Search

Prof. Dr. Dimitar T. Hrisoho was born on June 11, 1924 in Bitola, R. Macedonia. He died in Struga on September 22, 1986, and was buried in Skopje. He completed primary and secondary education in Bitola. He graduated from the Medical Faculty in Belgrade in 1951 as one of the best students of his generation (average grade of 9.75). In 1953 he was employed at the Internal Clinic of the Medical Faculty in Skopje, where in 1955 he passed the specialist exam in internal medicine. He successfully defended his habilitation “Polyarthritis chronica evolutiva” and his doctoral dissertation “Clinical features of Vitina nephropathy”. The doctoral dissertation indicates that Vitina nephropathy is a new site of the Balkan Endemic Nephropathy entity and that more genetic testing of patients were needed. Based on numerous clinical and scientific researches published in over 200 papers, he was elected a Full Professor of internal medicine at the Medical Faculty of the Ss. Cyril and Methodius University in Skopje in 1971. In 1970, he formed the nephrology section of the Macedonian Medical Association (MMA), which grew into the nephrology Association of MMA. Through the Association, the education of the medical staff from the field of nephrology was performed. He also set up a bio-cybernetics association. He achieved his vision and desire to transfer and apply the achievements of modern nephrology in the diagnosis and treatment of kidney patients in Macedonia at the Clinic of Nephrology of the Medical Faculty in Skopje, which was the first specialized institution established for examination and treatment of kidney patients in the former Yugoslavia and the Balkans. The Clinic educated nephrological staff and examined and treated kidney patients with new methods and drugs that positively affected the development of nephrology as a subspecialty of the internal medicine. D. Hrisoho was actively involved in the introduction of new methods for examination of kidney patients, as well as in the treatment of patients with acute and chronic renal insufficiency with dialysis since 1965. He also participated in the first two kidney transplantations from living donors performed in 1977. He wrote a chapter on “kidney examination”, printed in the book of Prof. A. J. Ignjatovski “Fundamentals of Internal Propedeutics” Part III, published by “Prosvetno delo”, 1963, in Skopje. This is the first text to investigate a patient with kidney disease published in a textbook in R. Macedonia. In 1984 he published the textbook “Clinical Nephrology” printed by the University of the Ss. Cyril and Methodius University in Skopje. Prof. D. Hrisoho organized the First Scientific Meeting of Yugoslav Nephrologists with international participation, from 26 to 28 September 1977, in Struga, R. Macedonia. The meeting was attended by prominent nephrologists from the former Yugoslavia, the Balkans, Europe and the United States, among them: J.S. Cameron from UK, J.L. Funck-Brentano from France, M. Burg and P. Ivanovich from the USA, R. Kluthe from Germany and A. Puchlev from Bulgaria. The scientific meeting was the largest nephrology event until then organized in the former Yugoslavia. The meeting provided an exchange of experiences with world-renowned nephrologists. D. Hrisoho presented the paper Artificial intelligence in nephrology. The author tried to apply bio-cybernetics in nephrology. Prof. D. Hrisoho was Vice Dean of the Medical Faculty in Skopje in the period 1963-1965 and Vice Rector of the University of the Ss. Cyril and Methodius University in Skopje in the period 1974-1975. Prof. Hrisoho was also active in socio-political organizations. For his medical, educational and scientific activities he received several awards and recognitions in the country and abroad. Thus, the work of Prof. D. Hrisoho was permanently embedded in the nephrology of R. Macedonia.

International audience

The activation of the renin-angiotensin system (RAS) in the clipped kidney plays a critical role in the development of two-kidney, one-clip Goldblatt hypertension (2K1C), but the roles of angiotensin II (Ang II) and AT 1a receptors in the proximal tubules has not been determined previously. The present study tested the hypothesis that genetic deletion of AT 1a receptors selectively in the proximal tubules attenuates the development of 2K1C Goldblatt hypertension via AT 1a receptor-mediated, Na + /H + exchanger 3 (NHE3)-dependent mechanisms. To test the hypothesis, 2K1C Goldblatt hypertension was induced by placing a silver clip, 0.2 mm internal diameter, on the left renal artery for 4 weeks in adult male wild-type (WT), global AT 1a receptor knockout ( Agtr1a -/- ), proximal tubule (PT)-specific Agtr1a -/- (PT- Agtr1a -/- ), or PT- Nhe3 -/- mice, respectively. In WT mice, systolic blood pressure increased in a time-dependent manner reaching a maximal response by Week 3 (Basal: 112 ± 2 vs. 2K1C: 149 ± 4 mmHg, n=12, P P P P P Agtr1a -/- (Basal: 88 ± 4 vs. 2K1C: 92 ± 2 mmHg, n=9, n.s .), PT- Agtr1a -/- mice (Basal: 101 ± 2 vs. 2K1C: 104 ± 3 mmHg, n=12, n.s .) and PT- Nhe3 -/- mice (Basal: 103 ± 3 vs. 109 ± 5 mmHg, n=12, n.s .). Renin mRNA expression was not different in clipped and nonclipped kidney of Agtr1a -/- mice, but it was decreased in the nonclipped kidney of PT- Agtr1a -/- mice ( P 1a receptors selectively in the proximal tubules attenuates the development of 2K1C Goldblatt hypertension via AT 1a receptor-mediated, Na + /H + exchanger 3 (NHE3)-dependent mechanisms.

Coronavirus disease 2019 (COVID‐19) predisposes patients to bacterial and fungal superinfections due to the impairment of the immunological system. Among the associated opportunistic fungal infections, mucormycosis is one of the least frequent but with the highest mortality. We describe two cases of mucormycosis in two kidney transplant recipients, while they were hospitalized for SARS‐CoV‐2 pneumonia, with rhinosinusal and musculoskeletal involvement, respectively.

Dasatinib is the second-generation tyrosine kinase inhibitor used in the treatment of chronic myeloid leukemia. Proteinuria has been reported with this agent. We describe two kidney biopsy–proven cases of dasatinib-induced thrombotic microangiopathy that responded to stoppage of dasatinib and using an alternate tyrosine kinase inhibitor. Certain specific tyrosine kinase inhibitors lead to endothelial injury and renal-limited thrombotic microangiopathy. Hematologists and nephrologists need to be familiar with this off-target effect of dasatinib.

There is still no consensus on the optimal management of COVID-19 within the general population due to the emerging evidence base. High-risk groups, including kidney transplant recipients living with HIV present unique additional challenges. Here we discuss two kidney transplant recipients living with HIV with SARS-CoV-2 infection and their clinical course, and review the existing literature for this subset of challenging patients.

