Humoral factors in regulation of compensatory renal hypertrophy

Malt, Ronald A.

doi:10.1038/ki.1983.66

Cited by 34 publications

(10 citation statements)

References 58 publications

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“…The presence of well-differen tiated and presumably transporting epithelia may indi cate that tubular flow is maintained by continued glomer ular filtration and/or by high passive permeability in residual tubules. The presence of presumably functional epithelia is also of interest because simultaneous pres ence of reduced renal function and responsive target cells may explain adenomatous proliferation of renal tissue in analogy to the situation after renal ablation where renal growth response is mediated by circulating factors [28,29],…”

Section: Discussionmentioning

confidence: 99%

Multicystic Transformation of Kidneys in Chronic Renal Failure

Mickisch

Bommer

Bachmann

et al. 1984

Nephron

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With real-time sonography, 120 nondialyzed uremic patients prior to hemodialysis, 108 patients on maintenance hemodialysis and 9 patients postdialysis after successful homotransplantation were examined for the presence of renal cysts. Even in incipient renal failure, multiple cysts were demonstrable in some patients (at a serum creatinine of 3 mg/dl in 22% of patients), particularly in patients with analgesic nephropathy. When hemodialysis was started (serum creatinine approximately 10 mg/dl), 35% of the patients had multiple cysts. On hemodialysis, the prevalence, number and size of cysts rose progressively with time. After 8 years of hemodialysis, 92% of the patients had multiple cysts. However, enlargement of the kidneys was observed in only 2/108 patients. No major clinical complications were noted with the possible exception of 1 case of renal cell carcinoma. No correlation was noted between hematocrit and presence or extent of cystic transformation, but the 2 patients with cystic enlargement of the kidneys were polyglobulic. In 8/9 patients after transplantation, cysts were demonstrable in the patient’s own kidneys after a median follow-up of 16 months. On light microscopy, cysts were lined by cuboidal or columnar epithelial cells with frequent papillary or adenomatous proliferations. The cyst lumen was filled with amorphous or lamellated organic material, which exhibited microfibrillar structure on electron microscopy. One kidney examined after ex vivo perfusion fixation showed multiple interconnected cavities on scanning electron microscopy. Ultrastructural studies showed epithelia with either the characteristics of proximal tubular cells (i.e. numerous microvilli, interdigitations and abundant lysosomes or mitochondria) or distal tubular cells (i.e. highly interdigitating processes) or finally collecting duct cells (i.e. no interdigitations and few microvilli).

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Section: Discussionmentioning

confidence: 99%

Multicystic Transformation of Kidneys in Chronic Renal Failure

Mickisch

Bommer

Bachmann

et al. 1984

Nephron

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“…Pioneered by Brenner (6), it is known that experimental acute reduction in kidney mass results in compensatory mechanisms that affect both the size of the remaining tissue and its function (7)(8)(9)(10). However, hyperfiltration that occurs in the remaining nephrons has also been suggested as causing albuminuria and glomerulonephrosclerosis (11,12).…”

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confidence: 99%

Impact of Graft Mass on the Clinical Outcome of Kidney Transplants

Giral¹,

Nguyen²,

Karam³

et al. 2005

Journal of the American Society of Nephrology

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The effect of nephronic mass reduction of kidney transplants has not been analyzed specifically in a large cohort. Transplant injuries in cadaver kidney graft may have led to an underestimation of the magnitude of this factor. The aim of this study was to analyze the consequences of kidney mass reduction on transplantation outcome. The weights of 1142 kidney grafts were collected prospectively immediately before grafting. Donors and recipients <15 yr of age, simultaneous kidney/pancreas grafts, and technical failures before day 7 were excluded from the analysis. The analysis was performed on Cockroft-calculated creatinine clearance and proteinuria in 964 patients for whom all of the necessary information was available. This study reports that the smallest kidneys transplanted into the largest recipients (donor kidney weight/recipient body weight [DKW/RBW] <2 g/kg, n ‫؍‬ 88) increased their clearance by 2.38 ml/min every month for 6 mo (P < 0.0001) and by 0.27 ml/min thereafter (P < 0.0001). Conversely, creatinine clearance did not change for the largest kidneys transplanted into the smallest recipients (DKW/RBW ratios >4 g/kg). Next, using a Cox model analysis, it was shown that the risk of having a proteinuria >0.5 g/kg was significantly increased for the low DKW/RBW ratios <2 g/kg with 50% of patients having a proteinuria, compared with DKW/RBW ratios >4 g/kg (P < 0.001). In cadaver transplant recipients, graft mass has a rapid impact on graft filtration rate and proteinuria. Avoiding major kidney/recipient inadequacy should have a significant influence on long-term transplant function.

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“…The mechanism of the observed inhibitory effect on compensatory renal growth is unknown. Markedly ele vated levels of plasma glucagon, as might occur in patients with glucagonomia, lead to anorexia, diarrhea, and weight loss [28], and poor nutrition is known to retard compensatory renal growth [29]. The plasma glu cagon levels achieved by continuous subcutaneous infu sion in the present study produced mean plasma levels of 15-25 pg/ml, which were significantly higher than those observed in the vehicle-treated controls.…”

Section: Discussionmentioning

confidence: 47%

Effects of Glucagon on Physiologic and Compensatory Renal Growth in the Rat

Logan

Lee²

1988

Horm Res

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Glucagon has been implicated as a growth-promoting hormone in the kidneys of diabetic animals, but its role in the nondiabetic state is unknown. We evaluated the effect of subcutaneous glucagon administration on renal growth in intact rats with two kidneys and after 50% reduction in renal mass. The relative kidney weight was increased in intact rats treated with a glucagon infusion for 7 days (p < 0.01), but decreased in uninephrectomized rats treated with glucagon (p < 0.05). Absolute kidney weight gain and rates of renal DNA synthesis were also significantly blunted by glucagon infusion in uninephrectomized rats. These data suggest that ‘physiologic’ and ‘compensatory’ renal growth are governed by separate processes. Furthermore, the observation that glucagon promotes renal growth in intact nondiabetic animals supports its possible role as a growth factor in the early stages of diabetes.

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Humoral factors in regulation of compensatory renal hypertrophy

Cited by 34 publications

References 58 publications

Multicystic Transformation of Kidneys in Chronic Renal Failure

Multicystic Transformation of Kidneys in Chronic Renal Failure

Impact of Graft Mass on the Clinical Outcome of Kidney Transplants

Effects of Glucagon on Physiologic and Compensatory Renal Growth in the Rat

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