Abstract: SA-PO346
The Post-Stenotic Human Kidney Shows Microvascular Dropout and Remodeling
Session Information
- Hypertension and CVD: Mechanisms
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1403 Hypertension and CVD: Mechanisms
Authors
- Pawar, Aditya S., Mayo Clinic, Rochester, Minnesota, United States
- Eirin, Alfonso, Mayo Clinic, Rochester, Minnesota, United States
- Puranik, Amrutesh S., New York University Langone Health, New York, New York, United States
- Ferguson, Christopher M., Mayo Clinic, Rochester, Minnesota, United States
- Zhu, Xiang yang, Mayo Clinic, Rochester, Minnesota, United States
- Kim, Seo Rin, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
- Lerman, Amir, Mayo Clinic, Rochester, Minnesota, United States
- Textor, Stephen C., Mayo Clinic, Rochester, Minnesota, United States
- Lerman, Lilach O., Mayo Clinic College of Medicine, Rochester, Minnesota, United States
Background
In animal models, post-stenotic kidney shows microvascular rarefaction, with loss of small outer cortical vessels correlating with limited kidney recovery after revascularization. However, whether stenotic human kidney shows microvascular loss is incompletely understood. We tested the hypothesis that Renal srtery stenosis (RAS) leads to microvascular remodeling in human kidneys
Methods
Nephrectomy samples from 4 patients with obstructive RAS, & 5 discard donor kidneys (Lifesource, MN) as controls were collected after IRB approval. The renal arteries were cannulated & perfused at physiological pressure with an intravascular radiopaque contrast agent. The kidney was segmented, scanned with micro-CT at 20µm resolution, & 3D images reconstructed. Microvascular diameter & spatial density were quantified (Analyze™). Cortical vessels were tomographically isolated to calculate tortuosity (ratio of path/linear length) as a measure of angiogenic activity & vascular immaturity.
Results
Age (55-65 yrs), sex, & body mass index were similar in both groups. Spatial density of medium & large cortical micro vessels (200-500µm in size) was significantly diminished in outer & inner cortex in Renovascular disease (RVD) compared with normal kidneys (Fig. 1A-B). RVD kidneys showed significant loss of small (<200µm) micro vessels in the outer cortex, as well as an increase in microvascular tortuosity compared with normal kidneys, suggesting remodeling & compensatory angiogenic activity
Conclusion
The post-stenotic human kidney shows cortical microvascular loss & remodeling. These alterations may magnify deterioration of renal function & interfere with renal ability to recover upon treatment, supporting development of pro-angiogenic strategies to preserve the kidney