Background: Garlic (Allium sativum) has long been used both as a food and traditional medicine. Several studies have shown potential of garlic (Allium sativum) as an antihypertensive. In previous in vitro study found that dipeptide on garlic extract after hydrolyzed by the enzyme papain have ACE inhibitory activity. Induction of hypertension with 2 Kidney One Clip (2K1C) methodcauses the kidneys lose their physiological functions. A.sativum is expected to ameliorate kidney function. This study aimed to analyze creatinine levels in rat induced by 2K1C. Method: These study was an in vivo study with Pre-Post Test Only Control group Design. Before treatment, 30 subjects induced hypertension by 2K1C method. Treatment was conducted for four weeks. The recent study was conducted on 36 Rattus norvegicus, Wistar strain were divided into 6 groups. Measurement of creatinine was conducted by spectrophotometry method. Result: The results showed that there were significant differences in creatinine levels between groups (p < 0.05) both in the pre-test and post-test. The normal group and hypertension group did not have significant differences in creatinine pre- and post-test levels (p > 0.05). A.sativum 75m/kgBB gave the best decrease in creatinine levels up to 1.75 mg/dL compared to the A.sativum 25mg/kgBB and A.sativum group 50 mg/kgBB. There were significant differences in creatinine levels A.sativum 75 mg/kgBB and captopril (p 0.05). Kelompok A. sativum 75m/kgBB menunjukkan penurunan kadar kreatinin yang sangat signifikan hingga 1.75 mg/dL dibanding kelompok A. sativum 25mg/kgBB and A. sativum group 50 mg/kgBB. Terdapat perbedaan kadar kreatinin yang signifikan antara kelompok A. sativum 75 mg/kgBB dan captopril (p

Although chronic arterial hypertension (CAH) represents the major comorbid factor in stroke, it is rarely integrated in preclinical studies of stroke. The majority of those investigations employ spontaneously hypertensive rats (SHR) which display a susceptibility to ischemic damage independent of hypertension. Here, we used a renovascular model of hypertension (RH) to examine, with magnetic resonance imaging (MRI), brain alterations during the development of hypertension and after brain ischemia. We also examined whether MRI-derived parameters predict the extent of ischemia-induced brain damage. RH was induced according to the two-kidney one-clip model and multiparametric MRI was performed at 3, 6, 9, and 12 weeks after hypertension and also at 10, 50, and 60 min following stroke. Blood pressure values increased progressively and reached a plateau at 6 weeks after RH induction. At 12 weeks, all hypertensive animals displayed spontaneous brain lesions (hemorrhages, deep and cortical lesions, ventricular dilatation), increased apparent diffusion coefficient (ADC) values in the corpus callosum and higher fractional anisotropy in the cortex. Following ischemia, these animals showed larger brain lesions (406 ± 82 vs. 179 ± 36 mm3, p

Our study aimed to investigate the effects of iron-deficiency anemia (IDA) on renal tubular functions before and after iron treatment for infants and children with IDA. We measured urinary levels of two kidney injury markers: neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP).Thirty-six infants and children with IDA and 20 matched healthy controls were included. We assessed different laboratory parameters, estimated glomerular filtration rate, urinary levels of NGAL, and L-FABP. Urinary kidney injury markers were measured in IDA patients before and after 3 months of oral iron therapy.IDA patients had significantly higher urinary NGAL and L-FABP levels compared to their healthy controls. After 3 months of oral iron treatment, there was a significant improvement (decrease) in urinary NGAL and L-FABP in infants and children with IDA. Urinary markers returned to normal levels (healthy control levels) in children with IDA, but not for infants with IDA compared to their healthy controls.Subclinical kidney injury was found in infants and children with IDA. This injury was completely reversible in older children with IDA and partially reversible in infants with IDA after iron therapy. Higher urinary levels of kidney injury molecules in IDA infants after iron treatment are suggestive of more sensitivity of these infants to oxidative stress caused by iron therapy or may be due to the immaturity of the kidney and more damage caused by IDA which may require more time to recover.

The development of kidney injury and the characteristics of renal replacement therapy were considered in patient with dilated cardiomyopathy, who consequently underwent two heart transplantations and two kidney transplantations. Since the number of the patients needed both kidney and heart transplantation increases constantly, the multifaceted thorough research in this specific patient population is extremely important.

Proliferative glomerulonephritis with monoclonal immunoglobulin G deposit (PGNMID), a recently described pathologic entity in native kidneys, has been recognized in kidney transplant patients, where it can present as either recurrent or de novo disease. There is no definitive treatment to date, in either population. Here, we present two cases of PGNMID in kidney allografts that illustrate the challenges of diagnostic approach and highlight the allograft outcome after treatment with rituximab as a potential treatment of this condition.

Renin angiotensin system (RAS) plays a key role in the pathogenesis and progression of hypertension and renal injury. Angiotensin-II (Ang-II) type 1 receptor (AT1R) mediates the actions of Ang II to increase blood pressure, fluid retention, and aldosterone secretion. Ang II is involved in cell injury, vascular remodeling, and inflammation by releasing inflammatory and pro-inflammatory mediators. The effects of Ang II could be counteracted through its catabolism into the vasodilator peptide Ang (1-7) by angiotensin converting enzyme 2 (ACE2) and/or neprilysin (NEP). Diabetes and high blood pressure are the major causes of chronic kidney disease which could lead to end stage renal disease. Our previous studies demonstrated that shedding of renal ACE2 and NEP in the urine of db / db diabetic mice could act as biomarkers for diabetic kidney disease. The aim of the study is to test the hypothesis that there is increased renal ACE2 and NEP shedding in the urine of two-kidney one clip (2K1C) model of renovascular hypertension. In addition, we investigated the effects of deleting AT1aR on these RAS components and on kidney injury molecule-1 (KIM-1). Renovascular hypertension was induced in AT1aR knock out (KO) and WT mice by 2K1C surgery. Blood pressure (BP) measurement by radio-telemetry revealed significant increase of 46.1± 3.6 mmHg in 2K1C mice compared to control mice (p

Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor–recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.

