ro13-9904 and Ureteral-Obstruction

Noncontrast computed tomography (CT) has great advantage with higher sensitivity and more clear modalities in detecting urinary tract radiolucent calculi in patients with acute renal insufficiency (ARI) compared to other image diagnosis approaches. We report two cases (female, 28 years old; male, 39 years old) with persistent flank pain and acute anuria after the administration of ceftriaxone (4.0 g daily) for 2 days intravenously. No abnormality was found in the kidney-ureter- bladder (KUB) areas with plain abdomen X-rays. A diagnosis of bilateral hydronephrosis was made by ultrasound examination in both cases. Serum creatinine levels reached up to 257 and 810 μ mol/L (normal serum creatinine level is 40-130 μ mol/L), respectively. Vague density spots were noticed in the pelvis with noncontrast multidetector-row CT (MDCT) scanning. However, distinguishable clusters of high-density shadows were seen in pelvic areas with maximum intensity projections (MIP, CT values in 30-128 HU). Ceftriaxone crystal calculi were found on both sides of distal ureters under endoscopy. Renal function recovered in both patients after double-J ureteral stents were installed. Out results demonstrated that noncontrast MDCT scanning and MIP reconstruction as an effective diagnostic tool could provide clear images in detection of radiolucent calculi in urinary tract when conventional X-rays image are not suitable in the patients with obstructive anuria and ARI of unknown origin.

Topics: Acute Kidney Injury; Adult; Ceftriaxone; Creatinine; Female; Humans; Male; Radiographic Image Enhancement; Radiographic Image Interpretation, Computer-Assisted; Tomography, X-Ray Computed; Ultrasonography; Ureteral Calculi; Ureteral Obstruction

The aim of the present study was to evaluate the effects of phosphodiesterase 5 inhibitors on renal tubular apoptosis and also on expressions of endothelial and inducible nitric oxide synthases (eNOS and iNOS) in the ipsilateral kidney after partial unilateral ureteral obstruction (PUUO) in a rat model. Forty Wistar albino rats were divided into five groups. In Groups 1-4, left experimental PUUO was created. Sildenafil, vardenafil, and tadalafil were administrated to the rats of Groups 2-4, respectively. The pills were orally given to the rats for 30 days. Group 5 was defined as sham. After 30 days, all rats were sacrificed, and nephrectomy was performed. The renal specimens were examined histopathologically. Left hydroureteronephrosis was observed in Groups 1-4. Mean apoptotic cell count and eNOS and iNOS levels were significantly increased in Group 1 when compared with the other groups. The rats in Groups 2-4 showed significantly decreased apoptotic cell count and eNOS and iNOS values in the renal tubular tissue in accordance with Group 1 (p<0.05). There were significant differences in apoptotic cell counts between sildenafil group and the other two study groups. The sildenafil group demonstrated lesser apoptotic cell count than the vardenafil (p=0.021) and tadalafil (p=0.009) groups. PUUO increases the renal tubular apoptosis and elevates NOS concentrations in renal tubular tissue after PUUO. Phosphodiesterase 5 inhibitors have a protective effect against the tubular apoptosis.

Topics: Animals; Apoptosis; Carbolines; Ceftriaxone; Imidazoles; Kidney Tubules; Nitric Oxide Synthase Type II; Nitric Oxide Synthase Type III; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Rats; Rats, Wistar; Sildenafil Citrate; Sulfones; Tadalafil; Triazines; Ureteral Obstruction; Vardenafil Dihydrochloride