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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The best definition of risk factors for renal injury, irrespective of the aetiological agent, comes from observations in patients with acute renal failure. From such observations, two subdivisions have evolved, i.e., acute insults and host risk factors. Acute renal insults include: hypertension, sepsis, use of nephrotoxic drugs (e.g., aminoglycoside antibiotics and contrast media), haemoglobinuria or myoglobinuria, liver disease and extracellular volume depletion. Host risk factors include: advanced age, hypertension, gout and hyperuricaemia, diabetes mellitus, chronic renal failure and use of diuretics. Furthermore, the mechanism of acute renal injury can be correlated with different risk factors: for a tubular toxic agent, acting either directly on the cells or haemodynamically, a dose-dependency is characteristic; while for immunologically mediated injury, genetic predisposition is more important. The identification of risk factors for chronic toxic injury is confounded by the possibilities of multiple episodes of subclinical renal injury, the distinct possibility that a major component of the ageing process may be a loss of renal reserve, and a progressive body burden, of, e.g., cadmium, which may deplete intrinsic protective mechanisms. However, clinically relevant risk factors can alert the clinician to exercise additional caution when prescribing medications that are potentially nephrotoxic. Such factors include dehydration, pre-existing renal disease, age, co-existing diseases that cause renal ischaemia, gender, concomitantly administered drugs, and electrolyte abnormalities.
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PMID:Risk factors for toxic nephropathies. 265 33

A forty-two year-old man with left epididymo-testicular malakoplakia was reported. Thirty-two cases of testicular malakoplakia with (5 cases) and without (27 cases) epididymal malakoplakia were reviewed. The mean age was 48. 2 year-old. Two-thirds of the cases suffered from right side involvement. All cases except a few cases received orchiectomy within 2.6 months on average from the onset of the symptoms. Diabetes mellitus, malignant diseases, or chronic renal failure seem to have a causal relation to the development of testicular malakoplakia. Six cases of epididymal malakoplakia were also reviewed.
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PMID:[A case of malakoplakia of the testis and epididymis]. 266 1

Between February 1963 and January 1988, 174 patients were treated for acute and 307 for chronic renal failure by dialysis in the St. Joseph Hospital Eindhoven, a general hospital. Sixty-two per cent of the patients treated for acute renal failure had tubular necrosis as a cause. In the patients treated for end-stage renal disease the median age of the dialysis population increased from 37 to 62 years. Vascular renal disease and diabetes mellitus were more frequent during the last ten years. Because of the inflow of older people, the outflow by death increased strongly, while the outflow by transplantation remained stable during the last 15 years. Due to an active transplantation policy together with haemodialysis at home and CAPD, 66% of the total now living patient population could be discharged from the dialysis department. Infection and cardiovascular accidents were the major causes of morbidity and mortality among the dialysis and transplant patients. Overall survival curves of all treated patients showed a 5-year survival of 60% and a 10-year survival of 42%.
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PMID:[25 years of kidney replacement treatment at a general hospital]. 267 33

The simultaneous, complete rupture of both quadriceps tendons is a rare event. Only 30 previous cases have been reported and the majority have had well-documented predisposing factors, such as chronic renal failure, gout, hyperparathyroidism, diabetes and obesity. We report a case which presented without any predisposing cause, and review the literature to date.
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PMID:Simultaneous bilateral rupture of the quadriceps tendon. 269 88

Plasma potassium lowering effect of a selective beta-2 adrenergic stimulant, terbutaline sulfate (TRB) was investigated in fourteen patients with chronic renal failure (CRF) receiving maintenance hemodialysis. Fourteen CRF patients with chronic glomerulonephritis (CGN) (5 male, 2 female) and diabetes mellitus (DM) (3 male, 4 female) were infused with 0.4 mg TRB dissolved in 100 ml of 10% maltose solution. Serum potassium level in the CGN group significantly (p less than 0.01) decreased after 20 minutes infusion and maximum lowering effect (1.1 mEq/l) was obtained 40 minutes after the start. On the other hand, the maximum lowering effect of serum potassium level in the DM group (0.77 mEq/l) was obtained 60 minutes after the start. No serious metabolic and hemodynamic side effect was observed except only slight transient tachycardia in 2 CGN patients and 3 DM patients. Thus, a beta-2 selective adrenergic stimulant, terbutaline sulfate may be useful for acute treatment of hyperkalemia in CRF patients by way of the stimulation of potassium uptake in the cells.
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PMID:[A new treatment of hyperkalemia in renal failure with selective beta 2-adrenergic stimulant, terbutaline sulfate]. 274 8

An integrated approach is described for the computerized management of a nephrology department. On a medical point of view, the system comprises a minimum medical record for every patient, different specialized records and knowledge bases presently covering hypertension, diabetes and chronic renal failure. From a technical point of view, the methodology used integrates data and knowledge management techniques. Various individual reports facilitate patient management. For hypertensive patients, an expert system is combined with the record system. The results of a preliminary evaluation are reported and future developments considered.
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PMID:Computerized patient management in a nephrology department. 276 69

