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)

A retrospective review of 246 patients with established acute renal failure (ARF) needing dialysis from 1990-1994 is reported from Hospital Sultanah Aminah, Johor Bahru. Peritoneal dialysis was more commonly used than haemodialysis or haemofiltration. Patients on mechanical ventilation in Intensive Care Unit (ICU) who were hypercatabolic and fluid overloaded were treated with haemofiltration. Males outnumbered females by a ratio of 1.5:1. The majority were Malays (61.4%). Most patients were from the district of Johor Bahru, but 41.5% were from other districts in the Johor state. The mean age was 47.1 years (SD 18.2). The ARF was caused by acute tubular necrosis in 55.3%, post-renal obstruction in 22.8%, nephrotoxins in 5.7% and other causes in 16.2%. The proportions of patients referred from the medical, surgical and obstetric and gynaecology units were 50.8%, 45.5% and 3.7% respectively. The mortality rate was 48%. Patients with established ARF should be dialysed early as they tolerate uraemia poorly. Prevention is by prompt treatment of patients with sepsis, avoidance of hypovolaemia and nephrotoxic drugs.
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PMID:Acute renal failure requiring dialysis--a 5 year series. 1096 94

The influence of chronic renal failure on renal susceptibility to an acute ischemic insult was evaluated. Recipient Lewis rats were randomly assigned to undergo 5/6 nephrectomy (chronic renal failure, CRF) or sham operation (normal renal function, NRF). After 11 weeks, normal kidneys of Lewis donor rats were transplanted in the recipients. The outcome of the isografts was assessed. Filtration capacity of the isografts in the CRF rats was preserved to approximately one-quarter of its normal capacity on the 1st day post-transplantation, whereas it fell to 0 in the NRF rats. This was reflected by a significantly higher increase in serum creatinine in the latter group. The isografts in the CRF rats had a significantly lower degree of acute tubular necrosis and no increase in the number of macrophages and T lymphocytes in the first 24 h in contrast to the NRF rats. Epithelial regeneration and repair started earlier in the CRF group. In conclusion, the present study indicated that CRF blunted ischemia/reperfusion injury of a transplanted kidney, and that its regeneration capacity was certainly not hampered by the presence of chronic uremia. These results will be the basis for studies on modulation of early leukocyte-endothelial interactions resulting from immunological disturbances inherent to the uremic environment.
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PMID:Acute ischemia/reperfusion injury after isogeneic kidney transplantation is mitigated in a rat model of chronic renal failure. 1275 13

Acute renal insufficiency is often called "lower nephron nephrosis." Its recognition, its prognostic significance, and its therapy by conservative measures are receiving increasing clinical emphasis. The mortality rate in this complicated syndrome still remains unduly high. One method of therapy of anuric patients whose lives are in jeopardy because of fulminating uremia or critical potassium intoxication is use of an artificial kidney to "purify" the blood stream by means of extracorporeal dialysis.The author describes clinical (and laboratory) experience with ten such dialyzed patients, eight of whom presented the classical picture of acute renal insufficiency. Four died, one from unrecognized coronary occlusion, another from antecedent, overwhelming peritonitis. Two other patients with chronic kidney disorders received no benefit from dialysis and died of renal disease. Good biochemical and clinical response was brought about in six cases of lower nephron nephrosis. Presumably, these six patients would have died had they not been subjected to artificial dialysis.
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PMID:The Kolff-Merrill artificial kidney; clinical application in acute renal insufficiency. 1436 83

A case is presented in which numerous mitotic figures were found in the liver, pancreas, and adrenal glands of a patient who died in uraemia due to acute tubular necrosis. The possibilities of the failure of excretion of a waste product acting as a stimulus to mitosis, or that a mitotic stimulant is released from the acutely ischaemic kidney, are suggested.
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PMID:Increased mitotic activity in the liver and other organs in a case of acute renal tubular necrosis. 1444 32

Hepatitis A is generally regarded as a mild, self-limiting disease of the liver. Acute renal failure has rarely been reported in association with non-fulminant acute hepatitis A. Acute tubular necrosis is the most common form of renal injury in such patients. We recently experienced two cases of hepatitis A in which acute renal failure occurred early in the course of the illness and had a clinical course suggestive of acute tubular necrosis. In both patients, the clinical course of renal dysfunction was almost parallel to that of hepatic dysfunction. Hemodialysis was performed in patient 1 because of severe uremia despite maintaining urine output more than 2,000 mL per day. On the other hand, hemodialysis was not performed in patient 2 who showed a rapid recovery of renal dysfunction. The renal biopsy of patient 1 demonstrated typical findings of acute tubular necrosis on microscopy.
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PMID:[Two cases of acute renal failure associated with non-fulminant acute hepatitis A]. 1718 26

The prognostic of uremic syndrome had been improved by the development of renal replacement therapy. Uremic syndrome remains a dramatic medical concern in African sub-saharan countries. Nephrology practice has been introduced recently in Burkina Faso and epidemiological data on acute renal failure is not available. We conducted this study with the aim to describe the clinical profile of hospitalized patients. One hundred and twenty-one patients (18.4% of all admissions) with acute renal failure (creatinine>240micromol/L, abrupt onset) were included (age: 38.6+/-16.3y; creatinine: 1246.1+/-870.5micromol/L; urea: 40.2+/-18.3micromol/L), 75 men (age: 41.2+/-16.4) and 46 women (age: 34.2+/-15.2y). Acute renal failure was of medical cause in 91 cases, surgical cause in 16 cases and gyneco-obstetrical in 14 cases. Many pathophysiological factors have been identified like volume depletion, infections and obstruction. Acute renal failure was renal in 57 cases (age: 38.2+/-14.6y), prerenal in 43 cases (age: 36.8+/-16.7y) counting acute tubular necrosis in 21 cases, obstructive in 15 cases (age: 50.5+/-15.6y) and unclassified in six cases. Comorbidities have been identified: heart failure (13 cases), hepatocellular failure (eight cases), tumours (four cases) and severe hypertension (13 cases). Dialysis was justified in 84 cases but only accomplished in 14 cases. Hospital length of stay was 20.4+/-14.9 days. Twenty-nine patients died and causes were uraemia in 13 cases, hepatic in three cases, sepsis in 10 cases, malignant tumour in two cases and associated in one case.
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PMID:[Acute renal failure in Burkina Faso]. 1983 24


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