Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Heroin addiction is associated with several severe and occasionally fatal renal complications. Acute renal failure consequent to rhabdomyolysis and myoglobinuria, when treated supportively, carries a good prognosis. Staphylococcal or other bacterial septicemia may in itself prove fatal and is associated with a proliferative immune complex, acute glomerulonephritis, which generally follows the course and prognosis of septicemia. The necrotizing angiitis reported in heroin addicts still is largely undefined. Focal and segmental glomerular sclerosis is the most common pathologic finding in the syndrome of heroin-associated nephropathy (HAN). Typically, HAN presents with massive proteinuria and progresses rapidly to renal failure. Presumptive evidence supports the premise that heroin or its vehicles elicits immunologically mediated renal damage. The antigen still is unidentified. Removing the antigenic challenge by stopping heroin injection apparently interdicts the progression of renal disease. Renal transplantation can be effectively accomplished in patients with HAN without early recurrence if patients discontinue the use of heroin.
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PMID:Renal consequences of narcotic abuse. 2 85

The frequency of severe reactions to allopurinol has probably been underestimated. A retrospective study encompassing a five-year period has yielded 20 patients with severe hypersensitivity reactions to allopurinol. Patients with preexisting renal impairment or who were receiving concomitant thiazide diuretics appeared to be especially predisposed. Cutaneous reaction patterns included maculopapular eruptions, exfoliative dermatitis, and toxic epidermal necrolysis. eosinophilia was uncommon. Forty percent of the patients developed hepatic involvement and 45% had renal involvement. Hepatic and renal changes usually were reversible and were not unique to any one cutaneous reaction pattern. Three patients with renal involvement required prolonged administration of systemic steroids. Complications included sepsis, decubitus ulcers, and thromboembolism. Two patients required hyperalimentation. Sequelae included dry eyes, pigmentary disturbances, and keloids. Three patients died as a result of their reaction. It is concluded that allopurinol should be used only in select patients, and the dosage should be modified if renal disease exists.
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PMID:Severe hypersensitivity reactions to allopurinol. 15 91

Over a period of 2 years, 82 patients out of 2,390 (3.43%) admitted to an intensive care unit developed acute renal failure (ARF). The diagnosis of ARF was based on the usual criteria of oliguria, a rising blood urea nitrogen and creatinine, urine sodium concentration greater than 20 mmol/l and a U/P osmolality ratio less than 1.1. In 9.2% of patients the latter two criteria were misleading. Sepsis was the commonest cause of vasomotor nephropathy but in 20.7% potentially nephrotoxic agents had been administered before development of ARF. Overall mortality was 73.2%, with patients older than 50 years of age having the highest mortality. ARF is associated with prolonged bed occupancy--an average of 59.8 days for the dialysed patients with ARF versus an average length of stay of 8.4 days for the hospital overall.
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PMID:Aetiology, diagnosis, treatment and prognosis of acute renal failure in an intensive care unit. 54 32

Acute renal failure may be a contributory cause of death in patients with acute leukemia. The purpose of this study was to define the causes and course of acute renal failure in group of patients with acute leukemia in order to identify preventive measures and reversible aspects of the renal insufficiency. Among 88 patients with acute leukemia whose courses were followed to the time of death, ten developed acute renal failure. Etiologic factors of the renal failure were uric acid nephropathy, sepsis with complicating hypotension and hypovolemia, and the administration of nephrotoxic antibiotics. In one patient ureteral obstruction from clots was responsible for renal failure, while in another patient disseminated aspergillosis led to renal failure. Other causes of acute renal failure in persons with acute leukemia, but not observed in this patient group, are hypercalcemia and leukemic infiltration of the kidneys.
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PMID:Acute renal failure in patients with acute leukemia. 63 12

A 65 year old man developed endocarditis and septicemia due to Hemophilus aphrophilus, a Gram-negative coccobacillus. Renal rather than cardiac failure was the principal feature of his illness and renal biopsy was compatible with glomerulonephritis secondary to septicemia. Rapid recovery of renal function and improvement of the glomerular lesion followed antibiotic treatment of the septicemia. This case illustrates the renal damage that can occur in association with septicemia due to rarer infectious agents. As with more common organisms, specific antimicrobial therapy leads to rapid improvement of the nephropathy.
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PMID:Glomerulonephritis associated with Hemophilus aphrophilus endocarditis. 63 69

