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

Clinical, hemodynamic and pathologic findings of three patients with total anomalous pulmonary venous drainage to the portal vein system are presented. Some of the findings are emphasized because of its rarity in previous reports. These are: 1) Cyanosis was mild. 2) There was some obstruction of the foramen ovale, besides the obstruction at the portal system level. In two patients gastrointestinal bleeding and analitical evidence of renal failure, were found, both findings not previously reported to our knowledge.
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PMID:[Total anomalous pulmonary venous drainage below the diaphragm. Report of three cases and semiologic considerations (author's transl)]. 44 40

A three-day-old female infant was transferred to the Pediatric Intensive Care Unit with chief presenting problems of progressive change of cyanosis and respiratory distress. Physical examination revealed tachypnea, acrocyanosis, hepatomegaly, undetectable pulse of extremities and oozing over the place of venous puncture. Chest roentgenograms revealed slight cardiomegaly; other X-rays were within normal limits. Complete electrocardiograms showed right axis deviation and right ventricular hypertrophy. Because of an impression of neonatal sepsis, the patient was put in an incubator with oxygen and antibiotics were given. Persistent anuria appeared associated with sighs of cardiac and renal failure; the ventilator was applied; dopamine and lasix were also given. Unfortunately, the cyanosis worsened progressive. Despite several attempts at resuscitations, the infant expired eight hours later. Pathology disclosed the heart size as normal; hypoplasia of ascending aorta as 0.4 cm in diameter; a PDA with 1 cm in diameter; a diminutive bean-sized left ventricle; hypertrophy of right ventricle and atresias of aortic and mitral valves. There was no evidence of septicemia.
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PMID:[Hypoplastic left heart syndrome due to aortic and mitral atresias: report of one case]. 263 9

A 72-years-old male patient is described who presented with relapsing, digital ulcers on both feet, accompanied by digital cyanosis ("purple toes"). All episodes occurred 5 months after starting coumarin treatment for chronic atrial fibrillation and low output failure. Massive mural thrombosis was discovered of the entire abdominal aorta. Because of the clinical picture, together with progressive renal failure and persistent eosinophilia, cholesterol embolization from an ulcerated atherosclerotic plaque within the mural thrombus was highly suspected. Besides the clinical presentation of our patient, the spectrum of cholesterol embolization is much wider. The role of coumarin therapy is still speculative. Numerous reports however, indicate a potential role in precipitating the syndrome. The only therapy available consists of removing the source whenever possible.
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PMID:Relapsing digital ulcers. 280 Aug 41

Two patients developed the cholesterol embolization syndrome after coronary angiography and intravenous streptokinase therapy for acute myocardial infarction. Clinical manifestations included cyanosis, ulcers, gangrene of the hands and feet, myalgias, intestinal infarction, eosinophilia, and renal failure. One patient died; one has survived with chronic renal failure. Streptokinase therapy may expose atheromatous plaques to the circulation by lysing platelet-fibrin thrombi.
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PMID:Cholesterol embolization syndrome. Occurrence after intravenous streptokinase therapy for myocardial infarction. 365 5

A fatal case of poisoning by a mixture of methanol and ethylene glycol is described. A 72-year-old man was hospitalized when he was found stuporous to semicomatose, and despite massive bicarbonate therapy, died 36 hr after the admission. While the presence of numerous oxalate crystals in urine strongly suggested ethylene glycol intoxication, the GC analysis of the liquid the patient ingested revealed that he presumably drunk about 150 to 200 ml of a mixture of methanol (80%) and ethylene glycol (20%), the amount well over the lowest lethal dose when the additiveness of toxicity was considered. Retrospective evaluation of the signs suggested that while some of them such as oxalate crystalluria, elevated CPK, hypocalcemia, renal failure are attributable to the toxicity of ethylene glycol, others including elevated serum amylase and cyanosis are indicative of methanol poisoning. Disturbed consciousness was considered to be of metabolic origin; the high anion gap observed (38.2 mEq/liter) may be due not only to lactic acidosis but also to acidogenicity of the two chemicals ingested. The importance of gas chromatographic analysis for identification of the causative chemical(s) is stressed.
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PMID:A case of poisoning by a mixture of methanol and ethylene glycol. 667 Jan 3

