1 with subsequent attenuation of renal inflammation, apoptosis and fibrosis.

Serum malondialdehyde in different stages of chronic renal disorder

Background: Chronic kidney disease (CKD) is a widespread public health problem, which may have several adverse consequences such as renal failure, cardiovascular disease, and premature death. Kidney-related pathologies have increasing prevalence rates, produce a considerable financial burden, and are characterized by elevated levels of oxidative stress (OS). Several markers emerged as well-suited indicators of OS such as malondialdehyde (MDA) and lipid hydroperoxides. The reduced activities of antioxidant enzymes status and increased production of MDA in the CKD patients confirm the presence of OS. The alteration in antioxidant status and MDA in CKD patients supports the role of OS in CKD patient. Aims and Objectives: The aim of the study was to compare serum MDA in different stages of CKD with that of control. It is well known that inflammation has an important role in CKD and MDA is an oxidant biomarker. Materials and Methods: This was a cross-sectional study having 400 participants with 300 known cases of CKD and 100 healthy controls. Serum MDA levels were measured by thiobarbituric acid assay. Results: There was a significant difference between the groups regarding the MDA values (P<0.001) with that of control. The mean MDA value in Stage III (5.64±1.93 Umol/L), Stage IV (6.14±1.584 Umol/L), and Stage V (10.761±3.347 U moL/L) of CKD patients were high in comparison to healthy control (1.88±0.181 U mol/L). Conclusion: We concluded that MDA is a useful biomarker in CKD patients. The correlations of serum MDA among different stages of CKD patients were significant. Larger studies focused on CKD severity and antioxidant/oxidant biomarkers are required.

POS-087 SEVERE SEPSIS AND DEATH DUE TO MYCOBACTERIUM FORTUITUM IN A PATIENT WITH CHRONIC KIDNEY DISEASE ON MAINTENANCE HEMODIALYSIS

Patients with chronic kidney disease (CKD) or end-stage renal disorder (ESRD) have impaired cell mediated immunity. Despite adequate care and caution, the risk of opportunistic infections is higher in this patient population. Apart from the Mycobacterium tuberculosis certain nontuberous mycobacterium are reported causing mild to severe disseminated infection.

Health-related quality of life in chronic kidney disease; A descriptive study in Pakistan.

Objective: To explore, examine, investigate, analyze, and interpret the harshness or evil effects of chronic kidney disease, and to measure, describe and evaluate the psychological distress level and health associated quality of life in chronic kidney disease patients. Study Design: Descriptive Cross-sectional Survey. Setting: Department of Nephology, DHQ Teaching Hospital, District Dera Ghazi Khan, Province Punjab, Pakistan. Period: 18th December 2020 to 18th April 2021. Material & Methods: Total three hundred and seventy two (372) _chronic kidney disease patients participated and were enrolled in this research. Kidney Disease Quality of Life-Short Form was selected and utilized to explore, examine, investigate, and describe the health associated quality of life. General Health Questionnaire (GHQ) was utilized and used to identify and determine the psychological distress. Results: revealed that most respondents 29.8% ratified poor or worse health. 63.29% participants extremely or strongly limited their physical activities.78.5% of respondents reduced duration of time on their work. 29.8% of the respondent’s emotional/physical health problems/troubles restricted or interfered with their social activities for most of the time. Only 24.3% of the study participants had positive emotional health for most of the time or often they felt relax, happy and cheerful. 48.1% of the respondents were somewhat/moderately satisfied about the support and aid taken or received from family and friends. Conclusion: In conclusion, we found a negative or poor health associated and related quality or attribute of life of chronic renal disorder.

