Indoxyl sulfate (IS) is related to the development of cardiovascular disease and total mortality in dialysis patients. High‐performance liquid chromatography (HPLC) is the conventional measurement ...approach. However, the HPLC method is difficult to perform in real time. Recently, the IS Assay Kit “NIPRO”, which enables the measuring of total IS by the enzyme method, was developed. This new reagent allows the easy and quick measurement of many samples using the automatic biochemical analyzer. Moreover, it was reported that it demonstrated satisfactory analytical performance. If this enzyme method is useful for measuring IS in hemodialysis, we can expect that the mechanism in which the IS effects adversely on a body as uremic toxins will be clarified. However, the enzyme method is more easily influenced by other coexisting substances. In this study, we have assessed on how the uremic toxins and anticoagulation effect on this new reagent and evaluate whether it can be put into practice effectively for hemodialysis patients. For the enzyme method, accuracy, simultaneous repeatability, linearity, limit of detection, influence of coexisting materials, and correlation with the HPLC method were examined. Accuracy and simultaneous repeatability were satisfactory, and linearity was good. The limit of detection was acceptable, and there was no influence of coexisting materials. With regard to the correlation, the regression equation was y = 0.947X + 7.987 and the correlation coefficient (r) was 0.972. This new reagent showed sufficient fundamental performance and had a good correlation with the conventional HPLC method for assessing the plasma of dialysis patients.
Here, we report a case of a 68‐year‐old woman with cT4N0M1 (liver invasion and multiple lung metastases) metastatic renal cell carcinoma. We could carry out less invasive nephrectomy with partial ...hepatectomy because nivolumab administration as second‐line therapy reduced the primary tumor remarkably. To the best of our knowledge, this is the first report of the use of nivolumab before carrying out surgery, and histological findings showed a pathological complete response.
The long-term split renal function after robot-assisted partial nephrectomy (RAPN) is yet to be elucidated. This study aimed to assess long-term renal function of RAPN, using renal scintigraphy, and ...to identify clinical factors related to deterioration of renal function on the affected side of the kidney.
RAPN for small tumors was performed, and split renal function was evaluated using 99m-Tc DTPA renal scintigraphy before and 1 year after surgery. Clinical factors (age, gender, body mass index, tumor side, presence of urinary protein, diabetes, hypertension, and dyslipidemia), perioperative factors (renal nephrectomy score RNS, tumor diameter, overall surgery duration, console time, warm ischemic time, and amount of bleeding), and renal function (estimated glomerular filtration rate eGFR and glomerular filtration rate GFR measured using scintigraphy on both the affected and contralateral kidneys) were analyzed.
Sixty-six patients were included in the study. The median eGFR decreased from 71.9 to 63.9 mL/min after 1 year (
< 0.001), accounting for a mean loss of 10.1%. In scintigraphy examination, the median GFR on the affected kidney side decreased from 41.1 to 33.7 mL/min after 1 year (
< 0.001), accounting for a mean loss of 16.8%. RNS was significantly associated with renal function. Among RNS factors, the N factor is associated with renal function after RAPN.
RNS, particularly the N factor, possibly influences the long-term deterioration of renal function after RAPN.
Introduction
Renal autotransplantation is considered a surgical procedure for extensive ureteral defects. Herein, we report a case of severe ureteral injury repaired by laparoscopic nephrectomy and ...renal autotransplantation with an iliac vein patch using bovine pericardium.
Case presentation
A 56‐year‐old woman who had previously undergone gynecological surgery complained of right‐sided abdominal pain. She was then later diagnosed with a right middle ureteral injury with a 5‐cm long defect. We performed retroperitoneal laparoscopic nephrectomy and renal autotransplantation. As the iliac vein was fragile, venous patching using bovine pericardium was performed. The patient's renal function was well preserved after surgery.
Conclusion
Laparoscopic nephrectomy and renal autotransplantation is an effective method for repairing severe ureteral injury with the preservation of renal function. A venous patch using bovine pericardium might be considered as a replacement for a fragile vein.
Introduction
Patients with translocation renal cell carcinoma (tRCC) have a poor prognosis without standardized treatment.
Case presentation
The first case was of a 72‐year‐old woman who underwent ...robot‐assisted partial nephrectomy for a left renal tumor and was pathologically diagnosed with tRCC. Recurrence was observed in the left retroperitoneal soft tissue. After treatment with avelumab–axitinib, continued progression‐free survival was confirmed at the 90‐week follow‐up. The second case was of a 41‐year‐old woman referred to our hospital and presented with translocation renal cell carcinoma metastasis to a para‐aortic lymph node. After treatment with avelumab–axitinib, continued progression‐free survival was confirmed at the 43‐week follow‐up.
Conclusion
The outcomes of these cases indicate that avelumab–axitinib therapy has a long‐term antitumor effect in some patients with tRCC.
Abstract
Purpose
This study aimed to evaluate cytokine levels in plasma samples over time from living-donor renal transplant recipients with no evidence of pathological and clinical rejection at ...least 1 year post-procedure.
Methods
We examined plasma cytokine levels in 15 living-donor renal transplant recipients who were treated at our hospital from 2015 to 2018 and who presented with no evidence of pathological or clinical rejection for 1 year or longer. We collected blood samples before renal transplantation and at 1 week and 1 year post-procedure. We evaluated levels of 40 cytokines in plasma using Bio-Plex Pro™ Human Chemokine Assay kit.
