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Sample records for chronic renal failure

  1. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2009-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  2. HBV Vaccination in Chronic Renal Failure Patients

    OpenAIRE

    Mir-davood Omrani; Mohammad Hassan Khadem Ansari

    2006-01-01

    HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unre...

  3. High serum enalaprilat in chronic renal failure

    DEFF Research Database (Denmark)

    Elung-Jensen, T; Heisterberg, J; Kamper, A L;

    2001-01-01

    renal failure. METHODS: Fifty nine out-patients with plasma creatinine >150 micromol/L and chronic antihypertensive treatment with enalapril were investigated, in a cross-sectional design. RESULTS: Median glomerular filtration rate (GFR) was 23(range 6-60) ml/minute/1.73 m2. The daily dose of enalapril......-68) ml/minute and correlated linearly with GFR (r=0.86, p=0.003). Intra-subject day-to-day variation in trough concentrations was 19.7%. CONCLUSION: Patients with chronic renal failure given small or moderately high doses of enalapril may thus have markedly elevated levels of serum enalaprilat. Whether......BACKGROUND: Most angiotensin-converting enzyme (ACE) inhibitors and their metabolites are excreted renally and doses should hence be reduced in renal insufficiency. We studied whether the dosage of enalapril in daily clinical practice is associated with drug accumulation of enalaprilat in chronic...

  4. Parathyroid hormone secretion in chronic renal failure

    DEFF Research Database (Denmark)

    Madsen, J C; Rasmussen, A Q; Ladefoged, S D;

    1996-01-01

    The aim of study was to introduce and evaluate a method for quantifying the parathyroid hormone (PTH) secretion during hemodialysis in secondary hyperparathyroidism due to end-stage renal failure. We developed a method suitable for inducing sequential hypocalcemia and hypercalcemia during...... failure. By the use of a standardized method we show that the calcium set-point is normal or slightly elevated, indicating normal parathyroid reactivity to calcium in chronic renal failure......., blood PTH/ionized calcium curves were constructed, and a mean calcium set-point of 1.16 mmol/liter was estimated compared to the normal mean of about 1.13 mmol/liter. In conclusion, we demonstrate that it is important to use a standardized method to evaluate parathyroid hormone dynamics in chronic renal...

  5. Malnutrition in patients with chronic renal failure

    OpenAIRE

    Qureshi, Abdul Rashid Tony

    2000-01-01

    Protein-energy malnutrition is common in patients with chronic renal failure (CRF) and may contribute to a poor clinical outcome. However, the role of nutrition in this regard has not been clearly defined. Malnutrition in patients with CRF may have many causes, including disturbances in protein and energy metabolism, hormonal derangements, as well as low food intake because of anorexia, caused by uremic toxicity, various superimposed illnesses and psychosocial problems. Alth...

  6. Gastrointestinal Angiodysplasia in Chronic Renal Failure

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    Kaaroud H

    2008-01-01

    Full Text Available Gastrointestinal (GI hemorrhage is a frequent and sometimes life-threatening complication of end-stage renal failure. Angiodysplasia (AD, vascular malformation, is the most common cause of recurrent lower-intestinal hemorrhage in patients with renal failure. We report four chronic hemodialysis patients with AD. All patients presented with severe anemia requiring transfusion. GI hemorrhage ceased spontaneously in three cases and after treatment with argon plasma coagulation in another. Diagnosis of AD is usually challenging, since its cause is still unknown, and its clinical presentation is variable. Lesions are multiple in 40-75% of cases, often located in the stomach and duodenum but can affect the colon and the jejunum. Diagnosis is improved by endoscopy which has a much higher sensitivity compared to angiography. Capsular endoscopy may reveal the hemorrhage site in the small intestine when regular endoscopy fails, and therapeutic intervention usually include argon plasma coagulation.

  7. HBV Vaccination in Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Mir-davood Omrani

    2006-12-01

    Full Text Available HBV infection in chronic renal failure (CRF becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α| and interleukin (IL 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. Moreover, human leukocyte antigen (HLA genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response. Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID administered second-generation S antigen vaccines. Both intramuscular (IM and intradermal (ID vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.

  8. Nuclear medicine in acute and chronic renal failure

    International Nuclear Information System (INIS)

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

  9. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    International Nuclear Information System (INIS)

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

  10. Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

    Energy Technology Data Exchange (ETDEWEB)

    Kroepelin, T.; Ziupa, J.; Wimmer, B.

    1983-05-01

    Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to.

  11. [CHRONIC RENAL FAILURE AND PREGNANCY--A CASE REPORT].

    Science.gov (United States)

    Amaliev, G M; Uchikova, E; Malinova, M

    2015-01-01

    Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure. Determining the optimum time for authorization birth depends on the condition of the mother, the condition of the fetus and the rate of progression of renal failure, and the deadline the pregnancy should be terminated is 35 weeks. We present a case of a patient with chronic renal failure, with favorable perinatal outcome. PMID:26137779

  12. Oral disorders in patients with chronic renal failure. Narrative review.

    OpenAIRE

    Carolina Hernández

    2016-01-01

    Chronic renal failure (CRF) is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, wh...

  13. Investigating Awareness in Chronic Renal Failure Among Family Physicians

    Directory of Open Access Journals (Sweden)

    Birgül ATAMAN

    2014-05-01

    Full Text Available OBJECTIVE: The conditions underlying chronic renal failure have become epidemics in the world. The aim of this study was to reveal the degree of awareness of chronic renal failure among family physicians. MATERIAL and METHODS: Using data collected with a structured questionnaire and considering physicians’ socio-demographic features and their education on nephrology, we evaluated physicians’ awareness of the definition, frequency and clinical features of chronic renal failure. The questionnaire was filled in by volunteering family medicine specialists (FMS, family medicine assistants (FMA and family physicians (FP during a family medicine meeting. RESULTS: Out of 310 physicians, 25.2% (n=78 were FMS, 27.7% (n=86 FMA and 47.1% (n=146 FP. %35,2 of physicians (n=109 (FMS: % 62,8 (n=49, FMA: %52.3 (n=45, FP: %10.3 (n=15, p0.05. However, less than 15% of the physicians reported that they felt competent enough to follow patients with chronic renal failure. The rate of the physicians who felt the need to refer these patients to health institutions was high. However, the Fps did not like the patient care style of internal medicine specialists and thought that patients faced financial problems to access the nephrologist. CONCLUSION: Appropriate care and management of referrals are life-saving for patients with chronic renal failure. New strategies should be developed to increase awareness concerning chronic renal failure and the management of this condition.

  14. CT of the kidney in chronic renal failure

    International Nuclear Information System (INIS)

    The transverse size of the kidneys was measured by CT, and CT findings of the kidneys were studied in 94 patients with chronic renal failure under hemodialysis (HD), 58 patients with chronic renal failure not under hemodialysis (CRF) and 100 controls. The transverse size of the kidneys decreased according to the deterioration of renal function. The ratio of the maximal renal transverse size to the minimal vertebral size, which the author proposed as a new criterion for renal atrophy, was 1.8 in controls, 1.2 in CRF and 0.8 in HD. A kidney smaller than the vertebral body indicated chronic renal failure. Characteristic CT features in CRF were mild renal atrophy and cystic changes (41.4 %). In HD, renal atrophy was more advanced, the occurrence of cystic changes was more frequent (64.9 %), and there were frequent renal (68.1 %) and aortic calcifications. Furthermore acquired cystic disease of the kidney (ACD) was observed (27.7 %) only in HD. In this study no renal neoplasm was found in ACD. However, several complications in HD, one perirenal hematoma and six hydronephroses, were observed. (author)

  15. CT of the kidney in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Kanji

    1988-10-01

    The transverse size of the kidneys was measured by CT, and CT findings of the kidneys were studied in 94 patients with chronic renal failure under hemodialysis (HD), 58 patients with chronic renal failure not under hemodialysis (CRF) and 100 controls. The transverse size of the kidneys decreased according to the deterioration of renal function. The ratio of the maximal renal transverse size to the minimal vertebral size, which the author proposed as a new criterion for renal atrophy, was 1.8 in controls, 1.2 in CRF and 0.8 in HD. A kidney smaller than the vertebral body indicated chronic renal failure. Characteristic CT features in CRF were mild renal atrophy and cystic changes (41.4 %). In HD, renal atrophy was more advanced, the occurrence of cystic changes was more frequent (64.9 %), and there were frequent renal (68.1 %) and aortic calcifications. Furthermore acquired cystic disease of the kidney (ACD) was observed (27.7 %) only in HD. In this study no renal neoplasm was found in ACD. However, several complications in HD, one perirenal hematoma and six hydronephroses, were observed.

  16. Clinical Study on Treatment of Chronic Renal Failure with Shenshuailing

    Institute of Scientific and Technical Information of China (English)

    鞠建伟; 郭亚玲; 梁延平; 孙世宁; 杨建华; 杨素云

    2001-01-01

    The therapeutic effects of Shenshuailing Kou Fu Ye (SKFY肾衰灵口服液, the Oral Liquid for Renal Failure) and Shenshuailing Guan Chang Ye (SGCY肾衰灵灌肠液, the Enema for Renal Failure) were evaluated in treatment of chronic renal failure, with coateg aldehyde oxystarch as the controls. The changes in the clinical symptoms, serum creatinine, blood urea nitrogen and creatinine clearance rate were observed. The total effective rate in the former was 90.46%, and the latter 60.43%.

  17. Urinary Peptide Levels in Patients with Chronic Renal Failure

    OpenAIRE

    Mungli Prakash; Phani, Nagaraj M; Kavya R; Supriya M

    2010-01-01

    Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF) patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary pepti...

  18. Zhang Qi's Experience in Treating Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    LIN Qi-zhan; XU Da-ji; MA Yu-peng

    2008-01-01

    @@ Chronic renal failure is a result of the parenchymatous injury of kidney and progressive exacerbation due to many reasons.It is a svstematic clinical syndrome caused by the disturbance in excreting metabolites,adjusting water-electrolyte and acid-base balance as well as production and inactivation of active substances of endocrine.Prof Zhang Qi has rich clinical experience in treating renal failure.A report follows.

  19. Urinary Citrate: A view in Chronic Renal Failure

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    SANTHOSH KUMAR.N

    2013-12-01

    Full Text Available Aim & Objective: To evaluate the 24 hour urinary citrate levels in chronic renal failure and healthy controls and to define the role of urinary citrates in the chronic renal failures. Materials and Methods: The 24 hours urinary citrates, Blood urea, Serum creatinine, Na+, K+were evaluated in 25 chronic renal failure patients and25 healthy subjects taken as controls. In both groups participants were on their usual diet. In addition, none of the participant was taking any drugs that could interfere with the citrate excretion. Results: The mean 24 hour urinary citrate excretion in patients and healthy controls was 296.3 ± 8.543mg and 323.9 ± 4.304mg respectively. Using previously defined values of normal urinary citrates as more than 320 mg.The difference in 24 hour urinary citrateexcretion in all patients and healthy control was statistically significant (

    renal failures and healthy controls. Uniformly low citrate excretion in patients indicates that low citrate levels may be a feature seen in predisposing factor for renal failure

  20. Growth Hormone Therapy in Children with Chronic Renal Failure

    OpenAIRE

    Cayir, Atilla; Kosan, Celalettin

    2014-01-01

    Growth is impaired in a chronic renal failure. Anemia, acidosis, reduced intake of calories and protein, decreased synthesis of vitamin D and increased parathyroid hormone levels, hyperphosphatemia, renal osteodystrophy and changes in growth hormone-insulin-like growth factor and the gonadotropin-gonadal axis are implicated in this study. Growth is adversely affected by immunosuppressives and corticosteroids after kidney transplantation. Treating metabolic disorders using the recombinant huma...

  1. Uterine Prolapse as a Cause of Chronic Renal Failure

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    Savaş SİPAHİ

    2014-09-01

    Full Text Available Uterine prolapse, common in old and multiparous women, has been reported as a rare cause of obstructive uropathy. In this case, the management of a 75-year-old female patient who presented at the outpatient clinic with a history of anuresis and diagnosed with total uterine prolapse, bilateral hydronephrosis, urinary infection and acute renal failure is presented. The renal failure clinical picture regressed with appropriate treatment. However, the patient refused surgery and chose to have a pessary implemented. Four months after dismissal, she was readmitted to the hospital with recurrent renal failure that required dialysis treatment. The patient did not respond to therapy and was placed on a chronic dialysis program with a diagnosis of end-stage renal disease due to posterenal causes.

  2. Captopril for refractory hypertension in patients with chronic renal failure and renal transplantation.

    OpenAIRE

    Hamilton, D V; Evans, D. B.; Maidment, G; Pryor, J S

    1981-01-01

    The converting-enzyme inhibitor, captopril, was given to ten patients with refractory severe hypertension of renal origin: 6 patients had chronic renal failure, 3 patients had hypertension following renal transplantation, and one patient had hypertension and congestive cardiac failure. Control of blood pressure was achieved with doses from 78 to 400 mg/day. Severe hyperkalaemia occurred in one patients, ageusia (dose dependent) in another, and one patients withdrew from treatment because of n...

  3. Chronic renal failure in Al-Anbar of Iraq

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    Sami M Awad

    2011-01-01

    Full Text Available There is no precise study of the epidemiology and prevalence of chronic renal failure in Al-Anbar, Iraq. Therefore, we studied 230 hemodialysis (HD patients at the HD unit of Al-Ramadi teaching hospital during the period from April 1, 2008 to April 1, 2009. There were 124 (53% male patients with a mean age of 48 ± 18.5 years, and 146 (63% patients were older than 40 years. The estimated prevalence of chronic renal failure was 141 patients per million population. Diabetes mellitus (33% and hypertension (22.6% were the most common causes of chronic renal failure, followed in order by obstructive uropathy in 17.3%, undetermined causes in 14%, pyelonephritis in 4.7%, glomerulonephritis in 4.3%, and polycystic kidney disease in 3.9%. This study suggests that large number of patients with end-stage renal disease (ESRD have diabetes and hypertension. However, those patients with undetermined cause still form a significant portion of etiology of ESRD, and this reflects late referral combined with diagnostic limitations.

  4. Sulphasalazine induced renal failure.

    OpenAIRE

    Dwarakanath, A D; Michael, J.; Allan, R. N.

    1992-01-01

    Two men with longstanding ulcerative colitis who were treated with sulphasalazine for several years and who developed chronic renal failure are reported. Renal biopsy specimens showed histological changes consistent with drug induced chronic intestinal nephritis. Extensive investigation made other causes of chronic renal failure unlikely. One of these patients underwent renal transplantation, the other has impaired but stable renal function.

  5. Urinary Peptide Levels in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Mungli Prakash

    2010-10-01

    Full Text Available Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary peptide levels in CRF patients and Urinary % peptides were significantly decreased in CRF patients as compared to healthy controls. Urinary % peptides correlated negatively with proteinuria. Conclusion: we have found decrease in urinary peptides and % urinary peptides in CRF patients and possibly measurement of % urinary peptides may possibly serve as better indicator in early detection of impairment in renal function.

  6. [Carbonyl stress and oxidatively modified proteins in chronic renal failure].

    Science.gov (United States)

    Bargnoux, A-S; Morena, M; Badiou, S; Dupuy, A-M; Canaud, B; Cristol, J-P

    2009-01-01

    Oxidative stress is commonly observed in chronic renal failure patients resulting from an unbalance between overproduction of reactive oxygen species and impairement of defense mechanisms. Proteins appear as potential targets of uremia-induced oxidative stress and may undergo qualitative modifications. Proteins could be directly modified by reactive oxygen species which leads to amino acid oxydation and cross-linking. Proteins could be indirectly modified by reactive carbonyl compounds produced by glycoxidation and lipo-peroxidation. The resulting post-traductional modifications are known as carbonyl stress. In addition, thiols could be oxidized or could react with homocystein leading to homocysteinylation. Finally, tyrosin could be oxidized by myeloperoxidase leading to advanced oxidative protein products (AOPP). Oxidatively modified proteins are increased in chronic renal failure patients and may contribute to exacerbate the oxidative stress/inflammation syndrome. They have been involved in long term complications of uremia such as amyloidosis and accelerated atherosclerosis. PMID:19297289

  7. HEARING ASSESSMENT IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

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    Arjun Singh

    2014-01-01

    Full Text Available The auditory sensitivity of 63 patient of chronic renal failure on hemodialysis was assessed in order to know the effect of dialysis on hearing threshold. All selected patient were non diabetic with normal tympanic membrane and with no history of ototoxic drug and any hereditary hearing problems. Pure tone audiometry was done before and after dialys is and all cases were followed for 3 month. A high incidence of high frequency sensorineural hearing loss was obtained which could not be attributed to age , noise exposure and ottotoxicity. An association between high frequency sensorineural hearing loss a nd hemodialysis is thus suggested KEYWORDS: Hemodialysis ; Pure tone audiometry ; High frequency sensorineural hearing loss ; Duration of disease ; Chronic renal failure

  8. Exercise training and the progression of chronic renal failure

    DEFF Research Database (Denmark)

    Eidemak, I; Haaber, A B; Feldt-Rasmussen, B;

    1997-01-01

    The possible beneficial effect of regular exercise training on the progression of chronic renal failure was studied in a prospective randomized controlled study. Thirty patients with a median glomerular filtration rate (GFR) of 25 ml/(min.1.73 m2) (range 10-43) were randomized to physical training...... rate of progression judged by the slope of GFR versus time plot was equal in the two groups. Hence, the beneficial effect of exercise training, earlier observed in rat studies, could not be reproduced in our patients. Physical exercise had no untoward effect on progression of renal disease....

  9. The clinical meanings of leptin RIA in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between chronic renal failure and serum leptin levels in patients with chronic renal failure. Methods: Serum leptin levels (with RIA) were determined in 134 patients (male, 73, female 61) with chronic renal failure and 40 controls. Results: The serum levels of leptin in the chronic renal failure group were significantly higher than those in the controls (t=2.39, P<0.01). There were no significant differences among the leptin levels in patients with different stages of renal failure. Conclusion: There were hyper-leptinemia and leptin resistance in patients with chronic renal failure. The increase of leptin levels is thought to be harmful in patients with chronic renal failure, however, the precise mechanism remains to be studied further. (authors)

  10. Is chronic renal failure a risk factor for the development of erosive osteoarthritis?

    Science.gov (United States)

    Duncan, I J; Hurst, N P; Disney, A; Sebben, R; Milazzo, S C

    1989-03-01

    Erosive osteoarthritis of the hands of unusually early onset and severity was seen in two patients treated for chronic renal failure by long term haemodialysis and renal homograft respectively. The significance of this observation is discussed in the light of previous studies of erosive arthropathy in patients with chronic renal failure. Factors associated with chronic renal failure may predispose to the development of erosive osteoarthritis. PMID:2649026

  11. Is chronic renal failure a risk factor for the development of erosive osteoarthritis?

    OpenAIRE

    Duncan, I J; Hurst, N P; Disney, A; Sebben, R; Milazzo, S C

    1989-01-01

    Erosive osteoarthritis of the hands of unusually early onset and severity was seen in two patients treated for chronic renal failure by long term haemodialysis and renal homograft respectively. The significance of this observation is discussed in the light of previous studies of erosive arthropathy in patients with chronic renal failure. Factors associated with chronic renal failure may predispose to the development of erosive osteoarthritis.

  12. Radiological features of progressive tumoral calcinosis in chronic renal failure.

    LENUS (Irish Health Repository)

    Hodnett, P

    2012-02-03

    We present the case of a young adult patient with chronic renal failure who developed painful subcutaneous nodules after failed renal transplant and recommencing dialysis. These nodules were juxta-articular in location and initially located over both shoulders. Radiological evaluation suggested tumoral calcinosis. The patient was placed on a strict dialysis and dietary regimen but was suboptimally compliant with same. The patient developed progressive disease with an increase in size and number of juxta-articular calcified soft-tissue masses. However, 6 months following a second renal transplant clinical and radiological follow up demonstrated marked resolution both in symptomatology and radiographic findings. We present the plain radiographic, CT and MRI findings which demonstrate the typical radiological features of tumoral calcinosis. We correlate these findings with clinical course and histological findings following surgical excision of one of these masses.

  13. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D;

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim was to...... compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  14. Na+-K+ pump in chronic renal failure

    International Nuclear Information System (INIS)

    This review summarizes the evidence for the defect in Na+-K+ pump in chronic renal failure, considers the role of various factors in causing this defect, and discusses the clinical implications thereof. Intracellular Na is elevated in erythrocytes, leukocytes, and muscle cells from some patients with chronic renal failure (CRF). Recent evidence suggest that this elevation of cell Na may be, in large part, a consequence of decreased number of Na+-K+ pump units per cell. Maintenance dialysis over a period of weeks ameliorates the defect in intracellular Na+, and this improvement is contemporaneous with an increase in the number of Na+-K+ pump sites per cell. In erythrocytes with normal cell Na+, acute hemodialysis increases the rate of 22Na+ and 42K+ transport. Many factors such as the presence of retained toxic metabolite or circulating inhibitor in the uremic plasma, or biochemical changes produced by acute hemodialysis, may explain this finding. In cells with high cell Na+, the pump-mediated 42K+ transport is normalized at the expense of a raised cell Na+. The decreased muscle membrane potential in uremic subjects has been attributed to a decreased activity of Na+-K+ pump. The authors discuss the role of hormonal abnormalities and circulating inhibitors, which may cause an acute inhibition of the pump and of other factors such as K+ depletion, which may cause more chronic alterations. The implications of alteration of Na+ and K+ pump transport and raised cell Na+ on other non-pump-mediated transport pathways are discussed. Raised cell Na+ may be a marker for the adequacy of maintenance dialysis in patients with end-stage renal failure

  15. Chronic renal failure and macrogenitalia associated with genitourinary neurofibromatosis.

    Science.gov (United States)

    Dündar, Bumin Nuri; Oktem, Faruk; Armağan, Abdullah; Dündar, Nihal Olgaç; Bircan, Sema; Yesildag, Ahmet

    2010-02-01

    Neurofibromatosis (NF) is a genetic disorder of the nervous system that primarily affects the development and growth of neural cell tissues. This disorder is characterized by the development of various tumors, including neurofibromas, neuroniomas, malignant and benign peripheral nerve sheath tumors, and meningiomas. Accompanying skin changes and bone deformities are also common in NF. However, genitourinary involvement in NF is a rare condition, and penile enlargement has been reported only in a few males with plexiform NF. We report a 6-year-old boy with chronic renal failure associated with plexiform neurofibromas of the bladder and prostatic urethra which led to urinary obstruction and macrogenitalia due to genitourinary NF. PMID:19826840

  16. Bone scan appearance of renal osteodystrophy in diabetic chronic renal failure patients

    International Nuclear Information System (INIS)

    To investigate Tc-99m methylenediphosphonate (MDP) bone scan appearance in diabetic chronic renal failure patients, we compared the bone scan images of chronic renal failure patients with and without diabetes. The number of patients studied was 134, of whom 43 had diabetes. Two nuclear medicine physicians read Tc-99m MDP bone scan images and for six areas - the axial skeleton, long bone, skull and mandible, periarticular areas, costochondral junction, and sternum - assigned a score of either 1 or 0. The sums of scores were compared. We also performed multivariate analysis including sex, age, and serum creatinine level using analysis of covariance. DM group patients scored significantly lower (2.01±0.95) than those of the non-DM group (3.26±1.16). Analysis of covariance revealed that the lower DM group score was independent of sex, age, and serum creatinine level. The bone scans of diabetic chronic renal failure patients showed less Tc-99m MDP uptake than those of non-diabetic patients. Thus, diagnosing renal osteodystrophy in diabetic chronic renal failure patients on bone scan images could be difficult. (author)

  17. Helicobacter Pylori in Patients with Chronic Renal Failure

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    B Allahverdi

    2004-07-01

    Full Text Available Background: Helicobacter pylori (H.Pylori is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD. Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2% had pathologic defect in endoscopy and 57 patients (82.6% had gastrointestinal symptoms. Prevalence of H pylori positive was 21.7% (15 patients. H pylori was positive in 21% patients with gastrointestinal symptoms. Conclusion: Chronic renal failure and dialysis had no effect on prevalence of H pylori.

