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1.
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Introduction
| Acute renal failure due to phosphate nephropathy following bowelcleansing with an oral sodium phosphate solution is a rare,but well-known, complication [1]. Several authors have reporteddiffuse tubular injury and tubular deposition of calcium phosphatein biopsies taken from such patients [1–4]. In these patients,the term acute phosphate nephropathy more aptly describes thisentity than the previously used term acute nephrocalcinosis[1]. It has been a matter of debate whether these changes aredirectly induced by the phosphate load or whether they werebeing present before the procedure [3]. We, therefore, reporta patient with acute phosphate nephropathy who had kidney biopsiestaken before and after bowel cleansing with sodium phosphate.
Case report
| In 2002, a 69-year-old woman was 相似文献
2.
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Introduction
| Collapsing glomerulopathy (CG) is a renal injury described initiallyin association with HIV-induced nephropathy but also seen increasinglyin non-HIV-infected individuals. Some authors recognise it asa separate clinicopathological variant of focal segmental glomerulosclerosis(FSGS) associated with nephritic syndrome, rapidly progressivechronic renal failure and the histopathologic features of glomerularcapillary collapse [1,2]. It has also been linked with otherviral infections including hepatitis C, but to date not withcytomegalovirus (CMV). There may be an association with lymphoproliferativedisorders and autoimmune disease, but this is less certain [3].We report the first case 相似文献
3.
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Introduction
| An increase in serum levels of the parathyroid hormone (PTH)and hyperplasia of the parathyroid glands have been observedto occur in the early stages of chronic kidney disease withdecreased renal function, in an attempt to maintain serum calciumwithin the normal range [1]. However, this secondary hyperparathyroidismbecomes maladaptive when chronic renal failure progresses toend-stage renal failure, leading to severe hyperparathyroidism,which is refractory to medical therapy. When severe hyperparathyroidismis associated with hypercalcaemia and/or hyperphosphataemia,parathyroidectomy (PTX) should be considered. However, PTX insuch cases can often result in an acute decrease of serum calciumand is one of the leading causes of acute hypocalcaemia. Hypocalcaemiais associated with a wide spectrum of symptoms and signs, mostlyrelated to acute changes in serum calcium, rather 相似文献
4.
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Introduction
| Paradoxical embolism is a rare cause of severe renal arteryocclusion and is frequently under-diagnosed [1]. Rapid endovascular intervention with minimal morbidity may makeclot removal possible and reverse organ function [2,3]. We present here the case of a patient with an acute renal failuredue to a bilateral renal artery paradoxical embolism that wassuccessfully treated by a modified standard technique of anendovascular procedure, with a rapid mechanical and local pharmacologicalthrombolysis. The patient partially recovered her renal functionand was able to stop dialysis.
Case report
| A 70-year-old female with a past medical history of type IIdiabetes, hypertension and dyslipidaemia was admitted for pulmonaryembolism associated with a recurrent deep vein thrombosis ofthe right lower extremity. The anti-coagulation treatment wasinitially well tolerated, but had to 相似文献
5.
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Introduction
| Renal-artery stenosis is the basis of ischaemic nephropathyand is associated with renovascular hypertension. In patientswith renal-artery stenosis, acute renal failure may occur dueto several reasons such as treatment with an angiotensin convertingenzyme inhibitor or spontaneous progression of renal-arterystenosis to occlusion [1]. In patients with a solitary kidney,occlusion of the renal artery causes anuric acute renal failure.Rapid diagnosis and treatment are the cornerstones of kidneysurvival. Following revascularization, the underlying causeof the renal-artery occlusion has to be elucidated. We presenta patient who had severe renal-artery stenosis due to Takayasu'sarteritis. In such patients, further diagnostic 相似文献
6.
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Introduction
| Endovascular repair of an abdominal aortic aneurysm (AAA) istoday a widely accepted alternative to conventional open surgicaltreatment, especially in patients with a high risk of complications[1]. We describe a case of acute renal failure following theimplantation of an endograft in a patient 相似文献
7.
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Introduction
| Various scoring systems have been developed to optimize theuse of clinical experience in ICU for prognosis and to addressquestions of effectiveness, efficiency, quality of care andcorrect allocation of scarce resources [1,2]. The general severityscoring systems, however, are inappropriate for a disease-specificpopulation [3]. We introduced a scoring system, useful for allpatients with acute renal failure (ARF) admitted to the ICU,whether treated or not with renal replacement therapy (RRT).The Stuivenberg Hospital Acute Renal Failure (SHARF) score forhospital mortality of patients with ARF was developed in a singlecentre study, using two scoring moments (baseline and after48 h) [4]. In a second phase, the SHARF score 相似文献
8.