Evaluation of Treatment of Unstable Distal Radial Fractures by External Fixator

Background: Distal radial fractures are very common in Orthopaedic practice but still there is no unanimity about its treatment. Objective: To evaluate the external fixator for the treatment of unstable distal radius fractures. Methods: This prospective observational study was carried out from January 2018 to December 2019 over a period of two years. Twenty-five consecutive patients of both sexes between the ages of 18 to 60 years with closed or open unstable distal radius fractures with or without intraarticular extension admitted in the Department of Orthopaedic Surgery, 250 Bedded General Hospital, Tangail & several private hospitals in Tangail & Dhaka city were selected. Patients with diabetes mellitus or chronic renal or hepatic disorder or extra-articular fractures or volar & dorsal shear injuries (Barton fractures) were excluded from this study. All the patients were evaluated thoroughly including distal neurovascular status and any associated injuries ruled out. Patients were operated as early as possible. But 4 cases were lost to follow up. Remaining 21 patients were followed up for at least 6 months and a maximum period of 12 months. Results: In this series mean age of the patient was 35.71±11.65 years and males (66.7%) were predominant than females (33.3%). In this series right side was involved in 13 patients (61.9%) and left side in 8 patients (38.1%). The mechanism of injury included road traffic accident 13 (61.9%), fall on slippery ground 7 (33.3%) and occupational accident 1 (4.8%). Six patients of this study (28.6%) had associated injury other than the local soft tissue injury. Most of the patients (66.7%) were operated on the day of admission, 2 patients (9.5%) were operated within 3 days and 5 patients (23.8%) were operated within 7 days. As per AO classification, majority (38.1%) injury was type C3 fracture followed by C1 (33.3%), C2 (14.3%), B1 (9.5%) and A3 (4.8%). According to functional outcome, satisfactory was 76.2% and according to anatomical outcome, satisfactory was 85.7%. Conclusion: According to this study finding satisfactory outcome was 76.2% (functional) and 85.7% (anatomical). J Shaheed Suhrawardy Med Coll 2021; 13(1): 20-25

Isolation and Identification of Acanthamoeba Strains From the Oral Cavity of Patients Undergoing Hemodialysis in Shahrekord County, the Southwest of Iran in 2018

Background and aims: Acanthamoeba spp. as opportunistic microorganisms are widespread in a wide range of environmental sources in the world and may cause severe diseases in immune-deficient patients. The aim of this study was to determine the prevalence and genotypes of Acanthamoeba spp. in hemodialysis patients in Shahrekord county of Chaharmahal and Bakhtiari province.Methods: In this cross-sectional study, 79 oral swabs were collected from the mouth of patients with chronic renal disorder undergoing hemodialysis from June to October 2018. The samples were then cultured on non-nutrient agar and examined by Giemsa staining, polymerase chain reaction (PCR), sequencing, and tolerance testing methods.Results: Morphological investigations indicated that 30.4% (24/79) of the subjects were infected with some free-living amoebae (FLA), and the PCR showed that only 3 samples contained Acanthamoeba spp. The sequencing of the latter samples demonstrated that these isolates belonged to T2 and T4 genotypes. After performing the assay tolerance test, 2 of these 3 isolates were related to T4 genotypes representing a high pathogenic potance.Conclusion: The infection of hemodialysis patients with some of Acanthamoeba spp. particularly, the T4 genotype should be considered important for these patients. Therefore, it is recommended that dialysis machines and dialysis units in hospitals be checked and disinfected periodically.

Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India.

Background Abdominal wall hernia is a common surgical entity worldwide with groin hernias having the most common presentation among them. They are a cause of morbidity and mortality if not addressed in time. A variety of surgical methods are available for the repair of hernias. The tension-free repair using synthetic mesh has the least recurrence and is the most accepted. Aim To describe the surgical burden and clinical profile of abdominal wall hernias as well as experiences in their management in a rural setup. Methods This was a retrospective observational study of all the cases of abdominal wall hernias presenting to various surgical divisions of Mahatma Gandhi Institute of Medical Sciences, Sevagram, during a two-year period from December 2011 to November 2013. Relevant details were collected from the hospital information statistics and patient file records and analysis of obtained data was done. Result A total of 910 out of 90,056 surgical outpatients (10.10%) seen during this period had abdominal wall hernias; 816 (89.67%) got operated. A total of 163 (20%) of 816 were operated in an emergency. Groin hernias were the most common 653 (80%), followed by incisional 82 (10%), umbilical and paraumbilical 41 (5%), epigastric 33 (4%), and rarer hernias in 8 (1%). Of 816 operations, 24 (2.9%) had recurrent hernias and 83 (10.17%) were pediatric patients. Male to female ratio was 9:1 in adults and 4:1 in children. The median age among adults was 49 years (range: 14–95 years), and among the pediatric age group, it was 7 years (range: 3 months–14 years). The majority of the adult patients were from a low-income group and presented more than 2 years after symptoms appeared. Comorbid conditions encountered were hypertension in 212 (26%), diabetes in 155 (19%), chronic airway disorders in 449 (55%), cardiac problems in 163 (20%), obesity in 10 (1.2%), and chronic renal failure and liver disorder in 82 (1%). Predisposing factors in the majority of the patients were chronic cough 449 (55%), prostatic problems in 187 (23%), chronic constipation in 163 (20%), previous surgeries in 82 (10%), obesity in 10 (1.2%), and ascites in 9 (0.1%). Hernia surgery was performed laparoscopically in 51 (6.25%) patients. Simultaneous other surgeries were performed in 130 (16%) patients. Mortality occurred in 2 (0.24%) patients operated in emergency, and chief morbidity was due to wound infection in 25 (3%) and chronic pain in 30 (3.9%) patients. Conclusion Abdominal wall hernias are common clinical entities. Although the pattern of presentation and management is similar, the challenges faced in a rural setup are due to ignorance, social inhibitions, and financial restraints, leading to delayed presentations which increase their morbidity and mortality. Health programs and surveys to increase awareness in rural areas as well as cutting down on expenses could help these patients.

