Objective: The aim of this work is to evaluate the effect of warm ischemia on renal function. Methods: Within a multicentric study, the data about tumor-affected solitary kidney were obtained from 9 urological centers in the Czech Republic. Patients were divided into groups according to the WIT (warm ischemia time). In each group the mean preoperative serum creatinine was determined, as well as on 3rd and 7th postoperative day and the lowest GF postoperatively. In each group the mean R.E.N.A.L. nephrometric score was determined. Results: The study compriese data totally of 97 patients. The open approach was chosen in 78 cases, in 16 cases laparoscopic approach was chosen. The robotic surgery was performed in 3 patients. PN with zero ischemia was performed in 29 patients (30%). Conclusion: Our findings confirm that non-clamping partial nephrectomy in a solitary kidney minimizes renal injury. For the non-clamping partial nephrectomy can be mainly indicated smaller exophyticall tumors without deep parenchymal invasion. Unfortunately, most of PN should be performed with vascular clamping, allowing precise closure of collecting system, vascular and parenchymal defect, especially for larger tumors with deep parenchymal invasion. According to our observation that WIT of 15 minutes for a kidney is safe. Clamping of...

Thesis (M.Sc. (Statistics)) -- University of Limpopo, 2020 / Peritoneal Dialysis (PD) is a process of replacing kidney function which cleans waste from the blood and remove extra fluid from the body. In most cases, the process of PD is slowed down by a peritoneal membrane infection called peritonitis. Despite recent advancements in treatments and prevention, peritonitis still remains the leading complication which results in high morbidity and technique failure among PD patients. Using a prospective peritonitis dataset of 159 kidney patients who were on PD from 2008 to 2015 in Pietersburg Provincial Hospital, the aim of this study was to identify potential social, demographic and biological risk factors that contribute to the first episode of peritonitis. Both semi-parametric (Cox PH) and parametric (Accelerated Failure Time: Weibull, exponential, loglogistic, and gamma) survival models were fitted to the peritonitis dataset. Akaike Information Criterion (AIC) was applied to select models which best fit to the peritonitis data. Accordingly, log-logistic Accelerated Failure Time (AFT) model was found to be a working model that best fit to the data. A total of 96 (60.38%) peritonitis cases were recorded over the follow-up period with majority of peritonitis infection coming from females (65.4%) and rural dwellers (65.7%) with (62.6%) of black Africans showing higher risk of developing peritonitis. The multivariate log-logistic AFT model revealed that availability of water (p-value=0.018), electricity (p-value=0.018), dwelling (p-value=0.008), haemoglobin status (p-value=0.002) and duration on PD (p-value=0.001) are significant risk factors for the development of peritonitis. Therefore, patients with no water and electricity, coming from rural background with low level of haemoglobin and shorter duration on PD are associii ated with high risk or hazard of developing peritonitis for the first time.

Alpacas kept in Central Europe are often deficient in vitamin D3, which is supplemented orally or by injection by the owners or veterinarians. Vitamin D3 can be specified in two different units (IU and µg), which differ by a factor of 40. By mixing up these units, an overdosage can be induced. In this study, three alpaca crias were examined after vitamin D3 intoxication, with particular reference to kidney function. All three animals developed non-specific clinical alterations 1–2 weeks after a vitamin D3 overdose of approximately 40 times. Plasma of the animals revealed several alterations. The main findings were severe azotemia, hypercalcemia and hyperphosphatemia, 15 days after treatment. Kidney function analysis (endogenous creatinine clearance) in two of the crias revealed severe glomerular damage. All crias died despite intensive treatment within 23 days after vitamin D3 treatment. Necropsy revealed calcification in different organs, mainly the kidneys, lungs and liver. Since nine other crias in the same group were treated with comparable doses of vitamin D3 and no clinical signs were observed in these animals, it is concluded that individual animals show different levels of sensitivity to vitamin D3.

