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Background and aimsThe immune system plays a crucial role in the development of kidney diseases. Chronic kidney disease (CKD) can lead to various complications, potentially affecting multiple systems throughout the body. Currently, the description of the immune system in human CKD is not comprehensive enough. Constructing a CKD kidney atlas using single-cell RNA sequencing (scRNA-seq) can provide deeper insights into the composition and functional changes of immune cells in CKD, facilitating the discovery of new therapeutic targets.MethodsWe processed and integrated scRNA-seq datasets from healthy and CKD kidneys from three independent cohorts using the same approach (including 42 normal samples and 23 chronic kidney disease samples). Subsequently, we conducted gene enrichment and intercellular communication analysis to construct an immune cell atlas of the kidneys in CKD patients.ResultsWe identified nine major kidney cell clusters. Further clustering analysis of different immune cell clusters revealed that, compared to normal kidneys, CKD patients’ kidneys had decreased CD16+ NK cells while CD4+ naive helper T cells and CCR7+ DC increased. Partial activation of the WNT signaling pathway was observed in T cells and NK cells of CKD patients, while some metabolism-related genes were inhibited. Myeloid cell subgroups also exhibited abnormal signaling pathway alterations. Additionally, we discovered a unique population of SPP1 macrophages in CKD, which are recruited by chemokines released from aPT and aTAL cell subpopulations. These SPP1 macrophages may promote cellular fibrosis through the signaling of SPP1, FN1, and various receptors.ConclusionWe established a human CKD kidney immune cell atlas and identified SPP1 macrophages as a unique cell type in CKD. The interaction between SPP1 macrophages and damaged cells may serve as a potential therapeutic target for treating CKD in the future.

Background: A range of diseases can result in end-stage renal disease (ESRD), characterized by a gradual decline in kidney function and associated with significant morbidity and mortality. Currently, renal transplantation as the most effective treatment for managing ESRD. Tissue engineering presents a considerable opportunity to expand the available supply of donor organs for kidney transplants. The aim of this research was to develop a suitable technique for preparing decellularized kidney scaffolds from human tissues. Methods: The present study was carried out from April 2019 to August 2019 in Mashhad University of Medical Sciences. In this study, two decellularization protocols were compared using sections of human kidney tissue. Therefore, two human kidneys which collected from Ghaem and Imam Reza hospitals were used. In the first protocol, detergents such as 1% Triton X-100 (1A) and 1% SDS (Sodium Dodecyl Sulfate) (1B) were employed, followed by the application of DNase I. The second protocol utilized 0.5% SDS (2A) and 1% SDS (2B). The effectiveness of these techniques was evaluated using hematoxylin and eosin (H&E) staining, 4',6-diamidino-2-phenylindole (DAPI), DNA quantification, and immunohistochemistry (IHC). Results: Based on H&E staining results, comparison of the decellularized and native human kidney tissues showed a successful elimination of cell nuclei and the ameliorate extracellular matrix preservation in triton-treated scaffolds (1A) in comparison with the SDS-treated scaffolds (1B) at all times protocols. Furthermore, DNA quantification illustrated triton X-100 in removing DNA was more effective in eliminating DNA from kidney tissues compared to other protocols in renal tissues. In addition, IHC staining demonstrated that the expression of collagen IV and laminin was preserved throughout the decellularization process with Triton X-100 on day fifth. Also, IHC staining indicated human leukocyte antigen (HLA) was completely eliminated in the cortex-medulla of human scaffolds treated with Triton X-100 within day fifth. Conclusion: Our results demonstrated that triton X-100 outperformed SDS as a detergent for decellularizing human kidneys. Meanwhile these results indicate suitable method for decellularization of human kidneys to produce functional kidneys.

Health literacy plays a pivotal role in shaping an individual's adoption of a healthy lifestyle, particularly among students transitioning into adolescence and adulthood. Hence, integrating health literacy into educational curricula is imperative. For instance, the study of the human kidney excretory system, which necessitates the use of measuring instruments, can serve as a platform to enhance students' health literacy skills within the realm of biology education. This study was conducted to develop and determine the feasibility of human kidney health literacy instruments. The research method used in this study is ADDIE development research which consists of 5 stages, including (1) preliminary needs analysis (2) product design (3) Development (4) Implementation, and (5) evaluation. The trial results stated that the instrument was feasible to use with a linguist assessment of 9.8% very feasible category, and a material expert of 91% very feasible category. The empirical validity test was conducted with a limited trial to 47 students of Al-Azhar 9 Yogyakarta High School and the results showed that 92% of the items were declared valid with a high reliability value of 0.7. This study produced 16 statement items on the attitude aspect, 6 items on the knowledge aspect, and items on the skill aspect. The total question items produced in this study were 24 question items that were valid and feasible to use as a tool to improve the quality of education.

