Fig. 8.1. Glomerular Filtration Barrier. the Glomerular Filtration Barrier
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Calcium Phosphate Microcrystals in the Renal Tubular Fluid Accelerate Chronic Kidney Disease Progression
The Journal of Clinical Investigation RESEARCH ARTICLE Calcium phosphate microcrystals in the renal tubular fluid accelerate chronic kidney disease progression Kazuhiro Shiizaki,1,2 Asako Tsubouchi,3 Yutaka Miura,1 Kinya Seo,4 Takahiro Kuchimaru,5 Hirosaka Hayashi,1 Yoshitaka Iwazu,1,6,7 Marina Miura,1,6 Batpurev Battulga,8 Nobuhiko Ohno,8,9 Toru Hara,10 Rina Kunishige,3 Mamiko Masutani,11 Keita Negishi,12 Kazuomi Kario,12 Kazuhiko Kotani,7 Toshiyuki Yamada,7 Daisuke Nagata,6 Issei Komuro,13 Hiroshi Itoh,14 Hiroshi Kurosu,1 Masayuki Murata,3 and Makoto Kuro-o1 1Division of Anti-aging Medicine, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan. 2Yurina Medical Park, Shimotsuga, Japan. 3Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan. 4Division of Cell and Molecular Medicine, 5Division of Cardiology and Metabolism, Center for Molecular Medicine, 6Division of Nephrology, Department of Internal Medicine, 7Department of Clinical Laboratory Medicine, and 8Division of Histology and Cell Biology, Department of Anatomy, Jichi Medical University, Shimotsuke, Japan. 9Division of Ultrastructural Research, National Institute for Physiological Sciences, Okazaki, Japan. 10Electron Microscopy Analysis Station, Research Network and Facility Service Division, National Institute for Materials Science, Tsukuba, Japan. 11Healthcare Business Unit, Nikon Corporation, Yokohama, Japan. 12Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan. 13Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 14Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. The Western pattern diet is rich not only in fat and calories but also in phosphate. -
« Glomerulogenesis and Renal Tubular Differentiation : Role of Hnf1β »
THESE DE DOCTORAT DE L’UNIVERSITE PARIS DESCARTES Ecole doctorale « Bio Sorbonne Paris Cité », ED 562 Département Développement, Génétique, Reproduction, Neurobiologie et Vieillissement (DGRNV) Spécialité : Développement Présentée pour obtenir le titre de DOCTEUR de l’Université Paris Descartes « Glomerulogenesis and renal tubular differentiation : Role of HNF1 β » Par Mlle Arianna FIORENTINO Soutenance le 13 décembre 2016 Composition du jury : Mme. Evelyne Fischer Directrice de thèse M. Marco Pontoglio Examinateur M. Jean-Jacques Boffa Rapporteur M. Yves Allory Rapporteur M Rémi Salomon Examinateur M Jean-Claude Dussaule Examinateur Equipe "Expression Génique, Développement et Maladies" (EGDM) INSERM U1016/ CNRS UMR 8104 / Université Paris-Descartes Institut Cochin, Dpt. Développement, Reproduction et Cancer 24, Rue du Faubourg Saint Jacques, 75014 Paris, France A. Fiorentino HNF1beta in kidney development “Connaître ce n'est pas démontrer, ni expliquer. C'est accéder à la vision.” (Le Petit Prince- Antoine de Saint-Exupéry) 2 A. Fiorentino HNF1beta in kidney development Aknowledgments - Remerciements – Ringraziamenti During this long adventure of the PhD, I was surrounded by many people that I will try to thank to in these pages. In first place, I would like to thank the members of the jury that have kindly accepted to evaluate my work: Jean-Jacques Boffa, Yves Allory, Jean-Claude Dussaule and Rémi Salomon. For the supervision and the precious advices, I would like to thank Evelyne Fischer and Marco Pontoglio that overviewed all my work. I thank Evelyne, my thesis director, for the scientific exchanges of ideas, for the guidance to complete my project and for her help in difficult moments. I thank Marco for the discussions, even for the heated ones, because the pressure in the environment not only helped me to work harder on science but more importantly on my character, to face the problems and solve them. -
Interpretation of Canine and Feline Urinalysis
