Nephrology (Carlton, Vic.)最新文献

{"title":"Review article: Managing sleep apnoea in kidney diseases.","authors":"John J Sim,&nbsp;Scott A Rasgon,&nbsp;Stephen F Derose","doi":"10.1111/j.1440-1797.2009.01260.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01260.x","url":null,"abstract":"<p><p>A higher prevalence of sleep apnoea (SA) has been observed in the chronic kidney disease (CKD) population compared with estimates in the general population. Increased rates of SA have been described in patients with various renal-related diagnoses including dialysis, renal transplant, early-stage CKD and proteinuria. The mechanism or underlying aetiology for this association is different for each type of kidney disease. The extracellular fluid volume and metabolic derangements that characterize the uremic state likely contributes to SA in the dialysis population. SA causing direct renal insults from haemodynamic changes, ischaemic stress, or an intermediary condition such as hypertension, can lead to early CKD and proteinuria. While renal transplantation has cured SA in some patients, the post-transplant state is itself a risk factor for SA. The high prevalence of SA in kidney disease and the associated clinical implications warrant vigilance in diagnosis and treatment of SA in the CKD patient. This review focuses on the prevalence of SA in patients with CKD including dialysis and transplant patients, and those with early-stage CKD and proteinuria. SA may vary in form and aetiology depending on type or stage of CKD. Based on these associations, we discuss our rationale for recommendations on screening and management of SA specific to the CKD population.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"146-52"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01260.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28989197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors for progression in immunoglobulin A nephropathy with significant proteinuria.","authors":"Hyeon Seok Hwang,&nbsp;Byung Soo Kim,&nbsp;Young Shin Shin,&nbsp;Hye Eun Yoon,&nbsp;Joon Chang Song,&nbsp;Bum Soon Choi,&nbsp;Cheol Whee Park,&nbsp;Chul Woo Yang,&nbsp;Yong Soo Kim,&nbsp;Byung Kee Bang","doi":"10.1111/j.1440-1797.2009.01196.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01196.x","url":null,"abstract":"<p><strong>Aim: </strong>Proteinuria is a primary factor requiring treatment in immunoglobulin (Ig)A nephropathy. The purpose of this study was to assess the relevance of treatment response and relapse of proteinuria with renal function decline.</p><p><strong>Methods: </strong>One hundred and twenty-five biopsy-proven primary IgA nephropathy patients who had more than 1.0 g/day proteinuria at the first assessment were studied. All patients underwent anti-proteinuric treatment, and the association of the rate of renal function decline with treatment responsiveness, clinical and laboratory data was investigated.</p><p><strong>Results: </strong>The treatment response of the patients was: 30.4% complete response (<0.3 g/day proteinuria), 32.8% partial response (0.3-1.0 g/day), 23.2% minimal response (decrement but not reduced to <1 g/day) and 13.6% no response (no decrement of proteinuria). The slope of renal function decline (-1.06 vs-1.24 mL/min per 1.73 m(2)/year, P = 0.580) was comparable between complete and partial response groups, but they were slower than those of minimal or non-response groups (P < 0.001). In multivariate analysis including other parameters, mean arterial pressure (MAP; beta = -0.240, P = 0.004) during follow up, minimal (beta = -0.393, P < 0.001) and non-response (beta = -0.403, P < 0.001) were significant predictors. In further investigation of complete and partial response groups, MAP (beta = -0.332, P = 0.001) and relapse of proteinuria (beta = -0.329, P = 0.001) were independently associated with slope of renal decline.</p><p><strong>Conclusion: </strong>Achievement of less than 1.0 g/day proteinuria and MAP were important for limiting the loss of renal function, and relapse of proteinuria should be closely monitored in proteinuric IgA nephropathy.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"236-41"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01196.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28988458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous perirenal hematoma (Wunderlich's syndrome) in a man on haemodialysis.","authors":"Chih-Chia Liang,&nbsp;Hung-Chieh Yeh,&nbsp;Chiu-Ching Huang,&nbsp;Chiz-Tzung Chang","doi":"10.1111/j.1440-1797.2009.01192.