Search Results (339)

Fish are widely recognized as effective bioindicators in ecotoxicological studies due to their repeated exposure to aquatic pollutants that accumulate in metabolically active organs, often leading to histopathological changes. In aquaculture, cage-farmed fish experience continuous environmental and culture-related stress, which can affect renal integrity. The kidney, a central osmoregulatory organ, is particularly sensitive to such conditions. Renal tissues were collected from different growth stages of cage-farmed rainbow trout. Hematoxylin and eosin staining was performed to detect morphological alterations, while transmission electron microscopy was used to assess cellular damage at the ultrastructural level. The expression of fibronectin and caspase-3, markers of extracellular matrix remodeling and apoptosis, respectively, was also evaluated. TEM examination showed pronounced alterations in both the glomeruli and renal tubules, accompanied by increased expression of fibronectin and caspase-3, indicating ongoing tissue remodeling and cellular stress. This study demonstrates that cage-farmed rainbow trout exhibit progressive ultrastructural kidney alterations that appear to be associated with environmental confinement, nutritional practices, and prophylactic treatments. These conditions collectively contribute to renal stress and the onset of nephropathic changes in aquaculture settings. Further research should focus on molecular marker expression to better understand renal adaptation and injury progression under intensive farming conditions. Full article

Background/Objectives: Fouquieria splendens Engelm. is a medicinal plant traditionally used in North America for treating metabolic disorders; however, its antihyperglycemic properties and safety profiles remain poorly studied. We investigated the phytochemical composition, oral acute toxicity, mutagenicity, and antihyperglycemic activity of the foliar ethanolic extract of F. splendens (EFS). Methods: Phytochemical analysis was performed using ultra-performance liquid chromatography–mass spectrometry. Acute toxicity and mutagenicity were evaluated following the OECD guidelines. Antihyperglycemic activity was assessed in streptozotocin-induced diabetic rats treated with EFS (200 mg/kg) alone or in combination with metformin for 30 days. Results: Eleven phenolic compounds were identified in the EFS, including ellagic acid, morin, apigenin, and luteolin 7-Oglucoside. EFS was non-mutagenic and had an LD₅₀ of >2000 mg/kg. This treatment significantly reduced blood glucose levels and enhanced the effect of metformin in diabetic rats. Histopathological analysis showed preserved morphology in the pancreatic, hepatic, and renal tissues of the treated animals. Conclusions: EFS exhibited significant antihyperglycemic activity and a favorable safety profile, supporting its potential as a complementary phytotherapeutic agent for diabetes management. These results highlight the pharmacological value of F. splendens and promote the exploration of native plants as adjuncts for chronic disease therapy. Full article

Sulfated polysaccharides (SPs) are abundant in seaweed and have several industrial and biomedical applications, but their renal effects remain unclear. This study evaluated the effects of total sulfated polysaccharides (TSPs) from Gracilaria cornea using an isolated rat kidney perfusion model. TSP at 3 µg/mL increased perfusion pressure and renal vascular resistance at 90–120 min, while 4.5 µg/mL induced earlier and more pronounced changes (from 60 min). Urinary flow decreased at 1 µg/mL (90 min) but increased at 4.5 µg/mL (90–120 min). Sodium transport was reduced at all concentrations, whereas potassium and chloride transport remained unchanged. Histological analysis revealed protein deposits in tubules and urinary space, indicating tubular injury. In vitro, TSP reduced MDCK cell viability in a concentration-dependent manner and induced apoptosis, with some cells progressing to secondary necrosis. In conclusion, TSP altered renal physiology and morphology and triggered apoptotic pathways in renal cells, highlighting the need for further mechanistic and translational studies. Full article

