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)

At the Mubarak Al-Kabeer University Hospital of Kuwait (Arabian Gulf), 77 episodes of acute renal failure were collected prospectively over 2 years, yielding a mean annual incidence rate of 9.5/100,000 population. Forty-four episodes occurred in hospital, a rate of 1.3 per 1000 admissions. In this group, acute tubular necrosis was the commonest cause (27 episodes). Thirty-three episodes occurred in the community, acute tubular necrosis accounting for 11 episodes. In contrast to hospital-acquired renal failure there was a tendency for increased incidence of community-acquired renal failure in the summer months. A more striking observation was the lower mortality in the community-acquired form. The mortality was not related to severity of renal failure even within the group with acute tubular necrosis.
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PMID:Cause and prognosis of acute renal failure in Kuwait: a 2-year prospective study. 281 Apr 51

In the past 15 years, there has been an explosion in the number of nonsteroidal anti-inflammatory drugs on the market. Along with this explosion have come increasing reports of the physiologic and pathologic changes seen in the kidneys. This report reviews the effects of prostaglandins on the kidney and the physiologic changes that result when prostaglandin synthesis is blocked. The world literature on renal complications of nonsteroidal anti-inflammatory drugs is reviewed and 274 cases of acute renal disease associated with their use are reported. The following cases are described: nephrotic syndrome (34); acute interstitial nephritis (51); acute tubular necrosis (29); papillary necrosis (53); poor perfusion with renal failure (40); acute glomerulitis or vasculitis (13); and unspecified renal failure (102). Fenoprofen appeared to be more nephrotoxic than other nonsteroidal anti-inflammatory drugs and resulted in multiple renal lesions in the same patient.
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PMID:Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function. 286 41

In 3 years seventeen patients presented to one unit with renal failure associated with the use of non-steroidal anti-inflammatory drugs (NSAID). Seven patients presented with acute renal failure, in four due to acute tubular necrosis and in three to acute interstitial nephritis; all recovered when NSAID treatment was stopped. Four patients presented with symptomless renal impairment discovered during routine follow-up in a rheumatology clinic; again all improved on withdrawal of NSAID. The remaining six patients presented with chronic renal failure, a disorder not previously associated with NSAID treatment. The pattern of renal disease associated with NSAID may be more extensive than has previously been recognised. A history of NSAID use should be sought in all patients presenting with unexplained renal failure.
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PMID:Non-steroidal anti-inflammatory drugs and renal failure. 286 13

Three categories of acute renal failure have been identified: prerenal, postrenal, and renal. Prerenal failure results from decreased perfusion of the kidney and postrenal failure from obstruction distal to the nephron; renal failure, in the surgical setting, usually represents acute tubular necrosis. A rational approach to the diagnosis of acute renal failure is outlined, and the treatment of acute tubular necrosis is discussed. High-risk factors are identified, and the importance of maintaining intravascular volume to prevent acute renal failure is stressed, since the mortality rate may approach 50% in patients in whom this perioperative complication develops.
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PMID:Acute renal failure in the surgical patient: initial diagnosis and treatment. 294 85

Acute renal failure is a most challenging clinical problem when it occurs in pregnancy. It requires an understanding of the normal physiology of the kidney in pregnancy and the natural history of different underlying renal diseases when pregnancy occurs. Because patients with chronic renal disease may present with worsening proteinuria, hypertension, and renal function, these disorders must be excluded from those conditions that cause acute deterioration of renal failure in otherwise normal women during pregnancy. As in all patients who develop acute renal failure, prerenal and obstructive causes must be excluded. Particularly important causes of prerenal azotemia in pregnancy include hyperemesis gravidarum and uterine hemorrhage, especially if it is unsuspected as in abruptio placentae. Infectious causes of acute renal failure in the pregnant woman include acute pyelonephritis and septic abortion. The clinical presentation of both these conditions should be apparent, and appropriate diagnosis and treatment can then be promptly instituted. Renal cortical necrosis is another cause of renal failure that occurs more frequently in pregnancy, and it must be differentiated from the many causes of acute tubular necrosis that may be associated with pregnancy. Those conditions that cause renal failure unique to pregnancy must always be considered when renal function deteriorates in the last trimester or the postpartum period. Severe preeclampsia, acute fatty liver of pregnancy, and idiopathic postpartum acute renal failure may all present similar complications, but the approach to each of these clinical disorders must be individualized. By understanding the causes of renal functional deterioration in pregnancy, a logical differential diagnosis can be established, allowing appropriate therapeutic decisions to preserve both maternal and fetal well-being.
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PMID:Acute renal failure in pregnancy. 305 11