The intratubular renin-angiotensin system (RAS) is thought to play an essential role in hypertensive renal disease, but information regarding sex-related differences in this system is limited. The present study investigated sex differences in the intratubular RAS in two-kidney, one-clip (2K1C) rats. A 2.5-mm clip was placed on the left renal artery of Sprague-Dawley rats, and rats were euthanized 3 or 5 wk after the operation. Systolic blood pressure increased in 2K1C rats in both sexes but was significantly higher in male rats than in female rats, and an antihypertensive effect was not observed in 2K1C ovariectomized (OVX) female rats. Compared with male 2K1C rats, intratubular angiotensin-converting enzyme (ACE) and ANG II were repressed, and intratubular ACE2, angiotensin (1–7), and Mas receptor were increased in both kidneys in female 2K1C rats 5 wk after surgery. Comparison with male and female rats and intratubular mRNA levels of ACE and ANG II type 1 receptor were augmented in OVX female rats, regardless of the clipping surgery 3 wk postoperation. ANG II type 2 receptor was upregulated in female rats with or without OVX; thus, the ANG II type 1-to-type 2 receptor ratio was higher in male rats than in female rats. In conclusion, female rats were protected from hypertensive renal and cardiac injury after renal artery clipping. An increase in the intratubular nonclassic RAS [ACE2/angiotensin (1–7)/Mas receptor] and a decrease in the ANG II type 1-to-type 2 receptor ratio could limit the adverse effects of the classic RAS during renovascular hypertension in female rats, and estrogen is suggested to play a primary role in the regulation of intratubular RAS components.

Hibiscus sabdariffa aqueous extract (HS) is often used as complementary therapy for hypertension. However, some studies have shown that coadministration with a conventional antihypertensive drug can affect drug potency. We compared the effects of HS plus captopril (CAP) coadministration to HS and CAP administration alone on blood pressure and renin-angiotensin-aldosterone system (RAAS) biomarkers in the rat two-kidney-one-clip (2K1C) model of hypertension. Male Sprague Dawley rats were randomly divided into seven groups (n=6/group), a normal control (SHAM) group, and six 2K1C groups. In 2K1C animals, hypertension was induced using a stainless microclip (inner diameter of 0.20 mm). Four weeks after 2K1C surgery, blood pressure was significantly higher than in the SHAM group. Then, model rats were randomly divided into negative control (2K1C, no treatment), positive control (4.5 mg captopril/200 g body weight [BW] orally [p.o.]), HS alone (30 mg/200 g BW; p.o.), and 3 co-treatment groups receiving HS (15, 30, or 60 mg/200 g BW; p.o.) plus 4.5 mg/200 g BW captopril. The treatments were performed for two weeks. Blood pressure was significantly reduced by all the drug treatments to near the level of SHAM controls. Plasma renin level, serum angiotensin converting enzyme (ACE) activity, and plasma angiotensin II level were also significantly elevated in the 2K1C group compared to the SHAM group. Both serum ACE activity and plasma angiotensin II level were significantly reduced to near SHAM group levels by all the drug treatments. Hibiscus sabdariffa aqueous extract alone can reduce blood pressure. This extract appears could be used as a supplement with captopril but may not provide any additional benefit.

Stomata are structures on the surfaces of most land plants that are required for gas exchange between plants and their environment. In Arabidopsis thaliana, stomata comprise two kidney bean-shaped epidermal guard cells that flank a central pore overlying a cavity in the mesophyll. These guard cells can adjust their shape to occlude or facilitate access to this pore, and in so doing regulate the release of water vapor and oxygen from the plant, in exchange for the intake of carbon dioxide from the atmosphere. Stomatal guard cells are the end product of a specialized lineage whose cell divisions and fate transitions ensure both the production and pattern of cells in aerial epidermal tissues. The stomatal lineage is dynamic and flexible, altering stomatal production in response to environmental change. As such, the stomatal lineage is an excellent system to study how flexible developmental transitions are regulated in plants. In this Cell Science at a Glance article and accompanying poster, we will summarize current knowledge of the divisions and fate decisions during stomatal development, discussing the role of transcriptional regulators, cell–cell signaling and polarity proteins. We will highlight recent work that links the core regulators to systemic or environmental information and provide an evolutionary perspective on stomata lineage regulators in plants.

Salamanders possess a bipartite kidney: a caudal portion contains nephrons that primarily function in urine formation (pelvic kidney nephrons) and a cranial portion where nephrons also serve as sperm conduits (genital kidney nephrons). Nephrons of these two kidney regions were examined microscopically in Notophthalmus viridescens. No microstructural differences were observed between the filtration barriers of renal corpuscles from pelvic and genital kidney nephrons. However, pelvic kidney renal corpuscles were significantly larger than genital kidney renal corpuscles and possessed a much more developed, and vascularized, glomerular structure. Furthermore, whereas filtrate was easily observed in the urinary space of pelvic kidney renal corpuscles, the urinary space of genital kidney renal corpuscles did not bind with stains used for examination with transmission electron microscopy. This finding corresponds with the previous lack of filtrate observed in the proximal tubules of genital kidney nephrons in co...

Death with a functioning kidney graft is now the leading cause of graft loss after renal transplantation. Aim: To determine if renal function at the last outpatient visit before the recipient’s death was different according to the following causes of death: infections, cardiovascular diseases, gastrointestinal disorders or cancer. Patients and Methods: Retrospective cooperative cohort study conducted in two kidney transplant centers. All patients who received a kidney graft in the last 32 years were included. During that lapse, 431 kidney transplants were performed. Among them, 85 patients died with a functioning graft and were classified due to their cause of death. Glomerular filtration rate (eGFR) was estimated with the Modification of Diet in Renal Disease formula. Declining renal function was defined as a > 20% decline in eGFR during the last 6 months prior to the last outpatient visit. Results: Eighty four patients were included in the analysis. Of these, 28.2% died of cardiovascular causes, 35.3% of infectious diseases, 15.3% of cancer and 20% of digestive diseases. Patients dying from cancer had a significantly higher eGFR prior to death than those who died from cardiovascular causes, infectious and digestive diseases (p < 0.01). Declining renal function occurred in 34.8% of deaths from cardiovascular causes, 39.3% from infectious diseases, 16.7% from cancer and 40% from digestive diseases. There were no significant differences between groups. Conclusions: Kidney graft recipients who die with a functioning graft have better renal function prior to their death when it is due to cancer than when it originates from infectious, cardiovascular or digestive diseases. Declining renal function is similar in the four groups of death causes

Kidney is a pair of organ in our urinary system that function to filter blood and urine establishment through filtration, reabsorption and secretion process.Formation of urine is done through one of processes, named tubular reabsorption. This process is a process of diffusion, passively and facilitated. The process happens in tubular reabsorption in kidney can be simulated by using Monte Carlo Cell simulation. Making model of 4 compartments consist of blood vessel, 2 kidneys with one kidney experiencing decreased function of kidney and bladder. Two kidney compartments with one of it experiencing decreased function affect the diffusion process that happens in substance reabsorption process in kidney.The purpose of this research is to study the diffusion process which happens in kidney by selecting several fixed variable and indicators which will be inspected by using Monte Carlo Cell simulation. The use of Monte Carlo Cell simulation enable to try any probabilities that occur in diffusion process of filtration, reabsorption and secretion process in kidney. The result of this research shows that the fewer number of molecules, the slower the molecular displacement and also the fewer number of surface molecules, the slower the molecular displacements.

