BASIC, CLINICAL, AND SURGICAL NEPHROLOGY

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1 BASIC, CLINICAL, AND SURGICAL NEPHROLOGY

2 DEVELOPMENTS IN NEPHROLOGY Cheigh JS, Stenzel KH, Rubin AL: Manual of clinical nephrology of the Rogosin Kidney Center ISBN Nolph KD ed.: Peritoneal dialysis ISBN Gruskin AB, Norman ME eds: Pediatric nephrology ISBN Schuck 0 ed: Examination of the kidney function ISBN Strauss Jed: Hypertension, fluid-electrolytes and tubulopathies in pediatric nephrology ISBN Strauss Jed: Neonatal kidney and fluid-electrolytes ISBN X. Strauss Jed: Acute renal disorders and renal emergencies ISBN Didio LJA, Motta PM eds: Basic, clinical, and surgical nephrology ISBN Friedman EA, Peterson CM eds: Diabetic nephropathy: Strategy for therapy ISBN Dzurik R, Lichardus B, Guder Weds: Kidney metabolism and function ISBN DiDio LJA, Motta PM eds: Basic, clinical, and surgical nephrology ISBN

3 Basic, Clinical, and Surgical Nephrology edited by L.J.A. DIDIO Department of Anatomy Medical College of Ohio Toledo, Ohio, USA P.M. MOTTA Department of Anatomy Faculty of Medicine University of Rome Rome, Italy 1985 MARTINUS NIJHOFF PUBLISHING a member of the KLUWER ACADEMIC PUBLISHERS GROUP BOSTON / DORDRECHT / LANCASTER

4 Distributors for the United States and Canada: Kluwer Academic Publishers, 190 Old Derby Street, Hingham, MA 02043, USA for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited, Falcon House, Queen Square, Lancaster LA1 1RN, UK for all other countries: Kluwer Academic Publishers Group, Distribution Center, P.O. Box 322, 3300 AH Dordrecht, The Netherlands Book information ISBN-I3: Library of Congress Cataloging in Publication Data MB1n entr,y under title: Basic, clinical., and surgical. nephrology_ (Developments in nephrology) Includes bibliographies and index 1. Kidneys-Diseases. 2. Nephrology. I. DiDio, Liberato J. A., II.!btta, Pietro M. III. Series. CDlIIM: 1. Kidney-anatoll\Y " histol'ogy. 2. Kidney Diseases. Wl DE99BEB I WJ 300 B311J RC9Q3.B ' ISBN-13: e-isbn-13: DOl: / Copyright 1985 by Martinus Nijhoff Publishing, Boston. Softcover reprint of the hardcover 1st edition 1985 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publishers, Martinus Nijhoff Publishing, 190 Old Derby Street, Hingham, MA 02043, USA.

5 To our late beloved Professor Enzo Nesci, former chairman of the Department of Normal Human Anatomy, University of Palermo, whose premature death left an unfillable gap in our field of study and in our friendship. To the late Harry Goldblatt in commemoration of the fiftieth anniversary of the experimental production of renal hypertension ( ).

6 Foreword This unique volume may very well foreshadow the treatment of renal disease in the twenty-first century. The editors have obviously compiled and reviewed the current clinical problems in which the kidney plays a major role. They then selected as topics for chapters those in which recent scientific investigations have added significant new data. The investigators themselves or their peers have been persuaded to produce a summary of current concepts of renal structure and function for each topic. The result is a volume which will be as invaluable as a clinical guide on the laboratory bench as it will be a reference for the clinician seeking guidance to rational therapy at the bedside. The strength of the volume lies in the incorporation of those data on renal cellular structure and function which hold the key to the etiology of the majority of renal diseases we now call 'end-stage'. Fully, two-thirds of the volume is devoted to current concepts of renal function and related subcellular structure of various renal tissues. The illustrations, correlations, and explanations are superbly presented in much detail and with an obvious effort to fill out the current knowledge of each subject. We may anticipate this book will remain a valuable reference for many years to come. o In the past quarter century, we have dramatically prolonged life in patients with end-stage renal disease by substitution or support of renal function. Before the next century, we may begin the process of definition, arrest or reversal of renal attrition, are ultimately prevention of many or all of these diseases. If so, much of the currently available fundamental data and the basic patterns of approach to the problem may already be assembled in 'Basic, Clinical, and Surgical Nephrology'. May 7,1985 Prof. Dr. William H. Boyce Department of Surgery (Urology) The Bowman Gray School of Medicine of Wake Forest University Winston-Salem, North Carolina, USA