Yes / Acute kidney injury (AKI) can occur rarely in patients exposed to iodinated contrast and result in contrast-induced AKI (CI-AKI). A key risk factor is the presence of pre-existing chronic kidney disease (CKD), therefore it is important to assess patient risk and obtain kidney function measurement prior to administration. Point of care (PoC) testing provides an alternative strategy but there remains uncertainty, with respect to diagnostic accuracy and clinical utility. A device study compared three PoC analysers (Nova StatSensor, Abbott i-STAT, Radiometer ABL800 FLEX) with a reference laboratory standard (Roche Cobas 8000 series, enzymatic creatinine). Three hundred adult patients attending a UK hospital phlebotomy department were recruited to have additional blood samples for analysis on the PoC devices. The ABL800 FLEX had the strongest concordance with laboratory measured serum creatinine (mean bias=-0.86, 95% limits of agreement = -9.6 to 7.9) followed by the i-STAT (average bias=3.88, 95% limits of agreement = -8.8 to 16.6) and StatSensor (average bias=3.56, 95% limits of agreement = -27.7 to 34.8). In risk classification, the ABL800 FLEX and i-STAT identified all patients with an eGFR≤30, whereas the StatSensor resulted in a small number of missed high-risk cases (n=4/13) and also operated outside of the established performance goals. The screening of patients at risk of CI-AKI may be feasible with PoC technology. However in this study it was identified that the analyser concordance with the laboratory reference varies. It is proposed that further research exploring PoC implementation in imaging department pathways is needed. / Yorkshire and Humber Academic Health Science Network (Grant Number: YHP0318)

Vários estudos mostram que na doença renal policística autossômica dominante os cistos surgem a partir de um mecanismo de "dois-golpes". A patogênese das manifestações não-císticas, contudo, é pouco compreendida. Neste estudo usamos uma linhagem de camundongos endogâmica com uma mutação nula em Pkd1, onde animais heterozigotos apresentam formação cística renal mínima até 40 semanas de idade. O clearance de inulina e o número de glomérulos foram menores em machos Pkd1+/- que Pkd1+/+, enquanto o volume glomerular médio foi maior em heterozigotos. A excreção urinária de NO2/NO3 não diferiu significantemente entre os dois grupos. Avaliamos a osmolalidade urinária máxima em machos e fêmeas Pkd1+/- and Pkd1+/+, porém não foi detectada diferença significante entre os grupos heterozigoto e selvagem. Nossos resultados oferecem evidência direta de que a haploinsuficiência de Pkd1 resulta em anormalidades anatômicas e funcionais renais e sugerem que o estado haploinsuficiente de Pkd1 possa resultar na redução do número de néfrons por diminuir a ramificação tubular renal durante a nefrogênese / Several studies show that in autosomal dominant polycystic kidney disease cysts arise through a "two-hit" mechanism. The pathogenesis of non-cystic features, however, is poorly understood. In this study we used an inbred mouse line with a null mutation of Pkd1, where heterozygotes had minimal renal cyst formation up to 40 weeks of age. Inulin clearance and the number of glomeruli were lower in Pkd1+/- than in Pkd1+/+ males, while a higher average glomerular volume was observed in heterozygotes. The urinary excretion of NO2/NO3 did not significantly differ between the two groups. Maximal urinary osmolality was evaluated in Pkd1+/- and Pkd1+/+ males and females, but no significant difference was detected between the heterozygous and the wild type groups. Our results provide direct evidence that haploinsufficiency for Pkd1 results in anatomic and functional abnormalities of the kidney and suggest that Pkd1 haploinsufficiency may result in a reduced number of nephrons by diminishing renal tubule branching during nephrogenesis

Vários estudos mostram que na doença renal policística autossômica dominante os cistos surgem a partir de um mecanismo de "dois-golpes". A patogênese das manifestações não-císticas, contudo, é pouco compreendida. Neste estudo usamos uma linhagem de camundongos endogâmica com uma mutação nula em Pkd1, onde animais heterozigotos apresentam formação cística renal mínima até 40 semanas de idade. O clearance de inulina e o número de glomérulos foram menores em machos Pkd1+/- que Pkd1+/+, enquanto o volume glomerular médio foi maior em heterozigotos. A excreção urinária de NO2/NO3 não diferiu significantemente entre os dois grupos. Avaliamos a osmolalidade urinária máxima em machos e fêmeas Pkd1+/- and Pkd1+/+, porém não foi