Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A long-term study of 17 patients with paroxysmal nocturnal hemoglobinuria revealed an unexpectedly high incidence of functional and anatomic renal abormalities. All patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. All patients also had granular casts in multiple urinalyses. Evaluation of renal function revealed hyposthenuria, abnormal tubular function and declining creatinine clearance. Radiologically, one or more of these demonstrated enlarged kidneys, renal cortical infarcts and thinning, papillary necrosis, acute renal atrophy, retroperitoneal hematoma and ureteral infarction, which were confirmed by autopsy studies. Hypertension developed in 7 patients. Urinary tract infection was uncommon and no patient had a clinical history compatible with chronic or acute pyelonephritis. Contrary to usual opinion our compatible clearly showed evidence of frequent and widespread renal pathology in paroxysmal nocturnal hemoglobinuria most likely due to repeated microvascular thromboses similar to the venous trombosis involving other organs in this disorder. Since most of these patients present initially to urologists knowledge of this entity is mandatory.
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PMID:Urologic manifestations of paroxysmal nocturnal hemoglobinuria. 114 29

A total of 132 infants and children with grades III and IV primary vesicoureteral reflux was entered into a prospective trial comparing medical to surgical management. Inclusion criteria were an age not exceeding 10 years and a glomerular filtration rate of at least 70 ml. per minute per 1.73 m.2. Children with significant urinary tract malformations and clinical signs/symptoms of dysfunctional voiding were not accepted into the trial. Medical therapy consisted of continuous low dose antibiotic prophylaxis until vesicoureteral reflux resolved. The type of surgical procedure used for the correction of reflux was left to the discretion of the surgeon. Outcome variables included the appearance or progression of renal lesions, rate of renal growth, recurrence rate of urinary tract infection or pyelonephritis, changes in total kidney glomerular filtration rate, development of hypertension and resolution rate of vesicoureteral reflux. Followup at 6, 18, 36 and 54 months after entry included, in addition to history and physical examination, voiding cystourethrography, excretory urography and a urine culture. Of the patients 68 were allocated to the medical group and 64 to the surgical group. They were stratified for age, sex and preexisting renal scarring. Of the patients 10% were boys, 47% were between 2 and 6 years old at entry, 93% had a history of pyelonephritis, 67% had either scarring or thinning of the parenchyma at entry, 87% had grade IV vesicoureteral reflux in at least 1 unit and 56% had bilateral reflux. There were no significant differences in the frequency distribution of entry characteristics between the patients allocated to either group. New renal scarring developed in 22% of medical and 31% of surgical patients (p < 0.4). Growth of kidneys with grade IV vesicoureteral reflux was slightly less than normal in the medical (-0.67 +/- 0.15 standard deviation) and surgical (-0.42 +/- 0.11 standard deviation) groups (p < 0.7). Pyelonephritis occurred in 15 medical patients versus 5 surgical patients (p < 0.05). There was no significant change in glomerular filtration rate within each treatment group and no difference in glomerular filtration rate between groups. No patient had hypertension during the followup period. The disappearance rate of vesicoureteral reflux in patients with grade IV reflux was approximately 8% per year. Of the medical patients 75% still had vesicoureteral reflux after 3 years of observation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). The International Reflux Study in Children. 143 85

32 patients with chronic lymphoid leukemia (CLL) were examined to specify reasons of renal damage. Measurements were made of blood urea, creatinine, total protein, electrolytes, uric acid. Also, urinary sediment, diurnal loss of protein and creatinine with urine, glomerular filtration rate, concentration ability of the kidneys were studied. Urinary system was assessed by ultrasound. Most CLL patients studied had renal affection characteristic for chronic pyelonephritis with chronic renal insufficiency. The ultrasonic investigation stated reduced size of the kidneys, thinning of the cortex, extension of the renal pelvis and calyces, concrements. The kidneys and ureters were pressed and displaced by enlarged spleen, liver, lymph nodes. The plan of CLL patients' examination must include ultrasonic investigation of the abdominal organs for early detection of renal lesions.
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PMID:[Renal lesions in patients with chronic lymphocytic leukemia]. 1243 39

