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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed 119 renal biopsies performed between 1964 and 1982 on adults aged 60 or more. The two main indications wer: renal failure (35/119) and nephrotic syndrome (35/119). Histology showed: primary glomerular diseases (76/119), systemic diseases with renal involvement (31/119), arteriosclerosis only (5/19), tubulo-interstitial nephritis only (5/119). No obvious lesion was seen in 2 cases. Additional arteriosclerosis was observed in 21 cases and additional tubulo-interstitial nephritis in 6 cases. Primary glomerular diseases consisted mainly in diffuse membranous glomerulonephritis (18/76). Systemic Lupus Erythematosus (7/31) and amyloidosis (6/31) represented most of the systemic diseases with renal involvement. The usefulness of renal biopsy in diagnosis, treatment and prognosis of a wide variety of renal diseases in elderly adults is demonstrated.
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PMID:[Renal puncture biopsy in the aged subject: apropos of 119 cases]. 404 Nov 86

Clinical findings and structural alterations in the kidneys of 6 patients with sarcoidosis and an associated glomerulonephritis are described. Five of the 6 patients manifested the nephrotic syndrome during some phase of their illness. Additional clinical evidence of renal disease included persistent microscopic hematuria (5 patients), hypertension (4 patients) and progressive renal failure (3 patients). Glomerular pathology varied and included proliferative glomerulonephritis (3 patients), membranous glomerulonephritis (1 patient), and chronic glomerulonephritis (2 patients). In 2 patients sequential examination of the kidney was possible, with renal biopsies preceding autopsy examination by 3 and 6 years, respectively. Glomerular pathology had progressed in severity in each case. Immunofluorescent studies in 2 patients revealed patterns of glomerular antibody localization consistent with immune complex disease. Electron microscopic studies of 1 revealed membranous changes characterized by electron-dense subepithelial and intramembranous deposits. Totally unexpected were virus-like intraendothelial structures in the glomeruli identical to those previously reported in systemic lupus erythematosus. Since current evidence suggests that the pathogenesis of both membranous and proliferative types of glomerulonephritis is immunologic, it should not be surprising that sarcoidosis, a disease which quite possibly results from an immune response to a disseminated antigen(s), should occasionally include glomerulonephritis as a part of its histologic expression.
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PMID:Glomerulonephritis associated with sarcoidosis. 455 25

A multi-centre controlled trial of steroid treatment of the nephrotic syndrome was carried out on 125 patients. Of these, 64 were controls and 61 received prednisone in a recommended dose range of 20-30 mg./24 hours. The actual initial dose averaged 29 mg./24 hours. Treatment was continued for a variable period, but not less than six months. More than 10 mg./24 hours was given on average for 12 months to all patients, and for longer periods to some. Patients were classified, on the basis of biopsy specimens, into three groups: A, minimal change; B, membranous nephropathy; and C, proliferative glomerulonephritis. In groups B and C prednisone did not have any strikingly favourable effect on proteinuria or on renal function as compared with the control group. In group A, however, prednisone reduced proteinuria to a striking and statistically significant extent. It had little if any effect on long-term renal function in any group. The death rate was higher in the combined prednisone groups (17/61) than in the control groups (12/64). This difference was not statistically significant, but there was a significantly higher number of deaths from cardiovascular disease in the prednisone group, whereas the numbers of deaths from renal failure were not significantly different in the two groups.
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PMID:Controlled trial of prednisone in adult patients with the nephrotic syndrome. 491 90

Membranous nephropathy is the most frequent histological category among black children with nephrotic syndrome. In this study 31 African children with this condition are described. There were more boys than girls and the peak age was four to 11 years. The incidence of this histological category and clinical outcome in the African children were similar to these features in adults with membranous nephropathy. During a follow-up period of up to six years there was spontaneous remission in a third of patients, persistent proteinuria in just over a third (37.5%) and persistent relapse in under a third (29.2%). Hypertension occurred more frequently (19.3%) and spontaneous remission less often (33.3%) than in children with membranous nephropathy elsewhere. Hypertension, the lower remission rate and persistence of proteinuria during the course of the disease were similar to the disease seen in adults. Renal failure was not encountered in any patients. Steroids were of little value in the treatment of these children. Five children (16.2%) had associated infections. HBsAg was present in three of six children tested.
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PMID:Extramembranous nephropathy in black South African children. 619 44