detectada diferença significante entre os grupos heterozigoto e selvagem. Nossos resultados oferecem evidência direta de que a haploinsuficiência de Pkd1 resulta em anormalidades anatômicas e funcionais renais e sugerem que o estado haploinsuficiente de Pkd1 possa resultar na redução do número de néfrons por diminuir a ramificação tubular renal durante a nefrogênese / Several studies show that in autosomal dominant polycystic kidney disease cysts arise through a "two-hit" mechanism. The pathogenesis of non-cystic features, however, is poorly understood. In this study we used an inbred mouse line with a null mutation of Pkd1, where heterozygotes had minimal renal cyst formation up to 40 weeks of age. Inulin clearance and the number of glomeruli were lower in Pkd1+/- than in Pkd1+/+ males, while a higher average glomerular volume was observed in heterozygotes. The urinary excretion of NO2/NO3 did not significantly differ between the two groups. Maximal urinary osmolality was evaluated in Pkd1+/- and Pkd1+/+ males and females, but no significant difference was detected between the heterozygous and the wild type groups. Our results provide direct evidence that haploinsufficiency for Pkd1 results in anatomic and functional abnormalities of the kidney and suggest that Pkd1 haploinsufficiency may result in a reduced number of nephrons by diminishing renal tubule branching during nephrogenesis

40% of severe acute respiratory syndrome coronavirus two (SARS-CoV-2) severe cases develop acute kidney injury (AKI). Current treatment for renal complications limits financial and material resources available. To explore alternative treatments and accelerate research in case of future coronavirus outbreaks, a mouse model of coronavirus disease 2019-associated AKI (C19-AKI) would represent a critical biomedical research tool. The surrogate model of C19-AKI (SMC) developed consisted of angiotensin-converting enzyme two (ACE2) knockout (KO) mice receiving 400 ng/kg/min of angiotensin (Ang) II by osmotic minipump for eight days with a single injection of lipopolysaccharide (LPS; 10 mg/kg) on the seventh day of Ang II and euthanasia 24 hours after LPS. Similarly, to C19-AKI, the SMC exhibited albuminuria, elevated blood urea nitrogen, electrolyte imbalance, neutrophil infiltration, and upregulation of the G-coupled protein receptor (GPR)84 and pro-inflammatory and injury markers. GPR84 was found in bronchoalveolar lavage fluid neutrophils of coronavirus disease 2019 (COVID-19) patients, suggesting a potential implication of GPR84 in the disease. We hypothesised that GPR84 deletion or antagonism with GLPG-1205 could attenuate SMC’s indices of renal injury and inflammation. GLPG-1205 and GPR84 KO had no effects in the SMC model, as suggested by unchanged albuminuria, electrolytes, and markers expression. Interestingly, neutrophil infiltration was attenuated by GLPG-1205 only. The SMC is an interesting tool for therapeutic development for infections associated with renal injury, such as SARS-CoV-2. GPR84 role in the SMC needs to be further assessed.

principal dificuldade na identificação de novos biomarcadores para doenças renais consiste em encontrar marcadores que são específicos do rim ou do processo patológico em que se encontra, além de conseguir caracterizar a doença renal independente de outras doenças pré-existentes. Assim, o objetivo deste estudo foi identificar novos candidatos a biomarcadores, predominantemente renais, de lesão renal em um modelo suíno controlado unilateral de lesão renal aguda (LRA) por isquemia/reperfusão (I/R) renal percutânea. Para isto, foram feitas análises do proteoma e do nitroproteoma de amostras de urina e soro nos períodos pré-isquemia, isquemia (60min) e pós-reperfusão (4 ou 6h, 11 e 16h), e das de amostras do córtex renal após 24h de reperfusão, todas no Q-ExactiveTM. Os resultados foram analisados no MaxQuant seguidos da análise de biologia de sistemas. A seleção das proteínas candidatas a biomarcadores de lesão renal foi baseada na predominância de expressão dessas proteínas no rim através do banco TiGER e/ou Atlas Human Protein. Foram identificadas 1365 proteínas no proteoma total dos córtices renais, das quais 535 estavam presentes em pelo menos 3 animais e mais expressas no rim isquêmico, com excessão da Xaa-pró aminopeptidase 2. Estas proteínas participam dos processos de transcrição, tradução, adesão celular, proliferação e reparo, importantes para a recuperação da lesão renal após 24h. A intersecção das proteínas sub ou superexpressas no rim isquêmico com os proteomas do soro ou da urina resultou em seis