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

Twelve Rhesus monkeys were inoculated intravenously with about 500 000 malaria parasites, Plasmodium knowlesi. Acute hemolysis occurred 5 days later, and all animals died on the 6th or 7th day after inoculation. All organs were gray-green to gray-brown because of deposition of hemoglobin and malaria pigments. This deposition was particularly striking in the lung, brain, abdominal fat and serous surfaces. Microscopic changes indicative of acute hypoxia were found in the liver (centrilobular necrosis) and kidneys (acute tubular necrosis). Terminal intravascular coagulopathy was evidenced by widely distributed, recently formed, fibrin thrombi.
 ...
PMID:Plasmodium knowlesi malaria in the Rhesus monkey. 41 5

Since 1988 in this referral center for severe cases of malaria for South Vietnam, a specialist team has managed malaria-associated renal failure (MARF) with peritoneal dialysis, and the mortality rate of MARF has fallen from 75% (78 of 104) to 26% (27 of 104) (P < .0002). Sixty-four patients with MARF (of whom 12 died) were compared to 66 patients with severe malaria whose serum creatinine levels remained < 250 mumol/L (six died). MARF had the clinical and biochemical features of acute tubular necrosis and was significantly associated with liver dysfunction (P < .05). A fatal outcome was associated significantly with anuria, a short history of illness, multisystem involvement, and high parasitemia. Most patients died from complications related to renal failure. Recovery of renal function was unrelated to parasitemia or hemoglobinuria; the median (range) time until urine output exceeded 20 mL/(kg.d) was 4 (0-19) days, and the time (mean +/- SD) for serum creatinine level to return to normal was 17 +/- 6 days. MARF can be managed effectively by prompt and careful peritoneal dialysis, but more effective dialysis or diafiltration might reduce the mortality rate further.
 ...
PMID:Acute renal failure in patients with severe falciparum malaria. 144 88

We observed 3 patients with a severe falciparum malaria infection. Although the patients appeared not to be seriously ill on admission, severe complications occurred. Renal impairment was a prominent feature and haemodialysis was sometimes necessary. Many hypotheses have been proposed regarding the aetiology of renal failure in Plasmodium falciparum but cannot yet be fully substantiated. Whatever the aetiology of renal failure might be, we believe that treatment should not differ essentially from that of acute tubular necrosis after circulatory shock and early diagnosis and treatment is imperative in spite of an initially ostensibly good clinical condition.
 ...
PMID:Acute renal failure in severe chloroquine resistant falciparum malaria. 164 68

Fifteen (34.8%) of 43 patients of falciparum malaria screened for urinary abnormalities showed significant proteinuria (greater than 150 mg/24 h), haematuria (greater than 1/HPF) and casts, with or without azotaemia. Light microscopic examination of renal biopsy tissue from 12 patients revealed mesangial and endothelial proliferative change in 8, and acute tubular necrosis in one patient. Immunofluorescence showed IgM alone, or IgG and IgM along with C3, in 7 patients within the mesangium or along the capillary walls. Repeat kidney biopsy after 6 wk in 5 patients revealed no residual pathology indicating the reversible nature of the lesions.
 ...
PMID:Immunopathological changes in kidney in Plasmodium falciparum malaria. 218 4

We report two patients who had cerebral malaria, heavy parasitemia, hyperbilirubinemia, hypercatabolism with rapid rises of blood urea and serum creatinine and acute renal failure. There was no evidence of intravascular hemolysis. Renal biopsy was consistent with acute tubular necrosis. Both patients responded to treatment with intravenous quinine and dialysis.
 ...
PMID:Acute renal failure in falciparum malaria. 767 79

Although malaria has been largely eradicated from temperate countries, it is on the increase in the tropics. Infection with Plasmodium falciparum affects a vast number of people and kills over a million annually. Severe malaria is a multisystem disease affecting particularly the central nervous system (causing coma and convulsions), the kidneys (resulting in acute tubular necrosis), and the liver (contributing to lactic acidosis and hypoglycaemia). Acute pulmonary oedema (acute respiratory distress syndrome) may occur in adults particularly in association with renal impairment. In children these symptoms are rare, whereas hypoglycaemia, lactic acidosis and severe anaemia are more common. Malaria should be suspected in any febrile patient living in or returning from the tropics, and a blood smear examined. Chloroquine has been the mainstay of antimalarial treatment for the past 40 years, but resistance in P. falciparum is now widespread throughout the tropics and has recently been recognised in P. vivax from Oceania. Sulfadoxine-pyrimethamine resistance is also common. Fortunately, quinine, and the newly introduced compounds, halofantrine and mefloquine, can be relied upon nearly everywhere. The most rapidly acting and effective of all antimalarial drugs, artemisinin and its derivatives, have come from China. They offer a genuine prospect of reducing mortality from malaria in the tropics.
 ...
PMID:Clinical malaria in the tropics. 833 22

