fibrin and Renal-Artery-Obstruction

Percutaneous transluminal renal angioplasty and stent placement with use of a coronary protection device was performed in a total of four patients with hypertension (n = 4) and/or renal insufficiency (n = 3) referred for revascularization of five renal arteries. Renal revascularization was successful in all five renal arteries (100%), but renal revascularization under protection by the FilterWire EX was achieved in only three of five renal arteries (60%). In one of these three, only a suboptimal seal was achieved between the vessel wall and the filter basket. Nevertheless, use of the device was safe and fibrin and/or cholesterol fragments were retrieved from three renal arteries. The FilterWire EX needs to be modified for the renal circulation to achieve the full theoretical advantages of these systems in this vascular bed.

Topics: Aged; Aged, 80 and over; Alloys; Angioplasty, Balloon; Cholesterol; Embolism; Female; Fibrin; Filtration; Humans; Hypertension; Male; Middle Aged; Polyurethanes; Renal Artery Obstruction; Renal Insufficiency; Retrospective Studies; Stents; Treatment Outcome

Ischaemic-reperfusion injury as a model of acute renal failure (ARF) results in increased macromolecular permeability, tubular obstruction, and renal oedema. To investigate the role for coagulation in this model, anticoagulated and saline-pretreated rats were subjected to 60 min unilateral renal artery occlusion (RAO). After 15 min of reflow, specimens were collected for electron and light microscopic examination. Morphometry was employed to study podocyte changes and Bowman's space dilatation as measures of increased permeability and tubular obstruction, respectively. After 15 min of reflow, Bowman's space increased significantly and the podocytes were markedly widened and flattened. Rats pretreated with heparin or warfarin showed less widening of Bowman's space than saline-treated rats, whereas no significant difference was seen regarding the podocyte changes. In saline-treated rats, fibrin-positive material was seen in the tubules but not in the urine sediments collected after 90 min of reflow, either due to fibrinolysis or poor urinary elimination. The results suggest that anticoagulation does not preclude the glomerular sieving of macromolecules, but seems to reduce tubular obstruction, probably by preventing conversion of filtered fibrinogen into fibrin.

Topics: Acute Kidney Injury; Animals; Anticoagulants; Female; Fibrin; Fluorescent Antibody Technique, Direct; Kidney Glomerulus; Kidney Tubules; Microscopy, Electron; Rats; Rats, Sprague-Dawley; Renal Artery Obstruction; Reperfusion Injury

To investigate whether fibrin deposition in the kidney occurs in ischaemic acute renal failure, rats were subjected to a left renal artery occlusion (RAO) for 1 h and contralateral nephrectomy. The animals were killed 0, 5, 15 and 60 min after re-establishment of the circulation. Kidney tissue was snap-frozen for immunofluorescence microscopy and scanning electron microscopy, and immersion-fixed for light microscopy and transmission electron microscopy. Immunofluorescence studies showed small amounts of immune reactive fibrinogen/fibrin deposits in the peritubular capillaries. Substantial amounts of fibrinogen/fibrin positive material was observed in Bowman's space and in the tubular lumina. Scanning electron microscopy of freeze-dried tissue disclosed granular and fibrillar material in Bowman's space. A temporary enlargement of Bowman's space was noted; it may have been caused by tubular obstruction. No deposits were found in the control (right) kidneys and in kidneys of heparinized rats subjected to RAO. The results indicate that fibrin deposition occurs in the ischaemic model of acute renal failure in rat, both intravascularly and in the urinary space. Its importance for the development of renal functional impairment remains to be studied.

Topics: Acute Kidney Injury; Animals; Female; Fibrin; Fibrinogen; Fluorescent Antibody Technique; Kidney; Kidney Glomerulus; Microscopy, Electron, Scanning; Rats; Rats, Inbred Strains; Renal Artery Obstruction

Topics: Blood Coagulation Factors; Fibrin; Glomerulonephritis; Humans; Renal Artery Obstruction; Thrombosis

Infusion of thrombin and the fibrinolysis inhibitor tranexamic acid during ether anaesthesia in the rat gives rise to fibrin deposition in the renal glomeruli. This resulted in renal insufficiency as indicated by an increase in the serum urea nitrogen, reduction in the renal blood flow and patchy cortical necrosis in the kidneys. The plasma renin activity was elevated initially probably due to the ether anaesthesia. Infusion of the angiotensin II antagonist saralasin prevented the renal insufficiency if it was given during the thrombin infusion but not if it was given afterwards. The deposition of fibrin in the kidneys was also reduced. The results indicate that angiotensin II is involved in the pathogenesis of the renal injury.

Topics: Acute Kidney Injury; Angiotensin II; Animals; Female; Fibrin; Rats; Rats, Inbred Strains; Renal Artery Obstruction; Renal Circulation; Renin; Renin-Angiotensin System; Saralasin; Thrombin

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; Arteriosclerosis; Blood Platelets; Cholesterol; Embolism; Fibrin; Humans; Leukocytes; Macrophages; Male; Microscopy, Electron; Protein Binding; Rabbits; Renal Artery; Renal Artery Obstruction; Time Factors

Topics: Adrenal Glands; Aneurysm; Aorta; Autopsy; Biopsy; Disseminated Intravascular Coagulation; Fibrin; Humans; Kidney; Kidney Glomerulus; Male; Meningococcal Infections; Myocarditis; Pulmonary Veins; Purpura; Renal Artery Obstruction; Testis; Thrombosis; Urinary Bladder; Vasa Vasorum; Vena Cava, Superior

Topics: Blood Proteins; Connective Tissue; Electrons; Fibrin; Hypertension; Hypertension, Renal; Mesenteric Arteries; Microscopy; Microscopy, Electron; Morphogenesis; Pathology; Rats; Renal Artery Obstruction; Research

Topics: Arteries; Arteriosclerosis; Blood Proteins; Fibrin; Fibrinogen; Gold Colloid; Gold Colloid, Radioactive; Hypertension; Iodine Isotopes; Mesenteric Arteries; Morphogenesis; Pathology; Rats; Renal Artery Obstruction; Research