Prediction of Diagnosing Chronic Kidney Disease using Machine Learning: Classification Algorithms

Chronic Kidney Disease is a very dangerous health problem that has been spreading as well as growing due to diversification in life style such as food habits, changes in the atmosphere, etc. The branch of biosciences has progressive to a bigger extent and has bring out huge amounts of data from Electronic Health Records. The primary aim of this paper is to classify using various Classification techniques like Logistic Regression (LR), K-Nearest Neighbor (KNN) Classifier, Decision Tree Classifier Tree, Random Forest Classifier, Support Vector Machine (SVM), and SGD Classifier. According to the health statistics of India 63538 cases has been registered on chronic renal disorder. Average age of men and women susceptible to renal disorders occurs within the range of 48 to 70 years.

Pediatric Nephrotic Syndrome; Clinical Characteristics and Nutritional Status

Nephrotic syndrome (NS), is the most common chronic renal disorder in children, with multifactorial risk factors and complex etiology. Therefore, the aim of the present study was to determine the age and gender distribution and also determine the clinical characteristics and nutritional status of pediatric nephrotic syndrome. A total of 75 patients with nephrotic syndrome series were selected through semi-constructed questionnaires. The age of our subjects ranged between 1-18 years. Body weight and height were extracted from patient files or self-reported to calculate BMI percentile. Laboratory tests such as blood glucose, lipid profile vitamin D, and HbA1C were included. All samples were analyzed through either mean ±SEM or Chi-square for determining significant differences. The present study showed that 75 patients were diagnosed as nephrotic syndrome. The average age of patients was 9 years old and the age which showed significance was 6-10 years (p=0.04). In comparison to females, males were highly significant (p=0.000). Blood biochemistry showed low levels of total protein, albumin, hemoglobin, HCT, MCV, WBC, (gran %), calcium and sodium, and high levels for lymphocyte (mid %), urea, creatinine, ESR, potassium, hematuria, serum cholesterol, TG and VLDL. All patients were diagnosed as idiopathic nephrotic syndrome. Low birth weight showed significant increase in nephrotic diseases (p<0.05). Nutritional indices showed high body weight status with more junk and nutritious foods consumed among nephrotic patients. The present study revealed that nephrotic syndrome significantly increased in males (p<0.05) and male to female ratio 2.6:1. It also showed that the age groups between 6-10 years are more prone to suffer from a nephrotic disease (p<0.05). A history of low birth weight in infants or child family ranking were shown to be risk factors contributing to nephrotic disease (p=0.000).

Regional variations in trajectories of long-term readmission rates among patients in England with heart failure

BackgroundWe aimed to compare the characteristics and types of heart failure (HF) patients termed “high-impact users”, with high long-term readmission rates, in different regions in England. This will allow clinical factors to be identified in areas with potentially poor quality of care.MethodsPatients with a primary diagnosis of heart failure (HF) in the period 2008–2009 were identified using nationally representative primary care data linked to national hospital data and followed up for 5 years. Group-based trajectory models and sequence analysis were applied to their readmissions.ResultsIn each of the 8 NHS England regions, multiple discrete groups were identified. All the regions had high-impact users. The group with an initially high readmission rate followed by a rapid decline in the rate ranged from 2.5 to 11.3% across the regions. The group with constantly high readmission rate compared with other groups ranged from 1.9 to 12.1%. Covariates that were commonly found to have an association with high-impact users among most of the regions were chronic respiratory disease, chronic renal disease, stroke, anaemia, mood disorder, and cardiac arrhythmia. Respiratory tract infection, urinary infection, cardiopulmonary signs and symptoms and exacerbation of heart failure were common causes in the sequences of readmissions among high-impact users in all regions.ConclusionThere is regional variation in England in readmission and mortality rates and in the proportions of HF patients who are high-impact users.