Captopril (Lopirin, Squibb, von Heyden) is an inhibitor of the angiotensin-I converting enzyme. In congestive heart failure angiotensin mediated vasoconstriction and aldosterone secretion is reversed by captopril. Both effects of captopril induce reduction of cardiac preload and afterload. The clinical state of patients with congestive heart failure therefore improves since cardiac output increased and pulmonary pressures decrease. Captopril acts orally and the dosage used for the treatment of congestive heart failure ranges from 50 to 150 mg daily. After oral ingestion of a single dose the maximum haemodynamic effect is observed after 45-90 min. No tolerance induction or tachyphylaxis has been observed during maintenance therapy over a period of 18 months. There are some reversible adverse reactions like pruritus, skin rash and partial or complete taste loss which are dose related. Serious side effects include leucopenia, agranulocytosis, renal failure and membranous glomerulonephritis. Therefore regular urinary and blood analysis is necessary during captopril therapy.
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PMID:[Captopril in congestive heart failure (author's transl)]. 621 Jul 98

This case report describes a patient who initially had a pleuritis and arthalgias. During the follow-up he developed first a membranous glomerulonephritis with nephrotic syndrome and subsequently a crescentic, rapidly progressive glomerulonephritis with glomerular basement membrane antibodies (anti-GBM). An analysis of the serum samples obtained during the follow-up revealed no infections at the onset of renal failure. However, anti-GBM could be demonstrated in the serum samples obtained 2 months before the deterioration of the renal function. The anti-GBM did not react with alveolar BM and the patient had no signs of pulmonary hemorrhage. The etiology and the sequence of the pathological events of rapidly progressive glomerulonephritis is discussed in the light of these observations.
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PMID:Transformation of membranous glomerulonephritis into crescentic glomerulonephritis with glomerular basement membrane antibodies. Serial determinations of anti-GBM before the transformation. 623 78

An oral glucose tolerance test and an assay of insulin receptor activity were performed in patients with chronic glomerulonephritis (CGN) to elucidate the aberration of glucose metabolism in such patients. Ninety of 123 patients with CGN without renal failure showed abnormal glucose tolerance, including 72.6% with IgA nephropathy, 81% with benign recurrent hematuria, 87% with chronic proliferative glomerulonephritis, 100% with membranoproliferative glomerulonephritis, and 80.0% with membranous nephropathy. Insulin responses in CGN patients during oral glucose tolerance tests showed lower levels of basal insulin and significantly higher levels after 90, 120, and 180 min compared with those of normal controls. The binding of radiolabeled insulin to blood mononuclear cells in 22 CGN patients with abnormal glucose tolerance was significantly (P = 0.0023) decreased in comparison with 5 normal controls. However, plasma obtained from such patients showed no significant (P = 0.4761) inhibition of the binding of insulin to normal mononuclear cells. It was concluded that glucose tolerance capacity was impaired in 80.4% of patients with CGN without renal failure. Such impairment of glucose metabolism might be due to decreased activity of insulin receptors on cells in CGN patients.
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PMID:Abnormal glucose tolerance in patients with chronic glomerulonephritis without renal failure. 635 11

A 39-year-old woman with documented sarcoidosis and membranous glomerulonephritis (GN) with renal failure received a kidney from her identical twin. A few months after transplantation a proliferative GN appeared with hematuria, proteinuria and progressive renal failure over 2 years. Indeed the occurrence of GN in patients with sarcoidosis raises the question of whether the relationship between these two conditions is causal or fortuitous. This report suggests that GN is secondary to sarcoidosis.
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PMID:Pre- and posttransplant glomerulonephritis in a case of sarcoidosis. 635 54

8 Zimbabwean children are discussed in whom the nephrotic syndrome (NS) was a manifestation of membranous glomerulonephritis (GN) which was associated in every case with hepatitis B antigenaemia. This marks the first occasion that such an association has been reported in African children, although it has been thoroughly documented in children in Europe, the Far East and America. Microhaematuria, hypertension and mild to moderate renal insufficiency were frequent early associated findings, and every child exhibited hypocomplementaemia and a markedly diminished immunoglobulin G (IgG) level. The disease followed a benign course in the majority, and only 1 child died in renal failure.
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PMID:Association of hepatitis B (HBs) antigenaemia and membranous glomerulonephritis in Zimbabwean children. 638 36

In the absence of lupus, mesangial electron-dense deposits in membranous nephropathy are thought to be uncommon. In this study 18 renal biopsies of 16 cases seen over a 2-year period were evaluated by light and electron microscopy and immunofluorescence, directing particular attention to the mesangium. Lupus had been excluded in every instance by the usual serologic tests. In seven of the 18 biopsies, mesangial electron-dense deposits were found. Clinically, almost all of these patients were characterized by atypical features: five patients had underlying diseases which have been associated with membranous nephropathy (renal vein thrombosis, epidermoid carcinoma of the lung, SH-antigenemia, rheumatic heart disease and penicillamine therapy); there was one instance of spontaneous remission and another patient who progressed to terminal renal failure in less than 2 years. The results suggest that the presence of mesangial deposits in membranous nephropathy may be more common than has previously been suspected. This finding is not necessarily associated with systemic lupus erythematosus and may indicate an unusual or atypical form of membranous nephropathy.
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PMID:Mesangial electron-dense deposits in membranous nephropathy. 644 44


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