fibrin and Hydronephrosis

Hydronephrosis is associated with interstitial fibrosis and occlusion of renal capillaries by fibrin. However, the mechanisms leading to fibrin formation is unknown.. Twenty days after unilateral ligation of the ureter, interstitial fibrosis occurred in the ligated kidney. Fibrosis was preceded by infiltration of inflammatory cells (macrophages, B and T lymphocytes). Staining with an antibody against von Willebrand factor demonstrated newly formed capillaries in the fibrosing tissue as well as prominent fibrin deposition. Fibrin staining was found around vessels, in the interstitium, the glomeruli, and tubuli. Fibrin deposition was less prominent in the non-ligated kidney and almost absent in sham-operated animals. The expression of tissue factor, the central initiator of coagulation, was induced within 5 days after ligation in the operated kidney but not in the sham-operated animals. Tissue factor positivity was observed by immunohistochemistry in vascular endothelial cells, the vessel wall, tubular epithelial cells, glomerular capsular cells, Bowman's space and in the interstitium. Tissue factor induction was due to increased transcription, since in-situ hybridization showed increased levels of mRNA in the ligated kidney compared to sham-operated rats. The tissue factor gene is under control of the transcription factors activator protein-1 (AP-1) and nuclear factor-kappa B (NF-kappa B). When extracts of operated organs were compared with kidneys of sham-operated rats or contralateral kidneys in electrophoretic mobility shift assays, an increase in AP-1 and NF-kappa B binding activity to their respective binding sites in the tissue factor gene was observed in the operated, but not in the contralateral kidney or kidneys of sham-operated animals.. Ureteral ligation leads to infiltration of inflammatory cells, increased AP-1 and NF-kappa B expression in the kidney, resulting in increased tissue factor transcription and translation, and ultimately in increased fibrin deposition.

Topics: Animals; B-Lymphocytes; Base Sequence; DNA Probes; Fibrin; Hydronephrosis; Immunohistochemistry; In Situ Hybridization; Kidney; Male; Molecular Sequence Data; NF-kappa B; Rats; Rats, Sprague-Dawley; T-Lymphocytes; Thromboplastin; Transcription Factor AP-1

The concentration of fibrin/fibrinogen degradation products in urine (FDPu) was measured in samples obtained from 114 patients and 63 clinically healthy volunteers, once or repeatedly. The FDP titers measured by the hemagglutination inhibition (HI) method corresponded to less than 2.6 mug/ml FDP in all samples from healthy controls. Slightly elevated FDP concentrations were found in urine obtained from a few patients with disorders not primarily involving the urinary tract. The clinical importance of these isolated findings remains unclear. Urinary tract infections were not frequently accompanied by elevated FDPu concentrations. In patients with glomerulonephritis FDP excretion correlated somewhat better with severity of the renal affection. A further group of patients showed an unequivocal correlation between FDP excretion in the urine and postoperative complications following renal transplantation. However, the clinical diagnosis of acute rejection crisis was usually established at the same time or even before an increase in FDPu was found. Our results suggest that among diagnostic procedures the measurement of FDPu contributes little specific information for the evaluation of urinary tract disease. FDPu measurements in the immediate postoperative phase following renal transplantation may however be important for prognostic evaluation and, in individual cases, predict transplant rejection. We also attempted to define the FDPu qualitatively by simultaneous measurements using HI and the staphylococcal clumping test (SCT). Immunoelectrophoresis confirmed the well-known fact that the SCT detects only high-molecular FDP; this limits its clinical usefulness, despite its high sensitivity.

Topics: Female; Fibrin; Fibrinogen; Glomerulonephritis; Graft Rejection; Hemagglutination Inhibition Tests; Humans; Hydronephrosis; Kidney Calculi; Kidney Transplantation; Male; Pregnancy; Pregnancy Complications; Proteinuria; Pyelonephritis; Time Factors; Transplantation, Homologous; Urologic Diseases

Topics: Acute Kidney Injury; Animals; Blood Urea Nitrogen; Diagnosis, Differential; Disease Models, Animal; Fibrin; Fibrinogen; Graft Rejection; Hydronephrosis; Iodine Radioisotopes; Kidney Transplantation; Ligation; Protein Binding; Rabbits; Renal Artery Obstruction; Renal Veins; Thrombophlebitis; Thrombosis; Transplantation, Homologous

Topics: Animals; Fibrin; Fibrinogen; Graft Rejection; Hydronephrosis; Iodine Isotopes; Kidney; Kidney Transplantation; Microscopy, Fluorescence; Rats; Rats, Inbred Strains; Renal Veins; Thrombosis; Transplantation Immunology; Transplantation, Homologous