Ultrasonographic Characteristics of Diabetes Impacts in Kidneys’ Morphology

A total sample size consisting of 150 Diabetic male patients has been investigated by ultrasound system General Electric using gray-scale B-mode imaging with curvilinear transducer 3 MHz to assess the impact of diabetes in kidney morphology and it is distributed in Sudan. The collected data were the patient age, height, weight, kidneys size, ultrasound findings of involved kidneys, and duration of diabetes and residence region. The analyzed data show that the diabetes has been as endemic disease in central Sudan (Khartoum & Jazeera) representing 55% and in the west of Sudan representing 38%. The BMI of diabetic patients has been significantly (R2 = 0.6) decreasing following aging. The kidney size increases significantly as R2 = 0.75 and 0.6 for left and right kidney respectively. Their correlation is fitted in the following equations: y = 3.95x + 27.26 and y = 2.41x + 35.12 for the left and right kidney respectively. The impact of duration was a reduction in size significantly as R2 = 0.61 and 0.55 with a correlation fitted in the following equations: y = –2.22x + 139.9 and y = –1.51x + 96.59 for the left and right kidney respectively. The mean kidney length was (14.5 cm) and the renal cortex in the range of 2 - 2.3 cm, the kidneys size were so enlarged as 92.4 ± 11.7 and 121 ± 17.1 for the right and left kidney respectively while in late case of Diabetes, the kidney is more echogenic, atrophied size with loss of corticomedullary differentiation.

Post COVID-19 infection:Long-term effects on liver and kidneys

Coronavirus disease 2019 is a pandemic,which has affected millions of people across the globe in the year 2020.This disease is caused by a virus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),that belongs to the family of coronaviruses and primarily affects the respiratory system.This infection has a wide spectrum of clinical manifestations ranging from asymptomatic form to mild,moderate and severe forms depending upon the age,comorbidity and immunity of an affected individual.Hyper-inflammatory response due to SARSCoV-2 adversely affect several internal organs.Besides lung injury,which is the main outcome of SARS-CoV-2 infection,it has been reported to adversely impact other organs including the liver and kidneys.SARS-CoV-2 virus can also have a direct adverse impact on liver as well as kidneys due to systemic inflammatory response or drug toxicity,leading to elevated levels of liver injury markers and acute kidney injury.Clinical outcomes of SARS-CoV-2 infection could be worse in patients suffering from pre-existing liver and kidney disease.So far,there have been several reports on the mechanism of liver and kidney injury during SARSCoV-2 viral attack.However,the long-term impact of this infection on these organs is yet to be understood.This review summarizes the possible causes and effects of SARS-CoV-2 on the liver and kidneys during the infection and post recovery based on available literature.

Value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating differential glomerular filtration rate for chronic obstructed kidneys

Objective To evaluate the value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating the differential glomerular filtration rate ( GFR) for chronic obstructed kidneys,and to compare the correlations between two morphologic indices of renal parenchyma and GFR for chronic obstructed kidneys.

Complexity and Management of Chronic Kidney Disease

Chronic Kidney Disease (CKD) is ongoing damage of the kidneys, which affects their ability to filter the blood the way they should. Worldwide CKD is considered as the 16th leading cause of death and affects 8% - 16% of the population. CKD often goes unnoticed and is revealed as an incidental finding. Healthcare providers diagnose the condition as CKD based on persistent abnormal kidney function tests revealing kidney damage markers > 3 months, urine albumin creatinine ratio (UACR) > or equal to 30 mg/g per 24 hours, and GFR < 60 mL/min/1.73m2. In this article, we have discussed chronic kidney disease in terms of kidney physiology, chronic kidney disease pathophysiology, etiology, diagnosis, signs and symptoms, and management.

Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract

Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.