Review of 112 renal transplants in 95 patients with end-stage renal disease revealed a wound infection rate of 18 percent. The incidence of infection was unquestionably greater if drains were placed in the wound. An 8.8 per cent incidence of pulmonary infection was represented by lung abscess, bronchopneumonia and necrotizing pneumonitis. Three deaths were attributable to fungal infections-candida sepsis, cryptococcal sepsis, and Nocardia brain abscess. In 14 per cent of this series vascular anastomotic complications occurred, and were attributable to stenosis, thrombosis, or hemorrhage. The complications of ureterovesical anastomosis include urinary fistulas and ureteral obstruction.
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PMID:Renal transplantation: an analysis of operative complications. 76 18

The efficacy of renal transplantation for patients with end-stage renal disease was reviewed in 108 patients receiving 111 transplants followed for an average of two and one-half years after transplantation. Overall patient survival decreased 10 per cent per year from 90 per cent after the first year to 70 per cent at three years. Kidney survival was slightly less, with a similar pattern. Patients with better tissue matches and living related donor allografts had fewer and less severe rejections and better ultimate function than did patients with poor tissue matches and cadaver allografts. However, a significant number of patients with poor tissue matches and cadaver allografts had excellent results. Eighty-six per cent of all survivors with functioning kidneys had serum creatinines of 2.0 mg./100 ml. or below. Mortality was associated primarily with sepsis from a variety of bacterial, fungal, viral and protozoan organisms often associated with other complications such as rejection or gastrointestinal bleeding. Recipients over the age of 40 were in a higher risk group. Rejection per se, however, played a minor role. Urological and skeletal complications were a major source of morbidity but were not associated with mortality.
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PMID:Treatment of end-stage renal disease by transplantation: clinical results with 111 cases. 80 51

Nephropathy, eosinophilia and fever were observed in an 18-year-old man being treated for staphylococcal septicemia. Parenteral challenge with suspected sensitizing agents confirmed methicillin as the likely offender. Review of the literature relating to methicillin-induced nephropathy suggests a hypersensitivity origin for this disorder, but immunologic and ultrastructural investigation to date has failed to elucidate pathogenesis.
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PMID:Nephropathy caused by methicillin therapy for staphylococcal septicemia. 94 Oct 54

Fifty-eight patients with chronic laryngitis, defined as diffuse laryngeal inflammation, of an average duration of approximately 1 year, were investigated. The sex incidence was equal and the average age 45 years. Occupational factors were of minor importance, and the smoking habits of the patients were the same as those of a similar matched population. Of the haematological factors investigated, anaemia, diabetes, renal disease and syphilis were of no importance whatsoever. The most important aetiological factor was sepsis of the upper and lower respiratory tracts which was present in over half the patients.
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PMID:The aetiology of chronic laryngitis. 103 54

We retrospectively evaluated the clinical outcome of 45 female and 11 male patients with biopsy-proven lupus nephritis, followed at our hospital between February 1974 and February 1990. In the majority signs of nephritis were present at the time systemic lupus erythematosus was diagnosed (range: -42-156 months) and the median time from onset of nephritis to biopsy was 2 months. The median follow-up from the time of the biopsy was 53.5 months (range: 2-192), the median age at biopsy 25 years and the median serum creatinine level 1.2 mg/dl. Initial renal biopsies had the following histopathological classes according to the World Health Organization criteria (n): I (2); II (10); III (10); IV (28); V (5); VI (1). Over the study period active episodes were treated with high-dose oral prednisone alone or combined with intravenous nitrogen mustard and oral chlorambucil (1974-75), azathioprine (1978-86), cyclophosphamide (1986-90) and/or plasma-exchange (1976-84). These strategies were based on literature data or multicenter studies in which we participated. Eight patients developed end-stage renal disease (ESRD) (median: 47 months post-biopsy; range: 20-120). In these, initial biopsies showed class IV in seven, and class V in one. Confounded risk factors for ESRD were class IV biopsy, male gender and serum creatinine level above 1.4 mg/dl. The calculated proportion without ESRD 5 years post-biopsy was 87% (95% confidence limits: 98-76%), and at 10 years 70% (95% confidence limits: 90-49%). Five patients (11.2%) died; causes of death were cerebrovascular accident (n = 2), cerebral lupus (n = 2) and S. aureus sepsis (n = 1).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The long-term clinical outcome of 56 patients with biopsy-proven lupus nephritis followed at a single center. 130 70


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