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

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.
Proc Eur Dial Transplant Assoc 1979
PMID:Use of thermography in kidney transplantation: two year follow up study in 75 cases. 39 11

Hypothermic pulsatile perfusion did not adversely affect long-term renal allotransplant function and did not result in an increased rate of rejection. Thus, we can conclude that perfusion had little effect on the immunogenicity of renal allografts. The incidence of acute tubular necrosis was directly related to the length of warm ischaemia and perfusion time. However, long-term renal function was not influenced by acute tubular necrosis. Perfusion is a safe and reliable way of preserving cadaver donor kidneys until transplantation.
Proc Eur Dial Transplant Assoc 1976
PMID:Effect of organ preservation in cadaver kidney transplantation. 77 42

The utilization of a hypothermic, hyperosmolar, intracellular washout solution for human kidney preservation was shown to be successful in 18 kidneys obtained from 9 heart beating cadavers. The ischemic interval ranged from 2 hrs and 57 mins to 39 hrs and 48 mins. All 18 kidneys functioned within 3 hrs of revascularization. Acute tubular necrosis with oliguria was noted in 4 of 6 patients with ischemic intervals longer than 20 hrs but not in the 12 patients obtaining kidneys preserved for 19 hrs or less. All patients with acute tubular necrosis required hemodialysis for one to 16 days post-transplantation with eventual recovery.
Proc Clin Dial Transplant Forum 1975 Nov
PMID:Human cadaver kidney preservation using hypothermic hyperosmolar, intracellular washout solution. 78 59

Five episodes of acute renal failure due to rifampicin (R-ARF) were observed in four patients and the clinical and histological data were compared with the records of 52 episodes reported in the literature. The bulk of data supports the assumption that the by far most frequent renal injury responsible for R-ARF is acute tubular necrosis produced by a vasomotor mechanism. Nevertheless a few data, above all immunohistological findings, suggest the local presence of allergic process. It may be, that the development of an immunological renal lesion is prevented or blunted by the consequences of vasomotor effects.
Proc Eur Dial Transplant Assoc 1976
PMID:Acute renal failure due to rifampicin (R-ARF). 93 13

During a 4-year period, acute renal failure was observed in 27 patients (mean age 65 years) treated by various angiotensin-converting-enzyme (ACE) inhibitors for hypertension, heart failure, or a combination of both. None had significant renal artery stenosis on angiography. Overt volume depletion was present in 21 and hypotension in 12 cases. All patients received diuretic therapy and/or a low-salt diet. Other facilitating factors included cardiac failure, pre-existing chronic renal insufficiency, combined therapy with non-steroidal anti-inflammatory drugs, and diabetes mellitus. Twenty-two patients had two or more of these factors at presentation. A renal biopsy performed in 10 cases showed severe arteriosclerosis of small renal arteries in eight and acute tubular necrosis in five instances. Therapy comprised volume expansion, and withdrawal of diuretics and, except in two patients, of ACE inhibitors. Twenty-one patients recovered normal renal function, two died, and permanent renal damage remained in four. These results suggest that sodium depletion has a critical role in inducing acute renal failure, whose outcome is not always benign. A combination of diuretics and ACE inhibitors should be prescribed with caution, especially in older patients with small as well as with large renal vessel disease.
Nephrol Dial Transplant 1992
PMID:Acute renal failure after the use of angiotensin-converting-enzyme inhibitors in patients without renal artery stenosis. 131 66

To evaluate the diagnostic role of ultrasound in spontaneous renal allograft rupture we reviewed 18 cases observed in our centre in 10 years. Ultrasound studies were performed immediately before surgery in 15 cases. Renal allograft rupture occurred during the first 3 weeks after transplantation in 17 cases (94%). Clinical findings were consistent with previous reports. The diagnosis was confirmed by surgical exploration in 17 cases, and by necropsy in the remaining one. Nine patients were treated by corsetage and eight by graft nephrectomy, while one patient died before surgery. Acute rejection was present in nine cases, and severe acute tubular necrosis in five; no renal tissue was available for histological study in four patients. On ultrasound examination, perirenal haematoma was the most frequent finding, while subcapsular/intrarenal haematoma or findings suggesting rejection or urinary tract obstruction were less frequently observed. In six cases, disruption of the white linear echoes of the capsule of the graft could be seen; this finding has not been described previously. Ultrasound has a definite role in presurgical evaluation of suspected renal transplant rupture.
Nephrol Dial Transplant 1992
PMID:Renal allograft rupture: diagnostic role of ultrasound. 132 23