Abstract In humans, uric acid is an end-product of purine metabolism. Urate excretion from the human kidney is tightly regulated by reabsorption and secretion. At least eleven genes have been identified as human renal urate transporters. However, it remains unclear whether all renal tubular cells express the same set of urate transporters. Here, we show renal tubular cells are divided into three distinct cell populations for urate handling. Analysis of healthy human kidneys at single-cell resolution revealed that not all tubular cells expressed the same set of urate transporters. Only 32% of tubular cells were related to both reabsorption and secretion, while the remaining tubular cells were related to either reabsorption or secretion at 5% and 63%, respectively. These results provide physiological insight into the molecular function of the transporters and renal urate handling on single-cell units. Our findings suggest that three different cell populations cooperate to regulate urate excretion from the human kidney, and our proposed framework is a step forward in broadening the view from the molecular to the cellular level of transport capacity.

Background: Telocytes are interstitial stromal cells identified in various human organs, including the kidney. Their presence and role in human diabetic kidney disease remain unknown. Methods: To identify and localize telocytes in glomerular and tubule-interstitial compartments, both normal and diabetic human renal tissues were examined using immunohistochemistry, immunofluorescence, and transmission electron microscopy. Results: Renal telocytes are elongated interstitial cells with long, thin telopodes, showing alternating thin and thick segments. They expressed CD34, Nestin, α-SMA, and Vimentin markers. Occasionally, c-Kit expression was observed in some rounded and spindle cells, while no positivity was detected for PDGFR-β and NG2. Telocytes were identified around Bowman’s capsule, tubules, and peritubular capillaries in both normal and diabetic conditions. In diabetic renal samples, there was a significant increase in α-SMA expressing telocytes, leading to periglomerular fibrosis. These telocytes also exhibited a synthetic phenotype with proteoglycan deposition in the extracellular matrix and, in some cases, showed pre-adipocytic differentiation. Conclusions: Telocytes were identified in normal and diabetic human kidneys. These cells form an elastic mechanical scaffold in the interstitium and are present in all renal cortical compartments. In diabetic samples, their increased α-SMA expression and synthetic phenotype suggest their potential role in the pathogenesis of diabetic nephropathy.

Summary: Background: Estimation of glomerular function is necessary to diagnose kidney diseases. However, the study of glomeruli in the clinic is currently done indirectly through urine and blood tests. A recent imaging technique called Ultrasound Localization Microscopy (ULM) has appeared. It is based on the ability to record continuous movements of individual microbubbles in the bloodstream. Although ULM improved the resolution of vascular imaging up to tenfold, the imaging of the smallest vessels had yet to be reported. Methods: We acquired ultrasound sequences from living humans and rats and then applied filters to divide the data set into slow-moving and fast-moving microbubbles. We performed a double tracking to highlight and characterize populations of microbubbles with singular behaviors. We decided to call this technique “sensing ULM” (sULM). We used post-mortem micro-CT for side-by-side confirmation in rats. Findings: In this study, we report the observation of microbubbles flowing in the glomeruli in living humans and rats. We present a set of analysis tools to extract quantitative information from individual microbubbles, such as remanence time or normalized distance. Interpretation: As glomeruli play a key role in kidney function, it would be possible that their observation yields a deeper understanding of the kidney. It could also be a tool to diagnose kidney diseases in patients. More generally, it will bring imaging capabilities closer to the functional units of organs, which is a key to understand most diseases, such as cancer, diabetes, or kidney failures. Funding: This study was funded by the European Research Council under the European Union Horizon H2020 program (ERC Consolidator grant agreement No 772786-ResolveStroke).

In the context of renal proteinuric diseases, TRPC6 has been shown to play an important role in ultrafiltration associated with the slit diaphragm through the control of the intracellular Ca2+ concentration in the podocytes of glomeruli. However, to date, the properties of TRPC6 have been studied mainly in cell lines or in animal models. Therefore, the aim of the study presented here was to investigate the presence and distribution of TRPC6 in human kidneys in order to possibly verify the applicability of the results previously obtained in nonhuman experiments. For this purpose, kidneys from nine cadavers were prepared for immunohistochemical staining and were supplemented with a fresh human kidney obtained by nephrectomy. TRPC6 was detected in glomeruli and in the parietal epithelial cells of Bowman’s capsule. Larger amounts were detected in the tubular system and collecting ducts. In contrast to the peritubular capillary bed, which showed no immune reaction, the cortical resistance vessels showed mild TRPC6 staining. In conclusion, our studies on the expression of TRPC6 in human kidney tissue support the translational concept of the involvement of TRPC6 in various renal diseases and reveal new aspects of the distribution of TRPC6 in the human kidney.

