International Urology and Nephrology (INT UROL NEPHROL )

Publisher: Springer Verlag


International Urology and Nephrology publishes original papers on a broad range of topics in urology nephrology and andrology. The journal integrates papers originating from clinical practice. In addition to the regular papers book reviews also form an essential feature of the journal. International Urology and Nephrology is published at bimonthly intervals.

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    International Urology and Nephrology website
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    International urology and nephrology (Online)
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    Document, Periodical, Internet resource
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    Internet Resource, Computer File, Journal / Magazine / Newspaper

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Springer Verlag

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Publications in this journal

  • [show abstract] [hide abstract]
    ABSTRACT: Kidney diseases (KD), a major public health problem that affects about 10 % of the general population, manifest in progressive loss of renal function, which ultimately leads to complete kidney failure. However, current approaches based on renal histopathological results and clinical parameters lack sensitivity and are not sufficient to characterize the category and progression of nephrology or to predict nephrology progression risk reliably or to guide preventive interventions. The high incidence and financial burden of KD make it imperative to diagnose KD at early stages when therapeutic interventions are far more effective. Nowadays, the appearance of metabolomics (the high-throughput measurement and analysis of metabolites) has provided the framework for a comprehensive analysis of KD and serves as a starting point for generating novel molecular diagnostic tools for use in nephrology. Changes in the concentration profiles of a number of small molecule metabolites found in either blood or urine can be used to localize kidney damage, or assess kidneys suffering from injury. The power of metabolomics allows unparalleled opportunity to query the molecular mechanisms of KD. Novel metabolomics technologies have the ability to provide a deeper understanding of the disease beyond classical histopathology, redefine the characteristics of the disease state, and identify novel approaches to reduce renal failure. This review gives an overview of its application to important areas in clinical nephrology, with a particular focus on biomarker discovery. Great strides forward are being made in breaking down important barriers to the successful prevention and treatment of this devastating disorder.
    International Urology and Nephrology 10/2013;
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    ABSTRACT: Purpose Sensitization to HLA antigens resulting in anti-HLA antibodies (panel reactive antibodies; PRA) is a major problem in chronic kidney disease (CKD) patients awaiting transplantation. Induction of anti-HLA antibodies normally occurs through blood transfusion, pregnancy and prior transplantation. However, some patients develop these antibodies for unknown immunological reasons. It is hypothesized that deviations in immune regulation may account for PRA positivity in these patients. We, therefore, investigated whether a quantitative deficiency in peripheral natural regulatory T cells (CD4+CD25highFoxp3+; nTreg) plays a role in this phenomenon. Methods Peripheral blood mononuclear cells from 14 patients with positive (Class I and Class II; 10–100 %) and 25 patients with negative PRA, who had not previously been sensitized by blood transfusion, pregnancy and prior transplantation and who had not received any immunomodulatory treatment within the last year, were analyzed for absolute lymphocyte and nTreg numbers through flow cytometry. Samples from 10 healthy people were also used as control. Results Mean absolute nTreg numbers were determined to be severely reduced in CKD patients (12 ± 9; n = 39) compared with healthy individuals (53 ± 17; n = 10) (p = 0.008). However, absolute nTreg numbers were similar between PRA− (12 ± 11) and PRA+ (11 ± 8) groups. Interestingly, there was a moderate correlation between the nTreg numbers and HLADR2 genotype (n = 9, r = 0.508, p < 0.05). Conclusion This is the first study to demonstrate that the quantitative peripheral nTreg deficiency in CKD patients does not show a causal relationship with the presence of anti-HLA antibodies.
    International Urology and Nephrology 05/2013;
  • International Urology and Nephrology 01/2013;
