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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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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
3.
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Introduction
| Ticlopidine hydrochloride is a platelet aggregation inhibitorthat is used for the prevention of vascular thrombosis. So far,only six cases of ticlopidine-induced lupus have been documentedin the literature [1–3]. We report here a first case ofticlopidine-induced lupus with renal involvement.
Case
| A 相似文献
4.
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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
5.
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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
6.
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Introduction
| Early renal transplant dysfunction can be caused by acute rejection,acute tubular necrosis (ATN), infection, ciclosporin toxicity,bleeding, urethral obstruction, urinary leak, lymphocele andthrombosis [1]. Prompt treatment of early allograft dysfunctionis essential and therefore accurate diagnosis mandatory. Wedescribe a patient with an unusual cause of allograft dysfunction,which was resolved by a simple surgical intervention.
Case report
| A 32-year-old man with congenital blindness, hypertension andend-stage renal disease underwent renal transplantation. Hehad been haemodialysis-dependant since the age of 24 years.Dialysis was performed through an 相似文献
7.
The first 150 words of the full text of this article appear below. Key points Surgery for lower limb revascularization is associatedwith a high risk of cardiac morbidity and mortality. Preoperativecardiac risk assessment is important and risk-reducing measuresshould be started appropriately. Perioperative ß-blockadedecreases perioperative cardiac complications in the highestrisk patients. The quality of anaesthetic practice rather thanspecific technique per se has the most important influence onpatient outcome. Acute limb ischaemia is an emergency thatprecludes prolonged preoperative cardiac evaluation.
Critical limb ischaemia
| Critical limb ischaemia (CLI) is defined as chronic ischaemicrest pain, ulcers or gangrene attributable to objectively provenarterial occlusive disease. Peripheral vascular disease (PVD)is a marker for severe multi-system atherosclerosis and patientswith critical limb ischaemia presenting for lower limb revascularizationpresent a significant challenge to the anaesthetist. They areusually elderly with a high prevalence of hypertension, diabetesmellitus, cerebrovascular and renal vascular disease, and smoking-relatedrespiratory disease. Only 8% of patients with PVD . . . [Full Text of this Article]Treatment strategies
Preoperative assessment
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Preoperative management
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Perioperative management
| MonitoringGeneral anaesthesiaRegional anaesthesia
Postoperative management
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Acute limb ischaemia
| 相似文献
8.
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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
9.
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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
10.
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Introduction
| Polytetrafluoroethylene (PTFE) grafts are widely used to facilitateaccess for haemodialysis. They may present with complicationsincluding infection and thrombosis. However, localised lymphomaassociated with a PTFE graft has not been previously described.Here we present the case of a patient with B-cell lymphoma arisingaround a PTFE graft.
Case
| A 77-year-old Italian woman with end-stage renal failure ofunknown origin had been on haemodialysis since 1995. Her past 相似文献
11.
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Introduction
| Haemodialysis access graft is so important as to be called alifeline for the patient on maintenance haemodialysis. The vascularaccess problem is the leading cause of admission in patientswith end-stage renal disease. Many complications of the prostheticvascular access graft are reported, such as graft thrombosis,infection, aneurysm or pseudoaneurysm, and arterial steal syndrome[1]. We recently experienced two cases of graft thrombosis relatedto the iatrogenic fistula between haemodialysis access graftand autogenous vein at the needling site during haemodialysis.We report our cases with their clinical manifestation and thetreatment outcome and possible methods of prevention [2].
Case 1
| A 76-year-old female on long-term haemodialysis 相似文献
12.
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Introduction
| Rhabdomyolysis is a well-known cause of renal failure and iscommonly associated with drugs, toxins and infections. Therehas been one reported case of rhabdomyolysis attributed to influenzavaccine causing renal failure in native kidneys.
Case Report
| A 57-year-old Caucasian man was diagnosed to have focal segmentalglomerlosclerosis (FSGS) in 1995. He eventually underwent acadaveric renal transplantation in February 2002 and becausethis was complicated by delayed graft function, his creatinineplateaued at a 相似文献
13.
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Introduction
| The continuing disparity between the demand for kidney transplantsand the supply of organs has necessitated the use of organsfrom an extended criteria donor pool [1–3]. Clearly, organsthat would have been previously thought unsuitable are currentlyused for transplantation. In this study, we report the successfulkidney transplantation from a heart transplant candidate whohad received therapy with a biventricular assist device forterminal heart failure complicated by severe pulmonary hypertension,and who died because of a fatal cerebral haemorrhage.
Case report
| Donor The donor was a 63-year-old female patient with end-stage bilateralheart failure due to ischaemic heart disease, considered forlisting for heart transplantation. The 相似文献
14.
