Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor dete...Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.展开更多
The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants worldwide.This activity was,however,accompanied by many issues and challenges.An accurate diagnosis and ...The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants worldwide.This activity was,however,accompanied by many issues and challenges.An accurate diagnosis and appropriate management of causes of graft dysfunction were and still are,a big challenge.Kidney allograft biopsy played a vital role in addressing the above challenge.However,its interpretation was not standardized for many years until,in 1991,the Banff process was started to fill this void.Thereafter,regular Banff meetings took place every 2 years for the past 30 years.Marked changes have taken place in the interpretation of kidney allograft biopsies,diagnosis,and classification of rejection and other non-rejection pathologies from the original Banff 93 classification.This review attempts to summarize those changes for increasing the awareness and understanding of kidney allograft pathology through the eyes of the Banff process.It will interest the transplant surgeons,physicians,pathologists,and allied professionals associated with the care of kidney transplant patients.展开更多
Acute tubular necrosis(ATN)induced by ischemia is the most common insult to donor kidneysdestined for trarsplantation.ATN results from sweling and subsequent damage to cells lining thelkidney tubules.In this study,we ...Acute tubular necrosis(ATN)induced by ischemia is the most common insult to donor kidneysdestined for trarsplantation.ATN results from sweling and subsequent damage to cells lining thelkidney tubules.In this study,we demonstrate the capability of optical coherence tomography(OcT)to image the renal microst ructures of living human donor kidneys and potentially providea measure to det ermine the extent of A TN.We also found that Doppler-based OCT(i.e.,DOCT)reveals renal blood flow dynamics that is another major factor which could relate to post-transplant renal finction.All OCT/DoCT oberva tions were performed in a noninvasive,sterileand timely manner on intact human kidneys both prior to(er vivo)and following(in vivo)theirtransplantation.Our results indicate that this imaging model provides transplant surgeons withan objective visualization of the transplant lidneys prior and immediately post transplantation.展开更多
Focal segmental glomerulosclerosis (FSGS) is characterized histologically by hyalinosis and sclerosis of glomeruli associated or not with podocyte involvement. The objective of our work was to clarify the epidemiologi...Focal segmental glomerulosclerosis (FSGS) is characterized histologically by hyalinosis and sclerosis of glomeruli associated or not with podocyte involvement. The objective of our work was to clarify the epidemiological aspects and histological variants of FSGS in Côte d’Ivoire. Materials and Methods: This was a descriptive retrospective study, conducted from January 2015 to December 2019 using the renal biopsy registers (RB) of the Pathological Anatomy and Cytology departments of the Teaching Hospital of Cocody and Bouake in collaboration with the Nephrology Services of Côte d'Ivoire and the sub-region. The biopsies underwent conventional histopathology and/or immunofluorescence techniques. The parameters analyzed were: frequency, age, gender, proteinuria, biopsy indications and histological aspects and the different correlations between histological aspects and socio-demographic characteristics. Results: FSGS represented 58.1% (n = 104) of glomerular nephropathies. The average age of patients was 32.1 ± 13.3 years, with extremes of 13 and 70 years. The sex ratio was equal to 1. Nephrotic syndrome (68.9%), chronic renal failure (14.3%) and acute renal failure (10.1%) were the main indications for renal biopsy (RB). The mean proteinuria at the time of diagnosis was 4 ± 3.7 g/24 h. It was massive (3.5 g/24 h) in 42.3% of patients. FSGS was primary in 29.8% (n = 31) and secondary in 70.2% (n = 73) of patients, of which 27.9% (n = 35) was due to HIV. According to the Columbia classification, 62.5% NOS type was found;23.1% collapsing type;7.7% tip lesion type;4.8% cell type and 1.9% perihilary type. Conclusion: FSGS is a complex heterogeneous entity. It affects young people in our context with a homogeneous gender distribution. Understanding its histogenesis is essential for optimal patient management.展开更多
BACKGROUND Urinary tract lymphoepithelioma-like carcinoma is rarely seen.Although it is termed after lymphoepithelioma at the nasopharynx,it behaves more like high grade urothelial carcinoma by immunohistochemical fea...BACKGROUND Urinary tract lymphoepithelioma-like carcinoma is rarely seen.Although it is termed after lymphoepithelioma at the nasopharynx,it behaves more like high grade urothelial carcinoma by immunohistochemical features.Most published literatures focused on its rarity but few discussed results of long-term follow-ups.As no available guidelines are applicable,we postulated that principles should be similar to that of urothelial carcinoma at urinary tract.As of now,this work features the longest follow-up of this cancer at the upper urinary tract.CASE SUMMARY A 63-year-old female had a chief complaint of intermittent left flank pain for 2 mo,along with accompanying symptoms including vomiting and body weight loss,about 7 kg over 2 mo.Laboratory data showed normocytic anemia,mildly poor renal function,and hyperparathyroidism.Urine analysis showed mild hematuria.Computed tomography showed a 4.2-cm-width irregular mass over left renal pelvic and enlarged lymph node at the left renal hilum.Whole-body bone scan was negative of active bone lesions.Biopsy from ureteroscopy showed urothelial carcinoma.Specimen from laparoscopic nephroureterectomy with bladder cuff resection showed lymphoepithelioma-like carcinoma with muscular invasion(pT3).She took adjuvant chemotherapies of 2 cycles and full courses of radiation therapy.No recurrence was observed with designed investigative programs.CONCLUSION Locally advanced urinary tract lymphoepithelioma-like carcinoma could benefit from nephroureterectomy and bladder cuff excision in terms of recurrence-free survival.展开更多
基金Supported by the National Natural Science Foundation of China,No.82100883the Research Project of Educational Commission of Jilin Province of China,No.JJKH20231214KJ.