Graphical Abstract

Given the current state of COVID-19, it is crucial to reveal its evolving relationship with and effect on different body organ systems and their diseases. The severity and outcome of COVID-19 have a very complex relationship, especially to the vital organs including the kidney, either in their state of health or disease. Additionally, it is well known that diabetes affects the kidney, leading to diabetic nephropathy. The kidney is also affected by different pathological and immunopathological reactions with COVID-19 infection, leading to acute kidney injury. Therefore, this review intended to extract the recent advances, updates, and discoveries about the effects of COVID-19 on diabetic patients and the relationship between COVID-19 invasion and the diabetic kidney and to discuss the current state of knowledge that has not yet been proved or disproved, leading to numerous controversial issues in looking for the effect of COVID-19 associated with diabetes mellitus on the human kidney.

Pannexins are transmembrane glycoproteins that constitute channels involved in purinergic signaling through ATP release from cells in various physiological and pathological processes. In this study, the distribution of Panx1 expression in different cell populations of healthy postnatal human kidneys and during human embryonic and early fetal development was investigated by double immunohistochemistry. In addition, the glomerular and tubular expression of Panx1 was examined in patients with type 2 diabetes mellitus (DM2) and the control group, and renal Panx1 expression was correlated with serum creatinine. In the 6th week of embryonic development (DW), Panx1 expression was found in mesonephric glomeruli and mesonephric tubules. At the transition from 6th to 7th DW, Panx1 immunoreactivity was found in the mesonephric tubules and mesonephric duct, as well as in the metanephric ureteric bud and ampullae. In the 7th DW, strong Panx1 immunoreactivity was observed in the developing ureteric bud in the metanephros, whereas no Panx1 immunoreactivity was found in the metanephric cup. In the 8th DW, Panx1 expression was also found in the ureteric bud of the metanephros, the renal vesicle and comma-shaped nephron, and the epithelial cells of Bowman’s capsule. Expression of Panx1 was found at an early stage in both the paramesonephric duct and the mesonephric duct and diminished toward the 8th DW. During the 6th–10th DW, colocalization of Panx1 with alpha smooth actin (aSMA) was found in developing blood vessels. In the postnatal kidney, strong Panx1 immunoreactivity was present in medullary and cortical collecting duct cells, renin-producing cells, and proximal tubules. Very weak Panx1 immunoreactivity was found in certain distal tubule cells and the thin descending limbs of the loop of Henle. Panx1 immunoreactivity was also found in nephrin-immunoreactive podocytes. Panx1 was not colocalized with aSMA immunoreactivity in the vessels of the postnatal human kidney, but it was present in the endothelium. A significant positive correlation was found between Panx1 expression in glomeruli and serum creatinine only in diabetic patients and was not found in the nondiabetic group. The spatiotemporal expression of Panx1 during the early stages of human kidney development supports its possible role in cellular differentiation, migration, and positioning in the developing human kidney. In addition, our data suggest that glomerular Panx1 expression is a potential indicator of worsening renal function in patients with type 2 diabetes.

Environmental food contaminants constitute a threat to human health. For instance, the globally spread mycotoxin Ochratoxin A (OTA) contributes to chronic kidney damage by affecting proximal tubule cells via unknown mechanisms. We applied a top-down approach to identify relevant toxicological mechanisms of OTA using RNA-sequencing followed by in-depth bioinformatics analysis and experimental validation. Differential expression analyses revealed that OTA led to the regulation of gene expression in kidney human cell lines, including for genes enriched in cell cycle-related pathways, and OTA-induced gap 1 and 2 (G1 and G2) cell-cycle arrests were observed. Weighted correlation network analysis highlighted cyclin dependent kinase 2 (CDK2) as a putative key regulator of this effect. CDK2 was downregulated by OTA exposure, and its overexpression partially blocked the OTA-induced G1 but not G2 cell-cycle arrest. We, therefore, propose CDK2 as one of the key regulators of the G1 cell-cycle arrest induced by low nanomolar concentrations of OTA.

The mature renal papilla is characterized by medullary collecting ducts, Henle’s loops, vasa recta and the interstitium. Cortical and medullary stromal cells are essential for the regulation of urine concentration and other specialized kidney functions. Mechanisms that direct the renal papilla development are not clearly understood. In recent years, the renal papilla has been identified as a niche for renal stem/progenitor cells in the adult mouse. Studies on experimental animals evidenced a probably common interstitial progenitor for the medullary and cortical stromal cells, characterized by the Foxd1+/PAX2- phenotype. Moreover, Hox10 and Hox11 expression is required for differentiation and patterning of the multiple subtypes of developing medullary interstitial cells. Given the scarcity of morphological and molecular studies on the human renal papilla, this work aimed to evidence morphological changes during human gestation, both in the architecture of the medullary interstitium and in cell types differentiating between the collecting tubules and the Henle’s loops. Future immunohistochemical studies are needed to better identify different interstitial cell types giving rise to the mature interstitium of the renal papilla.