Introduction: In minimally invasive, off-clamp partial nephrectomy (ocMIPN), the reconstructive strategy profoundly influences functional outcomes. Traditional nephrometry scores aid preoperative planning but do not directly inform the choice of closure technique. This dual-institutional study aimed primarily to identify preoperative CT-derived parameters predictive of renorrhaphy versus a sutureless approach, and secondarily to compare perioperative and functional outcomes between these techniques. Methods: We retrospectively analyzed 201 consecutive ocMIPN cases performed using a standardized off-clamp technique by two experienced surgical teams across robotic platforms and conventional laparoscopy. Preoperative CT scans were centrally reviewed to quantify morphometric features, including contact surface area (CSA), tumor radius, and Gerota’s fascia thickness. Univariable and multivariable logistic regression models—one restricted to radiologic variables and one expanded with RENAL score terms—were generated to identify independent predictors. Perioperative outcomes, renal functional metrics, and Trifecta rates were compared between cohorts. Results: Among the 201 patients, 101 (50.2%) underwent sutureless reconstruction and 100 (49.8%) renorrhaphy. Cohorts were comparable at baseline except for tumor size (3.1 vs. 3.6 cm; p = 0.04). In multivariable analysis, CSA > 15 cm² (OR 3.93; 95% CI 1.26–12.26; p = 0.02) and tumor radius (OR 1.14 per mm; 95% CI 1.01–1.29; p = 0.04) consistently predicted renorrhaphy, while Gerota’s fascia < 10 mm emerged as significant only in the expanded specification (OR 0.08; 95% CI 0.01–0.70; p = 0.02). Integration with RENAL improved predictive performance (ΔAUC 0.06; NRI 0.14; IDI 0.07), and the final model demonstrated strong discrimination (AUC 0.81) with satisfactory calibration. Perioperative outcomes, postoperative renal function, and Trifecta achievement were similar between groups (all p ≥ 0.21). Conclusions: A concise set of CT-derived morphologic markers—CSA, tumor radius, and perinephric fascia thickness—anticipated reconstructive strategy in ocMIPN and augmented the discriminatory power of RENAL nephrometry. When anatomy was favorable, sutureless repair was not associated with statistically significant differences in perioperative safety or renal function, although the study was not powered for formal equivalence testing. These findings support the integration of radiologic markers into preoperative planning frameworks for nephron-sparing surgery. Full article

Purpose: Renal angiomyolipomas (AMLs) are benign renal neoplasms that may lead to spontaneous hemorrhage. Transcatheter arterial embolization (TAE) is a nephron-sparing treatment option, yet data on predictors of hemorrhage and re-intervention remain limited. This study evaluates clinical and radiologic outcomes of TAE and identifies predictors of hemorrhage and repeat embolization. Materials and Methods: A retrospective review of 66 patients (69 AMLs) undergoing TAE between 2010 and 2024 was conducted. Clinical, radiological, and procedural variables were analyzed. Tumor size, vascularity, and aneurysmal features were assessed pre- and post-embolization. Logistic regression models identified predictors of hemorrhage and repeat TAE. Results: Pre-treatment tumor diameter was the only significant predictor of hemorrhage (p = 0.011), with a threshold of 6.8 cm yielding 84.6% sensitivity and 71.3% specificity. All hemorrhagic tumors measured ≥4 cm. Post-embolization tumor volume predicted repeat TAE (p = 0.001), with a 248 mL cutoff. TAE significantly reduced tumor diameter (−33.5%) and volume (−60%) (p < 0.001). Radiologic success was achieved in 97% of cases, with a durable success rate of 84%. Clinical success was 94%, and complications occurred in 7.2% of patients, including two major events. Conclusions: TAE is a safe and effective treatment for renal AMLs. Tumor diameter >6.8 cm is a strong predictor of hemorrhage, while larger post-embolization volumes predict the need for re-intervention. These findings challenge the conventional 4 cm treatment threshold and support more individualized management strategies incorporating tumor morphology and response to embolization. Full article