Kidney disease in non-kidney solid organ transplantation

Kidney disease after non-kidney solid organ transplantation(NKSOT)is a common post-transplant complication associated with deleterious outcomes.Kidney disease,both acute kidney injury and chronic kidney disease(CKD)alike,emanates from multifactorial,summative pre-,peri-and post-transplant events.Several factors leading to kidney disease are shared amongst solid organ transplantation in addition to distinct mechanisms unique to individual transplant types.The aim of this review is to summarize the current literature describing kidney disease in NKSOT.We conducted a narrative review of pertinent studies on the subject,limiting our search to full text studies in the English language.Kidney disease after NKSOT is prevalent,particularly in intestinal and lung transplantation.Management strategies in the peri-operative and post-transplant periods including proteinuria management,calcineurin-inhibitor minimization/sparing approaches,and nephrology referral can counteract CKD progression and/or aid in subsequent kidney after solid organ transplantation.Kidney disease after NKSOT is an important consideration in organ allocation practices,ethics of transplantation.Kidney disease after SOT is an incipient condition demanding further inquiry.While some truths have been revealed about this chronic disease,as we have aimed to describe in this review,continued multidisciplinary efforts are needed more than ever to combat this threat to patient and allograft survival.

Relationships between Diatom Abundances in Rat Organs and in Environmental Waters

Objective:A diagnosis of drowning remains one of the most challenging issues in forensic science,especially for decomposed bodies.Diatom analysis is considered as an encouraging method for diagnosing drowning.In this study,we developed a drowned rat model using different diatom densities in water.Methods:A total of 120 adult Sprague-Dawley rats were used and divided into six groups,wherein experimental groups 1-5 were drowned rats(group A)and postmortem submersion rats(group B)that were submerged in water with five different Cyclotella sp.diatom densities,while the remaining group was used as a blank control.The combination of microwave digestion and vacuum filtration method was used to accomplish efficient tissue digestion and ascertain higher accuracy of diatom determinations within organs.Results:The abundances of diatoms in the lungs,livers,and kidneys were significantly different.The diatom abundances in the lungs,livers,and kidneys were directly proportional to the water diatom densities,and specific quantitative relationships could be approximated by separate regression equations for each organ type.However,the trends associated with the diatom increases among organs slightly differed.In addition,the diatom abundances in the lungs,livers,and kidneys were all positively correlated.Diatoms were not observed in the postmortem submersion groups nor in the blank control groups.Conclusion:The results of this study provide valuable information for establishing a quantitative diatom framework for informing future forensic medicine efforts.

Feeding Different Omega-3 Polyunsaturated Fatty Acid Sources Influences Renal Fatty Acid Composition, Inflammation, and Occurrence of Nephrocalcinosis in Female Sprague-Dawley Rats

The general population is encouraged to increase omega-3 polyunsaturated fatty acid (n-3 PUFA) intake in order to optimize health for preventative health care. Consumers are typically unaware that different amounts, types, and structural forms of n-3 PUFA have different efficacy. Therefore, the objectives of this study were to characterize different sources of n-3 PUFAs and to determine whether consumption of these oils influences renal fatty acid composition and renal health. Lipid classes and fatty acid profile of corn (CO), flaxseed (FO), menhaden (MO), salmon (SO), tuna (TO) or krill (KO) oils were determined by thin-layer and gas chromatography. All dietary oils consisted of >65% triglyceride with the exception of KO. KO and FO also contained phospholipids. FO was rich in the n-3 PUFA, alpha-linolenic acid (18:3n-3) whereas, the marine oils were rich in the long-chain n-3 PUFAs (>18 carbons). Following characterization of the oil sources, female Sprague-Dawley rats (age 28 d) were randomly assigned (n = 10/group) to be fed a high fat 12% (wt) diet consisting of these different oil sources for 8 weeks. Rats fed MO, TO, and SO had significantly higher renal eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) deposition and this in turn, modulated inflammatory responses. Feeding rats MO, SO and TO reduced urinary excretion of 13,14-dihydro-15-keto prostaglandin E2. Feeding rats TO and SO reduced (P ≤ 0.002) nuclear factor kappa B activity and circulating TNFα (P < 0.05). In contrast, rats consuming KO had heavier kidney weights (P < 0.001), total calcium content, and histological evidence of renal calcification and tubulo-interstitial injury. This was due to increased (P < 0.001) urinary phosphorus excretion associated with the phospholipids content of KO. The study results indicated that consumption of n-3 PUFAs influences renal health and the effects varied depending on the n-3 PUFA source consumed.

