nÃo hà / Lectinas sÃo glicoporteÃnas que interagem de forma reversÃvel e especificamente com carboidratos. A lectina Vatairea macrocarpa (VML) à uma lectina ligadora de galactose pertencente à famÃlia de leguminosas da tribo Dalbergiae. No presente estudo, nÃs investigamos os efeitos da lectina Vatairea macrocarpa (VML) no modelo de rim isolado de rato, bem como as alteraÃÃes histolÃgicas. O rim isolado a partir de ratos Wistar, pesando entre 240 e 280g foram perfundidos com soluÃÃo de Krebs-Henseleit contendo 6% de albumina bovina sÃrica. Os parÃmetros estudados incluem: pressÃo de perfusÃo (PP), resistÃncia vascular renal (RVR), ritmo de filtraÃÃo glomerular (RFG), fluxo urinÃrio (FU), percentual de transporte tubular de sÃdio (%TNa), percentual de transporte tubular de potÃssio (%TK), e percentual de transporte tubular de cloro (%TCl). A lectina Vatairea macrocarpa (10 Âg/ml) aumentou a pressÃo de perfusÃo, a resistÃncia vascular renal, o fluxo urinÃrio e o ritmo de filtraÃÃo glomerular. Por outro lado, a Vatairea macrocarpa (VML) nÃo alterou o percentual de transporte dos Ãons sÃdio, potÃssio e cloro. O complexo Galactose-Lectina (Gal-VML) quando utilizado nÃo causou qualquer alteraÃÃo nos parÃmetros avaliados, ou seja, bloqueou significativamente o aumento dos parÃmetros PP, RVR, UF e RFG, observados pela aÃÃo da lectina Vatareia macrocarpa (VML). No grupo controle a histologia apresentou um pequeno aumento de material proteinÃceo nos espaÃos urinÃrios, no entanto, nÃo foram detectadas alteraÃÃes a nÃvel de tÃbulos renais. A administraÃÃo de galactose sozinha nÃo modificou os parÃmetros funcionais renais. Os rins prÃ-tratados com Gal-VML teve apenas um pequeno acÃmulo de material proteinÃceo nos espaÃos urinÃrios, mas nenhuma anormalidade foi nos tÃbulos renais. Estes resultados sugerem que a lectina obtida a partir de semestres de Vatairea macrocarpa apresenta importante efeito sobre o sistema renal relacionado com o sÃtio carboidrato-ligante, tendo em vista observamos reversÃo dos efeitos renais quando se utilizou o inibidor especÃfico. O presente trabalho à a primeira demonstraÃÃo de atividade biolÃgica da VML em rim isolado de rato. / Lectins are glycoproteins that interact reversibly and specifically with carbohydrates. The Vatairea macrocapa lectin (VML) is a galactose-binding lectin present in the family leguminosae and in the tribe Dalbergieae. ln the present study, we investigated the effect of Vatairea macrocarpa lectin (VML) in the isolated rat kidneys, as well as histological changes. Isolated kidneys from Wistar rats, weighing 240 to 280g, were perfused with Krebs-Henseleit solution containing 6% of bovine serum albumin. The parameters studied included perfusion pressure (PP), renal vascular resistance (RVR), glomerular filtration rate (GPR), urinary flow (UF), percent of sodium tubular transport (%TNa+), percent of potassium tubular transport (%TK+) and percent of chloride tubular transport (%TCl-). The latairea macrocarpa lectin (10 Âg/mL) increased the PP, RVR, UF and GPR. On the other hand, VML did not change the %TNa+, %TK+ and % TCl-. The lectin plus galactose complex (Gal-VML) signihcantly blocked the increase in the PP, RVR, UF and RFG. ln the control group showed a small amount of a proteinaceous material in the urinary space, although no alteration in the renal tubules was detected. The administrated of galactose alone did not modify the functional kidney parameters. The kidneys perfused with /ML showed moderate deposit of proteinaceous material in the tubules and urinary space. ln the kidneys pretreated with Gal-VML had only small amount of a proteinaceous material in the urinary space. But no abnormalities were seen in renal tubules. These results suggest that lectin from Vatairea macrocarpa seeds presents important effect on renal system reported carbohydrate-binding site, taken into account that showed the reversion of renal effects using the inhibitor specific. The current experiments are first demonstration of biological action of VML in the isolated kidney.

