This last pattern was found in most of the advanced age UT-A1/3(-/-) mice and in aquaporin-1 knockout mice. The UT-A1/3(-/-) mice also had increased mean arterial blood pressures. Feeding the mice a low protein diet did not prevent development of their renal pelvic abnormalities. Our studies show that real time imaging of renal pelvic structure in genetically manipulated mice provides a tool for the non-destructive, temporal evaluation of kidney structure.”
“CASE PRESENTATION
A 5-year-old female was referred
for evaluation of steroid-resistant nephrotic syndrome (SRNS). At 3 years of age, her family was concerned about the proteinuria (3+) and hematuria (2+) and brought her to the hospital for evaluation. There was no antecedent infection, fever, or rash. No family history of renal disease was noted, and her parents and her elder brother were negative for urinalysis Dorsomorphin price ( Figure 1a). At the initial visit, laboratory studies revealed hypoproteinemia ( serum albumin 3.1 g/100 ml) and hyperlipidemia ( total cholesterol 282 mg/100 ml), whereas renal function was normal ( serum creatinine 0.2 mg/100 ml, and an estimated glomerular filtration rate 135 ml/min/1.73 m(2), Figure 1b, c and Table 1). On presentation to the hospital, the patient appeared normal. Physical examination was unremarkable with normal growth; the height was 98.2 cm (+0.8 s.d., 68 percentile) and
weight was 13.0 kg (-0.5 s.d., 38 percentile). There was no dysmorphic features, edema, joint swelling, or hearing loss. The systemic workup including cardiovascular, neurological, and ophthalmological examination LCL161 in vivo was unremarkable. Renal sonogram demonstrated normal-sized, symmetric kidneys without
hydronephrosis or cysts. Urological studies including computed tomography were normal.
The renal biopsy obtained at 3 years of age revealed glomeruli of normal size, with most glomeruli only exhibiting mild segmental mesangial cell proliferation ( Figure 2a). There was no glomerulosclerosis, tuft adhesions, or crescent formation affecting glomeruli. There was no cellular infiltrates or fibrosis evident in the tubulointerstitium or arterial vessels. Direct immunofluorescence revealed low-intensity, granular staining of IgG, IgM, and C3 in the mesangium. Electron microscopy demonstrated diffuse foot process effacement, with Phosphoglycerate kinase occasional glomerular basement membrane (GBM) alterations such as thinning, splitting, and some mesangial deposits, there by excluding a primary GBM or an immunocomplex disorder. Following the biopsy, she still had persistent nephrotic-range proteinuria ( urine protein-to-creatinine ratio, 3.8 mg/mg), although maintaining normal renal function. She was treated with oral prednisone (1 mg/kg daily for 4 weeks), but her proteinuria did not respond ( Figure 1b). Because of the unresponsiveness, cyclosporin (5 mg/kg daily) was started in addition to alternate-day predonisone (1 mg/kg).