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Abstract: We performed Pfannenstiel laparoendoscopic reduced‐port bilateral radical nephrectomy on a patient with renal cell carcinoma undergoing hemodialysis. A 4‐cm Pfannenstiel incision was made, and a GelPOINT access was inserted. Three trocars were placed through the access platform, and additional 5‐ and 3‐mm trocars were inserted in the umbilicus and paraumbilical area, respectively. After left nephrectomy, right nephrectomy was successfully completed in 401 min, with an estimated blood loss of 70 mL. There were no intraoperative or postoperative complications, and the patient was discharged 10 days postoperatively. The umbilical scar was concealed within the umbilical fold, and the scar from the 3‐mm trocar was almost invisible. The Pfannenstiel scar was minimal and concealed by the patient's underwear. Pfannenstiel laparoendoscopic reduced‐port simultaneous bilateral radical nephrectomy is a safe and technically feasible procedure that offers great cosmesis for patients with bilateral renal tumors and end‐stage renal disease. [ABSTRACT FROM AUTHOR]

AIMS It has been reported that cytochrome P450 (CYP)3A activity increases significantly in patients with end stage renal disease (ESRD) after kidney transplantation, withwide interindividual variability in the degree of increase. The aim of this studywas to evaluate the influence of CYP3A5 polymorphism on the increase in CYP3A activity after living kidney transplantation, by measuring the plasma concentration of 4ß-hydroxycholesterol. METHODS This prospective study recruited 22 patients with ESRD who underwent a first living kidney allograft transplantation, comprising 12 patients with CYP3A5*1 allele (CYP3A5*1/*1 or *1/*3) and 10 patients without CYP3A5*1 allele (CYP3A5*3/*3). RESULTS No significant difference in estimated glomerular filtration rate over time was observed between patients with the CYP3A5*1 allele and patients without the CYP3A5*1 allele, suggesting that the degrees of recovery in renal function after living kidney transplantation were similar in the two groups. However, plasma concentrations of 4ß-hydroxycholesterol on days 90 (57.1 ± 13.4 vs. 39.5 ± 10.8 ng ml-1) and 180 (55.0 ± 14.5 vs. 42.4 ± 12.6 ng ml-1) after living kidney transplantation were significantly higher in the presence of the CYP3A5*1 allele than in the absence of the CYP3A5*1 allele [P = 0.0034 (95% confidence interval of difference 6.55, 28.6) and P = 0.043 (95% confidence interval of difference 0.47, 24.8), respectively], suggesting that CYP3A activity may increasemarkedly associated with recovery of renal function in patients with the CYP3A5*1 allele. CONCLUSIONS These findings suggest that the presence of the CYP3A5*1 allele contributes to marked elevation of CYP3A activity associated with recovery of renal function after kidney transplantation. [ABSTRACT FROM AUTHOR]

Background. Monocyte chemoattractant protein (MCP)-1 is closely related to the pathogenesis of the progression of various chronic renal diseases, including IgA nephropathy (IgAN), through its chemoattractant effect on macrophages. However, the correlation of MCP-1 gene polymorphism with the long-term prognosis of Japanese patients with IgAN has not been clearly determined yet. Methods. We investigated 277 Japanese patients diagnosed with IgAN based on renal biopsy to clarify the association between the progression of IgAN and MCP-1 gene polymorphism at position A-2518G, which regulates the transcription of the MCP-1 gene. Results. The incidence of endstage renal disease was signifi- cantly higher in patients with the AA genotype (47.1%) compared to those with the AG (24.1%) or GG (27.4%) genotype (P = 0.024). Moreover, Kaplan-Meier analysis revealed that the AA genotype significantly facilitated the progression of renal disease (log rank; P = 0.0029), and Cox proportional hazards regression model analysis showed that the AA genotype represented a 2.058-fold risk for the progression of renal disease (P = 0.026) compared to the AG/ GG genotype. However, when the patients were treated with angiotensin-converting enzyme inhibitor and/or angiotensin receptor blocker, or corticosteroid, homozygosity for the -2518A allele was not associated with a higher rate of incidence of endstage renal disease. Serum MCP-1 levels were higher although not significantly so, in the patients with IgAN possessing the AA genotype. Conclusions. The AA genotype at MCP-1 -2518 was an independent risk factor for the progression of renal disease in Japanese patients with IgAN, and was closely associated with renal survival. [ABSTRACT FROM AUTHOR]

The article presents information on a haplotype that has an association with the development of IgA nephropathy (IgAN). The frequency of the haplotype, which includes major alleles of each SNP in this linkage disequilibrium block, was significantly low in IgAN patients. The protocol study was approved by the ethics committee of the institution with written informed consent for the genetic studies from all participants.

The article examines the regulatory effect of bezafibrate (BZF), a ligand, on glomerulonephritis using rat anti-glomerular basement membrane (GBM) nephritis model. The histopathological alteration induced by rabbit anti-GBM serum rats treated with BZF was marked attenuated. Severe pathological changes such as necrotizing glomerulitis were observed in rats injected with anti-GBM antiserum. The regulatory actions of BZF on immune cells might be responsible for the suppressive effect on the development of rat anti-GBM nephritis.