$50. 00 Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Interpretation of Canine and Feline Urinalysis Dennis J. Chew, DVM Stephen P. DiBartola, DVM Clinical Handbook Series Preface Urine is that golden body fluid that has the potential to reveal the answers to many of the body’s mysteries. As Thomas McCrae (1870-1935) said, “More is missed by not looking than not knowing.” And so, the authors would like to dedicate this handbook to three pioneers of veterinary nephrology and urology who emphasized the importance of “looking,” that is, the importance of conducting routine urinalysis in the diagnosis and treatment of diseases of dogs and cats. To Dr. Carl A. Osborne , for his tireless campaign to convince veterinarians of the importance of routine urinalysis; to Dr. Richard C. Scott , for his emphasis on evaluation of fresh urine sediments; and to Dr. Gerald V. Ling for his advancement of the technique of cystocentesis. Published by The Gloyd Group, Inc. Wilmington, Delaware © 2004 by Nestlé Purina PetCare Company. All rights reserved. Printed in the United States of America. Nestlé Purina PetCare Company: Checkerboard Square, Saint Louis, Missouri, 63188 First printing, 1998. Laboratory slides reproduced by permission of Dennis J. Chew, DVM and Stephen P. DiBartola, DVM. This book is protected by copyright. ISBN 0-9678005-2-8 Table of Contents Introduction ............................................1 Part I Chapter 1 Sample Collection ...............................................5 -
LYME DISEASE: TREATMENT of ACUTE and CHRONIC MANIFESTATIONS Justine A
LYME DISEASE: TREATMENT OF ACUTE AND CHRONIC MANIFESTATIONS Justine A. Lee, DVM, DACVECC, DABT CEO, VetGirl [email protected] www.vetgirlontherun.com Lyme disease, caused by the spirochete Borrelia burgdorferi (Bb), is one of the most common tick-borne diseases in the world. The Centers for Disease Control and Prevention (CDC) reported a dramatic increase in the number of diagnosed human infection cases, increasing from 30,000 to 300,000 recently.1 According to the CDC, 95% of human Lyme disease cases came from the following 13 states: CT, DE, ME, MD, MA, MN, NH, NJ, NY, PA, VT, VA, WI.2 Are we seeing this increase in our canine population? In the United States, more than 90% of the canine cases occur in the northeast and Midwest.3 That said, only 5% of seropositive dogs in endemic areas develop infection or show clinical signs.3-5 With the Idexx 3D or 4D SNAP test, there is likely an over-diagnosis of Lyme disease. How do we interpret a positive test, and more importantly, how do we treat acute and chronic manifestations of Lyme disease? Transmission While Bb can be transmitted by urine, milk, and blood, the most common transmission is likely via tick infestation by hard-shell deer ticks (e.g., Ixodes scapularis or other related Ixodes species). Ixodes ticks have a 2-year life cycle,3,4 and hatch in the spring (into larvae). A female tick lays approximately 2000 eggs.3 Larvae become infected with Bb when feeding on white- footed mice, which are persistently infected, but often remain unaffected or asymptomatic.3 The larvae molt into nymphs that feed on new hosts. -
Urine Protein/Creatinine Ratio
Woodley Equipment Company Ltd. E.R.D.-HealthScreen® Urine Tests Paul Lymer, B.Sc. European Sales Manager Woodley Equipment Company Ltd. E.R.D.-HealthScreen® Urine Tests What do you know about kidneys? E.R.D.-HealthScreen® Test What is its purpose? Used to detect albumin in the urine Urinary System Kidney What are the functions of the kidneys? Regulate water and soluble substances by: • Filtering the blood • Removing excess water and waste from the blood (urine) • Sending urine to the bladder • Releasing hormones into the blood How does a normal kidney handle albumin? 4 mg/dL albumin goes in 2-3 mg/dL albumin normally leaks through glomerulus and is reabsorbed by the proximal tubule <<1 mg/dL Russo et al 2002 AJKD 39:899 albumin D’Amico and Bazzi 2003 Kidn Internt’l 63:809 comes out The Glomerulus at work The kidneys filter a dog’s or cat’s entire blood volume every 30 minutes. Systemic Disease & Albuminuria • Antigen-Antibody Complexes • Vasculitis • Hypertension The most common protein associated with kidney damage is albumin. 1º Causes of 2º renal damage • Inflammatory diseases • Infectious diseases • Metabolic diseases • Neoplasia • Hypertension • Drugs 1º Causes of 2º renal damage • Inflammatory diseases • Metabolic diseases – Dental disease – Diabetes mellitus – Pyoderma – Hyperadrenocorticism – IBD – Hyperthyroidism – Immune mediated diseases • Hypertension • Neoplasia • Infectious diseases • Drugs – Heartworm disease – Tick-borne diseases – Viral diseases Introduction to E.R.D.-HealthScreen Urine Test Technology Microalbuminuria -
