Hyperosmotic stress induces epithelial-mesenchymal transition through rearrangements of focal adhesions in tubular epithelial cells

Epithelial-mesenchymal transition (EMT) of tubular epithelial cells is a hallmark of renal tubulointerstitial fibrosis and is associated with chronic renal injury as well as acute renal injury. As one of the incidences and risk factors for acute renal injury, increasing the osmolality in the proximal tubular fluid by administration of intravenous mannitol has been reported, but the detailed mechanisms remain unclear. Hyperosmotic conditions caused by mannitol in the tubular tissue may generate not only osmotic but also mechanical stresses, which are known to be able to induce EMT in epithelial cells, thereby contributing to renal injury. Herein, we investigate the effect of hyperosmolarity on EMT in tubular epithelial cells. Normal rat kidney (NRK)-52E cells were exposed to mannitol-induced hyperosmotic stress. Consequently, the hyperosmotic stress led to a reduced expression of the epithelial marker E-cadherin and an enhanced expression of the mesenchymal marker, α-smooth muscle actin (α-SMA), which indicates an initiation of EMT in NKR-52E cells. The hyperosmotic condition also induced time-dependent disassembly and rearrangements of focal adhesions (FAs) concomitant with changes in actin cytoskeleton. Moreover, prevention of FAs rearrangements by cotreatment with Y-27632, a Rho-associated protein kinase inhibitor, could abolish the effects of hyperosmotic mannitol treatment, thus attenuating the expression of α-SMA to the level in nontreated cells. These results suggest that hyperosmotic stress may induce EMT through FAs rearrangement in proximal tubular epithelial cells.

Prognostic value of endotoxicosis criteria in the diagnosis of acute renal injury

In order to find informative statically significant laboratory criteria for endotoxicosis in the diagnosis of acute renal injury, a clinical and biochemical study of 40 patients with acute renal injury developed against the background of renal urological and extrarenal surgical pathology was conducted. The results of the study demonstrate pronounced changes in the mechanisms of antioxidant protection that develop in patients with acute renal injury. Deviations from the initial level of the studied criteria are interrelated with many links of pathogenesis, where one of the central links is ischemia of the renal parenchyma. The progression of endogenous intoxication, taking into account the data obtained, confirmed by a decrease in prooxidant protection contributes to the progression of intrarenal changes, aggravating functional changes in renal and extrarenal injuries. Key words: significance of endotoxicosis criteria, acute renal injury, endotoxicosis, serum creatinine, glomerular filtration rate.

Renal failure in patients with hematological malignancies (literature review)

Dysfunction of the natural detoxification organs remains a significant problem in patients with hematological malignancies. The reasons for the development of renal failure are associated with the individual characteristics of the malignant process, the patient’s comorbid background, the toxic effects of anticancer treatment and its complications. The efficacy of many anticancer drugs correlates with their dose, an increase in which is associated with increased toxic effects on healthy organs, including the kidneys. The main reasons for the renal failure development in hematological cancer patients and syndromes that prevent adequate antitumor therapy are considered. Diagnostic algorithm optimization and supportive intensive care of acute renal failure is the key to the successful application of highly effective modern protocols of drug anticancer treatment.A special group is represented by patients suffering from monoclonal gammopathies with acute renal injury and hyperproduction of immunoglobulins free light chains. Renal failure can be the onset and dominant clinical manifestation of multiple myeloma in 18–56 % of cases, of which 10 % require programmed hemodialysis. Antitumor therapy in presence of renal failure is limited, and in some cases impossible, while the renal function recovery is associated with an increase in survival.Organ damage in oncohematological patients can be a manifestation of paraneoplastic syndromes. Tumor lysis syndrome is an urgent problem of oncohematological practice associated with the development of acute renal injury and high mortality.The development of organ failure in oncohematological patients causes significant difficulties in antitumor therapy; a combination of organ dysfunction and the resulting change in anticancer therapy regimens worsen the prognosis. Modern methods of organ failure prevention and treatment can successfully solve complex clinical problems.

Case Report: Magic Mushroom (Psilocybe Cubensis) Intoxication

Introduction. Psilocybe mushroom, or wi dely known as the magic mushroom is a variety of mushroom commonly consumed because of hallucinogenic traits it causes toward its consumer. This hallucinogenic effect is caused by Psilocybin, a hallucinogenic substance often found within Psilocybe mushroom. This substance affects mental state of the consumer and has similar effect to those of LSD and Mescaline. Aside from its effect to cause mental disturbance, consumption of this mushroom may cause acute renal injury which leads to a fatal and life -threatening situation. Case presentation. A case of Psilocybe intoxication had been reported in a 22 years old male with a confirmed history of consuming Psilocybe mushroom. Patient first came with a symptom of disorientation and restlessness. Patient also often shook his head off, laughed out, screamed, and continuously making bizarre movements. Psychiatric examination confirmed a sign of auditory hallucination, unstable mood, and stereotypical behavior experienced by the patient. Conclusion. An approach is needed in the form of a ph ysical examination and support that supports a prompt and precise diagnosis, as well as comprehensive management that focuses on the direct management of life-threatening symptoms and symptomatic treatment, taking into account the si gns and symptoms of life-threateningnephrotoxicity