Background/Objectives: Diabetic nephropathy (DN) is a major complication of diabetes and a leading cause of end-stage renal disease, a condition associated with high mortality risks. Recently, supplementation with probiotics and postbiotics has been attracting attention. Especially, metabolites of natural products bioconverted by beneficial bacteria have emerged as a novel therapeutic intervention for metabolic diseases, including diabetes, due to the enhanced bioavailability of their metabolites. This study investigated the alleviating effects of metabolites derived from guava leaf extract bioconverted by Limosilactobacillus fermentum (GBL) on renal inflammation in type 2 diabetic mice. Methods: For this purpose, diabetes was induced in male C57BL/6J mice by a high-fat diet and streptozotocin injection (80 mg/kg BW) twice. Subsequently, mice with fasting blood glucose levels higher than 300 mg/dL were administered metabolites of L. fermentum (LF) (50 mg/kg BW/day) or guava leaf extract bioconverted by L. fermentum (GBL) (50 mg/kg BW/day) by oral gavage for 15 weeks. Results: GBL demonstrated potential in alleviating hyperglycemia-induced DN in diabetic mice. It markedly improved hyperglycemia, glucose tolerance, and morphological alterations, which might stem from activation of key regulators of energy metabolism. GBL uniquely reduced advanced glycation end products (AGEs) and suppressed nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)-driven inflammatory pathways, which significantly alleviated oxidative stress and apoptosis. Conclusions: This highlights the distinct therapeutic efficacy of GBL in addressing DN, primarily through its effects on renal inflammation. Taken together, GBL can be used as a promising nutraceutical to mitigate hyperglycemia and its associated renal inflammation, thereby alleviating the progression of DN. Full article

Background and Clinical Significance: Mucinous tubular and spindle cell carcinoma (MTSCC) is an uncommon subtype of renal cell carcinoma, representing 1–4% of epithelial renal tumors. It usually shows a low-grade morphology and indolent behavior, although sarcomatoid variants with an aggressive course have been described. Because of its overlap with papillary renal cell carcinoma (papRCC), sarcomatoid RCC, mesenchymal tumors, and oncocytic neoplasms, diagnosis requires the integration of imaging, histopathology, and immunohistochemistry. Case Presentation: We report a 71-year-old female who presented with a three-month history of right-sided lumbar pain and intermittent hematuria. Her laboratory tests were unremarkable. Contrast-enhanced CT revealed a well-circumscribed nodular lesion in the mid-portion of the right kidney, measuring 50 × 47 × 52 mm. The patient underwent right nephrectomy. Macroscopic findings revealed an encapsulated, yellowish-gray nodule (5.2 × 5 × 4 cm) without renal pelvis invasion. Microscopically, the tumor consisted of cuboidal- to spindle-shaped cells arranged in cords and tubular structures within a mucinous stroma, with focal necrosis and foamy macrophages. Immunohistochemistry showed positivity for CK19, CK7, EMA, PAX8, and AMACR, with a Ki-67 index <10%, while CD117, RCC, CD10, and chromogranin were negative. Together, the low Ki-67 proliferation index, absence of invasion, and low-grade histological architecture confirmed MTSCC of low malignant potential. At a five-year follow-up, the patient remained disease-free. Conclusions: MTSCC is a rare renal neoplasm that can be diagnosed by integrating clinico-radiological, histopathological, and immunophenotypic features. Molecular profiling may further distinguish MTSCC from papRCC and identify aggressive variants. Surgical excision remains the cornerstone of management, supported by vigilant long-term follow-up. Full article

Accurate glomerular segmentation in renal pathological images is a key challenge for chronic kidney disease diagnosis and assessment. Due to the high visual similarity between pathological glomeruli and surrounding tissues in color, texture, and morphology, significant “camouflage phenomena” exist, leading to boundary identification difficulties. To address this problem, we propose BM-UNet, a novel segmentation framework that embeds boundary guidance mechanisms into a Mamba architecture with a symmetric encoder–decoder design. The framework enhances feature transmission through explicit boundary detection, incorporating four core modules designed for key challenges in pathological image segmentation. The Multi-scale Adaptive Fusion (MAF) module processes irregular tissue morphology, the Hybrid Boundary Detection (HBD) module handles boundary feature extraction, the Boundary-guided Attention (BGA) module achieves boundary-aware feature refinement, and the Mamba-based Fused Decoder Block (MFDB) completes boundary-preserving reconstruction. By introducing explicit boundary supervision mechanisms, the framework achieves significant segmentation accuracy improvements while maintaining linear computational complexity. Validation on the KPIs2024 glomerular dataset and HuBMAP renal tissue samples demonstrates that BM-UNet achieves a 92.4–95.3% mean Intersection over Union across different CKD pathological conditions, with a 4.57% improvement over the Mamba baseline and a processing speed of 113.7 FPS. Full article