  18. Chronic renal failure among HIV-1-infected patients

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Kirk, Ole; Gatell, Jose;

    2007-01-01

    BACKGROUND: The role of exposure to antiretrovirals in chronic renal failure (CRF) is not well understood. Glomerular filtration rates (GFR) are estimated using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations. METHODS: Baseline was arbitrarily defined as the first...... recorded GFR; patients with two consecutive GFR determine odds ratio (OR) of CRF at baseline. ART exposure (yes/no or cumulative exposure) prior to baseline was included in multivariate models (adjusted for region...... of Europe, age, prior AIDS, CD4 cell count nadir, viral load, hypertension and use of nephrotoxic anti-infective therapy). RESULTS: Using CG, the median GFR at baseline (n = 4474) was 94.4 (interquartile range, 80.5-109.3); 158 patients (3.5%) had CRF. Patients with CRF were older (median, 61.9 versus 43...

  19. An Epidermolysis Bullosa Patient Complicated with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Özkan Ulutaş

    2013-03-01

    Full Text Available A 32-yr-old man with epidermolysis bullosa presented with clinical and laboratory findings of chronic renal failure. The patient was supposed to be suffering from mesangial IgA glomerulonephritis in view of the repeated persistent macroscopic episodes of hematuria and raised serum IgA levels, especially polimeric IgA. Because continuous vascular access could not be established, the patient died due to uremia and sepsis. Renal complications are associated with life-threatening problems in this inherited mechanobullous disease because it is impossible to obtain a continuous vascular access or a continuous peritoneal access. The possibility of IgA nephropathy should be considered in patients with epidermolysis bullosa. They should be periodically set up screened for IgA levels and hematuria.

  20. Acute renal failure: outcomes and risk of chronic kidney disease.

    Science.gov (United States)

    Block, C A; Schoolwerth, A C

    2007-09-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. The incidence of ARF is increasing. Efforts such as the Acute Dialysis Quality Initiative (ADQI) are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury that might confer a different prognosis. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease and more information regarding recovery from ARF is available. Controversy exists regarding the optimal management of ARF. Recent publications emphasize the importance of timing and dose of renal replacement therapy rather than the modality of treatment (intermittent hemodialysis vs continuous therapies). These issues are explored in this review. PMID:17912228

  1. Oral disorders in patients with chronic renal failure. Narrative review.

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2016-02-01

    Full Text Available Chronic renal failure (CRF is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent organ rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.

  2. Quality of life in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Petrović Lada

    2006-01-01

    Full Text Available Introduction. Hemodialysis and transplantation are performed not only to replace renal function, but also to improve patients' quality of life. The aim of our investigation was to compare the quality of life in patients with chronic renal failure (CRF before and after the introduction of active therapy. Material and methods. We tested 76 patients (pts: 20 pts on conservative therapy (CT, 21 pts on chronic hemodialysis and 35 pts with renal transplantation. A questionnaire (combining two questionnaires was used to investigate the physical, emotional and social aspects of health. Results. In regard to physical health of transplantation patients (TP it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40% than in hemodialysis patients (HD (19%, while family relationships were most damaged in pts on HD (28.57%. Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good; 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good. .

  3. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim of...... the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

  4. Ear, nose and throat manifestations in pediatric chronic renal failure patients undergoing peritoneal dialysis

    OpenAIRE

    Kumar, Sandeep; Chakravarti, A; Sahni, J. K.; Dubey, N. K.

    2004-01-01

    Ear, Nose and Throat manifestations have been frequently observed in patients with chronic renal failure. Many factors viz. ototoxic drugs, associated conditions of renal failure such as electrolyte imbalance, alteration in blood urea etc. have been implicated for these manifestations. The present study has been conducted to evaluate ear, nose and throat manifestations in thirty pediatric patients (age group 4-16 year) of chronic renal failure undergoing peritoneal dialysis. Probable patho-ph...

  5. Preemptive Renal Transplantation-The Best Treatment Option for Terminal Chronic Renal Failure.

    Science.gov (United States)

    Arze Aimaretti, L; Arze, S

    2016-03-01

    Renal transplantation is the best therapeutic option for end-stage chronic renal disease. Assuming that it is more advisable if performed early, we aimed to show the clinical, social, and economic advantages in 70% of our patients who were dialyzed only for a short period. For this purpose, we retrospectively collected data over 28 years in 142 kidney transplants performed in patients with sports, and reproduction. Immunosuppression consisted of 3 drugs, including steroids, cyclosporine, and azathioprine or mycophenolate. The cost in the 1st year, including patient and donor evaluation, surgery, immunosuppression, and follow-up, was $13,300 USD versus $22,320 for hemodialysis. We conclude that preemptive renal transplantation with <6 weeks on dialysis is the best therapeutic option for end-stage renal failure, especially in developing countries such as Bolivia, where until last year, full public support for renal replacement therapy was unavailable. PMID:27110013

  6. Children with chronic renal failure have reduced numbers of memory B cells.

    NARCIS (Netherlands)

    Bouts, A.H.M.; Davin, J.C.; Krediet, R.T.; Monnens, L.A.H.; Nauta, J.; Schröder, C.H.; Lier, R.A.W. van; Out, T.A.

    2004-01-01

    Reduced serum IgG and subclass levels have been demonstrated in children with chronic renal failure. To study possible causes of this reduction, we analysed B cell subset composition, T helper cell frequencies and immunoglobulin (Ig) production capacity in vitro in children with chronic renal failur

  7. Radiological diagnosis of pulmonary edema in chronic renal failure

    International Nuclear Information System (INIS)

    Pulmonary edema has been revealed in 132 patients (51.6 %) during radiologic examination of 256 patients with chronic renal failure. The performance of anterio-posterior chest radiographs was in most cases necessary and quite sufficient for making diagnostic conclusions. Follow up study of patients with pulmonary edema and analysis of radiologic picture of the alterations permitted physicians to distinguish approximately 3 stages of the process development, which transit from one into another. Stage 1 involves early disorders and prodromes of pulmonary edema; Stage 2 interstitial lung edema; Stage 3 alveolar edema. The circulation enforcement of the upper lobar vessels has been the main feature of stage 1. Radiogramometry provided additional information for the pulmonary edema diagnosis. For instance, cardioradiometric data are useful for pulmonary edema diagnosis and evidence in favour of its close connection with heart disorders

  8. Total and free thyroid hormone levels in chronic renal failure.

    Directory of Open Access Journals (Sweden)

    Mehta H

    1991-04-01

    Full Text Available The levels of serum total thyroxine (TT4, triiodothyronine (TT3, free T3, (FT3 free T4 (FT4 and thyrotropin (TSH were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF; and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals. Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001 as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05 as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.

  9. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    OpenAIRE

    Perihan Öztürk; Neslihan Dokur; Ergül Kurutaş; Ekrem Doğan; Tuğba Karakaş; Murat Kalender; Hasan Ekerbiçer

    2012-01-01

    Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined fo...

  10. Plasma homocysteine concentration in children with chronic renal failure.

    Science.gov (United States)

    Merouani, A; Lambert, M; Delvin, E E; Genest, J; Robitaille, P; Rozen, R

    2001-10-01

    Hyperhomocysteinemia, a risk factor for vascular disease, is commonly found in adult patients with end-stage renal disease. Major determinants of elevated plasma homocysteine levels in these patients include deficiencies in folate and vitamin B12, methylenetetrahydrofolate reductase (MTHFR) genotype and renal function. Little information is available for children with chronic renal failure (CRF). The prevalence and the factors that affect plasma homocysteine concentration were determined in children. Twenty-nine children with various degrees of CRF (15 were dialyzed, 14 were not dialyzed) were compared with 57 age- and sex-matched healthy children. Homocysteine concentrations were higher in patients than controls (17.3 micromol/l vs 6.8 micromol/l, P95th percentile for controls: 14.0 micromol/l) was seen in 62.0% of patients and 5.2% of controls. Folate concentrations were lower in patients (9.9 nmol/l) than controls (13.5 nmol/l), P<0.01. Vitamin B12 was similar in patients (322 pmol/l) and controls (284 pmol/l). Dialyzed patients have a higher prevalence of hyperhomocysteinemia than nondialyzed patients (87% vs 35%). Dialyzed patients with MTHFR mutation have higher plasma homocysteine (28.5 micromol/l) than nondialyzed patients with the mutation (10.7 micromol/l), P<0.002. In our study, differences between controls and patients in plasma homocysteine concentrations are observed when age is greater then 92 months, folate less than 21.6 nmol/l and vitamin B12 less than 522 pmol/l. Our study shows that hyperhomocysteinemia is common in children with CRF and is associated with low folate and normal vitamin B12 status, compared to normal children. Among the patients, the dialyzed patients with the MTHFR mutation are particularly at risk for hyperhomocysteinemia. Further studies are needed to investigate therapeutic interventions and the potential link with vascular complications in these patients. PMID:11605787

  11. Abnormalities of the breast in chronic renal failure and renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bae Young; Kim, Hak Hee; Choi, Kyu Ho; Park, Seog Hee [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2000-12-15

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

  12. Abnormalities of the breast in chronic renal failure and renal transplantation

    International Nuclear Information System (INIS)

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

  13. Effect of TGF-β1 antisense oligodeoxynucleotide on renal function in chronic renal failure rats

    Institute of Scientific and Technical Information of China (English)

    Law Chung HIONG; Kiew Lik VOON; Nor Azizan ABDULLAH; Munavvar A SATTAR; Nazarina AbduRAHMAN; Abdul Hye KHAN; Edward James JOHNS

    2008-01-01

    Aim:The aim of the present study was to investigate the effectiveness of trans-forming growth factor (TGF)-β1 antisense oligodeoxynucleotides (ODN) in ame-liorating deteriorated kidney function in rats with puromycin-induced chronic renal failure (CRF). Methods:Saline, puromycin, puromycin+TGF-β1 antisense ODN or puromycin+scrambled ODN were administered to unilaterally nephrecto-mized rats. Renal hemodynamic and excretory measurements were taken in the anaesthetized rats that had undergone surgical procedure. Results:It was ob-served that in the CRF rats, there was a marked reduction in the renal blood flow (RBF), glomerular filtration rate (GFR), severe proteinuria, and almost 6-fold in-creased fractional excretion of sodium (FE Na+) as compared to that in the control rats (all P<0.05). It was further observed that in the CRF rats, the treatment with TGF-β1 antisense, but not scrambled ODN, markedly attenuated the reduction of RBF, GFR, and proteinuria and markedly prevented the increase of the FE Na+ (all P<0.05). In addition, the renal hypertrophy in the CRF group (P<0.05 vs non-renal failure control) was markedly attenuated after treatment with TGF-1 antisense ODN (P<0.05). Focal segmental glomerulosclerosis was evident only in the un-treated and scrambled ODN-treated CRF groups. An interesting observation of this study was that in the CRF rats, although there was marked attenuating and preventive effects of the TGF-β1 antisense ODN on the deteriorated renal functions, the antisense treatment did not cause any marked change in the renal expression of TGF-β1 at the protein level. Conclusion:Collectively, the data obtained sug-gests that TGF-β1 antisense ODN possesses beneficial effects in puromycin-induced chronic renal failure and that the deterioration in morphology and im-paired renal function in this pathological state is in part dependent upon the action of TGF-β1 within the kidney.

  14. Turnover of VLDL-apoliporprotein b in chronic renal failure

    International Nuclear Information System (INIS)

    Chronic renal failure (CRF) has been known to be associated with apolipoprotein (Apo) and lipid abnormalities, leading to accelerated atherosclerosis (AS). This work is aimed at studying the lipoprotein (LP) metabolism of CRF patients in order to elucidate how this metabolism is linked with AS. The fractional synthesis rate (FSR) of ApoB in very low density lipoprotein (vLDL) was determined by using endogenous 15N-glycine labeling and GC-MS analysis in 5 patients with CRF. Plasma lipid profiles of CRF patients were also studied. The FSR of vLDL-ApoB obtained by this method was 3.19 ± 0.43%/day in CRF patients, while that in the normal subjects (5.6 ± 0.45%/day) was significantly higher (P<0.0001). The CRF patients also had reduced levels of HDL-cholesterol (34.6 ± 4.6% mg/dl) in comparison with the control (63.2 ± 4.6 mg/dl)

  15. Hearing evaluation in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Evis Bendo; Margarita Resuli; Spiros Metaxas

    2015-01-01

    Objective:To evaluate hearing threshold and the severity of hearing loss at different frequencies in patients with chronic renal failure (CRF), and to analyze the role of duration of disease on hearing threshold in patients of CRF by measuring pure-tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE). Methods: There were analysed 61 subjects (122 ears) from which 12 were patients starting hemodialise (A), 24 subjects were patients undergoing hemodialise over a year (B), 15 subjects were patients undergoing conservative treatment (C) and 10 controls (D). We did hearing evaluation by testing them using tympanometry, PTA and DPOAEs. Other parameters (blood pressure, body weight, blood chemistries) were also evaluated. Results:It was found a severe high-frequency hearing loss among patients with CRF comparing to the control group. Duration on haemodialysis treatment does not seem to have a significant impact on the incidence of hearing loss, although the method of treatment may influence the impact of the disease on hearing. Hearing loss among patients with CRF seemed to deteriorate further a year after the first evaluation. Conclusions:DPOAE raised the percentages of detection of SNHL indicating that it is a better technique than the conventional PTA for evaluation of hearing acuity.

  16. Antibody Response Rates To Hepatitis B Vaccination in Children With Chronic Renal Failure: An Observational Study

    OpenAIRE

    Ece, İbrahim; Kibar, Ayse Esin; Oflaz, Burhan; Cakar, Nilgun; Balli, Sevket; Akkok, Nermin; Kara, Nazli

    2013-01-01

    Introduction: Hepatitis B virus (HBV) infection is one of the most important factors increasing the mortality and the mobility in patients with chronic renal failure (CRF). There are a limited number of studies of pediatric patients with CRF regarding the response to double doses and protection rates. In this study, our aim was to compare the antibody levels and the respond rates to recombinant hepatitis B vaccine in children with chronic renal failure (CRF). Materials and Methods: In this pr...

  17. Effect of Atracylodes Rhizome Polysaccharide in Rats with Adenine-Induced Chronic Renal Failure

    OpenAIRE

    Yang, C.; C. Liu; Zhou, Q.; Xie, Y. C.; Qiu, X. M.; X. Feng

    2015-01-01

    The aim of the study was to elucidate the therapeutic effects of Atracylodes rhizome polysaccharide on adenine-induced chronic renal failure in rats. Fifty male Sprague Dawley rats were selected and randomly divided in to 5 groups (n=10 rats per group): The normal control group, the chronic renal failure pathological control group, the dexamethasone treatment group and two Atracylodes rhizome polysaccharide treatment groups, treated with two different concentrations of the polysaccharide, the...

  18. Dry Eye in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Pınar Yüksekkaya

    2014-05-01

    Full Text Available Objectives: To evaluate the dry eye symptoms based on objective test and subjective findings in children with chronic renal failure (CRF and to compare the results with those in healthy subjects. Materials and Methods: Thirty-four children with CRF and 89 age- and sex-matched healthy subjects were included in this prospective study. Tear break-up time (TBUT and Schirmer test, subjective symptoms (burning, foreign-body sensation, hyperemia, itching, tearing, calcification of the conjunctiva, and corneal staining were evaluated. In the study group, relation between TBUT and Schirmer test results and duration of disease, duration of dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were recorded. For statistical analysis, t-test, chi-square test, and Pearson’s correlation test were used. Results: In the study group, burning sensation was statistically higher than in the control group. Except this, according to the other subjective tests and corneal staining, there were no significant differences between the two groups (p>0.05. Conjunctival calcification was seen in 3 patients in the study group. The mean Schirmer test result was 21.1±8.0 and 23.7±8.0 mm in the study and control groups, respectively (p=0.101. The mean TBUT was 12.5±5.2 seconds (s in the study and 16.0±5.5 s in the control groups (p=0.002. None of the disease-related variables (the mean duration of disease and dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were associated with dry eye syndrome (p>0.05. Conclusion: TBUT was statistically significantly lower, but Schirmet test result was not significantly different between children with CRF and age- and sex-matched healthy subjects. The disease-related variables have no effect in the development of dry eyes. (Turk J Ophthalmol 2014; 44: 196-200

  19. Erectile dysfunction in patients with chronic renal failure

    OpenAIRE

    Leonardo E. Messina; Joaquim A. Claro; Nardozza Archimedes; Enrico Andrade; Valdemar Ortiz; Miguel Srougi

    2007-01-01

    OBJECTIVE: Determine the prevalence of erectile dysfunction in patients undergoing hemodialysis MATERIALS AND METHODS: This cross-sectional study was carried out to determine the prevalence of erectile dysfunction in a population of 58 patients in hemodialysis program. Erectile dysfunction was assessed by using the International Index of Erectile Function (IIEF). Information on demographic data, renal failure, comorbidities, laboratory tests and search for medical treatment for erectile dysfu...

  20. HEPATITIS C VIRUS INFECTION IN PATIENTS WITH CHRONIC RENAL FAILURE AND RENAL TRANSPLANTATION ECIPIENTS

    Directory of Open Access Journals (Sweden)

    MR. Ganji

    1997-07-01

    Full Text Available 'Die presence anil significance of hepatitis C virus infection among patients with chronic renal failure (CRF on hemodialysis and renal transplant recipient were evaluated a pcrioil of 30 months. A total of 125 patients, comprising 25 recieving chronic hemodialysis, 47 renal transplant candidates and 5.1 renal transplant recipients, were studied with a second generation immunoassay (ELISA II. We detected HCV antibody in 13% of hemodialysis patients which is 40 folds higher than the prevalence of HCV antihotly in general population of Iran (0.3%, as expected. Fortynine (39.2% of our patients were HCV antihotly positive, 2H of them were transplanted and 21 were renal transplant candidates. We compared HCV antihotly positive (group I and HCV antibody negative (group 2 patients. Die results of this study showed a positive correlation between HCV seroconversion, CRF, duration on hemodialysis and elevated liver enzyme levels. Duration of follow-up were 29.62 ± 15.62 months and 31.25 ± 17.50 months in group I and 2 respectively (I' = NS. Duration of preoperative hemodialysis were 54.14 ± 41.18 months and 16.00 ± 10.25 months in group 1 ami 2 respectively (I1 = 0.000}. During follow-up, elevated ALT levels were present in 43.3% and 9.26% of patients in group I ami 2 respectively (I'=0.0001. Immunosuppressive drug toxicity, 1'ostopeative complications including hyperacute rejection and acute tubular necrosis were more common in group I.

  1. Arteriovenous thrombosis in chronic renal failure patients receving renal replacement therapy

    International Nuclear Information System (INIS)

    To determine the frequency of thrombotic complications and to identify factors associated with arteriovenous thrombosis in patients of chronic renal failure receiving renal replacement therapy. Of the 3000 patients evaluated, 61 End Stage Renal Disease (ESRD) patients on regular dialysis, having recent renal transplant, were selected for the study after informed consent. These patients had arteriovenous thrombosis with temporary central lines thrombosis and vascular access problems. Cases of congenital or acquired thrombotic disorders, e.g. with malignancy, DIC, liver disease, systemic lupus erythematosus or other immunologic diseases, pregnancy or women using oral contraceptives, were excluded. Similarly, patients taking any type of anticoagulant therapy during the preceding one week were not included in the study. Findings were recorded in a structured questionnaire. Laboratory analysis was done after clinical and radiological evaluation. Thrombophilia screening included antithrombin, protein C, protein S deficiencies and lupus anticoagulant. Forty-seven out of 61 patients selected were positive for thrombophilia screening with protein C deficiency in 26.2%, protein S deficiency in 16.3%, antithrombin in 5%, lupus anticoagulant in 13.1% and combined deficiency was observed in 16.3%. Of the 3000 patients, 61 with frequency of 2% were found to be deficient in one or had combined deficiency of these. Thus, the study of ESRD patients presenting with arteriovenous thromboembolism emphasizes the need to reconsider the perception that this clinical entity is rare and requires further studies. (author)

  2. Circadian variation of blood pressure in patients with chronic renal failure on continuous ambulatory peritoneal dialysis

    DEFF Research Database (Denmark)

    Clausen, P; Feldt-Rasmussen, B; Ladefoged, Jens

    1995-01-01

    The circadian pattern of blood pressure variation was investigated in 10 patients with advanced chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) and in an age-matched group of controls without renal disease with similar office blood pressure level. Monitoring was done using...

