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Karel Decaestecker, Benjamin Van Parys, Jeroen Van Besien, Nicolas Doumerc, Liesbeth Desender, Caren Randon, Frederic De Ryck, Thomas Tailly, Matthias Beysens, Carl Van Haute, Diederik Ponette, Kathia De Man, Piet Hoebeke, Frank Vermassen
BACKGROUND: Kidney autotransplantation (KAT) is the ultimate way to salvage kidneys with complex renovascular, ureteral, or malignant pathologies that are not amenable to in situ reconstruction. A minimally invasive approach could broaden its adoption. OBJECTIVE: To describe operative technique, perioperative complications, and early functional outcomes of robot-assisted kidney autotransplantation (RAKAT). DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of prospectively collected data regarding consecutive patients undergoing RAKAT between March 2017 and February 2018 at two university hospitals...
August 6, 2018: European Urology Focus
Jun-Li Tsai, Shang-Feng Tsai
Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes...
July 31, 2018: Experimental and Clinical Transplantation
Aspasia I Tzani, Ilias P Doulamis, Panagiotis S Konstantopoulos, Ermioni D Pasiou, Afrodite Daskalopoulou, Dimitrios C Iliopoulos, Ioannis V Georgiadis, Nikolaos Kavantzas, Stavros K Kourkoulis, Despina N Perrea
Chios mastic gum (CMG) exerts robust anti-inflammatory and antioxidant properties and it affects pathways that are implicated in the pathophysiology of endothelial and vascular inflammation. Aim of this study was to test the hypothesis that CMG administration lowers blood pressure (BP) and improves hypertension-induced target organ damage. 2-kidney, 1-clip (2K1C) hypertensive rats were treated with CMG (40 mg/kg body weight/day) for 2-weeks after the establishment of hypertension. Acute CMG administration lowered systolic, diastolic and mean arterial BP, while these hemodynamic effects were sustained throughout the 2-week administration period...
September 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Maria Florencia Albertoni Borghese, Sandra Hope, Maria Del Carmen Ortiz, Magalí Barchuk, Camila Kessler, Carlos Davio, Marcelo Vatta, Mónica Majowicz
AIMS: The aim of the present study was to evaluate the regulation of Aquaporin-2 (AQP2) water channel in the kidney of one-kidney, one-clip rats (Goldblatt-1 model). In addition, some mechanisms that underlie the role of AQP2 in the Goldblatt-1 model were evaluated. MAIN METHODS: Sprague-Dawley rats were divided in three groups: control two-kidney, no clip (C, 2 K-NC); nephrectomized one-kidney, no clip (N, 1 K-NC) and Goldblatt one-kidney, one-clip (G, 1 K-1C)...
July 13, 2018: Life Sciences
A Gromotowicz-Poplawska, A Stankiewicz, J Mikita, M Aleksiejczuk, N Marcinczyk, J Szemraj, E Chabielska
A strong correlation between raised aldosterone levels and increased risk of thrombotic disorders has been provided. Clinical studies have demonstrated the benefits of the addition of the aldosterone receptor antagonist to the standard therapy with angiotensin-converting enzyme inhibitor in the reduction of cardiovascular events in patients. We suggest that the benefits of this dual renin-angiotensin-aldosterone system (RAAS) blockade may be related to the drug's effects on the hemostatic and oxidative balance...
April 2018: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Rui Tan, You Mee Ahn, Hye Yoom Kim, Yun Jung Lee, Kyung Woo Cho, Dae Gill Kang, Ho Sub Lee
The change of the secretion of atrial natriuretic peptide (ANP) from the atria is to be defined in hypertension accompanied by ventricular hypertrophy and increased synthesis of ANP. To identify the change of the secretion and mechanisms involved, experiments were performed in isolated perfused beating atria from sham-operated normotensive and renovascular hypertensive rats. Expressions of ANP, natriuretic peptide receptor (NPR)-C, components of the renin-angiotensin system (RAS) and muscarinic signaling pathway were measured in cardiac tissues...
July 6, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Matthew W Harer, Alison L Kent
Hypertension is encountered in up to 3% of neonates and occurs more frequently in neonates requiring hospitalization in the neonatal intensive care unit (NICU) than in neonates in newborn nurseries or outpatient clinics. Former NICU neonates are at higher risk of hypertension secondary to invasive procedures and disease-related comorbidities. Accurate measurement of blood pressure (BP) remains challenging, but new standardized methods result in less measurement error. Multiple factors contribute to the rapidly changing BP of a neonate: gestational age, postmenstrual age (PMA), birth weight, and maternal factors are the most significant contributors...
