bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0093IMPROVED INTEROBSERVER AGREEMENT IN BANFF SCORING OF RENAL ALLOGRAFT BIOPSIES WHEN ROUTINELY USING CD3/PAS STAIN
Authors: Abrahams Neil , Abrahams Lauren , Freeman-Costin Katherine , Obregon Cecilia , Ziadie Mandolin 
Published: June 2020

Abstract

Background and Aims
The BANFF Classification of renal allograft rejection consists of scores for cellular and antibody mediated rejection. The scores for tubulitis (t), interstitial inflammation (i), glomerulitis (g), total inflammation (ti), and endotheliatis (v) have direct prognostic and therapeutic significance as they contribute to a diagnosis of renal allograft rejection. The original BANFF scoring was developed using hematoxylin and eosin (H&E) stain only. This study examines the level of interobserver agreement using H&E and a combination CD3/PAS stain that highlights T lymphocytes and basement membranes.

Method
50 consecutive renal allograft biopsies were retrieved and on each case H&E and CD3/PAS stains (Ventana/Roche Tissue Diagnostics clone 2GV6 for CD3) were performed. CD3/PAS and H&E slides were matched and blinded for two reviewers [reviewer (R1) and reviewer 2 (R2)]. Each case was graded in an identical manner following criteria designated for (t),(i),(g) and (ti) as previously described in the Banff Classification for Renal Allograft Biopsies. Cases were not graded for (v) as there were too few cases with endothelialitis to allow for statistical evaluation. The matched scores were analyzed using weighted Kappa statistics for interobserver agreement within each group. Agreement levels were characterized using Landis and Koch descriptions for level of agreement. All p values were two-tailed, values of &lt;0.05 were considered statistically significant. Statistical analyses was performed using SAS Version 9.4, Cary NC.

Results
Mean age was 44 years with a range of 9 -75 years. Standard deviation (SD) for age was 18 years. Gender distribution was 20% female and 80% male. Agreement between R1 and R2 for (t) scores was moderate (Weighted Kappa 0.5276) as opposed to fair for H&E group (Weighted Kappa 0.4189). Similarly, interobserver agreement was moderate for scores of (i) and (ti) in the CD3/PAS group and fair in the H&E group. For both CD3/PAS and H&E interrater evaluations, agreement was fair to poor for (g) with weighted Kappa of 0.3928 and 0.3559 respectively.

Conclusion
This study showed increased levels of interobserver agreement when using a CD3/PAS combination stain to score allograft biopsies for (t), (i) and (ti). Since (t), (i) and (ti) scores directly affect a diagnosis of rejection, we propose routine use of CD3/PAS in addition to H&E when reviewing renal allograft biopsies. Glomerulitis (g) shows poor interobserver agreement regardless of the stain used and further studies to refine the criteria for (g) in Banff revisions of the classification may be of value.
P0120FEATURES OF ULTRASTRUCTURAL CHANGES IN KIDNEY TISSUE IN THE PATIENTS WHO HAVE PASSED AWAY AS A RESULT OF SEPSIS
Authors: Agayev Mehman , Ismayilova Shalala , Ibishova Arzu 
Published: June 2020

Abstract

Background and Aims
It is believed that septicemia and septicopyemia can lead to functional failure of many organs, including the kidneys. In this regard, it is important to study the morphological features of ultrastructural changes in kidney tissue.

Method
Structural changes in renal tissue of 30 patients who died as a result of sepsis were investigated by electron-microscopy. The burial was carried out at an early stage (1-6 hours after death). The sections obtained for ultrasonic examination were examined on “James 100 S ” electron microscope after contrasting with uranyl acetate and lead citrate solution.

Results
An ultrastructural study of the cells of the cortical and medial layers of the kidneys revealed that there are changes in extracellular contacts and cell fragmentation as a result of lysis of the cytoplasmic membrane of cells. The integrity of the basal membrane of epithelial cells of the proximal and distal tubules are preserved.
However, the basal layer did not have a homogeneous structure, intersected and transparent in certain areas. Numerous vacuoles, lipid supplements and fragments of lysed intracellular proteins in the cytoplasm have been identified in the cytoplasm of cells. Most of the nucleus was in the collapse phase. The lumen of tubules is narrow and most of the microvilli of the brush border are destructed. It was revealed that in sepsis renal failure and severe destructive changes and the formation of necrosis sites in the structural elements of the nephron as a result of bacterial toxins were mainly observed in areas where bacteria were localized.

