Kazuo Nosaka

Acute tubulointerstitial nephritis with uveitis syndrome presenting as multiple tubular dysfunction including Fanconi's syndrome

We describe an 11-year-old male patient with acute tubulointerstitial nephritis with uveitis (TINU) syndrome. He presented with easy fatigability, pallor, nocturia and weight loss. laboratory examination disclosed anaemia, polyclonal hypergammaglobulinaemia, low molecular weight proteinuria, glycosuria, aminoaciduria, proximal and distal renal tubular acidosis, a urine concentration defect and decreased creatinine clearance. The multiple renal tubular dysfunction and slight glomerular dysfunction subsided spontaneously. Bilateral anterior uveitis was manifested 7 months after the onset of the disease. This is the first reported case of TINU syndrome with multiple proximal and distal tubular dysfunction including a complete type of Fanconis syndrome.

Serum protein acrolein adducts: utility in detecting oxidant stress in hemodialysis patients and reversal using a vitamin E-bonded hemodialyzer

Accumulating evidence indicates that protein modification by acrolein is one of the major hallmarks of atherosclerosis. The purpose of the present study was to evaluate the serum acrolein-modified protein adduct (Acr) level in end-stage renal disease (ESRD), and to elucidate the efficacy of vitamin E-bonded hemodialyzer in reducing Acr in a crossover trial. A significant increase in Acr was found in ESRD patients compared with healthy controls (p <.001). In ESRD, the Acr level of those patients with type 2 diabetes mellitus (DM) was significantly higher compared with the non-DM group (p <.05). Forty-one ESRD patients who exhibited Acr levels higher than the mean value in ESRD were treated by vitamin E-bonded hemodialyzer for 6 months. After 6 months of treatment, Acr levels were decreased to those found in healthy individuals (p <.001). When hemodialyzers were switched back from vitamin E bonded to the original regular ones, Acr levels increased to nearly their initial levels after 3 months (p <.001), compared with the 6 month time point. These results suggest the potential of Acr as an oxidative stress marker in ESRD, and that vitamin E-bonded hemodialyzer treatment is a reasonable approach to reduce oxidative stress in ESRD.

Role of leukotriene B4 in accelerated hyperlipidaemic renal injury

Aim:  Glomerular infiltration of macrophages is a characteristic alteration of renal pathology in hyperlipidaemic renal injury. Leukotriene B4 (LTB4) is a bioactive eicosanoid and macrophage and has two key enzymes for LTB4 synthesis, 5‐lipoxygenase and leukotriene A4 (LTA4) hydrolase. The purpose of this study was to evaluate the role of LTB4 in accelerated hyperlipidaemic renal injury.

Effects of Probucol on Renal Function and Urinary Protein Excretion in Spontaneously Hypercholesterolemic Rats Fed a Normal or High Cholesterol Diet

Background/Aim: Spontaneously hypercholesterolemic (SHC) rats develop hypercholesterolemia and focal glomerular sclerosis, and have been thought to be a model of lipid-induced glomerular injury. However, recent studies suggest that the hypercholesterolemia might be due to secondary mechanisms by massive proteinuria. The purpose of the present study was to determine in SHC rats the effects of a high cholesterol diet on serum lipid profiles and renal function/histology, and to examine whether or not the model of lipid-induced renal injury could be developed in a short period of the time. The effects of probucol were also studied. Methods: SHC rats were fed a high cholesterol diet for 6 weeks (H) or with probucol (HP), while control SHC rats were fed normal rat chow (N) or with probucol (P). Lipid profile and renal function/histology were examined. Results: H and HP showed increased levels of urinary protein excretion and serum creatinine, as well as extremely high serum cholesterol levels, compared with N and P. HP tended to show reduced urinary protein excretion compared with H, but the difference was not statistically significant. H and HP presented histologically characteristic changes with numerous foam cells accumulated in the glomerular mesangial area, and showed glomerular sclerosis. Conclusion: The data demonstrate that SHC rats have an intrinsically abnormal lipid metabolism, and that probucol does not exert obviously beneficial effects on renal function or lipid-lowering action. A lipid-induced renal injury model of rats was produced in 6 weeks.