7 Preface In view of the numerous and diverse scientific and medical developments related to the kidney that have occurred within the last few decades, the editors have been prompted to present in condensed and comprehensive form a monograph centering on certain basic, clinical, and surgical aspects of this organ. The focus of each chapter represents what has been considered meaningful by the contributors selected to write this book as well as what is considered of interest to clinicians and scientists. The book covers the major areas of nephrology, the concept of which is here understood in its broadest sense. The text includes basic knowledge and its application to both clinical and surgical aspects of the kidney. The selection of the topics represents the areas in which, in the view of the editors, new scientific, clinical, and therapeutic trends are developing. The aim of this volume is to offer both a balanced combination of general and specialized knowledge on the structural, functional, pathological, clinical, and surgical aspects of the kidney for the use of nephrologists, physicians, residents, and medical students. Anatomical aspects of the kidney have been limited to the recent recognition, description, and surgical application of segmentation as a background for partial nephrectomy. Special findings in the left renal vein were detailed as well as some of its embryological aspects. Renal embryogenesis, and light and electron microscopy of the kidney, including its vasculature, preceded scientific data on tubular transport. Another chapter has been devoted to immunological aspects owing to their importance in renal transplantation. Glomerular and vascular diseases of the kidney have been followed by electron microscopic aspects of renal biopsies. Dialysis, radiological, clinical, and surgical aspects of nephrology complete the contents of this monograph, which also represents an attempt to make such knowledge readily accessible to the generally interested reader. The emphasis on cell biology of the kidney has been intentional because it is felt that even general practitioners today should be aware of the intricacies of cell biology to understand and utilize their recently developed technology, such as in transplants. On the other hand, basic scientists have to be completely familiar with clinical problems for their investigations, from the planning of each research project to the interpretation of findings. This book should serve as a source also for this kind of information to assist both investigators and practitioners dealing with the kidney. The authors rely on the reader's indulgence with regard to omissions or errors, hoping to be notified of any such occurrences for deletion or correction in future editions. The editors wish to express their gratitude to the authors who so kindly contributed to this book. We wish to acknowledge as well the effort and dedication of Mr. J. Smith and his colleagues of the Martinus Nijhoff Publishing staff in the preparation of this book. September 13, 1984 Liberato J.A. DiDio Pietro M. Motta

8 Table of contents Foreword by Prof. Dr. William H. Boyce VII Preface IX List of contributors XIII 1. Segments of the Kidney: the Anatomical Basis for Nephrosegmentectomy by Liberato J.A. DiDio 1 2. Anatomical and Embryological Aspects of the Renal Venous Drainage by Liberato J. A. DiDio and Pietro M. Motta Embryogenesis of the Kidney by Cesare de Martino and Lidia Accinni Microscopic Structure of the Kidney by Cesare de Martino, Delmas J. Allen and Lidia Accinni Renal Vasculature as Observed by SEM of Vascular Casts. Basic, Architecture, Development and Aging of Glomerular Capillary Beds by Takuro Murakami, Akio Kikuta, Aiji Ohtsuka and Tetsuji Kaneshige Subcellular Structure of the Renal GlQmerulus by Tsuneo Fujita and Masayuki Miyoshi Recent Research on Some Aspects of Proximal Tubular Transport Phenomena by Paul H. Brand Immunologic Aspects of Renal Transplantation by David Senitzer Current Concepts of Glomerular Diseases by Amira F. Gohara and Peter J. Goldblatt Renal Vascular Diseases: Their Relationship to Hypertension by Peter J. Goldblatt and Amira F. Gohara... '"..., Renal Biopsies: Glomerular Subcellular Features by Silvia Casanova and Renzo Laschi Dialysis by Michael I. Sorkin Radiological Modalities in the Examination of the Kidney by Jean Paquelet and A. John Christoforidis... '"