INTRODUCTION Apixaban has revolutionized anticoagulation in patients with atrial fibrillation in preventing strokes. Anticoagulant-induced nephropathy with warfarin is well known, but nephropathy with apixaban is a rare entity, and here we present a case of Apixaban-induced nephropathy. Case Description A 71-year-old patient with a medical history of persistent atrial fibrillation on apixaban, Ischemic cardiomyopathy, and chronic kidney disease stage (CKD) IIIa presented to the hospital with complaints of dyspnea and hemoptysis and tea-colored urine of three-day duration. On admission, the patient had acute kidney injury (AKI) on CKD, Methicillin sensitive Staphylococcus aureus (MSSA) bacteremia, and elevated international normalized ratio (INR) and apixaban were held. The hemoptysis worsened and prompted bronchoscopy revealing diffuse alveolar hemorrhage. The urinalysis showed gross hematuria with high red blood cell (RBC) count and 1+ proteinuria presumed secondary to MSSA associated glomerulonephritis. Evaluation for coagulopathy with serum mixing studies and autoimmune workup has been unremarkable. The patient's coagulopathy was considered secondary to decreased clearance of apixaban with AKI on CKD. However, the patient's kidney function continued to worsen, needing continuous renal replacement therapy and a kidney biopsy for a definitive diagnosis for his decline in kidney function. Kidney biopsy revealed IgA dominant infection associated glomerulitis with one out of hundred glomeruli with the crescent formation and signs of anticoagulant induced nephropathy with several intratubular RBC casts out of proportion to the degree of glomerular injury causing acute tubular damage. The patient's INR improved on dialysis. However, he continued to be oliguric before being terminally extubated. DISCUSSION With the increasing incidence of atrial fibrillation and the use of oral anticoagulants, it is vital to have anticoagulant induced as a differential in patients presenting with supra therapeutic INR and AKI. Apixaban-induced nephropathy is a subset of anticoagulant-induced nephropathy and an uncommon cause of the acute decline in kidney function needing dialysis. Prompt recognition and treatment will prevent further deterioration in kidney function and possible improvement.

Multiple myeloma is characterized by the malignant proliferation of clonal plasma cells producing monoclonal paraproteins, leading to multi-organ damage. On the other hand monoclonal B-cell lymphocytosis (MBCL) is characterized by the malignant proliferation of clonal B-lymphocytes, with potential to develop into chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). CLL/SLL can result in visceromegaly, anemia, thrombocytopenia, fevers, night sweats and unintentional weight loss. Literature review demonstrates these two malignant clonal bone marrow disorders are most frequently seen independently in patients; however, we report one rare diagnostic challenge where both clonal disorders were identified in a single patient concurrently. A 64-year-old man initially presented with worsening back pain. Thoracic spine x-ray revealed a T11 compression fracture, confirmed by magnetic resonance imaging. Complete blood count revealed a white blood cell count of 7.3 K/uL with 54% lymphocyte predominance and peripheral smear demonstrated a population of small lymphocytes with round nuclei and an atypical chromatin pattern suggestive of CLL/MBCL. Flow cytometry revealed a monoclonal B-cell CD5 positive, CD23 positive, CD10 negative population with an absolute count of 1.6 K/uL. Due to the instability and pain associated with the spinal fracture, patient had kyphoplasty performed and intraoperative bone biopsies were taken from both T11 and T12 vertebrae. Interestingly each bone biopsy revealed involvement by both a kappa-light chain restricted plasma cell neoplasm, ranging from 15% to 30% cellularity, as well as a CD5-positive B-cell lymphocyte population. It suggested two concurrent but pathologically distinct pathologies including plasma cell myeloma and a separate B-cell lymphoproliferative disorder with immunophenotypic features suggestive of CLL/MBCL. Bone marrow biopsy was performed for definitive evaluation and confirmed multiple myeloma with 15-20% kappa-restricted plasma cells identified, and also confirmed concurrent MBCL with CD5 and CD23-positive, kappa-restricted B-cells identified on bone marrow flow cytometry. Adding an additional layer of complexity, bone marrow molecular genetics revealed presence of a MYD88 mutation, raising concern for possible lymphoplasmacytic lymphoma (LPL). However, secondary pathologic review ruled out LPL, as the immunophenotypic pattern of the clonal B-cells was not consistent with that of LPL, and although the MYD88 mutation is predominantly seen in LPL, it has also been seen in a small percentage of CLL/SLL cases and exceedingly rarely described in MM as well. Serum protein electrophoresis with immunofixation, serum quantitative immunoglobulins and serum quantitative free light chain assay revealed findings consistent with IgG kappa multiple myeloma and systemic CT imaging was negative for any lymphadenopathy, confirming MBCL. Patient was started on first-line multiple myeloma systemic therapy for transplant eligible patients and has demonstrated an excellent response to treatment thus far. This patient case serves to demonstrate the importance of maintaining a broad differential when approaching hematological problems; It also underlines the necessity for a complete diagnostic evaluation to identify rare clinical conundrums such as with our patient, allowing for proper and timely treatment. While we use “Occam’s razor” to explain multiple problems with a single unifying diagnosis the rare possibility of divergent diagnosis is to be always entertained.