Background: Reducing cadmium (Cd) exposure in Cd-polluted areas in Asia is urgently needed given the toxic effects of Cd. The short-term and long-term benefits of lowering Cd exposure are unknown because of its long half-life in the body. Objectives: We aimed to investigate whether an intervention with low-Cd rice in a contaminated area of China reduced urinary Cd (UCd) levels and improved blood pressure and kidney function outcomes compared to no-intervention in consumers of high-Cd rice in the same region. Methods: 106 non-smoking subjects were divided into three treatment groups: the intervention group (replacing homegrown high-Cd rice with market low-Cd rice, n = 34), the non-intervention group (continue eating high-Cd rice, n = 36) and the control group (continued eating low-Cd rice they have been eating for years, n = 36). The intervention period lasted for almost 8 months, during which participants were visited on up to 4 occasions and UCd, systolic and diastolic blood pressure (SBP, DBP), kidney function biomarkers (β2-microglobulin and N-acetyl-β-D-glucosaminidase) were measured. Results: After 3 months, the geometric mean UCd in the intervention (Int) group decreased significantly by 0.32 μg/g (p = 0.007), while changes were not significant in the non-intervention (non-Int) group (0.13 μg/g, p = 0.95) or the control group (−0.01 μg/g, p = 0.52). UCd in the Int group remained lower than in the non-Int group but higher than in the Control group through the end of follow up. DBP in the Int group decreased significantly from 80 mm Hg at month three (p = 0.03) and stayed around 74 mm Hg for the remainder of the study. SBP also decreased in the Int group but with variations similar to those observed in the other two groups. The two kidney biomarkers showed variations without a clear pattern. Conclusion: This study suggested that UCd reflected both short-term (

We report two unrelated cases of tenosynovitis caused by Mycobacterium malmoense in kidney transplant recipients. Both patients received immunosuppression and were referred to our tertiary hospital because of persisting complaints lasting >6 months not responding to corticosteroids or surgery. The mycobacterial cultures were positive for the slow-growing M. malmoense after several weeks of incubation. The patient in Case 1 was treated with a combination of surgical debridement and antibiotics, whereas the patient in Case 2 was only treated surgically. Both cases illustrate the doctor's delay in diagnosing mycobacterial infections, and remind us that nontuberculous mycobacterial infections should be part of the differential diagnosis of tenosynovitis, especially in immunocompromised patients.

Donor-derived fungal infection is a significant complication in renal transplant recipients that can be associated with serious and sometimes deadly consequences. This article reports two patients who develop severe vascular complications secondary to different fungal infections from the same donor. One patient is diagnosed with renal artery aneurysm that is caused by Candida parapsilosis, and the graft has to be removed. The other patient has developed renal arterial rupture that is attributed to Cryptococcus. Although the affected renal artery is excised and the remaining artery is anastomosed, the function of the graft is not restored. Early recognition and prompt management of vascular complications caused by fungal infections are crucial for favorable outcomes.

We aimed to investigate the clinical and genetic predictors of painful vaso-occlusive crises (VOC) in sickle cell disease (SCD) in Cameroon. Socio-demographics, clinical variables/events and haematological indices were acquired. Genotyping was performed for 40 variants in 17 pain-related genes, three fetal haemoglobin (HbF)-promoting loci, two kidney dysfunctions-related genes, and HBA1/HBA2 genes. Statistical models using regression frameworks were performed in R®. A total of 436 hydoxycarbamide- and opioid-naïve patients were studied; median age was 16 years. Female sex, body mass index, Hb/HbF, blood transfusions, leucocytosis and consultation or hospitalisation rates significantly correlated with VOC. Three pain-related genes variants correlated with VOC (CACNA2D3-rs6777055, p = 0 .025; DRD2-rs4274224, p = 0 .037; KCNS1-rs734784, p = 0.01). Five pain-related genes variants correlated with hospitalisation/consultation rates. (COMT-rs6269, p = 0.027; FAAH-rs4141964, p = 0.003; OPRM1-rs1799971, p = 0.031; ADRB2-rs1042713; p < 0.001; UGT2B7-rs7438135, p = 0.037). The 3.7 kb HBA1/HBA2 deletion correlated with increased VOC (p = 0.002). HbF-promoting loci variants correlated with decreased hospitalisation (BCL11A-rs4671393, p = 0.026; HBS1L-MYB-rs28384513, p = 0.01). APOL1 G1/G2 correlated with increased hospitalisation (p = 0.048). This first study from Africa has provided evidence supporting possible development of genetic risk model for pain in SCD.

Kidney stones is a renal disease with high prevalence and one of the major reasons for emergency room visits. The prevalence of kidney stones is increasing, and the lifetime recurrence rate is estimated as almost 50%. Thus, treatment of kidney stones becomes an increasingly important topic. However, different types of kidney stones require specific treatments, which creates the need for accurate diagnosis of the stone type prior to the intervention. Imaging techniques that are commonly used for the detection of kidney stones, such as X-ray CT and ultrasound, are insufficient to differentiate the types of kidney stones. In this paper, we present a proof-of-concept study for differentiating kidney stones using X-ray dark-field tomography. The most important advantage of this method is its ability to image non-homogeneous kidney stones, i.e., to localize and identify the individual components of mixed-material kidney stones. We use a weighted total-variation regularized reconstruction method to compute the ratio of dark-field over absorption signal (DA Ratio) from noisy projections. We evaluate the performance of the proposed approach on two kidney stones of homogeneous composition, and one well-defined numerical phantom with known ground truth for mixed types of stones. We illustrate that the DA Ratio is significantly distinguished for different materials from the experiments. Reconstruction of phantom data recovers voxel-wise material information with high accuracy. We show that X-ray dark-field tomography has a significant potential in selective characterization of kidney stones.

