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)

The clinical and diagnostic features of renal papillary necrosis (RPN) of 27 patients were studied. Diabetes mellitus was the most frequent (56%) condition associated with RPN. Analgesic abuse, sickle hemoglobinopathy and urinary tract obstruction were present in 4 patients each; in 6 of these 12 patients these conditions were present as a coexistent disease with diabetes mellitus. There was evidence of an acute or chronic infection of the urinary tract in 18 patients, as a coexistent condition with another underlying disease that itself can cause RPN in 14 patients and as the only cause of RPN in another 4. Thus, the presence of more than one diagnostic condition which might be implicated in the causation of RPN was present in 15 patients or 55% of the cases in this series. When infection was excluded, six patients or 22% of the cases had two coexisting diseases, each of which has been implicated as a cause of RPN. This observation underlines the multifactorial nature of this entity and might explain why RPN is not encountered more frequently in each of the various primary diseases with which it has been associated. The average age of the patients at the time of diagnosis was 53 years for women and 56 years for men. Only six of the patients were younger than 40 years, and three of these had sickle hemoglobinopathy. The diagnosis of RPN was based on x-ray findings in eight patients, on the histologic examination of papillary tissue in urine in one, and on autopsy findings in the rest. Papillary necrosis was bilateral in three-fourths of the cases. The clinical picture varied. Most of the patients (67%) presented with chills and fever. Flank pain and dysuria were present in 11 patients (41%). As a rule oliguria was rare and progressive uremia was uncommon. In cases diagnosed at post-mortem, the patients had succumbed to infection or to a primary severe extrarenal disorder with the possibility of RPN having been entertained clinically in only half these cases prior to autopsy.
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PMID:Renal papillary necrosis: an update. 703 74

A 43-year-old nondiabetic man, 5 years post-renal transplantation, presented complaining of oliguria, fever and dysuria of 1-day duration. Graft ultrasound did not reveal any obstructive changes. Graft function did not improve in spite of 3 days of antibiotics. On the fourth day he passed fleshy material in urine subsequent to which his urine output improved and fever recovered. His graft function settled near to the previous baseline. Histological analysis of the material revealed necrosed renal papillary tissue. Renal papillary necrosis in allograft is uncommon and generally reported in the immediate postoperative phase, but it can still occur later in transplant follow-up. It is a potentially treatable cause for acute allograft dysfunction and should be suspected in transplant patients presenting with acute pyelonephritis but not getting relief from antibiotic therapy.
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PMID:An unusual cause of renal allograft dysfunction: graft papillary necrosis. 1734 85