Papillary and surface micropuncture were used to study the handling of ammonium and the formation of net acid by surface nephrons, deep nephrons, and the terminal segment of collecting duct (CD) after renal mass was reduced by two-thirds. Net acid excretion by the remnant kidney (RK) was significantly reduced, averaging 794+/-81 neq/min (SE) compared with 1,220+/-105 neq/min after sham operation (P < 0.001), due to a decrease in ammonium excretion (494+/-54 vs. 871+/-79 nmol/min in controls, P < 0.001). Urinary pH and titratable acid excretion were not different in the two groups of animals. After RK formation, ammonium delivery to the end of the proximal tubule increased nearly threefold and averaged 66.2+/-5.6 compared with 18.4+/-2.9 pmol/min in controls, (P < 0.001). This greater delivery of ammonium was primarily due to renal tubule entry rather than to changes in the filtered load and was only partially related to the differences in flow rate. Ammonium processing by deep nephrons was profoundly affected by a reduction in renal mass. Although absolute delivery of ammonium was greater to the bend of Henle's loop (BHL), the difference could be accounted for on the basis of an increase in nephron size. Thus, fractional delivery (FD(NH+4)) to this site was not different for the two groups of animals, averaging 1,567+/-180% in controls and 1,400+/-181% in the group with the RK. Hydrogen secretion in the proximal segments of deep and surface nephrons did not increase in proportion to the decrease in renal mass and as a consequence bicarbonate delivery to the end of the proximal tubule of surface nephrons and to the BHL of deep nephrons was increased. When renal mass was reduced FD(NH+4) to the base of the terminal CD doubled but did not change by the tip. In both groups FD(NH+4) to the base of the CD was greater than to the end of the distal tubule. However, the increase was the same. On the other hand, the increase in the net acid index between the end of the distal tubule and the base of the CD was profoundly greater in rats with an RK. This difference was primarily due to bicarbonate reabsorption rather than enhanced ammonium reentry. Indeed, >400% of the fractional ammonium delivered to the end of the proximal tubule was lost from the tubule fluid. The data suggest that the decrease in acid excretion by the RK is due to two factors. First, hydrogen secretion in the proximal segments of both nephron populations fails to increase in the proportion to the reduction in renal mass. Second, a reduced reentrapment of ammonia, rather than its impaired production, causes ammonium excretion to decrease.
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http://dx.doi.org/10.1172/jci110921 | DOI Listing |
ACS Appl Mater Interfaces
January 2025
Faculty of Life Sciences, Department of Pharmaceutical Sciences, Laboratory of Macromolecular Cancer Therapeutics (MMCT), University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria.
Splice-switching oligonucleotides (SSOs) can restore protein functionality in pathologies and are promising tools for manipulating the RNA-splicing machinery. Delivery vectors can considerably improve SSO functionality in vivo and allow dose reduction, thereby addressing the challenges of RNA-targeted therapeutics. Here, we report a biocompatible SSO nanocarrier, based on redox-responsive disulfide cross-linked low-molecular-weight linear polyethylenimine (cLPEI), for overcoming multiple biological barriers from subcellular compartments to en-route serum stability and finally in vivo delivery challenges.
View Article and Find Full Text PDFUrol Res Pract
January 2025
Department of Urology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye.
Objective: Laparoscopic nephron sparing surgery (NSS) can be performed by mainly 2 methods, offclamp or on-clamp. Continuous bleeding during the off-clamp method may impair the clear visualization of the border between the tumor and parenchyma, even though it is done safely in experienced hands. Therefore, some surgical modifications may be needed during mass excision and renorraphy.
View Article and Find Full Text PDFBJU Int
January 2025
Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Objective: To evaluate the association between tumour size and the growth rate (GR) of small renal masses (SRMs) in patients managed by active surveillance (AS).
Materials And Methods: We queried the prospective, multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry for patients on AS with an imaging interval of ≥6 months, identifying 456 patients. We tracked tumour size over time; a GR >0.
J Intensive Med
January 2025
Department of Critical Care Medicine, Jiangsu Provincial Key Laboratory of Critical Care Medicine, Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
Background: Extracorporeal membrane oxygenation (ECMO) has been proven to be a support method and technology for patients with cardiopulmonary failure. However, the transport of patients under ECMO support is challenging given the high-risk technical maneuvers and patient-care concerns involved. Herein, we examined the safety of ECMO during the transport of critically ill patients and its impact on mortality rates, to provide more secure and effective transport strategies in clinical practice.
View Article and Find Full Text PDFFront Surg
January 2025
Department of Urology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Background: There is no systematic classification of renal vascular injuries conducted for severe post-percutaneous nephrolithotomy (PCNL) bleeding.
Aim: The aim of the present study was to explore the various types of artery injury and clinical characteristics of patients who underwent transcatheter angioembolization (TAE) after PCNL.
Methods: A retrospective analysis was performed on 52 patients who underwent renal arteriography (RA) because of severe bleeding after PCNL between April 2009 and December 2023.
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