Introduction Acute interstitial nephritis (AIN), also called tubulointerstitial nephritis, is a renal pathology that can cause a significant decline in kidney function. Drug-induced AIN accounts for 70% of all cases and is often due to non-steroidal anti-inflammatory drugs (NSAIDs), antimicrobials, and proton pump inhibitors. However, there have been isolated reports of other drugs being responsible for AIN. We hereby report a case of furosemide-induced AIN. Case Presentation A 68-year-old caucasian male with a medical history significant for chronic kidney disease (CKD) stage 3 due to hypertensive nephrosclerosis with a baseline serum creatinine (Cr) of 1.3-1.5, hypertension, hyperlipidemia, atrial fibrillation, heart failure with preserved ejection fraction (HFpEF), and hypogonadism was admitted for evaluation of worsening renal failure. At initial evaluation, the patient had nonspecific symptoms like malaise, nausea, and vomiting but denied any other complaints. Physical examination was unremarkable, without any rashes or abdominal bruit. The patient’s creatinine progressively trended up from his baseline to 3.5 over three months. Pre-renal pathology was suspected initially, and the patient's furosemide was held on admission with concurrent fluid resuscitation. However, this did not improve his kidney function as repeat lab work showed a worsening Cr level of 4.4, along with a blood urea nitrogen (BUN) of 72. Further evaluation showed a complete blood count significant for mild eosinophilia with urinalysis revealing hematuria, pyuria with eosinophiluria but no protein, WBC casts, or RBC casts. Renal ultrasound and abdominal CT scan were unremarkable. The patient had no known drug allergies until that point and was on a stable medication regimen for his chronic conditions for several years, except for a daily dose of furosemide started three months ago for fluid retention and elevated BNP. Ultrasound-guided renal biopsy revealed findings consistent with acute interstitial nephritis on top of chronic tubulointerstitial fibrosis plus underlying moderate arterial sclerosis from hypertension. Other extensive workup was negative for any autoimmune process, IgG4 related disease, sarcoidosis, or infection, thus favoring the diagnosis of drug-induced acute interstitial nephritis. Given the temporal relationship between the initiation of furosemide in this patient and his worsening kidney function makes it the likely offending agent. He was observed off furosemide without any immunosuppressant treatment. The patient’s creatinine level gradually trended down and ultimately returned to his baseline at a one-month follow-up. Discussion Furosemide is a loop diuretic, often used in patients to prevent volume overload. Therefore, furosemide is often implicated as a cause of pre-renal acute kidney injury (AKI) secondary to volume depletion. However, interstitial inflammation as a mechanism of furosemide-induced kidney injury is uncommon and can often be overlooked as a potential cause, especially in patients with long medication lists. In such patients, a causal link can be established by correlating the onset of decline in kidney function with the time of initiation of a new drug and resolution of AKI after discontinuation of the drug.