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    ABSTRACT: Purpose The aim of this pilot study was to describe the hydration and nutritional status of a cohort of elderly dialysis patients and to explore the association between these parameters and the quality of life (QoL). Methods All patients over 75 years of age being in chronic dialysis by January 2008 at 3 dialysis units (n = 34) were asked to participate in this pilot study, 24 patients were entered. Hydration status was assessed by bioimpedance spectroscopy (BIS) and nutritional status by the subjective global assessment (SGA), BIS, anthropometric measures and biochemical parameters. Based on these assessments the patients were classified as being cachectic or not according to newly defined criteria. QoL was measured using the SF-36. Results The results showed cachexia in 6 (25 %), 37.5 % had a body mass index below 24, whereas according to SGA 91 % were malnourished. BIS showed low lean tissue index in 46 % and overhydration in 35 % of the patients. Compared to non-cachectic and normohydrated, cachectic and overhydrated patients reported consistently poorer QoL. For cachectic patients, the differences were clinically significant for all SF-36. BIS was easily applicable when used before dialysis. Conclusions The high frequency of nutritional deficits in this study calls for more attention to nutritional status in elderly dialysis patients. There is a need for a general agreement on how nutritional status should be assessed and reported, both in clinics and in research.
    International Urology and Nephrology 09/2012; 44:1885-1892.
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    ABSTRACT: The nested variant of transitional cell carcinoma is extremely rare in the bladder. Here we reported a new case and review the literature.
    International Urology and Nephrology 04/2012; 32(2):257-258.
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    ABSTRACT: With the widespread use of obstetric echography the incidence of fetal hydronephrosis has been reported more frequently. Consequently, many uropathies have been detected in asymptomatic neonates. The authors report their experience with prenatally detected primary non-refluxing megaureter. Newborns with fetal hydronephrosis were investigated by ultrasonography and micturating cystourethrogram after the beginning of chemoprophylaxis. If primary megaureter was identified, after 1 month the children underwent 99tm-DMSA, diuretic 99tm-DTPA, and intravenous urography. Eight infants with primary megaureter (bilateralin 3 cases) were identified, for a total of 11 renal units for study. All children were submitted to non-operative management. We performed ultrasonography and diuretic 99tm-DTPA during follow-up, which lasted on average 75 months. The mean cross-sectional diameter of the dilated ureter was 13.6 mm during neonatal period, and reached 8.4 mm atthe end of follow-up. The renal function and the diuretic renogram remained stable throughout follow-up. Two neonates presented transitory hypertension. Our results support the notion that conservative management is safe for primary megaureter detected in asymptomatic neonates, with most cases showing spontaneous regression during aprolonged follow-up.
    International Urology and Nephrology 04/2012; 32(1):13-18.
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    ABSTRACT: Chronic renal failure is a risk factor fortuberculosis. In the past five years we have identifiedtwo cases of tuberculosis in our dialysis population.The first patient, showed chronic failure to thrive onhemodialysis. An enlarged cervical lymph node wasbiopsied and, although no acid fast bacilli (AFB) wereseen, a culture grew Mycobacterium tuberculosum (TB). Her chest X-ray did not show evidence of pasttuberculosis. The second patient was a long timesmoker who presented with an enlarged cervical node,which was biopsied. AFB were not seen on her biopsy,but her culture grew TB. Extrapulmonary TB is commonin patients with ESRD, and lymph node involvement isthe most common extrapulmonary presentation. Screening with the purified protein derivative (PPD)is not helpful in ESRD patients, since defects in cellmediated immunity are common. A high index ofsuspicion for TB is warranted in patients with ESRD.
    International Urology and Nephrology 04/2012; 32(2):181-183.