Conclusion
Abnormalities of podocytes, of endothelial cells, disruption of the basal membrane layers as a result of abnormal damage of organelles especially mitochondria, changes of proximal and distal tubules may be caused by severe renal failure due to sepsis.
P0121KIDNEY BIOPSY FINDINGS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Authors: Ahbap Dal Elbis , Basturk Taner , Sakaci Tamer , Hasbal Nuri Baris , Sevinç Mustafa , Ozagari Ayse Aysim , Eken Kamile Gulcin , Unsal Abdulkadir 
Published: June 2020

Abstract

Background and Aims
The aim of the study is to evaluate kidney biopsy findings other than renal diabetic changes in patients with type 2 diabetes mellitus.

Method
Diabetic patients with kidney biopsy between January 2003 and January 2020 were enrolled to the study. Kidney biopsy was performed to patients with suspicion of kidney disease other than diabetic nephropathy. The suspicious cases were patients without diabetic retinopathy, diabetes mellitus history less than 5 years, creatinine increase faster than expected course and hematuria. Demographic features, biopsy finding were all noted.

Results
Totally, 135 patients’ data were evaluated in which 54.1% was male. Demographic characteristics of the patients and laboratory data are given in Table 1. Mean age was 55.4±11 years and mean diabetes duration was 6.9±6.3 years. Mean duration of diabetes was 5.3±5.5 years in patients with nondiabetic nephropathy whereas it was 10.2±6.4 and 11.2±7.6 years in patients with diabetic and/or nondiabetic pathologies respectively (p&lt;0.05). Serum creatinine and proteinuria level were lower, and hemoglobin levels were higher in patients with nondiabetic nephropathy (p &lt;0.05).C3 was low in 3.7% of patients. ANA and ANCA positivity were seen in 8.1% and 3.7% of the patients, respectively. Patients without diabetic retinopathy was 81.7% of the total cohort. Biopsy indications were renal insufficiency (8.9%), nephrotic syndrome (24.4%), non-nephrotic proteinuria (16.4%), renal insufficiency with nephrotic range proteinuria (25.9%), renal insufficiency with non-nephrotic proteinuria (24.4%). Mean glomeruli number was 19.3±11.1. Ten patients had macroscopic hematuria in which all resolved with conservative care. Early diabetic changes, diffuse and/or nodular glomerulosclerosis were present in 3.1% and 96.9% of diabetic patients, respectively. Biopsies with diabetic changes with other nondiabetic pathologies were 3% of the biopsies. Isolated nondiabetic nephropathy was found in 23.7% of patients. Pathologic findings other then diabetic changes were as follows in patients without diabetic nephropathy: focal segmental glomerulosclerosis (FSGS) 49.5%, membranous glomerulonephritis 14,1%, Ig A nephropathy 12,1%, membranoproliferative glomerulonephritis 5 %, crescentic glomerulonephritis 4,1%, acute tubular necrosis 4,1%, amyloidosis 3%, tubulointerstitial damage 2%, others 6,1%.

Conclusion
Biopsy in diabetic patients is beneficial to show both diabetic nephropathy and other kidney pathologies. Kidney biopsy may be performed if there is suspicion of other glomerular pathologies. Focal segmental sclerosis was the most common pathology in our patients without diabetic nephropathy
P0125ELECTRON MICROSCOPIC DESCRIPTION OF A SENSITIVE DIAGNOSTIC PROXIMAL EPITHELIAL LYSOSOMAL LESION IN PATIENTS WITH CINAC/CKDU/MEN AND CNI NEPHROTOXICITY
Authors: Vervaet Benjamin , Nast Cynthia , Jayasumana Channa , Schreurs Gerd , Roels Frank , Herath Chula , Kojc Nika , Samaee Vahid , Rodrigo Sonali , Gowrishankar Swarnalata , Mousson Christiane , Dassanayake Rajeewa , Orantes Carlos , Vuiblet Vincent , Rigothier Claire , D'Haese Patrick , De Broe Marc 
Published: June 2020

Abstract

Background and Aims
In CINAC patients from Sri Lanka, we recently observed a sensitive constellation of proximal tubular cell findings including cellular/tubular atrophy, cell fragment shedding and, by electron microscopy (EM), the presence of an increased number of enlarged lysosomes. Here we focused on precisely defining the EM lysosomal phenotype and evaluating its presence in CINAC/MeN/CKDu cases and controls from other countries.