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Introduction
| Despite intensive therapy, the mortality rate in acute renalfailure still exceeds 30% [1]. Advanced age, multiple organfailure, oliguria and high blood urea nitrogen (BUN) at thetime of diagnosis are associated with a poorer prognosis [2].Rapid diagnosis and prompt treatment are critical to preventdeath and irreversible renal failure. Renal biopsy remains thegolden standard for diagnosis. Glucocorticoids and cyclophosphamideare the cornerstones in the treatment of rapidly progressiveglomerulonephritis; they dramatically ameliorate glomerularinjury 相似文献
9.
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Introduction
| BK-virus-induced interstitial nephritis (BK nephropathy) isa recently recognized condition affecting renal allografts thatmay lead to graft failure [1]. BK-virus infection is endemicworldwide with seroprevalence rates in normal adults of 60–80%[1]. Risk factors for BK nephropathy include high levels ofimmunosuppression, particularly involving tacrolimus [2]. Thereis no established treatment other than reduction of immunosuppressionto aid viral clearance, which risks acute irreversible rejection[3]. There are in vitro data showing that cidofovir inhibitsBK virus replication, but there are 相似文献
10.
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Introduction
| Hereditary renal disease is not an uncommon cause of end-stagerenal failure (ESRF) and accounts for 15.7% of the patientsin the Irish dialysis population [1]. Adult polycystic kidneydisease was the underlying diagnosis in the majority (68%) ofthese individuals. Although familial interstitial nephritisis rare, we have previously reported two siblings who developedESRF as a consequence [2]. They also had retinitis pigmentosabut did not fit into any previously described renal-retinalsyndrome. Both patients have since undergone successful cadavericrenal transplantation but have subsequently developed recurrenceof their disease with ultimate graft loss. The implicationsof these findings are discussed.
Case 1
| A 16-year-old female was admitted with worsening night blindnessand renal failure in 1988. She was obese and her IQ was estimatedat 130 using the Wechsler Adult Intelligence Scale 相似文献
11.
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Introduction
| Severe acute respiratory syndrome (SARS)-associated coronavirus(SARS-CoV) has been identified as the causal agent of SARS.Although not common, acute renal failure (ARF) in SARS patientsusually has a catastrophic outcome, with a mortality rate of77% [1]. The causes of ARF in association with SARS are unknown.An increase in creatine kinase (CK) may play a role [2]. Wepresent two patients who met the definition of probable SARS.
Case 1
| A 78-year-old man 相似文献
12.
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Introduction
| Secondary hypertension is responsible for 5–10% of causesof hypertension in the general population [1,2]. It is rarelypossible to reverse/cure secondary hypertension, but if thepatient is relatively young, and the causation of the raisedblood pressure is diagnosed early enough a cure can be effected.This is most typically after renal arterial intervention forfibromuscular dysplasia, or after removal of an endocrinologicallyactive tumour. We describe three cases of a rare cause of secondary hypertension(sometimes as here with acute renal failure), the ‘Pagekidney’, where there is sustained renal parenchymal compressionleading to ischaemia and activation of the renin–angiotensin–aldosteronesystems. We then discuss the definition and pathophysiologyof the ‘Page kidney’ phenomenon [3]. In addition,we include a mini-review of the literature regarding the reportedcauses, 相似文献
13.
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Introduction
| Common causes of gross haematuria include stones, neoplasms,tuberculosis, trauma and prostatitis. However, macroscopic haematuriacan occur in patients with IgA nephropathy. IgA nephropathyusually occurs in patients under 40 years of age, and loin painoften accompanies the haematuria [1]. Furthermore, macroscopichaematuria in IgA nephropathy often causes acute renal failurebecause of tubular obstruction by red blood cells [2–4].Obstruction or haematoma of the renal pelvis and lower urinarytract by gross haematuria in IgA nephropathy or any other diseasescausing haematuria has not been reported. Here, we report thecase of a patient with pelvic haematoma in IgA nephropathy,that was erroneously suspected for pelvic malignancy leadingto its radical resection.
Case
| A 相似文献
14.
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Introduction
| Tenofovir is an antiviral nucleotide with activity against humanimmunodeficiency virus type I (HIV-1). Tenofovir is extensivelyand rapidly excreted in the urine by the kidneys [1]. Thereare no available data on tenofovir pharmacokinetics in patientswith renal failure. We report here on the clinical effects andthe pharmacokinetics of tenofovir in one patient with end-stagerenal disease (ESRD) undergoing haemodialysis.
Case
| The patient was a 46-year-old Caucasian man co-infected withHIV-1 and hepatitis B virus (HBV) who was undergoing haemodialysistwice a week for end-stage renal failure (ESRD) secondary toautosomal polycystic kidney disease. At the time of the study,his creatinine clearance was 10 ml/min with a urinary outputof 相似文献
15.