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01192.x","url":null,"abstract":"A 52 year old man on chronic haemodialysis presented to the emergency department with right flank pain. There was no history of trauma and no exposure to anticoagulants including heparin during haemodialysis. Abdominal computed tomography (CT) scan without contrast media (Fig. 1) revealed a perirenal haematoma along the anterior aspect of the subcapsular haematoma of right contracted kidney. The arrowhead (Fig. 1) depicts the ruptured site of the renal capsule. Cysts, malignant tumours or angiomyolipomas could not be found in the right kidney. A diagnosis of spontaneous subcapsular and perirenal haematoma – namely, Wunderlich’s syndrome – was established. The patient was treated with blood transfusion alone because angiography failed to disclose active renal haemorrhage. Finally, he was discharged 3 days after this event. In the 19th century, Wunderlich first described this condition of spontaneous renal bleeding with diversion of blood into the subcapsular and/or perirenal spaces. Spontaneous perirenal haematoma is a rare condition in clinical practice, especially in haemodialysis patients.","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"268"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01192.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28991197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B virus-related membranous nephropathy treated with entecavir.","authors":"Ryota Ikee,&nbsp;Kunihiro Ishioka,&nbsp;Machiko Oka,&nbsp;Kyoko Maesato,&nbsp;Hidekazu Moriya,&nbsp;Sumi Hidaka,&nbsp;Takayasu Ohtake,&nbsp;Shuzo Kobayashi","doi":"10.1111/j.1440-1797.2009.01165.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01165.x","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"266"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01165.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28991195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visfatin and endothelial function in dialyzed patients.","authors":"Jolanta Malyszko,&nbsp;Jacek S Malyszko,&nbsp;Michal Mysliwiec","doi":"10.1111/j.1440-1797.2009.01180.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01180.x","url":null,"abstract":"<p><strong>Aim: </strong>Visfatin is an adipocytokine that has recently generated much interest. The aim of the study was to assess visfatin in correlation with markers of endothelial damage and inflammation in haemodialyzed and peritoneally dialyzed patients.</p><p><strong>Methods: </strong>Visfatin, leptin, apelin and adiponectin, markers of coagulation (thrombin-antithrombin complexes (TAT), prothrombin fragments 1+2 (F1+2)), fibrinolysis (tissue plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1)), endothelial function/injury (Von Willebrand factor (vWF), thrombomodulin, intracellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), CD146) and inflammation (high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6) were assessed.</p><p><strong>Results: </strong>Triglycerides, hsCRP, creatinine, IL-6, TNF-alpha, vWF, F1+2, TAT, thrombomodulin, ICAM, VCAM, CD146, PAI-1, leptin, adiponectin and visfatin were elevated in dialyzed patients over controls. Visfatin correlated significantly, in univariate analysis, in haemodialyzed patients with markers of endothelial damage/inflammation (CD146, ICAM, IL-6), other adipocytokines, Kt/V and dialysis vintage, and tended to correlate with hsCRP. In peritoneally dialyzed patients, visfatin correlated significantly with haemoglobin, and markers of endothelial damage. In the healthy volunteers visfatin correlated significantly with ICAM, creatinine and IL-6. In multiple regression analysis in HD patients visfatin was only independently related to Kt/V, dialysis vintage and IL-6.</p><p><strong>Conclusion: </strong>Elevated visfatin related to markers of inflammation might represent a novel link between inflammation and adipocytokines in dialyzed patients. Time on dialyses and dialysis adequacy may influence visfatin in dialyzed patients due to the decreased clearance of visfatin.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"190-6"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01180.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28988451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of renin-angiotensin-aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy.","authors":"Tayfun Eyileten,&nbsp;Alper Sonmez,&nbsp;Mutlu Saglam,&nbsp;Erdinc Cakir,&nbsp;Kayser Caglar,&nbsp;Yusuf Oguz,&nbsp;Abdulgaffar Vural,&nbsp;Mujdat Yenicesu,&nbsp;Mahmut Ilker Yilmaz","doi":"10.1111/j.1440-1797.2009.01173.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01173.x","url":null,"abstract":"<p><strong>Aim: </strong>Plasma visfatin levels are elevated in diabetic nephropathy in parallel to the severity of proteinuria and glomerular filtration rate. The aim of this study was to find out whether the renin-angiotensin-aldosterone system (RAAS) blockage has any effect on the plasma visfatin levels.</p><p><strong>Methods: </strong>Thirty-two patients with diabetic proteinuria (>500 mg/day) with a normal glomerular filtration rate (GFR) and 33 healthy subjects were enrolled. Patients were treated with ramipril 5 mg daily for 2 months. Proteinuria, GFR, high-sensitivity C-reactive protein (hsCRP), visfatin, flow-mediated dilatation (FMD) and homeostasis model assessment of insulin resistance (HOMA-IR) index measurements were performed both before and after the treatment.