Method
Thirthy-two renal biopsies (18 Sri Lanka, 10 El Salvador, 1 India, 3 France) of patients with a diagnosis of CINAC (CKD 1-3A, 3B) were examined by electron microscopy (EM) in comparison to renal biopsies of normal kidneys at implantation, patients with calcineurin inhibitor (CNI) toxicity (n=17), proteinuric nephropathies (n=15), light chain disease (n=4), several cases on nephrotoxic drugs (lomustine, clomiphene, lithium, tenofovir, cisplatinum) and patients with reduced renal function of various causes (n=20).

Results
The aberrant lysosomal phenotypes can be defined as enlarged (&gt;1.2µm) and dysmorphic with a light-medium electron-dense matrix containing dispersed dark electron-dense non-membrane bound round to irregular shaped “aggregates”. In addition, indicative clusters of 4-6 smaller lysosomes with the same features could be observed. No cristae or other features of mitochondria, autophagic vacuoles, lipofuscin/ceroid droplets, peroxisomes (marginal plate), lysosomal myeloid bodies (aminoglycoside nephropathy) or electron dense laminated lysosomal inclusions (Fabry disease) were observed. Patients with calcineurin inhibitor nephrotoxicity and several cases on nephrotoxic drugs (lomustine, clomiphene, lithium) and a subset of patients with light chain disease, all conditions that can either directly or indirectly be linked to calcineurin inhibition, presented the same lesions. We present an image set demonstrating the phenotypical consistency of the diagnostic lysosomal lesion versus similar features that are non-diagnostic.

Conclusion
A rather sensitive constellation of lysosomal lesions in renal proximal tubular cells was detected associated with CINAC/CKDu/MeN and CNI nephrotoxicity in several countries, suggesting a common new pathomechanistic paradigm where CINAC patients are experiencing a tubulotoxic mechanism similar to CNI nephrotoxicity.
P0130THE MORPHOMETRIC ANALYSIS OF GLOMERULI IN OBESE AND NON-OBESE PATIENTS WITH GLOMERULAR DISEASES
Authors: Jordanova Elena , Jankovic Radmila , Naumovic Radomir , Celic Dejan , Ljubicic Bojana , Pantic Igor , Simic-Ogrizovic Sanja , Jovanovic-Basta Gordana 
Published: June 2020

Abstract

Background and Aims
The aim of the study was to evaluate glomerular morphometry in obese and non-obese patients with glomerular diseases: FSGS, IgA nephropathy, membranous glomerulonephritis (MGN) and membranoproliferative glomerulonephritis (MPGN).

Method
The study included 125 patients with glomerular diseases (77 males, mean age 46± 15.2 years): obese (BMI&gt; 27kg/m2- 63 patients) and non-obese (BMI&lt; 27kg/m2-62 patients). The serum concentration of creatinine, proteins, albumin, cholesterol, trygliceride, daily proteinuria were measured at the time of kidney biopsy. Formula Cockcroft-Gault#(Cockcroft-Gault: non-obese) and Cockcroft-GaultLBW: obese) was calculated. Glomerular radius (GR), glomerular volume (GV) and glomerular density (GD) were compared morphometrically between two groups.

Results
At the time of kidney biopsy the obese had significantly lower eGFR, significantly higher creatinine, trygliceride, daily proteinuria compared to non-obese. Obese FSGS patients had significantly higher GR (109.44±6.03 μm vs 98.53±14.38 μm) and GV (3.13±0.49 x106 μm?vs 2.26±0.83 x106 μm?, only midly lower GD (1.91±0.39/mm2 vs 1.95±0.61/mm2) compared to non-obese. Obese IgA nephropathy patients had higher GR (110.69± 15.24 μm vs 107.77±14.53 μm), significantly higher GV(3.34±1.78 x106 μm?vs 2.31± 1.51 x106 μm? and significantly lower GD (1.21±0.29/mm2 vs 2.14±0.54/mm2) in comparation with non-obese. Significant positive association between GV and BMI (r=0.439; p&lt;0.01) in FSGS patients was found. Significant positive correlation between GV and BMI (r=0.683; p&lt; 0.01), but significant negative correlation between GD and BMI (r=-0.710; p&lt; 0.01) in IgA nephropathy patients were found. Obese MGN patients had lower GR (112.82± 13.65 μm vs 118.39± 14.52 μm), GV (3.57± 1.19 x106 μm?vs 4.07± 1.28 x106 μm? and GD (1.89± 0.17/ mm2 vs 1.91± 0.92/mm2) but without significance compared to non-obese. Obese MPGN patients had higher GR(105.89± 12.24 μm vs 92.73± 30.01 μm), GV (2.94± 0.91 x106 μm?vs 2.31± 1.27 x106 μm? and GD (2.32± 0.63/ mm2 vs 2.03± 0.73/ mm2) but without significance in comparation with non-obese. Significant negative association between GD and daily proteinuria (r=-0.417; p&lt;0.01) in MGN patients was found.