  3. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  4. Chronic renal failure (CRF in children in Jugoslavia

    Directory of Open Access Journals (Sweden)

    Peco-Antić Amira

    2003-01-01

    Full Text Available The aim of this study was to analyse the demographic variables of chronic non-terminal (CRF and terminal (TRF renal failure patients (pts younger than 19 years treated in Serbia in June 2001. The prevalence of CRF pts was registered as 4,7 per million total population (pmtp or 14,1 per million child population (pmcp while corresponding values for TRF pts were 4,5 pmtp or 13,5 pmcp. The incidence of TRF pts during the period Jan.2000-Jan.2002 was 4,35 pmcp. Boys dominated only among CRF pts (34:14; 60,4% beeing between the ages of 6 and 19 yrs while at the time of diagnosis of HBI, 33,3 % of boys were yanger than 2 yrs.The causes of CRF were: reflux nephropathy 58,3%, congenital kidney disease 16,7%, familial/hereditary 14,6% glomerulonephritis 6,2% and Willms tu 4,1%. Reflux nephropathy was also the most common underlying disease of TRF accounted for 36,9% of total cases while glomerulonephritis was responsible for 23,9 %. Reflux nephropathy was associated with neural tube defect in 53,3% and with congenital lower urinary tract obstruction in 66,7%. The most of CRF (81,25% and TRF pts (95,6% were from Serbia, the others were from Monte Negro and Republic Srpska. The most of CRF (65% and TRF (80% pts were treated in University Children’s Hospital in Belgrade. Of CRF pts 46% had serum sreatinine 100-200 μmol/l, in 11% of pts it was 400-600 μmol/l and 2% of pts were in pre-terminal CRF. One third of CRF pts had proteinuria 150-500 mg/l, and second third had proteinuria greater of 1000 mg/l. Anemia was present in 54% of CRf pts, and arterial hypertension in 56%. Hemodialysis was dominant treatment modality for TRF pts and only 23,9% had functioning transplant. Conclusion: This is the first national study of demographic characteristics of pediatric CRF in Serbia. Since its prevalence is considerably lower than that in Western and North European countries the true prevalence is some what higher. The increasing incidence of pediatric TRF from 2

  5. Hepatitis C, Chronic Renal Failure, Control Is Possible!

    Directory of Open Access Journals (Sweden)

    Seyed-Moayed Alavian

    2006-06-01

    Full Text Available Hepatitis C virus (HCV infection has come to the top of virus-induced liver diseases in many parts of the world. In Iran, it seems that HCV prevalence in general population is less than one percent, which is much lower than in most of the regional countries(1. However, the infection is emerging in Iran mostly due to problem of intravenous drug abuse and needle-sharing in the country (2, 3. The patients receiving maintenance transfusion such as chronic renal failure (CRF patients and the patients with thalassemia major are the other population who are at the high risk of HCV acquisition although compulsory blood screening has been able to remarkably decrease the HCV incidence in these patients (4. The prevalence of HCV infection among CRF patients on hemodialysis in Tehran, the capital of Iran, was around 13 percent in 2002 (5. There is no valid data regarding HCV incidence rate among CRF patients in country. However, according to the most recent official report of Management of Special Diseases and Transplantation Center (MSDT, the prevalence of HCV infection among patients on hemodialysis in the whole country has decreased from 14.4% in 1999 to 4.5% in 2005. Various reasons might be responsible for this reduction such as blood screening; developing technology of alternative modalities instead of transfusion in Iran like producing domestic Erythropoietin which has been resulted in decreasing transfusion; early transplantation; and training health staffs. On the other hand, the other reason such as mortality ofHCV infected CRF patients should not be neglected. Although there is no data in this regard in Iran, a meta-analysis, demonstrated that HCV infected patients on dialysis have an increased risk of mortality compared to HCV negative cases (6. Therefore, with the lack of data defining incidence rate in Iran, the reduction of HCV prevalence in the country should not overlook the necessity of designing a comprehensive strategy to control HCV

  6. Anemia, renal impairment and in-hospital mortality, in acute worsening chronic heart failure patients

    OpenAIRE

    Bojovski, Ivica; Vavlukis, Marija; Caparovska, Emilija; Pocesta, Bekim; Shehu, Enes; Taravari, Hajber; Kitanoski, Darko; Kotlar, Irina; Janusevski, Filip; Taneski, Filip; Jovanovska, Ivana; Kedev, Sasko

    2014-01-01

    Aim of the study: To analyze the impact of anemia and renal impairment on in-hospital mortality(IHD), in patients with acute worsening chronic heart failure. Methods: 232 randomly selected patients with symptoms of HF were retrospectively analyzed. Analyzed variables: gender, age, risk factors and co-morbidities: HTA, HLP, DM, COPD, CAD, PVD, CVD, anemia(defined as Hgb ≤10mg/dl), renal failure. Measured variables: systolic and diastolic BP, Hgb, sodium, BUN, creatinine, length of hospital sta...

  7. Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.

    OpenAIRE

    Duncan, I J; Hurst, N P; Sebben, R; Milazzo, S C; Disney, A

    1990-01-01

    The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipi...

  8. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  9. Colchicine-induced neuromyopathy in a patient with chronic renal failure: the role of clarithromycin.

    NARCIS (Netherlands)

    Velden, W van der; Huussen, J.; Laak, H ter; Sevaux, R de

    2008-01-01

    Neuromyopathy is a rare side effect of chronic colchicine therapy, most often occurring in patients with chronic renal failure. Drugs interacting with colchicine metabolism through CYP(3)A(4) and P-glycoprotein can accelerate accumulation and toxicity. We describe a case of an interaction between cl

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  11. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  12. Tumoral calcinosis in a dog with chronic renal failure : clinical communication

    Directory of Open Access Journals (Sweden)

    T.C. Spotswood

    2003-06-01

    Full Text Available A 2-year-old male German shepherd dog in poor bodily condition was evaluated for thoracic limb lameness due to a large, firm mass medial to the left cranial scapula. Radiography revealed several large cauliflower-like mineralized masses in the craniomedial left scapula musculature, pectoral region and bilaterally in the biceps tendon sheaths. Urinalysis, haematology and serum biochemistry showed that the dog was severely anaemic, hyperphosphataemic and in chronic renal failure. The dog was euthanased and a full post mortem performed. A diagnosis of chronic renal failure with secondary hyperparathyroidism was confirmed. The mineralized masses were grossly and histopathologically consistent with a diagnosis of tumoral calcinosis. Tumoral calcinosis associated with chronic renal failure that does not involve the foot pads is rarely seen.

  13. The impact of chronic heamodialysis on the personality of patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evgenia Vlachu D.

    2009-07-01

    Full Text Available People with chronic diseases, deal with permanent changes in their everyday life. At the same time these patients appear to have different pathological behavior and personality disturbances as aresult of the disorders of their biological functions.AIM: The aim of this study is the examination of the psychological behavior of patients with chronic renal failure who submit themselves to recurrent heamodialysis (CRH.MATERIAL METHODS:The research was based on the completion of a questionnaire which has been used on foreigners and Greek patients who complained about chronic diseases. This questionnaire guarantees the highest reliability of all so that it will be possible to specify the negative influence of their disease upon the different sides of their life. Emphasis should be given on the fact that the personality questionnaire of Eysenck has been intensively evaluated on the Greek population as very trustworthy for secure conclusions. It included 84 questions in four different disorders (psychotism, neurotism, ex/introversion and check inversion for inaccuracies. The questionnaire has been proved very useful for the evaluation of the influence of the different interventions upon the quality of life of patients under heamodialysis. It appeared also that it was more reliable in comparison with the Sickness Impact Profile and with a test, whhb ic was aout the exercise under stress conditions. RESULTS: It has been discovered that all the three scales of control of the personality disturbances have systematically been influenced according to the control group of 138 persons from different age and sex groups. Furthermore, it has been found that the men patients underthe CRH were in lower region of the scale of neurotism while women patients appeared to be lower in the scale of psychotism. The T‐test shows that there is no important statistic difference between the two sexes according to the quality of their job. There is also no important difference

  14. Complementary and Alternative Medicine Methods in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Zeynep Erdogan

    2014-08-01

    Full Text Available Despite its long history, use of complementary and alternative medicine (CAM methods has increased dramatically only after 1990s. Up to 57% of patients with chronic renal use CAM methods.These patienys use CAM methods to overcome hypertension, fatigue, constipation, leg edema, pain, cramps, anxiety, depression, sleep disorders, to cope with symptoms such as itching, to stop the progression of kidney disease and to improve their quality of life. Methods used are herbal products and food supplements, acupressure, acupuncture, homeopathy, exercise, aromatherapy, yoga and reflexology. Nephrotoxic effect of several CAM therapies used in patients with renal impairment could disturb hemodynamics by reducing the glomerular filtration rate. For this reason, health care providers should question patients about used of CAM, methods. Communication with patients should be clear and should not act judgmental. Health care personnel should learn more about CAM methods in order to avoid unwanted situations that could develop after the application of CAM methods. Patients should be informed correctly and scientifically about these methods to avoid harmful and unnecessary uses. [Archives Medical Review Journal 2014; 23(4.000: 770-786

  15. Periodontal disease characterization in dogs with normal renal function or chronic renal failure

    Directory of Open Access Journals (Sweden)

    Barbudo-Selmi Glenda Ramalho

    2004-01-01

    Full Text Available The purpose of this study was to evaluate periodontal disease (PD in dogs with chronic renal failure (CRF and to compare it to PD in dogs with normal renal function (NRF. Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivitis, gingival recession, pocket, calculus, dental mobility, dental loss, and ulcers. These data were used to calculate plaque index (PI, gingival index (GI and periodontal destruction index (PDI. PD was graded as mild, moderate or severe based on the results. Mild, moderate or severe PD was observed in dogs with NRF, whereas dogs with CRF presented either mild or severe PD. Dogs with NRF showed higher involvement of the maxillary teeth, whereas dogs with CRF showed a higher involvement of the mandibular teeth. Plaque index was significantly higher in dogs with NRF. It was concluded that lesion distribution and periodontal disease progression may be altered in dogs with CRF, and gingival inflammatory response differs in dogs with NRF and CRF regarding to the stage of periodontal disease.

  16. Efficacy of regional renal nerve blockade in patients with chronic refractory heart failure

    Institute of Scientific and Technical Information of China (English)

    DAI Qi-ming; FEN Yi; LU Jing; MA Gen-shan

    2013-01-01

    Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure.We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance.Methods Eighteen patients with chronic refractory heart failure were enrolled (mean age (64±11) years).The patients were randomly divided into two groups (renal nerve blockade group and standard therapy group,n=9 each).Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance.Heart rate,mean arterial blood pressure,plasma and urine electrolytes,neurohormones,factional excretion of sodium (FENa),24-hour urine volume were monitored at baseline and the first 24 hours after therapy.Dyspnea and oedema were also evaluated.The major adverse cardiovascular events (MACE),plasma brain natriuretic peptide (BNP) level and left ventricular ejection fraction (LVEF) were compared between the two groups during the 3-12 months follow-up period.Results No complication was observed during the acute phase of renal nerve blockade.After renal nerve blockade,the 24-hour urine volume and FENa were significantly increased,while the level of plasma rennin,angiotensin Ⅱ,aldosterone,BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group.During three to 12 months of follow-up,the rate of MACE and plasma BNP level were significantly lower,while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group.Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.

  17. Progress of magnetic resonance spectroscopy in chronic renal failure patients with vertebral bone change

    International Nuclear Information System (INIS)

    Bone changes caused by kidney diseases affect the quality of life in the patients with chronic renal failure. How to improve evaluation of the bone change, and consequently start early intervention and treatment is an important topic. Magnetic resonance spectroscopy (MRS) has been successfully used in the evaluations of central nervous system, breast and prostate, etc. Evaluation of bone changes with MRS is under studied. This article reviewed the MRS in evaluation of vertebral body bone changes in patients with chronic renal failure. (authors)

  18. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...

  19. Sensorineural Hearing Affection In Sickle Cell Disease Patients With Chronic Renal Failure Under Dialysis

    Directory of Open Access Journals (Sweden)

    Saeed Abdelwhab Saeed MD*, Magdy M El Sharkawy

    2002-09-01

    Full Text Available Objective: to study the problem of hearing loss in patients of chronic renal failure on regular haemodialysis and The factors which affect it. And to study the effect of sickle cell disease on hearing loss. we studied hearing loss in dialysis patients, sickle cell disease patients and patients of sickle cell disease with chronic renal failure under dialysis compared to normal control subjects. Design: !"",include sickle cell disease patients with chronic renal fa"# $%& ' ", i ,nclude ( # #"# $%&'", , ,( #&'", i 9nclude the normal *+&*+' All groups are subjected to full history, thorough clinical examination including neurological and ENT examination, investigations includes Hb, s. creatinine, s.albumen, s.calcium and calculation of kt/v for dialysis patients. Full audiological assessment, using #,-GSI audiometer was done for all groups with special concentration at frequency of - .Results: hearing loss was found in patients with chronic renal failure more than normal control. Patient with sickle cell disease have hearing disorders significantly higher than $/%- .% 0( # #cell disease have significantly. Marked degree of SNHL than those with SCD only. Hearing loss in patients with 12( # * 3 &4 !4! '#"#"patients with chronic renal failure with or without SCD correlate with duration of dialysis , presence of peripheral neuropathy, s. calcium level, efficiency of dialysis marked by kt/v. Conclusion and recommendation: hearing disorder is common in patients with chronic renal failure under regular haemodialysis and it increase with duration of dialysis it should be suspected if there is Peripheral neuropathy. It can be reduced with efficient dialysis, correction of anemia, adjustment of calcium level. Patients with SCD suffer also some degree of hearing loss especially at higher frequency and this degree of hearing loss

  20. Salt-induced changes in cardiac phosphoproteome in a rat model of chronic renal failure.

    Directory of Open Access Journals (Sweden)

    Zhengxiu Su

    Full Text Available Heart damage is widely present in patients with chronic kidney disease. Salt diet is the most important environmental factor affecting development of chronic renal failure and cardiovascular diseases. The proteins involved in chronic kidney disease -induced heart damage, especially their posttranslational modifications, remain largely unknown to date. Sprague-Dawley rats underwent 5/6 nephrectomy (chronic renal failure model or sham operation were treated for 2 weeks with a normal-(0.4% NaCl, or high-salt (4% NaCl diet. We employed TiO2 enrichment, iTRAQ labeling and liquid-chromatography tandem mass spectrometry strategy for phosphoproteomic profiling of left ventricular free walls in these animals. A total of 1724 unique phosphopeptides representing 2551 non-redundant phosphorylation sites corresponding to 763 phosphoproteins were identified. During normal salt feeding, 89 (54% phosphopeptides upregulated and 76 (46% phosphopeptides downregulated in chronic renal failure rats relative to sham rats. In chronic renal failure rats, high salt intake induced upregulation of 84 (49% phosphopeptides and downregulation of 88 (51% phosphopeptides. Database searches revealed that most of the identified phospholproteins were important signaling molecules such as protein kinases, receptors and phosphatases. These phospholproteins were involved in energy metabolism, cell communication, cell differentiation, cell death and other biological processes. The Search Tool for the Retrieval of Interacting Genes analysis revealed functional links among 15 significantly regulated phosphoproteins in chronic renal failure rats compared to sham group, and 23 altered phosphoproteins induced by high salt intake. The altered phosphorylation levels of two proteins involved in heart damage, lamin A and phospholamban were validated. Expression of the downstream genes of these two proteins, desmin and SERCA2a, were also analyzed.

  1. Serum Lipoprotein (a) Levels in Chronic Renal Failure and Liver Cirrhosis Patients. Relationship with Atherosclerosis

    OpenAIRE

    Essam Mady; Gehane Wissa; Ali Khalifa; Mahmoud El-Sabbagh

    1999-01-01

    This study was carried out to investigate the relationship between lipoprotein (a) levels and the development of atherosclerosis in chronic renal failure (CRF) patients with the possible role of the liver. Serum Lp (a) levels were measured in samples from 20 CRF patients on hemodialysis (HD), 20 liver cirrhosis (LC) patients, 20 patients having both CRF and LC and undergoing HD, and 20 normal control subjects. Renal function (blood urea nitrogen (BUN) and creatinine), hepatic function (transa...

  2. Premature development of erosive osteoarthritis of hands in patients with chronic renal failure.

    Science.gov (United States)

    Duncan, I J; Hurst, N P; Sebben, R; Milazzo, S C; Disney, A

    1990-06-01

    The prevalence of grade III or IV osteoarthritis was determined in 210 patients with chronic renal failure, of whom 94 were receiving chronic haemodialysis and 116 had functioning renal transplants. The prevalence of grade III or IV osteoarthritis was three times greater in patients under 65 than in a control population, and all but two affected patients also had erosion of subchondral bone in at least one affected joint. The excess of osteoarthritis was apparent in both the transplant recipients and those receiving haemodialysis. Over the age of 65 there was no significant difference in prevalence. Metabolic bone disease, including osteopenia, might contribute to the development of erosive osteoarthritis in chronic renal failure. PMID:2383060

  3. An aggressive merkel cell carcinoma in a patient with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Sevda Gizlenti

    2014-12-01

    Full Text Available Merkel cell carcinoma (MCC is a rare cutaneous tumor arising from neuroendocrine cells and Merkel cells. Early diagnosis and treatment is important because of its aggressive course. We here report a 61 years old man with chronic renal failure, 3x5 cm mass on his right leg and inguinal-paraaortic lymph node metastases and resulting in death. MCC in the literature of the AIDS disease, organ transplantation, immunosuppressive therapy areas, and additional malignancies (multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and melanoma have been reported in patients with increased incidence. Up to date a patient with renal transplantation and Merkel cell carcinoma have been reported in the literature, Merkel cell carcinoma with chronic renal failure have not been reported.

  4. The Renal Nerves in Chronic Heart Failure: Afferent and Efferent Mechanisms

    Directory of Open Access Journals (Sweden)

    Alicia Marie Schiller

    2015-08-01

    Full Text Available The function of the renal nerves has been an area of scientific and medical interest for many years. The recent advent of a minimally invasive catheter-based method of renal denervation has renewed excitement in understanding the afferent and efferent actions of the renal nerves in multiple diseases. While hypertension has been the focus of much this work, less attention has been given to the role of the renal nerves in the development of chronic heart failure (CHF. Recent studies from our laboratory and those of others implicate an essential role for the renal nerves in the development and progression of CHF. Using a rabbit tachycardia model of CHF and surgical unilateral renal denervation, we provide evidence for both renal efferent and afferent mechanisms in the pathogenesis of CHF. Renal denervation prevented the decrease in renal blood flow observed in CHF while also preventing increases in Angiotensin-II receptor protein in the microvasculature of the renal cortex. Renal denervation in CHF also reduced physiological markers of autonomic dysfunction including an improvement in arterial baroreflex function, heart rate variability, and decreased resting cardiac sympathetic tone. Taken together, the renal sympathetic nerves are necessary in the pathogenesis of CHF via both efferent and afferent

  5. Antioxidants deficiency: a sensitive indicator of cardiometabolic risk in chronic renal failure?

    Directory of Open Access Journals (Sweden)

    Pooja S.K. Rai

    2013-04-01

    Full Text Available Background: Antioxidant depletion occurring in chronic renal failure patients is an important cause of associated morbidity & mortality, which in turn imposes a great socioeconomic burden of health care. Early diagnosis & targeted management of this preventable deficiency may have a positive impact on the management of co morbidities associated with chronic renal failure. Aims & Objectives: To evaluate the status of antioxidants as an early indicator of cardiometabolic risk in chronic renal failure patients. Settings & Design: This was a randomised case Control study including 10 controls of either sex with normal renal function between age group 20-60 years and 15 patients of chronic renal failure on dialysis between the age group of 16 - 60 years. Methods: 12 hour fasting venous blood samples were collected from all the participants and were assayed for various antioxidants. Statistical analysis: Results were analyzed by unpaired t test, p value was determined & Correlation coefficient was calculated amongst various parameters. Results: In the present study, significantly low levels of vitamin C ( Cases: 0.367 ± 0.13 mg/dl controls: 1.324 ± 0.61 mg/dl; p < 0.01 & vitamin E (cases: 0.235 ± 0.102 mg/dl, controls (0.854 ± 0.28 mg/dl; p < 0.01 were observed in chronic renal failure patients as compared to controls. Conclusion: Diminished levels of Vitamin C & E in our study may be an indicator of increased oxidative stress which can be a responsible factor for increased incidence of cardiovascular complications. Supplementing these patients with recommended dosage of these vitamins may provide an essential tool to reduce the burden of suffering. [Int J Res Med Sci 2013; 1(2.000: 87-92

  6. Vascular endothelial cell function and cardiovascular risk factors in patients with chronic renal failure

    DEFF Research Database (Denmark)

    Haaber, A B; Eidemak, I; Jensen, T;

    1995-01-01

    Cardiovascular risk factors and markers of endothelial cell function were studied in nondiabetic patients with mild to moderate chronic renal failure. The transcapillary escape rate of albumin and the plasma concentrations of von Willebrand factor, fibrinogen, and plasma lipids were measured in 29...

  7. High-NaCl diet impairs dynamic renal blood flow autoregulation in rats with adenine-induced chronic renal failure

    DEFF Research Database (Denmark)

    Saeed, Aso; DiBona, Gerald F; Grimberg, Elisabeth;

    2014-01-01

    This study examined the effects of 2 wk of high-NaCl diet on kidney function and dynamic renal blood flow autoregulation (RBFA) in rats with adenine-induced chronic renal failure (ACRF). Male Sprague-Dawley rats received either chow containing adenine or were pair-fed an identical diet without...... increase the susceptibility to hypertensive end-organ injury and progressive renal failure by facilitating pressure transmission to the microvasculature....... adenine (controls). After 10 wk, rats were randomized to either remain on the same diet (0.6% NaCl) or to be switched to high 4% NaCl chow. Two weeks after randomization, renal clearance experiments were performed under isoflurane anesthesia and dynamic RBFA, baroreflex sensitivity (BRS), systolic...

  8. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    A. Mashayekhi

    2011-09-01

    Full Text Available Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Havingknowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic renal failure through the crisis, with an aesthetically satisfying and functioning dentition.

  9. Gastric metaplasia and Campylobacter pylori infection of duodenum in patients with chronic renal failure.

    OpenAIRE

    Shousha, S; Keen, C; Parkins, R A

    1989-01-01

    Duodenal biopsy specimens from 80 patients with chronic renal failure, who were undergoing haemodialysis, were examined by light microscopy for evidence of inflammation, gastric metaplasia, and Campylobacter pylori infection. Chronic duodenitis was present in 47 (59%) of patients, of whom only seven (9%) showed evidence of active inflammation. Gastric metaplasia was present in 50 (62.5%) of patients, yet Campylobacter pylori was identified in only two patients (2.5%). It is suggested that the...

  10. Positive correlations between cerebral choline and renal dysfunction in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Osamu; Nakahama, Hajime; Nakamura, Satoko; Inenaga, Takashi; Kawano, Yuhei [National Cardiovascular Center, Division of Hypertension and Nephrology, Department of Internal Medicine, Osaka (Japan); Hattori, Noriaki; Inoue, Noriko; Sawada, Tohru [BF Research Institute, Osaka (Japan); Kohno, Shigeru [Nagasaki University School of Medicine, Second Department of Internal Medicine, Nagasaki (Japan)

    2006-05-15

    Cerebral metabolism in chronic renal failure (CRF) patients has not been fully evaluated. This study examined cerebral metabolites in CRF, using proton magnetic resonance spectroscopy (MRS). Subjects comprised 19 CRF patients and 21 healthy volunteers. Spectra were acquired from voxels of interest positioned in the parietal gray and white matter, and concentrations of the following cerebral metabolites were measured: N-acetyl group (NA), creatine + phosphocreatine (Cr), choline-containing compounds (Cho), myo-inositol and glutamate + glutamine. Among the 19 CRF patients, 9 who were started on hemodialysis (HD) underwent careful follow-up. Proton MRS was performed before and about 2 weeks after starting HD. In six patients in whom follow-up was possible, a third MRS was performed after about 18 months. The NA/Cr ratio was not significantly changed in CRF. However, elevations in the Cho/Cr ratio were found in both gray and white matter compared with controls. To the best of our knowledge, this is the first report of positive correlations between the Cho/Cr ratio in both regions and serum osmotic pressure. (orig.)

