肾脏病学与治疗学杂志

The nephron numbers individually varies in various mammalian species. In any renal diseases with reduced nephron mass, nephrons never regenerate because mature kidneys already lose their stem cells. Recently it has been reported that birth weight is related to nephron mass. The low birth weight leads to reduced nephron numbers and high risks for chronic kidney disease (CKD). Thus, the pathogenesis of CKD caused by nephron reduction is thought to be important for prognosis of such CKD patients. So we focused on hypoplastic kidney (HPK) with 80% nephron reduction in affected rats of HGNII strain. The affected HPK rats have a loss-of-function mutation on the gene encoding a microtubule-associated protein, Astrin. Although it has been reported that Astrin is required for mitotic progression in HeLa cells, in vivo function of Astrin especially in renal development and its’ involvement to renal diseases have not yet been established. Based on our previous reports (NDT 2005; 20: 1362-9, Pediatric Nephrol 2006; 21: 637- 42, Congenit Anom (Kyoto) 2007; 47: 34-44), we have hypothesized that the defect of Astrin might be related with development and prognosis of CKD. In the present study, we immunohistologically examined the progression of CKD in HPK rats at 5-30 weeks of age. In HPK rats at 5 weeks of age, the glomerulus already hypertrophied and exhibited infiltration of macrophages, increased TGF-β and fibronectin levels and desquamation of podocytes (discontinuity of podocin staining in glomerulus). In affected glomerulus at 20 weeks of age afterward, we found high levels of PDGF and its receptor, increases of mesangial cells and extracellular matrixes (ECMs) including collagen type 1, collagen type 4 and fibronectin and epithelial-mesenchymal transition in Bowman’s capsule. In the interstitium of HPK, we found increases of PDGF receptor β-positive fibroblasts at all week’s examined and α-SMA positive myofibroblasts after 10 weeks afterwards, indicating the transition from fibroblast to myofibroblast. Then we observed age-related accumulation of ECMs with increased levels of PDGF. Consisting with these changes, we observed hematological symptoms of renal dysfunction with age-related deterioration. These results suggested that congenital 80% nephron reduction due to loss of Astrin results in progressive renal fibrosis and glomerulosclerosis and that genetic abnormality of Astrin is one of the possible risk factors for CKD. Recently, it has been reported that Astrin is a negative mTOR regulator of stress response in HeLa cells (Cell 2013; 154: 859-74). We will discuss the possibility that Astrinis related with embryonic pathogenesis of HPK.

Nephrotic syndrome is a non-specific kidney disorder characterized by a number of signs of disease: Proteinuria, hypoalbuminemia and edema. It is characterized by an increase in permeability of the capillary walls of the glomerulus leading to the presence of high levels of protein in the urine. NPHS2 is encoding Podocin an important protein in renal filtration function. Analysis of the genetic variation that can alter the expression and the function of the NPHS2 gene was done using computational methods. Genomic analysis of NPHS1 was initiated By Sift and Polyphen-2 servers and yielded 18 mutations to be damaging, the mutant amino acids biophysical characteristics and multiple sequence alignment were demonstrated to be affecting the protein function using Align- GVGD and Panther platforms. 11 mutations affected protein function the most. Genetic co-expression profile and interactions were demonstrated by GeneMANIA server and NPHS2 is found to be co-expressed with a neuronal protein, 3D structure molding was done using Phyre2 and Chimera. Computational methods yield accurate results which can be a basis of diagnosis of steroid resistant nephrotic syndrome.

Not at all like investigations of resistance following liver transplantation where the paces of operational resilience are fundamentally higher than kidney and the drawn out results of dismissal following immunosuppressive medication decrease or withdrawal restricted with the brief determination and renewed introduction of more escalated immunosuppression, it is commonly believed that unconstrained resistance following kidney transplantation is an uncommon occasion and that scenes of dismissal related with drug withdrawal liable to bargain long haul join capacity and endurance. Along these lines without approved biomarkers of operational resistance most in the field trust it is risky to deliberately pull out immunosuppression except if incited by a clinical sign. Understanding that there were uncommon patients who had stopped all immunosuppression and kept on showing steady, great capacity of the relocated kidney and had subsequently effectively expected the danger independently we picked an examination plan that tried to recognize kidney relocate beneficiaries who had recently halted all immunosuppression. Recognized patients who consented to partake gave segment and clinical information just as natural examples for robotic examines. At the point when possible, only in the setting of living contributor kidney transplantation, endeavors were made to likewise acquire giver cells for extra unthinking tests. Following enlistment subjects went through testing to evaluate renal capacity (serum creatinine and estimation of eGFR), allograft injury (proteinuria and allograft biopsy), alloimmunity (cell measures of insusceptibility and screening for DSA), and more broad investigations to decide the aggregate of fringe platelets by stream cytometry just as quality articulation profiles of fringe platelets (quality cluster and QT-PCR) and shed urinary epithelial cells (QT-PCR). Information and organic examples were acquired from a few extra companions with the end goal of examination.

