Background Even among ostensibly healthy adults, there is often mild pathology in the kidney. The detection of kidney microstructural variation and pathology by imaging and the clinical pattern associated with these structural findings is unclear. Study Design Cross-sectional (clinical-pathological correlation). Setting & Participants Living kidney donors at Mayo Clinic (Minnesota and Arizona sites) and Cleveland Clinic 2000-2011. Predictors Pre-donation kidney function, risk factors, and contrast computed tomography scan of the kidneys. These scans were segmented for cortical volume and medullary volume, reviewed for parenchymal cysts, and scored for kidney surface roughness. Outcomes Nephrosclerosis (glomerulosclerosis, interstitial fibrosis/tubular atrophy, and arteriosclerosis) and nephron size (glomerular volume, profile tubular area, and cortical volume per glomerulus) determined from an implantation biopsy of the kidney cortex at donation. Results Among 1520 living kidney donors, nephrosclerosis associated with increased kidney surface roughness, cysts, and smaller cortical to medullary volume ratio. Larger nephron size (nephron hypertrophy) associated with larger cortical volume. Nephron hypertrophy and larger cortical volume associated with higher systolic blood pressure, higher glomerular filtration rate, higher urine albumin excretion, larger body mass index, higher serum uric acid, and family history of end-stage renal disease. Both nephron hypertrophy and nephrosclerosis associated with older age and mild hypertension. The net effect of both nephron hypertrophy and nephrosclerosis associating with cortical volume was that nephron hypertrophy diminished volume loss with age-related nephrosclerosis and fully negated volume loss with mild hypertension-related nephrosclerosis. Limitations Kidney donors are selected on health, restricting the spectrum of pathological findings. Kidney biopsies in living donors are a small tissue sample leading to imprecise estimates of structural findings. Conclusions Among apparently healthy adults, the microstructural findings of nephron hypertrophy and nephrosclerosis differ in their association with kidney function, macrostructure, and risk factors.

We have derived the 95% reference limit for number of globally sclerotic glomeruli in ostensibly healthy individuals accounting for age and the biopsy characteristics. Numbers of globally sclerotic glomeruli in a kidney biopsy that exceed these thresholds suggest chronic pathological injury in excess of that expected with normal aging.

Peripheral intravenous access is a common but stressful pediatric procedure. Though in use for some decades now, there is no consensus on factors affecting the duration of patency and complications. The present study is a randomized controlled trial covering all aspects associated with vascular access. This prospective interventional study was conducted over a period of 6 months in a general pediatric ward of Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital. This sample was composed of 88 patients, from neonates to 12-year-olds who were admitted to the pediatric ward, on whom a total of 377 catheters were started. Intravenous cannulations were randomized for heparin flushes (1:100 dilution) and splints. Prospective data were collected regarding duration of patency and complications. Both univariate and multivariate analysis were done. There was a statistically significant increase in the duration of patency with the use of heparin flushes and splints. The incidence of phlebitis increased with heparin flushes. Shorter patency duration and increased complications were associated with younger age, wrist and scalp insertions, and 24-gauge catheters.