  11. Blood pressure response to conventional and low-dose enalapril in chronic renal failure

    DEFF Research Database (Denmark)

    Elung-Jensen, Thomas; Heisterberg, Jens; Kamper, Anne-Lise;

    2003-01-01

    AIMS: In chronic renal failure, the clearance of most ACE inhibitors including enalapril is reduced. Hence, with conventional dosage, plasma enalaprilat may be markedly elevated. It is unclear whether this excess of drug exposure affords an improved control of blood pressure. The aim of the present...... study was to evaluate short-term blood pressure response to two different plasma levels of enalaprilat. METHODS: As part of an open, randomized, controlled trial of the effect of high and low dosage of enalapril on the progression of renal failure, short-term blood pressure response was evaluated. Data...... potassium concentrations at day 90 and patients in the low group experienced a slight increase in GFR. CONCLUSIONS: In moderate to severe chronic renal insufficiency the same degree of blood pressure control was achieved on low as well as moderate daily doses of enalapril. This was irrespective of...

  12. Erythropoietin treatment does not compromise cardiovascular function in chronic renal failure

    DEFF Research Database (Denmark)

    Haedersdal, C; Mehlsen, J; Stenver, Doris Irene;

    1994-01-01

    The anemia in patients with chronic renal failure can be corrected through treatment with recombinant human erythropoietin treatment. This correction is associated with changes in the rheologic variables, which could explain the changes in hemodynamics found by many investigators. The authors have...... followed up 11 patients with chronic renal failure on hemodialysis before and during six months of therapy with erythropoietin. The measurements were made before treatment, after four months of therapy, and after six months of therapy. The measurements included hematocrit, osmotic resistance of the red...... were unchanged. The conclude that, in spite of changes in rheologic variables, increasing viscosity of the blood and thus possibly increasing the peripheral resistance, these had no effect on the cardiovascular state. Erythropoietin treatment improves the subjective well-being in patients on chronic...

  13. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-05-01

    Full Text Available Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

  14. A CLINICAL STUDY OF CARDIOVASCULAR ABNORMALITIES IN PATIENTS WITH CHRONIC RENAL FAILURE AT VIMS HOSPITAL, BELLARY.

    Directory of Open Access Journals (Sweden)

    Huggi

    2014-12-01

    Full Text Available BACKGROUND: Chronic Renal Failure (CRF is one of the common conditions which a physician comes across in day to day practice. Chronic Renal Failure affects every aspect of the lives of the patients who suffer it and involves all systems of body & results in various abnormalities. Today , cardiovascular complications are a major clinical problem in ureamic patients accounting for 4 4% of all deaths in this population. Left Ventricular Hypertrophy (LVH is a major Echocardiographic finding in Chronic Renal Failure (CRF. Prevalence of LVH increases with decline of renal function. Left ventricular hypertrophy is an independent predictor of survival , present in approximately 70% of patients at the initiation of dialysis. MATERIALS AND METHODS : The data for this study was collected from the one hundred subjects fulfilling the inclusion /exclusion criteria admitted and patients vis iting OPD and patients undergoing dialysis in dialysis unit of VIMS Hospital during the period from Jan 2010 To June 2011. RESULTS : LVH is a major echocardiographic finding in uremic patients. In the present study , 12 (17% patients of mild , 18(26% patien ts of moderate and 39(57% patients of severe Chronic Renal Failure group had Left Ventricular Hypertrophy. In the present study , the most common cause of CRF in the Severe CRF group was Diabetes plus Hypertension in 47% followed by Diabetes alone in 33% a s compared to Moderate CRF group where in Diabetes plus Hypertension accounted for 47% , followed by Diabetes in 47% , whereas in Mild CRF group Diabetes was the cause 38% , followed by Diabetes plus Hypertension in 33% of cases. Pericardial effusion was seen in 25% of cases (15 cases had mild and 10 cases had moderate pericardial effusion . CONCLUSIONS : The high prevalence of Left ventricular hypertrophy in these populations on echocardiography implies that these patients require detailed cardiovascular evalua tion despite absence of symptoms and control of

  15. Liver disease and the e antigen in HBsAg carriers with chronic renal failure.

    Science.gov (United States)

    Coughlin, G P; Van Deth, A G; Disney, A P; Hay, J; Wangel, A G

    1980-02-01

    This study was undertaken to assess the frequency of development and the stages of evolution of chronic liver disease in patients with renal failure who are chronic carriers of hepatitis B surface antigen. Cirrhosis or chronic active hepatitis developed in five of 21 patients and could not be predicted by the initial histological appearance or by HLA-A and B typing but was associated with the e antigen in four of the five patients. However, the antigen was not a consistent indicator of a poor prognosis, as the four other e antigen positive patients did not develop chronic liver disease during the period of the study. Transmission of hepatitis B to spouses occurred in four cases, was fatal in one instance, and was associated with e antigen in three of the four. Determination of e antigen status in renal unit patients who are carriers of hepatitis B surface antigen may be of value to the patient and his home environment. PMID:7380332

  16. Liver disease and the e antigen in HBsAg carriers with chronic renal failure.

    OpenAIRE

    Coughlin, G P; Van Deth, A G; Disney, A P; Van Hay, J.; Wangel, A. G.

    1980-01-01

    This study was undertaken to assess the frequency of development and the stages of evolution of chronic liver disease in patients with renal failure who are chronic carriers of hepatitis B surface antigen. Cirrhosis or chronic active hepatitis developed in five of 21 patients and could not be predicted by the initial histological appearance or by HLA-A and B typing but was associated with the e antigen in four of the five patients. However, the antigen was not a consistent indicator of a poor...

  17. Helicobacter Pylori in Patients with Chronic Renal Failure

    OpenAIRE

    B Allahverdi; Esfahani ST; Najafi, M.

    2004-01-01

    Background: Helicobacter pylori (H.Pylori) is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD). Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2%) had pathologic defect...

  18. Growth speed in patients with chronic renal failure undergoing to renal transplantation between 2000 and 2009 in the Hospital Nacional de Ninos: research protocol

    International Nuclear Information System (INIS)

    The growth speed was investigated in children with chronic renal failure after renal transplantation, in the Hospital Nacional de Ninos during the study period January 2000-December 2009. Factors that have influenced are analyzed: age of onset of renal disease, etiology of renal disease, metabolic acidosis, anemia, renal osteodystrophy, episodes of infection and rejection. Besides, on the growth rate and expected family size, to intervene or prevent them in future cases. Also, the use that has given in the hospital to growth hormone, before and after renal transplantation is determined to eventually use parallel therapies to the transplantation. An echocardiographic study is recommended to perform as part of the treatment of chronic renal failure to identify the existence of left ventricular hypertrophy and heart failure, which may occur as a result of complications of the failure

  19. Mechanisms of epoxyeicosatrienoic acids to improve cardiac remodeling in chronic renal failure disease.

    Science.gov (United States)

    Zhang, Kun; Wang, Ju; Zhang, Huanji; Chen, Jie; Zuo, Zhiyi; Wang, Jingfeng; Huang, Hui

    2013-02-15

    Both clinical and basic science studies have demonstrated that cardiac remodeling in patients with chronic renal failure (CRF) is very common. It is a key feature during the course of heart failure and an important risk factor for subsequent cardiac mortality. Traditional drugs or therapies rarely have effects on cardiac regression of CRF and cardiovascular events are still the first cause of death. Epoxyeicosatrienoic acids (EETs) are the products of arachidonic acids metabolized by cytochrome P450 epoxygenases. It has been found that EETs have important biological effects including anti-hypertension and anti-inflammation. Recent data suggest that EETs are involved in regulating cardiomyocyte injury, renal dysfunction, chronic kidney disease (CKD)-related risk factors and signaling pathways, all of which play key roles in cardiac remodeling induced by CRF. This review analyzes the literature to identify the possible mechanisms for EETs to improve cardiac remodeling induced by CRF and indicates the therapeutic potential of EETs in it. PMID:23313758

  20. [Cardiovascular responses during laryngeal mask airway insertion in normotensive, hypertensive and chronic renal failure patients].

    Science.gov (United States)

    Yamauchi, M; Igarashi, M; Tsunoda, K; Edanaga, M; Suzuki, H; Tohdoh, Y; Namiki, A

    1999-08-01

    The hemodynamic response to the insertion of the laryngeal mask airway (LM) following induction with propofol 2 mg.kg-1 was assessed and compared in normotensive (Normal), hypertensive (HT) and chronic renal failure (CRF) patients (n = 23 in each group). Before induction, in HT and CRF groups blood pressure and rate pressure products (RPP) were higher than in Normal group (P < 0.05). Although blood pressure and RPP were decreased in every patient by induction with propofol, no patients needed vasopressor drugs. The decreases of blood pressure and RPP were larger in HT and CRF groups than in Normal group (P < 0.05). There were no differences between groups in heart rate and rate of successful LM insertion. We concluded that LM insertion with propofol 2 mg.kg-1 was an effective induction method preventing the adverse circulatory responses in normotensive, hypertensive and chronic renal failure patients. PMID:10481421

  1. Treatment of Chronic Renal Failure by Supplementing the Kidney and Invigorating Blood Flow

    Institute of Scientific and Technical Information of China (English)

    张勉之; 张大宁; 张文柱; 刘树松; 张敏英

    2004-01-01

    Objective: To evaluate the effectiveness of treatment of chronic renal failure by supplementing the kidney and invigorating blood flow. Method: The eligible patients were assigned to a treatment group (N =120)treated with the above principle and a control group (N = 128) treated with western drugs, and the effectiveness was evaluated when the study was completed in one year. Results: The total effective rate of 92.5% was achieved in the treatment group, better than that in the control group (49.2%); the difference was significant (P<0.01), especially in patients of stage Ⅰ and Ⅱ. Conclusion: The treatment of chronic renal failure by supplementing the kidney and invigorating blood flow proved to be very effective.

  2. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    OpenAIRE

    Adriana P. Castilho Dugaich; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Mirian A. Boim; Cássia T. Bergamaschi; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction ...

  3. Brown tumors in patients with chronic renal failure and secondary hyperparathyroidism: Report of 12 cases

    Directory of Open Access Journals (Sweden)

    Fatma Lilia

    2010-01-01

    Full Text Available Brown tumors are unusual but serious complications of renal osteodystrophy. We retrospectively studied 12 patients presenting with chronic renal failure and brown tumor related to secondary hyperparathyroidism. Eleven patients were on chronic hemodialysis. The median duration between renal failure and end stage renal failure was 36 months (range: 12-190 months and the median duration in dialysis for 11 cases: 92 months (range: 72-252 months. The bone pain was noted in all cases (100%, pathological fracture in one case (8% and a palpable bone tumor in 10 cases (83%. Elevated serum Calcium (> 2.35 mmol/L was noted in four cases (33%, elevated serum Phosphate (> 1.78 mmol/L in ten cases (80%, elevated serum Alkaline Phosphate (> 290 UI/L in all cases and intact PTH was > 300 pg/mL in all cases with a serum median rate at 1475 pg/mL (range: 682-3687 pg/L. Subtotal parathyroidectomy was performed in all cases with a resultant decrease in size of brown tumors. We report here patient with CKD with unusual frequency and variable locations. This may be attributed tothe lack of the new calcium free phosphate binders and calcimimetics.

  4. ELEVATION OF SERUM POTASSIUM AND ITS OUTCOME IN CHRONIC RENAL FAILURE PATIENTS

    OpenAIRE

    Punam Yadav; Dinkar Malik; Sandeep Kumar; Vijai Malik

    2014-01-01

    Potassium is the principal metallic ion inside the cells. During physical activity potassium ion leaves muscle cells and this leads to fatigue. When aldosteron instructs the kidney to retain sodium ion, they generally excrete more potassium ion. The kidneys are the principal organ of excretion for potassium, not only potassium is filtered by the kidneys in the glomeruli but it is also secreted by the tubules. Chronic renal failure does not cause severe or progressive hyperkala...

  5. Early oxidative change in low density lipoproteins during progressive chronic renal failure

    OpenAIRE

    Sasikala, M.; Subramanyam, C.; Sadasivudu, B.

    1999-01-01

    Modified low density lipoproteins (LDL), including their oxidized forms, have been widely implicated in the etiology of atherosclerosis and concomitant cardiovascular disease (CVD) in chronic renal failure (CRF). The nature of events that lead to oxidative changes in LDL proteins are not clearly understood. Thus, patients suffering from CRF were grouped into mild, moderate and severe categories based on their blood urea and serum creatinine levels. Progression of CRF was accompanied not only ...

  6. Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

    OpenAIRE

    Hawash, Yousry A.; Laila Sh. Dorgham; Amir, El-Amir M.; Sharaf, Osama F.

    2015-01-01

    It has been hypothesized that chronic renal failure (CRF) predisposes patients to infection with intestinal protozoa. We tested this hypothesis with a matched case-control study to determine the prevalence of these protozoa and their diarrhea associated symptoms among 50 patients with CRF (cases) from Taif, western Saudi Arabia. Fifty diarrheal patients without CRF were recruited in the study as controls. Participants were interviewed by a structured questionnaire and stool samples were colle...

  7. Accumulation of Scandium in Plasma in Patients with Chronic Renal Failure

    OpenAIRE

    Cristina Sánchez-González; Carlos López-Chaves; Lorenzo Rivas-García; Pilar Galindo; Jorge Gómez-Aracena; Pilar Aranda; Juan Llopis

    2013-01-01

    Scandium (Sc) is an element with many industrial applications, but relatively little is known about its physiological and/or toxicological effects, and very little data are available concerning the role of Sc in chronic renal failure (CRF). This paper examines the changes in plasma levels of Sc in predialysis patients with CRF and the relationship with blood parameters. The participants in this trial were 48 patients with CRF in predialysis and 53 healthy controls. Erythrocyte, haemoglobin, a...

  8. HEARING LOSS IN CHRONIC RENAL FAILURE - AN ASSESSMENT OF MULTIPLE AETIOLOGICAL FACTORS

    OpenAIRE

    Suja Sreedharan; Vishnu Prasad; Jayashree Bhatt; Mahesh Chandra Hegde; Salil Agarwal; Cherukattil Waheeda

    2015-01-01

    Introduction: Sensorineural hearing loss in chronic renal failure is believed to be of multifactorial etiology. Associated hypertension and diabetes mellitus, use of ototoxic drugs, hemodialysis and the changes in metabolic parameters are the various reasons quoted for the hearing loss. Objectives: Our study attempts to correlate the hearing thresholds with the multiple parameters like blood levels of urea, serum creatinine, sodium, potassium, calcium and hemoglobin values incriminated in...

  9. Effects of Sodium Citrate on Salt Sensitivity and Kidney Injury in Chronic Renal Failure

    OpenAIRE

    Kim, Sejoong; Yang, Jin Young; Jung, Eun Sook; Lee, Jeonghwan; Heo, Nam Ju; Lee, Jae Wook; Na, Ki Young; Han, Jin Suk

    2014-01-01

    Metabolic acidosis, which is observed in salt-sensitive hypertension, is also associated with kidney injury. Alkali therapy in chronic renal failure (CRF) may ameliorate the progression of kidney disease; however, few studies have examined the effects of alkali therapy on salt sensitivity and kidney injury in CRF. We randomly administered standard diet (SD), sodium chloride with 20% casein diet (NACL), or sodium citrate with 20% casein diet (NACT) to Sprague-Dawley rats after a CRF or a sham ...

  10. Tentorial and dural calcification with tertiary hyperparathyroidism: a rare entity in chronic renal failure

    International Nuclear Information System (INIS)

    A case of rare calcification of the tentorium cerebelli, the thoracal dura mater of the spine, and the sclera in an adult male patient with tertiary hyperparathyroidism is presented. The often reported feature in the skull is that of a combination of osteopenia and osteosclerosis giving a granular bone texture. Extensive dura calcification with this condition has very rarely been reported. It is the aim of this paper to document the latter in a patient with chronic renal failure and tertiary hyperparathyroidism. (orig.)

  11. Effects of chronic renal failure on protein synthesis and albumin messenger ribonucleic acid in rat liver.

    OpenAIRE

    Zern, M A; Yap, S.H.; Strair, R K; Kaysen, G A; Shafritz, D A

    1984-01-01

    Previously we reported that chronic renal failure in rats leads to preferential disaggregation of liver membrane-bound polysomes associated with a decrease in albumin synthesis. To determine whether reduced albumin synthesis results from reduced cellular levels of albumin messenger RNA (mRNA) or some other molecular mechanism, we have employed mRNA-DNA hybridization in conjunction with cell-free protein synthesis to determine albumin mRNA sequence content and biological activity in subcellula...

  12. Hemodynamic and neurochemical determinates of renal function in chronic heart failure.

    Science.gov (United States)

    Gilbert, Cameron; Cherney, David Z I; Parker, Andrea B; Mak, Susanna; Floras, John S; Al-Hesayen, Abdul; Parker, John D

    2016-01-15

    Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications. PMID:26561645

  13. Pseudomelanosis duodeni in a female adult with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Wei-Chih Sun

    2014-12-01

    Full Text Available Pseudomelanosis duodeni is a rare endoscopic finding that manifests as dark speckled spots in the duodenum. It is considered a benign condition and is associated with certain diseases and the use of certain medications. This study reports a case of a 74-year-old woman, with end-stage renal disease under maintenance hemodialysis, hypertension under regular medical control, iron deficiency anemia under oral iron supplement, and progressive anemia with suspicious occult gastrointestinal bleeding. Upper gastrointestinal endoscopy revealed multiple tiny brownish-black pigmentation throughout the proximal second portion of the duodenum. The histopathological examination showed pigment-laden macrophages with positive iron stain and negative melanin stain in the lamina propria of the mucosal villi.

  14. Variations in the lipid profile of patients with chronic renal failure treated with pyridoxine

    Directory of Open Access Journals (Sweden)

    Touceda Luis A

    2003-09-01

    Full Text Available Abstract Background Hyperhomocysteinemia and lipid abnormalities are commonly found in patients with chronic renal failure; both are recognized as risk factors for atherosclerosis. The homocysteine-lowering effect of pyridoxine is controversial. This study was performed to determine the effect of a high dose of pyridoxine (300 mg i.v. three times a week on plasma and red blood cell lipid profile and plasma homocysteine concentration in twelve chronic renal failure patients on regular hemodialysis. Fasting blood samples were taken at the beginning of the study (basal 1, after 30 and 60 days of treatment and 4 months after withdrawal (basal 2. Results Pyridoxine supplementation induced a significant decrease in total plasma homocysteine level and also a lowering effect in plasma total cholesterol and triglycerides. These biochemical data increased when the samples were taken at basal 2, reaching the levels obtained at the beginning of the experiment. LDL cholesterol increased whereas HDL cholesterol was reduced during the treatment. In erythrocyte membranes vitamin B6 therapy enhanced the cholesterol/phospholipid ratio as well as the fluorescence anisotropy of diphenyl-hexatriene. Conclusions We conclude that high doses of pyridoxine represent an effective strategy to ameliorate both plasma homocysteine levels and lipid profiles in chronic renal failure patients, protecting them from atherosclerosis. Further research using a long-term treatment would be necessary in an attempt to restore the fatty acid pattern and the fluidity of red cell membranes.

  15. Hiperhomocisteinemia na insuficiência renal crônica Hyperhomocysteinemia in chronic renal failure

    Directory of Open Access Journals (Sweden)

    Fabiana Baggio Nerbass

    2005-04-01

    Full Text Available A homocisteína é um aminoácido sulfurado proveniente do metabolismo da metionina, cujo acúmulo anormal no plasma é um fator de risco para doenças vasculares, tanto na população em geral como nos pacientes com insuficiência renal crônica. Nestes, a prevalência de indivíduos com hiperhomocisteinemia é bastante elevada, mesmo na fase não dialítica da doença, em que a função renal está diminuída, mas ainda não é necessário tratamento dialítico. O principal fator que parece estar implicado na elevação dos níveis de homocisteína nestes pacientes com insuficiência renal crônica é a perda da massa renal, já que esta exerce uma importante função no metabolismo desse aminoácido. O tratamento da hiperhomocisteinemia na população em geral consiste na suplementação com as vitaminas envolvidas no seu metabolismo (folato, B6 e B12. Porém, em pacientes com insuficiência renal crônica, este tratamento não é completamente eficaz, pois apesar de promover a redução dos níveis de homocisteína, não alcança a normalização dos mesmos na maioria dos pacientes. Este estudo compreende uma revisão da etiologia da hiperhomocisteinemia na insuficiência renal crônica, sua relação com as doenças vasculares, seus principais determinantes e as formas de tratamento.Homocysteine is a sulfur-containing amino acid derived from the metabolism of methionine, whose abnormal accumulation in plasma is a risk factor for vascular disease in the general population and in patients with chronic renal disease. In these patients, the prevalence of individuals with hyperhomocysteinemia is very high, even in the pre-dialysis stage of the disease. The main factor that seems to be implicated on the elevation of homocysteine levels in this population is the renal mass loss, considering that the kidney has an important role in the metabolism of such amino acid. The treatment of hyperhomocysteinemia consists on supplementation of the vitamins

  16. Pandigital and subcutaneous chronic tophaceous gout with acute renal failure

    Directory of Open Access Journals (Sweden)

    J Shashibhushan

    2015-01-01

    Full Text Available Gout (Podagra is a disorder of purine metabolism characterized by the deposition of monosodium urate crystals in joints and connective tissue and risk of deposition in kidney interstitium. Although acute gouty arthritis is familiar for most physicians, chronic gouty arthritis, which affects small joints of the hands can be difficult to distinguish from other common interphalangeal arthropathies such as rheumatoid arthritis (RA, psoriatic arthritis, and erosive osteoarthritis because of very similar presentations. Here we describe a 60-year-old male diabetic patient with pandigital, extensive subcutaneous tophaceous gout presented with uremic encephalopathy and joint deformities. He had been treated mistakenly as RA for 10 years.

  17. THE RELATIONSHIP OF THE CHRONIC RENAL FAILURE WITH CAROTID ARTERY CALCIFICATIONS, DENTAL PULP CALCIFICATIONS AND DENTAL PULP STONES

    OpenAIRE

    DAĞISTAN, Saadettin; MİLOĞLU, Özkan

    2015-01-01

    ABSTRACT Objective: The aim of this study was to investigate the existence of carotid artery calcifications in dental panoramic radiographs and dental pulp calcifications together with dental pulp stones in periapical radiographs in patients with chronic renal failure undergoing haemodialysis and healthy individuals, and to identify the relationship between the two groups.Patients and methods: A total of 115 cases (57 patients on haemodialysis for chronic renal failure and 58 healthy individu...