9 14. Clinical Aspects of Renal Insufficiency Induced by Drugs and Hepatic Disease by Joseph V. Nally Jr., Michael L. Gross, and James T. Higgins Jr Surgical Aspects of Nephrology by Kenneth A. Kropp Index

10 List of contributors Accinni, Lidia, Clinica Medica II, University of Rome, Rome, Italy Allen, Delmas, J., Department of Anatomy, Medical College of Ohio, C.S , Toledo, OH 43699, Brand, Paul, Department of Physiology, Medical College of Ohio, C.S , Toledo, OH 43699, Casanova, Silvia, Department of Clinical Electron Microscopy, University of Bologna, Policlinico S. Orsola, Bologna, Italy Christoforidis, A. John, Department of Radiology, Ohio State University, Columbus, OH 43210, De Martino, Cesare, Regina Elena Institute for Cancer Research, Viale Regina Elena 291,00161 Rome, Italy DiDio, Liberato J.A., Department of Anatomy, Medical College of Ohio, C.S , Toledo, OH 43699, Fujita, Tsuneo, Department of Anatomy, Niigata University School of Medicine, Asahi-Machi, Niigata 951, Japan Gohara, Amira F.., Department of Pathology, Medical College of Ohio, c.s , Toledo, OH 43699, Goldblatt, Peter J., Department of Pathology, Medical College of Ohio, C.S , Toledo, OH 43699, Gross, Michael L., Department of Medicine, Medical College of Ohio, C.S , Toledo, OH 43699, Higgins, James T., Department of Medicine, Medical College of Ohio, C.S., 10008, Toledo, OH 43699, Kaneshige, Tetsuji, Kidney Research Laboratory, Okayama Chuo Hospital, Okayama 700, Japan Kikuta, Akio, Department of Anatomy, Okayama University Medical School, Okayama 700, Japan Kropp, Kenneth A., Department of Surgery, Medical College of Ohio, C.S , Toledo, OH 43699, Laschi, Renzo, Department of Clinical Electron Microscopy, University of Bologna, Policlinico S. Orsola, Bologna, Italy Miyoshi, Masayuki, Department of Anatomy, Fukuoka University School of Medicine, , Nanakuma, Jonan-Ku, Fukuoka , Japan Motta, Pietro M., Department of Anatomy, Faculty of Medicine, University of Rome, Viale Regina Elena 289, Rome, Italy

11 XIV Murakami, Takuro, Department of Anatomy, Okayama University Medical School, and Kidney Research Laboratory, Okayama Chuo Hospital, Okayama 700, Japan Nally Jr., Joseph V., Department of Medicine, Medical College of Ohio, C.S., 10008, Toledo, OH 43699, Ohtsuka, Aiji, Department of Anatomy, Okayama University Medical School, Okayama 700, Japan Paquelet, Jean, Department of Radiology, The Ohio State University College of Medicine, Columbus, OH 43210, Senitzer, David, Department of Microbiology, Medical College of Ohio, C.S , Toledo, OH 43699, Sorkin, Michael I, Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, PA 15261,

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Atlas of Male Reproductive Pathology Current Histopathology Consultant Editor Professor G. Austin Gresham, TO, SeD, MO, FRC Path. Professor of Morbid Anatomy and Histology, University of Cambridge Volume