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Query: UMLS:C0022116 (ischemia)
91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic renal failure and its sequelae, particularly secondary hyperparathyroidism, may be associated with spontaneous quadriceps tendon ruptures. This is a report of two cases of bilateral spontaneous simultaneous quadriceps tendon ruptures in uremia and a review of the literature. The level at which the tendon ruptures is inconstant. Light microscopy reveals nonspecific changes of degeneration and calcification. Under electron microscopy, the structure and maturity of collagen fibers are normal. The ruptures occur in patients younger than 40 years of age who reject medical treatment (i.e. oral phosphate binder) and have long-standing renal disease (mean = 12.3 years). The predisposing causes of rupture are unknown. An abnormality of collagen metabolism, ischemia, direct effects of parathormone, and dystrophic calcification are some of the possible contributory factors.
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PMID:Quadriceps tendon ruptures in uremia. 397 53

Over a 10-year period, positive criteria of the Howard test and the Rapoport Index have shown consistently good correlation with sustained relief or marked improvement in hypertension, in patients with main renal artery lesions. Similar correlation was obtained with ischemic criteria from histopathologic studies.Differential function studies did not reveal positive ischemic criteria in any patient operated upon for unilateral parenchymal disease. Histopathologic criteria of ischemia were also infrequent in this group. Nevertheless, marked improvement or cure of hypertension occurred in 62% of the latter. No factor can be used to predict improvement in this type of renal hypertension. Differential renal function criteria may occasionally appear to indicate renal artery ischemia in the more normal kidney in patients with unilateral parenchymal renal disease; wrong interpretation is avoided by taking differential creatinine clearance into account. Until vasopressor substances can be easily measured and accurately interpreted, aortography is indicated in selected patients.
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PMID:Differential renal function studies in the diagnosis of renal hypertension. 543 68

Oliguric acute renal failure in man is characterized by intense outer cortical vasoconstriction and a marked increase in preglomerular resistance. The degree of preglomerlar resistance change needed to cause the expected 50 to 80 percent fall in blood flow far exceeds the level that would totally abolish filtration. By contrast, equal 3.0-fold increases in both pre- and postglomerular resistance provide this same degree of ischemia but leave filtration very well maintained. Such a scenario seems unlikely, however, since it would entail a mere 15 to 25 percent decrease in preglomerular resistance vessel caliber rather than the extreme attenuation observed. By contrast, there are reasons to believe that preglomerular constriction may be accompanied by postglomerular vascular relaxation. In sum, unless cortical ischemia reflects precisely matched increases in pre- and postglomerular resistances, filtration failure is inevitable in human vasomotor nephropathy.
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PMID:Hemodynamic basis for human acute renal failure (vasomotor nephropathy). 623 61

From March, 1976 to June, 1983, 22 patients (10 males, 12 females) treated by maintenance hemodialysis were autopsied in our department. Primary diseases of the autopsied cases were chronic glomerulonephritis (12 cases), diabetes mellitus (three cases), hydronephrosis (three cases), systematic lupus erythematosus (two cases), myeloma kidney (one case) and atherosclerosing nephropathy (one case). Direct causes of death in maintenance hemodialysis patients were bleeding (six cases), uremia (three cases), infection (three cases), carcinoma (four cases), heart failure (two cases), myocardial infarction (one case), brain ischemia (one case), cardiac tamponade (one case) and unknown (one case).
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PMID:Autopsy findings in maintenance hemodialysis patients. 653 69

Thirty-five cases of renal medullary crest necrosis morphologically similar to the renal papillary necrosis of analgesic nephropathy as described in man and rats are reported in horses receiving maintenance dosages of phenylbutazone. The primary lesion is a well-demarcated focal medullary necrosis resulting in sequestration of fragments of the renal crest. Renal cortical lesions are considered secondary to the medullary necrosis and consist of segmental pallor as a result of tubular dilatation, filtrate retention, and interstitial edema. Ischemia in concert with phenylbutazone is suggested as the etiology. Renal medullary crest necrosis is presented as more appropriate morphological terminology for this lesion in the equine species than renal papillary necrosis as is used in man and rats.
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PMID:Renal medullary crest necrosis associated with phenylbutazone therapy in horses. 664 37