Urinary System
OUTLINE 27.1 General Structure and Functions of the Urinary System 818 27.2 Kidneys 820 27 27.2a Gross and Sectional Anatomy of the Kidney 820 27.2b Blood Supply to the Kidney 821 27.2c Nephrons 824 27.2d How Tubular Fluid Becomes Urine 828 27.2e Juxtaglomerular Apparatus 828 Urinary 27.2f Innervation of the Kidney 828 27.3 Urinary Tract 829 27.3a Ureters 829 27.3b Urinary Bladder 830 System 27.3c Urethra 833 27.4 Aging and the Urinary System 834 27.5 Development of the Urinary System 835 27.5a Kidney and Ureter Development 835 27.5b Urinary Bladder and Urethra Development 835 MODULE 13: URINARY SYSTEM mck78097_ch27_817-841.indd 817 2/25/11 2:24 PM 818 Chapter Twenty-Seven Urinary System n the course of carrying out their specific functions, the cells Besides removing waste products from the bloodstream, the uri- I of all body systems produce waste products, and these waste nary system performs many other functions, including the following: products end up in the bloodstream. In this case, the bloodstream is ■ Storage of urine. Urine is produced continuously, but analogous to a river that supplies drinking water to a nearby town. it would be quite inconvenient if we were constantly The river water may become polluted with sediment, animal waste, excreting urine. The urinary bladder is an expandable, and motorboat fuel—but the town has a water treatment plant that muscular sac that can store as much as 1 liter of urine. removes these waste products and makes the water safe to drink. -
L8-Urine Conc. [PDF]
The loop of Henle is referred to as countercurrent multiplier and vasa recta as countercurrent exchange systems in concentrating and diluting urine. Explain what happens to osmolarity of tubular fluid in the various segments of the loop of Henle when concentrated urine is being produced. Explain the factors that determine the ability of loop of Henle to make a concentrated medullary gradient. Differentiate between water diuresis and osmotic diuresis. Appreciate clinical correlates of diabetes mellitus and diabetes insipidus. Fluid intake The total body water Antidiuretic hormone is controled by : Renal excretion of water Hyperosmolar medullary Changes in the osmolarity of tubular fluid : interstitium 1 2 3 Low osmolarity The osmolarity High osmolarity because of active decrease as it goes up because of the transport of Na+ and because of the reabsorbation of water co-transport of K+ and reabsorption of NaCl Cl- 4 5 Low osmolarity because of High osmolarity because of reabsorption of NaCl , also reabsorption of water in reabsorption of water in present of ADH , present of ADH reabsorption of urea Mechanisms responsible for creation of hyperosmolar medulla: Active Co- Facilitated diffusion transport : transport : diffusion : of : Na+ ions out of the Only of small thick portion of the K+ , Cl- and other amounts of water ascending limb of ions out of the thick from the medullary the loop of henle portion of the Of urea from the tubules into the into the medullary ascending limb of inner medullary medullary interstitium the loop of henle collecting -
Cases of Acute Nephritis, Many Acute Infections
