Histological Features of Acute Tubular Necrosis in Native Kidneys and Long-Term Renal Function

Abdulkader, Regina C. R. M.; Libório, Alexandre Braga; Malheiros, Denise Maria Avancini Costa

doi:10.1080/08860220802212460

Cited by 25 publications

(18 citation statements)

References 17 publications

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“…Finally in a small study of non‐RTX related ATI, Abdulkader et al. () showed that a combination of acute and chronic damage (ATI, interstitial fibrosis, tubular atrophy, and interstitial infiltrate) in biopsies of native kidneys related to renal function.…”

Section: Discussionmentioning

confidence: 99%

Histological characteristics of Acute Tubular Injury during Delayed Graft Function predict renal function after renal transplantation

et al. 2019

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Acute Tubular Injury ( ATI ) is the leading cause of Delayed Graft Function ( DGF ) after renal transplantation ( RTX ). Biopsies taken 1 week after RTX often show extensive tubular damage, which in most cases resolves due to the high regenerative capacity of the kidney. Not much is known about the relation between histological parameters of renal damage and regeneration immediately after RTX and renal outcome in patients with DGF . We retrospectively evaluated 94 patients with DGF due to ATI only. Biopsies were scored for morphological characteristics of renal damage (edema, casts, vacuolization, and dilatation) by three independent blinded observers. The regenerative potential was quantified by tubular cells expressing markers of proliferation (Ki67) and dedifferentiation ( CD 133). Parameters were related to renal function after recovery ( CKD ‐ EPI 3, 6, and 12 months posttransplantation). Quantification of morphological characteristics was reproducible among observers (Kendall's W ≥ 0.56). In a linear mixed model, edema and casts significantly associated with eGFR within the first year independently of clinical characteristics. Combined with donor age, edema and casts outperformed the Nyberg score, a well–validated clinical score to predict eGFR within the first year after transplantation ( R 2 = 0.29 vs. R 2 = 0.14). Although the number of Ki67+ cells correlated to the extent of acute damage, neither CD 133 nor Ki67 correlated with renal functional recovery. In conclusion, the morphological characteristics of ATI immediately after RTX correlate with graft function after DGF . Despite the crucial role of regeneration in recovery after ATI , we did not find a correlation between dedifferentiation marker CD 133 or proliferation marker Ki67 and renal recovery after DGF.

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Section: Discussionmentioning

confidence: 99%

Histological characteristics of Acute Tubular Injury during Delayed Graft Function predict renal function after renal transplantation

et al. 2019

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“…Over the past few years, a body of data from experimental animals as well as human studies has shown that AKI is not a limited insult and may result in permanent kidney damage [85,86]. In a prospective cohort study, Mammen et al [87] followed 126 children with AKI for up to three years after the AKI episode.…”

Section: Prognosis and Long-term Complications Of Akimentioning

confidence: 99%

Acute kidney injury in the fetus and neonate

Nada

Bonachea

Askenazi

2017

Seminars in Fetal and Neonatal Medicine

137

105

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SUMMARY Acute kidney injury (AKI) is an under-recognized morbidity of neonates; the incidence remains unclear due to the absence of a unified definition of AKI in this population and because previous studies have varied greatly in screening for AKI with serum creatinine and urine output assessments. Premature infants may be born with less than half of the nephrons compared with term neonates, predisposing them to chronic kidney disease (CKD) early on in life and as they age. AKI can also lead to CKD, and premature infants with AKI may be at very high risk for long-term kidney problems. AKI in neonates is often multifactorial and may result from prenatal, perinatal, or postnatal insults as well as any combination thereof. This review focuses on the causes of AKI, the importance of early detection, the management of AKI in neonates, and long-term sequela of AKI in neonates.

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“…However, over the past several years, a plethora of data from experimental animal and human studies have been published, indicating that AKI more than likely results in permanent kidney damage (i.e., chronic kidney disease—CKD) and may also result in damage to nonrenal organs [58–60]. Moreover, mortality is higher in adults surviving an AKI episode [61].…”

Section: Long-term Consequences Of Neonatal Akimentioning

confidence: 99%

Acute Kidney Injury in Neonates: From Urine Output to New Biomarkers

Libório

Branco

Bezerra

2014

BioMed Research International

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In the past 10 years, great effort has been made to define and classify a common syndrome previously known as acute renal failure and now renamed “acute kidney injury (AKI).” Initially suggested and validated in adult populations, AKI classification was adapted to the pediatric population and recently has been modified for the neonatal population. Several studies have been performed in adults and older children using this consensus definition, leading to improvement in the knowledge of AKI incidence and epidemiology. In spite of these advances, the peculiar renal pathophysiology of critically ill newborn patients makes it difficult to interpret urine output (UO) and serum creatinine (SCr) levels in these patients to diagnose AKI. Also, new urine biomarkers have emerged as a possible alternative to diagnose early AKI in the neonatal population. In this review, we describe recent advances in neonatal AKI epidemiology, discuss difficulties in diagnosing AKI in newborns, and show recent advances in new AKI biomarkers and possible long-term consequences after AKI episode.

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Histological Features of Acute Tubular Necrosis in Native Kidneys and Long-Term Renal Function

Cited by 25 publications

References 17 publications

Histological characteristics of Acute Tubular Injury during Delayed Graft Function predict renal function after renal transplantation

Histological characteristics of Acute Tubular Injury during Delayed Graft Function predict renal function after renal transplantation

Acute kidney injury in the fetus and neonate

Acute Kidney Injury in Neonates: From Urine Output to New Biomarkers

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