  18. A girl with Peters plus syndrome associated with myelomeningocele and chronic renal failure.

    Science.gov (United States)

    Motoyama, Osamu; Arai, Hiroko; Harada, Ryoko; Hasegawa, Kei; Iitaka, Kikuo

    2010-08-01

    A girl was born with sclerocornea of the right eye, corneal staphyloma of the left eye and lumbar myelomeningocele. The myelomeningocele was repaired soon after birth. The corneal staphyloma was perforated during infancy. She received keratoplasty and achieved light perception. Her right kidney revealed multicystic dysplasia and was non-functioning at birth. She had neurogenic bladder, and her renal function deteriorated gradually. Peters plus syndrome was diagnosed based on anterior ocular segment anomalies, short stature, developmental delay and characteristic face. Anterior ocular segment anomalies are rare findings, but seem to be occasionally associated with spina bifida and renal anomalies. Myelomeningocele and chronic renal failure in patients with Peters plus syndrome have not been reported to our knowledge. PMID:20424881

  19. Serum leptin level and its significance in chronic renal failure hemodialysis patients

    International Nuclear Information System (INIS)

    To study serum leptin level in chronic renal failure (CRF) hemodialysis patients and the relationship between serum leptin level and residue renal function, body composition, and indices of malnutrition, 31 end-stage CRF hemodialysis patients and 38 healthy people were enrolled. Serum leptin levels were detected by radioimmunoassay. BMI, %Fat and LBM were measured by bioelectrical impedance analysis device. Alb, Chol, Hgb, BUN, SCr and Ccr of the patients were also examined. Results showed that Serum leptin level in end-stage CRF hemodialysis patients was markedly higher than that in healthy controls (P0.05). Conclusion: Hyperleptinemia existed in end-stage CRF hemodialysis patients and might cause the loss of LBM. The leptin level was not correlated with residue renal function, but it could reflect the fat content. However, serum leptin did not play a significant role in protein malnutrition in end-stage CRF hemodialysis patients

  20. Failure of renal dopamine response to salt loading in chronic renal disease.

    OpenAIRE

    Casson, I. F.; Lee, M R; Brownjohn, A. M.; Parsons, F M; Davison, A. M.; Will, E J; Clayden, A D

    1983-01-01

    Eight patients with chronic glomerulonephritis and five age-matched normal volunteers were given additional sodium chloride by mouth under conditions of metabolic balance. Whereas in the normal volunteers plasma renin activity was suppressed and urinary excretion of free dopamine increased, in the patients dopamine was not mobilised and plasma renin activity was not completely suppressed. Abnormal retention of sodium and water in glomerulonephritis may be due partly to a failure to mobilise d...

  1. Biodegradable Magnesium (Mg) Implantation Does Not Impose Related Metabolic Disorders in Rats with Chronic Renal Failure

    Science.gov (United States)

    Wang, Jiali; Xu, Jiankun; Liu, Waiching; Li, Yangde; Qin, Ling

    2016-05-01

    Mg and its alloys have been considered as one of the most promising biodegradable medical devices, but it was still unclear whether hypermagnesemia involved health risks would occur in persons with kidney disease due to their deteriorated kidney function for Mg ions excretion from their body. In this study, we established a chronic renal failure (CRF) model in rats induced by adenine administration prior to Mg implantation, aiming to predict if CRF patients are suitable for the use of Mg implants. The results showed that Mg levels in serum, urine, feces and internal organs had no significant changes after Mg implantation for both normal and CRF rats. Biochemical indices detection and histopathological analysis in kidney, liver and heart tissue confirmed that Mg implants did not induce any extra damage in animals even with renal failure. Our study indicates that Mg based orthopaedic medical device may be considered for use in CRF patients without biosafety concerns.

  2. Clinical significance of determination of plasma homocysteine (HCY) levels in chronic renal failure patients on hemodialysis

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between the plasma homocysteine (HCY) level and the development of cardio-vascular complication in chronic renal failure (CRF) patients on hemodialysis. Methods: Plasma HCY levels were measured in 38 renal failure patients on hemodialysis both before and after 8 weeks oral administration of folic acid (5 mg tid) and VitB12 (500 μg tid) as well as in 40 controls. Results: The plasma levels of HCY in CRF patients on dialysis before taking folic acid and VitB12 (25.12 ± 12.51 μmol/L) were significantly higher than those in controls (8.2 ± 4.5 μmol/L) (P12 were significantly lowered (13.2 ± 5.74 μmol/L, vs before treatment, P12 might be beneficial in lessening the complications. (authors)

  3. Effect of castration on renal glycosaminoglycans and their urinary excretion in male and female rats with chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Lemos, C.C.S. [Disciplina de Nefrologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Tovar, A.M.F. [Laboratório de Tecido Conjuntivo, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Guimarães, M.A.M. [Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Bregman, R. [Disciplina de Nefrologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2013-08-10

    Glycosaminoglycans (GAGs) participate in a variety of processes in the kidney, and evidence suggests that gender-related hormones participate in renal function. The aim of this study was to analyze the relationship of GAGs, gender, and proteinuria in male and female rats with chronic renal failure (CRF). GAGs were analyzed in total kidney tissue and 24-h urine of castrated (c), male (M), and female (F) Wistar control (C) rats (CM, CMc, CF, CFc) and after 30 days of CRF induced by 5/6 nephrectomy (CRFM, CRFMc, CRFF, CRFFc). Total GAG quantification and composition were determined using agarose and polyacrylamide gel electrophoresis, respectively. Renal GAGs were higher in CF compared to CM. CRFM presented an increase in renal GAGs, heparan sulfate (HS), and proteinuria, while castration reduced these parameters. However, CRFF and CRFFc groups showed a decrease in renal GAGs concomitant with an increase in proteinuria. Our results suggest that, in CRFM, sex hormones quantitatively alter GAGs, mainly HS, and possibly the glomerular filtration barrier, leading to proteinuria. The lack of this response in CRFMc, where HS did not increase, corroborates this theory. This pattern was not observed in females. Further studies of CRF are needed to clarify gender-dependent differences in HS synthesis.

  4. Effect of castration on renal glycosaminoglycans and their urinary excretion in male and female rats with chronic renal failure

    International Nuclear Information System (INIS)

    Glycosaminoglycans (GAGs) participate in a variety of processes in the kidney, and evidence suggests that gender-related hormones participate in renal function. The aim of this study was to analyze the relationship of GAGs, gender, and proteinuria in male and female rats with chronic renal failure (CRF). GAGs were analyzed in total kidney tissue and 24-h urine of castrated (c), male (M), and female (F) Wistar control (C) rats (CM, CMc, CF, CFc) and after 30 days of CRF induced by 5/6 nephrectomy (CRFM, CRFMc, CRFF, CRFFc). Total GAG quantification and composition were determined using agarose and polyacrylamide gel electrophoresis, respectively. Renal GAGs were higher in CF compared to CM. CRFM presented an increase in renal GAGs, heparan sulfate (HS), and proteinuria, while castration reduced these parameters. However, CRFF and CRFFc groups showed a decrease in renal GAGs concomitant with an increase in proteinuria. Our results suggest that, in CRFM, sex hormones quantitatively alter GAGs, mainly HS, and possibly the glomerular filtration barrier, leading to proteinuria. The lack of this response in CRFMc, where HS did not increase, corroborates this theory. This pattern was not observed in females. Further studies of CRF are needed to clarify gender-dependent differences in HS synthesis

  5. A re-appraisal of volume status and renal function impairment in chronic heart failure : combined effects of pre-renal failure and venous congestion on renal function

    NARCIS (Netherlands)

    Sinkeler, Steef J.; Damman, Kevin; van Veldhuisen, Dirk J.; Hillege, Hans; Navis, Gerjan

    2012-01-01

    The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal imp

  6. Effect of Heme Oxygenase-1 Inducer Hemin on Chronic Renal Failure Rats

    Institute of Scientific and Technical Information of China (English)

    刘慎微; 石黎明; 刘晓城

    2004-01-01

    Summary: The role of HO 1 inducer, hemin, in chronic renal failure (CRF) rats and its possible mechanism of action was studied. 5/6 subtotal nephrectomy was performed to establish chronic renal failure model. Rats were randomly assigned to 4 groups: sham-operated group, CRF group,ferrous gluconate group and hemin group. At the 10th week after operation, serum creatinine,BUN, RBC, HGB and HCT were measured. Renal pathologic changes were observed. RT-PCR and immunohistochemistry were used to detect the expression and distribution of HO-1. RT-PCR and radioimmunoassay was used to determine the expression of ET-1 in the kidney and plasma. The results showed that as compared with CRF group, serum creatinine and BUN in hemin group were reduced significantly and nephrogenic anemia was improved markedly. Glomerular mesangial proliferation and interstitial lesion were also ameliorated significantly. Hemin not only increased the expression of HO-1 but also reduced the expression of ET-1 in the kidney. The level of ET-1 protein in the plasma was also reduced after hemin treatment. Most of these indexes were not obviously changed in ferrous gluconate group. It was suggested that through inducing the expression of HO-1 and reducing the level of ET-1 in the kidney and plasma, hemin plays an important protective role in 5/6 subtotal nephrectomized rats.

  7. Effects of olmesartan on arterial stiffness in rats with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Chuang Yao-Chen

    2012-06-01

    Full Text Available Abstract Background It has been suggested that the antioxidant properties of olmesartan (OLM, an angiotensin II type 1 receptor (AT1R blocker, contribute to renal protection rather than blood pressure lowering effects despite the fact that causal relationships between hypertension and renal artery disease exist. This study aimed to examine the hypothesis whether the antioxidative activities of OLM were correlated to arterial stiffness, reactive oxygen species and advanced glycation end products (AGEs formation in rats with chronic renal failure (CRF. Methods CRF rats were induced by 5/6 nephrectomy and randomly assigned to an OLM (10 mg/day group or a control group. Hemodynamic states, oxidative stress, renal function and AGEs were measured after 8 weeks of OLM treatment. Results All the hemodynamic derangements associated with renal and cardiovascular dysfunctions were abrogated in CRF rats receiving OLM. Decreased cardiac output was normalized compared to control (p p p p p p p  Conclusion OLM treatment could ameliorate arterial stiffness in CRF rats with concomitant inhibition of MDA and AGEs levels through the reduction of oxidative stress in aortic wall.

  8. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  9. [Ultrasonographic study on kidneys in patients with chronic renal failure. Part I. Ultrasonic measurement of renal size and analysis of renal ultrasonotomograms].

    Science.gov (United States)

    Yamaguchi, S; Fujii, H; Kaneko, S; Yachiku, S; Anzai, T; Inada, F; Kobayashi, T; Furuta, K; Ishida, H

    1990-08-01

    Ultrasonograms of 546 kidneys were obtained in 280 patients undergoing chronic dialysis. Dialysed kidneys could be detected in 529 of the 546 kidneys (96.9%) by ultrasonic examination. The ultrasonic diagnoses on dialysed kidneys were contracted kidney in 313 kidneys (59.2%) and acquired cystic disease of the kidney in 107 kidneys (20.2%). Ultrasonic measurement of the size of kidney (length and thickness) revealed that the kidneys in patients with chronic renal failure were much smaller than normal ones. But the kidneys in patients undergoing dialysis for more than 8 years gradually increased in size with incidence of acquired renal cysts. The kidneys in patients with diabetic nephropathy were greater in length and thickness than those with chronic glomerulonephritis. Sonographic features of dialysed kidneys were unclear renal imaging, unidentified central echoes, cortico-medulla + border and increased parenchymal echogenicity. Irregularity of the renal contour had a tendency to increase in number with incidence of cysts in long-term dialysis patients. The ultrasonograms of the kidneys with diabetic nephropathy showed fewer changes than normal ones. No major complication of the kidney was detected in the present study. However, two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. We believe that regular screening of the kidneys by ultrasonic examination is mandatory in patients on chronic dialysis for early diagnosis and treatment of these complications. PMID:2232408

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  11. Evaluation of Pleiotropic Effects of Statins in Chronic Renal Failure Patients

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    Sultan ÖZKURT

    2011-05-01

    Full Text Available OBJECTIVES: Atherosclerosis is seen more frequently in patients with chronic renal failure (CRF due to the oxidative stress, chronic inflammation and endothelial dysfunction. Besides lowering total and low density lipoprotein (LDL cholesterol levels, statins also lower the frequency of cardiovascular incidents in patients with chronic renal failure by their pleiotropic effects. We aimed to investigate whether atorvastatin had pleiotropic effects in dialysis patients. MATERIAL and METHODS: 21 hyperlipidemic dialysis patients (12 on hemodialysis and 9 peritoneal dialysis with LDL cholesterol levels over 130 mg/dl were included in this study. Atorvastatin was titrated and given to patients for 6 months. After LDL cholesterol level were reduced to under 100mg/day, we evaluated oxidized LDL, malondialdehyde (MDA, interleukin-6 (IL-6, high sensitive C reactive protein (hsCRP, fibrinogen, platelet count, sedimentation rate, nitric oxide (NO, Von Willebrand factor antigen (vWF ag, factor VIII (FVIII and homocysteine. RESULTS: Significant reductions were obtained in total cholesterol, LDL-cholesterol (p<0.001, triglyceride (p<0.05, oxidized LDL (p<0.001, sedimentation value (p<0.01 and platelet count (p<0.05 with atorvastatin treatment. No differences were seen in the other parameters. CONCLUSION: Atorvastatin is associated with significant improvement of lipid profile and reduction of ox-LDL, platelet count, and sedimentation in dialysis patients.

  12. Metabolism of red blood cells in chronic renal failure. I. Glycolytic enzyme levels.

    Science.gov (United States)

    Rodríguez-Commes, J L; Tabernero, J M; Martin-Vasallo, P; De Castro, S; Battaner, E

    1979-01-01

    This paper starts a series on red blood cell (RBC) metabolism in patients with chronic renal failure (CRF). The glycolytic enzyme levels and in vitro half-lives of these patients' RBCs were determined. A number of enzymes (hexokinase, glucose-6-phosphate isomerase, fructose-6-phosphate kinase, aldolase, glyceraldehyde-3-phosphate dehydrogenase and lactate dehydrogenase) showed higher activities than in normal control RBCs. Other enzyme activities were normal. These results were discussed and several possible mechanisms considered. We favour the point of view of a shortened life span of the RBCs in CRF, making the most unstable enzymes of the glycolytic sequence appear increase as compared with normal controls. PMID:226898

  13. Hyperprolactinemia as a rare cause of hypertension in chronic renal failure.

    Science.gov (United States)

    Gulleroglu, Kaan; Olgac, Asburce; Bayrakci, Umut; Erdogan, Ozlem; Kinik, Sibel Tulgar; Baskin, Esra

    2012-01-01

    Chronic renal failure (CRF) is associated with a high risk for hypertension. An individualized treatment should be initiated after the diagnosis of hypertension and underlying etiology. Many metabolic and endocrinal abnormalities are encountered in CRF. We present an 11-year-old boy with CRF developing galactorrhea and hyperprolactinemia associated with α-methyldopa, defective dopaminergic control, and resistance to multi-antihypertensive therapy. Cabergoline, a dopamine receptor agonist, was effectively used in the treatment of hypertension. It is important to remember that sometimes treatment of an illness becomes the cause of this illness. PMID:22462393

  14. Gene therapy by electroporation for the treatment of chronic renal failure in companion animals

    OpenAIRE

    Pope Melissa A; Bodles-Brakhop Angela M; Brown Patricia A; Draghia-Akli Ruxandra

    2009-01-01

    Abstract Background Growth hormone-releasing hormone (GHRH) plasmid-based therapy for the treatment of chronic renal failure and its complications was examined. Companion dogs (13.1 ± 0.8 years, 29.4 ± 5.01 kg) and cats (13.2 ± 0.9 years, 8.5 ± 0.37 kg) received a single 0.4 mg or 0.1 mg species-specific plasmid injection, respectively, intramuscularly followed by electroporation, and analyzed up to 75 days post-treatment; controls underwent electroporation without plasmid administration. Res...

  15. Effect of trimethoprim on serum creatinine in healthy and chronic renal failure volunteers.

    Science.gov (United States)

    Myre, S A; McCann, J; First, M R; Cluxton, R J

    1987-06-01

    The effect of trimethoprim (TMP) on serum creatinine concentration (SCr) was studied in 10 healthy (H) subjects and nine subjects with chronic renal failure (CRF). Each volunteer was given TMP 100 mg perorally every 12 h for 10 days followed by a 7-day washout period. SCr was measured colorimetrically immediately before the study (baseline), on day 10 of TMP, and 7 days after TMP had been discontinued. SCr increased an average of 14.8% from baseline during TMP administration in the H volunteers, but this increase was not statistically significant. During TMP administration to the CRF volunteers, a pronounced elevation (34.6%) of mean SCr from baseline was observed (p less than 0.05). SCr returned to baseline values in both groups following the 7-day washout period. These results are consistent with the hypothesis that TMP competitively inhibits the renal tubular secretion of creatinine. PMID:3617154

  16. Renal Function Reserve in Chronic Obstructive Pulmonary Disease with Type II Respiratory Failure

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    Manal Mahmoud*, Nesriene El Margoushy**, Hassan Shalby* and Aya

    2007-06-01

    Full Text Available Background and objective: increase in renal blood flow in response to certain stimuli such as dopamine infusion, oral protein load, and amino acid infusion. Reduced or absent renal functional reserve (RFR is an early index of renal impairment. Our work studies the (RFR in Chronic Obstructive Pulmonary Disease (COPD patients with chronic compensated type II respiratory failure. Methods: Our study included 15 COPD patients with compensated type II respiratory failure and 5 normal controls. The patient group had mean Pa O2 56.5±6.4 and Pa CO2 56.5±3.2, while in normal controls the mean Pa O2 was 97.4 ± o.3 and Pa CO2 was 42.3 ± 1.2. Hypoxic patients (Pa O2or = 60 mm Hg and Sa O2 > or = 90 % without rise of PaCO2 within 2 hours before and during the study. The pulsatility index (PI, an index of reno-vascular resistance (RVR, was measured non invasively by Doppler Ultrasonograghy at baseline and 20 minutes after infusion of dopamine in diuretic dose. Results: The baseline PI was nearly similar in the control group and in COPD patients (no significant difference, the PI fell significantly in the control group after dopamine infusion from 1.03 ± 0.14 to 0.83 ± 0.1(P< 0.05, but increased significantly in COPD patients from 1.02 ± 0.12 to1.18 ± 0.13 (P<0.05 after dopamine infusion. Conclusion: Renal functional reserve is impaired in hypercapnic COPD patients and this may be a factor in the development of edema frequently seen in these patients

  17. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  18. Supra-Acetabular Brown Tumor due to Primary Hyperparathyroidism Associated with Chronic Renal Failure

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    Rosaria M. Ruggeri

    2010-01-01

    Full Text Available A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months'duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12 62 pg/ml, but her serum calcium was normal (total = 9.4 mg/dl, nv 8.5–10.5; ionized = 5.0 mg/dl, nv 4.2–5.4 due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1 primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2 it was associated with a brown tumor of unusual location (right supra-acetabular region.

  19. Chronic Renal Failure in a Patient Due to Gluteal Compartment Syndrome After a Nephrectomy Operation

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    Özkan ULUTAŞ, , ,

    2013-09-01

    Full Text Available Gluteal compartment syndrome is a rare reason of rhabdomyolysis resulting from atraumatic origin, and leading to renal failure. Beside to other atraumatic causes like drug abuse, alcohol intoxication, and antihyperlipidemic medications prolonged operation duration in a fixed position is an important cause of this syndrome. Male sex, diabetes mellitus, hypertension and obesity are risk factors for gluteal compartment syndrome associated kidney failure. We report a 56 year old obese patient with a medical history of diabetes mellitus, and hypertension who undergo a nephrectomy operation resulting with gluteal compartment syndrome, and chronic kidney disease. We also highlight the importance of preventive cares and early recognition of gluteal compartment syndrome to avoid further morbidity.

  20. sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

    International Nuclear Information System (INIS)

    Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1. (author)

  1. Rapid Progression of Metastatic Pulmonary Calcification and Alveolar Hemorrhage in a Patient with Chronic Renal Failure and Primary Hyperparathyroidism

    International Nuclear Information System (INIS)

    Metastatic pulmonary calcification (MPC) is common in patients with chronic renal failure. The authors experienced a patient with chronic renal failure and primary hyperparathyroidism by parathyroid adenoma accompanied with rapid progressions of MPC and alveolar hemorrhage. Recent chest radiographs, compared with previous chest radiographs, showed rapid accumulation of calcification in both upper lungs. Following up on the high-resolution CT scan after five years demonstrates more increased nodules in size and ground glass opacity. The patient was diagnosed with MPC and alveolar hemorrhage by transbronchial lung biopsy. We assumed rapid progression of MPC and alveolar hemorrhage in underlying chronic renal failures could be a primary hyperparathyroidism which may be caused by parathyroid adenoma detected incidentally. Therefore parathyroid adenoma was treated with ethanol injections. Herein, we have reported on CT findings of MPC with alveolar hemorrhage and reviewed our case along with other articles.

  2. Rapid Progression of Metastatic Pulmonary Calcification and Alveolar Hemorrhage in a Patient with Chronic Renal Failure and Primary Hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eun Joo; Kim, Dong Hun; Yoon, Seong Ho [Chosun University College of Medicine, Gwangju (Korea, Republic of); Suk, Eun Ha [Dept. of Anaesthesiology and Pain Medicine, Seonam University College of Medicine, Namwon (Korea, Republic of)

    2013-06-15

    Metastatic pulmonary calcification (MPC) is common in patients with chronic renal failure. The authors experienced a patient with chronic renal failure and primary hyperparathyroidism by parathyroid adenoma accompanied with rapid progressions of MPC and alveolar hemorrhage. Recent chest radiographs, compared with previous chest radiographs, showed rapid accumulation of calcification in both upper lungs. Following up on the high-resolution CT scan after five years demonstrates more increased nodules in size and ground glass opacity. The patient was diagnosed with MPC and alveolar hemorrhage by transbronchial lung biopsy. We assumed rapid progression of MPC and alveolar hemorrhage in underlying chronic renal failures could be a primary hyperparathyroidism which may be caused by parathyroid adenoma detected incidentally. Therefore parathyroid adenoma was treated with ethanol injections. Herein, we have reported on CT findings of MPC with alveolar hemorrhage and reviewed our case along with other articles.