July 5, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Alfonso Eirin, Xiang-Yang Zhu, Sreela Jonnada, Amir Lerman, Andre J van Wijnen, Lilach O Lerman
BACKGROUND: Extracellular vesicles (EVs) released from mesenchymal stem/stromal cells (MSCs) mediate their paracrine effect, but their efficacy to protect the microcirculation of the kidney is unknown. Using a novel swine model of unilateral renovascular disease (RVD) complicated by metabolic syndrome (MetS), we tested the hypothesis that EVs would attenuate renal microvascular loss. METHODS: Four groups of pigs ( n = 7 each) were studied after 16 weeks of diet-induced MetS and RVD (MetS+RVD), MetS+RVD treated 4 weeks earlier with a single intra-renal delivery of EVs harvested from autologous adipose tissue-derived MSCs, and Lean and MetS Sham controls...
January 1, 2018: Cell Transplantation
Gonzalo I Gómez, Victoria Velarde
Boldine, a major aporphine alkaloid found in the Chilean boldo tree, is a potent antioxidant. Oxidative stress plays a detrimental role in the pathogenesis of kidney damage in renovascular hypertension (RVH). The activation of the renin-angiotensin system (RAS) is crucial to the development and progression of hypertensive renal damage and TGF-β is closely associated with the activation of RAS. In the present study, we assessed the effect of boldine on the progression of kidney disease using the 2K1C hypertension model and identifying mediators in the RAS, such as TGF-β, that could be modulated by this alkaloid...
June 25, 2018: International Journal of Molecular Sciences
Irina Iuliana Costache, Claudia Florida Costea, Vasile Fotea, Victor Laurian Rusu, Viviana Aursulesei, Razan Al Namat, Dan Alexandru Costache, Nicoleta Dumitrescu, Cătălin Mihai Buzdugă, Gabriela Florenţa Dumitrescu, Anca Sava, Camelia Margareta Bogdănici
Resistant hypertension is defined by the inability to maintain within normal limits the blood pressure values of an individual, while he is under treatment with maximal tolerated doses of three antihypertensive agents. One of the most common types of resistant hypertension is renovascular hypertension (RVH), which is caused by the narrowing of the renal arteries, in the context of existing atherosclerotic plaques at that level. We are presenting the case of a hypertensive 56-year-old man admitted in the Clinic of Cardiology for a sudden rise of his blood pressure values, despite undergoing the scheduled treatment...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Diana Vassallo, Robert N Foley, Philip A Kalra
Background: Risk stratification in atherosclerotic renovascular disease (ARVD) can influence treatment decisions and facilitate patient selection for revascularization. In this study, we aim to use variables with the best predictive value to design a risk calculator that can assist clinicians with risk stratification and outcome prediction. Methods: Patients with a radiological diagnosis of ARVD referred to our tertiary renal centre were recruited into this prospective cohort study between 1986 and 2014...
June 22, 2018: Nephrology, Dialysis, Transplantation
Maycon I O Milanez, Érika E Nishi, Alex Y S Sato, Henrique A Futuro Neto, Cássia T Bergamaschi, Ruy R Campos
The role of spinal cord neurons in renal sympathoexcitation remains unclear in renovascular hypertension, represented by the 2-kidney, 1-clip (2K1C) model. Thus, we aimed to assess the influence of spinal glutamatergic and AT1 angiotensin II receptors on renal sympathetic nerve activity (rSNA) in 2K1C Wistar rats. Hypertension was induced by clipping the renal artery with a silver clip. After six weeks, a catheter (PE-10) was inserted into the subarachnoid space and advanced to the T10-11 vertebral level in urethane-anaesthetized rats...
June 20, 2018: Brain Research
Zubair Khan, Sunit Tolia, Kumar Sanam, Gunjan Gholkar, Marc Zughaib, Sunil Naik, Marcel Zughaib
BACKGROUND: Renal artery (RA) stenosis has been implicated in the pathophysiological mechanism for resistant hypertension. Despite the increasingly diagnosed frequency of hemodynamically significant lesions, the value of RA revascularization remains controversial. Our group had previously demonstrated significant blood pressure (BP) reduction in a retrospective cohort of appropriately selected patients undergoing RA stenting up to 18-months of follow-up. We herein present long-term clinical outcomes data 5-years post revascularization on 26 subjects who continued follow-up at our institution...