BEHAVIORAL PROBLEMS IN CHILDREN WITH STEROID-SENSITIVE NEPHROTIC SYNDROME: AN IGNORED ASPECT

Background: Nephrotic syndrome (NS) is a common chronic renal disorder in children. Oral glucocorticoids are required in high doses for prolonged periods adding to various comorbidities including psychosocial issues and behavioral problems. Objectives: This study was done to analyze the behavioral profile of children with steroid-sensitive NS (SSNS), also its association with other factors such as mothers’ education, socioeconomic status, and age distribution. Materials and Methods: This was a questionnaire (child behavior checklist)-based cross-sectional study conducted at a tertiary care center. Children from 6 to 15 years with diagnosis of SSNS for the duration of 1 year or more were included in the study. Cases were divided into two groups: Infrequent and frequent relapsing NS (IFRNS)/steroid-dependent NS (SDNS). Equal number of children in 6–15 years age group attending outpatient clinic was taken as controls. Results: Children with SSNS (n=161) had behavioral problems in significant percentage (39.13%) compared to the control group (8.75%). It was observed more in boys (73.02%) who had more hyperactive, aggressive behavior, and externalizing problems. Internalizing problems (anxious/depressed, withdrawn/depressed, and somatic complaints) were significantly more in the study group (17.39%) as compared to none in the control group. Children with FRNS/SDNS course had more significant problems compared to relapse IFRNS group. Age distribution, socioeconomic status, and mother’s education had no significant effect on its occurrence. Conclusion: Significant behavioral problems are observed in children with SSNS and are related to the type of SSNS.

Free radical-induced nephrotoxicity following repeated oral exposureto chlorpyrifos alone and in conjunction with fluoride in rats.

Chronic renal disorder is becoming a major health problem worldwide. The purpose of the present study was to investigate alterations in the renal antioxidant system in rats induced by repeated exposure to chlorpyrifos (CPF) alone and in conjunction with fluoride. Wistar rats were randomly allocated to seven groups, each consisting of six rats, and were subjected to different treatment regiments for 28 days. Significant increases (P < 0.05) in plasma protein, blood urea nitrogen, and creatinine levels indicated alterations in renal functions on repeated exposure to CPF or fluoride; moreover, these changes were more pronounced in animals exposed to both toxicants concurrently. A significant increase (P < 0.05) in malondialdehyde levels and decreases in superoxide dismutase, catalase, and glutathione peroxidase activities in renal tissue were noted, indicating renal damage on exposure to CPF, fluoride, or the combination of those. Our observations suggested that the concurrent exposure to CPF and fluoride increased the extent of renal damage. These findings indicate that this damage is due to increased free radical formation and a reduced function of the antioxidant system in renal tissue. Thus, the application of CPF as an insecticide should be reduced in areas where the fluoride levels in ground waters are high in order to minimize renal damage in exposed populations.

A 13-Month-Old With Xanthogranulomatous Pyelonephritis With Features of Renal Malakoplakia.

Xanthogranulomatous pyelonephritis is an uncommon chronic inflammatory renal disorder caused by chronic infection with gram-negative bacteria leading to destruction of the renal parenchyma and replacement with foamy lipid-laden macrophages. Renal malakoplakia is another rare form of chronic inflammatory granulomatous disease in the kidney associated with infection usually occurring in adults with immunocompromised status or debilitating disease. It is hallmarked by the finding of foamy histiocytes with distinctive basophilic inclusions (Michaelis-Gutmann bodies). We present a case of a 13-month-old male with history of congenital hydronephrosis who presented with clinical and radiologic findings suggestive of xanthogranulomatous pyelonephritis. However, further pathologic studies revealed the presence of Michaelis-Gutmann bodies, which are pathognomonic for renal malakoplakia. With this case we hope to bring further evidence to support that these two conditions are not mutually exclusive but rather represent two pathologic processes on the same disease spectrum.