Twenty-six cases (4.8%) from a total of 540 patients with acute renal failure (ARF) of diverse aetiology had ARF in association with falciparum malaria. Their ages ranged from 15 to 85 years (mean 31.2). Urinary sediment abnormalities and proteinuria (less than 1 g/24 h) were observed in 15 (57.7%) cases. The probable underlying factors leading to ARF were: volume depletion 17 (65.3%), intravascular haemolysis 8 (30.8%), hyperparasitaemia 8 (30.8%), cholestatic jaundice 6 (23%), and hypotension 5 (19.2%). Dialysis therapy was required in 15 patients (57.7%) as they had severe renal failure, and the remaining 11 patients improved with supportive measures. All patients received antimalarial therapy. The clinical course of ARF was consistent with acute tubular necrosis in 20 patients. Six cases were subjected to percutaneous renal biopsy. One patient showed histological features of necrotizing glomerulonephritis along with acute tubulointerstitial nephritis. The biopsies in the other five patients showed features of acute tubular necrosis in three, and acute interstitial oedema with patchy tubular necrosis in two. The mortality rate was 30.8%. Thus falciparum malaria, which has been an important cause of ARF in certain highly endemic zones of India, is showing an increasing prevalence in other parts such as Eastern Uttar Pradesh due to an imbalance between the increasing population and inadequate sanitary facilities, which further worsen during floods.
 ...
PMID:Acute renal failure in falciparum malaria--increasing prevalence in some areas of India--a need for awareness. 930 75

Renal failure secondary to acute tubular necrosis is a common complication of severe Plasmodium falciparum malaria. The purpose of this report is to describe two cases of severe malaria featuring acute renal failure observed in young patients who had failed to comply with chemoprophylaxis. Occurrence of renal failure was delayed four to seven days in relation to the beginning of the malaria attack. Hemodialysis was required in one case. Both patients were successfully treated by quinine perfusion. The main pathophysiology mechanisms underlying acute tubular necrosis are obstruction of capillaries and post-capillary venules by infected red blood cells and activation of monocytes that release cytokines such as tumor necrosis factor. Other nonspecific mechanisms may come into play including hypovolemia, release of catecholamines and subsequent activation of the rennin-angiotensin system, complement activation, and rhabdomyolysis. Acute tubular necrosis is the main renal complication of Plasmodium falciparum malaria but latent forms of acute glomerulonephritis have also been documented. Prognosis is usually favorable depending mainly on early diagnosis and prompt treatment.
 ...
PMID:[Acute renal failure during severe malaria: physiopathology and therapeutic management. Apropos of 2 cases]. 1125 60

Following studies showing an association between helminth infections and protection from cerebral malaria, we compared 22 patients with malaria-associated acute renal failure with 157 patients with moderately severe malaria. Helminths were associated with protection from renal failure (adjusted odds ratio [AOR], 0.16 [0.03-0.85], P = 0.03). Helminth-infected controls were less likely to have jaundice (AOR, 0.39 [0.16-0.96], P = 0.04) or to have peripheral mature schizonts (AOR, 0.2 [0.07-0.62], P = 0.005) than controls without helminths. This suggested that preexisting helminth infections may have been protective by influencing sequestration and obstructive jaundice, 2 possible determinants of acute tubular necrosis.
 ...
PMID:Helminth infections are associated with protection from malaria-related acute renal failure and jaundice in Thailand. 1179 82

Plasmodium falciparum is highly prevalent in the tropics. Acute renal failure (ARF) is a common complication in severe falciparum malaria. The disorder is usually oliguric or anuric and hypercatabolic. Acute tubular necrosis (ATN), the principal pathologic lesion in falciparum malaria-induced ARF, is mediated by a complex interaction of mechanical, immunologic, cytokine, humoral, acute phase response, non specific factors, and hemodynamics factors. Parasitized erythrocytes express a central role in all aforementioned pathogenic factors of ARF.
 ...
PMID:Current knowledge in falciparum malaria-induced acute renal failure. 1218 7


1 2 3 Next >>