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1.
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Introduction
| Sarcoidosis is a systemic granulomatous disorder of unknownetiology, characterized by chronic non-caseating epitheloidgranulomatous inflammation with tissue destruction [1,2]. Renalinvolvement affects 20% of patients with sarcoidosis [1,2] andcan be found in patients with no other localizations of thedisease [3]. A common cause of renal dysfunction is hypercalcaemiaand hypercalciuria leading to nephrocalcinosis [2]. Granulomatousinterstitial nephritis (GIN) is also a cause of renal dysfunction,in which the clinical picture and laboratory evidence of tubulardefects point to tubulo-interstitial nephritis [4]. Sarcoidosisis a systemic disease, affecting many organs. However, largevessel involvement such as 相似文献
2.
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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
3.
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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
4.
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Introduction
| Bisphosphonates currently are important antiresorptive agentsused in the treatment of metabolic bone diseases, includingtumour-associated osteolysis and hypercalcaemia, Paget's diseaseand osteoporosis. These drugs cause a loss of the osteoclastruffled border, disruption of the osteoclast cytoskeleton andinhibition of actin ring formation, sufficient to prevent boneresorption [1]. Several studies have demonstrated that highconcentrations of bisphosphonates can cause apoptotic cell deathof mouse, rat and rabbit osteoclasts in vitro and in vivo byinhibiting the mevalonate pathway and protein prenylation [2].Bisphosphonates are excreted unchanged via the kidneys. Thehigh drug levels attained in the kidney may cause renal toxicitythrough a mechanism similar to that described in osteoclasts. Short-term [3] and long-term [4–6] tubular toxicity ofpamidronate were reported in humans. Recently, an associationbetween collapsing glomerulopathy 相似文献
5.
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Introduction
| Impaired control of the complement system activation due tomutations in complement factor H (CFH) has been described intwo apparently unrelated human diseases, membranoproliferativeglomerulonephitis type II (MPGN2) and non-Shiga toxin-associatedhaemolytic uraemic syndrome (non-Stx-HUS). Mouse models of thesediseases have been developed by Pickering et al., by knocking-outCfh gene (MPGN2) and by subsequently transferring a mutatedCfh gene in the Cfh –/– background (non-Stx-HUS).The data obtained from the two models provided precious informationto clarify the mechanisms that cause the disparate phenotypesunderlying CFH genetic defect.
MPGN2
| MPGN2 is a rare cause of chronic nephritis characterized bythe presence of dense deposits within the glomerular basementmembrane (GBM), capillary wall thickening, mesangial cell proliferationand glomerular fibrosis [1,2].
Non-Stx-HUS
| Non-Shiga toxin-associated haemolytic uraemic syndrome (non-Stx-HUS)is a rare disease with manifestations of haemolytic anaemia,thrombocytopenia and renal failure. The clinical outcome isunfavourable, 相似文献
6.
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Introduction
| Vascular access is the life-line of chronic haemodialysis patients.Its complications play a major role in morbidity and mortality[1]. Vascular access infection remains the leading cause foraccess failure when cuffed silicone catheters are used for long-termaccess and is the second most common cause of graft failurewhen polytetrafluoroethylene (PTFE) grafts are used [2]. Mostreports deal with dual-lumen tunneled cuffed catheter relatedbacteraemia. Arteriovenous (A-V) graft infection with Pseudomonassepticaemia, as reported here, has been rarely discussed.
Case
| A 72-year-old diabetic male had a history of hypertension andcerebral infarction with sequela of right side hemiplegia. AnA-V graft was created on the right forearm on 26 June 2003 fordiabetic nephropathy. He started maintenance haemodialysis onJuly 10 using this A-V graft. He was 相似文献
7.
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Introduction
| Nephrogenic fibrosing dermopathy (NFD) was first described byCowper et al. [1] as a cutaneous fibrosing disorder associatedwith renal dysfunction. In the last 3 years there has been agrowing body of literature regarding NFD. Clinically, skin isthickened or oedematous with indurated papules and plaques.The pathogenesis of NFD is largely unknown. Several authorshave discussed a reaction against the PVC materials used indialysis, but NFD has also occurred in patients without dialysis[2–4]. Spontaneous healing of NFD has not been documentedpreviously; however restitutio ad integrum after improvementof the renal situation has been reported [2]. The therapy ofNFD has to be regarded as 相似文献
8.
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Introduction
| Primary renal glucosuria (OMIM 233100) is defined by an increasedurinary glucose excretion in a patient with a normal blood glucoseconcentration in whom all other filtered substrates are handledcompletely normally by the proximal tubules. Mild renal glucosuriais a relatively common condition that was first studied at thebeginning of the last century [1], but it was not until 1987that a study on a patient with virtual absence of renal tubularglucose reabsorption was published. This condition has beentermed type 0 renal glucosuria [2]. Here we report on the long-termhistory of this patient whose underlying genetic defect hasrecently been identified [3,4].