proteínas séricas (VIM, HPSA8, HSPD1, COL1A1, LCP1e TPI1) entre as 170 identificadas capazes de fornecer um painel para LRA ou processo degenerativo. Enquanto na urina, foram identificadas 49 de 501 proteínas presentes na intersecção, sendo 4 predominantemente renais (BHMT2, GBA3, DDC e DPPIV). A atividade da DPPIV na urina aumentou após 4h de reperfusão retornando aos níveis basais após este período validando o nosso candidato a biomarcador. A DPPIV também foi validada em uma coorte de pacientes com nefropatia diabética que apresentou uma moderada correlação com os parâmetros ligados a disfunção renal: MDRD, proteinúria, hemoglobina glicada, PTH e renina. Apesar de não haver diferença na concentração de proteínas nitradas no rim contralateral e isquêmico houve uma diferença no perfil de proteínas encontradas. Foram identificadas 843 proteínas no nitroproteoma dos córtices renais das quais 53 estavam superexpressas no rim isquêmico e 2 no rim contralateral. Das 55 proteínas, 38% eram mitocondriais e relacionadas com as vias energéticas. Foi possível validar a nitração de duas destas proteínas, a DPPIV e a BHMT2. No nitroproteoma da urina identificou-se 126 proteínas das quais 27 se agruparam de forma diferente para cada período do experimento baseado no comportamento da expressão proteica. A excreção de proteínas nitradas também foi observada no tempo basal, supondo um papel fisiológico da nitração. Além disso, o perfil de excreção de proteínas nitradas ao longo da I/R foi independente das mudanças ocorridas no perfil proteico total. Por fim, duas proteínas se destacaram como candidatas a biomarcador, a UMOD e a ALDOB. Já, o nitroproteoma sérico resultou em 55 proteínas, das quais as 33 mais representativas dos animais foram capazes de separar o período antes e após a reperfusão renal. Duas destas proteínas foram consideradas candidatas a biomarcadores de lesão renal, a SEMG2 e a DMGDH, esta última foi validada. A partir dos resultados gerados, foi possível identificar alterações proteicas ao longo da I/R renal, novas proteínas nitradas e novos candidatos a biomarcador de lesão renal. Novos estudos com uma abordagem mais direcionada e aprofundada devem ser desenvolvidos, tanto para confirmar os candidatos a biomarcadores e seu potencial uso clínico, quanto para analisar o comportamento fisiopatológico e bioquímico das proteínas com e sem nitração na LRA por I/R renal em rins morfo-fisiologicamente semelhantes aos encontrados em humanos / The main bottleneck in studies aiming to identify novel biomarkers in kidney disease has been the identification of markers that are organ and process specific and characterize the kidney disease regarding other other pre-existing diseases. The aim of this study was to identify new candidates, predominantly renal, that could be used as systemic biomarkes for acute kidney disease (AKI) in a unilateral percutaneous controlled porcine renal ischemia/reperfusion (I/R) model. The nitroproteome and proteome of urine and serum samples were analyzed in Q-ExactiveTM on the period pre-ischemia, ischemia (60 min) and 4, 11 and 16 h post-reperfusion. The renal cortex samples were analyzed only after 24 h of reperfusion. The results were analyzed in the MaxQuant followed by systems biology analysis. The selection of candidate proteins for renal injury was based on the predominance of expression of these proteins in the kidney through TiGER and Atlas Human Protein. In renal cortex proteome, it was identified 1365 proteins which 535 were present at least 3 animals and more expressed in ischemic kidney, with exception of Xaa-pro aminopeptidase 2. These proteins participate of transcription, translational, cellular adhesion, proliferation and repair, important for the recovery of renal injury after 24h. Intersecting the set of proteins up- or down-regulated in the ischemic tissue with both serum and urine proteomes, 6 serum proteins from 170 identified proteins (VIM, HPSA8, HSPD1, COL1A1, LCP1 and TPI1) were identified that may provide a set of targets for AKI or degenerative process. Additionally, 49 from 501 urinary proteins were identified in the intersection, being 4 predominantly renal (BHMT2, GBA3, DDC and DPPIV). As a proof of concept, the activity of DPPIV in the urine increased after 4h of reperfusion returning to baseline levels after this period and with subsequent translational validation in a cohort of patients with diabetic nephropathy who presented a moderate correlation with the parameters related to renal dysfunction: MDRD, proteinuria, glycated hemoglobin, PTH and renin Althought there was no diference