Table 3.

Studies reporting renal histopathological findings related to venous congestion, elevation of intra‐abdominal pressure or obstructive nephropathy

Study	Design	Cohort	Methods	Findings
Faustinella et al., 1997 103	Single‐centre case vignette	34‐year‐old woman with idiopathic pulmonary hypertension; systolic pulmonary arterial pressure > 74 mmHg, 24 h proteinuria 5 g, and creatinine clearance 70 mL/min	Diagnostic kidney biopsy including immunohistologic and ultrastructural evaluation	Glomerulomegaly, mesangial hypercellularity and sclerosis, focal tubular atrophy, and interstitial fibrosis and inflammation; the authors postulate that elevation of central venous pressure, with passive congestion and glomerular capillary hypertension, is primarily responsible for the observed changes
Experimental
Schachtrupp et al., 2002 67	Prospective interventional	Intubated and anaesthetized domestic pigs	CO2 pneumoperitoneum (intra‐abdominal pressure of 15 mmHg for 24 h)	Low‐grade proximal tubular epithelial necrosis was observed
Sato et al., 2003 104	Prospective interventional	Mice vs. sham‐operated mice (wild‐type and Smad3‐null)	Double‐ligation of right proximal ureter a	Wild‐type mice showed tubulointerstitial fibrosis associated with epithelial–mesenchymal transition of the renal tubules and collagen accumulation; this was prevented by lack of Smad3
Li et al., 2012 77	Prospective interventional	Intubated and anaesthetized mice vs. sham‐operated mice (C57BL/6)	Clamping of renal artery, vein, or both (whole pedicle) for 30 min followed by reperfusion	At 24 h after renal vascular clamping, both kidney function and histologic injury are the most severe in the renal vein clamping group
Chang et al., 2013 105	Prospective interventional	Mice (ICR)	Intraperitoneal injection of albumin and normal saline (intra‐abdominal pressure of 0, 5, 10, or 20 cm H2O)	Increasing degrees of diffuse interstitial oedema, renal tubular lumen collapse, and interstitial inflammation were observed with increasing intra‐abdominal pressure
Shimada et al., 2018 78	Prospective interventional	Intubated and anaesthetized Sprague–Dawley rats vs. sham‐operated rats	Ligature by suture of inferior vena cava between renal veins to allow comparison of congestive left kidneys with non‐congestive right kidneys	3 days after surgery, congestive left kidneys showed lesions in peritubular capillaries with pericyte detachment, up‐regulated pathways involved in extracellular matrix expansion and induction of expression of tubular injury markers (kidney injury molecule‐1) in stressed tubules; renal decapsulation ameliorated the tubular injury and profibrotic effects in the cortical region only
Owji et al., 2018 102	Prospective interventional	28 intubated and anaesthetized Sprague–Dawley rats	Bilateral clamping of the renal artery, vein, or both (whole pedicle) for 30 min followed by 2 h reperfusion; n = 7 in each group	At ~2 h after renal vascular clamping, both kidney dysfunction and histologic tubular injury were the most severe in the renal vein clamping group, with distinctive haemorrhagic congestion of peritubular capillaries in the cortex and medulla
Cops et al., 2018 101	Prospective interventional	Intubated and anaesthetized Sprague–Dawley rats (n = 7) vs. sham‐operated rats (n = 6)	Permanent surgical constriction (20 gauge) of thoracic inferior vena cava (increasing central venous pressure to a mean of 17 mmHg)	12 weeks after surgery, glomerular surface area and width of Bowman capsule increased significantly in the inferior vena cava group compared with the sham group; no difference in the acute tubular damage biomarker kidney injury molecule‐1

^a Experimental ureteral obstruction provides a model of obstructive nephropathy resulting in tubular injury and renal fibrosis. ¹⁰⁶