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Will W Minuth
In healthy newborn babies, nephrogenesis proceeds unnoticed until birth. With start of the perinatal period, morphogenetic activity in the renal outer cortex consisting of an inner maturation zone and an outer nephrogenic zone is downregulated by unknown signals. One of the results is that the entire nephrogenic zone as well as the contained progenitor cells and niches disintegrate. In contrast, a too early inactivation of the nephrogenic zone takes place in the kidneys of preterm and low birth weight babies...
October 18, 2018: Cell and Tissue Research
Krithika Hariharan, Harald Stachelscheid, Bella Rossbach, Su-Jun Oh, Nancy Mah, Kai Schmidt-Ott, Andreas Kurtz, Petra Reinke
Human pluripotent stem cells (hPSCs) provide a source for the generation of defined kidney cells and renal organoids applicable in regenerative medicine, disease modeling, and drug screening. These applications require the provision of hPSC-derived renal cells by reproducible, scalable, and efficient methods. We established a chemically defined protocol by application of Activin A, BMP4, and Retinoic acid followed by GDNF, which steered hPSCs to the renal lineage and resulted in populations of SIX2+ /CITED1+ metanephric mesenchyme- (MM) and of HOXB7+ /GRHL2+ ureteric bud (UB)-like cells already by 6 days...
October 11, 2018: Cellular and Molecular Life Sciences: CMLS
Suchun Li, Miaojuan Qiu, Yonglun Kong, Xiaoduo Zhao, Hyo-Jung Choi, Maria Reich, Brady H Bunkelman, Qiaojuan Liu, Shan Hu, Mengke Han, Haixia Xie, Avi Z Rosenberg, Verena Keitel, Tae-Hwan Kwon, Moshe Levi, Chunling Li, Weidong Wang
BACKGROUND: The bile acid-activated receptors, including the membrane G protein-coupled receptor TGR5 and nuclear farnesoid X receptor (FXR), have roles in kidney diseases. In this study, we investigated the role of TGR5 in renal water handling and the underlying molecular mechanisms. METHODS: We used tubule suspensions of inner medullary collecting duct (IMCD) cells from rat kidneys to investigate the effect of TGR5 signaling on aquaporin-2 (AQP2) expression, and examined the in vivo effects of TGR5 in mice with lithium-induced nephrogenic diabetes insipidus (NDI) and Tgr5 knockout ( Tgr5 -/- ) mice...
October 10, 2018: Journal of the American Society of Nephrology: JASN
Nicolas Janus, Vincent Launay-Vacher, Gilbert Deray
The development of interventional radiology techniques regularly exposes patients to the potential renal toxocity of iodinated contrast media. Faced with this risk of nephrotoxicity, gadolinium-based contrast agents have long been considered as a safe alternative to iodinated contrast media, especially in sensitive or at risk patients. However, these gadolinium-based contrast agents are not devoid of nephrotoxicity and present another risk, a complication related to renal failure, the nephrogenic systemic fibrosis...
October 6, 2018: Néphrologie & Thérapeutique
Laura K Young, Shona Z Matthew, J Graeme Houston
OBJECTIVES: Recent safety concerns regarding gadolinium-based contrast agents (GdCAs) concluded with the suspension of some agents from the European market, yet a clinical consequence remains unknown. We used electronic health records to investigate the incidence of potential toxicity to gadoteric acid (Dotarem®) within our local population, including those with renal insufficiency (RI). METHODS: Data for patients who underwent contrast-enhanced MRI were identified, stratified by renal function at time of scan and retrospectively followed using routinely collected health data...
October 1, 2018: European Radiology
Stefanie Hardt, Lucie Valek, Jinyang Zeng-Brouwers, Annett Wilken-Schmitz, Liliana Schaefer, Irmgard Tegeder
Loss-of-function mutations of progranulin are associated with frontotemporal dementia in humans, and its deficiency in mice is a model for this disease but with normal life expectancy and mild cognitive decline on aging. The present study shows that aging progranulin deficient mice develop progressive polydipsia and polyuria under standard housing conditions starting at middle age (6-9 months). They showed high water licking behavior and doubling of the normal daily drinking volume, associated with increased daily urine output and a decrease of urine osmolality, all maintained during water restriction...
October 2018: Aging and Disease
Aoife Garrahy, Carla Moran, Christopher J Thompson
Central diabetes insipidus (CDI) is characterized by hypotonic polyuria due to impairment of AVP secretion from the posterior pituitary. In clinical practice, it needs to be distinguished from renal resistance to the antidiuretic effects of AVP (nephrogenic DI), and abnormalities of thirst appreciation (primary polydipsia). As nephrogenic diabetes insipidus is rare in adults, unless they are treated with lithium salts, the practical challenge is how to differentiate between CDI and clinical disorders of excess thirst...