between nitrated proteins levels in contralateral and ischemic kidneys, there was difference in the protein profile found. In niroproteome from cortex were identified 843 proteins, of which 53 were up-regulated in the ischemic kidney and 2 in the contralateral kidney. Of the 55 proteins, 38% were mitochondrial and related to the energy pathways. It was possible to validate the nitration of two of these proteins, DPPIV and BHMT2. In the urine nitroproteome, 126 proteins were identified, 27 of which were grouped differently for each period of the experiment based on the behavior of protein expression. The nitrated protein excretion was also observed at baseline, assuming a physiological role of nitration. In adition, the profile of urine proteins along I/R was independent of changes in the total protein profile. Finally, two proteins stood out as candidates for biomarker, UMOD and ALDOB. The serum nitroproteome resulted in 55 identified proteins, 33 were more representative from animals and they able to distinguish the periods before and after renal reperfusion. Two predominantly renal proteins, SEMG2 and DMGDH, were described as candidates to renal injury biomarkers and the last protein was validated. From these results, proteins changes were observed along the renal I/R, new nitrated proteins and new candidates for biomarkers of kidney injury were identified. New studies with a more focused and in-depth approach should be developed both to confirm the candidates for biomarkers and their potential clinical use and to analyze the pathophysiological and biochemical behavior of the proteins with and without nitration in AKI by I/R renal in kidneys morphologically and physiologically similar to those found in humans

Estudos tem demonstrado que a injúria renal aguda (IRA) pode evoluir para doença renal aguda ou crônica, principalmente quando associada à comorbidades como a hipertensão sal-dependente. Além disso, o desenvolvimento da perda de função renal é comumente associado a distúrbios mineral e ósseo. O uso de antioxidantes como a N-acetilcisteína (NAC) tem sido utilizado para prevenir a lesão da IRA, no entanto pouco se sabe sobre o uso deste medicamente em um período prolongado e os seus efeitos no metabolismo mineral e ósseo. Sendo assim os objetivos do presente estudo foram avaliar a repercussão da sobrecarga de sódio na dieta em modelo de IRA com ou sem tratamento com NAC, e observar a influência da IRA, dieta hipersódica e tratamento no metabolismo mineral e ósseo após 10 semanas de protocolo. Para isto foram utilizados ratos machos Wistar alimentados com dieta normossódica (0,5% Na - NS) ou hipersódica (3,2% Na - HS), tratados com ou sem NAC (IR NAC) (600mg/L) e submetidos à cirurgia de isquemia (45 minutos) e reperfusão renal bilateral (IR) ou Sham. Os animais foram acompanhados por 10 semanas após a cirurgia. Foram avaliadas pressão arterial caudal, função renal, metabolismo mineral e histomorfometria óssea. Os animais que sofreram IR e foram alimentados com dieta HS apresentaram maior excreção de sódio, cálcio e fósforo e albuminúria. A albuminúria correlacionou-se com o aumento do PTH induzindo a um maior tecido osteoide e superfície de osteoblastos nestes animais. A NAC diminuiu excreção de sódio, cálcio, fósforo, albuminúria e PTH, mas causou a diminuição do volume ósseo e aumento da separação trabecular. A ingestão do sódio influenciou nos níveis séricos altos de 1-25(OH)2D e baixos de FGF-23. Estes resultados sugerem que a sobrecarga de sal na dieta causou evolução da IRA após 10 semanas. Essa perda de função renal aumentou o PTH, volume osteoide e osteoblastos. Em contrapartida, o tratamento com a NAC preveniu a progressão da disfunção renal, mas levou à perda de massa óssea / Studies have shown that acute kidney injury (AKI) can progress to acute or chronic kidney disease especially when associated with co-morbidities such as salt-dependent hypertension. In addition to impairment of renal function there is association with mineral and bone disorders. The antioxidants such as N-acetylcysteine (NAC) has been used to prevent the AKI; however; the prolonged use and its effects in mineral and bone metabolism is not well studied. The aim of the study was to evaluate dietary sodium overload repercussion on the AKI associated to NAC treatment and to observe its effects on bone metabolism after 10 weeks. Were used Wistar rats were fed with normal sodium (0.5% NaCl - NS) or high sodium (3.2% NaCl - HS) diet and treated or not with NAC (600 mg/L) and submitted to renal ischemia (45 minutes) and reperfusion (IR) or Sham