We tested the new radioimmunoassay method of serum phospholipase A2 (PLA2). In healthy individuals, serum PLA2 concentrations were 301 +/- 65.6 ng/dl (mean +/- SD), and in patients with acute pancreatitis, significant elevations of serum PLA2 concentrations were observed. In clinical course of acute pancreatitis, serum PLA2 was maintained high level more longer than serum amylase and elastase 1. In patients with chronic pancreatitis, serum PLA2 concentration were low at a stage of severe exocrine dysfunction, and high at a stage of acute exacerbation. In patients with pancreatic cancer, serum PLA2 concentration were changed in accord with severity of disease states. After endoscopic retrograde pancreatography, serum PLA2 levels immediately elevated significantly, and returned to basal levels 24 hours later. Serum PLA2 concentrations were within normal range in patients with other malignant tumors, diabetes mellitus, chronic liver diseases, and hypertension, whereas in patients with chronic renal failure serum PLA2 concentrations were elevated. These results suggest that measurement of serum PLA2 can be clinically useful for diagnosis of pancreatitis and monitoring of mild and severe stage of pancreatitis.
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PMID:[Clinical studies of serum phospholipase A2 immunoreactivity]. 279 50

We report a case of renal cell carcinoma on maintenance dialysis for chronic renal failure. A 61-year-old male, treated for diabetes mellitus for 20 years, developed diabetic nephropathy and has been put on maintained hemodialysis during the past 2 years. He complained of asymptomatic hematuria. Computed tomographic scan and renal angiography suggested the presence of a malignant neoplasm in his right kidney. He underwent right nephrectomy, and hemodialysis was resumed on the 4th day post operation. Pathologic examination revealed renal cell carcinoma, clear cell type, together with hyalinized glomeruli, where an acquired cystic change was not detected.
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PMID:[A case of renal cell carcinoma on chronic hemodialysis]. 281 3

In a controlled study, equipotent doses of atracurium (20 patients) or vecuronium (22 patients) were given randomly to patients with chronic renal failure anaesthetized for renal transplantation. There were no statistically significant differences in the degree of muscle relaxation (electromyographic twitch response) and circulatory parameters. Plasma histamine concentration increased in three patients after the first dose of atracurium, but in none of the patients could any signs of allergic reactions be observed. Tracheal intubation was difficult in six patients of the atracurium group, all of whom had diabetes mellitus and varying degrees of neck stiffness. The neuromuscular block response in diabetic uraemic patients was similar to that in other uraemic patients.
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PMID:Comparison of atracurium and vecuronium in anaesthesia for renal transplantation. 288 52

Between January 1976 and December 1987, 278 patients (172 men, 106 women) aged over 15 and living in a region of some 400,000 inhabitants were treated with dialysis for end-stage chronic renal failure (CRF). The annual incidence of new cases treated was evaluated separately for 3 consecutive 4-year periods: 1976-79 (period A), 1980-83 (period B) and 1984-87 (period C). The incidence rose from 4.6-4.9 in periods A and B to 7.8/100,000 in period C, i.e. a 38 per cent progression. At the start of dialysis the mean age of women did not significantly vary throughout the 3 periods, whereas it increased significantly in men during period C. There was a significant increase of primary glomerulonephritis (GN) throughout the 3 periods: 1.25, 1.70 and 2.35/100,000 respectively; this disease accounted for 27.3, 34.6 and 30.6 per cent of all causes of CRF. Similarly, the incidence of secondary nephropathy (diabetes, amyloidosis) treated with dialysis increased from 0.6 (A) to 1.0 (B) and 1.9/100,000 (C) (P less than 0.05 with period A). The same happened with polycystic kidney: 0.25, 0.65 and 0.93/100,000. During period C, when 95 per cent of primary GN were diagnosed histologically, igAGN (13 per cent), diabetes (13 per cent) and polycystic kidney (12 per cent) were the main causes of CRF. During the whole 12-year period under study, when 80 per cent of primary GN were diagnosed, the prevalence of causes of CRF varied according to the patients' age. In patients under 65 at the start of dialysis primary GN were the principal causes of CRF (36.8 per cent, including 15.5 per cent of IgAGN), followed by secondary nephropathies (20.3 per cent, including 10.7 per cent of diabetes), chronic interstitial nephropathies (18.7 per cent, including 9.6 per cent of reflux nephropathy), hereditary nephropathies (14.4 per cent, including 10.7 per cent of cystic kidney) and vascular nephropathies (7 per cent). Above the age of 65, the principal causes of CRF were chronic interstitial nephropathies (27.7 per cent, including 8.9 per cent of drug-induced nephropathy), followed by secondary nephropathies (20 per cent, including 6.7 per cent of amyloidosis and 11.1 per cent of diabetes), vascular nephropathies (20 per cent), primary GN (12.2 per cent), and hereditary nephropathies (12.2 per cent) including 11.1 per cent of polycystic kidney).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Epidemiology of chronic renal insufficiency treated by dialysis in a region in France. Changes in a 12-year period]. 297 86


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