Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirteen patients developed a renal disease after using heroin alone or in combination with other drugs, for a period of 3 to 12 years. Eleven were IV drug addicts, 2 were sniffers. Six patients had acute tubular necrosis, due to rhabdomyolysis in 5 and to prolonged gentamicin therapy for bacterial endocarditis in 1. Five patients manifested a nephrotic syndrome, and renal biopsy showed various types of glomerulonephritis (GN) without glomerular sclerosis. The two last patients had hypertension with intrarenal vascular lesions and HBsAg was present in their serum. Chronic hemodialysis and/or renal transplantation were required in 2 cases with GN; all other patients recovered normal serum creatinine. There was no specific pathologic picture of heroin abuse in this series.
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PMID:[Renal disease associated with heroin abuse]. 321 43

A review of 85 patients aged 60 years or more, treated in a southern Indian hospital for conditions requiring renal biopsy, showed that diffuse poliferative glomerulonephritis was the most frequent diagnosis, being present in 24 cases of whom 11 had elevated serum streptococcal antibody titres. Infections were also important in 2 patients with amyloidosis secondary to tuberculosis, in 3 patients with acute tubular necrosis following infectious gastroenteritis and in a patient with acute pyaemic interstitial nephritis with septicaemia. Drugs including indigenous medicines were the other important cause of renal disease, being implicated in 11 cases.
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PMID:Medical renal disease in the elderly in a southern Indian hospital. 338 Feb 27

Nephrotic syndrome was the commonest clinical presentation among 2827 consecutive adult Indian patients from whom adequate kidney biopsies were obtained for suspected renal disease. In 83 per cent of cases the nephrotic syndrome was due to minimal change disease, focal segmental glomerulosclerosis, mesangiocapillary glomerulonephritis, membranous usually secondary to tuberculosis or leprosy, was present in only 34 patients. Acute nephritis, the next most frequent clinical presentation, was due to diffuse endocapillary proliferative, crescentic or mesangial proliferative glomerulonephritis in 88 per cent of cases, almost half of whom had elevated serum streptococcal antibody titres. Eosinophilia showed a highly significant association with diffuse endocapillary proliferative and mesangiocapillary glomerulonephritis. Idiopathic IgA nephropathy was present in only 10, and antiglomerular basement membrane antibody disease in only one, of the 238 patients whose biopsies were studied by immunofluorescence. Complications of pregnancy accounted for 70 per cent of cases of cortical necrosis. Acute gastroenteritis, septicaemia, abortions, snake bite and allopathic and indigenous medicines were important causes of acute tubular necrosis.
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PMID:Renal disease in adult Indians: a clinicopathological study of 2,827 patients. 344 84

Ultrasound was compared with histology in 66 cases to assess the accuracy of sonography in demonstrating abnormality in renal allografts. Patients with suspected acute, chronic or acute and chronic rejection, acute tubular necrosis and glomerulonephritis in the transplant kidney were included in the study. It was noted in this trial that ultrasound is less accurate at demonstrating abnormality in the grafted kidney than has been suggested previously in the literature. It was concluded that, where doubt exists, even when ultrasound examination is normal, biopsy should be considered.
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PMID:Diagnosis of disease in renal allografts: correlation between ultrasound and histology. 351 76

Indirect immunoperoxidase analysis using monoclonal antibodies (Mo Ab) was performed in 33 renal biopsies with interstitial cellular infiltration obtained from non-transplanted patients. We reviewed four acute interstitial nephritis (IN), three chronic IN, four granulomatous IN, four acute tubular necrosis, four vasculitis, seven primary glomerulonephritis and seven active lupus nephritis (LN). We used Mo Ab recognizing T and B cell markers [OKT3, OKT8, T4, B1, IOT14 (IL2 receptor)], HLA-DR related antigen (I2) and monocytes/macrophages (LeuM3). In all cases the interstitial cellular infiltrates were predominantly T cells, whereas the B cell population accounted for less than 20% of the infiltrate. LeuM3+ cells were present in 28 of 32 cases, usually in a lesser proportion than T cells. IOT14+ cells were exceptional. T4+/T8+ cells were clearly greater than one in three acute IN, three granulomatous IN, two LN and two vasculitis. The T8+ cell population predominated in one case of chronic IN related to a non-steroidal anti-inflammatory drug. In all the remaining cases T4+ and T8+ cells were equally present. Aberrant strong HLA-DR expression within tubular cells was noted in nine cases (4 LN) irrespective of the presence of tubular lesions. On the basis of the phenotypic analysis, our data do not support a specific pattern of the infiltrate in regard to a given etiology and thus cannot be used as a diagnostic tool. However, such analysis may aid in understanding the mechanisms of tissue injury.
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PMID:Characterization of mononuclear cell subsets in renal cellular interstitial infiltrates. 352 2