Aims. The aim of this study was to investigate the effects of the aqueous extract of Nardostachys chinensis Batalin (NCBAE) on blood pressure and cardiac hypertrophy using two-kidney one-clip (2K1C) hypertensive rats. Methods. 2K1C rat models were set up by clipping the left renal artery. Sham-operated rats underwent the same surgical procedure except for renal arterial clipping. 2K1C hypertensive rats were orally given NCBAE at doses of 210, 420, and 630 mg·kg−1·d−1 for 6 weeks. Twelve weeks after surgery, rat SBP and echocardiographic parameters were measured, cardiac histopathology was assessed, serum NO and LDH were detected, and the expression of Bcl-2 and caspase-3 of left ventricular tissue was assessed by western blot. Results. Treatment with NCBAE resulted in a decrease of SBP, LVPWd, LVPWs, IVSd, IVSs, LVW/BW ratio, and cardiomyocyte CSA, an increase of LVEF, and inhibition of 2K1C-induced reduction in serum NO and elevation of LDH compared with 2K1C group. NCBAE intervention also showed a significant increase of Bcl-2 expression and reduction of cleaved caspase-3 level dose-dependently in left ventricular tissue. Conclusion. Our data demonstrate that NCBAE has an antihypertensive property and protective effect on 2K1C-induced cardiac hypertrophy especially at the dose of 630 mg·kg−1·d−1.

Urinary complications such as urine leak, stricture, ureteric obstruction and vesicoureteral reflux are the most common technical adverse events following A variety of urinary tract reconstructive methods have been proposed and compared to find an ideal method with minimum urinary complications. Today, ureteroneocystostomy is the most common urinary tract reconstructive method utilized in kidney transplantation. The main aim of the present study was to compare urologic complications following the use of FTSL and LG techniques in kidney transplant ureteroneocystostomy in a clinical trial study.

Adverse outcomes from sub-optimal organs – including the death of two kidney recipients in the UK in 2013 – raise questions about the potential for surgeons to be held liable for using sub-optimal rather than standard or optimal organs. Could surgeons, transplant teams, ICU physicians, or hospitals be liable if the sub-optimal organ passes on an infection or cancer? When should transplant teams decline the offer of an organ from a compromised donor? How much detailed information should transplant teams pass on to potential recipients about the risks associated with the sub-optimal organ? If the recipient accepts the risks associated with a sub-optimal organ, does this absolve the surgeon of responsibility for those risks? This paper set the scene for an interdisciplinary academic discussion of these questions on 18 November 2016 at the University of Cambridge. The paper encourages readers to engage with higher order questions about regulatory design.

Objective: The present study was performed to examine whether the blood pressure (BP)-lowering effects of soluble epoxide hydrolase (sEH) inhibition in two-kidney, one-clip (2K1C) Goldblatt hypertension are nitric oxide (NO) dependent. Methods: Mice lacking the endothelial NO synthase (eNOS) gene (eNOS–/–) and their wild-type controls (eNOS+/+) underwent clipping of one renal artery. BP was monitored by radiotelemetry and the treatment with the sEH inhibitor cis-4-[4-(3-adamantan-1-yl-ureido)cyclohex-yloxy]-benzoic acid (c-AUCB) was initiated on day 25 after clipping and lasted for 14 days. Renal concentrations of epoxyeicosatrienoic acids (EETs) and their inactive metabolite dihydroxyeicosatrienoic acids (DHETs) were measured in the nonclipped kidney. Renal NO synthase (NOS) activity was determined by measuring the rate of formation of L-[14C]citruline from L-[14C]arginine. Results: Treatment with the sEH inhibitor elicited similar BP decreases that were associated with increases in daily sodium excretion in 2K1C eNOS+/+ as well as 2K1C eNOS–/– mice. In addition, treatment with the sEH inhibitor increased the ratio of EETs/DHETs in the nonclipped kidney of 2K1C eNOS+/+ as well as 2K1C eNOS–/– mice. Treatment with the sEH inhibitor did not alter renal NOS activity in any of the experimental groups. Conclusions: Collectively, our present data suggest that the BP-lowering effects of chronic sEH inhibition in 2K1C mice are mainly associated with normalization of the reduced availability of biologically active EETs in the nonclipped kidney and their direct natriuretic actions.

Mycotic infection of the blood vessels is extremely rare and is associated more frequently with the presence of a vascular prosthetic graft. In this article we report three cases of pseudoaneurysm formation due to Aspergillus infection in two kidney transplant recipients receiving kidneys from the same donor. Some considerations and a brief review of the literature and discussion of the existent reported cases are presented.

The world's most complex biological computer made from a group of engineered cells. Martin Fussenegger at ETH Zurich in Switzerland and his colleagues engineered two kidney cells to become a biological circuit capable of simple mathematics. Fussenegger and his team have engineered a multicellular system, in which different cells each perform a separate computation, and pass on the results to each other. The team wants to develop a single implant for in situ diagnosis.

R Nitric oxide probably plays an important role in mechanisms determining sexual dimorphism in the development of cardiovascular diseases, including hypertension. Because stress together with gender are significant cardiovascular risk factors, we studied the role nitric oxide in car-diovascular regulation in male and female nor-motensive and hypertensive rats under normal and stress conditions. Experiments were per-formed in mongrel normotensive and hyperten-sive (two kidney, one clip) rats of both sexes, weighing 200-250g. The study of mean arterial pressure and heart rate was carried out: 1) under control condition; 2) during nitric oxide blo- ckade by NG-nitro-L-arginine-methyl ester (L-NAME, 10 mg/kg, iv) 3) during 60 min immobilization stress and recovery; 4) during 60 min immobi-lization stress + L-NAME and recovery. We found that the severity of hypertension in fe-males was lower than in males. We also ob-served that both normotensive and hyperten-sive females demonstrated more favorable pat-tern of cardiovascular responses to stress. At rest, nitric oxide blockade increased the mean arterial pressure and decreased the heart rate more effectively in female normotensive and hypertensive rats than in male groups. During stress, nitric oxide blockade modified the stress- induced cardiovascular responses more sig-nificantly in female normotensive and hyper-tensive rats compared with male groups. Our data show that both normotensive and hyper-tensive females demonstrated the more effec-tive nitric oxide control of cardiovascular activ-ity under normal and especially stress condi-tions than male groups. This male-female dif-ference may be important mechanism respon-sible for greater in females vs. males of cardio-vascular resistance to stress and development of hypertension.