Safety of the Aqueous Extract of the Leaves of Senna alata (L.) Roxb. (Leguminosae-Caesalpinioideae), a Plant Used in Benin to Treat Infections

Description of the Subject: Senna alata (L.) was a plant in the Benin pharmacopoeia used to treat skin infections. Objectives: The aim of our work was to test its harmlessness in vivo. Method: Wistar rats received by gavage a single dose of 2000 mg/kg of Senna alata leaves aqueous extract for the Acute Oral Toxicity (AOT) test. For the sub-Chronic Oral Toxicity (SCT) test, rats force-fed the extract at a daily dose of 300 mg/Kg of body weight for 28 days. The weight of the rats was taken and the blood samples were collected on Day 0, then respectively day 14 for the AOT and Day 28 for the SCT. The renal balance was carried out by dosage of the creatinine, the liver balance by the transaminases AST and ALT and the blood balance by the hemogram. The liver, kidneys and spleen were removed for histological analysis. The results were analyzed using the Student test, with the significance level set at 5%. Results: The weight of the rats did not change significantly in the acute or subchronic oral toxicity tests suggesting an absence of physical disturbance in the rats. Serum creatinine did not vary significantly, suggesting preservation of renal function. That was the same for ASAT and ALAT transaminases, indicating an absence of hepatic cytolysis. In hematology, the hemoglobin level and the number of blood platelets did not vary significantly, suggesting that the extract did not create anemia and did not influence blood coagulation. Hepatic, renal and splenic parenchyma showed no atypia. Conclusion: The aqueous extract of Senna alata (L.) leaves did not reveal any acute or subchronic toxicity and offered prospects for its use in the treatment of infections.

Pre-transplant treatment of large polycystic kidney

AIM: To evaluate the indications, optimal timing andoutcomes of native nephrectomy and other techniques in pretransplant treatment of autosomal dominant polycystic kidney disease(PKD).METHODS: A literature review was conducted using the Pub Med and Epistemonikos databases. Keywords for pre-transplant surgical management of polycystic kidneys were: Transplant, treatment and PKD. Keywords for pre-treatment embolization of PKD were: Embolization, transplant and polycystic kidney disease. The inclusion criterions were all articles found using this search method. The exclusion criterions were articles found to include bias and not attending pre-transplant treatment options. Fifteen articles were included in our final analysis. Ten articles were found regarding embolization of PKD of which three reviews were selected for final analysis. The reviews were divided into pre transplant and intra transplant treatment for the surgical treatment of PKD. All articles meeting inclusion criteria were thoroughly analyzed by two independent reviewers. A third independent reviewer was consulted if the reviewers did not agree upon the inclusion or exclusion of a specific article. No statistical analysis was performed.RESULTS: Studies vary regarding the technique used(open or laparoscopic), laterality(single or bilateral) and temporality of nephrectomy with respect to renal transplant(pre-transplant or simultaneous to transplant). Several groups argue in favor of simultaneous nephrectomy and kidney transplant since it avoids the deleterious effects of being anefric. Long-term results and patient satisfaction are acceptable. However, it is associated with increased operative time, transfusion rate, morbidity and length of hospital stay. Based on small sample studies, bilateral nephrectomy prior to transplant has been associated with a higher risk of morbidity and mortality. Studies on laparoscopic approach report it as a feasible and safe alternative to the open surgery approach, highlighting its lower complication rate, transfusions and shorter hospital stay. Arterial embolization of the kidney appears as an effectiveand low morbid alternative for the management of large native kidneys. The reduction in renal size allow transplant in a significant number of patients, which makes it an appealing alternative to surgery.CONCLUSION: There is limited evidence regarding best pretrasnplant treatment of large PKD but to date embolization seems an appealing alternative to augment space for renal graft allocation.