Results
We detected no increase in plasma cytokine levels at either the 1 week or the 1 year time points. Plasma levels of 22 cytokines remained stable throughout and levels of 18 cytokine decreased after transplantation.
Conclusion
Plasma cytokine levels remained unchanged or were decreased in our patient cohort that included stable cases of living-donor renal transplantation. Our results suggest that renal transplantation may promote amelioration of chronic inflammation associated with end-stage renal failure and dialysis.
Objectives
This study aims to investigate whether a cribriform pattern on prostate biopsy may be a factor in suspicion of intraductal carcinoma of the prostate after radical prostatectomy.
Methods
...This retrospective study assessed 100 men who underwent prostatectomy from 2015 to 2019. Participants were grouped as 76 patients with Gleason pattern 4 and 24 patients without this pattern. All 100 participants underwent retrograde radical prostatectomy and limited lymph node dissection. The same pathologist evaluated all specimens. The cribriform pattern was evaluated with haematoxylin and eosin counterstaining, and intraductal carcinoma of the prostate was evaluated with immunohistochemical analysis of cytokeratin 34βE12.
Results
Patients with intraductal carcinoma of the prostate on immunohistochemical analysis showed a significant tendency to relapse in the postoperative period, and those with the cribriform pattern on biopsy had a significant recurrence rate. In univariate and multivariate analyses, intraductal carcinoma of the prostate confirmed in biopsy tissue was an independent predictor of biochemical recurrence after prostatectomy. The rate of intraductal carcinoma of the prostate confirmation was 28% of cases with a cribriform pattern in biopsy tissue, which was increased to 62% in prostatectomy tissues.
Conclusion
The cribriform pattern in the biopsy tissue may be a predictor for intraductal carcinoma of the prostate.
Abstract Background This study aimed to compare the outcomes of living donor kidney transplantation with blood- and non-blood-related donors across multiple facilities. Previous reports comparing ...these outcomes have been single-center studies. As the donors were the recipients’ spouses in all cases with non-blood-related donors, we independently compared the outcomes of wife-to-husband (WTH) and husband-to-wife (HTW) transplantations. No previous multicenter studies have compared transplant outcomes between spouses in this manner. Methods This retrospective study used a shared database including 643 cases from 6 facilities that primarily used tacrolimus as a calcineurin inhibitor. We used propensity score matching to compare the outcomes of transplantations with blood- and non-blood-related donors and those of WTH and HTW transplantations. Results Of the 643 cases examined, 381 and 262 had blood- and non-blood-related donors, respectively. All non-blood-related donor cases had spouses as donors. After propensity score matching, 84 cases each were selected from the blood- and non-blood-related donor groups for comparison, with no significant intergroup difference in the time to graft loss. Among the 262 interspousal transplantations, 91 were HTW transplantations and 171 were WTH transplantations. Following propensity score matching, 58 cases each were selected from the WTH and HTW groups for comparison, with no significant intergroup difference in the time to graft loss. Conclusions In this large multicenter retrospective study, no significant differences were observed in the outcomes of transplantations with blood- and non-blood-related donors. Furthermore, no significant differences were observed in the outcomes of WTH and HTW cases. Many centers that use tacrolimus-based four-drug immunosuppressive therapy may have similar trends as those observed in this study, making our findings significant for planning transplantation involving kidneys donated from patients’ spouses.
Introduction
Clear cell papillary renal cell carcinoma often develops in the context of the dialyzed kidney (end‐stage renal disease). However, the relationship between clear cell papillary renal ...cell carcinoma and microRNA expression in patients with end‐stage renal disease remains unclear.
Case presentation
A left renal tumor measuring 22 mm was detected and a radical nephrectomy was performed on a 50‐year‐old man who had received hemodialysis for the past 6 years. A pathological diagnosis of pT1aNxMx, clear cell papillary renal cell carcinoma was made. We studied the expression of miR‐155 in this case and compared it to the expression in nondialysis kidney tissue. The expression level of miR‐155 was upregulated in tumor tissue compared with expression levels in the renal cortex for the present case. The expression level of miR‐155 in the renal cortex was lower in the present case than in nondialysis kidney tissues.
Conclusion
We demonstrated upregulation of miR‐155 in a case of clear cell papillary renal cell carcinoma arising from end‐stage renal disease.
Abstract
Purpose
Hemodialysis patients tend to be in “unstable psychological conditions” because of complications and physical activity restriction. This study aimed to investigate unusual ...psychological factors and their influence on the quality of life (QOL) of hemodialysis patients.
Methods
This study targeted 55 patients who had experienced > 1 year of stable maintenance outpatient hemodialysis. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate unusual psychological conditions. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was used to evaluate QOL. Participants were grouped into “unstable psychological conditions” if HADS indicated that “depression is suspected” or “suspected depression, anxiety stated” (“Anxiety/Depression group”); this group was then compared to the “Stable group”.
Results
A total of 18 participants (32.7%) were included in the “Anxiety/Depression group”, and all QOL scores in this group were lower than those in the “Stable group”. In particular, a significantly low value was shown in the respective criteria such as “effects of kidney disease,” “social support,” and “general health perceptions”.
Conclusions
A possibility was suggested that the major causes were the restrictions of social activity by hospital visits and treatment and unique psychological conditions.
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