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    ABSTRACT: BACKGROUND: Hyperoxaluria is a rare metabolic disorder characterized by calcium oxalate deposition in different tissues. It is caused either by an inherited disease of oxalate metabolism [primary hyperoxalurias (PH)] or by an acquired disturbance (secondary hyperoxaluria). CASE: We report here an atypical presentation of enteric hyperoxaluria-induced renal failure that occurred after liver transplantation. Despite adapted treatment and intensive haemodialysis, the patient did not recover. This case allows the reviewing of the multiple pathophysiological mechanisms involved in this disease. CONCLUSION: Oxalate nephropathy should be considered in the differential diagnosis of acute renal failure, especially when previous renal impairment and fat malabsorption are present. We suggest performing renal biopsy early to allow a prompt diagnosis and therapeutic intervention.
    International Urology and Nephrology 01/2012;
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    ABSTRACT: The authors examined the number of interstitial cells of Cajal-like cells (ICC-LCs) in obstructed ureteropelvic junction (UPJ) in comparison with normal UPJ specimens and age-related changes. A total of 20 human formalin fixed, paraffin-embedded specimens of intrinsic UPJO from children at the mean age of 8.1 years (age range: 8 months-16.8 years) and 5 control samples from children at the mean age of 2.3 years (range 2.4 months-7.4 years) were investigated immunohistochemically for the expression of c-kit proto-oncogene by light microscopy with computerized image analysis. The results were examined by Fisher's exact test, Yates' chi-square test, and t test for Pearson's correlation coefficient. A P value less than 0.05 was considered statistically significant. The number of ICC-LCs-dense fields was significantly higher in UPJO specimens in comparison with the normal group (P = 0.0004). The number of ICC-LCs-sparse fields was significantly lowered in UPJO specimens in comparison with the normal group (P = 0.0122). There was no significant difference in the number of ICC-LCs-medium fields in obstructed and normal UPJ specimens. The number of ICC-LCs was decreasing significantly with increasing age of the patients with UPJO (P = 0.0038). The higher density of c-kit-positive ICC-LCs in UPJ may manifest the compensation of altered peristalsis in UPJO. The number of ICC-LCs-dense fields decreasing with age may show the failure of compensation and regression of the compensatory changes.
    International Urology and Nephrology 05/2011; 44(1):7-12.
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    ABSTRACT: ObjectiveQuestionnaires for adequate assessment of the urinary function of neurological patients are not available in Portuguese. The Qualiveen, developed in France for evaluation of general and urinary-related impact on QoL, has been successfully used in neurological patients. AimTo translate the Qualiveen, to adapt it crossculturally, and to validate it for Portuguese. MethodsFifty-one patients with spinal cord injury (SCI), multiple sclerosis (MS), and myelomeningocele (MMC) completed both Qualiveen and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) twice, at an mean interval of 15.5days. ResultsA reliability study revealed internal consistency (Cronbach’s alpha coefficients 0.75–0.90 for all four domains). Test–retest reliability demonstrated moderate to strong stability (intraclass correlation coefficient range from 0.62 to 0.86). Construct validity was assessed using the Qualiveen’s scores and ICIQ-SF final score. It was significant for the majority of Qualiveen’s score domains compared with the ICIQ-SF final score. ConclusionThe Portuguese version of the Qualiveen was successfully adapted and validated. It can be used for evaluation of general and urinary QoL in neurological patients.
    International Urology and Nephrology 02/2009; 41(1):29-33.
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    ABSTRACT: There is a continuing debate on the accurate prevalence estimates of overactive bladder (OAB) among different ethnicities and regions. The aims of our study were to determine the prevalence of OAB, associated risk factors, and the impact of OAB on the quality of life and sexual function of Iranian women. A total of 8748 women between 15 and 55years of age enrolled in this cross-sectional study. The definition of the 2002 International Continence Society (ICS) was applied to assess the prevalence of OAB. All participants underwent a detailed history and physical examination that included an evaluation of quality of life, coping strategies and treatment-seeking behavior, laboratory tests, urinalysis and current or previous therapy. The degree of bother was quantified using s visual analog scale (VAS). The overall prevalence of OAB was found to be 18.2% and increased with age from 10.9% in adults aged 15–29years to 26.2% in those aged >50years old (test for trend, P=0.001). A