Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute renal failure (ARF) complicated the use of traditional herbal remedies in six adult patients seen at Kenyatta National Hospital in a 2-year period (August 1984 to August 1986). This comprised 10.9% of all the cases of ARF and 24% of the cases of ARF due to medical causes. All the patients were oliguric and the period of oliguria in the four patients who survived ranged between 19-57 days (mean 26.3 days). Five of the patients had evidence of fluid overload. The blood urea nitrogen and serum creatinine were elevated in all the patients. The serum sodium was normal in all, while the serum potassium was elevated in 2 cases. Identity of the herbal medication was unknown in all the cases. The indication was abdominal pain in 4 cases, infertility and abdominal pain in one and prophylaxis against witchcraft in the other. All the patients were started on haemodialysis, two of them having had periods of peritoneal dialysis for 12 and 16 days. Two patients died. Of the four surviving patients, follow up has been carried out for 8, 6, 5 and 4 months. At four months follow up the creatinine clearance in the 4 surviving patients have been 54, 63, 51 and 43 ml/min.
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PMID:Acute renal failure following the use of herbal remedies. 180 Jan

The fetotoxic effects of angiotensin converting enzyme inhibitors when used during the second half of pregnancy are well known. The more recently developed angiotensin II receptor antagonists appear to yield similar fetal abnormalities. We report a premature infant born to a 41-year-old mother with a long history of infertility who had received losartan therapy for hypertension throughout an undetected pregnancy. Ultrasound examination 2 days prior to delivery identified a single fetus at 29 weeks gestation, anhydramnios, and an empty fetal bladder. The neonatal course was complicated by oliguria, hyperkalemia, marked renal dysfunction, respiratory failure, joint contractures, and a large anterior fontanelle with widely separated sutures. Hypotension (mean arterial pressure<25 torr) on day 1 responded to volume expansion, dopamine, and hydrocortisone. Serum creatinine reached a maximum of 2.7 mg/dL on day 6 and decreased to 0.4 by day 56. No formal urinalysis was performed, but the urine was reported to be visually clear throughout the course. Although a renal ultrasound on day 2 was normal, a follow-up study at 7 months revealed bilateral generalized parenchymal echogenicity, consistent with medical renal disease. Since then, weight and length have been at the 5th percentile or less, with apparent renal tubular acidosis necessitating the addition of sodium citrate supplements. This case emphasizes the importance of maintaining a high index of suspicion for potential pregnancy when contemplating the use of a drug of this class, and considering serial testing for pregnancy when using such drugs, even in patients with a longstanding history of infertility.
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PMID:Gestational therapy with an angiotensin II receptor antagonist and transient renal failure in a premature infant. 1679 14

The ovarian hyperstimulation syndrome (OHSS) is a serious but rarely fatal complication of medical interventions that seek to induce fertility; it is typically encountered in women who undergo controlled ovarian hyperstimulation, but there are very rare patients who have genetic defects who present with OHSS. In recent years, its pathogenesis has been elucidated; this knowledge will decrease the frequency of this syndrome. Clinical signs may include any or all of the following: rapid weight gain, ascites, oliguria, hemoconcentration, leukocytosis, along with intravascular hypovolemia, hyponatremia, and hyperkalemia. If the patient is not diagnosed early, ascites, pleural and more rarely pericardial effusions, severe respiratory failure and ARDS, hypercoagulability with tromboembolism and multiple organ system failure can occur. Due to the increased use of therapeutic strategies for infertility (particularly those using human chorionic gonadotropin), the systemic, particularly the pulmonary, complications of this syndrome must be identified early to allow appropriate diagnosis and management. We describe two cases of women with extremely severe OHSS presenting bilateral pleural effusions, and severe respiratory failure (paO2/FiO2 < 200) treated with non-invasive ventilation (NIV). The severe form of OHSS varies between 0.5% and 5%, depending on the population studied: intensive care may be required for management of tromboembolic complications, renal failure and severe respiratory failure. The diagnosis of severe OHSS was made, largely based on bedside ultrasonography showing increased ovarian size, mild ascites and bilateral pleural effusions. Owing to severe respiratory failure the patients were admitted to Respiratory Intermediate Care. Pulmonary intensive care may involve thoracentesis, oxygen supplementation and in more severe cases assisted ventilation. There are only a few studies in English that describe severe respiratory failure treated with non-invasive ventilation, but all of them have had good outcomes.
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PMID:Non-invasive ventilation for the treatment of acute respiratory failure following ovarian hyperstimulation syndrome: report of two cases and a brief review of the literature. 2650 72