Background: Tubular atrophy and interstitial fibrosis mark the final stage in most forms of progressive kidney diseases. Little is known regarding changes in the tubular proteome. In this study, we investigated changes in the tubular proteome of normal or minimally damaged tubular tissue in the non-clipped kidney from rats with two-kidney one-clip (2K1C) hypertension. Methods: Formalin-fixed paraffin-embedded kidney sections from four 2K1C rats with hypertensive kidney damage and 6 sham rats were used. Tubulointerstitial tissue without discernable interstitial expansion or pronounced tubular alterations was microdissected and this was assumed to represent an early stage of chronic tubular damage in 2K1C. Samples were analyzed by mass spectrometry and relative protein abundances were compared between 2K1C and sham. Results: A total of 1,160 proteins were identified with at least 2 unique peptides, allowing for relative quantitation between samples. Among these, 151 proteins were more abundant, and 192 proteins were less abundant in 2K1C compared with sham. Transgelin, vimentin and creatine kinase B-type were among the proteins that were most increased in 2K1C. Ingenuity Pathway Analysis showed increased abundance of proteins related to Rho signaling and protein turnover (eIF2 signaling and protein ubiquitination), and decreased abundance of proteins related to fatty acid β-oxidation. Conclusion: Tubular tissue from normal or minimally damaged hypertensive kidney damage demonstrate extensive proteomic changes with upregulation of pathways associated with progressive kidney damage, such as Rho signaling and protein turnover. Thus, proteomics presents itself to be a promising tool for the discovery of early damage markers from not yet morphologically visible tubular damage.

Background: Hypertension is an incurable pathological condition and lifelong therapy is required. Long term use of conventional synthetic anti-hypertensive drugs is associated with a spectrum of toxic effects. However, therapeutic interventions using herbal drugs for hypertension have gained considerable attention worldwide. Aim: To evaluate the anti-hypertensive activity of polyherbal formulation (SJT-HT-03). Materials and Methods: The polyherbal formulation (SJT-HT-03) comprises of leaves of Aegle marmelos L., fruits of Benincasa hispida Thunb., Garcinia indica Thouars, and flowers of Musa paradiasica L., Rosa indica L., Hibiscus rosa sinensis L. Selected plants as mentioned above were collected, dried and extracted with different solvents. Formulation SJT-HT-03 (250 mg/kg, p.o.), was evaluated using two kidney one clip (2K1C) model and deoxycorticosterone acetate (DOCA)-salt-induced hypertension model using the enalapril (10 mg/kg, p.o.) and hydrochlorothiazide (5 mg/kg, p.o.) as a reference standard drug in respective models. Results: SJT-HT-03 significantly reduced (P < 0.001, one-way analysis of variance followed by Turkey's multiple comparison tests) systolic as well as diastolic blood pressure (BP) in 2K1C and DOCA-salt model. Further, SJT-HT-03 has shown a significant reduction (P < 0.01) in angiotensin converting enzyme (ACE) activity in serum, clipped kidney as well as in lungs in 2K1C model, whereas significant reduction (P < 0.05) in serum Na+ and increase in serum K+ level in DOCA model. Conclusion: Polyherbal formulation SJT-HT-03 possess significant anti-hypertensive activity by producing direct depressant effect on heart, inhibition of ACE, aldosterone antagonistic as well as diuretic effect and thereby act on multiple targets to achieve optimal effect.

Renal transplantation is the treatment of choice for patients suffering end-stage renal disease, but as the long-term renal allograft survival is limited, most transplant recipients will face graft loss and will be considered for a retransplantation. The goal of this study was to evaluate the patient and graft survival of the 61 renal transplant recipients after second or subsequent renal transplantation, transplanted in our institution between 1990 and 2010, and to identify risk factors related to inferior outcomes. Actuarial patient survival was 98.3%, 94.8%, and 88.2% after one, three, and five years, respectively. Actuarial graft survival was 86.8%, 80%, and 78.1% after one, three, and five years, respectively. Risk-adjusted analysis revealed that only age at the time of last transplantation had a significant influence on patient survival, whereas graft survival was influenced by multiple immunological and surgical factors, such as the number of HLA mismatches, the type of immunosuppression, the number of surgical complications, need of reoperation, primary graft nonfunction, and acute rejection episodes. In conclusion, third and subsequent renal transplantation constitute a valid therapeutic option, but inferior outcomes should be expected among elderly patients, hyperimmunized recipients, and recipients with multiple operations at the site of last renal transplantation.

espanolIntroduccion: Trasplantes realizados de organos procedentes de donante vivo pueden serlo de un rinon y parciales de higado, intestino e incluso pulmon. Si bien varian fundamentalmente en el riesgo que supone para el donante y los resultados en la supervivencia del injerto, la implicacion legal es la misma. Asi, me centrare en el protocolo con mayor experiencia, menor riesgo para el donante y mejores resultados: la donacion renal de vivo. El trasplante renal ha demostrado ser el mejor tratamiento de la insuficiencia renal cronica en cuanto a supervivencia, calidad de vida, menores complicaciones y mejor relacion coste-beneficio frente a la dialisis. Situacion actual del donante vivo: El trasplante renal procedente de donante vivo se realiza en 14 de las 17 comunidades autonomas del territorio nacional. Destacan, en el ano 2013, Cataluna (165 trasplantes), Andalucia (60 trasplantes), Madrid (40 trasplantes) y Pais Vasco (38 trasplantes), y la evolucion del plan nacional de trasplante cruzado, con un incremento muy significativo en el numero de trasplantes, desde su comienzo en el ano 2009 con dos trasplantes renales hasta 41 trasplantes renales procedentes de donante vivo cruzado en el ano 2013. Legislacion: El trasplante renal de donante vivo estaba regulado en Espana por la Ley de trasplantes 30/1979. Esta ley regulaba la donacion en vida de un organo si es compatible con la vida y la funcion del organo o parte de el es compensada por el organismo. Especifica ademas que el destino del organo sera su trasplante a una persona determinada. Luego siguio el Real Decreto 2070/1999, la Ley de Autonomia del Paciente 41/2002 y finalmente el Real Decreto 1723/2012 de 28 de diciembre. En Europa, la Directiva 2010/45/UE del Parlamente Europeo y del Consejo Europeo de 7 de julio de 2010. EnglishIntroduction: Organ transplants from living donors may be a partial kidney and liver, intestine and even lung. If they vary mainly in the risk to the donor and results in graft survival, the legal implication is the same. So I will focus for this chapter in the protocol with more experience, the less risk to the donor and better results: the living kidney donation. Kidney transplantation has proven to be the best treatment of chronic renal failure in terms of survival, quality of life, fewer complications and better cost-benefit ratio compared to dialysis. Current status of the living donor: Kidney transplant from a living donor is performed in 14 of the 17 regions of the country. Highlighted in the year 2013 Catalonia (165 transplantations), Andalusia (60 transplants), Madrid (40 transplants) and the Basque Country (38 transplants). The evolution of cross-national transplantation plan, with a significant increase in the number of transplants, since its inception in 2009 with two kidney transplants, 41 kidney transplants from living donors crossed in 2013. Legislation: The living donor kidney transplantation was regulated in Spain by Law 30/1979 transplant. This law regulated living donation of an organ if it is compatible with the life and function of the body or part of it offset by the body. Further specifies that the fate of organ transplantation to be a certain person. Then he followed the Royal Decree 2070/1999, Law 41/2002 of Patient Autonomy and finally Royal Decree 1723/2012, 28 December. At the European level, Directive 2010/45/EU of the European Parliament and right of the European Council of July 7, 2010.

