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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Techniques applied in SEM studies of a solid organ such as the kidney are reviewed. The tissue can be prepared by razor sectioning, ethanol cryofracture and ultraplanning of polyethylene glycol embedded tissue. Tissues embedded in paraffin can also be used. Glomeruli and tubuli can be isolated from renal biopsies. A new procedure for tubular isolation is based on sequential digestion by trypsin, pepsin and Pronase E. SEM examination has proved useful in a number of renal diseases, such as glomerular diseases, hypertensive renal disease, an tubular diseases, including medullary cystic disease, adult polycystic disease, and acute tubular necrosis. Particularly in human acute tubular necrosis, SEM was helpful. SEM has also contributed to the study of the physiologically important basal-lateral surfaces of human, dog, rat, rabbit and frog renal tubules, and in particular allowed the elucidation of patterns of processes on the basal-lateral surfaces of proximal S1, S2, and S3 tubular segments, thin limbs, distal ascending and convoluted limbs and collecting ducts in human tubules.
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PMID:The complementary role of scanning electron microscopy in renal pathological diagnosis. 641 8

Chronic cortical and medullary damage have been produced in uninephrectomized homozygous Gunn rats by single doses of the analgesics aspirin, paracetamol and phenazone, and by analgesic mixtures. The lesions are more severe than those of other experimental models of analgesic nephropathy, and the appearances of the cortical lesions suggest that they are ultimately due to the effects of papillary necrosis rather than to acute tubular necrosis observed in acute experiments with this model. The presence of an acute inflammatory reaction in both cortex and medulla in a number of animals one month after administration of analgesics indicates the possibility that the observed chronic renal damage may result from the intervention of additional complicating factors rather than from a single direct effect of analgesics.
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PMID:Chronic renal lesions in the uninephrectomized Gunn rat after analgesic mixtures. 651 96

Immunological events in the acute, recovery and convalescent stages of typhoid fever were correlated with the occurrence of renal disease in 24 consecutively selected patients. Serum complement levels (C3) were significantly reduced in patients with renal disease during the acute state (p less than 0.01) and increased to normal levels in the recovery phase. IgG and IgM immunoglobulin levels were significantly lower than control values in all three stages (p less than 0.05). While IgA levels were elevated to above control levels in patients with and without renal disease in all three stages, IgA levels were lower in patients with renal disease compared to those without renal involvement in the acute stage (p less than 0.025). The percentage of T cells was increased significantly in all three stages (p less than 0.01). Seven patients showed renal abnormalities. All of them had glomerular disease demonstrated by proteinuria of 1.0 g or greater per 24 h, associated with significant haematuria. Almost all of these patients were glucose-six-phosphate-dehydrogenase (G.6.P.D.) deficient. Serum blood urea nitrogen was elevated in five of these patients who were G.6.P.D. deficient, and two of them developed classical acute tubular necrosis. It appears that renal involvement in typhoid fever commonly occurs as transient glomerular or tubular disease in G.6.P.D. deficient individuals. Glomerular disease is associated with a decrease in serum complement (C3) level in acute stage.
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PMID:Immunological and clinical aspects of kidney disease in endemic typhoid fever in Iran. 660 45

Two elderly women suffered an acute deterioration of renal function after treatment with cefoxitin sodium. One with stable chronic renal failure due to reflux nephropathy underwent a rapid deterioration of renal function which proved fatal. The other woman had rheumatoid arthritis and developed acute tubular necrosis after treatment with gentamicin and cefoxitin. All the data suggested that the antibiotic was responsible for the deterioration in renal function. The dose of cefoxitin should be reduced in patients with renal functional impairment. Cefoxitin should either be used with great caution or not prescribed in combination with aminoglycoside antibiotics.
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PMID:Cefoxitin-associated renal failure. 701 86

Ultrasound was used for imaging the kidneys in 55 neonates. The normal kidney in a neonate is characterized by prominent medulla and fetal lobulation, the main renal vessels are frequently demonstrated. Of 29 infants with normal kidneys by ultrasound, 4 had renal disease (3 acute tubular necrosis, one partial renal artery thrombosis) and one had a pelvic kidney. In 24 infants congenital abnormalities or acquired renal disease was diagnosed. Multicystic dysplastic kidney and hydronephrosis were the most frequently observed abnormalities. Polycystic kidneys at the early stage (both adult type and infantile) appeared as enlarged hyperechoic kidneys. In 2 neonates the kidneys were normal but they had adrenal mass lesions.
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PMID:Renal ultrasound in the neonatal period. 706 63