The pathogenetic factors leading to acute renal failure (ARF) in 223 children between the ages of 20 days and 14 years were studied. Diarrhoeal diseases were responsible for ARF in 49.8%, acute glomerulonephritis in 34.1%, drug induced intravascular hemolysis in glucose -6-phosphate dehydrogenase deficiency in 4.5%, snake bite in 4%, hemolytic uremic syndrome in 2.2%, and miscellaneous causes in 5.4%. Dialysis was instituted in 178 children and the others were treated conservatively. Renal histology in 39 out of 76 children who presented with an acute nephritic illness revealed acute endocapillary proliferative glomerulonephritis in 27 and crescentic glomerulonephritis in 12. The histology in 79 out of 147 remaining patients showed acute tubular necrosis in 64, acute cortical necrosis in 13, and acute interstitial nephritis in 2. Overall mortality was 27.4%. This high incidence of ARF due to infective diarrhoeas and dysentery reflects poor socio-economic and hygienic conditions, inadequate facilities in rural areas, delays in seeking medical advice, and lack of knowledge about fluid and electrolyte therapy amongst the staff.
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PMID:Acute renal failure amongst children in a tropical environment. 358 35

A study of the magnetic resonance imaging (MRI) appearances of the kidneys in six normal volunteers and 52 patients is reported. Corticomedullary differentiation was seen with the inversion-recovery (IR 1400/400) sequence in the normal volunteers and in patients with functioning transplanted kidneys and acute tubular necrosis. Partial or total loss of corticomedullary differentiation was seen in glomerulonephritis, acute and chronic renal failure, renal artery stenosis, and transplant rejection. The T1 of the kidneys was increased in glomerulonephritis with nephrotic syndrome, but the T1 was within the normal range for renal medulla in glomerulonephritis without nephrotic syndrome, renal artery stenosis, and chronic renal failure. A large staghorn calculus was demonstrated with MRI, but small calculi were not seen. Fluid within the hydronephrosis, simple renal cysts, and polycystic kidneys displayed very low signal intensity and long T1 values. Evidence of recent hemorrhage into cysts was seen in polycystic kidneys. Tumors displayed varied appearances. Hypernephromas were shown to be hypo- or hyperintense with the renal medulla on the IR 1400/400 sequence. After intravenous injection of gadolinium-DTPA, there was marked decrease in the tumor T1.
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PMID:Magnetic resonance imaging of the kidneys. 638 80

To determine the nature and frequency of renal disorders in AIDS we reviewed the records of thirty-two patients hospitalized over a twenty-two month period. Group I, including all patients with AIDS who demonstrated proteinuria and/or renal insufficiency, numbered thirteen patients, in ten of whom renal tissue was available. Renal abnormalities included proteinuria in twelve patients, which exceeded two grams per day in seven. The glomerular histologic lesions included focal glomerulosclerosis, diffuse mesangial hypercellularity, diffuse proliferative glomerulonephritis, and membranoproliferative glomerulonephritis. The nonglomerular histologic lesions included acute tubular necrosis, nephrocalcinosis, focal interstitial nephritis, and one case each of intrarenal cryptococcal infection and renal cell carcinoma. Nine of these thirteen patients developed renal insufficiency, and four of them required dialysis. Their mortality by the end of the study period was eleven of thirteen patients (85 percent), significantly worse in the short term than AIDS patients without renal problems. The patients in Group I were compared to the nineteen AIDS patients without renal abnormalities in Group II. The Group I patients had a higher incidence of oral and esophageal candidiasis, other fungal infections, and infections with Mycobacterium avium-intracellulare. They also had a higher incidence of exposure to aminoglycoside antibiotics and amphotericin B, and experienced more clinical shock than their Group II counterparts. It is concluded that patients with AIDS may demonstrate renal abnormalities on the basis of immune, hemodynamic, infectious, and neoplastic derangements.
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PMID:Renal disease in patients with AIDS: a clinicopathologic study. 673 86

Acute renal failure has been a rare, uniformly fatal complication of infection with Francisella tularensis. The literature suggests that either acute tubular necrosis, interstitial nephritis, or glomerulonephritis may be responsible for this syndrome. We have described a patient with tularemia who had nonoliguric acute renal failure probably due to interstitial nephritis and who recovered slowly but spontaneously during antimicrobial therapy with doxycycline.
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PMID:Tularemia complicated by acute renal failure. 682 14

The use of 131I-orthiodohippurate (OIH) scintigraphy combined with the estimated renal plasma flow (ERPF) and excretion index (EI) has been beneficial in separating impaired renal function due to graft rejection from acute tubular necrosis, ureteral obstruction, urinary extravasation and in some instances renal artery occlusion. The radionuclide data accurately identified acute and chronic rejection, confirmed by the clinical course, increase in BUN and serum creatinine and on occasion renal biopsy. Reversible and irreversible acute tubular necrosis (ATN) were clearly differentiated from acute rejection. When the ERPF and EI were plotted on a graph, multiple sequential radionuclide studies accurately predicted graft survival when chronic rejection existed. The limitation of this technique was the inability to discriminate between renal artery stenosis, ureteral obstruction and inflammatory disease. Scintigraphic studies did not distinguish between renal artery stenosis and chronic rejection. In these circumstances arteriography was the diagnostic procedure of choice. Although ureteral obstruction often can be correctly diagnosed by scintigrams, the ERPF, EI and intravenous pyelogram remained the most accurate diagnostic procedures. Recurrent glomerulonephritis, gram negative septicemia and generalized viral illness (herpes zoster or cytomegalovirus) simulated acute rejection and had to be separated by renal biopsy or the clinical course. The most valuable features of the radionuclide technique included: 1) the noninvasive method, 2) the simplicity, 3) the rapidity and 4) the reproducibility.
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PMID:Diagnosis of impaired renal function after kidney transplantation using renal scintigraphy, renal plasma flow and urinary excretion of hippurate. 698 32


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