1.Progress of small ubiquitin-related modifiers in kidney diseases.
Ou LI ; Qian MA ; Fei LI ; Guang-Yan CAI ; Xiang-Mei CHEN ; Quan HONG
Chinese Medical Journal 2019;132(4):466-473
OBJECTIVE:
Small ubiquitin-related modifiers (SUMOs) are a group of post-translational modification proteins extensively expressed in eukaryotes. Abnormal SUMOylation can lead to the development of various diseases. This article summarizes the progress on research of the role of SUMOs in various types of kidney diseases to further increase the understanding of the regulatory functions of SUMOylation in the pathogenesis of kidney diseases.
DATA SOURCES:
This review was based on articles published in the PubMed databases up to January 2018, using the keywords including "SUMOs," "SUMOylation," and "kidney diseases."
STUDY SELECTION:
Original articles and critical reviews about SUMOs and kidney disease were selected for this review. A total of 50 studies were in English.
RESULTS:
SUMO participates in the activation of NF-κB inflammatory signaling pathway, playing a central regulatory role in the inflammation and progression of DN, and the secretion of various chemokines in AKI. SUMO involves in the regulation of TG2 and Nrf2 antioxidant stress, affecting renal tubular injury in AKI. SUMO affects the MAPK/ERK pathway, regulating intracellular signal transduction, modulating the transcription and expression of effector molecules in DN. SUMO contributes to the TGF-β/Smad pathway, leading to fibrosis of the kidney. The conjugate combination of SUMO and p53 regulates cell proliferation and apoptosis, and participates in the regulation of tumorigenesis. In addition, SUMOylation of MITF modulates renal tumors secondary to melanoma, Similarly, SUMOylation of tumor suppressor gene VHL regulates the occurrence of renal cell carcinoma in VHL syndrome.
CONCLUSIONS
Tissue injury, inflammatory responses, fibrosis, apoptosis, and tumor proliferation in kidney diseases all involve SUMOs. Further research of the substrate SUMOylation and regulatory mechanisms of SUMO in kidney diseases will improve and develop new treatment measures and strategies targeting kidney diseases.
Acute Kidney Injury
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etiology
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Carcinoma, Renal Cell
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etiology
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Diabetic Nephropathies
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etiology
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Fibrosis
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Humans
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Kidney
;
pathology
;
Kidney Diseases
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etiology
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metabolism
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Kidney Neoplasms
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etiology
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SUMO-1 Protein
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physiology
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Sumoylation
2.A Case of Severe Acute Kidney Injury by Near-Drowning.
Eun Young SEONG ; Harin RHEE ; Naria LEE ; Sung Jun LEE ; Sang Heon SONG ; Dong Won LEE ; Soo Bong LEE ; Mee Young SOL ; Ihm Soo KWAK
Journal of Korean Medical Science 2012;27(2):218-220
Acute kidney injury (AKI) secondary to near-drowning is rarely described and poorly understood. Only few cases of severe isolated AKI resulting from near-drowning exist in the literature. We report a case of near-drowning who developed to isolated AKI due to acute tubular necrosis (ATN) requiring dialysis. A 21-yr-old man who recovered from near-drowning in freshwater 3 days earlier was admitted to our hospital with anuria and elevated level of serum creatinine. He needed five sessions of hemodialysis and then renal function recovered spontaneously. Renal biopsy confirmed ATN. We review the existing literature on near-drowning-induced AKI and discuss the possible pathogenesis.
Acute Kidney Injury/*diagnosis/*etiology
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Anuria/etiology
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Creatinine/blood
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Humans
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Kidney Tubular Necrosis, Acute/etiology/pathology
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Male
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Near Drowning/*complications
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Renal Dialysis
;
Young Adult
3.Bilateral parotid enlargement following snake bite: a rare sign.
Madi DEEPAK ; Achappa BASAVAPRABHU ; John T RAMAPURAM ; Chowta NITHYANANDA ; Soundarya MAHALINGAM
Asian Pacific Journal of Tropical Biomedicine 2013;3(2):154-155
Snakebite is a common medical emergency in India. Unusual complications may occur after viper bite. Bilateral parotid enlargement after viper bite is a rare entity. An 18-year old gentleman presented to our hospital with history of viper bite. On examination he had cellulitis of right lower limb. He developed swelling of both the parotid glands 12 h after admission. He developed coagulopathy, acute renal failure and died within 48 h of hospital admission. Development of parotid swelling after snake bite is associated with poor prognosis. This case is found worth reporting as it is an unusual complication having prognostic value.
Acute Kidney Injury
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etiology
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Adolescent
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Animals
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Blood Coagulation Disorders
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etiology
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Fatal Outcome
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Humans
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India
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Male
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Parotid Diseases
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etiology
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pathology
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Parotid Gland
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pathology
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Prognosis
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Russell's Viper
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Snake Bites
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complications
4.Multiple, Bilateral Fibroepithelial Polyps Causing Acute Renal Failure in a Gastric Cancer Patient.