Healthcare use and prescription of opioids in rural residents with pain

Chronic pain is a major public health problem. Increased healthcare utilization by individuals with pain puts enormous burden on financial and health resources. There is extremely limited understanding of psychosocial factors that affect healthcare use and prescription of opioids in individuals who experience heightened healthcare disparities associated with being African-American, having low income, and with rural residency. Health disparities research indicates that rural residency and low socioeconomic status are associated with greater self-reported pain levels. It is logical to expect then that this would be associated with increased needs for health services. However, at the same time, these very variables function as barriers in accessing health care. This disparity between greater need and limited access in turn creates greater distress. Further complicating the picture is the rapidly emerging concern about the misuse of prescription opioids in rural areas. As a result, empirical inquiry has started focusing on the variables influencing the likelihood of receiving opioid prescriptions in rural areas. The understanding of psychosocial factors affecting healthcare use and prescription of opioids in individuals who experience heightened healthcare disparities associated with being African-American, low-income, and living in rural areas remains extremely limited. The primary aim of this study was to examine the demographic and psychosocial variables that affect health services use in a rural, low-income population with chronic pain. Secondarily, the influence of these same variables on receiving prescription for opioids was examined. Healthcare use during a 3 month period, prescription analgesics, as well as medical comorbidities were obtained from the medical records of 64 patients with chronic pain. The participants were enrolling in an upcoming psychosocial intervention offered at two rural federally qualified health centers in a south-eastern state in the USA. For the present study, these participants consented to have their medical records reviewed for the 3 months prior to beginning the intervention protocol. Additionally, the pre-treatment (baseline) assessments were used in the present analyses. Demographic information, including age, sex, and education level, as well as measures of pain intensity, depressive symptoms, pain-related disability, and pain catastrophizing were collected. The participants were rural residents in medically underserved counties, primarily female (73.4%) and African-American (67.2%), and approximately 77% reported annual household income of less than $13,000. A majority had medical comorbidities, including diabetes mellitus (46.89%), cardiovascular disorders (29.7%), chronic renal disorder (14.1%), and asthma (6.3%). Approximately 30% had a diagnosis of depression. Demographic variables such as age, sex, and ethnicity did not influence the healthcare use or prescription of opioids. Depressive symptoms uniquely influenced health services use, with higher scores predicting greater health services utilization. In addition, those with a diagnosis of depression (per medical records) and those with a higher number of medical comorbidities were more likely to receive prescription opioids. This study adds to the current understanding of the factors affecting healthcare use and prescription of opioids in low-income individuals living in rural areas with chronic pain receiving treatment at federally qualified health centers. Since healthcare use was predicted by depressive symptoms and the prescription of opioids by a clinical diagnosis of depression, screening for depression is advised as part of the standard care of patients with pain, ideally with follow-up assessments and treatment of depression as necessary. Furthermore, making psychosocial interventions more available at rural healthcare centers may help in lowering psychological distress, which may have the ultimate effect of reducing opioid prescriptions for this subset of patients.

Ang II induce kidney damage by recruiting inflammatory cells and up regulates PPAR gamma and Renin 1 gene: effect of β carotene on chronic renal damage

Antioxidants are widely used for prevention of diseases associated with oxidative stress and ischemic disorder. We investigated the hypothesis of antioxidants (α-tocopherol and β-carotene) can suppress the renal disorder in apo E-/-mice. Renal damage induced by chronic infusion of Angiotensin II (Ang II) into 4month old male apo E-/-mice. After that the mice were treated with diet enriched α tocopherol and β carotene (800mg/kg) for 150days. Ang II treated kidney showed polycystic appearance with accumulation of clear fluid and constriction of renal artery and renal vein was noticed. Vacuolar/cystic degeneration as well as inflammatory reactions was noticed in the tubules/glomerulus of Ang II treated mice. β carotene treated mice showed enormous numbers of regenerated tubules in the kidney and over expression of ICAM proteins in the regenerated tubules. CD 45.2, MAC 3 proteins were over expressed in the inflammatory cells infiltrated into the tubular region of Ang II treated kidney. Gene expression studies revealed up regulation of Renin 1 (Ren 1) and PPARγ genes in the kidney of Ang II treated animals, but the β carotene treatment controlled the expression of these genes in the regenerated kidneys. β carotene may have protective effective on chronic renal disorder. It may repress the inflammatory genes (Ren 1, PPARγ) to achieve the protective effect on Ang II induced renal damage.

Chronic Renal Disorder after a Nuclear Crisis: A Brief Review

A present global public health concern is the adverse effect from nuclear leakage crisis in Japan. Based on the previous data on a previous famous nuclear crisis, Chernobyl crisis, the chronic renal disorder in affected population is an interesting topic in nephrology. Here, the author briefly reviews and discusses on the chronic renal disorder and nuclear denotation. Disturbance to the renal cell, alteration of renal function, and disorder of nephrological system in offsprings of exposed subjects are the three main focused topics.

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

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.

Erythropoietin-Producing Cells in the Liver of ICR-Derived Glomerulonephritis (ICGN) Mice

The ICR-derived glomerulonephritis (ICGN) mouse is an appropriate model for anemia associated with chronic renal disorder (CRD). Insufficient renal production of erythropoietin (EPO) induces the anemia associated with CRD. EPO mRNA is expressed in both kidneys and liver of progressing-stage ICGN mice. Hypoxic stimulation induced the EPO mRNA expression in the liver as well as in the kidneys of ICGN mice. The localization of EPO-producing cells in the liver remains controversial. Present study using an amplified in situ hybridization technique identified that nonparenchymal cells were the source of hepatic EPO production in ICGN mice under both normoxia and hypoxia.