Adolescent ; Child ; Humans ; Male ; Nephritis, Interstitial ; pathology ; Uveitis ; pathology

In order to determine the extent to which specific forms of glomerulonephritis (GN) contribute to the pool of crescentic GN, renal tissues from 17 crescentic GN patients were examined with special attention to glomerular and interstitial neutrophil infiltration. Renal tissues from five normal kidneys served as normal controls. Renal biopsy tissues from five patients with postinfectious GN in which crescent formation was not observed were also examined as disease controls. The patients were put into both three groups according to immunofluorescence findings and two groups according to the active or inactive phase of the crescents: group 1 with anti-glomerular basement membrane crescentic GN, one case; group 2 with immune complex crescentic GN, ten cases; and group 3 with pauci-immune crescentic GN, six cases. Four of the nine individuals tested were positive for anti-neutrophil cytoplasmic antibody (44.4%). Glomerular and interstitial neutrophil infiltrations were prominent in both the active and inactive phase groups, compared to normal controls (p<.05). Glomerular neutrophil infiltration was significantly prominent in the active phase group, compared to the inactive phase group (p<.001). In both the active and inactive phase groups, interstitial neutrophil infiltration was prominent, compared to disease control groups (p<.05). These results support the concept of the participation of periglomerular leukocytes in the renal tissue damage of crescentic GN, although the role of neutrophils was not examined.
Adult ; Aged ; Female ; Follow-Up Studies ; Glomerulonephritis/pathology* ; Glomerulonephritis/immunology ; Glomerulonephritis/classification ; Human ; Kidney Glomerulus/pathology* ; Kidney Glomerulus/immunology ; Male ; Middle Age ; Nephritis, Interstitial/pathology* ; Nephritis, Interstitial/immunology ; Neutrophils/physiology*

Even with improved immunosuppressive therapies, graft rejection remains the major cause of failure. Renal biopsy is the most sensitive tool and gold standard for the diagnosis of rejection and other causes of graft dysfunction. Because of the large number of conditions that can affect the allograft, sometimes in combination, renal transplantation pathology is one of the most challenging areas for the renal pathologist. The major causes of allograft dysfunction include rejection, postoperative acute tubular necrosis, perfusion injury, drug toxicity, obstruction, major vascular occlusion, infection, allergic interstitial nephritis, recurrent or de novo glomerular disease, and post-transplant lymphoproliferative disease. The criteria for grading rejection by the Banff 97 schema and the new concept of acute antibody-mediated rejection are introduced.
Allografts ; Biopsy ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Graft Rejection ; Kidney Transplantation* ; Necrosis ; Nephritis, Interstitial ; Pathology* ; Perfusion ; Transplants

Adult ; Biopsy, Needle ; Diagnosis, Differential ; Humans ; Kidney ; pathology ; Kidney Diseases ; pathology ; therapy ; Male ; Nephritis, Interstitial ; pathology ; Renal Dialysis ; Sarcoidosis ; pathology ; therapy ; Tuberculosis, Renal ; pathology

OBJECTIVE: To observe the expression of plasma thrombospondin-1(TSP-1) at different time in protein-overload rats and to analyze the relationship between plasma TSP-1 expression and renal interstitial fibrosis. METHODS: Forty-five male Sprague-Dawley rats were randomly divided into a bovine serum albumin (BSA) group and a control group after uninephrectomization. Rats with protein overload nephropathy induced by intraperitoneally injected BSA were used as a model (control group received saline). At the 1st, 5th, and 9th weekend, the level of 24 h proteinuria and renal function was assessed. Pathological changes were observed by electron and fluorescent microscopy. The expression of plasma TSP-1 was detected by Western blot. The relationship between plasma TSP-1 and tubulointerstitial lesions (TIL) score was analyzed. RESULTS: Twenty-four hour proteinuria and blood urea nitrogen (BUN) significantly increased in protein-overload rats compared with those in the control group. While protein-overload rats developed more severe fibrosis in the tubular and interstitium. Glomerulosclerosis index and TIL score were upregulated compared with those in the control group. The expression of TSP-1 increased significantly at the 5th and 9th weekend. The expression of TSP-1 was positively correlated with TIL score (r=0.836, P<0.01). CONCLUSION Plasma TSP-1 expression is positively correlated with renal interstitial fibrosis in protein-overload rats. Plasma TSP-1 may be used for an important biomarker of renal interstitial fibrosis.
Animals ; Fibrosis ; metabolism ; pathology ; Glomerulosclerosis, Focal Segmental ; pathology ; Kidney ; metabolism ; pathology ; Male ; Nephrectomy ; Nephritis, Interstitial ; etiology ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Thrombospondin 1 ; blood