Milk of calcium is a viscous colloidal suspension of calcium carbonate, calcium phosphate, or calcium oxalate, or a mixture of these compounds. The calcific material gravitates to the dependent portion of a cystic cavity. Crescent- or hemisphere-shaped calcium density with a sharp horizontal upper border at the milk of calcium-clear fluid interface confirms the diagnosis. Bilateral milk of calcium in the renal pelvis or in dilated calyces is very rare and has not been reported in patients with spinal cord injury. A 63-year-old male patient with T-10 paraplegia presented with recurrent urinary tract infections. X-ray of the kidneys, taken with the vertical beam while the patient lay supine, revealed a poorly defined opacity overlying the lower pole of the right kidney. Findings on ultrasonography of the kidneys were interpreted as a large, staghorn-type calculus in the dilated lower pole calyx of the right kidney. Because x-ray of the kidneys showed a poorly defined opacity overlying the lower pole of the right kidney, milk of calcium was suspected, and computed tomography (CT) of the kidneys was performed. Calcific debris with horizontal layering in the lower pole calyces of both kidneys was seen; this confirmed the diagnosis of milk of calcium. A 62-year-old female patient with C-7 tetraplegia underwent ileal conduit urinary diversion. Subsequently, she developed calculi in the right kidney, which were treated with shock wave lithotripsy. Follow-up x-ray revealed faintly opaque shadows with indistinct margins in the region of both kidneys. Intravenous urography showed cortical thinning at the upper poles and blunting of the calyces, suggestive of chronic pyelonephritis. The right renal pelvis was bulky, and bilateral renal calculi were diagnosed during ultrasonography; however, the presence of faintly radio-opaque shadows with indistinct margins raised suspicions of renal milk of calcium. A CT scan of the kidneys, which was performed in the supine and subsequently in the prone position, revealed gravity-dependent layering of calcific material in the pelves of both kidneys and in the midpole calyces of the right kidney, thus confirming the diagnosis of milk of calcium. In conclusion, CT scan of the kidneys confirmed the diagnosis of bilateral renal milk of calcium, a very rare entity in patients with spinal cord injury. Awareness of typical and unique features of milk of calcium during imaging enables physicians to recognize renal milk of calcium and to differentiate it from nephrolithiasis, thereby avoiding unwarranted interventions such as shock wave lithotripsy or endoscopic procedures.
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PMID:Bilateral renal milk of calcium masquerading as nephrolithiasis in patients with spinal cord injury. 1766 Jan 62

Primary renal squamous cell carcinoma is a very rare malignancy of the upper urinary tract. Most patients have history of chronic urolithiasis, analgesics abuse, radiotherapy or infection. Co-existence of SCC with xanthogranulomatous pyelonephritis is exceedingly rare with only few reports in the literature. We report a case of a 60-year-old male presented with right flank pain and mild tenderness of abdomen. Computed tomography of the abdomen revealed gross hydronephrosis with parenchymal thinning and irregular thick enhancing wall of pelvicalyceal system with multiple calculi in right kidney. Right renal vein appeared distended, filled with hypo dense material. Right nephrectomy was performed and sent for pathological examination. Histological evaluation revealed keratinizing squamous cell carcinoma with infiltration of renal vein and xanthogranulomatous pyelonephritis.
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PMID:Rare Co-existence of Squamous Cell Carcinoma with Infiltration of Renal Vein and Xanthogranulomatous Pyelonephritis. 2681 4

The paper provides a retrospective study of long-term results of ureterocalicostomy (UC) performed in one specialized center. The study included 37 patients who underwent UC as a primary (43.2%) or secondary (56.8%) operation for intrarenal hydronephrosis or urolithiasis. All surgical interventions were classified into two groups according to the type of kidney resection: Type I - if the kidney parenchyma was more than 10 mm, the entire lower pole of the kidney was removed (72.9%); Type II - if the parenchyma was less than 10 mm, a part of the lower pole (1.5-2.0 cm) was removed in the zone of maximal parenchymal thinning (24.3%). All resections, depending on the angle of their plane, were also divided into transverse (48.6%) and oblique (51.4%). Early postoperative complications were observed in 14 (37.8%) patients. All complications were not severe and were classified as Grade I-II according to the Clavien-Dindo system. The univariate analysis showed that the predictors of UC complications are the long duration of the operation, warm renal ischemia for more than 20 minutes, the secondary nature of the operation, as well as the presence of acute pyelonephritis and urinary extravasation before the operation. The rate of good long-term results was 81.1% (n=30), satisfactory - 13.5% (n=5), poor - 5.4% (n=2). The reliable prognostic value in terms of negative surgery results had: the thickness of the renal parenchyma below 10 mm, as well as the use of Type II resection of the renal parenchyma. Conclusion. A high level of good UC results was demonstrated. The most important predictor was the renal parenchyma thickness less than 10 mm.
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PMID:URETEROCALICOSTOMY FOR RECONSTRUCTION OF THE UPPER URINARY TRACT. 3284 Nov 77