  3. The Investigation of Nail Disorders in Patients with Chronic Renal Failure Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Perihan Öztürk

    2012-06-01

    Full Text Available Objective: Nail changes are often observed in patients with end-stage renal disease. These changes may occur due to chronic renal failure itself or to the treatment. This study aims to investigate the frequency of nail findings in patients undergoing hemodialysis therapy and to compare with healthy controls. Methods: One hundred and four patients with chronic renal failure treated with hemodialysis, and 104 healthy controls without any dermatological and sistemic diseases, were examined for nail signs. Groups were compared for the incidence of nail findings. Results: 74.4% of hemodialysis patients, and 51.9% of controls had at least one nail finding. The most common signs in hemodialysis patients were (58.7% absence of lunula, (40.5% streaking, (15.7% terry nail and (14.9% half and half nail. In the control group, the most common signs were vertical streaking (36.5%, absence of lunula (8.7% and coilonichi (2.9%. In hemodialysis patients, absence of lunula, beau lines, onycomycosis, terry nail, half and half nail and splinter hemorrhages were found to be significantly higher (p<0.05. Conclusion: The frequency of nail diseases in hemodialysis patients is higher than in the healthy control group. In our study, absence of lunula is the most frequently observed finding in hemodialysis patients. Although the second most common nail change was vertical streaking, it was not different from the control group statistically. We recommend that, when hemodialysis patients are examined, nail examination (as a part of physical examination should be performed. (Turk J Dermatol 2012; 6: 35-8

  4. Impact of renal transplantation on erectile dysfunction due to chronic renal failure in male patients

    International Nuclear Information System (INIS)

    Erectile dysfunction can be defined as the persistent inability of man to achieve penile erection and maintain it sufficient for satisfactory coitus. The objectives of this study were to find out the impact of successful renal transplantation on the degree and frequency of erectile dysfunction. Thirty patients of end stage renal disease that were on regular haemodialysis and candidates of renal transplantation of age range 20-55 years were included in the study after getting informed consent. Erectile functions were assessed by history, examination, investigations and international index of erectile function (IIEF) before and 3 and 6 months after renal transplantation, other information regarding disease and patient were collected in the performa. Out of thirty patients 14 (46.6%) patients had sever erectile dysfunction while 16 (53.3%) patients had moderate erectile dysfunction in the pre renal transplantation period. After three months of renal transplantation 15 (50%) had severe erectile dysfunction, 6 (20%) patients moderate erectile dysfunction and 9 (30%) patients mild erectile dysfunction. After six months 11 (36.6%), 10 (33.3%) and 8 (26.6%) patients had severe, moderate and mild erectile dysfunction respectively. There was improvement in 40%, no change in 53.3% and deterioration in 6.6% patients in the erectile functions after getting renal transplantation for end stage renal disease. (author)

  5. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  6. Upper gastrointestinal lesions in chronic renal failure and frequency of helicobacter pylori

    International Nuclear Information System (INIS)

    Objective: To highlight the commonest upper gastrointestinal (UGI) lesions in patients with chronic renal failure (CRF) and compare it to a control group of patients with symptoms of UGI disease without renal disease. And also to determine the prevalence of Helicobacter pylori (HP) infection in both groups of patients. Design: a case-control prospective study. Place and Duration of Study: The Department of Nephrology, and the Department of Gastroenterology and pathology, medical unit III, Jinnah Postgraduate Medical Center, Karachi, (Pakistan). Study conducted over a period of two years (01-97 to 31-12-98). Patients and methods: One hundred consecutive patients divided into two equal groups, those with CRF with or without symptoms of acid peptic disease (the study group), and the other (the control group) had symptoms of UGI disease with no evidence of renal disease. The stages of CRF, symptoms of acid peptic disease, type of UGI lesions, and the presence or absence of halicobacter pylori(HP) were noted. Result: The commonest UGI lesions in patients of CRF were gastric erosions 17(34%) followed by inflammatory lesions 16(32%), the incidence increasing with the severity of the renal disease. In the control Group 20 (42%) had gastric erosions and 17 (34%) had inflammatory lesions. HP infection occurred in 76-83% of patients in the study group, and in the control group it was found in 75-88% of patients. Conclusion: In both groups the commonest UGI lesions were gastric erosions, followed by inflammatory lesions mainly gastritis and esophagitis. These lesions occurred more frequently with increasing severity of renal disease. HP infection was common in both group almost equally. (author)

  7. Recurrent acute renal failure

    OpenAIRE

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  8. Nosogogy: when the learner is a patient with chronic renal failure.

    Science.gov (United States)

    Ballerini, L; Paris, V

    2006-11-01

    Patient education approaches are currently derived from a biomedical 'acute' model characterized by the sequence of health, disease, and recovery resulting from our professional intervention. Unfortunately, this model proves to be totally inadequate when applied to a chronic disease such as kidney failure. Our patients never fully regain their health and may continue to worsen under our care, even after many state-of-the-art treatments. The solution is represented in acquiring a new professional identity, shifting from the 'biomedical' acute model to a 'bio-psycho-social-educational model'. Within this model, a Therapeutic Education approach in predialysis has been proven to provide both short- and long-term positive results for renal patients. There is a tremendous difference between the learning processes in children and adults and two different sciences have already been described. 'Pedagogy' deals with child learning and 'Andragogy' with adult learning. Nevertheless, when the learner is a patient with a chronic disease, we believe that new considerations must be taken into account. We propose to create a novel science and to call it 'Nosogogy', derived from the ancient Greek word (see text), meaning 'disease'. Nosogogy could be defined as the science of teaching adults affected by chronic disease. The new educator is someone deeply involved in renal care who knows and understands the characteristic conflicts and dynamics that arise in the renal patient, and possesses adequate communication skills to deal with him. In our experience, we prefer to have educational sessions run by nephrologists and nurses who have great experience in the field. PMID:17080103

  9. [Analysis of hemodialysis and graft representations in patients with chronic renal failure: an anthropological approach].

    Science.gov (United States)

    Desseix, Aurélie; Merville, Pierre; Couzi, Lionel

    2010-04-01

    Hemodialysis and kidney transplant are two treatments for renal failure, which lead to numerous changes in the patients' way of life. We have questioned ourselves on the different ways they could deal with those changes by studying the representations and the ritualisation that surrounds the sick. From 2005 to 2007, qualitative interviews, based on the method of life stories, were conducted with 35 patients with chronic renal failure in three Aquitaine's centres. The results show three main groups of representation both in pre-transplant and in post-transplant. Specific behaviours are tied to each group of representation that are beneficial or deleterious with respect to treatment or the patient's social life. We will show that, on the one hand, the patients who see the hemodialysis treatment as a traditional rite of passage cope with the situation more easily and on the other hand, we will stress that this representation is closely linked to how the patients will later accept the kidney transplant. So, we have been able to link the representations of hemodialysis patients and transplant experience. Then these results have a practical consequence for the caregivers who can use the tools of anthropology (the interview guide, analysis grid) through a program of therapeutic education, to precociously take care of patients who are likely to come up against issues after their kidney transplant. PMID:20299298

  10. The relationship of H-type hypertension and renal insufficiency in coronary heart disease patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    郑卫峰

    2014-01-01

    Objective To discuss the relationship between Htype hypertension and renal insufficiency in patients with coronary atherosclerotic heart disease(CHD)and chronic heart failure(CHF).Methods 100 CHD patients with both hypertension and CHF were chosen in our hospital from January 2011 to July 2013.Left ventricular ejection fraction(LVEF)was measured with echocardiography and estimated glomerular filtration rate(e GFR)was calculated with the simplified modification of diet in renal

  11. Role of 11β-hydroxysteroid dehydrogenase 2 renal activity in potassium homeostasis in rats with chronic renal failure

    Directory of Open Access Journals (Sweden)

    N.L. Yeyati

    2010-01-01

    Full Text Available Aldosterone concentrations vary in advanced chronic renal failure (CRF. The isozyme 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2, which confers aldosterone specificity for mineralocorticoid receptors in distal tubules and collecting ducts, has been reported to be decreased or normal in patients with renal diseases. Our objective was to determine the role of aldosterone and 11β-HSD2 renal microsome activity, normalized for glomerular filtration rate (GFR, in maintaining K+ homeostasis in 5/6 nephrectomized rats. Male Wistar rats weighing 180-220 g at the beginning of the study were used. Rats with experimental CRF obtained by 5/6 nephrectomy (N = 9 and sham rats (N = 10 were maintained for 4 months. Systolic blood pressure and plasma creatinine (Pcr concentration were measured at the end of the experiment. Sodium and potassium excretion and GFR were evaluated before and after spironolactone administration (10 mg·kg-1·day-1 for 7 days and 11β-HSD2 activity on renal microsomes was determined. Systolic blood pressure (means ± SEM; Sham = 105 ± 8 and CRF = 149 ± 10 mmHg and Pcr (Sham = 0.42 ± 0.03 and CRF = 2.53 ± 0.26 mg/dL were higher (P < 0.05 while GFR (Sham = 1.46 ± 0.26 and CRF = 0.61 ± 0.06 mL/min was lower (P < 0.05 in CRF, and plasma aldosterone (Pald was the same in the two groups. Urinary sodium and potassium excretion was similar in the two groups under basal conditions but, after spironolactone treatment, only potassium excretion was decreased in CRF rats (sham = 0.95 ± 0.090 (before vs 0.89 ± 0.09 µEq/min (after and CRF = 1.05 ± 0.05 (before vs 0.37 ± 0.07 µEq/min (after; P < 0.05. 11β-HSD2 activity on renal microsomes was lower in CRF rats (sham = 0.807 ± 0.09 and CRF = 0.217 ± 0.07 nmol·min-1·mg protein-1; P < 0.05, although when normalized for mL GFR it was similar in both groups. We conclude that K+ homeostasis is maintained during CRF development despite normal Pald levels. This adaptation may be mediated by

  12. Effects of Low-Molecular-Weight-Chitosan on the Adenine- Induced Chronic Renal Failure Ratsin vitro andin vivo

    Institute of Scientific and Technical Information of China (English)

    ZHI Xuan; HAN Baoqin; SUI Xianxian; HU Rui; LIU Wanshun

    2015-01-01

    Theeffects of low-molecular-weight-chitosan (LMWC) on chronic renal failure (CRF) rats induced by adenine were investigatedin vivoand in vitro. Chitosan were hydrolyzed using chitosanase at pH 6–7 and 37℃ for 24h to obtain LMWC.In vitro, the effect of LMWC on the proliferation of renal tubular epithelial cells (RTEC) showed that it had no cytotoxic effect and could promote cell growth. For theinvivo experiment, chronic renal failure rats induced by adenine were randomly divided into control group, Niaoduqing group, and high-, medium- and low-dose LMWC groups. For each group, we detected serum creatinine (SCR), blood urea nitrogen (BUN), and total superoxide dismutase (T-SOD), glutathione oxidase (GSH-Px) activities of renal tissue, and obtained the ratio of kidney weight/body weight, pathological changes of kidney. The levels of serum SCR, BUN were higher in the adenine-induced rats than those in the controlgroup, indicating that the rat chronic renal failure model worked successfully. The re-sults after treatment showed that LMWC could reduce the SCR and BUN levels and enhance the activities/levels of T-SOD and GSH-PX in kidney compared to control group. Histopathological examination revealed that adenine-induced renal alterations were restored by LMWC at three tested dosages, especially at the low dosage of 100mgkg−1d−1.

  13. Evaluation of bone metabolism in patients with chronic renal failure treated by continuous ambulatory peritoneal dialysis

    International Nuclear Information System (INIS)

    Bone metabolism inpatients with chronic renal failure treated by continuous ambulatory peritoneal dialysis (CAPD) was evaluated. IRMA, RRA and RIA were used to detect PTH, 25 (OH)D3, 1,25(OH)2D3, BGP, Ca and P levels in the blood of 24 CAPD patients. PTH and BGP were increased in uremic patients ad decreased after CAPD. 25(OH)D3 and 1,25 (OH)2D3 were decreased in the patients, but their levels were not changed further after CAPD. PTH had negative correlation with 25 (OH)D3 (r = -0.379, P 2D3 (r = -0.451, P < 0.01). PTH had positive correlation with BGP (r 0.501, P < 0.01) in CAPD patients, and the correlativity was decreased by CAPD. The results showed: PTH hypersecretion is a main factor inducing bone metabolism disturbance, and bone turnover rate is decreased in these patients by CAPD

  14. The epidemiology and outcome of acute renal failure and the impact on chronic kidney disease.

    Science.gov (United States)

    Block, Clay A; Schoolwerth, Anton C

    2006-01-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. Recent publications have highlighted changes in the epidemiology and improvement in mortality that was long thought to be static despite improvements in clinical care. The incidence of ARF is increasing. Efforts, such as the Acute Dialysis Quality Initiative, are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease. Two brief case reports are offered to help frame the context and clinical impact of this disorder, followed by a review of some of the recent literature that addresses these points. PMID:17150044

  15. Oro-dental health in children with chronic renal failure and after renal transplantation: a clinical review.

    Science.gov (United States)

    Lucas, Victoria S; Roberts, Graham J

    2005-10-01

    As a consequence of chronic renal failure (CRF) and its treatment, a number of oro-dental changes occur that persist after the end-stage is reached. An early effect is enamel hypoplasia due to a defect of enamel development and mineralisation. This is usually reparable to a high aesthetic standard using dental composite filling material. Children with CRF have significantly less dental caries than healthy children due to the inhibitory effect of increased salivary urea levels. Grafted patients frequently develop gingival enlargement as a result of immunosuppression with cyclosporine A, which is further exacerbated by the additional use of antihypertensive calcium-blocking agents. Surgical reduction of gingival hyperplasia is effective and is required in approximately one third of adolescents. A very high standard of home care should be encouraged for all children with CRF in the form of thorough mechanical tooth cleaning and plaque inhibition through the use of an antibacterial mouthwash. In transplanted children presenting an increased risk of infection, antibiotic prophylaxis may be indicated for dental treatment procedures. The drug dosage should be adapted to the reduced renal function. Pediatric nephrologists should be aware that dental surgeons can make a considerable contribution to the general health and well-being of children with CRF. Thus, only oro-dental problems that are mainly encountered and treated by dental surgeons are reviewed. PMID:15947987

  16. Hiperhomocisteinemia na insuficiência renal crônica Hyperhomocysteinemia in chronic renal failure

    OpenAIRE

    Fabiana Baggio Nerbass; Sérgio Antonio Draibe; Lilian Cuppari

    2005-01-01

    A homocisteína é um aminoácido sulfurado proveniente do metabolismo da metionina, cujo acúmulo anormal no plasma é um fator de risco para doenças vasculares, tanto na população em geral como nos pacientes com insuficiência renal crônica. Nestes, a prevalência de indivíduos com hiperhomocisteinemia é bastante elevada, mesmo na fase não dialítica da doença, em que a função renal está diminuída, mas ainda não é necessário tratamento dialítico. O principal fator que parece estar implicado na elev...

  17. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    Science.gov (United States)

    Dugaich, Adriana P. Castilho; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Boim, Mirian A.; Bergamaschi, Cássia T.; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction of Ang II type 1 receptors (AT1) mRNA in the brainstem compared to controls (C). Tempol but not candesartan into the RVLM decreased MAP in CRF but not in C rats. GABA into the RVLM decreased MAP in CRF (63 ± 8 mmHg) more intensely than in C (33 ± 3 mmHg). The results suggest that increased oxidative stress within the RVLM has an important participation to maintain hypertension in CRF rats apparently independently of AT1 Ang II receptors. PMID:21253520

  18. Effects of chronic inflammatory reaction status on the development of complications in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between changes of serum contents of CRP, IL-6, TNF-α, IL-10 and the development of complications (anemia, malnutrition, atherosclerosis) in patients with chronic renal failure. Methods: Serum IL-6, TNF-α (with RIA) and CRP, IL-10 (with ELISA) levels were determined in 126 patients with chronic renal failure and 36 controls. Blood hemoglobin, albumin, glucose and triglycerides levels were also determined in all these patients. Echocardiography was performed in 95 patients. Results: (1) Serum contents of CRP, IL-6, TNF-α and IL-10 were all significantly higher in the patients than those in the controls (P6mmol/L, n=83) were significantly higher than those in the corresponding patients without anemia, malnutrition and hyperglycemia ( all P 1.71mmol/L, n=68), the levels were lower than those in patients without high TG (P<0.001 for IL-6, P<0.01 for CRP and IL-10). In patients with aortic arteriosclerosis shown on echocardiography (n=37), levels of the markers were higher than those in patients without arteriosclerosis (n=58) (P<0.001 for IL-10, P<0.001 for CRP and IL-6, P<0.05 for TNF-α). Correlation studies showed that levels of all the four markers were negatively correlated with levels of hemoglobin and albumin, TNF-α levels were correlated with levels of glucose and CRP, IL-6, IL-10 levels were negatively correlated with triglyceride levels. (3) Levels of each of the pro-inflammatory markers (CRP, IL-6, TNF-α) were correlated with levels of the anti-inflammatory cytokine IL-10 (r=0.463, 0.546 and 0.402 respectively). Conclusion: (1) Serum levels of CRP, IL-6, TNF-α and IL-10 were increased in patients with chronic renal failure. (2) Levels of these markers were correlated in some degree with the development of complications (anemia, malnutrition, arteriosclerosis......) in the patients. (3) Levels of pro-inflammatory markers were correlated with levels of anti-inflammatory cytokine IL-10. (authors)

  19. Gene therapy by electroporation for the treatment of chronic renal failure in companion animals

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    Pope Melissa A

    2009-01-01

    Full Text Available Abstract Background Growth hormone-releasing hormone (GHRH plasmid-based therapy for the treatment of chronic renal failure and its complications was examined. Companion dogs (13.1 ± 0.8 years, 29.4 ± 5.01 kg and cats (13.2 ± 0.9 years, 8.5 ± 0.37 kg received a single 0.4 mg or 0.1 mg species-specific plasmid injection, respectively, intramuscularly followed by electroporation, and analyzed up to 75 days post-treatment; controls underwent electroporation without plasmid administration. Results Plasmid-treated animals showed an increase in body weight (dogs 22.5% and cats 3.2% compared to control animals, and displayed improved quality of life parameters including significant increases in appetite, activity, mentation and exercise tolerance levels. Insulin-like growth factor I (IGF-I, the downstream effector of GHRH levels were increased in the plasmid treated animals. Hematological parameters were also significantly improved. Protein metabolism changes were observed suggesting a shift from a catabolic to an anabolic state in the treated animals. Blood urea nitrogen and creatinine did not show any significant changes suggesting maintenance of kidney function whereas the control animal's renal function deteriorated. Treated animals survived longer than control animals with 70% of dogs and 80% of cats surviving until study day 75. Only 17% and 40% of the control dogs and cats, respectively, survived to day 75. Conclusion Improved quality of life, survival and general well-being indicate that further investigation is warranted, and show the potential of a plasmid-based therapy by electroporation in preventing and managing complications of renal insufficiency.

  20. Assessment of leptin and some Antioxidants in Blood of Chronic Renal Failure Patients

    International Nuclear Information System (INIS)

    The aim of the present work is to study the effect of haemodialysis on the state of the antioxidants glutathione peroxidase (GPx) and vitamin C and the role of leptin hormone on the redox homeostasis in patients with chronic renal failure (CRF). This study was carried out on 25 patients (15 females and 10 males) with CRF,aged 19-55 years, in addition to 25 healthy control (10 females and 15 males). Patients were subjected to regular haemodialysis for 4 hours three times weekly and blood samples were collected before haemodialysis. In this study, plasma leptin was significantly increased in CRF group than normal control. Vitamin C and GPx were decreased significantly in CRF group in comparison with normal control. There was non-significant difference in serum leptin level between males and females in both control and patient groups. Patients showed significant lower body mass index (BMI) and albumin and higher cholesterol. In the control group, serum leptin levels showed significant positive correlation with BMI, while CRF group had significant negative correlation. In CRF group, serum leptin showed significant negative correlation with serum albumin and non-significant negative correlation with both creatinine and cholesterol. This is probably due to malnutrition status commonly occurs in renal failure. Serum leptin levels showed non-significant negative correlation between both GPx and Vitamin C in control group while in patient group, leptin showed significant positive correlation with GPx and vitamin C. In conclusion leptin acts on energy metabolism and plays a role in the modulation of cellular redox balance while the oxidative stress plays a role in many disease states. These diseases had increased incidence in uremia and particularly in haemodialysis

  1. Effect of vitamin C on endothelial function of children with chronic renal failure: An experimental study

    Science.gov (United States)

    Sabri, Mohammad Reza; Tavana, Esfandiar Najafi; Ahmadi, Alireza; Gheissari, Alaleh

    2015-01-01

    Background: It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF). Materials and Methods: In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial. Results: In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05). Conclusion: The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed. PMID:26918242

  2. Risk factors for chronic renal failure in Ivory coast: A prospective study of 280 patients

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    Ackoundou-N′Guessan K

    2011-01-01

    Full Text Available Chronic renal failure (CRF represents the major cause of mortality in the nephro-logy unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hos-pital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population. A total of 280 patients and 113 controls were recruited. The mean age of the patients was 37.88 ± 13.33 years and that of the controls was 41.5 ± 9.72 years. Both genders were equally represented. The main causes of CRF were chronic glomerulonephritis (47.48%, with HIV infec-tion accounting for 15% of them, and essential hypertension (HTA (25%. Essential HTA repre-sented the only factor which, if untreated, inevitably leads to CRF. Thus, our study indicates that HTA is a major public health concern. All efforts should be implemented to reduce the high prevalence of HTA and the deleterious effect of this disorder in Ivory Coast.

  3. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil......A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated......-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography...... (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions....

  4. Concentrations of serum soluble transferring receptors in anemic children suffering from chronic renal failure

    International Nuclear Information System (INIS)

    Inappropriate erythropoietin production is the main reason responsiblefor anemia in chronic renal failure children. Iron deficiency is the commonest cause of erythropoietin resistance in dialyzed children treated with recombinant human erythropoietin (r-HuEPO). Early detection of iron deficiency is vital to optimize management of chronic anemia associated with renal failure that is being treated with r-HuEPO but bclinical or functional iron deficiency is difficult to be diagnosed in these patients by the commonly used tests. This study was conducted in order to evaluate the role of serum soluble transferrin receptor (sTfR) in identifying iron deficiency among uremic children. Twenty-five patients with end stage renal failure were studied. They were classified into two groups; group I included 15 patients under conservative treatment and their ages ranged between 2-1] years with a mean value of 9.3 ± 3.79. Group II included 10 patients under regular hemodialysis treatment. This group was evaluated before receiving treatment (group IIa) and after treatment of anemia by r-HuEPO and intravenous iron for 8 weeks (group IIb). Their ages ranged between 4-10 years with a mean value of 8.1 ± 1.79 years. Ten healthy subjects, matched in age and sex, were served as controls (group III). All subjects were evaluated regarding renal function test, hematopoietic indices am ferrokinetic parameters including hypochromic cell percentage, serum iron, serum ferritin, total iron binding capacity (TIBC), sTfR and sTfR/log ferritu index. The study showed that the hypochromic cell percentage was significantly increased in both groups I and Ila when compared to controls (P < 0.0001). Also, a highly significant increase was detected in group Ila when compared with group I (P < 0.0001). Serum iron values showed reduction in both studied groups, which were not statistically significant. Serum ferritin showed high significant elevation in all the studied groups as compared to controls. There

  5. Periodontal parameters and BANA test in patients with chronic renal failure undergoing hemodialysis

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    Sérgio Aparecido Torres

    2010-06-01

    Full Text Available OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7±7.2 years with chronic renal failure (CRF and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD, gingival recession (GR, dental plaque index (PLI, gingival index (GI, and dental calculus index (CI were the clinical parameters recorded for the entire dentition (at least 19 teeth, while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B. RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77±0.32 and 2.65±0.53; GR: 0.58±0.56 and 0.51±0.36; PLI: 1.64±0.56 and 1.24±0.67; GI: 0.64±0.42 and 0.93±0.50; CI: 1.17±0.54 and 0.87±0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001 in the control group. Comparison of the other clincial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05 in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05. None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9% for the CRF group and 35.7% for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

  6. Two Brothers with Bardet-Biedl Syndrome Presenting with Chronic Renal Failure

    OpenAIRE

    Cem Sahin; Bulent Huddam; Gulhan Akbaba; Hasan Tunca; Emine Koca; Mustafa Levent

    2015-01-01

    Bardet-Biedl Syndrome (BBS) is a rarely seen autosomal recessive transfer disease characterised by retinal dystrophy, obesity, extremity deformities, mental retardation, and renal and genital system anomalies. BBS shows heterogenic transfer. To date, 18 genes (BBS1–18) and 7 BBS proteins have been defined as related to BBS. All of the defined BBS genes have been shown to be related to the biogenesis or function of cilia. Renal failure accompanying the syndrome, especially in the advanced stag...