Lithium is commonly employed in the treatment of bipolar disorders. The commonly reported nephrotoxic effects of lithium therapy are nephrogenic diabetes insipidus and chronic tubulointerstitial nephropathy with little or no proteinuria. Mild proteinuria is a common manifestation of most renal injuries including nephrotoxicity by lithium. But nephrotic syndrome related with lithium therapy is very rare and only one case of membranous glomerulonephritis has been reported in Korea by this time. We report a lithium toxicity case manifested by nephrotic syndrome, nephrogenic diabetes inspidus and chronic renal insufficiency in a 44-year-old man who had been taking lithium for 13 years for bipolar disorder. Kidney pathology showed minimal change disease and chronic tubulointerstitial nephritis which can be seen in chronic lithium toxicity. Polyuria and massive proteinuria disappeared with the withdrawal of lithium. Renal function was gradually improved but not to norma range. Careful and regular monitoring on the renal function in all patients on lithium treatment will be needed.
Adult ; Bipolar Disorder ; Diabetes Insipidus, Nephrogenic ; Glomerulonephritis, Membranous ; Humans ; Kidney ; Korea ; Lithium* ; Nephritis, Interstitial* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Pathology ; Polyuria ; Proteinuria ; Renal Insufficiency ; Renal Insufficiency, Chronic

Adult ; Aged ; Aristolochic Acids ; adverse effects ; Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; chemistry ; Female ; Humans ; Male ; Middle Aged ; Nephritis, Interstitial ; blood ; chemically induced ; pathology

The use of nonsteroidal antiinflammatory drugs (NSAIDs) can be complicated by severe forms of renal dysfunction. These include fluid and electrolyte abnormalities, acute renal insufficiency due to alteration in renal hemodynamics, or interstitial nephritis and proteinuria secondary to glomerular pathology, which has the histologic characteristics of minimal change glomerulopathy (MCG). While NSAID-induced nephrotic syndrome characteristically consists of MCG with interstitial nephritis, which is the most common clinical manifestation, it rarely consists of MCG without interstitial nephritis, which has been reported in a handful of patients who took fenoprofen, ibuprofen, sulindac, diclofenac, or zomepirac. We experienced a 66-year-old female patient who presented with low serum albumin, proteinuria and generalized edema and received Geworin for about 2 year before developing symptoms. She histologically had MCG without interstitial nephritis and achieved a complete remission thirty-fifth days after discontinuing the drug. A cause-and-effect relationship of this disease to Geworin administration is strongly suggested by the resolution of the proteinuria after the drug was stopped and by no evidence of any impairment in renal function after twenty eight months of follow-up.
Acute Kidney Injury ; Aged ; Analgesics* ; Anti-Inflammatory Agents ; Antipyrine ; Diclofenac ; Edema ; Female ; Fenoprofen ; Follow-Up Studies ; Hand ; Hemodynamics ; Humans ; Ibuprofen ; Nephritis ; Nephritis, Interstitial* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Pathology ; Proteinuria ; Serum Albumin ; Sulindac

The article summarized the general situation of the study on the renal toxicity caused by aristolochic acids (AAs) and Chinese herbs containing AAs. The renal lesion induced by AAs and Chinese herbs containing AAs locates mainly in renal tubules, and glomeruluses have no obvious histological change. The short term administration of large doses causes acute renal epithelia denaturalization and tubular necrosis, but the long-term administration may result in chronically progressive interstitial fibrosis of the kidney. Renal failure may occur following both acute and chronic renal lesion. The renal function should be strictly monitored while one is using the Chinese herbs containing AAs, and the dosage and duration for the treatment must be limited to prevent renal toxicity.
Animals ; Aristolochiaceae ; chemistry ; Aristolochic Acids ; adverse effects ; isolation & purification ; toxicity ; Drugs, Chinese Herbal ; adverse effects ; isolation & purification ; toxicity ; Fibrosis ; Humans ; Kidney ; pathology ; Kidney Tubules ; pathology ; Nephritis, Interstitial ; chemically induced ; pathology ; Plants, Medicinal ; chemistry ; Renal Insufficiency ; chemically induced

OBJECTIVETo review the mechanisms of epithelial to mesenchymal transition (EMT) and its role in the progression of tubulointerstitial fibrosis.

DATA SOURCESThe data used in this review were obtained mainly from the studies of EMT reported from 2000-2006.

STUDY SELECTIONRelevant articles on studies of EMT in tubulointerstitial fibrosis were selected. Data were mainly extracted from the 45 articles listed in the reference section of this review.

RESULTSThe process of EMT has gained wide recognition as candidate mechanism in progression of chronic fibrotic disorders. New markers were identified and facilitate the observation of EMT. EMT is regulated by many factors through activation of kinase-dependent signaling cascades. Recent findings suggest that EMT is a reversible process, which can be controlled by factors for their epithelial inducing activities.

CONCLUSIONRemarkable progresses of EMT research have been made recently. Preventing or reversing EMT is a promising strategy against renal fibrosis.

Animals ; Connective Tissue Growth Factor ; Disease Progression ; Epithelium ; metabolism ; pathology ; Fibrosis ; Humans ; Immediate-Early Proteins ; metabolism ; Intercellular Signaling Peptides and Proteins ; metabolism ; Mesoderm ; metabolism ; pathology ; Nephritis, Interstitial ; metabolism ; pathology ; Transforming Growth Factors ; metabolism