Introduction Severe hypercalcemia from chronic gout is a rare phenomenon seen after the advent of newer drugs for its treatment. The hypercalcemia is secondary to either granuloma formation around the tophi or chronic immobilization from severe gouty arthritis. We present a patient with chronic tophaceous gout presenting with severe hypercalcemia and acute kidney injury. Case presentation A 63-year-old male patient with a past medical history of hypertension and chronic gout presented to the office with chronic, severe left knee pain. Initial evaluation of the knee with X-rays revealed destruction of the knee joint with cystic changes, and subsequent MRI with contrast showed soft tissue mass in the suprapatellar pouch with intraosseous extension and involvement of medial and lateral collateral ligament involvement. After interdisciplinary evaluation between radiology, orthopedic surgery, and oncology, this was concerning for highly aggressive pigmented villonodular synovitis of the knee, and a decision was made for the patient to undergo complete knee replacement. Perioperative workup was significant for severe hypercalcemia with a total calcium level of 13.2 mg/dl with ionized calcium of 7.2 mg/dl. Further evaluation into the cause of hypercalcemia revealed a low normal intact parathyroid hormone (PTH) level with normal phosphorus, calcidiol, and calcitriol levels. Other etiologies of hypercalcemia such as multiple myeloma, malignancies, metastatic disease, autoimmune, granulomatous, and infectious processes are excluded with extensive workup. The hypercalcemia is treated with fluids, diuretics, and bisphosphonates, eventually normalizing the calcium levels. The patient underwent total left knee replacement, and the mass identified was sent for biopsy. Biopsy revealed a prominent granulomatous reaction to amorphous crystals containing birefringent crystals under polarised light. Uniquely during our evaluation, vitamin D metabolites, uric acid, and PTH levels were normal despite the biopsy findings. The patient's calcium continued to be normal (8.4 to 10.4 mg/dl) over six months after the surgery. Thus, the scenario is supportive of hypercalcemia secondary to granulomatous inflammation around the large tophi. Conclusion Although rare, the knee joint is a site of severe tophaceous gout, and deposition of uric acid crystals can invoke a granulomatous reaction presenting with severe hypercalcemia as in our patient. Unique to our case, the patient can have benign lab findings on evaluation of hypercalcemia. Only a few case reports are illustrated in the literature, making our case and patient presentation unique.

O estudo avaliou os efeitos agudos da Ang-(1-7) na reabsorção de bicarbonato (JHCO3-) no túbulo proximal cortical de rato, in vivo, medindo o pH intratubular pelo microeletródio sensível a H+. O JHCO3- controle é 2,84 ± 0,08 nmol. cm-2. s-1 (49), a Ang-(1-7; 10-12 ou 10-9 M) o reduz (35 ou 61 %) e a Ang-(1-7; 10-6 M) o eleva (56 %). A inibição do receptor Mas (por A779) eleva o JHCO3- (30 %), abole o efeito inibidor da Ang-(1-7), mas não afeta seu efeito estimulador. A inibição do NHE3 (por S3226) diminui o JHCO3- (45 %), não altera o efeito inibidor da Ang-(1-7), mas transforma seu efeito estimulador em inibidor. A concentração de cálcio citosólico ([Ca2+]i), medida pelo FURA-2-AM, controle é 100 ± 2,47 nM (35) e a Ang-(1-7; 10-12, 10-9 ou 10-6 M) a aumenta (152, 103 ou 53 %) transientemente (3 min). A inibição do receptor Mas aumenta a [Ca2+]i (26 %), mais inibe o efeito estimulador de todas as doses de Ang-(1-7). Os resultados indicam que o efeito bifásico dose-dependente da Ang-(1-7) sobre o JHCO3- no túbulo proximal é via receptor Mas e isoforma NHE3 e sugerem estimulação desse trocador por moderado aumento da [Ca2+]i na presença de Ang-(1-7; 10-6 M) e sua inibição por pronunciado aumento da [Ca2+]i na vigência de Ang-(1-7; 10-12 ou 10-9 M). / The action of Ang-(1-7) on bicarbonate reabsorption (JHCO3-) was evaluated in vivo middle proximal tubule of rat kidney, using H ion-sensitive microelectrodes. The control JHCO3- is 2,84 ± 0.08 nmol. cm-2. s-1 (49), Ang-(1-7; 10-12 or 10-9 M) decreases it (35 and 61 %) but Ang-(1-7; 10-6 M) increased it (56 %). A779 (an Ang-(1-7) receptor Mas antagonist) increases the JHCO3- (30 %), prevents the inhibitory effect of Ang-(1-7) and does not affect the stimulatory effect of Ang-(1-7). S3226 (10-6 M; an inhibitor of NHE3) decreases the JHCO3- (45 %), does not affect the inhibitory effect of Ang-(1-7) and changes its stimulatory effect on an inhibitory effect. The control cytosolic free calcium ([Ca2+]i), monitored by FURA-2-AM, is 100 ± 2,47 nM (35) and Ang-(1-7; 10-12, 10-9 or 10-6 M) causes a transient (3 min) increase of it (152, 103 or 53 %). A779 increases the [Ca2+]i (26 %) but impaired the stimulatory effect of Ang-(1-7). Our results indicate the biphasic dose-dependent effect of Ang-(1-7) on JHCO3- in proximal tubule is mediated via Mas receptor and NHE3 and are compatible with stimulation of this exchanger by a moderate increase in [Ca2+]i in the presence of Ang-(1-7, 10-6 M), and its inhibition by large increase in [Ca2+]i with Ang-(1-7, 10-12 or 10-9 M).