Therapeutic management of obesity includes exercise, a balanced diet, and healthy living habits. In addition, acupuncture can also be used as an adjunctive treatment for obesity. Acupuncture therapy in body weight reduction (BWR) in obese patients is approved. But there are more effects than BWR. This therapy is affecting glucose metabolism which is measurable with HbA1c levels before and after the acupuncture therapy for obesity, periodically. The novel study is reduction on HbA1c levels on patients coming for weight loss therapy in acupuncture clinic. Weight, BMI and HbA1c levels were measured both before and after the full course of acupuncture treatments for comparison. Comorbid conditions that influence the development of obesity such as diabetes, age and postmenopausal state were reviewed. Results confer reductions in weight, BMI and HbA1clevels after 20 sessions acupuncture therapy for obesity.

At the beginning it should be accentuated that few components of the investigation configuration made apparent or genuine restrictions in concerning the examinations' decisions. The main potential restriction emerges from the nonattendance of a genuine benchmark group. Not at all like investigations of resilience acted in the research center where it is conceivable to plan a benchmark group that copies the test bunch in with or without significant factors from the treatment used to initiate resistance or the lenient state itself, this isn't doable in the clinical setting. In this current gathering's original investigation of quality articulation profiles in suddenly open minded kidney relocate beneficiaries they decided to utilize subjects with ongoing dismissal, which they characterized as insusceptible interceded kidney allograft disappointment with re-visitation of dialysis and end of immunosuppression as their essential benchmark group. This decision probably adds to contrasts between huge numbers of the discoveries in this investigation and ensuing examinations by this or different gatherings where the essential correlation of open minded subjects was to those with stable renal allograft work getting customary immunosuppression. In planning the ITN study convention a few correlation bunches were thought of. In fact various partners that could be considered as a fitting correlation for at least one factors were selected incorporating subjects with stable capacity while accepting ordinary immunosuppression, subjects getting customary immunosuppression who based on clinical highlights and biopsy discoveries were resolved to have alloimmune-intervened join injury, patients with stable capacity while getting corticosteroid monotherapy, beneficiaries of kidneys from an indistinguishable twin contributor, and solid volunteers.

Background & Aims: Adult’s kidneys tumor classification expands rapidly with new categories which are including recently being incorporated tumors also. Mixed epithelial stromal tumor of the kidney (MESTs) was recently described and unusual entity. This rare complex renal neoplasm composed of a mixture of cystic and solid components. Although mesoblastic nephroma mostly detected in during the first few weeks of life, the first case of adult mesoblastic nephroma which was grossly and microscopically similar to congenital mesoblastic nephroma was described in 1973. These tumors also termed as benign mixed epithelial and stromal tumor (MESTs) by Michal and Syrucek in 1998. Since then, it has been reported with different names which are leiomiyomatous renal hamartoma, adult type congenital mesoblastic nephroma, adult metanephric stromal tumor, cystic hamartoma of renal pelvis, solitary multilocular cysts of the kidney and multilocular renal cyst with mullerian-like stroma. Herein, we report unusual tumor of the kidney which abundant stroma and devoid of epithelial component. Patient & Methods: A 22-year old female presented with a palpable right-sided abdominal mass and microscopic hematuria. She had no history of hypertension and all laboratory values were normal. A 15 cm heterogenous solid, right renal mass which was displacing the renal parenchyma revealed by contrast-enhanced CT scan without adenopathies Renal mass was also confirmed by MR imaging and there was marked displacement of the inferior vena cava without tumoral infiltration. Results: We performed open right radical nephrectomy. Gross examination revealed a large, tan-gray solid mass, compressing the adjacent renal parenchyma. On the cut surface, an encapsulated tan-gray renal mass with 14x13x12 cm in dimension was detected. There was no any cystic change and it had completely solid appearance. Microscopic examination revealed a well-circumscribed mesenchymal tumor consisting of mostly intersecting fascicles of spindle cells with abundant intercellular collagen. The lesion also focally consisted of hypocellular areas with myxoid changes. The lesion was devoid of epithelial component and tubule or gland like epithelial structures within the Müllerian stroma at periphery of the tumor. The final pathologic diagnosis was adult mesoblastic nephroma with no atypical features. Convalescence was uneventful and she was discharged 4th day of the surgery. The patient was free of disease on the 18-months follow-up examination. Conclusions: (MEST) is a rare neoplasm of the kidney. 25% of the subjects were detected incidentally and they consist 0.20 to 0.28 percent of renal tumors. The main differential diagnosis of (MEST) is renal cell carcinoma. For accurate diagnosis, histopathologic examination is a gold standard.

Computational Collaborative Healthcare data analytics is a method of methodical data analysis that allows healthcare specialists to discovery opportunities used for development in health system management processing the various information are stored. This proposed approach entails three parts comparable to preprocessing, attribute selection, classification algorithms. The goal of this work is to plan a machine-based diagnostic approach using machine learning technique. This method is developed to mining the risk factors of chronic kidney diseases. In this work, Random forest, SVM C5.0, Decision Tree, C4.5 and ANN algorithms were used to identify an early diagnosis of CKD patients. This work comparing other algorithms the best for Random forest algorithm with good accuracy and less time complexity.