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

In 43 renal transplant patients studied by ultrasonography there were 32 episodes of acute rejection and 17 of acute tubular necrosis. The size of the kidney increased in all cases. However, in 75 per cent of the patients with acute rejection the central echoes of the renal sinus increased conspicuously, while in 77 per cent of those with acute tubular necrosis the echogenicity of the central sinusal complex decreased. These findings may be expressions of different pathological lesions at the renal sinus level in patients with acute rejection and acute tubular necrosis, which would modify the acoustic interphase. Therefore, we have found panniculitis, vasculitis, thrombosis and inflammatory cellular infiltration of the urinary collecting systems to be significant in patients with acute rejection but not in those with acute tubular necrosis. Ultrasonography can be an adjuvant instrument for the sometimes difficult differential diagnosis between acute tubular necrosis and acute rejection immediately after transplantation, and also for the diagnosis of acute rejection whenever it appears.
J Urol 1981 Sep
PMID:The value of ultrasonic scanning in the differentiation of acute post-transplant renal failure. 702 69

The uptake of technetium-99m sulfur colloid (TSC) by transplanted kidneys undergoing rejection has been described. In this retrospective study, the value of TSC uptake in diagnosing renal rejection was studied in different time intervals after renal transplantation. Within 14 days after transplantation, increasing uptake was seen in 88% of 26 rejection episodes. In patients with acute tubular necrosis, 42% of their studies showed TSC uptake. TSC did not predict rejection within the three days prior to rejection. Sensitivity, specificity and accuracy of 128 TSC studies were compared at different thresholds of TSC uptake; at best, accuracy was only 76%. In later time intervals, a much smaller percentage of patients had increasing uptake with rejection; this tendency was to remain unchanged. Many non-rejection studies showed some TSC uptake. In chronic rejection, persistently marked uptake dominated prior to one year after transplantation, but not beyond this. Thus, within 14 days after transplantation, TSC uptake may support the diagnosis of rejection. Thereafter its value becomes greatly limited.
J Can Assoc Radiol 1981 Sep
PMID:Renal transplant uptake of technetium-99m sulfur colloid in various time periods after transplantation. 702 57

Three patients are reported who presented with severe oliguric renal failure due to retroperitoneal fibrosis and obstructive uropathy in whom spontaneous diuresis and recovery of renal function took place, a course resembling acute tubular necrosis. There were, however, several clinical and laboratory findings that provided clues to the presence of obstructive uropathy. Two of the three patients had low back or abdominal pain. All three patients presented with anemia and significant hyperkalemic, hyperchloremic metabolic acidosis with only a small increase in anion gap and two of the patients had an inappropriately high urine pH. Neither tubular cell casts nor pigmented granular casts were identified in the urine in any of the patients. In all three patients the urine output increased from oliguric levels to 1400 - 2000 ml/day within 1 day associated with rapidly improving renal function. This report demonstrates and reinforces the need to rule out obstruction in all patients with renal failure of unknown etiology and adds retroperitoneal fibrosis to the list of diseases associated with renal failure and spontaneous recovery.
Am J Kidney Dis 1982 Sep
PMID:Retroperitoneal fibrosis presenting as spontaneously reversible renal failure. 712 23