EXPERIMENTAL HYPOSTHENURIA"12 By J. M. HAYMAN, JR., N. P. SHUMWAY, P. DUMKE, AND MAX MILLERS (From the Department of Medicine, Western Reserve University Medical School, and the Lakeside Hospital, Cleveland) (Received for publication November 2, 1938) The clinical usefulness of the specific gravity vated blood pressure and cardiac enlargement, so that test of kidney function, and the variety of condi- more blood was forced " through the urinary apparatus," and noted that when the heart failed, "the abnormally tions under which impairment of concentrating large amount of urine falls off, and the abnormally low ability is encountered, furnished the incentive for specific gravity rises." Johnson (41) believed the poly- this study. This test is most commonly used as uria unrelated to the arterial tension, but caused by the an indication of the degree of renal damage in diuretic influence of some abnormal products in the cir- glomerulonephritis and arteriolar nephrosclerosis, culation. Newman (61) suggested that the polyuria of iri both of which there is a significant reduction the contracted kidney was due to obstruction of the lymphatics. Thoma (82) thought it due to increased in the number of nephrons. A urine of low spe- glomerular permeability. v. Koranyi (91) and his as- cific gravity, however, is also encountered in some sociates, who investigated hyposthenuria extensively, of- cases of acute nephritis, many acute infections, fered only the suggestion that with failing kidney func- chemical poisoning, prostatic obstruction, pyelo- tion, the capacity of the kidney to do the work entailed nephritis, trauma to the kidney, and severe anemia, in the processes of concentrating or diluting solutes with- no significant reduction drawn from the blood progressively diminishes. -
A Study of the Effect of Protein in Tubular Fluid in Proximal Tubular Reabsorption Robert Lee Mitchell Yale University
Yale University EliScholar – A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine 1964 A study of the effect of protein in tubular fluid in proximal tubular reabsorption Robert Lee Mitchell Yale University Follow this and additional works at: http://elischolar.library.yale.edu/ymtdl Recommended Citation Mitchell, Robert Lee, "A study of the effect of protein in tubular fluid in proximal tubular reabsorption" (1964). Yale Medicine Thesis Digital Library. 2943. http://elischolar.library.yale.edu/ymtdl/2943 This Open Access Thesis is brought to you for free and open access by the School of Medicine at EliScholar – A Digital Platform for Scholarly Publishing at Yale. It has been accepted for inclusion in Yale Medicine Thesis Digital Library by an authorized administrator of EliScholar – A Digital Platform for Scholarly Publishing at Yale. For more information, please contact [email protected]. YALE UNIVERSITY LIBRARY 3 9002 06679 0909 A STUDY OF THE EFFECT OF PROTEIN IN TUBULAR FLUID IN OXIMAL TUBULAR REABSORPTION ROBERT L. MITCHELL 19 6 4 YALE MEDICAL LIBRARY Digitized by the Internet Archive in 2017 with funding from The National Endowment for the Humanities and the Arcadia Fund https://archive.org/details/studyofeffectofpOOmitc A STUDY OF THE EFFECT OF PROTEIN IN TUBULAR FLUID IN PROXIMAL TUBULAR REABSORPTION by Robert L, Mitchell (B.A. DePauw I960) A Thesis Presented to the Faculty of the Yale University School of Medicine in Partial Fulfillment of the Requirements for the Degree of Doctor of Medicine Yale University School of Medicine 196U ACKNOWLEDGMENT With sincere appreciation* I wish to express my gratitude to Dr. -
Complete Urinalysis Panel
COMPLETE URINALYSIS PANEL INTERPRETATION GUIDE Scroll down or click on the following parameters to quickly access content A Complete Urinalysis is threefold: Physical exam Color Clarity - Turbidity Urine specific gravity Chemical exam pH PRO (protein) GLU (glucose) KET (ketones) UBG (urobilinogen) BIL (bilirubin) Blood LEU Sediment exam (see urine sediment guide) Cells, bacteria, casts, crystals and miscellaneous elements Urine Clarity Description In most animals, normal urine is clear to slightly cloudy. In horses, normal urine is cloudy due to the presence of calcium carbonate crystals and mucus. Values Below Reference Range Common Causes In an animal that typically shows cloudy urine, a clear urine would suggest absence of crystalluria. Values Above Reference Range Common Causes Excessively cloudy urine can be the result of high numbers of crystals, leukocytes, erythrocytes, bacteria, mucus, casts, lipids, or possibly sperm. Other Laboratory Tests Microscopic examination of the urine sediment is advised. References Barsanti JA, Lees GE, Willard MD, Green