Sun Ouck KIM ; Chul Woong YOUN ; Taek Won KANG ; Chang Min IM ; Sung Il JUNG ; Kyung Jin OH ; Dongdeuk KWON ; Kwangsung PARK ; Soo Bang RYU
Journal of Korean Medical Science 2010;25(4):644-646
We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.
Acute Kidney Injury/*etiology
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Aged
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Humans
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Male
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Neoplasms, Fibroepithelial/*pathology
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*Polyps/complications/pathology
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Stomach Neoplasms/*pathology
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Ureteral Neoplasms/*pathology
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Ureteral Obstruction/*pathology
5.Prognostic Value of Model for End-Stage Liver Disease Incorporating with Serum Sodium Score for Development of Acute Kidney Injury after Liver Transplantation.
Yuan CHENG ; Guo-Qing WEI ; Qiu-Cheng CAI ; Yi JIANG ; Ai-Ping WU
Chinese Medical Journal 2018;131(11):1314-1320
BackgroundContribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT.
MethodsPreoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected. Postoperative AKI was defined and staged in accordance with the clinical practice guidelines developed by Kidney Disease: Improving Global Outcomes. Univariate and multivariate analysis was performed to determine the risk factors for AKI following OLT. The discriminating power of MELD/MELD-Na score on AKI outcome was evaluated by receiver operating characteristic (ROC) curve. Spearman's correlation analysis was used for identifying the correlated relationship between MELD/MELD-Na score and the severity levels of AKI.
ResultsThe prevalence of AKI following OLT was in 206 out of 321 patients (64.2%). Three risk factors for AKI post-OLT were presented, preoperative calculated MELD score (odds ratio [OR] = 1.048, P = 0.021), intraoperative volume of red cell suspension transfusion (OR = 1.001, P = 0.002), and preoperative liver cirrhosis (OR = 2.015, P = 0.012). Two areas under ROC curve (AUCs) of MELD/MELD-Na score predicting AKI were 0.688 and 0.672, respectively; the difference between two AUCs was not significant (Z = 1.952, P = 0.051). The Spearman's correlation coefficients between MELD/MELD-Na score and the severity levels of AKI were 0.406 and 0.385 (P = 0.001, 0.001), respectively.
ConclusionsWe demonstrated that preoperative MELD score, intraoperative volume of red cell suspension transfusion and preoperative liver cirrhosis were risk factors for AKI following OLT. Furthermore, we preliminarily validated that MELD score seemed to have a stronger power discriminating AKI post-OLT than that of novel MELD-Na score.
Acute Kidney Injury ; blood ; etiology ; pathology ; Adult ; End Stage Liver Disease ; blood ; etiology ; pathology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Sodium ; blood
6.Clinical analysis of acute kidney injury in children with renal diseases.
Xu-Hui ZHONG ; Jie DING ; Xiao-Yu LIU ; Hui-Jie XIAO ; Yong YAO ; Jian-Ping HUANG
Chinese Journal of Pediatrics 2011;49(1):60-65
OBJECTIVEAcute kidney injury (AKI) was recently proposed for early recognition of renal function impairment and prompt interventions. Previous study revealed that AKI was highly associated with the prognosis. However, there was rare report of AKI in renal diseases, especially in children cohorts. Therefore, we performed the prospective clinical research in children with renal diseases in our hospital, aiming to study the prevalence, the clinical characteristics and the short-term prognosis of AKI.
METHODThe study was designed as a prospective, single-center observational study.
INCLUSION CRITERIA(1) the primary diagnosis was primary nephrotic syndrome (NS), Henoch-Schoenlein purpura nephritis (HSPN) or lupus nephritis (LN), (2) the duration from the onset of the renal diseases to the admission was less than 3 months. The serum creatinine and urine output of the subjects would be prospectively monitored. AKI was defined by the adult criteria and stratified by Acute Kidney Injury Network (AKIN) criteria. The patients were followed up at 6 months and 12 months after enrollment.
RESULTBetween October 2007 and April 2009, a total of 95 children were included, including 65 cases with NS, 15 HSPN and 15 LN. Mean age was (8.9 ± 3.9) years (range 2 - 16 years). Thirty-three of the 95 patients (34.7%) fulfilled the AKI criteria, 13 patients (13.7%) were diagnosed as acute renal failure (ARF). All the AKI in children with LN and HSPN presented with serum creatinine elevation. However, 65.4% of AKI in NS presented with decreasing urine output, only 19.2% accompanied with increasing creatinine, with higher stages of urine output. Regarding the etiology, only 26.9% of AKI in NS had definite cause, most of which resulted from side-effect of cyclosporine, hypovolemia or tubule-interstitial damage, independent of glomerular diseases. In contrast, the AKI in LN and HSPN were exclusively caused by glomerular diseases. The length and costs of hospitalization of AKI group were significantly higher than non-AKI [length of hospitalization (d), 28(6 to 94) vs. 21(7 to 100), Z = -1.971, P = 0.049; cost of hospitalization (yuan), 12 035.7 (1561.7 to 94 783.1) vs. 8594.3 (1390.1 to 98 876.5), Z = -1.993, P = 0.046]. There was no significant difference in the serum creatinine at 6-month and 12-month follow-up between AKI group and non-AKI [6-month, (60.4 ± 91.8) µmol/L vs. (42.8 ± 12.2) µmol/L, t = 0.937, P = 0.358; 12-month, (48.7 ± 18.1) µmol/L vs. (47.7 ± 14.2) µmol/L, t = 0.197, P = 0.845].
