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1.
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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
2.
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Background
| Recently increased attention for chronic renal failure has stimulatednew interest in renal function assessment by direct measurementas well as by algorithms or formulas [1–3]. In the failingrenal graft, a situation in which pharmacological therapy mayinterfere with the complex adaptation mechanisms of renal failure,the assessment of renal function may be particularly difficult[4]. Studies of patients with liver or heart transplantationand advanced kidney disease suggest that creatinine-based indexesmay be poor indicators of residual renal function under calcineurininhibitors [5,6]. The following two cases, displaying a discrepancybetween creatinine and urea 相似文献
3.
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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
4.
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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
5.
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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
6.
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Introduction
| Heavy chain deposition disease (HCDD) is a rare manifestationof plasma cell dyscrasia. Only 11 cases have been describedin the literature [1]. The clinical picture is variable, butin all patients renal biopsy showed a nodular sclerosing glomerulopathy[1–5]. We report a patient with rapidly progressive glomerulonephritisin whom the renal biopsy showed mainly intracapillary proliferativeglomerulonephritis due to HCDD.
Case
| The patient is a 55-year-old musician with an uneventful medicalhistory except ankylosing spondylitis diagnosed at the age of47. Six weeks before admission he noticed foamy urine, at 2weeks he developed generalized swelling, dyspnoea and a severeheadache. Upon admission 相似文献
7.
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Introduction
| Focal segmental glomerulosclerosis (FSGS) can recur after renaltransplantation and is associated with a reduced graft survival.In the case of recurrent FSGS, treatment with plasma exchange(PE) results in a remission of proteinuria in up to 85% of patients,especially if started shortly after the onset of recurrence[1,2]. However, many patients require repeated courses of PEbecause of frequent relapses [1,3]. Recently, a 7-year-old boywith recurrent FSGS after renal transplantation responded torituximab, a monoclonal anti-CD20 antibody, that was administeredfor a transplantation-related lymphoma [4]. Following this report,several other cases with recurrent FSGS after renal transplantationwere published, showing varying degrees of success after treatmentwith rituximab [5]. We describe 相似文献
8.
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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
9.
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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
10.
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Introduction
| Pregnancy in women with end-stage renal disease (ESRD) undergoingdialysis treatment is uncommon but increasingly observed overthe last few years [1]. The outcome in pregnancies in dialysedwomen is greatly influenced by maternal risk factors. Duringgestation, various risks may appear including the mother's fluidoverload, hypertension, anaemia and an increased risk for fetaland perinatal complications such as neonatal mortality, prematurityand small-for-gestational-age [2,3]. Here, we report on a 40-year-oldfemale patient who developed ESRD due to an extended Stanford-B-aneurysmof the aorta 1 year prior to conception. Nonetheless, the childwas delivered successfully by caesarian section after 31 weeksof gestation.
Case
| A 39-year-old female was referred to our centre with a hypertensivecrisis, dizziness, 相似文献
11.
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Introduction
| Acquired cystic kidney disease (ACKD) can be developed duringchronic renal insufficiency. The probability of developing cysticdiseases rises with the increase of time in dialysis [1]. Menand African-American population are more likely to develop ACKD.Also, kidney volumes are bigger and cyst size increases fasterin this population [1,2]. Typical complications of ACKD areintra- and pericystic bleeding as well as rupture with retroperitonealhaemorrhage. Patients with ACKD also present a higher risk ofmalignant transformation. Haemoperitoneum is an unusual complicationin patients undergoing peritoneal dialysis (PD), most casesbeing attributed to mechanical, gynaecological or intraperitoneal 相似文献
12.
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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
13.
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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
14.
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Introduction
| Nephronophthisis (NPHP) is an autosomal recessive disease withprevalent renal manifestations, characterized by occasionalcysts in medulla and severe tubulo-interstitial fibrosis, evolvingto end-stage renal failure [1]. It represents the most frequentcause of uraemia in children, with major clinical, physiologicaland social consequences including high costs for substitutiveapproaches and renal transplant. NPHP is a clinical and geneticheterogeneous disease with at least five genes ( NPHP1–5)identified and variable extra-renal manifestations [2–6].Retinal dysfunction constituting Senior Loken syndrome (SLS1–5)is the most common association [1]. Other organ defects identifyspecific subsets such as liver fibrosis in NPHP3 and situs inversusin NPHP2. NPHP1 [OMIM 相似文献
15.
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
16.
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Introduction
| Patients with end-stage renal disease who require chronic dialysisare at high risk of developing malignancy. There are many reportedcases of the development of renal or urothelial cancer in suchpatients [1–8]. We report the first case, to our knowledge,of multifocal, invasive transitional cell carcinoma (TCC) andunilateral renal cell carcinoma (RCC) with acquired cystic disease,occurring simultaneously in a patient on haemodialysis treatedby complete urinary tract exenteration. Our patient was managedsuccessfully with an aggressive treatment.
Case
| A 69-year-old man was referred to our institution 相似文献
17.
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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
18.
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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
19.
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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
20.
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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
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