RA. Urinary disorders. In Small Animal Clinical Diagnosis by Laboratory Methods. Willard MD, Tvedten H, Turnwald GH, eds. Philadelphia, Pa: WB Saunders Company; 1999. DiBartola SP. Clinical approach and laboratory evaluation of renal disease. In Textbook of Veterinary Internal Medicine. Ettinger SJ, Feldman EC, eds. Philadelphia, Pa: WB Saunders Company; 1995. Duncan JR, Prasse KW, Mahaffey EA. Veterinary Laboratory Medicine. Ames, Iowa: Iowa State University Press; 1994. Urine Specific Gravity Description Specific gravity is a reflection of solute concentration. It should be determined by refractometry as dipsticks are inaccurate. Assuming normal hydration status and no treatments that alter water resorption by the kidneys, expected specific gravity results are: o Dogs: 1.015–1.045 o Cats: 1.035–1.060 o Horses: 1.020–1.050 The amount of other substances in urine should be interpreted in consideration of the specific gravity. -
The Distal Convoluted Tubule and Collecting Duct
Chapter 23 *Lecture PowerPoint The Urinary System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Urinary system rids the body of waste products. • The urinary system is closely associated with the reproductive system – Shared embryonic development and adult anatomical relationship – Collectively called the urogenital (UG) system 23-2 Functions of the Urinary System • Expected Learning Outcomes – Name and locate the organs of the urinary system. – List several functions of the kidneys in addition to urine formation. – Name the major nitrogenous wastes and identify their sources. – Define excretion and identify the systems that excrete wastes. 23-3 Functions of the Urinary System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Diaphragm 11th and 12th ribs Adrenal gland Renal artery Renal vein Kidney Vertebra L2 Aorta Inferior vena cava Ureter Urinary bladder Urethra Figure 23.1a,b (a) Anterior view (b) Posterior view • Urinary system consists of six organs: two kidneys, two ureters, urinary bladder, and urethra 23-4 Functions of the Kidneys • Filters blood plasma, separates waste from useful chemicals, returns useful substances to blood, eliminates wastes • Regulate blood volume and pressure by eliminating or conserving water • Regulate the osmolarity of the body fluids by controlling the relative amounts of water and solutes -
URINARY TRACT DISORDERS in HORSES- Advances in Diagnostics and Treatments Thomas J
URINARY TRACT DISORDERS IN HORSES- Advances in Diagnostics and Treatments Thomas J. Divers, DVM, DACVIM, DAVECC College of Veterinary Medicine Cornell University, Ithaca, New York USA Introduction- Drs. Lisle George and Robert Whitlock in 1976 during my residency encouraged me to develop and interest in studying urinary tract diseases in large animals. I am grateful to him for encouraging me to do so. In these notes, I will give a brief overview of equine urinary tract disorders pointing out some of the discoveries or observations made over the last 45 years. Acute Renal failure/ Acute Kidney Injury In most of the recent literature the term acute renal failure (ARF) has been replaced by acute kidney injury (AKI). One commonly used definition of AKI is an acute increase in serum creatinine of 0.3 mg/dl or greater and oliguria. The switch in terms from ARF to AKI is semantic and in my mind has not improved our understanding or management of the disease. Uremia is the clinical condition caused by renal failure and accumulation of harmful products in the blood associated with decline in kidney function. AKI leading to renal failure and uremia can result from either intrinsic (kidney) disease/dysfunction or obstruction/rupture of the urinary tract. Acute renal failure is more common in large animals than chronic renal failure (CRF) and we can often reverse the disease process in ARF. Intrinsic causes of acute renal failure (ARF/AKI) include those disorders that cause significant functional decreases in glomerular filtration rate (GFR), mostly due to abnormal glomerular filtration pressures (common with septic shock), or morphologic nephron damage (common with nephrotoxins) or both.