Case
| Patient P.M., a male of German descent, was born in 相似文献
9.
Sir, Ethambutol can cause ocular toxicity and hyperuricaemia, butethambutol-associated acute renal failure during treatment ofpulmonary tuberculosis is extremely rare [1,2]. Here we reportthe case of a man who manifested with oliguric acute renal failureand jaundice associated with ethambutol. Case. 相似文献
10.
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Introduction
| The causative agents of sexually transmitted diseases are seldominvolved in kidney disease. Only a handful of cases have beendescribed of pyelonephritis or immune complex-mediated glomerulonephritisin patients with gonococcal infections [1,2]. The most importantassociation is present in human immunodeficiency virus (HIV)-infectedpatients: HIV-associated nephropathy was diagnosed at autopsyin 12% of HIV-infected black people and in 1% of HIV-infectednon-black people [3]. A clear relationship between hepatitisC virus infection and glomerulonephritis has been demonstrated.Cryoglobulinaemic membranoproliferative glomerulonephritis andmembranous nephropathy occur in 2.6 and 1.8% of cases, respectively[4]. Hepatitis B virus infection is also associated with glomerulonephritis,but the prevalence is not known. However, it is estimated tobe low because of the low endemicity 相似文献
11.
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Introduction
| In this edition of NDT, Manlucu et al. [1] present results froma systematic review they performed on dose reducing of histamine2 receptor antagonists (H2RA) in the presence of renal failure.Fundamentally, they demonstrate that H2RA should be given inlower doses as renal function deteriorates. These results inthemselves are not surprising as H2RA are primarily excretedin the urine unchanged, and there is substantial evidence thatclearance is reduced with renal failure [2–4]. The moresurprising result is that these authors managed to identify16 published clinical 相似文献
12.
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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
13.
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Introduction
| Filamentous fungal infections are associated with a high morbidityand mortality in solid organ transplants. Species of the Aspergillusfamily account for the majority of these infections, and Aspergillusfumigatus, in particular, may be regarded as the most importantairborne saprophytic fungus [1,2]. There are numerous conidiaof this fungus inhaled constantly by humans, which are normallyeliminated in immunocompetent hosts by innate mechanisms. Anaspergilloma or allergic bronchopulmonary aspergillosis arethe only infections observed in such hosts. Thus, Aspergilluswas regarded as a weak pathogen for many years until there werean increased number of 相似文献
14.
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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
15.
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Introduction
| Chinese-herb nephropathy (CHN) was initially reported as a progressiverenal interstitial fibrosis caused by the regular intake ofChinese herbal medicine belonging to the Aristolochia speciescontaining nephrotoxic and carcinogenic aristolochic acid (AA)[1–3]. Prior exposure to AA was attested by the detectionof specific DNA adducts formed by AA metabolites in kidneysand ureters of patients suffering from end-stage renal disease(ESRD) due to CHN [4–6]. Among these patients, a highprevalence of upper urinary tract carcinoma was observed [5,7]. 相似文献
16.
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Introduction
| Tuberous sclerosis complex (TSC) is an autosomal dominant diseasewith a wide spectrum of pathological lesions [1,2]. Almost halfof the patients with TSC have an underlying renal pathology,mainly angiomyolipomas, cysts and/or renal cell carcinoma [3,4].TSC rarely involves medium size and large vessels, includingthe renal arteries. Arterial aneurysms have been reported forintracranial arteries, for the aorta and for the kidneys inpatients with TSC [5]. The clinical management of the two maincomplications, fever and haematuria, in these patients is uncertain.Here we report on a patient with two large intrarenal arterialaneurysms who presented with 相似文献
17.
Sir, Peptic ulcer and its complications may easily develop afterrenal transplantation in the setting of already damaged gastroduodenalmucosa and/or in the presence of Helicobacter pylori infection[1,2]. We report upper gastrointestinal endoscopy (UGE) findingsand the incidence of H.pylori infection in children on intermittenthaemodialysis (HD) treatment. Twenty-five children with end-stage renal disease (ESRD) aged4–18 years (12.3 ± 3.9) and on intermittent HDfor 0.3–8 years (2.7 ± 2.1) were investigated.None of the patients received antibiotics, 相似文献
18.
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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
19.
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Introduction
| Injury to the kidney can be initiated via diverse mechanisms,such as genetic defects, autoimmune reactions, environmentalinsults and metabolic defects [1,2]. Based on the kinetics ofdisease progression, renal injury is traditionally grouped aseither being an acute or chronic effect [3,4]. While the kidneydisplays an enormous potential to regenerate after acute renalinjury, chronic renal disease is generally irreversible [1,5,6].The switch from the normal potential to repair after acute injury,to an irreversible chronic disease phase, is not yet well understood.It has been 相似文献
20.
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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
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