Accepted causes (acute insults) and risk factors for the development of acute renal failure were defined, quantitatively assessed, and tested for statistical significance in 143 patients with acute tubular necrosis. Sixty-two percent of patients had more than one acute insult, and 48 percent had more than one suspected risk factor. Hypotension, excessive aminoglycoside exposure, pigmenturia, and dehydration were identified as highly significant acute insults, while it was concluded that sepsis and administration of radiocontrast material could not be incriminated as causes of acute tubular necrosis. An additive interaction between acute insults was demonstrated, and the severity of acute renal failure was related to the number and severity of acute insults. Patients with oliguric renal failure had more severe acute insults than patients with nonoliguric renal failure. Preexisting renal disease and chronic hypertension were significant risk factors, the latter only when hypotension had been one of the acute insults. An age of more than 59 years, gout and/or chronic hyperuricemia, diabetes, and long-term diuretic administration were not found to be significant risk factors.
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PMID:Acute renal failure. Multivariate analysis of causes and risk factors. 711 78

2 patients with systemic lupus erythematosus and mild renal functional impairment were treated with ibuprofen, one of the phenylproprionic nonsteroidal anti-inflammatory drugs. Within days after the onset of therapy, both developed renal insufficiency manifested by elevated serum creatinine levels, increased proteinuria, and active urinary sediments; 1 patient was oliguric. Renal biopsies disclosed mesangial proliferative lupus glomerulonephritis and acute tubular necrosis, the latter more pronounced in the oliguric patient. Renal failure resolved following discontinuation of ibuprofen and supportive therapy. It is postulated that altered blood flow, mediated through the well-known prostaglandin synthetase inhibitory effects of ibuprofen, resulted in tubular necrosis. This undesirable complication of ibuprofen therapy may be enhanced in patients with underlying renal disease, and may be a factor governing the limitation of its usage.
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PMID:Ibuprofen-induced acute renal failure with acute tubular necrosis. 718 Sep 1

Urinalysis is a simple, efficient, and accurate guide in the diagnosis of renal disease. By determining a patient's history and obtaining a physical examination, the physician is very often able to diagnose a patient's renal lesion. Heavy proteinuria and a microscopic sediment containing red cells and red cell casts strongly suggest acute glomerulonephritis. The causes of this nephropathy are legion. On the other hand, mild proteinuria and a lack of microscopic findings suggest nephrosclerosis, interstitial nephritis, or acute tubular necrosis in the proper clinical setting. When glomerular disease produces nephrotic syndrome, the various types of glomerular disease can be diagnosed accurately without biopsy in a high percentage of cases.
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PMID:Urinalysis and clinical renal disease. 721 37

The diagnostic work-up of the urologic patient must be tailored to the presenting symptom complex, carefully selecting from the many modilities available, those most likely to establish the diagnosis and extent of the suspected lesions. Intravenous urography is the most rewarding initial procedure for many presenting symptoms, including suspected masses, pyuria, hematuria, and flank pain. Nuclear imaging is particularly effective in differentiating renal lobulations from true masses, in demonstrating parenchymal scarring in chronic pyelonephritis when the IVP is equivocal, and in assessing the decrease in perfusion and function in obstructive nephropathy when the IVP is indeterminate. It is the preferred procedure for acute renal infarction and acute tubular necrosis and has a greater sensitivity of detection for renal trauma than the IVP. Gallium-67 renal imaging appear helpful in the detection of occult pyelonephritis or interstitial nephritis. However, it cannot differentiate focal acute pyelonephritis from abscess or abscess from neoplasm. Ultrasoneography is the initial procedure of choice in the differentiation of cystic from solid renal masses and in anuria or oliguria. When a kidney fails to visualize by IVP or nuclear imaging, it can confirm or rule out obstruction. In upper tract infections, it may demonstrate renal or perirenal abscess. Although retrograde pyelography is performed less frequently in recent years, it remains extremely useful in confirming and relieving obstructive uropathy and in delineating tumors of the collecting system. Computed tomography effectively demonstrates hydronephrosis, renal abscess, tumors, and cysts and retroperitoneal involvement. More experience is needed to judge the efficiency of "dynamic" CT for the quantification of renal function. Renal angiography remains invaluable as a secondary procedure (as opposed to initial screening) in renal trauma, vascular anomalies, and in renal tumors to delineate the anatomy of the arterial supply and possible renal vein involvement.
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PMID:Medical imaging of renal diseases-suggested indication for different modalities. 724 59

A retrospective review of 27 patients with nonvisualization on 131I-orthoiodohippurate (Hippuran) renal scan during 1972--1977 was carried out. 5 patients had renal failure caused by urinary tract obstruction and of these, 4 were submitted to surgical relief. Varying levels of life-sustaining renal function were recovered in all 4 patients. 16 had chronic intrinsic renal disease, of whom 7 were admitted for reasons not directly related to renal failure. All of these required chronic dialysis within 3--6 months. The remaining 7 patients had acute renal failure (clinically, acute tubular necrosis) and none of them survived. It had been well established that the prognosis for recoverability of renal function is extremely poor in patients with nonvisualization on hippuran scan. It is important, therefore, to emphasize that nonvisualization on 131I-orthoiodohippurate renal scan in patients with urinary tract obstruction does not exclude the potential for recoverable renal function. Therefore, even in the absence of renal visualization, the need to definitively rule out urinary tract obstruction remains.
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PMID:Obstructive uropathy in patients with nonvisualization on renal scan. 735 84


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