</p><p><strong>Results: </strong>The plasma visfatin, and hsCRP levels of the patients were significantly higher and the FMD was significantly lower (P < 0.001 for all). The visfatin levels were significantly correlated to FMD, systolic and diastolic blood pressures, proteinuria, eGFR, HOMA-IR and hsCRP. Ramipril treatment resulted in a significant decrease in plasma visfatin, proteinuria, hsCRP, HOMA-IR and increase in FMD (P < 0.001) in patients (P < 0.001 for all).</p><p><strong>Conclusion: </strong>The present study suggests that plasma visfatin levels are related to the endothelial functions, inflammation and the severity of proteinuria in diabetic nephropathy. Treatment with ramipril causes a significant decrease in visfatin levels along with the improvement of proteinuria, endothelial dysfunction and inflammatory state in diabetic nephropathy.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"225-9"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01173.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28988456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenge to chronic kidney disease in Asia: The report of the second Asian Forum of Chronic Kidney Disease Initiative.","authors":"Yusuke Tsukamoto,&nbsp;Vivekanand Jha,&nbsp;Gavin Becker,&nbsp;Hung Chun Chen,&nbsp;Vlado Perkovic,&nbsp;Wiguno Prodjosudjadi,&nbsp;Kriang Tungsanga,&nbsp;Haiyan Wang,&nbsp;Zaki Morad","doi":"10.1111/j.1440-1797.2009.01269.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01269.x","url":null,"abstract":"<p><strong>Background: </strong>The Asian Forum of Chronic Kidney Disease Initiative started in 2007 in Hamamatsu, Japan when delegates from 16 countries joined together to facilitate collaboration in studying chronic kidney disease (CKD) in the Asia-Pacific region. Based on the outcome of the first meeting, the second meeting was organized as a consensus conference to frame the most relevant issues, and develop research recommendations and action plan.</p><p><strong>Proceedings: </strong>The meeting was held on 4 May 2008 as a pre-conference meeting to the 11th Asian Pacific Congress of Nephrology in Kuala Lumpur. This meeting consisted of three sessions: Session I was dedicated to the estimation of glomerular filtration rate and the standardization of serum creatinine measurements. Session II discussed specific considerations in the aetiology of and risk factors for end-stage renal disease in Asia. We concluded that there were regional specific problems that might lead to a very high prevalence of end-stage renal disease. Session III discussed the issue of facilitation of coordination and integration of the CKD initiative between developed and developing countries in the Asia-Pacific region.</p><p><strong>Conclusion: </strong>The following action plans were formulated: (i) validating the existing global estimated glomerular filtration rate equation or creating a new one using serum creatinine standardized by a central laboratory; (ii) establishing a pan-Asian CKD registry to facilitate risk analysis of CKD and its comorbidities; (iii) adapting existing clinical practice guidelines for CKD detection and management to address specific problems in this region; and (iv) working closely with other international professional organizations to promote manpower development and education in different aspects of CKD in developing countries.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"248-52"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01269.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28991192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irritable bowel syndrome in haemodialysis: Prevalence, link with quality of life and depression.","authors":"Baris Afsar,&nbsp;Rengin Elsurer,&nbsp;M Ilker Yilmaz,&nbsp;Tayfun Eyileten,&nbsp;Müjdat Yenicesu","doi":"10.1111/j.1440-1797.2009.01189.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01189.x","url":null,"abstract":"<p><strong>Aim: </strong>Health-related quality of life (HRQOL) is decreased in haemodialysis (HD) patients. Irritable bowel syndrome (IBS) is highly prevalent in general population. This study evaluated the prevalence of IBS and its association with HRQOL and depression in HD.</p><p><strong>Methods: </strong>Sociodemographic and laboratory variables were recorded. Severity of depressive symptoms and HRQOL were assessed by the Beck Depression Inventory (BDI) and Short Form 36 (SF-36), respectively. Diagnosis of IBS was based on Rome II criteria.</p><p><strong>Results: </strong>Among 236 patients 69 (29.2%) had IBS. Patients with IBS had lower SF-36 scores and had higher depressive symptoms than patients without IBS. Presence of IBS was associated with sleep disturbance (odds ratio (OR) = 2.012; P = 0.045), physical component summary score (OR = 0.963, P = 0.029), mental component summary score (OR = 0.962, P = 0.023), BDI score (OR = 1.040, P = 0.021) and albumin (OR = 0.437, P = 0.01).</p><p><strong>Conclusion: </strong>IBS is highly prevalent in HD patients. Presence of IBS is closely related with HRQOL and depression.