Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An immunogenetic study of 71 patients with essential hypertension associated with no signs of heart or renal failure, and 276 normal Russian male residents of Moscow demonstrated a significantly increased frequency of antigens HLA-B13 (p less than 0.01) and HLA-B22 (p less than 0.05), as well as HLA-A11 (p less than 0.05), in the hypertensive sample. Aggravated heredity (familial hypertension) was established in 64% of hypertensive carriers of antigens HLA-B13 and HLA-B22.
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PMID:[Distribution of HLA antigens in patients with hypertension]. 406 58

Thirty-six patients received allogeneic (34) or syngeneic (two) bone marrow transplants as treatment for severe aplastic anaemia or acute leukaemia. Nineteen of the allogeneic recipients received methotrexate (MTX) and 15 received cyclosporin A (CyA) as the predominant immunosuppressive agent to minimize graft-versus-host disease (GVHD) post transplant. In the first 100 d post transplant renal dysfunction was much less frequent in the MTX recipients than in the CyA recipients who exhibited three distinct syndromes of nephrotoxicity: most commonly. CyA recipients developed asymptomatic azotaemia, proteinuria, urinary casts, impaired urinary concentrating ability and hypertension. Secondly, two CyA recipients developed acute reversible renal failure precipitated by systemic bacterial infection which required dialysis and in which the kidney was the sole target organ; thirdly, two recipients of HLA-genotypically non-identical grafts developed a rapidly progressive fatal syndrome with multiple organ involvement including lung, brain and kidney which clinically and histologically resembled thrombotic thrombocytopenic purpura.
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PMID:Cyclosporin A associated nephrotoxicity in the first 100 days after allogeneic bone marrow transplantation: three distinct syndromes. 634 55

IgA-glomerulonephritis (IgA-GN) accounts for approximately 20 per cent of all glomerulonephritis in our unit. Seventeen out of 50 patients with IgA-GN developed renal failure, which appeared in 11 out of 17 over the course of a mean follow-up of 68 months. Haemodialysis was required in three patients. Twenty-two out of 50 patients had hypertension, five with malignant hypertension. Perivascular IgA deposits were found in skin biopsies of 29 per cent of patients with IgA-GN and also in 19 per cent of patients with other GN, but not in healthy controls. Mucosal (salivary and nasal) secretory IgA concentrations were normal. In cutaneous and glomerular IgA/IgM deposits, IgA1 was demonstrated using monoclonal antibodies. No excess of HLA-A, B or DR antigens and no relation of clinical course and HLA-Bw35 were found.
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PMID:Clinical and serological features of mesangial IgA glomerulonephritis. 634 57

Analysis of data on renal transplantation collected in two large multicenter observational studies resulted in the concordant identification of five factors that correlated highly and at a substantial level of statistical significance with the outcome of unrelated cadaveric donor transplantation (i.e., they were associated with differences in one-year graft survivals of 0.07-0.21 and P values less than 0.05). These factors were: blood transfusions prior to the transplant, race of the recipient (white or black), prior failure in transplantation, level of sensitization to lymphocyte alloantigens, and diabetes as the cause of end-stage renal failure. Multivariate analysis with a mathematical survival model confirmed the importance and independence of these prognostic factors. Matching of HLA antigens appeared to be beneficial in both studies, but failed to attain high statistical significance in one. Systematic differences in the use of pretransplant splenectomy and, probably, in the nature of the antilymphocyte serum or globulin led to discordance in assessment of the importance of these factors in the two studies. Although advanced age (greater than 45 years) of the recipient was associated with reduced graft survival in both studies, analysis by means of the model failed to detect a significant correlation between the recipient's age and the outcome in one of the studies because the relation was not monotonic. In an illustration of their utility in the detailed assessment of performance, the prognostic factors were found to substantially account for the markedly superior results at one center and partly for lower graft survivals at another. These prognostic factors may be used to predict probable outcomes for populations and for individual patients subjected to particular arrays of conditioning strategies.
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PMID:Assessment of prognostic factors and projection of outcomes in renal transplantation. 635 3

Analysis of 2808 first and 823 second or subsequent cadaveric renal allograft recipients transplanted between June 1977 and July 1982 as part of the Southeastern Organ Procurement Foundation (SEOPF) Prospective Study was performed to determine the influence of pretransplant bilateral native nephrectomy (BNN) on graft and patient outcome. A highly significant increase in overall graft survival was associated with BNN in first transplant recipients (P less than 0.003) but not in regrafted patients. However, no increased graft survival was seen in patients receiving BNN at the time of the transplant operation. Interestingly, the improvement in graft survival associated with BNN appeared to be the result of a significant decrease in the incidence of graft loss caused by rejection--and especially accelerated acute rejection (P less than 0.007). Comparing actuarial graft survival for first graft recipients that had BNN prior to transplantation (n = 434) with those who had no nephrectomy (n = 2240) showed differences of 62% +/- 3 vs. 52% +/- 1 and 46% +/- 3 vs. 38% +/- 2 at one and three years, respectively. Analysis of first graft survival stratified for other factors known to influence outcome showed that the beneficial influence of BNN was independent of transfusion status or the number of transfusions given, use of antilymphocyte serum, pretransplant splenectomy, HLA match, or time on dialysis. The most striking increase in graft survival associated with BNN was seen in patients with evidence of presensitization as manifested by a positive panel reactive antibody (PRA) and in patients having delayed function (ATN) posttransplantation. The beneficial association of BNN was also found to be independent of the primary cause of renal failure or the specific indication leading to nephrectomy. These results suggest that patients receiving native bilateral nephrectomy prior to transplantation have a reduced incidence of graft loss from rejection by some as yet unexplained mechanism.
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PMID:The association of pretransplant native nephrectomy with decreased renal allograft rejection. 636 65

