Esteras Raquel, Cannata-Ortiz Pablo, Del Palacio-Tamarit Marta, Guerrero-Hue Melania, García-Caballero Cristina, Egido Jesús, Gimeno Javier, Ortiz Alberto, Gracia-Iguacel Carolina, Moreno Juan Antonio
Department of Nephrology, Fundacion Jimenez Diaz Health Research Institute (IIS-FJD), Autonoma University of Madrid, Madrid, Spain.
Red de Investigacion Renal, Madrid, Spain.
Clin Kidney J. 2019 Aug 23;14(1):424-428. doi: 10.1093/ckj/sfz104. eCollection 2021 Jan.
The AngioJet technique combines localized thrombolysis and percutaneous mechanical thrombectomy (PMT). However, PMT may cause acute kidney injury (AKI), which has been ascribed to severe mechanical haemolysis, although no renal biopsies have been reported. We now report the first renal biopsy in a patient with AKI following PMT. There is histological evidence of haemoglobin (Hb)-induced tubular injury and podocyte stress characterized by intracellular Hb and staining for ferritin and hemo-oxygenase-1, suggestive of an adaptive response to oxidative stress. This confirms that Hb is involved in kidney cell injury and supports the existence of several different kidney cellular targets.
AngioJet技术结合了局部溶栓和经皮机械血栓切除术(PMT)。然而,PMT可能导致急性肾损伤(AKI),这被归因于严重的机械性溶血,尽管尚无肾活检报告。我们现在报告首例PMT后发生AKI患者的肾活检情况。有组织学证据表明存在血红蛋白(Hb)诱导的肾小管损伤和足细胞应激,其特征为细胞内Hb以及铁蛋白和血红素加氧酶-1染色阳性,提示对氧化应激的适应性反应。这证实Hb参与了肾细胞损伤,并支持存在几种不同的肾细胞靶点。