The glomerular changes in children with reflux nephropathy

Article Abstract:

Reflux nephropathy, sometimes called chronic pyelonephritis, is characterized by the presence of scarring in the kidneys caused by bacterial infection. In many cases, the disease has been observed to begin in childhood. Recurrent or severe urinary tract infection is a common cause of renal (kidney) scarring and kidney failure. The scarring process involves an infiltration of inflammatory cells (white blood cells) that later are replaced by fibroblasts (connective tissue cells) and collagen. The progression of the scarring cannot be prevented by surgery and is often accompanied by proteinuria (the presence of protein in the urine). The proteinuria is believed to be caused by a dilation of kidney blood vessels, an increase in the amount of blood being filtered by the kidney (hyperfiltration vasculopathy), kidney enlargement, and an increase in the amount of protein passing through the capillary walls into the urine. Renal biopsy samples were obtained from 24 patients, ages 5 to 19, with proteinuria. Eight of the samples revealed the presence of lesions of the glomeruli (clusters of capillaries, the functional units of the kidney) in the form of focal segmental glomerulosclerosis (FSGS). There was a positive correlation between the extent of scarring and the amount of protein excreted in the urine. The biopsy samples that did not show signs of FSGS showed signs of enlargement and thickening. It is concluded that glomerular hypertrophy (enlargement of the glomeruli) and hyperfiltration begin prior to the development of proteinuria. By the time proteinuria is detected, it is likely that FSGS will have already developed. Early monitoring for proteinuria in patients suspected of having reflux nephropathy is recommended. Future studies should determine whether a protein-restricted diet may be of benefit in the management of reflux nephropathy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Causes of, Development and progression, Kidney diseases, Glomerular filtration rate, Proteinuria, Bladder diseases, Nephrosclerosis

---

Leakiness of gastric superficial and foveolar cells: a quantitative electron microscopic study using tannic acid

Article Abstract:

Biopsies from the distal (intestinal) portion of the stomach were taken from 41 patients who had upper gastrointestinal tract problems. The samples were examined for the presence of the bacteria Helicobacter pylori and graded as to the extent of gastritis, or chronic inflammation of the stomach. H. pylori causes damage to the lining of the stomach and may lead to gastritis. Other samples were prepared for electron microscopic examination, in which the sample is magnified 5,000 to 17,000 times, making it possible to observe great detail within the cells. The samples were stained with the chemical tannic acid, which shows if the cells are ''leaky,'' that is, if the cell membranes are damaged and the contents of the cells escape. A relationship was seen between the extent of leakiness, indicating cell damage, and the grade of gastritis, as determined by examination of the tissue. A correlation was also seen between the extent of gastritis and the number of polymorphonuclear white blood (PMNs) cells in the tissues, the number of PMNs that were present in the glands of the stomach, the number of cells infected with H. pylori, and patient age. (Polymorphonuclear white blood cells are drawn to sites of infection.) Different grades of gastritis could not be determined when the stomach was examined with an endoscope (a flexible fiberoptic instrument that allows visualization of the interior of a body cavity or organ). (Consumer Summary produced by Reliance Medical Information, Inc.)

Bacterial infections, Helicobacter infections, Tannins, Gastritis

---

A quantitative analysis of the mesangium in children with IgA nephropathy: sequential study

Article Abstract:

IgA (immunoglobulin A) nephropathy, a disease affecting the glomerulus of the kidneys, has been accepted as a distinct disease entity with variable clinical features and variable outcomes. This disease is characterized by pathological alterations in the mesangium, a central part of the kidney glomerulus between capillaries, resulting in excess cell and tissue growth. A large number of cases, for unknown reasons, progress to kidney (renal) failure. This study examined the relationship between the changes in the mesangium and the clinical and pathological outcome of the patient. The study group consisted of 41 children with IgA nephropathy who had repeat renal biopsies taken during 1981 and 1986 at Kobe University hospital. Children diagnosed with blood in the urine that was considered benign were used as control subjects. Biopsied tissues were examined by light microscopy and immunofluorescence. The IBAS (Zeiss) analysis method was used, which analyzed the image and the area of the mesangial matrix of the specimens by computer. Most of the patients showed an increase or no change in the mesangial matrix, with persistent proteinuria in repeat renal biopsies. This increase appears to be irreversible, and when accompanied by proteinuria, is associated with, and indicative of, a deteriorating clinical condition. The clear-cut value of repeat serial biopsies in children with this illness is demonstrated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Complications and side effects, IgA glomerulonephritis, Kidney glomerulus, Glomeruli

Similar abstracts:

• Abstracts: The serum selenium concentrations in children and young adults: a long-term study during the Finnish selenium fertilization programme
• Abstracts: Molecular mimicry in HLA-B27-related arthritis. The cost-effectiveness of cyclooxygenase-2 inhibitors for treating chronic arthritis
• Abstracts: Anencephalics as organ donors. Fetal and fetal organ volume estimations with magnetic resonance imaging. An updated pediatric perspective on the Apert syndrome
• Abstracts: Serial abuse in children who are shaken. Bacterial meningitis in older children. Mediterranean spotted fever in children returning from France
• Abstracts: Heart-lung transplantation for patients with cystic fibrosis: a test of clinical wisdom. Angiotensin-converting enzyme inhibitors in congestive heart failure

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.