To determine whether preexistent glomerular injury and the nephrotic syndrome increase renal susceptibility to ischemic renal injury, normal rats and rats with either experimental minimal-change disease (Adriamycin nephropathy) (AN) or membranous nephropathy (passive Heymann nephritis) (PHN) underwent renal functional and histologic studies under either basal conditions or 18 h after bilateral renal artery occlusion (over 30 min). Prior to renal ischemia AN and PHN rats had minimally depressed glomerular filtration rate (GFR), normal (AN) or increased (PHN) renal blood flow (RBF), heavy proteinuria, hypoalbuminemia, decreased urine sodium excretion, extensive glomerular foot process fusion, and intratubular hyalin cast formation. Losses of GFR in response to ischemia were comparable among the three groups of rats (controls, 0.29; AN, 0.28; PHN, 0.25 ml X min-1 X 100 g body wt-1) despite prevailing differences in postischemic hemodynamics. Neither light nor transmission electron microscopy showed any differences in the degree of ischemic renal injury. These results suggest that 1) glomerulopathy and the nephrotic syndrome do not significantly increase renal susceptibility to ischemic renal injury; 2) the syndrome of acute renal failure that occurs in patients with minimal-change glomerulopathy is not due to a marked susceptibility of these kidneys to clinically occult ischemic events; and 3) foot process fusion is probably not a pathophysiologically significant lesion in ischemic acute renal failure, as previously suggested.
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PMID:Glomerulopathy does not increase renal susceptibility to acute ischemic injury. 670 61

Fifty perfused cadaver kidneys transplanted in this institution were statistically analyzed with an IBM computer to determine the most important prognostic factors in long-term actual function, namely, the kidney donor warm ischemia, length of preservation, the perfusion characteristics (flow, pressure, perfusate gases, and occasionally electrolytes and osmolarity), and the recipient's response and clinical history (age, sex, race, original renal disease, HLA-antigen matching, number of transplants, number of rejection episodes, kidney function, final outcome, etc.). Although we found no significant (P greater than 0.05) correlation between graft survival and the parameters studied, high perfusate flow appeared to have an important beneficial effect on long-term graft function. Other prognostic indicators of posttransplantation renal function were not clearly seen in our study. It is important to mention that although no significant (P greater than 0.05) differences were seen, patients without diabetes mellitus, first cadaver kidney transplants, and more than two HLA-antigen matches did better than the group without these characteristics.
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PMID:Are there any important predicting factors of renal function during hypothermic pulsatile perfusion for transplantation? 699 29

Predicting the outcome of human renal allografts based on studies of one hour biopsy specimens is still controversial. We have tried to correlate histologic, ultrastructural, and immunofluorescence findings in 96 one hour biopsy specimens with histocompatibility matching, the presence of preformed antibodies, allograft ischemia and preservation times, the donor's age, the original renal disease, and allograft source, function, and survival. Ultrastructurally, 22 allografts had fibrin deposits in glomerular loops. There was a significant correlation between this finding and poor allograft function (p < 0.01), cold ischemia time (p < 0.02), and cadaveric allograft source (p < 0.01). Sixteen allografts showed epithelial cell detachment from tubular basement membranes. This finding correlated with cadaveric allograft source (p < 0.01). Many other morphologic changes were evaluated by both light and electron microscopy, but they did not bear any significant relationship to any of the aforementioned clinical parameters. Of 30 biopsy specimens studied by direct immunofluorescence, 11 showed positive findings (immunoglobulins or C3) in either glomeruli, vessels, or both. There was no significant correlation between these findings and the clinical parameters.
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PMID:Histologic, ultrastructural, and immunomicroscopic findings in 96 one hour human renal allograft biopsy specimens. Immunologic and clinical significance. 699 67

Renal cholesterol embolization can occur spontaneously or as a complication of aortic surgery or major vessel angiography in patients with diffuse atherosclerosis. The demonstration of characteristic cholesterol crystals in tissue biopsy specimens is a pathognomonic finding. However, renal cholesterol embolism may be clinically diagnosed when renal failure develops after known inciting factors or together with systemic manifestations of atheromatous embolization such as lower extremity livedo reticularis, focal digital ischemia or retinal embolism. Previous investigators have emphasized the progressive nature of renal insufficiency due to cholesterol embolism, its poor prognostic significance and almost uniformly fatal outcome. In this report, we describe five additional patients with renal cholesterol embolization. In three of them only moderate renal insufficiency developed, and kidney function subsequently improved in all. In two patients the condition progressed to end-stage renal disease; one died with chronic renal failure whereas the other patient required four months of hemodialysis before kidney function eventually improved. Thus, cholesterol embolization may produce a spectrum of renal functional impairment. In some patients there is only a moderate loss of renal function with subsequent improvement; in others renal failure ensues. In this latter group, eventual return of kidney function can occur even after a prolonged period of renal insufficiency.
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PMID:The clinical spectrum of renal cholesterol embolization. 724 79

A study of renal disease in familial dysautonomia identified excess glomerulosclerosis in 10 or 13 autopsied and biopsied patients. Sympathetic nerve terminals could not be found on renal vessels in biopsied tissue; they were invariably demonstrable in controls. Altered renovascular responsivity to systemic hypotension in familial dysautonomia may lead to ischemia and subsequent sclerosis of glomeruli. Review of 79 living outpatients showed that clinically overt renal disease was rare in familial dysautonomia. Nevertheless, frequent observations of elevations of serum creatinine concentrations (32% of patients) and blood urea concentrations (76% of patients) indicated a high prevalence of abnormality. An association was found between hypotension and renal dysfunction.
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PMID:Renal disease in familial dysautonomia. 737 14


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