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)

We have studied the frequencies of HLA-A, -B antigens in 73 Berger's disease patients, plus HLA-DR antigens in 35 of them, and compared the percentages of antigens frequencies with those of a local and national panel. This study does not confirm the positive associations with HLA-Bw35 or HLA-B12 which have been previously reported. The HLA-DR typing only showed increased frequency of blanks in the patients (P smaller than 0.01, but no significant corr.P). Patients with Berger's disease and renal failure have a higher (but still not significant) HLA-Bw35 frequency than those without renal failure. The reasons for the discrepancy between our group and others are analysed.
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PMID:HLA antigens and Berger's disease. 746 80

The aetiology and pathogenesis of focal glomerulosclerosis is poorly understood and many conflicting reports suggest HLA locus associations in both familial and non-familial glomerulosclerosis. We report a family in which 4 of 5 sisters developed proteinuria, 2 with hypertension and 1 progressing to end-stage renal failure (index case). Three underwent renal biopsy which displayed characteristic features of focal glomerulosclerosis and all shared the HLA alleles HLA-A1, B8, DR3, DR7. The index case received two cadaveric renal transplants from HLA-A1, B8, DR3 donors and developed chronic rejection with no histological evidence of recurrent glomerulonephritis in either kidney. The frequency of this haplotype in the Australian dialysis and transplant population with focal glomerulosclerosis was compared to that seen in the general Australian Caucasian population and was not significantly different suggesting that the presence of the HLA alleles HLA-A1, B8, DR3, DR7 may increase the predisposition to familial glomerulosclerosis but additional factors are required for disease development and progression.
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PMID:Familial focal glomerulosclerosis: a genetic linkage to the HLA locus? 750 47

1. Approximately half of the pediatric patients received grafts from their parents and half from cadaver donors. Pediatric recipients accounted for only 5% of cadaver-donor transplants. 2. Pediatric patients differed from adults in the incidence of primary disease, principally in the occurrence of diabetes (almost no juvenile diabetics had progressed to renal failure compared with 30% among adults). Obstructive uropathy and dysplasia were the primary diseases for about 37% of pediatric patients compared with 3% in adults. 3. Pediatric patients under the age of one had a markedly lower graft survival with cadaver donors. Such patients had much higher survival rates with parental donor kidneys. 4. Pediatric retransplants from parents had a graft survival comparable to adult grafts. Regraft survival in children given cadaveric kidneys were significantly lower than adult grafts. 5. Patients under the age of 18 with no diuresis on the first day or who required dialysis in the first week had a markedly lower graft survival rate compared with that of adults with comparable early dysfunction. 6. Kidneys from donors under 2 years old yielded a 67% one-year graft survival rate in infants, but an 87% survival in patients 16-18 years of age at 6 selected individual centers. These centers, that had performed more than 20 infant-donor renal transplants, achieved results comparable to those of transplants using grafts from older donors in recipients aged over 11 years. 7. Pediatric patients who received grafts mismatched for 5- and 6-HLA antigens had a significantly lower graft survival rate than those with better matches. 8. Black patients ages 11-18 years old had a lower graft survival rate than White patients in the same age group.
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PMID:Pediatric renal transplantation. 754 71

This study was undertaken to examine the clinical relevance of antibodies detected in the sera of patients following renal transplantation. The sera from 23 transplant recipients with acute rejection and 10 transplant recipients with diagnosed chronic rejection were tested against various epithelial, monocyte and endothelial cell lines (A549, HTB44, primary renal epithelial, U937 and Ea-hy 926). The test used for detecting binding antibodies was a simple, indirect immunofluorescence flow cytometric technique. The level of IgG antibodies directed against the test cell lines was examined in the sera of patients with mild or severe rejection and compared to those of patients showing no signs of rejection. Patients with chronic rejection were found to have increased levels of antibodies (IgG and IgM) when compared to patients with either end-stage renal failure or patients with stable post-transplant renal function. Antibodies detected by the present technique were directed against antigens found on all cell lines tested, and immunoblotting indicated that they were directed against non-HLA antigens. In conclusion, monitoring for the presence of such antibodies may provide a valuable prognostic indicator of graft rejection in renal transplant patients.
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PMID:The clinical significance of post-transplantation non-HLA antibodies in renal transplantation. 762 82

Karyomegalic interstitial nephritis was first described in 1979 by Mihatsch, who was reporting three such cases. We report here four additional cases as well as two family investigations. Our findings support the association of karyomegaly and interstitial nephritis as a distinct entity. Typical clinical features are asymptomatic progressive renal failure in the third decade of life and recurrent infections, mostly of the upper respiratory tract. Histologic alterations consist of markedly enlarged and hyperchromic nuclei in many tubular epithelial cells throughout the nephron accompanied by interstitial fibrosis in the surrounding atrophic tubules. Karyomegaly is not limited to the kidneys. In one case, autopsy revealed karyomegaly in epithelial and mesenchymal cells of many other organs. However, no association of karyomegaly with further histologic damage is evident except in the kidneys. Because of the familial clustering, karyomegalic interstitial nephritis seems to be an inherited disease. Examination of the nuclear proliferation-associated structures proliferating cell nuclear antigen/cyclin, Ki 67, and p53 suggests an inhibition of mitosis in karyomegalic cells. The finding of the same HLA haplotype, A9/B35, in four of six HLA-typed cases suggests the possibility of a genetic defect on chromosome 6, which is inherited and linked to the HLA locus.
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PMID:Karyomegalic interstitial nephritis: further support for a distinct entity and evidence for a genetic defect. 854 34