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Introduction
| It is well known that late referral to a nephrologist is associatedwith many adverse outcomes [1–4], and indeed has beenthe subject of a recent review in this journal [5]. Some ofthe more important negative outcomes include more rapid onsetof end-stage renal disease (ESRD), progression of co-morbidconditions such as anaemia and cardiovascular disease, suboptimalvascular access at initiation of dialysis, increased use ofcentre-based haemodialysis (HD), increased hospital utilization,increased cost and worse survival. The literature has many examplesof suboptimal chronic kidney disease (CKD) care provided byprimary care physicians prior to referral, and also shows clearlythat care provided by nephrologists is better [6,7]. There isa consensus within the renal community that early referral isdesirable [5,8–10].M
Multidisciplinary team-based CKD care
| There is much less consensus 相似文献
15.
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Introduction
| Familial juvenile hyperuricaemic nephropathy (FJHN; OMIM 162000)is considered a rare cause of end-stage renal disease (ESRD).FJHN is characterized by hyperuricaemia and gout after adolescenceand the slow development of renal insufficiency, leading toESRD in adulthood. The disorder is characterized by a renalunder-secretion of urate, which may be detected already duringearly childhood [1]. The histological lesions in affected subjectsare characterized by unspecific tubulo-interstitial nephropathy.FJHN is inherited in an autosomal dominant pattern with a highpenetrance. Recently, the gene(s) for FJHN was localized toa candidate interval at the short arm of chromosome 16 [2,3].
Case
| We report a Caucasian four-generation family with FJHN withoutconsanguinity between spouses and a clustering of 相似文献
16.
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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
17.
The first 150 words of the full text of this article appear below. Key points - Atrial fibrillation (AF) is the commonest cardiacarrhythmia; its incidence increases with age.
- Diabetes mellitus,hypertension and ventricular hypertrophy are commonly associatedwith non-valvular atrial fibrillation.
- Primary aims of managementof AF are conversion to sinus rhythm, maintenance of sinus rhythmand prevention of thromboembolic complications.
- In elderlypatients who are asymptomatic, adequate rate control of AF appearsto offer the same benefits as rhythm control.
- Chronic AF carriesa high risk of ischaemic stroke from thromboembolism; all patientsat risk must receive adequate anticoagulation.
- Anticoagulationshould be continued in patients with risk factors despite successfulconversion to sinus rhythm.
Atrial fibrillation (AF) is the commonest cardiac arrhythmia.The incidence increases with age and affects 5% of UK populationabove the age of 65 yr and 10% above 75 yr. 1 2 In the UnitedStates, AF accounts for more than 35% of all admissions forcardiac arrhythmias. 3 Men are . . . [Full Text of this Article]
Definition and electrocardiographic patterns
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Classification
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Pathophysiology and mechanisms
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Causes and risk factors
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Principles of management
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Restoration of sinus rhythm
| Direct current cardioversionPharmacological restoration of sinus rhythm
Maintenance of sinus rhythm
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Rate control of atrial fibrillation
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Prevention of thromboembolism
| Non-pharmacological management
Management in special situations
| Cardiac surgeryAcute myocardial infarctionPregnancyVentricular pre-excitationHyperthyroidismPulmonary disease 相似文献
18.
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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
19.
The first 150 words of the full text of this article appear below. Key points - Complications of blood transfusion are rare but canbe life-threatening.
- Since 2005, it has been a legal requirementthat all serious adverse reactions attributable to the safetyor quality of blood are reported.
- Most reported complicationsare because of transfusion of mismatched blood products andare avoidable through clinical vigilance.
- Massive blood transfusionsresult in abnormalities of coagulation status, serum biochemistry,acid–base balance and temperature homeostasis.
- Transfusion-relatedacute lung injury is the most common cause of major morbidityand death after transfusion.
The serious hazards of transfusion (SHOT) scheme has collecteddata on significant adverse events resulting from transfusionof blood components from volunteer organizations since 1996.However, after the implementation of the European Union Directiveon Blood Safety and Quality in 2005, it is now a requirementthat all ‘Blood Establishments and Hospital Blood Banksreport to the Secretary of State for Health all serious adversereactions . . . [Full Text of this Article]
Massive transfusion
| CoagulationBiochemistryHypocalcaemiaHyperkalaemiaAcid–base abnormalitiesHypothermia
Transfusion-related acute lung injury
| Clinical features
Pathogenesis
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Incidence
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Haemolytic transfusion reactions
| Immediate reactionsDelayed reactions
Non-haemolytic febrile reactions
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Allergic reactions
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Transfusion-related infections
| BacterialViralPrion
Transfusion-associated graft-vs-host disease
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Immunomodulation
| 相似文献
20.
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Introduction
| Sezary syndrome is a cutaneous T-cell lymphoma (CTCL), characterizedby erythroderma and infiltration of the epidermis, the dermisand the bone marrow by monoclonal CD4 + T lymphocytes [1]. Renalcomplications of patients with CTCLs have rarely been reported[2–4]. In patients with other haematological malignancies,treated with interferon-
Case
| A 63-year old male, who had been diagnosed with Sezary syndrome 相似文献
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