BACKGROUND:Despite a high prevalence of herbal and dietary supplement use (HDS) in pre-dialysis patients, the reasons are unknown as to why they decide to use HDS. Objectives of the cross-sectional and qualitative studies were to determine reasons for the use and non-use of HDS in Thai patients with chronic kidney disease (CKD).METHODS:This prospective study recruited 421 patients with stage 3-5 CKD from two kidney clinics in Thailand, and 357 were followed up regarding their HDS use over 12 months. Patients receiving renal replacement therapy at baseline were excluded. Participants were interviewed at baseline and in the twelfth month regarding their HDS use, and reasons for their use or non-use of HDS. Among HDS users, 16 patients were enrolled in a qualitative study and were interviewed using eight-open ended questions about reasons for HDS use. Descriptive and thematic analyses were performed.RESULTS:Thirty-four percent of patients with CKD consistently used HDS over the 12 months and 17% of all patients intermittently took them during the follow-up period. At baseline, family or friends' recommendation was the most common reason for HDS use (35%), followed by having a perception of benefits from using HDS (24%). During the follow-up period, perceived benefits of HDS was a frequently reported reason for either continuing with HDS use (85%) or starting to use HDS (65%). Negative experience from using HDS influenced patients to stop using them (19%). Although the main reason for non-use of HDS was trust in a doctor or effectiveness of conventional medicine (32%), doubt about the benefits from HDS or concerns about negative effects were frequently reported reasons for non-use (23%). Doctor's recommendations to avoid using HDS were the main influence for non-users (19%) and for those who had stopped using HDS (23%). The media and patients' social network had an impact on HDS use.CONCLUSIONS:Patients who perceived benefits from HDS use were more likely to use HDS, whilst non-users had negative attitudes towards HDS. Health professionals therefore should educate patients and their relatives about the risks and benefits from using HDS

The present study is the first attempt to examine the effect of left ventricular hypertrophy (LVH) on the excitation pattern of the ventricular epicardium in experimental hypertensive rats. The left renal artery was clipped in Wistar rats (n = 8; 6-8 months old; weight, 174-295 g) to produce two-kidney one-clip (2K1C) hypertension. After 4 weeks, blood pressure was measured, and epicardial potential mapping was performed under sinus rhythm from 64 unipolar electrodes regularly distributed over the ventricular epicardium. Systolic blood pressure was approximately 40% higher in the rats with a clipped renal artery (162 +/- 14 mmHg, mean +/- s.d.) than in the normotensive rats (115 +/- 3 mmHg). LVH (approximately 23% increase in the ratio of the left ventricular weight to the body weight, P < 0.05) was observed in the 2K1C hypertensive rats. The depolarization pattern of the ventricular epicardium in the normotensive rats was similar to that in the rats with 2K1C hypertensive LVH. The duration of ventricular epicardial activation was shown to increase (approximately 35%, P < 0.05) in the hypertensive rats as compared to the normotensive animals. This study provides an explanation for alterations of the body surface potential distribution in hypertensive patients with LVH.

Summary Objective: To determine whether Belzer solution (Viaspan®, Bristol-Myers Squibb, Brussels, Belgium), which is more expensive than Eurocollins solution, was better at preventing delayed graft function (DGF) and whether it was cost-effective as it could potentially reduce post-transplantation complications. Method: The risk of occurrence of complications associated with the use of these two rinsing and preserving solutions was estimated from a survey of 106 patients undergoing renal transplantation between 1 January 1993 and 31 March 1998. Both efficacy and adverse outcomes were recorded along with the costs directly associated with the transplantation procedure in the hospital setting: hospitalization, rinsing and preserving solutions, medical and technical interventions and diagnostic tests. Results: For the 45 kidney grafts rinsed and preserved with Eurocollins (strategy S1: n1 = 45) the cost/graft was estimated at 40 €. With Viaspan® (strategy S2: n2 = 61) the corresponding cost/graft was 424 €. Logistic regression analysis showed that Viaspan® was better than Eurocollins solution (eβ = 0·437; P = 0·05) in preventing DGF. Overall, S2 was less expensive than S1, from the hospital's perspective. The mean difference per patient was 278 €, which amounts to a saving of 2% of the total cost per renal transplantation. For rinsing and preserving kidney grafts Belzer solution is therefore preferable to Eurocollins solution.