Two cases of acute tubular necrosis without hepatic failure following acetaminophen overdose are reported. A 19-year-old Caucasian woman ingested 100 500-mg capsules of acetaminophen. She was admitted to a hospital 68 hours after ingestion, and serum acetaminophen concentration 70 hours after ingestion was 3 microgram/ml. Liver-function test results were markedly elevated, and urinalysis was abnormal on admission. Liver function improved over the next five days, but the patient's renal function deteriorated. Her condition initially was diagnosed as prerenal azotemia, but was later consistent with acute tubular necrosis. Hemodialysis was begun on the fifth day of hospitalization. On the eleventh hospital day, the patient's renal function began to improve, and she was subsequently discharged. In the second case, a 19-year-old Spanish-American woman ingested 30 500-mg capsules of acetaminophen. She was seen in an emergency room 16 hours after the ingestion; her serum acetaminophen concentration was 32 microgram/ml 19 hours after ingestion. Oral acetylcysteine therapy was begun, and liver-function test results were elevated and peaked on the third hospital day. Renal function began to decline on the fifth hospital day; her condition was consistent with acute tubular necrosis. She was hemodialyzed once, and her renal function improved on the tenth hospital day. She was subsequently discharged. It is concluded that acute renal failure without prior hepatic failure may occur after acetaminophen overdose.
Am J Hosp Pharm 1981 Sep
PMID:Acute renal failure after acetaminophen overdose: report of two cases. 728 22

The urographic nephrogram is an important indicator of underlying functional and structural renal disease. With expansions in use of cross-sectional imaging, the computed tomographic (CT) nephrogram (ie, contrast material enhancement within the renal parenchyma) has assumed a greater role in the evaluation of urinary tract disorders. Both quantitative and qualitative nephrographic abnormalities are well demonstrated by CT, including global or segmental absence or persistence of the nephrogram, slowed temporal progression, striated pattern, and rim pattern. Global absence is nearly always unilateral and is most often seen with blunt abdominal trauma with renal pedicle injury. Segmental absence is attributable to focal renal infarction, most likely due to arterial emboli. Global persistence, which is much more common than segmental persistence, may be unilateral (caused by renal artery stenosis, renal vein thrombosis, or urinary tract obstruction) or bilateral (due to systemic hypotension, intratubular obstruction, or abnormalities in tubular function). Striated nephrograms may be unilateral or bilateral and are caused by ureteric obstruction, acute pyelonephritis, contusion, renal vein thrombosis, tubular obstruction, hypotension, and autosomal recessive polycystic kidney disease. The rim pattern is most often associated with renal infarction and occasionally with acute tubular necrosis and renal vein thrombosis. Careful evaluation of the CT nephrogram is an integral part of the abdominal CT examination.
Radiographics 1995 Sep
PMID:The CT nephrogram: implications for evaluation of urinary tract disease. 750 51

The incidence of in-hospital acute renal failure (ARF) due to drugs is estimated at 20% of all patients hospitalized for ARF. According to recent surveys, analgesic and non-steroidal anti-inflammatory drugs are now more frequently involved than antibiotics. The incidence of ARF in patients taking angiotensin-converting enzyme inhibitors is increasing. More than half of the patients have a non-oliguric course. Acute tubular necrosis and acute interstitial nephritis are found in most biopsied cases. The mortality rate ranges between 6% and 12%. Most patients recover but 15% to 20% have some degree of residual renal impairment, particularly older and oliguric patients, those with previous chronic renal insufficiency and whose ARF period is prolonged. The long-term renal effects of NSAIDs is a concern. ARF due to drugs is a preventable disease since two-thirds of patients received inappropriately high or prolonged doses of the offending drug and or were patients at risk to develop ARF.
Rev Prat 1995 Sep 01
PMID:[Acute kidney failure induced by drugs or contrast media]. 756 90

The mortality rate of acute renal failure is still high, about 50%. About 10% of the survivors have chronic renal failure, sometimes requiring dialysis. The course of some of these cases can be improved by appropriate therapeutic measures, if they are undertaken early. Early identification of these lesions is therefore mandatory. The clinical diagnosis is often difficult: 1. rare atypical forms of acute tubular necrosis, with renal or extrarenal signs, may lead to renal biopsy; 2. vascular and glomerular disease are most often recognized clinically (sometimes misdiagnosed), but the histological type (and therefore the appropriate treatment) cannot be determined; 3. acute interstitial nephritis is rarely diagnosed clinically and the nature of the infiltrate remains unknown. In certain cases of acute renal failure, the contribution of early renal biopsy to the etiological diagnosis and to prognosis and therapy is obvious. In acute renal failure, renal biopsy should be considered early in a rather limited number of patients (about 20%), everytime the diagnosis of tubular necrosis is doubtful, especially in acute renal failure associated with persistent infection, in order to guide the therapy.
Rev Prat 1995 Sep 01
PMID:[Contribution of renal biopsy to the diagnosis and treatment of acute kidney failure]. 756 93