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Avaliou-se a atividade de Bothrops marajoensis (Bmj) e suas fraÃÃes no sistema cardiorrenal. A resposta pressora do veneno bruto demonstrou uma diminuiÃÃo da pressÃo arterial mÃdia e da freqÃÃncia cardÃaca, sem alteraÃÃes significativas na freqÃÃncia respiratÃria. Em ratos atropinizados demonstrou a permanÃncia dos efeitos. Na perfusÃo de coraÃÃo isolado de ratos observou-se uma diminuiÃÃo na forÃa de contraÃÃo miocÃrdica acompanhada de um aumento da pressÃo de perfusÃo, sem alteraÃÃes no fluxo coronariano. A anÃlise eletrocardiogrÃfica em ratos apÃs injeÃÃo de Bmj provocou um bloqueio Ãtrio ventricular gradual atà um bloqueio completo indicando arritmia e dificuldade de conduÃÃo atrial. Em leito vascular mesentÃrio prÃ-contraÃdo com fenilefrina nÃo houve alteraÃÃes significativas. No sistema de perfusÃo renal em ratos apresentou decrÃscimo significativo na pressÃo de perfusÃo, resistÃncia vascular, fluxo urinÃrio, ritmo de filtraÃÃo e transportes de sÃdio e de cloreto. Fosfolipase miotÃxica (tipo 1) demonstrou alteraÃÃes somente no transporte de Ãons. A atividade de Bmj em doses crescentes em nervo FrÃnico Diafragma de rato mostrou um bloqueio na forÃa de contraÃÃo dose dependente, com efeito significante nas maiores doses. Em canal deferente de camundongos induziu a uma inibiÃÃo dose dependente da contraÃÃo estimulada por campo elÃtrico. Este feito nÃo foi revertido pela Ioimbina nem por naloxone. Em outro estudo a adiÃÃo do veneno bruto de Bmj inibiu a contraÃÃo neurogÃnica,quando comparado com nenhuma queda significante pela contraÃÃo com Cch, NA ou ATP (em Krebs normal ou enriquecido com guanetidina e fentolamina. A ausÃncia de efeito do veneno bruto de Bothrops marajoensis sobre a contraÃÃo induzida pelos principais agonistas purinÃrgicos demonstra provÃvel atividade a nÃvel prÃ-sinÃptico. FraÃÃes de fosfolipases miotÃxicas (tipo 1 e tipo 2) demonstraram uma inibiÃÃo da contraÃÃo dose dependente. / In this article we evaluated the activity of Bothrops marajoensis (Bmj) and its fractions in the cardio-renal system. The results of the total venom in blood pressure experiments showed a decrease in the mean arterial pressure and heart rate without significant changes in respiratory rate. The same experiments performed in rats atropinized showed the permanence of falling blood pressure and heart rate. After administration of Bmj used in infusion of isolated rats heart of there was a decrease in myocardial force of contraction accompanied by an increase in perfusion pressure, without changes in coronary flow. The electrocardiographic analysis after injection of Bmj in rats causes a progressive atrioventricular block until a complete blockage and difficulty in atrial conduction. The assessment in the mesenteric vascular bed Bmj did not produce significant changes. The system renal perfusion in rats caused significant decrease in perfusion pressure, renal vascular resistance, urinary flow, filtration rate, transport of sodium and chloride. The phospholipase (PLA2) type 1 showed only an alteration in the transport of electrolytes. The Bmj fractions neurotoxicity in rat phrenic nerve diaphragm increasing showed a blockage dose-dependent in the strength of contraction. In mice vas deferens we observed an induced of a dose-dependent inhibition of contraction stimulated by electric field. This fact was not reversed by yohimbine or by naloxone. In another study the addition of the total venom of Bmj inhibited the neurogenic contraction, compared with no significant decrease in contraction by Cch, NA or ATP (in normal Krebs solution or with enriched with guanethidine and phentolamine). The fractions, PLA2 (type 1 and type 2) showed a dose-dependent inhibition of contraction.