negative impact of OAB on sexual function was reported by 72.3% of the women. Frequency was the most commonly reported symptom (67% of women), followed by urgency (54%). Subjects with OAB had a higher prevalence of anxiety (28.2 vs. 8.8%; P=0.001), depression (38.2 vs. 18.2%; P=0.02) and tiredness (16.4 vs. 2.7%; P=0.001), and they reported significant impairment in carrying out household chores (P=0.01), physical activities (P=0.01) and work-related activities (P=0.01) as well as negative effects on education (P=0.02), sleep (P=0.001), relationships (P=0.001) and annual income (P=0.01). The prevalence of OAB in Iranian women is higher than that reported in many previous studies in developed and developing countries. Our results reveal that OAB is a highly prevalent condition among Iranian women and that is has a serious impact on quality of life and sexual function.
    International Urology and Nephrology 01/2009; 41(1):35-45.
  • International Urology and Nephrology 11/2008; 40(4):1009-14.
  • International Urology and Nephrology 10/2008; 40(4):1127-32.
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    ABSTRACT: Fibroblast growth factor (FGF) 23 is a circulating factor that regulates phosphate (P) metabolism. Since higher P levels are associated with vascular calcification, we examined the role of serum FGF-23 levels in P metabolism and vascular calcification in hemodialysis (HD) patients with and without diabetes mellitus (DM). Chronic HD patients with DM (n = 39) and without DM (n = 50) were enrolled. Serum samples were obtained before the start of dialysis sessions, and the FGF-23 levels were determined by enzyme-linked immunosorbent assay. Abdominal computed tomography (CT) scan was performed, and the aortic calcification index (ACI) was determined by one examiner, blinded to the patient characteristics. Measurements of bone mineral density (BMD) were performed at the time of ACI estimation. Log plasma FGF-23 levels were higher in non-DM (3.74 +/- 0.71 pg/ml) than in DM (3.35 +/- 0.74 pg/ml) patients. The log FGF-23 correlated positively with serum creatinine (r = 0.424, P < 0.0001), albumin (r = 0.225, P = 0.0337), Ca (r = 0.392, P = 0.0001), P (r = 0.735, P < 0.0001), and Ca x P product (r = 0.780, P < 0.0001). There were negative correlations between log FGF-23 and age (r = -0.208, P = 0.0497), glucose (r = -0.231, P = 0.0294), and CRP (r = -0.222, P = 0.0359). Multiple regression analyses were performed to explore the correlations between plasma FGF-23 and other factors associated with vascular calcification in all HD patients. Independent variables were selected based on the results of univariate analyses. The significant factors associated with FGF-23 in HD patients were age, serum levels of creatinine, albumin, glucose, Ca, P, and Ca x P product. Plasma FGF levels did not correlate significantly with either ACI or BMD in these patients. Our findings indicate that the plasma FGF-23 level is associated with calcium-phosphate metabolism disorders, but not with aortic calcification, in both non-DM and DM patients on chronic HD. In addition, plasma FGF-23 is associated with serum levels of creatinine and albumin. Therefore, the plasma FGF-23 level may provide a reliable marker for Ca and P imbalance and nutritional status in HD patients.
    International Urology and Nephrology 10/2008; 40(4):1067-74.
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    ABSTRACT: During the last few years, the number of elderly patients with end-stage renal disease (ESRD) has been increasing worldwide. Establishment of a viable vascular access is of primary importance in these patients. This review discusses the advantages and disadvantages of the available vascular access modalities [namely arteriovenous (AV) fistulae, AV grafts, and central venous catheters (CVCs)] in elderly ESRD patients. AV fistulae seem to be superior when compared with other vascular access alternatives with respect to patency, morbidity and mortality rates. On the other hand, due to the age-related advanced atherosclerosis in the elderly, higher failure rates for AV fistulae in this age group have been described. Two controversial issues, namely the higher infection and thrombosis rates in elderly ESRD patients, are also discussed. Current evidence suggests that old age should not comprise a drawback when selecting the appropriate vascular access modality (AV fistula, AV graft or CVC) for the performance of hemodialysis. The possible vascular access options in elderly ESRD patients should not be different from younger individuals.
    International Urology and Nephrology 10/2008; 40(4):1133-42.

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