Podocyte and tubular involvement in AngioJet-induced kidney injury

Raquel Esteras; Pablo Cannata-Ortiz; Marta Del Palacio-Tamarit; Melania Guerrero-Hue; Cristina García-Caballero; Jesús Egido; Javier Gimeno; Alberto Ortiz; Carolina Gracia-Iguacel; Juan Antonio Moreno

doi:10.1093/ckj/sfz104

Podocyte and tubular involvement in AngioJet-induced kidney injury

Clin Kidney J. 2019 Aug 23;14(1):424-428. doi: 10.1093/ckj/sfz104. eCollection 2021 Jan.

Authors

Raquel Esteras^{1

2}, Pablo Cannata-Ortiz^{2

3}, Marta Del Palacio-Tamarit⁴, Melania Guerrero-Hue^{5

6}, Cristina García-Caballero^{5

6}, Jesús Egido^{1

7}, Javier Gimeno⁸, Alberto Ortiz^{1

2}, Carolina Gracia-Iguacel^{1

2}, Juan Antonio Moreno^{5

6}

Affiliations

¹ Department of Nephrology, Fundacion Jimenez Diaz Health Research Institute (IIS-FJD), Autonoma University of Madrid, Madrid, Spain.
² Red de Investigacion Renal, Madrid, Spain.
³ Department of Pathology, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.
⁴ Department of Internal Medicine, Fundacion Jimenez Diaz University Hospital, Madrid, Spain.
⁵ Renal, Vascular and Diabetes Research Laboratory, Fundacion Jimenez Diaz Health Research Institute, Autonoma University of Madrid, Madrid, Spain.
⁶ Department of Cell Biology, Physiology and Immunology, Maimonides Biomedical Research Institute of Cordoba, University of Córdoba, Córdoba, Spain.
⁷ Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain.
⁸ Department of Pathology, Hospital del Mar, Barcelona, Spain.

Abstract

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.

Keywords: AngioJet; acute kidney injury; haemoglobinuria; mechanical thrombolysis; podocyte; tubular cell.

Publication types

Case Reports