O estudo avaliou os efeitos agudos da Ang-(1-7) na reabsorção de bicarbonato (JHCO3-) no túbulo proximal cortical de rato, in vivo, medindo o pH intratubular pelo microeletródio sensível a H+. O JHCO3- controle é 2,84 ± 0,08 nmol. cm-2. s-1 (49), a Ang-(1-7; 10-12 ou 10-9 M) o reduz (35 ou 61 %) e a Ang-(1-7; 10-6 M) o eleva (56 %). A inibição do receptor Mas (por A779) eleva o JHCO3- (30 %), abole o efeito inibidor da Ang-(1-7), mas não afeta seu efeito estimulador. A inibição do NHE3 (por S3226) diminui o JHCO3- (45 %), não altera o efeito inibidor da Ang-(1-7), mas transforma seu efeito estimulador em inibidor. A concentração de cálcio citosólico ([Ca2+]i), medida pelo FURA-2-AM, controle é 100 ± 2,47 nM (35) e a Ang-(1-7; 10-12, 10-9 ou 10-6 M) a aumenta (152, 103 ou 53 %) transientemente (3 min). A inibição do receptor Mas aumenta a [Ca2+]i (26 %), mais inibe o efeito estimulador de todas as doses de Ang-(1-7). Os resultados indicam que o efeito bifásico dose-dependente da Ang-(1-7) sobre o JHCO3- no túbulo proximal é via receptor Mas e isoforma NHE3 e sugerem estimulação desse trocador por moderado aumento da [Ca2+]i na presença de Ang-(1-7; 10-6 M) e sua inibição por pronunciado aumento da [Ca2+]i na vigência de Ang-(1-7; 10-12 ou 10-9 M). / The action of Ang-(1-7) on bicarbonate reabsorption (JHCO3-) was evaluated in vivo middle proximal tubule of rat kidney, using H ion-sensitive microelectrodes. The control JHCO3- is 2,84 ± 0.08 nmol. cm-2. s-1 (49), Ang-(1-7; 10-12 or 10-9 M) decreases it (35 and 61 %) but Ang-(1-7; 10-6 M) increased it (56 %). A779 (an Ang-(1-7) receptor Mas antagonist) increases the JHCO3- (30 %), prevents the inhibitory effect of Ang-(1-7) and does not affect the stimulatory effect of Ang-(1-7). S3226 (10-6 M; an inhibitor of NHE3) decreases the JHCO3- (45 %), does not affect the inhibitory effect of Ang-(1-7) and changes its stimulatory effect on an inhibitory effect. The control cytosolic free calcium ([Ca2+]i), monitored by FURA-2-AM, is 100 ± 2,47 nM (35) and Ang-(1-7; 10-12, 10-9 or 10-6 M) causes a transient (3 min) increase of it (152, 103 or 53 %). A779 increases the [Ca2+]i (26 %) but impaired the stimulatory effect of Ang-(1-7). Our results indicate the biphasic dose-dependent effect of Ang-(1-7) on JHCO3- in proximal tubule is mediated via Mas receptor and NHE3 and are compatible with stimulation of this exchanger by a moderate increase in [Ca2+]i in the presence of Ang-(1-7, 10-6 M), and its inhibition by large increase in [Ca2+]i with Ang-(1-7, 10-12 or 10-9 M).