文摘Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.
文摘The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants worldwide.This activity was,however,accompanied by many issues and challenges.An accurate diagnosis and appropriate management of causes of graft dysfunction were and still are,a big challenge.Kidney allograft biopsy played a vital role in addressing the above challenge.However,its interpretation was not standardized for many years until,in 1991,the Banff process was started to fill this void.Thereafter,regular Banff meetings took place every 2 years for the past 30 years.Marked changes have taken place in the interpretation of kidney allograft biopsies,diagnosis,and classification of rejection and other non-rejection pathologies from the original Banff 93 classification.This review attempts to summarize those changes for increasing the awareness and understanding of kidney allograft pathology through the eyes of the Banff process.It will interest the transplant surgeons,physicians,pathologists,and allied professionals associated with the care of kidney transplant patients.
文摘Acute tubular necrosis(ATN)induced by ischemia is the most common insult to donor kidneysdestined for trarsplantation.ATN results from sweling and subsequent damage to cells lining thelkidney tubules.In this study,we demonstrate the capability of optical coherence tomography(OcT)to image the renal microst ructures of living human donor kidneys and potentially providea measure to det ermine the extent of A TN.We also found that Doppler-based OCT(i.e.,DOCT)reveals renal blood flow dynamics that is another major factor which could relate to post-transplant renal finction.All OCT/DoCT oberva tions were performed in a noninvasive,sterileand timely manner on intact human kidneys both prior to(er vivo)and following(in vivo)theirtransplantation.Our results indicate that this imaging model provides transplant surgeons withan objective visualization of the transplant lidneys prior and immediately post transplantation.
文摘Focal segmental glomerulosclerosis (FSGS) is characterized histologically by hyalinosis and sclerosis of glomeruli associated or not with podocyte involvement. The objective of our work was to clarify the epidemiological aspects and histological variants of FSGS in Côte d’Ivoire. Materials and Methods: This was a descriptive retrospective study, conducted from January 2015 to December 2019 using the renal biopsy registers (RB) of the Pathological Anatomy and Cytology departments of the Teaching Hospital of Cocody and Bouake in collaboration with the Nephrology Services of Côte d'Ivoire and the sub-region. The biopsies underwent conventional histopathology and/or immunofluorescence techniques. The parameters analyzed were: frequency, age, gender, proteinuria, biopsy indications and histological aspects and the different correlations between histological aspects and socio-demographic characteristics. Results: FSGS represented 58.1% (n = 104) of glomerular nephropathies. The average age of patients was 32.1 ± 13.3 years, with extremes of 13 and 70 years. The sex ratio was equal to 1. Nephrotic syndrome (68.9%), chronic renal failure (14.3%) and acute renal failure (10.1%) were the main indications for renal biopsy (RB). The mean proteinuria at the time of diagnosis was 4 ± 3.7 g/24 h. It was massive (3.5 g/24 h) in 42.3% of patients. FSGS was primary in 29.8% (n = 31) and secondary in 70.2% (n = 73) of patients, of which 27.9% (n = 35) was due to HIV. According to the Columbia classification, 62.5% NOS type was found;23.1% collapsing type;7.7% tip lesion type;4.8% cell type and 1.9% perihilary type. Conclusion: FSGS is a complex heterogeneous entity. It affects young people in our context with a homogeneous gender distribution. Understanding its histogenesis is essential for optimal patient management.
文摘BACKGROUND Urinary tract lymphoepithelioma-like carcinoma is rarely seen.Although it is termed after lymphoepithelioma at the nasopharynx,it behaves more like high grade urothelial carcinoma by immunohistochemical features.Most published literatures focused on its rarity but few discussed results of long-term follow-ups.As no available guidelines are applicable,we postulated that principles should be similar to that of urothelial carcinoma at urinary tract.As of now,this work features the longest follow-up of this cancer at the upper urinary tract.CASE SUMMARY A 63-year-old female had a chief complaint of intermittent left flank pain for 2 mo,along with accompanying symptoms including vomiting and body weight loss,about 7 kg over 2 mo.Laboratory data showed normocytic anemia,mildly poor renal function,and hyperparathyroidism.Urine analysis showed mild hematuria.Computed tomography showed a 4.2-cm-width irregular mass over left renal pelvic and enlarged lymph node at the left renal hilum.Whole-body bone scan was negative of active bone lesions.Biopsy from ureteroscopy showed urothelial carcinoma.Specimen from laparoscopic nephroureterectomy with bladder cuff resection showed lymphoepithelioma-like carcinoma with muscular invasion(pT3).She took adjuvant chemotherapies of 2 cycles and full courses of radiation therapy.No recurrence was observed with designed investigative programs.CONCLUSION Locally advanced urinary tract lymphoepithelioma-like carcinoma could benefit from nephroureterectomy and bladder cuff excision in terms of recurrence-free survival.