In the past, hemlock poisoning was only known for its neurotoxic effects; quite recently non-neurological features, consisting of rhabdomyolysis and acute renal failure, have been also described. Here we report our experience with these clinical findings, which we frequently observe in accidental hemlock poisoning. Between 1972 and 1990 we studied 18 patients: 17 of them were poisoned by conline (an alkaloid of Conium maculatim) in Apulia (Italy), and one by cicutoxin (the active principle of water hemlock) in New Mexico (USA). In the non-rapidly-fatal cases we tested myoglobinuria, serum muscle enzymes, and renal function. In the patients with acute renal failure we performed microscopical examination of kidney specimens; immunohistochemistry was carried out to identify myoglobin and actin in tubules. Coniine was detected in urine, serum, or tissues. Neurological features were present in all of our cases: coniine had a curare-like effect on the neuromuscular junction, whereas cicutoxin was convulsant on the central nervous system. In addition rhabdomyolysis was noted in the 17 subjects poisoned by coniine. Acute renal failure was observed in five patients; it was confirmed by histological evidence of tubular necrosis with intratubular deposition of myoglobin and actin released by rhabdomyolysis. Our cases seem to be the first with histopathologically proven acute tubular necrosis in coniine intoxication. In conclusion, in hemlock poisoning neurotoxic manifestations may be accompanied by rhabdomyolysis and acute tubular necrosis; increased awareness of these clinical features is recommended in order to improve the diagnostic and therapeutic procedure.
Nephrol Dial Transplant 1991
PMID:Clinical spectrum of accidental hemlock poisoning: neurotoxic manifestations, rhabdomyolysis and acute tubular necrosis. 179 93

The outcome of renal transplantation in CAPD patients is still controversial since age and clinical differences often make comparison with hemodialysis patients difficult. The aim of this study was to analyse two homogeneous groups of patients, on CAPD and on hemodialysis. 18 CAPD (Group A) and 18 hemodialysis patients (Group B) were selected for a case-control analysis, matched for age, presence of acute tubular necrosis and Cyclosporine A regimen. Group A and B were not different for male/female ratio, donor age, HLA-Dr mismatches, arterial pressure, cold ischemia, or follow-up. Patient, graft survival and number of rejection episodes did not differ significantly at 1 year; serum creatinine at 6 and 12 months and CyA doses at 1 and 6 months were not different; hospitalization rates for first and subsequent admissions did not differ. Infection-free patients were 9/18 in Group A and 15/18 in Group B, with 12 episodes in Group A and 3 in Group B. Post transplant cholesterol levels showed a trend to increase in both groups and triglycerides levels to a decrease; differences in pre and post transplant in body weight were not significant at 12 months. In conclusion, the outcome of transplantation in CAPD patients is not significantly different from that in hemodialysis patients with similar clinical characteristics.
Adv Perit Dial 1990
PMID:Comparison between two dialytic populations undergoing renal transplantation. 198 44

To evaluate changes in T-lymphocyte subsets and DR expression on tubular cells, 74 fine-needle allograft aspirates (FNAB) were evaluated in 31 patients with cadaver kidney transplants. Monoclonal antibodies against T helper CD4+, cytotoxic/suppressor CD8+, and HLA-DR were used with an indirect alkaline-phosphatase-staining technique. Cases with acute rejection (n = 11) showed a significant increase of CD8+: CD4+ ratio versus those with stable function (n = 21), acute tubular necrosis (n = 10) or CsA toxicity (n = 7) (ANOVA F = 10; P less than 0.01). Cases with chronic rejection or CMV infection showed no differences in the CD8+: CD4+ ratio with the other groups. DR expression on tubular cells was frequently found in cases of acute rejection, chronic rejection and CMV (73%, 66%, and 43% respectively), occasionally found in CsA toxicity (14%), but never seen in controls or ATN. Both tests, the CD8+: CD4+ ratio and the DR expression on tubular cells, had a high sensitivity and specificity in differentiating acute rejection versus controls, acute tubular necrosis, and CsA toxicity. When both tests are taken together no case without rejection showed a CD8+:CD4+ ratio greater than 1.6 and DR expression on tubular cells. Cases with acute rejection who lost the graft (n = 6) had a CD8+:CD4+ ratio significantly greater than those who responded to antirejection therapy (n = 5) (t = 2.9; P less than 0.05).
Nephrol Dial Transplant 1990
PMID:Monoclonal analysis of fine-needle aspiration biopsy in kidney allografts. 212 91

Periodical determinations of the urinary secretory immunoglobulin A (S-IgA) excretion rate were performed in 12 cadaveric graft recipients. In five patients with primary functioning grafts the S-IgA excretion on the first postoperative day was 4.2 +/- 2.6 mg/g creatinine, decreasing to 1.8 +/- 1.2 mg/g creatinine (P less than 0.05) at the day of discharge. Acute tubular necrosis developed in the seven remaining patients. In this group the initial S-IgA excretion was 12.6 +/- 7.5 mg/g creatinine (P less than 0.05 compared to the former group), decreasing to 2.0 +/- 0.9 mg/g creatinine (P less than 0.05) at discharge. An acute rejection episode was observed in six patients. The S-IgA excretion increased from 3.0 +/- 1.5 mg/g creatinine 3-4 days before rejection to 6.4 +/- 3.1 mg/g creatinine (P less than 0.05) 1-2 days before rejection, and peaked at 14.0 +/- 8.6 mg/g creatinine (P less than 0.05) when the diagnosis of rejection was established and anti-rejection treatment was started. In three patients the initial steroid pulse therapy was not successful and S-IgA excretion further increased to 29.0 +/- 15.6 mg/g creatinine. After successful anti-rejection treatment, using steroids and OKT3, the S-IgA excretion decreased to 3.4 +/- 2.6 mg/g creatinine. In acute graft rejection, the elevated globulin synthesis by infiltrating plasma cells. In the early phase of rejection, dimeric IgA is the only immunoglobulin able to penetrate into the urine by transepithelial transport after binding to secretory component expressed on tubular epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1990
PMID:Urinary secretory immunoglobulin A in acute renal allograft rejection. 213 Feb 99


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