Embryology, Anatomy, and Physiology of the Kidneys and Ureters
Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple in Basic Urological Sciences, 2021
The kidney consists of (Figure 8.4):The outer cortex and inner medulla.A collecting system of calyces and renal pelvis draining into the ureter.Renal medulla − made up of conically shaped ‘pyramids’.Pyramid bases point laterally.The pyramid apex points to the renal papilla as it enters its individual minor calyx.
Urinary System
Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard in Toxicologic Pathology, 2018
Among toxicologic insults to the inner medulla and renal papilla, papillary necrosis and pyelonephritis are by far the most commonly encountered in nonclinical studies. The renal medulla and papilla are vulnerable to ischemic necrosis because of the unique arrangement of their blood supply and the local interstitial hypertonicity. Hydrodynamic effects may also be reflected in marked changes in the papilla such as the medullary atrophy that occurs with hydronephrosis or necrosis associated with distal outflow obstruction. There may be marked differences in papillary responses to toxins between unipapillate kidneys of rodents or dogs and multipapillate species such as the pig. It should be noted that there are also differences between species of monkeys, with cynomolgus monkey kidneys representing unipapillate types and rhesus monkeys representing the multipapillate type, and agents may affect these species much differently. Focal mineralization may be noted in the papilla as a background lesion in multiple species, including rodents, monkeys, and minipigs (Frazier et al. 2012; Jeppesen and Skydsgaard 2014).
Urinary tract infections in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Affecting 1% to 2% of all pregnancies, pyelonephritis is one of the most common serious medical problems encountered during pregnancy. It will develop in 36% to 42% of untreated women with ASB; this risk falls to £3% with the treatment for bacteriuria (39,49). Only approximately 1.4% of women without bacteriuria early in a pregnancy will subsequently develop pyelonephritis before delivery (40). Pyelonephritis occurs most commonly during the second or third trimester, although up to one-quarter of infections are diagnosed intrapartum or postpartum (1,50,51). In addition to other risk factors for UTIs in general, younger age, nulliparity (51), and sickle cell trait (52) or disease (OR 1.3, 95% CI 1.0–1.8) (53) make pyelonephritis more likely. It is usually an ascending infection, more likely to occur during pregnancy because of the physiologic changes predisposing to urinary stasis. Conditions unique to the renal medulla make the kidney particularly vulnerable to infection in the presence of stasis: high urine osmolarity, high urea and sodium concentrations, and low pH impair chemotaxis and inhibit polymorphonuclear leukocyte phagocytosis.
Aging erythrocyte membranes as biomimetic nanometer carriers of liver-targeting chromium poisoning treatment
Published in Drug Delivery, 2021
Qing Yao, Guobao Yang, Hao Wang, Jingzhou Liu, Jinpeng Zheng, Bai Lv, Meiyan Yang, Yang Yang, Chunsheng Gao, Yongxue Guo
Mice were intravenously injected with K2CrO4, and the treatment was started on the 8th day. After 14 days, HE staining of the sections of the main organs of the mice was observed, as shown in Figure 4(E). The liver and lungs of the K2CrO4 poisoning group were damaged to a certain extent. The liver, spleen, and lung tissues of the free-DMSA, DMSA-NLC, and AEM-DMSA-NP groups (compared to the K2CrO4-infected group) were not significantly affected. The HE staining of muscle fibers in each heart tissue was uniform, the epicardium was not thickened, some muscle spaces were not significantly enlarged or smaller, myocardial nuclei were round or oval, the transverse striations of muscle fibers were clear, and no eosinophilic lesions were seen in the muscle fibers (Huang et al., 2018). In the renal tissue, the renal capsule was smooth, the boundary between the cortex and medulla was obvious, the glomeruli in the renal cortex were normal and evenly distributed, and no obvious changes were observed in the renal medulla area. The brain tissue of each group was clear, the nerve cells were closely arranged, the nucleus was clear, and the cytoplasmic nucleus was clearly stained. The results showed that DMSA had low toxicity and a good effect on detoxifying chromium poisoning.
Therapeutic role of Azadirachta indica leaves ethanolic extract against diabetic nephropathy in rats neonatally induced by streptozotocin
Published in Ultrastructural Pathology, 2021
Abd El-Fattah B. M. El-Beltagy, Amira M.B. Saleh, Amany Attaallah , Reham A. Gahnem
The renal sections from control (Figure 2A&A1) and neem supplemented (Figure 2B&B1) rats appeared with normal histological architecture whereas it is differentiated into outer cortex and inner medulla. The renal cortex displayed well-organized renal corpuscles and tubules. The renal corpuscle consists of glomerulus that is surrounded by Bowman’s space and intact Bowman’s capsule that lined with simple squamous epithelium. The renal tubules represented by proximal tubules (PT), distal tubules (DT) and collecting ducts (CD). The PT is characterized by its star-shaped lumen that is lined with brush bordered cubical epithelium. Moreover, the DT has relatively rounded lumen that lined by cubical epithelium with little microvilli. The CD lined with short cubical epithelium and has a relatively wider lumen than the PT and DT. The renal medulla displayed well-organized collecting ducts and Henel,s loops.
The intellectual base and global trends in contrast-induced acute kidney injury: a bibliometric analysis
Published in Renal Failure, 2023
Heng Wang, Tingting Gao, Ruijing Zhang, Jie Hu, Yuwen Wang, Jianing Wei, Yun Zhou, Honglin Dong
The pathophysiological mechanisms of CI-AKI are not fully understood, but direct and indirect cytotoxic effects and hemodynamic alterations remain the main mechanisms of injury [44]. In keyword clusters #0 and #4, the keywords ‘oxidative stress’ and ‘nitric oxide’ were associated with pathophysiological mechanisms, while ‘cystatin c’ and ‘gelatinase-associated lipocalin’ were relevant markers of injury. Direct toxic effects of CM on renal tubular epithelial cells lead to cell death and dysfunction [22,79]. Indirect effects are mainly related to ischemic-hypoxic injury due to vasodilatory changes mediated by vasoactive substances, such as endothelin, reactive oxygen species, nitric oxide, and prostaglandins [80–83]. The outer renal medulla has a relatively low partial pressure of oxygen, which when combined with enhanced metabolic demands makes the medulla particularly susceptible to the hemodynamic effects of CM [83–85]. In addition, we found that the pathological changes in the peritubular capillaries precede those in the renal tubules in the early stage of CI-AKI, and the related molecular mechanisms are being investigated.
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