Gene/Protein Disease Symptom Drug Enzyme Compound
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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirteen patients with chronic renal insufficiency who had been transferred from haemodialysis to haemofiltration treatment because of dialysis and drug resistant hypertension (10 with high plasma renin activity) showed normalisation of blood pressure during a treatment period of 8 months, after which only one patient required antihypertensive drug therapy. During the first period blood pressure drop paralleled body weight loss and after 3--4 weeks blood pressure remained normal in spite of an increase in body weight. In the course of the second phase the effect of fluid withdrawal on blood pressure was directly proportional to the blood pressure at the beginning of the procedure. Adaptation of baroreceptor function must be assumed. In contrast to haemodialysis, haemofiltration did not influence the inulin space. Because of the reduced removal of small molecular substances compared with haemodialysis, extracellular osmolarity was kept stable during haemofiltration. Withdrawal of even large amounts of fluid was sustained without collapse reactions or signs of orthostatic dysregulation.
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PMID:Treatment of severe hypertension in chronic renal failure by haemofiltration. 60 Sep 48

Cyclosporine A (CyA) given to prevent xenograft rejection induces renal function impairment. In the last few years many studies have been devoted to understanding the mechanism(s) of CyA-induced renal insufficiency. In humans, several specific findings--interstitial fibrosis, toxic tubulopathy, peritubular capillary congestion, arteriolopathy--have been associated with CyA administration. It is now recognized that CyA renal toxicity mainly manifests under three different syndromes: (1) acute reversible decrease in glomerular filtration rate (GFR), (2) acute microvascular disease with the pattern of thrombotic microangiopathy, and (3) chronic irreversible renal damage. This review analyzes the available evidence that the clinical syndromes of CyA nephrotoxicity are related to changes induced by CyA on renal vessels. Experimental studies have failed to document that the activation of renin-angiotensin axis or sympathetic nervous system plays a relevant role in the development of CyA-associated renal vasoconstriction, which is the main causal factor of acute reversible decrease in GFR, whereas it is possible that changes in arachidonic acid metabolites with vasoactive properties contribute to this CyA-induced phenomenon. In this context, findings of increased urinary TxB2 and protective effect of TxA2 receptor blocking are of particular interest. Since the introduction of CyA in clinical practice, a syndrome of thrombotic microangiopathy resembling hemolytic uremic syndrome/thrombotic thrombocytopenic purpura has been recognized in humans and reproduced in experimental animals. This is a rare form of vascular toxicity attributed to CyA which may have a poor prognosis and possibly results from a direct toxic effect of CyA on vascular endothelium. The syndrome of chronic progressive deterioration of renal function associated with CyA was first recognized in humans. Until recently the possibility of reproducing this syndrome in animals in order to better understand its nature was not addressed. As in humans, when animals are given CyA for greater than 2 months they may develop chronic renal insufficiency with tubular arteriopathy and interstitial fibrosis. A peculiar form of tubulointerstitial damage has been recognized in association with CyA, and called striped interstitial fibrosis, that is probably due to tubular collapse induced by afferent vasoconstriction. This lesion may be improved by withdrawal of CyA, but renal function usually does not normalize.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal vascular and thrombotic effects of cyclosporine. 265 May 37

The authors report on 4 cases of acute oligo-anuric renal failure that followed intravenous urography (IVU) independently from myeloma or cardiovascular collapse. Eighty other cases can be found in the literature. Post-IVU renal failure only occurs in patients already presenting with chronic renal insufficiency, those with diabetic or geriatric arterial disease being particularly at risk. It is reversible in only one out of two cases when serum creatinine levels exceed 440 mumol/l. The various triiodide contrast media with a high osmolality are equally nephrotoxic. The pathophysiology and prevention of this complication of IVU are discussed.
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PMID:[Acute renal failure following intravenous urography. 4 cases (author's transl)]. 742 2

Destructive spondyloarthropathy has recently been described in patients who undergo maintenance hemodialysis for chronic renal disease. The condition most frequently involves the lower segment of the cervical spine, although the craniocervical junction also may be affected. Although the pathogenesis of destructive spondyloarthropathy remains unclear, the disorder is thought to relate to a hemodialysis-associated amyloidosis. It appears that the disease correlates with the duration of hemodialysis, although it has been reported in patients with chronic renal insufficiency not associated with hemodialysis. Radiographic features simulate those of an infectious process, encompassing a range of abnormalities from superficial erosions to large bony defects. Computed tomography (CT) images reveal osteolytic areas, with bone sclerosis of adjacent vertebral endplates, and minimal osteophytosis. The intervertebral spaces appear narrow or obliterated. On magnetic resonance imaging (MRI), the disorder may show the imaging characteristics of spondylodiskitis. The absence of high signal intensity on T2-weighted images generally helps to eliminate the diagnosis of an infection. With progression of the disease, collapse of a vertebral body and spinal instability may occur. Severe complications of destructive spondyloarthropathy in long-term dialysis patients may include spinal cord compromise, necessitating surgical decompression, with or without spinal stabilization.
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PMID:Imaging in dialysis spondyloarthropathy. 1219 Oct 28