One hundred seventeen patients with renal failure resulting from insulin-dependent diabetes mellitus received primary renal allografts from June 1970 to April 1983. Factors significantly associated with improved graft and patient survival were LRD sources (in particular, HLA-identical) and splenectomy. Variables such as transfusions, age, sex, and the administration of ALG were not significantly associated with transplant outcome. However, survival of patients and grafts has improved in recent years and continues to compare favorably with hemodialysis results. Although splenectomy might be the most important variable responsible for the improvement of our recent results, the use of ALG for rejection episodes might have contributed substantially to the improvement. Early transplantation, not analyzed in this study, might prove to be the most significant variable in the outcome of transplantation in patients with diabetic renal failure.
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PMID:Improving results in primary diabetic renal transplantation. 637 28

Stimulation of human lymphocytes with concanavalin A (Con A) resulted in variable lymphokine responses as indicated by factors inhibiting macrophage migration (MIF) or stimulating macrophage migration (MStF), or resulted in negligible responses. These responses were consistent for a given individual when repeated after several months. MIF responses were observed more frequently than MStF responses in patients with renal failure who had demonstrable alloantibodies. MStF responses were statistically associated with the presence of HLA DR1 antigens in patients with renal failure and two separate groups of healthy individuals, while MIF responses were associated with DR7 in the three groups studied. There was no correlation between immunoglobulin allotypes and lymphokine responses. These results suggest that lymphokine responses to Con A are indicators of nonspecific immunological responsiveness and are influenced by genes associated with the major histocompatibility complex.
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PMID:Lymphokine responses to concanavalin A stimulation: association with HLA DR antigens. 638 Aug 45

The survival of renal allografts between SLA-matched swine has been found to be subject to non-SLA-linked Ir gene control. Using three herds of miniature swine, each homozygous for a different SLA haplotype (designated aa, cc, and dd, respectively), we initially observed that all animals of the c haplotype rejected SLA-matched renal allografts. In contrast, the subset of dd animals which were the product of continuous homozygous matings since establishment of the dd herd (ddR) accepted SLA-matched grafts indefinitely without any immunosuppression. A formal backcross study was therefore performed in which offspring of (cd x ddR) matings (designated cdbc and ddbc) were bilaterally nephrectomized and transplanted with SLA-matched renal allografts. Acceptors and rejectors were found among both backcross types, with a total of 6 of 17 (35%) of the animals dying of renal failure secondary to rejection. When ddbc animals were used as donors for ddR recipients, all grafts were accepted, ruling out the possibility that rejection was attributable to strong non-SLA antigens segregating within the cc herd. These results are consistent with a model in which rejection of SLA-matched renal allografts is controlled by either one or two non-SLA-linked immune response genes. These findings raise the possibility that the observed 5 to 15% frequency of rejection of HLA-identical living related donor renal allografts in man could involve similar immune response gene control.
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PMID:Transplantation in miniature swine. X. Evidence for non-SLA-linked immune response gene(s) controlling rejection of SLA-matched kidney allografts. 680 77

HLA antigens of the A and B loci were determined on the lymphocytes of 30 patients with acute lymphocytic leukemia (A.L.L.), as well as all of their mothers and 26 of the fathers. Seven of the 26 parents shared a common haplotype. This incidence of 269 per 1,000 contrasts with an expected incidence of 90.7 per 1,000, calculated from haplotype frequencies in a North American population (X2=7.61, P smaller.than 0.01) and a frequency of one in 27 in parents of patients with renal failure in the local population (X2=3.91, P smaller than 0.05). There was no statistical difference between the latter group and the North American controls (X2=0.39, P greater than 0.10). This suggests that the genetic background of a large proportion of patients with A.L.L. has restricted heterogeneity, presumably leading to the increased expression of leukemia associated recessive genes.
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PMID:Restricted genetic heterogeneity in families of patients with acute lymphocytic leukemia. 693 67

In Australia, it has been logistically possible, with integrated programmes of dialysis and transplantation, to use finite resources optimally for the treatment of patients presenting with terminal renal failure (30 per million population per year). Transplantation is offered as definitive treatment in most instances. Transplantation rates (20 per million per year) will need to increase to meet the continuing demand, if the results of transplantation remain unchanged. Patient survival after transplantation is approximately 80 per cent at year, 50 per cent at 5 years and 20 per cent at 15 years. Most grafts are from cadavers. Graft survival of 60 per cent at 1 year thereafter declines steadily with a 3 per cent graft loss per year. Patient and graft survival are adversely affected by increasing age, and the use of cadaver rather than living donors. Graft survival is superior with a 4 antigen match on HLA A and B matching, and is significantly lower in patients receiving no blood transfusions prior to transplantation. Long term morbidity is significant in two-thirds of patients receiving grafts. Problems include chronic rejection and toxic effects of immunosuppression. The increased tumour risk after transplantation (which in Australia has been mostly skin tumours) is of major concern; 30 per cent of patients by 10 years have developed cancer.
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PMID:Renal transplantation--15 years' experience. 700 31


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