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Introduction
| Since 1990, recombinant human erythropoietin (r-HuEPO) has beenused for the treatment of anaemia of chronic renal failure (CRF).Correction of anaemia may improve cardiovascular as well asnon-cardiovascular morbidity and mortality. Despite these potentiallybeneficial effects of r-HuEPO, some CRF patients who have previouslyor are currently using r-HuEPO have been reported to displaysuspected or confirmed pure red cell aplasia (PRCA) [1,2]. Thesepatients developed an unexplained sudden decrease in their haemoglobin(Hgb) level. Anti-r-HuEPO antibody (Ab), which has been demonstratedin several studies [3–5], seems to be the proximate causeof the PRCA. Currently, there 相似文献
16.
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Introduction
| Fournier's gangrene is a rapidly progressive and potentiallylethal disease that affects the perineum and male genitalia.Treatment consists of supportive care, surgical debridationand antibiotic therapy. Even with the use of broad-spectrumantibiotics and the development of asepsis and antiseptic measuresin the operating theatre as well as modern surgical techniquesand intensive care units, there is still a high mortality ratefor Fournier's gangrene [1,2]. Erectile impotence is a commonproblem in male patients with renal failure. The managementof erectile impotence with prosthetic implants in renal transplantpatients may lead to life-threatening infection 相似文献
17.
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Introduction
| Renal transplant patients remain at risk of graft loss due toacute rejection, calcineurin inhibitor toxicity and chronicallograft nephropathy. Less frequent causes include opportunisticinfections related to immunosuppressive therapy. However, infectionsare a major clinical issue in the field of renal transplantation,impacting on graft and patient survival. Fungal infections accountfor about 5% of infections in renal transplant recipients [1].Candida species are the most common fungal pathogen, and themost common forms of infection are oral and esophageal candidiases,vascular access device-related and urinary tract infections[2]. The incidence of candidiasis of the renal allograft israre and not very well documented.
Case report
| A 50-year-old white female with a prior medical history of hypertension, 相似文献
18.
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Introduction
| We report on a 57-year-old woman with polymyositis who on twooccasions presented with rhabdomyolysis and myoglobinuria, withresultant oliguric acute renal failures, the second episosdeof which required haemodialysis. Polymyositis is a rare and gradually progressive autoimmuneinflammatory disease of skeletal muscle that is characterizedby muscle weakness, usually proximal and symmetric, elevatedmuscle enzymes, and distinctive findings on electromyographyand muscle biopsy [1]. The disease may be associated with infectionsor with other collagen vascular diseases, such as Sjögren'ssyndrome and sarcoidosis [1]. Rhabdomyolysis is a term that refers to disintegration of striatedmuscle, which results in the release of muscle cell constituents,in particular myoglobin, into extracelluar fluid and the circulation.The released myoglobin is filtered by glomeruli and reachesthe tubules, where it may cause obstruction and renal dysfunction[2]. The main causes of rhabdomyolysis 相似文献
19.
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Introduction
| Trichuriasis is a worldwide parasitic infection most prevalentin tropical and subtropical areas [1,2]. It is the third mostcommon roundworm parasite in humans [1,2]. Trichuriasis is usuallyclinically asymptomatic. However, heavy infection, especiallyin small children, can cause gastrointestinal symptoms, suchas abdominal pain, diarrhoea, nausea, vomiting, anorexia, constipationand chronic appendiceal syndrome [1,2]. In a cross-sectionalstudy, the prevalence of Trichuris trichiura was 39.7% in schoolchildrenin tropical areas [3]. Despite the high prevalence, it has rarelybeen reported as a cause of severe diarrhoea in renal allograftrecipients. In this report, we are presenting a 43-year-old renal 相似文献
20.
The impact of primary cytomegalovirus infection (pCMV) on renal allograft function and histology is controversial. We evaluated the influence on incidence of acute rejection, allograft loss, allograft function and interstitial fibrosis/tubular atrophy (IF/TA). Retrospective case–control study, recipients transplanted between 2000 and 2014. Risk of acute rejection and allograft loss for those who experienced pCMV infection compared with those who did not, within an exposure period of two months after transplantation. Besides, its influence on allograft function and histology at one to three years after transplantation. Of 113 recipients experienced pCMV infection, 306 remained CMV seronegative. pCMV infection in the exposure period could not be proven as increasing the risk for acute rejection [HR = 2.18 (95% CI 0.80–5.97) P = 0.13] or allograft loss [HR = 1.11 (95%CI 0.33–3.72) P = 0.87]. Combination of pCMV infection and acute rejection posed higher hazard for allograft loss than acute rejection alone [HR = 3.69 (95% CI 1.21–11.29) P = 0.02]. eGFR(MDRD) values did not significantly differ at years one [46 vs. 50], two [46 vs. 51] and three [46 vs. 52]. No association between pCMV infection and IF/TA could be demonstrated [OR = 2.15 (95%CI 0.73–6.29) P = 0.16]. pCMV infection was not proven to increase the risk for acute rejection or allograft loss. However, it increased the risk for rejection-associated allograft loss. In remaining functioning allografts, it was not significantly associated with decline in function nor with presence of IF/TA. 相似文献
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