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

The clinical observation of 6 out of 250 renal transplant patients showed that acute renal rejection may lead to reversible acute tubular necrosis (ATN) necessitating intermittent haemodialysis treatment. Despite missing early response to high-dose (methyl-) prednisolone therapy (during a mean period of 4.7 days) all 6 patients developed spontaneous diuresis 14.5 days on average after onset of rejection while on maintenance immunosuppressive therapy. From the clinical course the conclusion was drawn that in severe cases of renal rejection with arteriographic and histological findings consistent with acute tubular necrosis, prolonged therapy with high doses of (methyl-) prednisolone is not desirable, since after reversal of immunological rejection the onset of spontaneous diuresis will be determined mainly by the duration of the healing and recovery phase of acute tubular necrosis.
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PMID:Reversible acute tubular necrosis following severe acute renal rejection. 38 Dec 34

During a followup period of 18 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a not invasive, quickly available and reproduceable method. Because of the high incidence of 85% exact diagnoses this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommendable for transplant patients, if postoperative haemodialysis is necessary. In these cases information can easily be obtained whether postoperative olig-anuria is caused by acute tubular necrosis or by primary insufficient vascularisation of the transplant.
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PMID:[Diagnostic relevance of thermography in renal transplantation (author's transl)]. 38 82

Autotransplantation of the kidney was performed in seven adult mongrel dogs. A model of acute tubular necrosis (ATN) was developed by subjecting the kidney to warm ischemia (37 degrees C) for 40 to 60 minutes. Serial ultrasound examinations were performed every 12 hours until the animal died or was killed. Sonographic findings were correlated with laboratory and histological data. Throughout the course of ATN, the characteristic normal echo pattern of the kidney remained unchanged in six of seven dogs. In one animal there were changes in the renal cortex, while the medullary pyramids showed no alteration from the base-line study. This contrasts with extensive abnormalities found during rejection.
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PMID:Evaluation of acute post-transplant renal failure by ultrasound. 38 18

Mannitol may be useful clinically both as a diuretic and as an obligate extracellular solute. As a diuretic it can be used to treat patients with intractable edema states, to increase urine flow and flush out debris from the renal tubules in patients with acute tubular necrosis, and to increase toxin excretion in patients with barbiturate, salicylate or bromide intoxication. As an obligate extracellular solute it may be useful to ameliorate symptoms of the dialysis disequilibrium syndrome, to decrease cerebral edema following trauma or cerebrovascular accident, and to prevent cell swelling related to renal ischemia following cross-clamping of the aorta. Largely unexplored uses for mannitol include its use as an osmotic agent in place of dextrose in peritoneal dialysis solutions, its use to maintain urine output in patients newly begun on hemodialysis, and its use to limit infarct size following acute myocardial infarction.
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PMID:Mannitol. 38 67

Three hundred and fifty-eight renal imaging studies with quantitation of renal perfusion were performed following injection of 99Tcm-DTPA in 22 children aged 6--15 years with renal transplants. In 58 of 62 scans performed at the onset of a rejection episode, renal perfusion was decreased. This was the only feature of rejection in 6 episodes, in 5 of which the patient was oliguric due to post-operative acute tubular necrosis. In 4 episodes perfusion fell, but antirejection treatment was not given as a repeat scan was normal. On 18 occasions the plasma creatinine concentration (Pc) rose, but the scan was unchanged; no treatment was given and repeat Pc was normal. Three patients had a ureteric obstruction and 2 patients a lymphocoele detected from the images. There was no morbidity. Sequential renal scintigraphy was valuable in the early diagnosis of rejection and in the avoidance of unnecessary therapy.
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PMID:Serial quantitative imaging with 99Tcm-DTPA in pediatric renal transplantation. 38 5

