Fig 1.
Placement of ureteral catheter and balloon catheter for occlusion, irrigation and pressure measurement confirmed by fluoroscopic pyelography.
Table 1.
Primers used for qPCR.
Fig 2.
First MR-scan for each of the 5 animals with visual changes appearing as dark areas (arrows). In animal no. 4 the study was performed on the right kidney due to catheter placement failure on the left side. 1: 22 min—25 mmHg 2: 5 min– 20 mmHg 3: 25 min– 22 mmHg 4: 20 min– 22 mmHg 5: 5 min– 16 mmHg.
Fig 3.
Time series of MR-scans in 1 animal from baseline (0 mins) to end scan (80 mins) showing increased T1 values with rising intraluminal pressure (10 mmhg– 50 mmHg) in the right kidney. 0 min—10 mmHg 20 min– 22 mmHg 40 min– 31 mmHg 60 min– 40 mmHg 80 min– 50 mmHg.
Fig 4.
Fraction of whole cortex T1 changes as a function of time from baseline scan to 60 mins. scan for all 5 experimental animals. The curves are ended at 60 mins. as some of the experiments were ended at this time point. At 60 minutes a mean of 66% of the cortex was affected by intrarenal backflow.
Fig 5.
Final MR-scan for the 5 animals showing widespread T1 changes as dark areas (arrows) due to increased intraluminal pressure in the treated kidneys. Time range 60–80 mins; pressure range 20–54 mmHg. In animal no. 4 the study was performed on the right kidney due to ureteral catheter placement failure on the left side. 1: 72 min—51 mmHg 2: 60 min– 20 mmHg 3: 80 min– 40 mmHg 4: 80 min– 50 mmHg 5: 60 min– 54 mmHg.
Fig 6.
T1 vs accumulated pelvis pressure.
The development of T1 with increasing accumulated pressure (mmHg x min) was assessed by placing ROI’s in different segments of the kidneys, and plotting T1 as function of time x pressure. Left vertical axis: T1; right vertical axis: accumulated pressure; horizontal axis: time. Each graph represents the treated kidney of each of the 5 animals. Cortex remote: visibly non-affected area; cortex 1–4: visibly affected cortical areas; renal pelvis; medulla and dorsal muscle ROIs depicted by lines. Pressure at a given time depicted by colour filled area under the curve. T1 values in affected areas decrease as a function of increasing pressure/time.
Fig 7.
KIM-1 was not associated with any statical significant difference between the upper (U), mid (M) and lower (P) pole of the kidney (p = 0.044), nor between the ureteroscopically treated and the contralateral kidney (p = 0.18). No statistical significant difference was found between the kidney regions and between the contralateral and the ureteroscopic treated kidney respectively for NGAL (p = 0.38, p = 0.45), COX-2 (p = 0.75,p = 0.75), IL-1beta (p = 0.52,p = 0.42), IL-6 (p = 0.33,p = 0.80) and TNF-alpha (p = 0.65,p = 0.79). MCP-1 was on the other hand found to be statistical significant upregulated in the ureteroscopic treated (p = 0.04), while no regional difference was found (p = 0.55). Y-axis units: KIM-1 and NGAL: ng/ml. COX-2, IL-1beta, IL-6, MCP-1 and TNF-alfa: mRNA expression (qPCR marker/GAPDH ratio).
Fig 8.
The development of T1 with increasing pressure was assessed by placing ROI’s in different segments of the treated kidneys, and plotting T1 as function of time/pressure. Left vertical axis: T1; right vertical axis: pressure; horizontal axis: time. Each graph represents the treated kidney of each of the 5 animals. Cortex remote: visibly non-affected area; cortex 1–4: visibly affected areas; renal pelvis; medulla and dorsal muscle ROIs depicted by lines. Pressure at a given time depicted by colour filled area under the curve. T1 values in affected areas decrease as a function of increasing pressure/time.