  7. Oro-Dental Health Status and Salivary Characteristics in Children with Chronic Renal Failure

    OpenAIRE

    Mashayekhi, A.; Ahmadi, M; Ramezani, N.; R. Ahmadi; Seraj, B.

    2011-01-01

    Children suffering from decreased renal function may demand unique considerations regarding special oral and dental conditions they are encountered to. It is mentioned that renal function deterioration may affect the hard or soft tissues of the mouth. Having knowledge about the high prevalence of dental defects, calculus, gingival hyperplasia, modified salivary composition and tissue responses to the dental plaque may aid the physician and the dentist to help nurture the patient with chronic ...

  8. Roles of organic anion transporters in the progression of chronic renal failure.

    Science.gov (United States)

    Enomoto, Atsushi; Niwa, Toshimitsu

    2007-10-01

    Renal proximal and distal tubules carry out specialized directional transport of various solutes. The family of organic anion transporters (OATs), which belongs to the major facilitator superfamily (SLC22A), are expressed in the renal epithelial cells to regulate the excretion and the reabsorption of endogenous and exogenous organic anions that include various kinds of drugs and their metabolites. In recent years, it is revealed that indoxyl sulfate, one of uremic toxins, is a novel physiological substrate for OAT family, and its accumulation within the renal tubules via OATs induces renal dysfunction. The OATs are also expressed in the blood-brain barrier, muscle cells, and bone osteoblasts, which hint at various pathogenic roles of OAT-mediated transport of uremic toxins. In this review, we introduce and discuss the function of OATs in the context of their roles in the progression of chronic renal disease. PMID:17976081

  9. Effects of Chronic Renal Failure on Brain Cytochrome P450 in Rats.

    Science.gov (United States)

    Naud, Judith; Harding, Jessica; Lamarche, Caroline; Beauchemin, Stephanie; Leblond, Francois A; Pichette, Vincent

    2016-08-01

    Chronic renal failure (CRF) impedes renal excretion of drugs and their metabolism by reducing the expression of liver cytochrome P450 (P450). Uremic serum contains factors, such as parathyroid hormone (PTH), that decrease liver P450s. The P450s are also involved in the metabolism of xenobiotics in the brain. This study investigates: 1) the effects of CRF on rat brain P450, 2) the role of PTH in the downregulation of brain P450s in CRF rats, and 3) the effects of PTH on P450s in astrocytes. Protein and mRNA expression of P450s were assessed in the brain of CRF and control (CTL) rats, as well as from CTL or CRF rats that underwent parathyroidectomy (PTX) 1 week before nephrectomy. CYP3A activity was measured using 3-[(3, 4-difluorobenzyl) oxy]-5, 5-dimethyl-4-[4-methylsulfonyl) phenyl] furan-2(5H)-1 metabolism in brain microsomal preparation. CYP3A protein expression was assessed in primary cultured astrocytes incubated with serum obtained from CRF or CTL rats or with PTH. Significant downregulations (≥40%) of CYP1A, CYP2C11, and CYP3A proteins were observed in microsomes from CRF rat brains. CYP3A activity reduction was also observed. CYP3A expression and activity were unaffected in PTX-pretreated CRF rats. Serum of PTX-treated CRF rats had no impact on CYP3A levels in astrocytes compared with that of untreated CRF rats. Finally, PTH addition to normal calf serum induced a reduction in CYP3A protein similar to CRF serum, suggesting that CRF-induced hyperparathyroidism is associated with a significant decrease in P450 drug-metabolizing enzymes in the brain, which may have implications in drug response. PMID:27271372

  10. Changes in the Conformational State of Hemoglobin in Hemodialysed Patients with Chronic Renal Failure

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    Anna Pieniazek

    2015-01-01

    Full Text Available The aim of this study was to evaluate the properties of internal components of erythrocytes in chronic renal failure (CRF patients undergoing hemodialysis (HD in comparison to control subjects. For investigation of conformational state of hemoglobin and nonheme proteins (NHP the maleimide spin label (MSL in electron paramagnetic resonance (EPR was applied. The studies were performed using MSL in whole cells and hemolysate as well as proteins separated by ion exchange chromatography and checked by electrophoresis. Additionally the level of –SH groups in hemolysate and isolated internal proteins of CRF erythrocytes was determined using 4,4′-dithiodipyridine. All measurements were performed before and after hemodialysis. Oxidative stress accompanying CRF/hemodialysed patients caused a significant decrease in the mobility of internal components inside erythrocytes indicated by MSL (P < 0.02. The significant decrease in mobility of spin labeled HbA1c and HbA both before and after HD (P < 0.0002 as well as in nonheme proteins before hemodialysis (P < 0.05 versus control was indicated. Decrease in mobility of internal components of erythrocytes was accompanied by loss of thiols before and after hemodialysis versus control in NHP (P < 0.05, HbA1c (P < 0.0002, and HbA (P < 0.0005. These findings showed oxidative influence of hemodialysis on hemoglobins and internal nonheme proteins in erythrocytes of CRF patients.

  11. HEARING LOSS IN CHRONIC RENAL FAILURE - AN ASSESSMENT OF MULTIPLE AETIOLOGICAL FACTORS

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    Suja Sreedharan

    2015-04-01

    Full Text Available Introduction: Sensorineural hearing loss in chronic renal failure is believed to be of multifactorial etiology. Associated hypertension and diabetes mellitus, use of ototoxic drugs, hemodialysis and the changes in metabolic parameters are the various reasons quoted for the hearing loss. Objectives: Our study attempts to correlate the hearing thresholds with the multiple parameters like blood levels of urea, serum creatinine, sodium, potassium, calcium and hemoglobin values incriminated in decreased hearing in CRF patients. Materials and methods:Prospective study of 25 patients receiving treatment for CRF. The threshold of the worsen ear was considered for statistical analysis. Results:18% of the patients at low frequencies (250 and 500 Hz, 32% of the patients at mid-frequencies (1000 and 2000 Hz, and 72% of the patients at high frequencies (4000 and 8000 Hz had decreased hearing for both bone and air conduction hearing. We found a positive correlation between hearing loss and increasing number of hemodialysis sessions, the levels of blood urea, serum creatinine, serum sodium and use of ototoxic drugs; while serum calcium, serum potassium and hemoglobin levels had a negative correlation. Conclusion:Though the management of CRF including hemodialysis has been refined, hearing loss continues to cause disability in CRF patients.

  12. [The observation of therapy of anemia in chronic renal failure with recombinant human erythropoietin].

    Science.gov (United States)

    Jiang, Y; Liu, P; Wang, E J

    1994-02-01

    Anemia is one of the serious complications of chronic renal failure, therapy with recombinant human erythropoietin (r-HuEPO) can correct such anemia officiently. For most patients, the initial dose of r-HuEPO is 100U/kg, by intravenously or subcutaneous, three times a week. After 6 weeks of treatment, Hb could increase to 100g/L, and Hct to above 0.33-0.35. Then 500/kg 3 time a week can be used as maintaining dose. 4 patients need maintaining dose of 150U/kg, for pulmonary infection, poor nutrition, and poor iron supply. Therefore, during the treatment, iron folie acid and Vit B12 should be applied sufficiently and treat the infection effectively with the increasing of Hb and Hct, 2/3 of the patients have hypertension which can be controlled with medication. If there is thrombosis in the dialyzer, the dose of heparin should be increased. The patients on r-HuEPO should be dialysised sufficiently to prevent hyperkalemia. PMID:8070295

  13. [Erectile dysfunction and quality of life in patients with chronic renal failure].

    Science.gov (United States)

    Bellinghieri, G; Santoro, D; Satta, E; Savica, V

    2008-01-01

    Erectile dysfunction (ED) is associated with a reduced quality of life; it represents a risk factor for the development of depression. ED may induce depression, loss of self-esteem, poor self-image, anxiety, and tension in the relationship with the partner. These emotional disturbances can create physical conditions that lead to increased difficulty in achieving an erection. Depression can deprive a person of the ability to experience many of life's pleasures. It not only affects the mind but also the body--often in unexpected ways. As a result, many men who have been diagnosed with depression find themselves suffering from another condition: ED. Sexual dysfunction is a big problem also in patients with chronic renal failure and seriously affects their quality of life. About 40% of men on dialysis suffer from ED. Many uremic patients have additional symptoms including reduction of libido and a decreased frequency of sexual intercourse. With the start of dialysis some of these symptoms may improve, without, however, returning to normal. PMID:19048573

  14. Effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Selim Aydemir; Binnaz Handan Ozdemir; Gurden Gur; Ibrahim Dogan; Ugur Yilmaz; Sedat Boyacioglu

    2005-01-01

    AIM: To evaluate the effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure (CRF).METHODS: Forty-four patients were enrolled in this study and divided into four groups with respect to their Helicobacter pylori (H pylori) and CRF status. Groups were labeled as follows: 1a: normal renal function, H pylori negative (n = 12), 1b: normal renal function,H pylori positive (n = 11), 2a: CRF, H pylori negative (n = 10), 2b: CRF, H pylori positive (n = 11). Upper gastrointestinal endoscopy was done in all the patients involved in the study. During endoscopical investigation,antral biopsy specimens were taken from each patient.In order to evaluate the cell apoptosis and proliferation in gastric epithelial cells, Bax and proliferating cell nuclear antigen (PCNA) labeling indexes (LI) were assessed with immunohistochemical staining method.RESULTS: For groups 1a, 1b, 2a, and 2b, mean Bax LI was identified as 34.4±13.7, 44.1±16.5, 46.3±20.5,60.7±13.8, respectively and mean PCNA LI was identified as 36.2±17.2, 53.6±25.6, 59.5±25.6, 67.2±22,respectively. When the one-way ANOVA test was applied,statistically significant differences were detected between the groups for both Bax LI (P = 0.004 <0.01) and PCNA LI (P = 0.009 <0.01). When groups were compared further in terms of Bax LI and PCNA LI with Tukey's HSD test for multiple pairwise comparisons, statistically significant difference was observed only between groups 1a and 2b (P = 0.006 <0.01).CONCLUSION: In gastric epithelial cells, expression of both the pre-apoptotic protein Bax and the proliferation marker PCNA increase with H pylori infection. This increase is more evident in patients with uremia. These findings suggest that uremia accelerates apoptosis and proliferation in gastric epithelial cells.

  15. Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction

    OpenAIRE

    D. Scrutinio; Agostoni, P; Gesualdo, L.; U. Corra; Mezzani, A; Piepoli, M; Di Lenarda, A.; Iorio, A.; Passino, C; Magri, D.; Masarone, D; Battaia, E; Girola, D; Re, F.; Cattadori, G

    2015-01-01

    Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V˙O2) in heart failure (HF) patients. Methods and Results: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerula...

  16. Darbepoetin alpha reduces oxidative stress and chronic inflammation in atherosclerotic lesions of apo E deficient mice in experimental renal failure.

    Directory of Open Access Journals (Sweden)

    Nicole Arend

    Full Text Available BACKGROUND: Cardiovascular morbidity and mortality is very important in patients with chronic renal failure. This occurs even in mild impairment of renal function and may be related to oxidative stress and chronic inflammation. The nephrectomized apo E knockout mouse is an accepted model for evaluating atherosclerosis in renal dysfunction. Erythropoietin derivates showed anti-oxidative and anti-inflammatory effects. Therefore, this study evaluates the effects of Darbepoetin on markers of oxidative stress and chronic inflammation in atherosclerotic lesions in apo E knockout mice with renal dysfunction. METHODS: Apo E knockout mice underwent unilateral (Unx, n = 20 or subtotal (Snx, n = 26 nephrectomy or sham operation (Sham, n = 16. Mice of each group were either treated with Darbepoetin or saline solution, a part of Snx mice received a tenfold higher dose of Darbepoetin. The aortic plaques were measured and morphologically characterized. Additional immunhistochemical analyses were performed on tissue samples taken from the heart and the aorta. RESULTS: Both Unx and Snx mice showed increased expression of markers of oxidative stress and chronic inflammation. While aortic plaque size was not different, Snx mice showed advanced plaque stages when compared to Unx mice. Darbepoetin treatment elevated hematocrit and lowered Nitrotyrosin as one marker of oxidative stress, inflammation in heart and aorta, plaque stage and in the high dose even plaque cholesterol content. In contrast, there was no influence of Darbepoetin on aortic plaque size; high dose Darbepoetin treatment resulted in elevated renal serum parameters. CONCLUSION: Darbepoetin showed some protective cardiovascular effects irrespective of renal function, i.e. it improved plaque structure and reduced some signs of oxidative stress and chronic inflammation without affecting plaque size. Nevertheless, the dose dependent adverse effects must be considered as high Darbepoetin treatment

  17. Effects of Chinese herbal enema therapy combined basic treatment on BUN,SCr,UA,and IS in chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    邹川

    2012-01-01

    Objective To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients,thus providing evidence for further optimizing the comprehensive treatment. Methods Using nonrandomized concurrent control

  18. PATHOGENESIS OF IMMUNE ALTERATIONS AND CORRECTIVE ROLE OF AMLODIPINE IN EXPERIMENTAL CHRONIC RENAL FAILURE

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    M. V. Osikov

    2016-01-01

    Full Text Available The purpose of this study was to assess some mechanisms of changes in immune state, and to evaluate a role of amlodipine, a known calcium channel blocker, as a potential corrective drug in experimental chronic renal failure (CRF. An animal CRF model was produced in rats by a two-stage operative resection of 5/6 of the renal tissue. Amlodipine is used per os at a daily dose of 0.25 mg/kg for 7 days. Flow cytofluorimetric approach was used to discern peripheral blood lymphocytes: CD3+ (mainly, T lymphocytes, CD45RA+ (mainly, B cells, as well as the following cell markers: Annexin 5-FITC+/7-AAD- (early apoptosis, Annexin 5-FITC+/7-AAD+ (late apoptosis and, in part, necrotic cells. Moreover, we have measured serum concentrations of urea, creatinine, phosphate, total calcium, parathyroid hormone (PTH, IL-1β, IL-4, interferon-γ, superoxide dismutase (SOD and catalase activities. Evaluation of Th1- and Th2-dependent immune response was carried out, respectively, by detection of delayed-type hypersensitivity, and scoring the antibody-forming cells in rat spleen induced by immunization with allogeneic erythrocytes. Primary, secondary and final products of lipid peroxidation were evaluated in lipid extracts from peripheral blood lymphocytes. Changes of immune state in CRF included depression of Th1 and Th2 dependent immune response, reduced number of lymphocytes bearing T and В cell markers, increased IL-1β concentrations in blood, along with decreased amounts of IFNγ and IL-4. Probable pathogenesis of the altered immune state may be associated with increased number of peripheral lymphocytes being at early and late stages of apoptosis/necrosis, elevated blood levels of IL-1β, total calcium, parathyroid hormone, reduced concentrations of IFNγ, and increased contents of primary, secondary and final peroxidation products in peripheral blood lymphocytes, being accompanied by inhibition of the SOD and catalase activity in blood plasma

  19. Effects of chronic renal failure on the expression of connexin 43 in the rat's corpus cavernosum

    Institute of Scientific and Technical Information of China (English)

    Qiang Fu; Jia-Jv Lv; Hui Zhang

    2008-01-01

    Aim: To explore the mechanism of chronic renal failure (CRF)-related erectile dysfunction (ED). Methods: CRF experimental models were established by 5/6 nephrectomy from male Sprague-Dawley rats. Both the rats from the control group (NCRF group, n = 6) and the experimental group (CRF group, n = 30) were injected with a low dose (80 μg/kg) of apomorphine in the 12th week after resection surgery to measure corresponding penile erections.Western blot method was thereafter conducted to measure the expression of connexin 43 (CX43) in the rat corpus cavernosum in the 12th week after the resection surgery. Results: There was one death in the NCRF group and five in the CRF group. The penile erection ratio of the CRF group was 28% (7/25), whereas that of the NCRF group was 100% (5/5), which presents a significant difference between the two groups (P < 0.05). In terms of penile erection frequency, the average of the CRF group was 1.0±0.0, which was significantly different from that of the NCRF group (2.2±0.8) (P < 0.05). As for the expression of CX43 in the rat corpus cavernosum, a notable difference existed between the CRF group (0.21±0.07) and the NCRF group (0.53±0.27) (P < 0.01). Conclusion: CRF signifi-cantly reduces the erectile function of rats. A close correlation exists between the expression of CX43 in rats' corpus cavemosum and CRF-related ED.

  20. Evaluation of patients with upper gastrointestinal bleeding in chronic renal failure

    Directory of Open Access Journals (Sweden)

    Mehmet Sinan Dal

    2011-06-01

    Full Text Available Incidence of gastrointestinal complications especially gastric bleeding increased in patients with chronic renal failure (CRF. The aim of this study was to comparatively investigate upper gastrointestinal bleeding (UGB in patients with non-hemodialysis CRF and the patients without CRF.Materials and Methods: Seventy-six patients (55 men and 21 women with and without CRF and UGB was included. The first group who had CRF consisted of 23 patients and the control group 53. All patients were evaluated in the view point of age, gender, smoking status, other illnesses, medicine usage, laboratory parameters, endoscopic evidence and endoscopic intervention (scleroteraphy.Results: Calcium levels of patients with a history of previous UGB was significantly lower compared with those bleeding for the first time (p<0.05. The mean parathormon level was higher in patients with CRF (171.24 ± 141.96 pg/ml (p<0.05. Serum albumin level was negatively correlated with urea and creatinine (p<0.001, and positively correlated with hemoglobin and hematocrit levels (p=0.003 and p=0.005. The patients undergoing sclerotherapy more frequently needed transfusions (p<0.05. The hospitalization time found to be shortening with increasing hemoglobin, hematocrit, calcium and albumin levels; and lengthens with increased urea and creatinine.Conclusion: The history of previous gastrointestinal bleeding and detection of pathological findings in endoscopy were more frequent in patients with CRF. Gastrointestinal bleeding risk did not reduce using by gastric protection against acetylsalicylic acid and other non-steroidal antiinflammatory drugs. Also, low albumin levels and secondary hiperparathyroidism in these patients may be risky for gastrointestinal bleeding. J Clin Exp Invest 2011;2(2:207-13

  1. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  2. Vitaminas B y homocisteína en la insuficiencia renal crónica Vitamin B complex and homocysteine in chronic renal failure

    Directory of Open Access Journals (Sweden)

    C. Sánchez

    2007-12-01

    Full Text Available Durante la insuficiencia renal crónica ocurren cambios metabólicos, bioquímicos y hormonales que suelen ir acompañados frecuentemente de estados de malnutrición. En pacientes en prediálisis, conocer el estado nutricional en vitaminas hidrosolubles como la tiamina, riboflavina, piridoxina, cianocobalamaina y ácido fólico cobra cada vez más importancia ya que algunas de las manifestaciones de la insuficiencia renal crónica podrían deberse a la deficiencia de algunas de estas vitaminas hidrosolubles. Las rutas metabólicas en las que participan la mayoría de ellas se encuentran interrelacionadas y resulta complejo comprender de qué manera afecta individualmente la deficiencia de cada vitamina a la patología renal. Este trabajo trata de revisar no sólo este aspecto, sino también el estatus en estas vitaminas hidrosolubles que diferentes autores han encontrado en grupos de pacientes en prediálisis. Por otra parte se aborda la problemática de la elevada prevalencia de hiperhomocisteinemia en la insuficiencia renal crónica como principal factor de riesgo de mortalidad por patologías cardiovasculares, así como la implicación de las vitaminas objeto de esta revisión en el metabolismo de la homocisteína y por consiguiente en los niveles plasmáticos de dicho metabolito en pacientes en prediálisis.Metabolic, biochemical, and hormonal changes occur in chronic renal failure usually associated with hyponutrition states. In predialysis patients, knowing the nutritional state about water-soluble vitamins such as thiamine, riboflavin, pyridoxine, cianocobalamine, and folic acid is becoming more and more important since some of the manifestations of chronic renal failure may be due to the deficiency of some of these water-soluble vitamins. The metabolic pathways in which most of these vitamins participate are interrelated and it is difficult to understand how the individual deficits of each vitamin affect renal pathology. This work aims

  3. 肾衰宁颗粒治疗慢性肾功能衰竭疗效观察%Renal Failure Better Treatment of Chronic Renal Failure Particles Clinical Observation

    Institute of Scientific and Technical Information of China (English)

    许晓明

    2011-01-01

    目的:探讨肾衰宁颗粒治疗早中期慢性肾功能衰竭的临床疗效.方法:将65例慢性肾功能患者,随机分为治疗组和对照组.治疗组35例采用肾衰宁颗粒口服,对照组30例予包醛氧淀粉口服,观察两组患者用药前后的临床症状及肾功能、血常规、血液流变学变化的改善情况.结果:治疗组总有效率为83.42%,明显高于对照组(P<0.01),且无明显毒副作用.结论:肾衰宁颗粒可延缓慢性肾功能衰竭的进展,能有效的改善肾功能,无明显不良反应,耐受性好,为有效的治疗药物.%Objective: To investigate the treatment of renal failure early and mid Granules chronic renal failure in clinical efficacy. Methods : 65 patients with chronic renal patients were randomly divided into treatment and control groups. Treatment group,35 patients with renal failure, oral granules, to package the control group of 31 cases of oral starch aldehyde oxygen to observe the 2 groups before and after treatment in patients with clinical symptoms of renal function, blood, blood rheology changes in the situation. Results : The total effective rate was 83.42%, significantly higher than the comparison group ( P<0.01 ), and no obvious side effects. Conclusion : Renal Failure Granules for delaying the development of chronic renal failure have a good role for effective treatment.