June 20, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Nirmal K Onteddu, Zakaria Hindi, Gaurav Rajashekar, Sanjeeva P Kalva
The commonest site of primary dissection involving the visceral vessels is renal arteries; however, spontaneous bilateral renal artery dissection is an extremely rare entity. Spontaneous renal artery dissection (SRAD) is rarely a cause of renovascular hypertension. Segmental arterial mediolysis is a rare arteriopathy of unknown etiology which is a nonatherosclerotic and noninflammatory condition. We report a case of a 51-year-old male patient with spontaneous dissection of bilateral renal arteries with clinical, laboratory, and angiographic findings consistent with segmental artery mediolysis...
April 2018: Radiology Case Reports
Johanna Päivärinta, Niina Koivuviita, Vesa Oikonen, Hidehiro Iida, Kaisa Liukko, Ilkka Manner, Eliisa Löyttyniemi, Pirjo Nuutila, Kaj Metsärinne
BACKGROUND: Microvascular function plays an important role in ARVD (atherosclerotic renovascular disease). RFR (renal flow reserve), the capacity of renal vasculature to dilate, is known to reflect renal microvascular function. In this pilot study, we assessed PET (positron emission tomography)-based RFR values of healthy persons and renal artery stenosis patients. Seventeen patients with ARVD and eight healthy subjects were included in the study. Intravenous enalapril 1 mg was used as a vasodilatant, and the maximum response (blood pressure and RFR) to it was measured at 40 min...
June 11, 2018: EJNMMI Research
Daan J L van Twist, Pieter W M de Heer, Alfons J H M Houben, Michiel W de Haan, Peter W de Leeuw, Abraham A Kroon
OBJECTIVE: Fibromuscular dysplasia (FMD) can be classified in a multifocal and a unifocal subtype. As unifocal FMD generally leads to more severe hypertension at younger age, we hypothesized that renal hemodynamics are more disturbed in unifocal renal artery FMD as compared with multifocal FMD, leading to increased renin secretion. METHODS: We measured renal blood flow (Xenon washout method), renin secretion, and glomerular filtration rate per kidney in 101 patients with FMD (26 unifocal and 75 multifocal), all off medication and prior to balloon angioplasty...
August 2018: Journal of Hypertension
Norikazu Inamura, Masanori Sato
No abstract text is available yet for this article.
May 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Alynne Carvalho-Galvão, Danilo D A Gadelha, José L de Brito Alves, Barkat A Khan, Raul J H Castro-Gomez, Josiane C Cruz, Marciane Magnani, Valdir A Braga
This study was designed to investigate the effects of a newly synthesized carboxymethyl-glucan (CM-G) on blood pressure (BP), baroreflex sensitivity (BRS) and sympathetic vascular modulation in renovascular hypertensive rats. Male Wistar rats were divided into four groups: Sham ( n = 10); 2K1C (subjected to renal artery clipping to induce renovascular hypertension, n = 10); Sham + CM-G (treated with CM-G, n = 7) and 2K1C + CM-G (treated with CM-G, n = 7). The daily treatment with CM-G (40 mg/kg) was performed for 2 weeks...
2018: Frontiers in Physiology
Sonu Kashyap, Mazen Osman, Christopher M Ferguson, Meryl C Nath, Bhaskar Roy, Karen R Lien, Karl A Nath, Vesna D Garovic, Lilach O Lerman, Joseph P Grande
Inflammation plays an important role in the pathogenesis of renal and cardiovascular disease in renovascular hypertension (RVH). Ccl2 is an important mediator of inflammation, and is induced within 24 hours following surgery to establish RVH in the murine 2 kidney 1 clip model, a time prior to onset of interstitial inflammation, fibrosis, or tubular atrophy. We tested the hypothesis that Ccl2 deficiency protects the stenotic kidney (STK) from development of chronic renal damage in mice with renovascular hypertension due to renal artery stenosis (RAS)...
June 5, 2018: Scientific Reports
Robert Louis, Daniella Levy-Erez, Anne Marie Cahill, Kevin E Meyers
BACKGROUND: Fibromuscular dysplasia (FMD) is a non-inflammatory vascular disease that in children unlike in adults shows no sex predilection. FMD is often underdiagnosed, and its pathophysiology is unclear. Delayed diagnosis may lead to refractory hypertension and decreases the chance of successful treatment. Doppler ultrasound (US), magnetic resonance angiography (MRA), computed tomography angiography (CTA), and catheter-based angiography (angiography) are currently used to help make a clinicoradiological diagnosis of FMD...
September 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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