The kidney plays a crucial role in the complex inter-organ communication that occurs during obesity, leading to the development of oxidative stress, inflammation, and fibrosis. Dysfunction of the transient receptor potential (TRP) ion channels contributes to this pathophysiology. This study was designed to evaluate the effects of antioxidant-rich fruit tart cherry (Prunus cerasus L.) on kidney morphology and protein expression in rats with diet-induced obesity (DIO). Methods include histological staining and immunohistochemical and Western blot assays. Obese rodents were fed with seed powder (DS) and seed powder plus juice (DJS) of the tart cherry. Results demonstrated that rats fed a high-fat-diet (HFD) showed a significant reduction in renal expression of the pro-inflammatory cytokines interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) following tart cherry supplementation. Furthermore, the study provided evidence that TRP channels, specifically TRP canonical 1 (TRPC1) and TRP melastatin 2 (TRPM2), were significantly upregulated in obese animals (p < 0.05 vs. CHOW rats) and markedly downregulated following tart cherry supplementation (p < 0.05 vs. DIO rats). In conclusion, these TRP proteins offer new insights for identifying targets and biomarkers for developing therapeutic strategies against HFD-induced renal damage, characterized by glomerulosclerosis, fibrosis, and inflammation. Tart cherries supplementation exerted a protective effect on the kidneys by reducing protein oxidation and pro-inflammatory cytokine expression. Full article

Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus that is associated with long-term morbidity and mortality. Pathomorphological findings of LN are broadly divided into proliferative lupus nephritis (PLN) and membranous lupus nephritis (MLN). PLN is characterized by diffuse global or segmental proliferative glomerulonephritis with significant infiltration of inflammatory cells. Type 1 T-helper (Th1) cells, which predominate under inflammatory conditions, and NETosis, as the process of forming neutrophil extracellular traps (NETs), are key factors in the development of PLN. Meanwhile, MLN is characterized by diffuse membranous nephropathy (MN) with global granular subepithelial immune deposits. MLN patients usually experience massive proteinuria, and occasionally show an unfavorable renal prognosis despite aggressive treatment, similar to PLN patients. Intriguingly, in some instances, MLN patients do not show the general immunoserological characteristics of SLE, such as low serum complement and elevated anti-DNA antibody titers. Several reports have indicated an association between Th2 cell dominance and the development of MLN. Moreover, exostosin 1 (EXT1) and exostosin 2 (EXT2) on the glomerular basement membrane have recently been discovered as novel putative antigens for secondary MN, and have been shown to be up-regulated in patients with MLN. To date, many studies have focused on the dissimilarities between PLN and MLN. However, the reason for two polar morphological forms existing within the same disease is not completely clear. The present review addresses published observations on this topic in addition to providing our assertion regarding characteristic NETosis and glomerular EXT1/EXT2 expressions between PLN and MLN. Full article