Conclusion
Obese FSGS patients had significantly higher GV, lower GD compared to non-obese. Obese IgA nephropathy patients had significantly higher GV and significantly lower GD. Obese MGN patients had lower and obese MPGN patients had higher morphometric parameters of glomeruli compared to non-obese. Significant positive correlation between GV and BMI in FSGS and IgA nephropathy patients were found.
P0131HIGH-DOSE URIC ACID ALTERS CELLULAR PROTEOME, INCREASES INTRACELLULAR ATP, ENHANCES TISSUE REPAIR CAPABILITY AND INCREASES CALCIUM OXALATE CRYSTAL-BINDING CAPABILITY OF RENAL TUBULAR CELLS: IMPLICATIONS TO HYPERURICOSURIA-INDUCED KIDNEY STONE DISEASE
Authors: Sutthimethakorn Suchitra , Thongboonkerd Visith 
Published: June 2020

Abstract

Background and Aims
Hyperuricosuria is well documented to get involved in the pathogenesis of kidney stone disease, especially uric acid (UA) and calcium oxalate (CaOx) types. Nevertheless, hyperuricosuria-induced alterations in renal tubular cells and cascade mechanisms that subsequently trigger kidney stone formation remained largely unknown. This study aimed to examine changes in cellular proteome and function in renal tubular cells after treatment with high-dose UA.

Method
MDCK cells were incubated with 3.5 mM uric acid for 48-h. Cellular proteins were extracted and subjected to quantitative proteomics analysis using 2-D PAGE followed by nanoLC-ESI-ETD MS/MS. The proteome data were confirmed by Western blotting, whereas functional analyses were performed using various assays.

Results
Quantitative proteomics analysis revealed significant changes in levels of 22 proteins in the UA-treated cells that were related to ATPase activity, mitochondrial transport, cell adhesion and molecule binding, cell projection organization and maintenance of location network, metabolic process, response to unfold proteins, and vesicle-mediated transport. Western blotting confirmed changes in levels of cellular proteins identified by quantitative proteomics. Functional assays revealed an increase in intracellular ATP level and enhancement of tissue repair capability in the UA-treated cells. Interestingly, isolation/purification of apical membranes followed by Western blotting showed the increased levels of HSP70 and HSP90 (the known receptors for CaOx crystals) on apical membranes of the UA-treated cells. CaOx crystal-cell adhesion assay revealed significant increase in CaOx-binding capability of the UA-treated cells, whereas neutralization of the surface HSP70 and HSP90 using their specific monoclonal antibodies caused significant reduction in such binding capability (even below the basal level).

Conclusion
These findings highlighted changes in renal tubular cells in response to high-dose UA that might be related to the pathogenic mechanisms of kidney stone disease associated with hyperuricosuria.
P0133INCREASED INTRA-ABDOMINAL PRESSURE DURING LAPARASCOPIC PNEUMOPERITONEUM ENHANCES ALBUMINURIA VIA RENAL VENOUS CONGESTION, ILLUSTRATING PATHOPHYSIOLOGICAL ASPECTS OF HIGH OUTPUT PREECLAMPSIA
Authors: Schoutteten Melanie , Pauline Dreesen , Vande Velde Nele , Heylen Line , Kaminski Iris , De Moor Bart , Malbrain Manu , Gyselaers Wilfried 
Published: June 2020

Abstract

Background and Aims
Intra-abdominal hypertension (IAH) causes severe organ dysfunction. Our aim is to evaluate the effect of increased intra-abdominal pressure (IAP) on renal function, hypothesizing that venous congestion may increase proteinuria and fluid retention without endothelial dysfunction.

Method
Three urine samples were collected from 32 non-pregnant women undergoing laparoscopic assisted vaginal hysterectomy (LAVH) and from 10 controls placed in Trendelenburg position for 60 minutes. Urine sampling was done before (PRE), during or immediately after (PER), and two hours after (POST) the procedure. Urinary albumin, protein and creatinine concentrations were measured in each sample, ratios were calculated and compared within and between groups.