In a review of 126 heart specimens of simple complete transposition of the great arteries with ventricular septal defect (VSD), coarctation was noted in eight (6%). In 105 Taussig-Bing heart specimens, coarctation and/or aortic outflow tract obstruction was noted in 56 (53%) (p less than 10(-10). This was similar to our surgical experience in 26 patients with transposition and VSD or Taussig-Bing heart. Six of nine patients with Taussig-Bing heart also had coarctation of the aorta, whereas all 17 patients with transposition and VSD had a normal aorta. Four patients with Taussig-Bing heart underwent coarctation repair and pulmonary artery banding at 2 to 7 days of age. The remaining two patients with Taussig-Bing heart did not have a hemodynamically significant coarctation. Five of the six patients with Taussig-Bing heart and coarctation underwent a Senning procedure between the ages of 7 weeks and 3 1/2 years. In four (all less than 4 months of age) the VSD could not be closed through the tricuspid valve. A right ventriculotomy was done in two and contributed to their deaths. In the other two patients the VSD was left alone and the pulmonary artery banded. Both remain well. The fifth child, aged 3 1/2 years, had the VSD closed through the tricuspid valve but died in the postoperative period of renal failure. The sixth patient is awaiting further operation following coarctation repair and pulmonary artery banding. We conclude that the presence of coarctation strongly suggests that Taussig-Bing heart malformation exists rather than transposition and VSD. Pulmonary artery banding and coarctation repair are the initial procedures of choice in the management of these critically ill newborn infants. Increasing cyanosis and failure to thrive will necessitate further operation. Closure of the VSD through the tricuspid valve in these infants is difficult. Pulmonary artery banding in association with a Senning procedure is preferable to a right ventriculotomy. Closure of the VSD is then planned at a later stage.
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PMID:Coarctation in Taussig-Bing malformation of the heart. Surgical significance. 687 64

Two patients developed acute oliguric renal failure following paraphenylene-diamine intoxication. The associated clinical features included vomiting, angioneurotic edema, cyanosis, intravascular hemolysis and methemoglobinemia. Therapeutic dialysis and symptomatic management was followed by complete recovery in one, and death due to septicemia during the oliguric phase in the other patient. Renal histology in both cases revealed acute tubular necrosis. The pathogenetic mechanisms involved in the development of acute renal failure following paraphenylene-diamine have been discussed.
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PMID:Acute renal failure following paraphenylene diamine [hair dye] poisoning: report of two cases. 695 50

Arteriovenous (AV) fistulas are routinely constructed for hemodialysis in patients with renal failure. The case of a hemodialysis patient with cyanosis of the hand distal to an AV fistula is described. Pulse oximeter analysis found a saturation of 72% in the cyanotic hand with a normal saturation of 97% in the opposing hand. Evaluation of 11 additional patients with AV fistulas and no cyanosis or symptoms found no difference in oxygen saturation between extremities. Pulse oximetry was found to be useful for evaluating the oxygenation status distal to an AV fistula, and in asymptomatic patients with an AV fistula, the oxygenation status distal to the fistula should be no different from that of the opposing extremity.
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PMID:Pulse oximeter analysis of peripheral cyanosis distal to an AV fistula. 863 99

The prognosis of renal cholesterol crystal embolism (CCE) is poor, and many patients progressively develop to the end-stage of chronic renal failure. We herein experienced a 66-year-old male patient who recovered from hemodialysis (HD) shortly after an amputation of inflammatory toes. The patient complained of painful digital cyanosis at bilateral toes and livedo reticularis at right lower leg 4 weeks following aortic angiography. Laboratory examinations revealed eosinophilia and overt proteinuria (3.0 g/day). His serum creatinine level increased from 2.18 to 8.57 mg/dl over 6 weeks, and HD treatment was started. Treatment with simvastatin (5 mg/day) did not reverse renal failure and hypereosinophilia, but the amputation of right gangrene toes promptly increased urine output and eosinophilia completely disappeared concomitantly with a decline of C-reactive protein from 9.7 to 0.7 mg/dl. Serum creatinine level was also reduced to 3.46 mg/dl, and he eventually stopped HD totally after 32 sessions. This case suggested that the surgical amputation promptly recovered renal function. Reversal of inflammation may be more effective than lipid-lowering therapy for renal failure in our patient.
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PMID:Recovery from hemodialysis therapy in a patient with renal cholesterol crystal embolism. 1218 14

Primary hyperoxaluria is a rare autosomal recessive disorder resulting in precipitation of insoluble oxalate crystals in the joints, kidneys, heart, eyes, and skin. Two thirds of patients have calcium oxalate nephrolithiasis by age 5 years and 80% die of renal failure by age 20 years. Rarely, the disease will present in adulthood, with the onset of symptoms occurring as late as the sixth decade. We present a 27-year-old woman with end-stage renal disease who presented to the dermatology department for the evaluation of a reticular rash shortly after beginning peritoneal dialysis. Associated symptoms included arthralgias and episodic acral cyanosis. Previous kidney and skin biopsy specimens revealed crystalline deposition, however, the diagnosis of primary hyperoxaluria was not entertained until an atrial mass was found to have the same crystalline material. This report reviews primary hyperoxaluria and underscores the importance of recognizing the disease as a cause of renal failure in a patient with livedo reticularis and skin lesions resembling calciphylaxis. Early recognition of the disease is important because combined liver-kidney transplantation may achieve long-term survival.
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PMID:Primary hyperoxaluria in a 27-year-old woman. 1451 27


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