Introduction: Acute Kidney Injury (AKI) is a frequent complication of kidney failure with high mortality, leading to brain dysfunction. This study aimed to investigate the possible protective effect of Ischemic Postconditioning (IPo) against brain dysfunction induced by Bilateral renal ischemia (BRI). Methods: Male Wistar rats underwent BRI, sham, or IPo surgery 24h and 1w after reperfusion. The rats’,explorative behaviors and motor function were evaluated by an open field, rotarod, and wire grip tests. The cognitive function was assessed by passive avoidance learning and Morris water maze tests. Western blotting was performed to evaluate hippocampal Brain-Derived Neurotrophic Factor (BDNF) expression. Results: The impairment of balance function induced by BRI was not reversed,however, passive avoidance learning impairment was reversed by postconditioning 24h after reperfusion. IPo increased muscle strength compared to the BRI group,however, explorative behaviors and balance function had no difference 1w after reperfusion. BRI significantly decreased the BDNF protein expression in the hippocampus, and postconditioning increased 24h after reperfusion. Conclusion: The obtained results demonstrated the deleterious effect of BRI on cognitive and balance function 24h after reperfusion. IPo indicated a curative effect against cognitive dysfunction probably by enhancing BDNF protein expression in the hippocampus.

One of the most common causes of mortality in acute kidney injury is brain dysfunction. Here we investigated the possible protective effect of erythropoietin (EPO) on cognitive impairments induced by Bilateral renal ischemia (BRI). Eighty male Wistar rats were allocated into 8 groups: 1, 2) Sham+V (Vehicle), 3, 4) Sham+EPO, 5, 6) BRI+V, 7, 8) BRI+EPO. The groups followed by the reperfusion periods of 24hours (24 h) and 1week (1w). EPO or saline was administrated 30 min before surgery (1000 IU/kg, i.p). The cognitive function was assessed by passive avoidance learning and Morris water maze tests. Hippocampal brain-derived neurotrophic factor (BDNF) protein expression was assessed by western blotting. BUN (blood urea nitrogen) and creatinine (Cr) concentrations were significantly increased in BRI+V group 24 h after reperfusion. BRI+V rats had just an increased level of BUN but not Cr 1w after reperfusion. EPO reversed passive avoidance learning impairments observed in BRI+V group 24 h after reperfusion. There were no significant differences in spatial and passive avoidance learning between experimental groups 1w after reperfusion and histological evaluation confirmed the behavioral data. BRI significantly decreased the BDNF protein expression in the hippocampus and EPO increased that 24 h after operation. These observations showed protective effect of EPO against cognitive dysfunctions following BRI 24 h after reperfusion through increase in BDNF protein expression.

renal artery stenosis now is one of the well recognized causes of Ischemic nephropathy and arterial Hypertension. It is one of the most challenging fields in medicine. Like other vascular anomalies, renal artery stenosis does not always have clinical outcomes. renal artery stenosis can be seen with accompanying of other vascular abnormalities like arterial duplication, but stenosis of all supplying arteries together is rare.Case Reportation: Patient is a 65 years old man, known case of poor control hypertension, chronic renal insufficiency and CVA, presented with diarrhea, repeated vomiting and deterioration of renal function. After clinical evaluation, patient underwent renal angiography and with Bilateral duplication and renal arteries stenosis in all four arteries, and then angioplasty was per formed. renal function returned to normal and blood pressure controlled.

This is a rare case report of Bilateral schwannoma in lower poles of both kidneys in a 36 year old Diabetic man. Preoperative radiographic evaluations suggested the presence of two solid retroperitoneal tumors attached to the lower poles of both kidneys without any regional or distant extension. The final diagnosis was confirmed by histological and immonohistological studies.