September 30, 2018: Clinical Endocrinology
Waltraud Friesenbichler, Wolfgang Krizmanich, Karoly Lakatos, Andishe Attarbaschi, Michael Dworzak, Gabriele Amann, Rhoikos Furtwängler, Norbert Graf, Leo Kager
Although the fate of nephrogenic rests varies, they are known to be precursors of Wilms tumour. Thus, nephrogenic rests require adequate treatment to prevent malignant transformation. We added 13-cis retinoic acid to the standard chemotherapy with vincristine and actinomycin-D in two patients with bilateral nephrogenic rests/nephroblastomatosis. Patient 1 also had a history of Wilms tumour. 46 (patient 1) and 81 (patient 2) months after end of treatment, both patients show stable conditions with no signs of relapse or progressive disease...
September 27, 2018: Pediatric Hematology and Oncology
Y Zhang, K M Hansson, T Liu, K Magnell, Y Huang, N G Carlson, B K Kishore
AIM: Therapeutic use of lithium in bipolar disorder is limited by the development of nephrogenic diabetes insipidus (NDI). We reported that pharmacological blockade of P2Y12 receptor (R) with clopidogrel or prasugrel significantly ameliorated lithium-induced NDI in rodents. Using mice genetically lacking P2Y12 -R we evaluated whether the observed amelioration is mediated through P2Y12 -R. METHODS: P2ry12-/- mouse line (C57/BL6) was rederived from cryopreserved embryos of the knockout (KO) mice generated by Deltagen Inc...
September 26, 2018: Acta Physiologica
S T Jendrek, B Kahle, G Riemekasten
BACKGROUND: Systemic sclerosis (SSc) is characterized by heterogeneous clinical symptoms. Peripheral skin fibrosis can be a common symptom. Nevertheless, a variety of diseases with different etiologies are associated with a thickening of the skin and make the initial diagnosis of systemic sclerosis more difficult. OBJECTIVE: The different disease entities that can lead to dermal fibrosis should be differentiated. An earlier diagnosis of SSc would therefore be facilitated...
September 25, 2018: Zeitschrift Für Rheumatologie
Yoshito Tsushima, Kazuo Awai, Gen Shinoda, Hiroyuki Miyoshi, Masayuki Chosa, Toshiyuki Sunaya, Jan Endrikat
PURPOSE: To evaluate the safety of gadobutrol for magnetic resonance imaging in a prospective, non-interventional, post-marketing surveillance in Japan. MATERIALS AND METHODS: Gadobutrol was administered in accordance with Japanese prescribing information over a 2-year enrollment period, using a standardized questionnaire to collect information. The primary outcome was the incidence of adverse reactions (ARs) following gadobutrol injection. RESULTS: Questionnaire data were analyzed for 3337 patients (age, 58...
September 19, 2018: Japanese Journal of Radiology
Youbin Hu, Yongguang Zhang, Hua Wang, Yong Yin, Chunhua Cao, Jing Luo, Yunfei Wang
We aimed to investigate the clinical curative effect of percutaneous renal artery stent implantation (PTRAS) in the treatment of atherosclerotic renal artery stenosis (ARAS), and to analyze the factors influencing the curative effect of PTRAS. A total of 230 patients with unilateral or bilateral renal artery stenosis were retrospectively analyzed. According to whether adverse cardiogenic or nephrogenic events occurred, 230 patients were divided into two groups to analyze the risk factors of adverse cardiogenic or nephrogenic events...
September 2018: Experimental and Therapeutic Medicine
Val M Runge
The issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents...
October 2018: Investigative Radiology
Rodolphe Cabibel, Ludovic Gerard, Dominique Maiter, Vincent Collin, Philippe Hantson
Volatile anesthetic agents, such as sevoflurane, are increasingly used for long-term sedation in intensive care units worldwide, with improved clinical outcomes reported in recent studies due to favorable pharmacological properties. Despite possible renal toxicity related to the production of plasma inorganic fluoride and concerns related to reversible impairment of renal concentrating abilities, renal injury associated with sevoflurane sedation has rarely been reported in the intensive care unit setting. We hereby report 3 cases of nephrogenic diabetes insipidus associated with prolonged sevoflurane sedation using the AnaConDa device and review the possible mechanisms of renal toxicity...