Hypertensive nephrosclerosis is one of the most frequent causes of chronic kidney failure. Proteome analysis potentially improves the pathophysiological understanding and diagnostic precision of this disorder. In the present exploratory study, we investigated experimental nephrosclerosis in the two-kidney, one-clip (2K1C) hypertensive rat model.The renal cortex proteome from juxtamedullary cortex and outer cortex of 2K1C male Wistar-Hannover rats (n = 4) was compared with the sham-operated controls (n = 6), using mass spectrometry-based quantitative proteomics. We combined a high abundant plasma protein depletion strategy with an extended liquid chromatographic gradient to improve peptide and protein identification. Immunohistology was used for independent confirmation of abundance.We identified 1724 proteins, of which 1434 were quantified with at least two unique peptides. Comparative proteomics revealed 608 proteins, including the platelet-derived growth factor receptor-β signalling pathway, with different abundances between the non-clipped kidney of hypertensive 2K1C rats and the corresponding kidney of the normotensive controls (P 0.05, absolute fold change ≥1.5). Among the most significantly altered proteins in the whole cortex were periostin, transgelin, and creatine kinase B-type. Relative abundance of periostin alone allowed clear classification of 2K1C and controls. Enrichment of periostin in 2K1C rats was verified by immunohistology, showing positivity especially around the fibrotic vessels.The proteome is altered in hypertension-induced kidney damage. We propose periostin, especially in combination with transgelin and creatine kinase B-type, as possible proteomic classifier to distinguish hypertensive nephrosclerosis from the normal tissue. This classifier needs to be further validated with respect to early diagnosis of fibrosis, prognosis, and its potential as a novel molecular target for pharmacological interventions.

To determine whether on-clamp partial nephrectomy (ON-PN) has any significant impact on long-term renal function in a two kidney model.From November 1999 to July 2013, 607 patients underwent PN at our institution. After excluding patients with solitary kidneys, multiple renal masses, and follow-up less than 90 days, 331 remained. Patient demographics were assessed, as was renal function based on pre- and postoperative mercaptoacetyltriglycine (MAG-3) renal scans and change in estimated glomerular filtration rate (eGFR) using the preoperative and most recent recorded creatinine levels.There were a total of 236 patients who underwent ON-PN and 95 who underwent off-clamp PN (OFF-PN) during the study period. The longest follow-up was 12.6 years with mean follow-up of 3 years. Mean ischemia time of patients undergoing ON-PN was 25 minutes (range 8-63 min). No differences were noted between the ON-PN and OFF-PN cohorts with respect to estimated change in eGFR (ON-PN: -6.07 mL/min/1.73 m(2) vs OFF-PN: -6.00 mL/min/1.73 m(2), P=0.69). No differences were noted in the % change in the MAG-3 renal scans (ON-PN: -0.77% vs OFF-PN: -1.1%, P=0.94). A post hoc sensitivity analysis of the same two variables stratified by age revealed no differences in change in estimated GFR or % change in differential function on renal scan.In the two kidney model, ischemia does not appear to affect long-term renal function outcomes after PN. These data provide evidence that ON-PN is perfectly acceptable in the appropriately selected patient with two kidneys.

This study was carried out on conscious two-kidney, one-clip (2K1C) rats to establish whether different levels of hypertension induced opposite diuretic behaviors from the nonclipped kidney. Mildly hypertensive rats and severely hypertensive rats were produced by, respectively, constricting their right renal arteries with 0.3-mm and 0.15-mm clips. On the 11th day of the study, the systolic blood pressure (SBP) of the 0.3-mm clip rats was 150 +/- 2 mm Hg, the water intake was 24 +/- 1 ml, and the urine output was 7 +/- 1 ml. The SBP of the 0.15-mm clip rats was 231 +/- 10 mm Hg, the water intake was 46 +/- 4 ml, and the urine output was 27 +/- 6 ml. The data from the two groups are significantly different. On the 19th day half of the mildly hypertensive (0.3-mm clip) rats that received cilazapril from day 15 had, with respect to their water-treated counterparts, a SBP of 140 +/- 8 as compared with 159 +/- 7 mm Hg, the water intake was 37 +/- 5 as compared with 26 +/- 4 ml, and the urine output was 18 +/- 4 as compared with 12 +/- 1 ml. In contrast, half of the severely hypertensive (0.15-mm clip) rats that received cilazapril had, with respect to their water-treated counterparts, a SBP of 143 +/- 4 as compared with 227 +/- 10 mm Hg, the water intake was 30 +/- 2 as compared with 51 +/- 9 ml, and the urine output was 8 +/- 2 as compared with 29 +/- 4 ml. All changes induced by cilazapril are significant in both groups. The data of this study suggest that different levels of hypertension in the rat 2K1C model induce opposite water elimination modes from the nonclipped kidney. This conclusion is supported by the different shift in the water intake and urine output among the cilazapril-treated rats of the two groups. This contrast in the response to cilazapril seems to be dependent on the magnitude of the resulting hypotension. Thus, it seems that in this model, when the hypertension is mild, the antidiuretic effect of angiotension II on the nonclipped kidney is exhibited, whereas, when the hypertension is severe, the diuretic influence of the blood pressure is evident. Irrespective of these different characteristics of the submodels of 2K1C, angiotensin I converting enzyme inhibitors, such as cilazapril, are effective in normalizing the blood pressure.

A study was designed to elucidate the antihypertensive effect of garlic in the two-kidney--one-clip (2K-1C) Goldblatt model. Since the hypertension in this model depends largely on the increasing concentrations of vasopressor agents (prostaglandins and angiotensin II) there is a strong indication that reducing these factors could contribute in controlling the pathological rise in blood pressure. In this study, single or multiple doses of 0.5 ml of aqueous extract of garlic were given orally to 2K-1C rats. The data shows that the single dose of garlic used had a maximum antihypertensive effect 2-6 h after administration. The residual effect of this single dose continued for up to 24 h. The multiple dose of garlic appeared to be effective in restraining the expected rise in blood pressure that normally occurs in 2K-1C rats. Switching multiple-dose treatments halfway through the experiment further strengthened the findings. The study suggests that garlic does have an effective antihypertensive ability, and may be used as a supplementary and natural remedy in cases of unilateral renovascular hypertension.

Garlic reduces blood pressure (BP) in two-kidney, one-clip (2K-1C) rats, and enhances nitric oxide (NO) synthesis in in vivo and in vitro experiments. NO is an important modulator of BP in the 2K-1C model. This study investigated the role of NO in the BP-lowering effect of garlic in the 2K-1C model. BP readings (mm Hg) were obtained from 2K-1C rats in 4 groups treated intraperitoneally for 2 wk with either normal saline (NS), garlic, L-nitroarginine-methylester (L-NAME), or L-NAME+garlic (n=4x5). BP was determined using the tail-cuff method and compared with data of 4 similarly treated groups of normal (unclipped) rats (NRs). The BP readings of NR groups were 120+/-3 mm Hg for the NS-treated group, 120+/-2 mm Hg for the garlic-treated group, 167+/-3 mm Hg for the L-NAME treated group (higher than NS or garlic, P

Attenuated contractility in afferent arterioles during development of proteinuria in two-kidney, one-clip hypertensive rats