The clinical manifestations of drug-induced renal disease may include all the manifestations attributed to natural or spontaneous renal diseases such as acute renal failure, chronic renal failure, acute nephritic syndrome, renal colic, haematuria, selective tubular defects, obstructive nephropathy, etc. It is therefore vital in any patient with renal disease whatever the clinical manifestations might be, to obtain a meticulous drug and toxin inventory. Withdrawal of the offending drug may result in amelioration or cure of the renal disorder although in the case of severe renal failure it may be necessary to utilise haemodialysis or peritoneal dialysis to tide the patient over the period of acute renal failure. Analgesic nephropathy is an important cause of terminal chronic renal failure and it is therefore vital to make the diagnosis as early as possible. The pathogenesis of some drug-induced renal disorders appears to be immunologically mediated. There are many other pathogenetic mechanisms involved in drug-induced renal disorders and some drugs may under appropriate circumstances be responsible for a variety of different nephrotoxic effects. For example, the sulphonamides have been incriminated in examples of crystalluria, acute interstitial nephritis, acute tubular necrosis, generalised hypersensitivity reactions, polyarteritis nodosa and drug-induced lupus erythematosus.
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PMID:Drug-induced renal disease. 38 1

After renal transplantation low urinary sodium concentration (UNa) has been used to diagnose acute rejection (AR), for the early phase of AR is often associated with reduced renal perfusion. Early postoperative graft failure without low UNa favors the diagnosis of ischemic tubular damage (ATN). As fractional excretion of filtered sodium (FENa) better reflects glomerulotubular balance in renal sodium handling, FENa was analyzed during the first 2 weeks in 118 renal allografts. From data on 41 transplants with good early renal function (GEF), a temporal profile of FENa was obtained and used to evaluate the behavior of FENa by means of standardized FENa (Z score). Individual subjects followed their own profile with a small deviation (delta Z less than 1.4 for 2 days). In 31 instances, acute rejection was diagnosed. In 14 with AR, the Z score deviated little; 2 responded to methylprednisolone given intravenously. In 17 with AR, the Z score fell significantly (delta Z greater than 1.5 for 2 days), an average of 2.6 days before the first rise in serum creatinine concentration; 15 responded to treatment. The difference between these two groups was significant (P less than 0.001). This functional heterogeneity and different responses to treatment may indicate different immunologic mechanisms which damage different target cells in the graft in AR. In 46 patients with acute tubular necrosis after cadaver kidney transplantation FENa was significantly higher than it was in the GEF group as early as the first posttransplantation day and approached normal as the renal function recovered. This behavior of FENa was clearly different from that in AR.
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PMID:Fractional excretion of sodium after renal transplantation. 39 Feb 18

Out of a total of 184 transplant operations there were 27 kidneys with 2 or more renal arteries. Five of these were in 23 related transplants. Ischaemic times were increased compared with those of kidneys with single arteries, but the incidence and duration of acute tubular necrosis and also the length of time spent in hospital were similar in both groups. Excessive bleeding and other complications were no more common than following single arterial anastomosis. Kidneys with multiple arteries can be used safely if careful interrupted suturing is performed, the kidneys are perfused before and kept cool during the procedure and polar arteries are not tied.
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PMID:Renal transplantation with multiple arteries. 39 18

During a period of 24 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a non-invasive, quickly available and reproducible method. Because of the 92% incidence of exact diagnosis this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommended for patients if postoperative haemodialysis is necessary. In these cases information can easily be achieved whether postoperative oligo-anuria is caused by acute tubular necrosis or by primary vascular insufficiency of the transplant.
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PMID:Use of thermography in kidney transplantation: two year follow up study in 75 cases. 39 11

Cefoxitin was administered by the intramuscular route to 102 patients who had infections of mild or moderate severity. The assessment of clinical and bacteriologic outcome was derived from data for 79 patients. Assessments of tolerance and safety were made for all patients who received 1 g of cefoxitin diluted in 1 ml of 0.5% or 1.0% lidocaine four times daily. Cure or improvement occurred in 45 of 47 patients with skin or soft tissue infections, in all of 16 patients with lower respiratory tract infections, and in 10 of 12 patients with urinary tract infections. One patient developed acute tubular necrosis. Eosinophilia was seen in 7% of patients treated with cefoxitin. The intramuscular preparation was not painful to 96% of the patients. Cefoxitin given by the intramuscular route can be used as an alternative to intravenous cefoxitin for treatment of mild or moderate infections, for continuation of treatment when the intravenous route is not appropriate, and for treatment of ulcers of polymicrobial etiology on ischemic extremities or on extremities of diabetic patients.
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PMID:Intramuscular cefoxitin. 40 Sep 34


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