August 16, 2018: A&A practice
Muhammad Abdullah Zain, Abbas Raza, Muhammad Owais Hanif, Zehra Tauqir, Maryam Khan, Muhammad J Mahboob, Fariha Ashraf, Waqas Javed Siddiqui, Hasan Arif, Larry E Krevolin
BACKGROUND Patients with malignancies often have electrolyte abnormalities. We present a case of a patient with central diabetes insipidus secondary to metastatic pituitary invasion complicated by hypercalcemic nephrogenic diabetes insipidus. CASE REPORT We present a case of 40-year-old female with a history of stage IV breast cancer with skeletal and leptomeningeal metastasis, who was admitted with polyuria, polydipsia, and recent onset of confusion. The patient was found to have profound hypernatremia and severe hypercalcemia with normal parathyroid and vitamin D serum levels...
August 18, 2018: American Journal of Case Reports
M Zhao, A X Wang, X Zhu, J J Yu, W Wang, D H Zhang, X L He, H Y He, X D Teng
Objective: To investigate the clinicopathologic and differential diagnostic features of glomus tumor of the kidney. Methods: Four cases of glomus tumor of the kidney were collected from the archives of Peking University Third Hospital, the Second Hospital of Tianjin Medical University, Ningbo Yinzhou Second Hospital and Zhejiang Provincial People's Hospital between January 2012 to June 2017; the clinical and radiologic features, histomorphology, immunohistochemistry, ultrastucture and prognosis were analyzed and the relevant literature was reviewed...
August 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
William Pedrosa, Juliana Beaudette Drummond, Beatriz Santana Soares, Antônio Ribeiro-Oliveira
OBJECTIVES: The water deprivation test (WDT) is widely used for the differential diagnosis of the polyuria-polydipsia syndrome (PPS). However, it is inconvenient and may not always be precise in differentiating partial forms of diabetes insipidus (DI) from primary polydipsia (PP). The aim of this study was to evaluate the results of a combined outpatient and inpatient overnight WDT protocol that included an overnight non-supervised period concerning its feasibility and safety. METHODS: Retrospective analysis of clinical data and laboratory results of 52 patients with PPS undergoing WDT in a single center was undertaken...
August 14, 2018: Endocrine Practice
Michael N Rozenfeld, Daniel J Podberesky
Gadolinium-based contrast agents (GBCAs) are widely used in medical imaging, with greater than 300 million doses administered since their introduction. The risk of adverse reactions is very low, and GBCAs were thought to be very safe until the discovery of nephrogenic systemic fibrosis (NSF). Since that time, gadolinium has been found to deposit throughout the body, including the brain, where it is visible on non-contrast T1-weighted MR images in people with normal renal function. The clinical effects of this deposition remain unknown and may not exist...
August 2018: Pediatric Radiology
Noriko Namatame-Ohta, Shuntaro Morikawa, Akie Nakamura, Kumihiro Matsuo, Masahide Nakajima, Kazuhiro Tomizawa, Yusuke Tanahashi, Toshihiro Tajima
Almost 90% of nephrogenic diabetes insipidus (NDI) is caused by mutations in the arginine vasopressin receptor 2 gene ( AVPR2 ) on the X chromosome. Herein, we reported clinical and biochemical parameters in four cases of three unrelated Japanese families and analyzed the status of the AVPR2. Two of the four patients had poor weight gain. However, in the male and female sibling cases, neither had poor weight gain while toddlers, but in the male sibling, episodes of recurrent fever, polyuria, and polydipsia led to the diagnosis of NDI at 4 years of age...
2018: Case Reports in Pediatrics
Wiebke Fenske, Julie Refardt, Irina Chifu, Ingeborg Schnyder, Bettina Winzeler, Juliana Drummond, Antônio Ribeiro-Oliveira, Tilman Drescher, Stefan Bilz, Deborah R Vogt, Uwe Malzahn, Matthias Kroiss, Emanuel Christ, Christoph Henzen, Stefan Fischli, Anke Tönjes, Beat Mueller, Jochen Schopohl, Jörg Flitsch, Georg Brabant, Martin Fassnacht, Mirjam Christ-Crain
BACKGROUND: The indirect water-deprivation test is the current reference standard for the diagnosis of diabetes insipidus. However, it is technically cumbersome to administer, and the results are often inaccurate. The current study compared the indirect water-deprivation test with direct detection of plasma copeptin, a precursor-derived surrogate of arginine vasopressin. METHODS: From 2013 to 2017, we recruited 156 patients with hypotonic polyuria at 11 medical centers to undergo both water-deprivation and hypertonic saline infusion tests...
August 2, 2018: New England Journal of Medicine
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