Numerous transfusion issues arise in the support of solid organ transplantation. ABO and HLA can cause graft rejection immunity or problems in transfusion support. Blood usage has been reduced by the use of erythropoietin in renal failure and aprotinin during liver transplants. Multifactorial coagulopathy during liver transplant surgery continues to be a challenge requiring close monitoring, however. The beneficial effect of transfusions on graft survival has lessened in recent years, but remains an area of active research.
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PMID:Transfusion therapy in solid organ transplantation. 786 Apr 40

Prednisone withdrawal was attempted in 121 of 915 renal transplants recipients between 1967 to 1992. There were 57 males, 64 females. Age range was 21 to 62 (mean 39.2 years). Etiology of renal failure was chronic glomerulonephritis (54), diabetic nephropathy (36), interstitial disease (17), hypertensive nephrosclerosis (6), and other (8). Kidney source was from HLA-identical living-related donors (LRD) in 54 (Group I), one haplotype-matched LRD in 23 (Group II), and cadaver in 44 (Group III). Prior to the introduction of cyclosporin A (CsA) in 1984, prednisone withdrawal was attempted only in Group I. After 1984, prednisone withdrawal was also attempted in patients in Groups II and III, selected on the basis of having had no rejection episodes during the six months after transplantation. Forty-five patients in Group I were treated with azathioprine (Aza) and prednisone, and the remaining patients in Groups I to III were treated with Aza, prednisone and CsA. Mean follow-up was 93 months (6 to 207). Prednisone was gradually tapered and withdrawn in 94 of 121 patients after a mean period of 22.5 months (9 to 60). In 27 other patients, the prednisone dosage has been tapered to 5 mg/day or less with the aim of discontinuing the drug. There were seven episodes of acute rejection (3 during taper, and 1 each at 6, 7, 24 and 114 months after prednisone withdrawal); all seven were successfully reversed. Four other patients developed chronic vascular rejection (2 during taper and 2 after withdrawal).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prednisone withdrawal in HLA identical and one haplotype-matched live-related donor and cadaver renal transplant recipients. 824 66

Major histocompatibility complex (MHC) determinants are critical to the induction or suppression of immune response and have been shown to control the ability to produce antibodies in response to protein antigen. Hepatitis B vaccine commonly fails among patients with renal failure, but genetic factors that modulate response to this vaccination are not yet characterized. The availability of HLA Class II genotyping by hybridization with specific oligonucleotidic probes, following DNA amplification by the polymerase reaction (PCR), has made the analysis of HLA class II loci a reliable and practical approach. Antibody response to HBs and HLA class II oligotyping were assessed among 203 hemodialyzed patients having received a full course of vaccination. Twenty-two percent (N = 45) produced less than 10 IU (radioimmunoassay) of anti-HBs antibodies following the fourth injection. These nonresponder patients had a significantly decreased frequency of the DR2 haplotype compared to responder patients or to a group of 405 normal controls (8.9% vs. 21.5% and 26.2%, P < 0.01). The frequency of the DR3 haplotype was not increased among subjects with lower response. No significant difference appeared in the responder group. These results argue in favor of the presence of HLA-linked immune response gene(s) controlling humoral response to HBs antigen, rather than in favor of the presence of an immune suppressive gene.
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PMID:HLA genetic heterogeneity of hepatitis B vaccine response in hemodialyzed patients. 832 Sep 10

Renal transplantation in patients presenting end-stage renal failure can be hampered by the presence of alloantibodies against HLA antigens. In 4 out of 5 patients with HLA-specific alloantibodies waiting for a renal allograft, treatment with high-dose i.v. Ig resulted in a prolonged suppression (over 3 months) of most of the panel-reactive anti-HLA antibodies (PRA). Intravenous polyclonal human Ig (IVIg) and F(ab')2 fragments from IVIg inhibited the binding of patients' plasma and IgG fractions to peripheral blood lymphocytes from normal donors as well as their cytotoxicity, suggesting that the in vivo effect of IVIg was mediated by the presence, in the IVIg preparation, of anti-idiotypes directed against idiotypes borne on the anti-HLA antibodies. Thus, treatment with IVIg can be a valuable tool toward the transplantation of immunized patients.
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PMID:Suppression of HLA-specific alloantibodies by high-dose intravenous immunoglobulins (IVIg). A potential tool for transplantation of immunized patients. 835 87

In the 19th century, several authors recognized that some renal diseases tend to run in families. Alport pointed to the constellation of nephritic urinary sediment, hearing loss and progression into renal failure. Today this is recognized to result from abnormal basement membrane (BM) collagen synthesis. Recently it has been recognized, however, that other forms of glomerulonephritis may also run in families. In about 10% of patients with glomerulonephritis one or more sibling also suffers from glomerulonephritis. Genetically determined derangements of immune regulation may play a role in the genesis of primary chronic glomerulonephritis. Potentially associated immunogenetic abnormalities include inherited defects of the complement system, increased prevalence of certain HLA-types, altered frequencies of polymorphisms in immunoglobulins and TCR genes and others. This overview summarizes immunogenetic studies performed in patients with glomerulonephritis with special emphasis on patients with mesangial IgA GN.
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PMID:Immunogenetic findings in glomerulonephritis. 846 22


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