Acute exertional compartment syndrome has been described as occurring after sustained maximal exertion. The case described is that of acute exertional compartment syndrome of the leg occurring in a soldier after he attempted to complete the Army physical fitness test. This condition was initially neglected; necrotic muscle and acute tubular necrosis were sequelae. Earlier intervention could have occurred if the signs and symptoms were considered by the treating health care professionals. All active duty troops are required to perform to maximum exertion. Their complaints should be considered with the same differential diagnosis as those of a highly trained athlete.
Orthop Rev 1994 Sep
PMID:Acute exertional compartment syndrome occurring after performance of the army physical fitness test. 780 Apr 3

Fifty two children (upto 12 years age) with acute renal failure (ARF) admitted to the Nephrology services between January, 1989 to August, 1992 were studied to determine the cause and outcome. Of these, 39 were boys and 13 girls; 27 (51.9%) patients were below 4 years of age. Hemolytic uremic syndrome (HUS) was the commonest cause of ARF (30.8%) followed by acute tubular necrosis (ATN) in 28.84% and acute glomerulonephritis in 19.23%. All patients had severe renal involvement with anuria in 53.6% and oliguria in 46.4% at presentation. HUS was the leading cause of anuria (53.6%), followed by obstructive uropathy (21.4%). Thirty five patients required dialytic support for a median duration of 18 days (2-90 days). The mortality was 34.6%. Seven patients of HUS, 4 patients of ARF following surgery, 3 patients each of ATN and glomerulonephritis and one patient of obstructive uropathy died. Anuria at onset, central nervous system or respiratory complications and delay in institution of dialytic support were bad prognostic factors. We conclude that early referral and prompt institution of dialytic support may be helpful in decreasing the mortality.
Indian Pediatr 1994 Sep
PMID:Pattern of acute renal failure at a referral hospital. 788 59

Rats with untreated diabetes mellitus are protected from gentamicin-induced nephrotoxicity. In order to evaluate the role of hyperglycemia, glycosuria, and polyuria in this phenomenon, miniosmotic pumps filled with insulin were implanted for 15 days in seven female Sprague-Dawley rats with streptozotocin-induced diabetes mellitus. Plasma glucose levels were successfully maintained under 126 mg/dl. To serve as the control group, eight age-matched diabetic (plasma glucose > 400 mg/dl) rats had miniosmotic pumps placed delivering only Ringer's solution. Six days after placement of the pumps, gentamicin (40 mg/Kg/day) was administered to all animals for 9 days. The insulin-treated diabetic rats exhibited clear signs of nephrotoxicity by Day 6 of gentamicin, whereas the diabetic control group remained free from any functional or morphological evidence of proximal tubular damage throughout the 9 days of the aminoglycoside administration. At the end of the experiment, the creatinine clearance in the insulin-treated diabetic group was 45% lower than in the untreated diabetic group (P < 0.005). In addition, there was a rise in plasma creatinine (P < 0.02), muramidase appeared in the urine, and mild patchy acute tubular necrosis of the renal cortex was observed by light microscopic examination. The insulin-treated group also accumulated more gentamicin in the renal cortex than the untreated animals (P < 0.005). It is concluded that protection against the nephrotoxic effects of gentamicin is a feature of untreated experimental diabetes mellitus in the rat and that correction of the hyperglycemic state with insulin reverses this resistance.
Proc Soc Exp Biol Med 1994 Sep
PMID:Insulin reverses the protection given by diabetes against gentamicin nephrotoxicity in the rat. 807 55


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