<p>The kidney's major role in filtration depends on its high blood flow, concentrating mechanisms, and biochemical activation. The kidney's greatest strengths also lead to vulnerability for drug-induced nephrotoxicity and other renal injuries. The current standard to diagnose renal injuries is with a percutaneous renal biopsy, which can be biased and insufficient. In one particular case, biopsy of a kidney with renal cell carcinoma can actually initiate metastasis. Tools that are sensitive and specific to detect renal disease early are essential, especially noninvasive diagnostic imaging. While other imaging modalities (ultrasound and x-ray/CT) have their unique advantages and disadvantages, MRI has superb soft tissue contrast without ionizing radiation. More importantly, there is a richness of contrast mechanisms in MRI that has yet to be explored and applied to study renal disease.</p><p>The focus of this work is to advance preclinical imaging tools to study the structure and function of the renal system. Studies were conducted in normal and disease models to understand general renal physiology as well as pathophysiology. This dissertation is separated into two parts--the first is the identification of renal architecture with ex vivo MRI; the second is the characterization of renal dynamics and function with in vivo MRI. High resolution ex vivo imaging provided several opportunities including: 1) identification of fine renal structures, 2) implementation of different contrast mechanisms with several pulse sequences and reconstruction methods, 3) development of image-processing tools to extract regions and structures, and 4) understanding of the nephron structures that create MR contrast and that are important for renal physiology. The ex vivo studies allowed for understanding and translation to in vivo studies. While the structure of this dissertation is organized by individual projects, the goal is singular: to develop magnetic resonance imaging biomarkers for renal system. </p><p>The work presented here includes three ex vivo studies and two in vivo studies:</p><p> </p><p>1) Magnetic resonance histology of age-related nephropathy in sprague dawley.</p><p>2) Quantitative susceptibility mapping of kidney inflammation and fibrosis in type 1 angiotensin receptor-deficient mice. </p><p>3) Susceptibility tensor imaging of the kidney and its microstructural underpinnings. </p><p>4) 4D MRI of renal function in the developing mouse. </p><p>5) 4D MRI of polycystic kidneys in rapamycin treated Glis3-deficient mice.</p> / Dissertation

O objetivo foi determinar se aldosterona e corticosterona agem sobre a acidificação do túbulo proximal e se esses efeitos são genômicos e/ou não-genômicos. A reabsorção de HCO3- foi avaliada por microperfusão estacionária. Aldosterona e corticosterona perfundidas na luz tubular causaram aumento significante do JHCO3-. Na presença de etanol, actinomicina D, cicloheximida ou espironolactona, o JHCO3- foi estatisticamente igual ao valor controle (2,84 ± 0,079 nmol.cm-2.s-1). RU486 sozinho inibiu o efeito estimulador da aldosterona e corticosterona. Losartan não alterou o JHCO3-. Concanomicina ou S3226 diminuiram o efeito estimulador da corticosterona. A aldosterona perfundida nos capilares peritubulares aumentou o JHCO3-. Assim, a aldosterona e corticosterona tem um efeito rápido, não-genômico, estimulante do JHCO3-, provavelmente com a participação do GR e pela ativação do NH3 e da H+-ATPase luminais. Além disto, a aldosterona e corticosterona endógenas estimulam o JHCO3- no túbulo proximal. / The purpose was to determine if aldosterone and corticosterone act on the acidification of proximal tubule and if these hormonal effects are genomic and/or nongenomic. Bicarbonate reabsorption was evaluated by microperfusion. Aldosterone and corticosterone caused a significant increase in JHCO3-. In the presence of ethanol, actinomycin D, cycloheximide or espironolactone, the JHCO3- was not different from the control value (2.84 ± 0.079 nmol.cm-2.s-1). However, in the presence of RU486 a decrease on JHCO3- was observed. Losartan inhibited the JHCO3-. Concanamicyn or S3226 decreased the stimulatory effect of corticosterone. Aldosterone perfused into peritubular capillaries also increased JHCO3-. Our results indicate that: aldosterone and corticosterone has a rapid, nongenomic, stimulatory effect on JHCO3-; probably, GR participates in this process and; this effect, probably, occurs by activation of luminal NH3 and H+-ATPase. Besides, endogenous aldosterone and corticosterone stimulate JHCO3-.