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"197-202"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01189.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28988452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tight relations between coronary calcification and atherosclerotic lesions in the carotid artery in chronic dialysis patients.","authors":"Ilona Kurnatowska,&nbsp;Piotr Grzelak,&nbsp;Ludomir Stefańczyk,&nbsp;Michał Nowicki","doi":"10.1111/j.1440-1797.2009.01169.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01169.x","url":null,"abstract":"<p><strong>Aim: </strong>Both vascular calcification and atherosclerosis are highly prevalent in patients with end-stage renal disease (ESRD) and have been associated with increased cardiovascular morbidity. Because those two phenomena might be only coincidentally related in chronic haemodialysis (HD) patients, in this study, coronary artery calcification (CAC), common carotid artery intima media thickness (CCA-IMT) and thickness of atherosclerotic plaques in the carotid artery were simultaneously measured.</p><p><strong>Methods: </strong>In a cross-sectional study of 47 HD patients (31 male, mean age 56.8 +/- 11.4 years, and 16 female, mean age 56.0 +/- 7.5 years) without history of major cardiovascular complications. CCA-IMT and presence and thickness of atherosclerotic plaques were measured with ultrasound and CAC with multidetector computed tomography.</p><p><strong>Results: </strong>The CAC were present in 70.2% of patients. The mean CAC was 1055 +/- 232, the mean CCA-IMT was 0.96 +/- 0.21. The atherosclerotic plaques in the common carotid arteries were visualized in 38 patients (80.1%), the mean thickness of the atherosclerotic plaque was 1.61 +/- 0.8 mm. We found a significant positive correlation between CAC and CCA-IMT (r = 0.70, P < 0.001). The thickness of atherosclerosis plaque positively correlated with CAC as well as with CCA-IMT (r = 0.60, P < 0.001 and r = 0.7, P < 0.003, respectively).</p><p><strong>Conclusion: </strong>The study revealed close relationships between CAC, intima media thickness and the thickness of atherosclerotic plaques in dialysis patients. It may indicate that both vascular calcification and atherosclerotic lesions frequently coexist in patients with ESRD and that the intima media thickness could serve as a surrogate marker of vascular calcification.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"184-9"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01169.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28989202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upregulation of hyaluronan and its binding receptors in an experimental model of chronic cyclosporine nephropathy.","authors":"Dong He Han,&nbsp;Hyun Kuk Song,&nbsp;So Young Lee,&nbsp;Ji-Hyun Song,&nbsp;Shang Guo Piao,&nbsp;Hye Eun Yoon,&nbsp;Jung Yeon Ghee,&nbsp;Hyung Ju Yoon,&nbsp;Jin Kim,&nbsp;Chul Woo Yang","doi":"10.1111/j.1440-1797.2009.01167.x","DOIUrl":"https://doi.org/10.1111/j.1440-1797.2009.01167.x","url":null,"abstract":"<p><strong>Aim: </strong>Hyaluronan (HA) is an important extracellular matrix (ECM) proteoglycan. The localization of HA and its binding receptors, CD44 and LYVE-1, was evaluated in an experimental model of chronic cyclosporine A (CsA)-induced nephropathy.</p><p><strong>Methods: </strong>Sprague-Dawley rats maintained on a low-salt diet (0.05% sodium) received an s.c. injection of vehicle (1 mL/kg per day olive oil; VH groups) or CsA (15 mg/kg per day; CsA groups) for 1 or 4 weeks. Induction of chronic CsA nephropathy was evaluated according to renal function and pathology and expression of HA, CD44, LYVE-1, ED-1 and alpha-smooth muscle actin (alpha-SMA).</p><p><strong>Results: </strong>CsA treatment for 4 weeks caused renal dysfunction, which was accompanied by typical striped interstitial fibrosis. In the VHroup, HA immunoreactivity was observed only in the inner medulla. However, the area of HA immunoreactivity increased with the duration of CsA treatment: CsA treatment for 1 week extended HA immunoreactivity to the outer medulla, and CsA treatment for 4 weeks caused a further extension of HA immunoreactivity to the cortex, which was vulnerable to CsA-induced renal injury. HA binding receptor, CD44 and LYVE-1 expression were also upregulated in the CsA groups, and were localized to the area of fibrosis and the peritubular capillaries of the cortex. In the CsA groups, ED-1 and alpha-SMA were predominantly expressed in fibrotic areas in which HA had accumulated.</p><p><strong>Conclusion: </strong>These findings suggest that upregulation of HA and its binding receptors are involved in interstitial fibrosis in chronic CsA-induced renal injury.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":" ","pages":"216-24"},"PeriodicalIF":2.5,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1797.2009.01167.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28988455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}