Chronic kidney disease (CKD) is a common and serious condition in felines. Accordingly, several cell therapies have been studied over the past decades for effective treatments. This study aimed to develop a new lineage of renal progenitor cells for use in cats with CKD. Metanephric and mesonephric progenitor cells were obtained from mesonephros and metanephros tissues of feline conceptuses at four distinct gestational stages. The cultured cells were characterized by their morphology, tumorigenic potential, immunophenotype determined by flow cytometry, and differentiation potential. We then conducted a pilot study in CKD-affected cats, comparing intraperitoneal injections of cultured metanephric progenitor cells (n = 4) to a placebo solution (n = 3). All four cell types exhibited adhesion and colony formation, but showed no tumorigenic potential. Cells tested positive for renal progenitor markers (CD117, Nephron, and WT1), confirming their identity. Treated cats showed no statistically significant differences (p ≤ 0.05) in any of the data analyzed. However, caregivers reported a voluntary increase in appetite after cell administration. Veterinarians confirmed this information during double-blind evaluations conducted after treatment. Although this data are qualitative, no clinical deterioration was observed in cats. Our results suggest that this new lineage of renal progenitor cells did not induce immediate adverse effects, thus supporting its potential for use in cell-based therapies. However, further studies are needed to evaluate its efficacy in treating renal diseases. Full article

Tick infestation represents a significant constraint on livestock productivity in Saudi Arabia; however, there remains a substantial gap in research addressing tick species diversity, distribution, and their direct effects on milk production. This study aimed to morphologically and molecularly identify tick species infesting dairy cattle, quantify the impact of tick infestation on milk yield and composition, and contribute to the limited understanding of tick ecology and its economic implications in the region. Ticks were collected from infested cows and identified morphologically using taxonomic keys. Molecular identification was performed via PCR amplification of the mitochondrial cytochrome c oxidase subunit I (COI) gene. Milk production and quality parameters were assessed in tick-infested and healthy cows in Hafar Al-Batin, Eastern Saudi Arabia. Morphological and genetic analyses confirmed Hyalomma anatolicum as the predominant tick species in the study area, with COI sequences showing high similarity to regional isolates. Tick-infested cows exhibited substantial reductions in milk yield, fat, calcium, and potassium levels, indicating significant metabolic disruptions. Blood biochemical analysis revealed elevated levels of liver enzymes [aspartate aminotransferase (AST) increased by 238.6%, gamma-glutamyl transferase (GGT) by 155.7%], renal markers [creatinine increased by 788.9%, urea by 130.0%], and electrolyte imbalances [serum calcium decreased by 39.5%, potassium by 45.2%]. Hematological findings included increased white blood cell (WBC) and red blood cell (RBC) counts by 44.9% and 124.7%, respectively, along with a 53.1% decrease in hemoglobin (HGB), suggesting a systemic inflammatory response and possible anemia. This study is among the first to genetically confirm the presence of H. anatolicum in Hafar Al-Batin using molecular tools, thereby enhancing the accuracy of species-level identification and highlighting the physiological impact of tick burden on dairy productivity. Full article

Background: Clear cell renal cell carcinoma with rhabdoid features (ccRCC-R) is a highly aggressive variant of renal cell carcinoma that carries a poor prognosis and limited treatment options. Methods: To better define the clinicopathologic and molecular landscape of ccRCC-R, we conducted an integrated clinicopathologic and molecular study of 17 tumors of ccRCC-R, utilizing comprehensive histomorphologic evaluation, immunohistochemistry, and targeted next-generation sequencing (NGS). Results: Histologically, all tumors demonstrated classic clear cell renal cell carcinoma morphology with focal to extensive rhabdoid differentiation, characterized by eccentrically located nuclei, prominent nucleoli, abundant eosinophilic cytoplasm, and paranuclear intracytoplasmic inclusion. Architectural alterations, including solid/sheet-like, alveolar/trabecular, and pseudopapillary growth patterns, were frequently observed. Immunohistochemically, tumors commonly exhibited loss of PAX8 and Claudin4 expression, preserved cytokeratin AE1/AE3 staining, and diffuse membranous CAIX expression. Frequent loss of SMARCA2 with retained SMARCA4 supported aberrations in chromatin remodeling. Unsupervised hierarchical clustering based on pathway-specific somatic mutations identified four distinct molecular subgroups defined by recurrent alterations in (1) DNA damage repair (DDR) genes, (2) chromatin remodeling genes, (3) PI3K/AKT/mTOR signaling components, and (4) MAPK pathway genes. Clinicopathologic correlation revealed that each subgroup was associated with unique biological characteristics and suggested distinct therapeutic vulnerabilities. Conclusions: Our findings underscore the molecular heterogeneity of ccRCC-R and support the utility of pathway-based stratification for guiding precision oncology approaches and biomarker-informed clinical trial design. Full article