surgery. The animals were followed up for 10 weeks after surgery. We evaluated caudal blood pressure, renal function, mineral metabolism and bone histomorphometry. In our results urinary sodium, calcium, phosphorus excretion and albuminuria were higher in HS IR animals. There was a positive correlation between albuminuria and PTH leading to osteoid tissue and surface of osteoblasts augmentation in these animals. In other hand, NAC decreased sodium, calcium, phosphorus excretion, albuminuria and PTH; however, it was observed lower bone volume and higher trabecular separation. Sodium intake had an isolated effect on 1-25(OH)2D and FGF-23. These results suggest that overload salt diet caused AKI development. Loss of renal function increased PTH, osteoid volume and osteoblasts Treatment with NAC prevented renal function impairment, however it induced to bone mass loss

Estudos tem demonstrado que a injúria renal aguda (IRA) pode evoluir para doença renal aguda ou crônica, principalmente quando associada à comorbidades como a hipertensão sal-dependente. Além disso, o desenvolvimento da perda de função renal é comumente associado a distúrbios mineral e ósseo. O uso de antioxidantes como a N-acetilcisteína (NAC) tem sido utilizado para prevenir a lesão da IRA, no entanto pouco se sabe sobre o uso deste medicamente em um período prolongado e os seus efeitos no metabolismo mineral e ósseo. Sendo assim os objetivos do presente estudo foram avaliar a repercussão da sobrecarga de sódio na dieta em modelo de IRA com ou sem tratamento com NAC, e observar a influência da IRA, dieta hipersódica e tratamento no metabolismo mineral e ósseo após 10 semanas de protocolo. Para isto foram utilizados ratos machos Wistar alimentados com dieta normossódica (0,5% Na - NS) ou hipersódica (3,2% Na - HS), tratados com ou sem NAC (IR NAC) (600mg/L) e submetidos à cirurgia de isquemia (45 minutos) e reperfusão renal bilateral (IR) ou Sham. Os animais foram acompanhados por 10 semanas após a cirurgia. Foram avaliadas pressão arterial caudal, função renal, metabolismo mineral e histomorfometria óssea. Os animais que sofreram IR e foram alimentados com dieta HS apresentaram maior excreção de sódio, cálcio e fósforo e albuminúria. A albuminúria correlacionou-se com o aumento do PTH induzindo a um maior tecido osteoide e superfície de osteoblastos nestes animais. A NAC diminuiu excreção de sódio, cálcio, fósforo, albuminúria e PTH, mas causou a diminuição do volume ósseo e aumento da separação trabecular. A ingestão do sódio influenciou nos níveis séricos altos de 1-25(OH)2D e baixos de FGF-23. Estes resultados sugerem que a sobrecarga de sal na dieta causou evolução da IRA após 10 semanas. Essa perda de função renal aumentou o PTH, volume osteoide e osteoblastos. Em contrapartida, o tratamento com a NAC preveniu a progressão da disfunção renal, mas levou à perda de massa óssea / Studies have shown that acute kidney injury (AKI) can progress to acute or chronic kidney disease especially when associated with co-morbidities such as salt-dependent hypertension. In addition to impairment of renal function there is association with mineral and bone disorders. The antioxidants such as N-acetylcysteine (NAC) has been used to prevent the AKI; however; the prolonged use and its effects in mineral and bone metabolism is not well studied. The aim of the study was to evaluate dietary sodium overload repercussion on the AKI associated to NAC treatment and to observe its effects on bone metabolism after 10 weeks. Were used Wistar rats were fed with normal sodium (0.5% NaCl - NS) or high sodium (3.2% NaCl - HS) diet and treated or not with NAC (600 mg/L) and submitted to renal ischemia (45 minutes) and reperfusion (IR) or Sham surgery. The animals were followed up for 10 weeks after surgery. We evaluated caudal blood pressure, renal function, mineral metabolism and bone histomorphometry. In our results urinary sodium, calcium, phosphorus excretion and albuminuria were higher in HS IR animals. There was a positive correlation between albuminuria and PTH leading to osteoid tissue and surface of osteoblasts augmentation in these animals. In other hand, NAC decreased sodium, calcium, phosphorus excretion, albuminuria and PTH; however, it was observed lower bone volume and higher trabecular separation. Sodium intake had an isolated effect on 1-25(OH)2D and FGF-23. These results suggest that overload salt diet caused AKI development. Loss of renal function increased PTH, osteoid volume and osteoblasts Treatment with NAC prevented renal function impairment, however it induced to bone mass loss