Results
During LAVH, the albumin/creatinine ratio (ACR) increased and persisted POST-procedure, which was not observed in controls. A positive correlation existed between the LAVH duration and the relative change in both ACR and protein/creatinine ratio (PCR) PER- and POST-procedure.

Conclusion
Iatrogenic IAH increases urinary ACR and PCR in non-pregnant women via a process of venous congestion. This mechanism might explain the presentation of one specific subtype of late-onset preeclampsia, where no drop of maternal cardiac output is observed.
P0134PROTEINURIA IS NOT ALWAYS ASSOCIATED WITH PROGNOSIS IN IGA NEPHROPATHY
Authors: Cho Byoung-Soo , Yun Hyaejin , Jung Sungmin , Lee Hyun-soon 
Published: June 2020

Abstract

Background and Aims
To date the most widely well studied risk factor for progression to ESRD in patients with IgA nephropathy is proteinuria. Recent report suggests proteinuria reduction as a surrogate end point in trial of IgA nephropathy(2019,CJASN). Sensitivity of most biomarkers such as blood and urine gd-IgA1 level, IgG/IgA autoantibody, sCD89, sCD71, NGAL, KIM-1, Cystatin-C etc were compared with the amount of proteinuria. Most nephrologists do not performing kidney biopsy in patients without proteinuria or proteinuria less than than 500mg/day even though IgA nephropathy is suspected. However we recently experienced severe IgA nephropathy (HSD Lee, grade IV) in patients with normal urinalysis, and more than half the patients showed stationary or aggravated renal pathology at the follow up renal biopsy although urinalysis findings were normalized after methylprednisolone pulse therapy.

Method
In our center we performed 892 renal biopsies during last 6 years, we experienced 253 IgA nephropathy, of which 152 cases were done follow up renal biopsies to see the pathologic changes who showed normalized urinalysis findings after methylprednisolone pulse therapy.

Results
Of the 253 patients 241 patients showed initial abnormal urinalysis like hematuria and or proteinuria. However eleven patients showed normal urinalysis at the time of renal biopsy, of which 5 cases were diagnosed as essential hypertension and 6 cases were normal urinalysis associated with lowered GFR. Of the 152 follow up renal biopsies we evaluated 99 cases who showed normalized urinalysis findings after therapy, of which 65 cases(65.7%) showed stationary or aggravated renal pathology.

Conclusion
In conclusion further long term studies are needed, proteinuria could not be a surrogate marker for prognosis of the IgA nephropathy, Regardless of proteinuria if associated with hypertension and or lowered GFR, renal biopsy should be done. Follow up renal biopsy might be needed to confirm the healing of IgA nephropathy regardless of urinary findings to see the disappearance of IgA deposition, decreasing mesangial and endocapillary hypercellularity, disappearance of crescent formation, decreasing sclerosis, etc.
P0135EFFECT OF LYSOPHOSPHATIDIC ACID REGULATION ON THE AGING KIDNEY
Authors: JIN YONGJIE , Kim Eun Nim , Lim Ji Hee , Kim Hyung Duk , Kim Yaeni , Ban Tae Hyun , Park Cheol Whee , Choi Bum Soon 
Published: June 2020

Abstract

Background and Aims
Lysophosphatidic Acid (LPA) is a bioactive lysophospholipid that is present in all tissues. It has been reviewed that LPA could induce oxidative stress and inflammation. Oxidative stress is a major characteristic of aging which is a critical risk factor of renal dysfunction. Nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor that regulates the expression of antioxidants, which could improve cell viability by reducing oxidative stress, is found to be decreased in the aging kidney. Also, LPA regulates the expression of Nrf2 has been reported. In this study, we evaluate the effect of LPA in the aging kidney by elucidating the potential LPA-Nrf2 signaling pathway.

Method
Male 2- and 24-month-old C57/BL6 mice were used in this study. We measured histological change, oxidative stress, and aging-related protein expression in the kidneys.

Results
24-month-old mice displayed increased albuminuria. Creatinine clearance decreased with aging. There were increases in mesangial volume and tubulointerstitial fibrosis in 24-month-old mice. There were also increases in autotaxin, LPAR1, PI3K, Akt, GSK3β expression with aging and Nrf2, NQO1, HO1, SOD1, SOD2 were decreased in 24-month-old mice.

Conclusion
LPA signaling decreased antioxidants expression via down-regulating Nrf2. Targeting the LPA-Nrf2 pathway provides new evidence to decrease aging-related disease in the kidney.