CONCLUSIONThe prevalence of AKI (34.7%) was higher than that of ARF (13.7%) in children with renal diseases. Most of the AKI in NS resulted from non-glomerular diseases. In contrast, most AKI in LN and HSPN were caused by underlying glomerular diseases. The length and costs of hospitalization were significantly higher in AKI group. However, there was no significant difference in serum creatinine between AKI and non-AKI group in the follow-up at 6 months and 12 months. Further investigations on criteria for the diagnosis of AKI in children with renal diseases are still needed.
Acute Kidney Injury ; etiology ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Lupus Nephritis ; complications ; pathology ; Male ; Nephrotic Syndrome ; complications ; pathology ; Prospective Studies ; Purpura, Schoenlein-Henoch ; complications ; pathology ; Risk Factors
7.Acute renal failure induced by primary hyperuricemia in children: a case report.
Yan LIU ; Bi-li ZHANG ; Xuan ZHANG
Chinese Journal of Pediatrics 2005;43(7):525-525
Acute Kidney Injury
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blood
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diagnosis
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etiology
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Child, Preschool
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Humans
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Hyperuricemia
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blood
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complications
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Kidney
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pathology
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Magnetic Resonance Imaging
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Male
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Uric Acid
;
blood
9.Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children.
Ning SUN ; Ying SHEN ; Qiang SUN ; Xu-ran LI ; Li-qun JIA ; Gui-ju ZHANG ; Wei-ping ZHANG ; Zhi CHEN ; Jian-feng FAN ; Ye-ping JIANG ; Dong-chuan FENG ; Rui-feng ZHANG ; Xiao-yu ZHU ; Hong-zhan XIAO
Chinese Medical Journal 2009;122(3):245-251
BACKGROUNDInfants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.
METHODSData of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.
RESULTSAll the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1+/-8.2) mmol/L and creatinine (Cr) was (384.2+/-201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5+/-1.9) days for cystoscopy group, (2.7+/-1.1) days for lithotomy group, (3.8+/-2.3) days for dialysis group, and (2.7+/-1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00+/-1.78) days.
CONCLUSIONSMelamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It was observed that the short-term prognosis was satisfactory.
Acute Kidney Injury ; diagnosis ; etiology ; pathology ; therapy ; Child, Preschool ; Cystoscopy ; Female ; Humans ; Infant ; Male ; Peritoneal Dialysis ; Retrospective Studies ; Treatment Outcome ; Triazines ; poisoning ; Urinary Calculi ; complications ; diagnosis ; pathology ; therapy
10.Immunoglobulin A Nephropathy Associated with Plasmodium falciparum Malaria.
Dong Eun YOO ; Jeong Ho KIM ; Jeong Hae KIE ; Yoonseon PARK ; Tae Ik CHANG ; Hyung Jung OH ; Seung Jun KIM ; Tae Hyun YOO ; Kyu Hun CHOI ; Shin Wook KANG ; Seung Hyeok HAN
Journal of Korean Medical Science 2012;27(4):446-449
Glomerulonephritis occurs as a rare form of renal manifestation in Plasmodium falciparum malaria. Herein, we report a case of falciparum malaria-associated IgA nephropathy for the first time. A 49-yr old male who had been to East Africa was diagnosed with Plasmodium falciparum malaria. Microhematuria and proteinuria along with acute kidney injury developed during the course of the disease. Kidney biopsy showed mesangial proliferation and IgA deposits with tubulointerstitial inflammation. Laboratory tests after recovery from malaria showed disappearance of urinary abnormalities and normalization of kidney function. Our findings suggest that malaria infection might be associated with IgA nephropathy.
Acute Kidney Injury/etiology/pathology
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Antimalarials/therapeutic use
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Creatinine/blood
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Glomerulonephritis, IGA/*diagnosis/*etiology
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Hematuria/etiology
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Humans
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Immunoglobulin A/*metabolism
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Malaria/*complications/drug therapy/*pathology
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Male
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Middle Aged
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Plasmodium falciparum/*isolation & purification
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Proteinuria/etiology
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Quinine/therapeutic use