Background/Objectives: Chronic kidney disease (CKD) is a prevalent condition with many cases remaining undiagnosed, although early detection is essential. Adipose tissue distribution—particularly perirenal fat thickness (PrFT)—has recently been linked to renal pathophysiology. This study assessed the association between CT-derived parameters of fat distribution and kidney morphology with CKD. Materials and Methods: This retrospective study included 237 patients (117 subjects, 120 controls) who underwent abdominal CT and had serum creatinine data. The dataset was randomly split (70% training, 30% test) to develop and evaluate a logistic regression model. CKD was defined as estimated Glomerular Filtration Rate (eGFR) < 60 mL/min/1.73 m². PrFT was measured as the distance from the posterior renal capsule to the posterior abdominal wall; renal hilum fat was segmented using a −195 to −45 HU range. Additional parameters (measured using automated segmentation tools) included kidney volume (KV), visceral/subcutaneous fat areas, skeletal muscle area and attenuation, and liver attenuation. Bilateral measurements were averaged. Results: KV (OR = 0.249, 95% CI: 0.146–0.422, p < 0.001) and PrFT (2nd tercile: OR = 7.720, 95% CI: 2.860–20.839; 3rd tercile: OR = 16.892, 95% CI: 5.727–49.822; both p < 0.001) were identified as independent predictors of CKD. These variables were used to construct a simplified model, which demonstrated moderate clinical applicability (AUC = 0.894) when evaluated on the test subset. Conclusions: KV and PrFT emerged as independent predictors of CKD, forming the basis of a simplified model with potential for opportunistic clinical application. This approach may facilitate earlier detection of CKD in patients undergoing CT imaging for unrelated clinical reasons. These imaging parameters are not intended to replace serum creatinine or eGFR but may serve as complementary predictors in specific clinical contexts. Full article

Objective: The purpose of this study was to report the clinical characteristics and prognosis of spontaneous isolated abdominal aortic dissection (SIAAD) based on the dissection length. Methods: Between March 2012 and September 2023, 159 of 7572 patients with aortic dissection were diagnosed with SIAAD and enrolled in the retrospective study. We proposed a new morphologic classification: extensive SIAAD (e-SIAAD) and focal SIAAD (f-SIAAD), based on whether the dissection length exceeds 50 mm or not. The clinical baseline, computed tomography angiography (CTA) findings, and long-term follow-up of the two types were compared. Results: SIAAD prevalence was 2.1%. Patients with f-SIAAD were significantly older (63.74 ± 10.97 vs. 50.70 ± 10.10 years, p < 0.001), had more atherosclerosis risk factors, arteriosclerosis, and penetrating aortic ulcers compared to e-SIAAD patients. Conversely, e-SIAAD presented more acutely (72.97% vs. 34.12%, p = 0.001), exhibited more frequent symptoms (85.14% vs. 61.18%, p = 0.0037), larger dissection diameters (31.89 ± 10.99 vs. 24.41 ± 11.28 mm, p = 0.001), and greater involvement of the renal and iliac arteries. Treatment involved medical management (30%), endovascular repair (65%), or surgery (2.5%), without significant differences between groups. In-hospital mortality was higher in f-SIAAD (six deaths vs. one in e-SIAAD). During median follow-up of 48 months (range, 6–148 months), mortality was higher in f-SIAAD (70% vs. 90% estimated 10-year survival). Conclusions: SIAAD classification by dissection length revealed significant differences in clinical presentation, CTA characteristics, and prognosis. Focal dissections correlated with advanced age, severe arteriosclerosis, and poorer long-term outcomes, emphasizing the need for tailored management approaches. Full article