A non-fatal case of acute renal failure after envenomation by a common brown snake (Pseudonaja textilis) is described. The renal failure required dialysis but resolved rapidly. There were no signs of neurotoxic envenomation or myoglobinuria. A mild disturbance of coagulation was noted with severe thrombocytopenia. This is the first documented case of renal failure (acute tubular necrosis) after envenomation by the common brown snake to present with this clinical picture. It is also the first clinical evidence that an Australian snake venom may contain a direct nephrotoxic component.
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PMID:Acute renal failure after envenomation by the common brown snake. 320 Jan 99

Magnetic resonance imaging (MRI) was compared with radionuclide scintigraphy (RNS) in 16 patients with renal transplants undergoing renal failure to determine which modality could best discriminate between rejection, acute tubular necrosis (ATN), and cyclosporin nephrotoxicity (CN). Although all rejecting transplants had reduced corticomedullary differentiation (CMD) on T1-weighted MR images, four of five cases of ATN had appearances that could not be distinguished from rejection. A normal CMD suggests nonrejection, but diminished CMD is nonspecific. Tc-99m DTPA/I-131 hippuran RNS was superior to MRI in differentiating rejection from ATN. Although ATN and CN have similar RNS patterns, this distinction can usually be made based on the clinical time course. Other potential uses of MRI in the evaluation of the renal transplants are discussed.
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PMID:Comparison of magnetic resonance imaging and radionuclide imaging in the evaluation of renal transplant failure. 328 80

The pathogenesis of acute renal failure (ARF) in such common conditions as acute tubular necrosis, acute interstitial nephritis, and primary graft anuria (ischemic transplant ARF) is poorly understood. Animal models may not exactly mimic the situation in man and thus human morphologic studies are of particular importance. Non-replacement of individual sloughed tubular cells and simplification of the brush border and basolateral infoldings of tubular cells are prominent morphologic changes which correlate with the presence of renal failure. It is possible that the initial injury inhibits cell membrane synthesis, thus interfering with proximal tubular sodium reabsorption with resulting activation of the renin angiotensin system and afferent arteriolar vasoconstriction. Tubular backleak, tubular obstruction by casts and debris, and decreased glomerular ultrafiltration coefficient may also play a role. Although poorly studied until now, the renal failure in primary graft anuria may have a completely different pathogenesis from that in acute tubular necrosis and acute interstitial nephritis. Cyclosporine nephrotoxicity is an important component of primary graft anuria, as seen in many transplant centers in the 1980's.
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PMID:Acute renal failure in man: pathogenesis in light of new morphological data. 330 Nov 19

Recovery of renal function after acute tubular necrosis usually begins within a few days or weeks, provided the patient does not succumb to the complications of uremia or of the precipitating illness. However, some studies suggest a high incidence of permanent renal failure perhaps reflecting the survival of patients who previously died because of less ideal treatment. Recently, we observed a patient with acute tubulo-interstitial nephritis whose course was notably different from the usual pattern since the patient required chronic dialysis. We believe that the cause of this permanent lesion is multifactorial including age, nephrotoxic agents (aminoglycosides, intravenous contrast media) and perhaps immunological mechanism. Treatment with prednisone did not produce improvement in our case and the patient has been treated by maintenance hemodialysis.
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PMID:[Chronic terminal renal failure: an unusual outcome of acute tubulointerstitial nephritis]. 344 94

Over a 3 1/2 year period, 133 children with hepatic failure underwent orthotopic liver transplantation (OLT) at our center. Renal failure (creatinine clearance less than 20 ml/min/1.73 m2) was present in 19 (14.3%) of these children. In seven of the 19 children, renal failure was present before OLT, and in the other 12 after OLT. The causes of renal failure included hepatorenal syndrome in seven, postischemic acute tubular necrosis in five, severe prerenal azotemia in five, and cyclosporine nephrotoxicity in two. Eight other patients died of renal failure while awaiting emergency transplantation. Of the total of 31 deaths among 133 children who underwent OLT, nine occurred in the 19 patients with renal failure. Thus patients with OLT and renal failure had a significantly higher mortality than other patients with transplants (P less than 0.025). Dialysis was not associated with improved survival. The majority of deaths in patients with renal failure were related to severe hemorrhage, thromboembolic events, and systemic fungal infections. Our experience suggests that renal failure is common in children with hepatic failure and is associated with reduced patient survival after OLT.
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PMID:Renal failure in children with hepatic failure undergoing liver transplantation. 351 8


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