  4. Carotid artery intima media thickness as a surrogate marker of atherosclerosis in patient with chronic renal failure on hemodialysis

    Directory of Open Access Journals (Sweden)

    Jayanta Paul

    2012-01-01

    Full Text Available Background: In patients with chronic renal failure (CRF, carotid artery intima media thickness (CAIMT is increased when the patients are on hemodialysis. Vascular events caused by atherosclerosis are the major cause of death in patients undergoing hemodialysis. Aims: This study was done to find out the relationship between carotid artery intima media thickness and hemodialysis in chronic renal failure patients independent of classical risk factors and also the relationship between CAIMT of hemodialyzed patients and nonhemodialyzed CRF patients. Materials and Methods: In this observational study, CAIMT of 78 CRF patients was examined by B-mode ultrasonography. Glomerular filtration rate (GFR was calculated by using the "Modification of Diet in Renal Disease" formula. CRF patients, who had been on regular hemodialysis treatment (treated thrice weekly for at least 6 months, were identified as hemodialyzed patients. Data were analyzed by software Statistical package for the social Sciences (SPSS (17 th version. Results: There was significant positive correlation between CAIMT and hemodialysis (P=0.045 independent of traditional risk factors. Hemodialyzed patients had higher mean CAIMT (1136.30±21.21 μm, P<0.001 than mean CAIMT of age and sex matched nondialyzed patients (959.30±23.01 μm. Conclusion: Hemodialysis is an independent risk factor for atherosclerosis in CRF patents. Hemodialyzed patients have significantly higher CAIMT than nondialyzed CRF patients.

  5. Evaluation of lipid parameters and bioindices in patients with different stages of chronic renal failure

    Directory of Open Access Journals (Sweden)

    Čabarkapa Velibor

    2012-01-01

    Full Text Available Background/Aim. Cardiovascular morbidity and mortality are markedly increased in chronic renal failure (CRF. The aim of this study was to evaluate lipid parameters and bioindices in patients with different stages of CRF. Methods. In 46 hemodialysed (HD, 50 CRF patients with II, III and IV stage of CRF (non-HD and 48 control subjects triglycerides (TG, total cholesterol (C, HDL-C, urea, creatinine, creatinuria (standard biochemical methods, apolipoprotein (apo AI, apo B, lipoprotein(a, cystatin C (immunoturbidimetric method were evaluated, and LDL-C, non-HDL-C, LDLC/ HDL-C, non-HDL-/HDL-C, TG/HDL-C, and new bioindices, LTI (lipid tetrad index, logLTI, LPI (lipid pentad index, logLPI, AIP (atherogenic index of plasma, and creatinine clearance were calculated. Results. There were significant differences in the levels of TG, HDL-C, LDL-C, non- HDL-C, total C and apo A-I between the HD and non-HD patients, and the HD patients and the controls. LTI and LPI were significantly higher in the HD and non-HD patients compared to the controls (p < 0.05, without a good separation by the Box-Whisker plots. The values of TG/HDL-C ratio and AIP were significantly higher in the HD and non- HD-patients compared to the controls (p < 0.05, and significantly higher in the HD compared to non-HD patients (p < 0.05. AIP > 0.11 was found in 71.7% of the HD, 56% of non-HD and 31.3% of the controls. Conclusion. Among lipid parameters and indices, AIP and TG/HDL-C ratio are most suitable for evaluation of lipid disturbances in different stages of CRF. In addition to, non-HDL-/HDL-C, and apoB/A-I ratios, apo A-I, HDL-C and TG are important markers in HD patients. Non-HDL-C is not a suitable marker. LTI and LPI need to be further investigated.

  6. A study on hearing evaluation in patients of chronic renal failure

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    Ravinder Sharma

    2011-01-01

    Full Text Available Aims and Objective: The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies (250Hz, 500Hz, 1000Hz, 2000Hz, 3000Hz, 4000Hz, 6000Hz, and 8000Hz in patients of chronic renal failure (CRF, and to analyze the role of duration of disease on hearing threshold in patients of CRF. Materials and Methods: Fifty two patients of CRF were evaluated in Nephrology unit and ENT OPD. Cases with middle ear involvement were not included in the study. Pure tone audiometry was done in all cases to establish hearing threshold at different frequencies. Cases with hearing loss were classified according to the severity of hearing loss. In patients with sensorineural hearing loss, mean hearing threshold was calculated. Cases were classified in two groups on the basis of duration of disease (less than two years and more than two years and the mean hearing thresholds were calculated. The significant differences between the mean hearing thresholds of these two groups were assessed using student′s t test for unequal samples. Results : A total of 52 patients (28 males and 24 females were included in the study. Majority of the patients were in 21 to 40 year age group (mean age 36.84 years. Of the 104 ears, 76 ears (73.07% had sensorineural hearing loss and 28 ears (26.93% had normal hearing. Majority of the ears with hearing loss had mild (44.73% or moderate (42.11% sensorineural hearing loss. Mean hearing threshold was higher at low frequencies and high frequencies with a relative sparing of mid frequencies. Comparison of the mean hearing threshold in patients of Group I (duration of disease less than two years - 42 ears and Group II (duration of disease more than two years - 34 ears showed a statistically significant difference (P<0.05 in mean hearing threshold at 250 Hz. Conclusion: Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. Hearing

  7. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  8. Prolonged Pulmonary Exposure to Diesel Exhaust Particles Exacerbates Renal Oxidative Stress, Inflammation and DNA Damage in Mice with Adenine-Induced Chronic Renal Failure

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    Abderrahim Nemmar

    2016-05-01

    Full Text Available Background/Aims: Epidemiological evidence indicates that patients with chronic kidney diseases have increased susceptibility to adverse outcomes related to long-term exposure to particulate air pollution. However, mechanisms underlying these effects are not fully understood. Methods: Presently, we assessed the effect of prolonged exposure to diesel exhaust particles (DEP on chronic renal failure induced by adenine (0.25% w/w in feed for 4 weeks, which is known to involve inflammation and oxidative stress. DEP (0.5m/kg was intratracheally (i.t. instilled every 4th day for 4 weeks (7 i.t. instillation. Four days following the last exposure to either DEP or saline (control, various renal endpoints were measured. Results: While body weight was decreased, kidney weight increased in DEP+adenine versus saline+adenine or DEP. Water intake, urine volume, relative kidney weight were significantly increased in adenine+DEP versus DEP and adenine+saline versus saline. Plasma creatinine and urea increased and creatinine clearance decreased in adenine+DEP versus DEP and adenine+saline versus saline. Tumor necrosis factor α, lipid peroxidation and reactive oxygen species were significantly increased in adenine+DEP compared with either DEP or adenine+saline. The antioxidant calase was significantly decreased in adenine+DEP compared with either adenine+saline or DEP. Notably, renal DNA damage was significantly potentiated in adenine+DEP compared with either adenine+saline or DEP. Similarly, systolic blood pressure was increased in adenine+DEP versus adenine+saline or DEP, and in DEP versus saline. Histological evaluation revealed more collagen deposition, higher number of necrotic cell counts and dilated tubules, cast formation and collapsing glomeruli in adenine+DEP versus adenine+saline or DEP. Conclusion: Prolonged pulmonary exposure to diesel exhaust particles worsen renal oxidative stress, inflammation and DNA damage in mice with adenine-induced chronic

  9. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    Directory of Open Access Journals (Sweden)

    Hadi Rokni Yazdi

    2012-03-01

    Full Text Available Background: Endothelial injury is a well-known complication in chronic kidney disease (CKD and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases.Objectives: In previous studies on CKD patients who underwent chronic hemodialysis, hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis can produce these changes. In this study, we tried to answer this question.Patients and Methods: Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes with chronic renal failure (CRF who underwent hemodialysis, 17 patients (34 eyes with CRF without a history of hemodialysis and 17 normal patients (34 eyes. The peak systolic velocity (PSV, end diastolic velocity (EDV and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease.Results: The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value = 0.001 with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI] in the central retinal artery.Conclusions: The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV of the central retinal artery were noted between different groups.These findings suggest

  10. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    International Nuclear Information System (INIS)

    Endothelial injury is a well-known complication in chronic kidney disease (CKD) and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases. In previous studies on CKD patients who underwent chronic hemodialysis,hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis) can produce these changes. In this study, we tried to answer this question. Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes) with chronic renal failure (CRF) who underwent hemodialysis, 17 patients (34 eyes)with CRF without a history of hemodialysis and 17 normal patients (34 eyes). The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease. The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value =0.001) with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI)] in the central retinal artery. The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV) of the central retinal artery were noted between different groups. These findings suggest that microvascular disease and endothelial cell dysfunction of the orbital

  11. Renal failure in malaria

    OpenAIRE

    B.S. Das

    2008-01-01

    Acute renal failure (ARF) is seen mostly in Plasmodium falciparum infection, but P. vivax and P. malariae can occasionally contribute for renal impairment. Malarial ARF is commonly found in non-immune adults and older children with falciparum malaria. Occurance of ARF in severe falciparum malaria is quite common in southeast Asia and Indian subcontinent where intensity of malaria transmission is usually low with occasional microfoci of intense transmission. Since precise mechanism of malaria...

  12. Response Rate to Hepatitis B Vaccination in Patients with Chronic Renal Failure and End-Stage-Renal-Disease: Influence of Diabetes Mellitus

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    Sh Taheri

    2005-11-01

    Full Text Available Background: Hepatitis B vaccination is recommended for all individuals with renal failure. Nevertheless, the response rate for this vaccine in hemodialysis patients is low. This study was designed to determine the response rate to hepatitis B vaccination in chronic renal failure (CRF and end stage renal disease (ESRD patients and those factors that Methods: We evaluated antiHBs level after primary vaccination in 32 predialysis and 93 dialysis patients. HBsAg positive patients were excluded. AntiHBs titers were determined in the period of 1 to 6 months after completion of vaccination. Results: Seroconversion (antiHBs>10mIU/ml was found in 100 patients (80%, but an excellent response (titer>100 mIU/ml was observed only in 74 (59.2%. Response rate were 71.9 and 82.8 in predialysis CRF and ESRD patients, respectively, but this difference was not significant (χ2-test; p=0.183. Predialysis patients showed an excellent response more than dialysis patients (χ2-test; p<0.05. Age, sex, and initial serum creatinine didn’t influence response rate. Response rate in patients with diabetic mellitus was lower than others (62.2% vs. 87.5% (χ2-test; p=0.001, and multiple logistic regression analysis showed a significant risk for vaccination nonresponse when patients were diabetics (oddsratio 4.38; 95% confidence interval: 1.70-11.24, p=0.002. Conclusion: Our result showed that 1 hepatitis B vaccine nonresponders are more likely to have diabetes mellitus and 2 response rate in predialysis patients is the same as in dialysis patients but predialysis patients, as compared with dialysis patients, were more inclined to show an excellent response. Key words: HBV vaccination, Chronic Renal Failure, dialysis, Diabetes Mellitus

  13. Thyroid hormone levels in patients with chronic renal failure under haemodialysis

    International Nuclear Information System (INIS)

    This study was conducted with three main objectives, to study thyroid hormones (T 4, T 3) and TSH levels in patients with CRF under haemodialysis and to compare them with normal subjects, to study best means of treatment and to compare these findings with results from other parts of the world. This study was done on 61 patients with renal failure in Khartoum dialysis and kidney transplant centre U of K, 45 males and 16 females with ages ranging from 17-75 years and 42 symptoms-free subjects 14 males and 23 females with age ranging from 16-60 years. The radioimmunoassay (RIA) technique was used for the determination of serum T 4, T 3 and TSH. By using t-test found that the mean concentrations of T 4, T 3 of normal subjects were much higher than those of the patients (p0.05). These results also illustrated that 45.9% of patients with renal failure of low T 4, and 91.8%, 90.26 of patients had T 3 and TSH hormone levels in the normal range, respectively. No significant difference was observed in the mean of thyroid hormones (T 4, T3) and thyroid-stimulating hormones between males and females (p>0.05). The T 3 and T '4 concentrations in patients at all age groups (year) was less than the age groups of the control group, and this decrease was statistically significant (p0.05).(Author)

  14. [Renal failure and cystic kidney diseases].

    Science.gov (United States)

    Correas, J-M; Joly, D; Chauveau, D; Richard, S; Hélénon, O

    2011-04-01

    Cystic kidney diseases often are discovered at the time of initial work-up of renal failure through ultrasound or family history, or incidentally at the time of an imaging test. Hereditary diseases include autosomal dominant or recessive polycystic kidney disease (PKD), tuberous sclerosis (TS) and medullary cystic kidney disease (MCKD). Autosomal dominant PKD is characterized by large renal cysts developing in young adults. Renal failure is progressive and becomes severe around 50-60 years of age. Atypical cysts (hemorrhagic or hyperdense) are frequent on CT and MRI examinations. Imaging plays a valuable role in the management of acute complications such as cyst hemorrhage or infection. Autosomal recessive PKD is often detected in neonates, infants or young adults. It is characterized by renal enlargement due to the presence of small cysts and liver disease (fibrosis and biliary ductal dilatation). Late manifestation or slow progression of autosomal recessive PKD may be more difficult to distinguish from autosomal dominant PKD. These cystic kidney diseases should not be confused with non-hereditary incidental multiple renal cysts. In tuberous sclerosis, renal cysts are associated with angiomyolipomas and sometimes pulmonary lymphangioleiomyomatosis. Renal failure is inconstant. Other hereditary cystic kidney diseases, including MCKD and nephronophtisis, are usually associated with renal failure. Non-hereditary cystic kidney diseases include multicystic renal dysplasia (due to complete pelvi-ureteric atresia or hydronephrosis), acquired multicystic kidney disease (chronic renal failure, chronic hemodialysis) and varied cystic kidney diseases (multicystic renal disease, glomerulocystic kidney disease, microcystic kidney disease). PMID:21549887

  15. Depressed cerebral oxygen metabolism in patients with chronic renal failure. A positron emission tomography study

    International Nuclear Information System (INIS)

    In order to elucidate brain oxygen metabolism in uremic patients, the regional cerebral blood flow (rCBF), oxygen extraction (rOEF) and oxygen metabolism (rCMRO2) were measured by positron emission tomography (PET) in both 10 hemodialysis patients (HD: male [m]/female [f]=2/8, age of 49±3 [SEM] years old, HD duration of 113±26 months) and 13 pre-dialysis renal failure patients (CRF: m/f=10/3, age of 61±2 years old, serum creatinine (SCr) of 6.3±1.0 mg/dl). Data were compared with 20 non-uremic subjects (Control: m/f=7/13, age of 62±2 years old, SCr of 0.9±0.1 mg/dl). They had no neurological abnormalities, congestive heart failure, history of cerebrovascular accident, diabetes mellitus, or symptomatic brain lesion on magnetic resonance imaging. The age of HD was significantly younger than the other groups (p2 in both HD (1.82±0.10 ml/min/100 g) and CRF (1.95±0.09) showed significantly lower values as compared to Control (2.23±0.05) (p<0.01, respectively). Hemispheric rCBF in HD (35.6±2.1 ml/100 g/min) and in CRF (36.1±2.1) were not different from that in Control (31.8±1.4). Hemispheric rOEF in CRF (45.7±1.6%) was significantly higher than that in Control (40.5±1.2%) (p<0.02), but that in HD (43.7±1.9%) did not increase significantly. These tendencies were similar in all regions of interest, especially in the cerebral cortices, but not in the cerebellum. All PET parameters in the frontal cortices tended to show the lowest value in renal failure patients. For all HD patients, rCBF in both the frontal cortex and the white matter correlated inversely with HD duration (frontal cortex: r=-0.649, p<0.05; white matter: r=-0.706, p<0.02). Based on these data, it is concluded that brain oxygen metabolism is depressed in renal failure patients on or before hemodialysis treatment. The cause for the depressed brain oxygen metabolism is considered to be due either to the dysregulation of cerebral circulation or to lower brain cell activity. (author)

  16. Effect of gum arabic on oxidative stress and inflammation in adenine-induced chronic renal failure in rats.

    Directory of Open Access Journals (Sweden)

    Badreldin H Ali

    Full Text Available Inflammation and oxidative stress are known to be involved in the pathogenesis of chronic kidney disease in humans, and in chronic renal failure (CRF in rats. The aim of this work was to study the role of inflammation and oxidative stress in adenine-induced CRF and the effect thereon of the purported nephroprotective agent gum arabic (GA. Rats were divided into four groups and treated for 4 weeks as follows: control, adenine in feed (0.75%, w/w, GA in drinking water (15%, w/v and adenine+GA, as before. Urine, blood and kidneys were collected from the rats at the end of the treatment for analysis of conventional renal function tests (plasma creatinine and urea concentration. In addition, the concentrations of the pro-inflammatory cytokine TNF-α and the oxidative stress markers glutathione and superoxide dismutase, renal apoptosis, superoxide formation and DNA double strand break frequency, detected by immunohistochemistry for γ-H2AX, were measured. Adenine significantly increased the concentrations of urea and creatinine in plasma, significantly decreased the creatinine clearance and induced significant increases in the concentration of the measured inflammatory mediators. Further, it caused oxidative stress and DNA damage. Treatment with GA significantly ameliorated these actions. The mechanism of the reported salutary effect of GA in adenine-induced CRF is associated with mitigation of the adenine-induced inflammation and generation of free radicals.

  17. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment...

  18. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U; Møller, M L; Ladefoged, S D; Mehlsen, J; Jensen, H A

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment with a...

  19. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause. PMID:26600445

  20. Depressed cerebral oxygen metabolism in patients with chronic renal failure. A positron emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Hirakata, Hideki; Kanai, Hidetoshi; Nakane, Hiroshi; Fujii, Ken-ichiro; Hirakata, Eriko; Ibayashi, Setsuro; Kuwabara, Yasuo; Deenitchna, S.S.; Fujishima, Masatoshi [Kyushu Univ., Fukuoka (Japan). Graduate School of Medical Sciences

    2001-07-01

    In order to elucidate brain oxygen metabolism in uremic patients, the regional cerebral blood flow (rCBF), oxygen extraction (rOEF) and oxygen metabolism (rCMRO{sub 2}) were measured by positron emission tomography (PET) in both 10 hemodialysis patients (HD: male [m]/female [f]=2/8, age of 49{+-}3 [SEM] years old, HD duration of 113{+-}26 months) and 13 pre-dialysis renal failure patients (CRF: m/f=10/3, age of 61{+-}2 years old, serum creatinine (SCr) of 6.3{+-}1.0 mg/dl). Data were compared with 20 non-uremic subjects (Control: m/f=7/13, age of 62{+-}2 years old, SCr of 0.9{+-}0.1 mg/dl). They had no neurological abnormalities, congestive heart failure, history of cerebrovascular accident, diabetes mellitus, or symptomatic brain lesion on magnetic resonance imaging. The age of HD was significantly younger than the other groups (p<0.02) and the hemoglobin (Hb) levels in both HD (10.5{+-}0.5 g/dl) and CRF (9.8{+-}0.9) were significantly lower than that in Control (13.3{+-}0.3) (p<0.02). In the hemisphere, rCMRO{sub 2} in both HD (1.82{+-}0.10 ml/min/100 g) and CRF (1.95{+-}0.09) showed significantly lower values as compared to Control (2.23{+-}0.05) (p<0.01, respectively). Hemispheric rCBF in HD (35.6{+-}2.1 ml/100 g/min) and in CRF (36.1{+-}2.1) were not different from that in Control (31.8{+-}1.4). Hemispheric rOEF in CRF (45.7{+-}1.6%) was significantly higher than that in Control (40.5{+-}1.2%) (p<0.02), but that in HD (43.7{+-}1.9%) did not increase significantly. These tendencies were similar in all regions of interest, especially in the cerebral cortices, but not in the cerebellum. All PET parameters in the frontal cortices tended to show the lowest value in renal failure patients. For all HD patients, rCBF in both the frontal cortex and the white matter correlated inversely with HD duration (frontal cortex: r=-0.649, p<0.05; white matter: r=-0.706, p<0.02). Based on these data, it is concluded that brain oxygen metabolism is depressed in renal failure

  1. Effects of dialysis on left ventricular diastolic filling in patients with chronic renal failure

    International Nuclear Information System (INIS)

    To examine the effects of dialysis on left ventricular (LV) filling, gated radionuclide ventriculography was conducted in 15 patients with renal failure before and after dialysis. The LV regional function was assessed by subdividing the LV region of interest into 4 regions from which global and regional time-activity curves and their first-derivative curves were obtained. Early diastolic asynchrony was measured as the sum of the absolute values (total Δt) of the time differences (Δt) between the global peak LV filling rate (PFR) and that for each of the other 3 regions. Dialysis produced an increase in the peak LV ejection rate (PER), heart rate, total Δt and total Δt/diastolic time. It caused a delay or tendency to delay in the time to PFR without significant changes in the PFR either globally or regionally, and the PFR/PER ratio decreased both globally and regionally. These alterations indicated a failure of improvement of the global and regional LV filling, with more asynchronous filling occurring after dialysis despite the increases in PER and heart rate, both of which are expected to increase PFR and shorten the time to PFR. There was a negative correlation between the change in total Δt/diastolic time and the change in the PFR/PER ratio (r=-0.62, p<0.01), with a greater increase in asynchrony occurring with the relative greater reduction in the relative global PFR compared with the global PER after dialysis. Dialysis can produce early diastolic asynchronous filling, which will be associated with a failure of improvement of LV filling despite the increases in LV peak ejection rate and the heart rate. Thus, LV filling requires careful attention in patients undergoing dialysis, since the pattern and timing of the filling is altered, and the excessive water removal by dialysis may affect the LV diastolic filling. (author)

  2. Wireless capsule endoscopy in the investigation of patients with chronic renal failure and obscure gastrointestinal bleeding (preliminary data)

    Institute of Scientific and Technical Information of China (English)

    Stephanos Karagiannis; Spyros Goulas; Georgios Kosmadakis; Petros Galanis; Dimitrios Arvanitis; John Boletis; Evangelos Georgiou; Christos Mavrogiannis

    2006-01-01

    AIM: To investigate the role of wireless capsule endoscopy (WCE) in detection of small bowel (SB) pathology in patients with chronic renal failure (CRF) and obscure bleeding.METHODS: Consecutive CRF patients with obscure bleeding were prospectively studied. Patients with normal renal function and obscure bleeding, investigated during the same period with WCE, were used for the interpretation of results.RESULTS: Seventeen CRF patients (11 overt, 6 occult bleeding) and 51 patients (33 overt, 18 occult bleeding) with normal renal function were enrolled in this study.Positive SB findings were detected in 70.6% of CRF patients and in 41.2% of non-CRF patients (P < 0.05). SB angiodysplasia was identified in 47% of CRF patients and in 17.6% of non-CRF patients. Univariate logistic regression revealed CRF as a significant predictive factor for angiodysplasia (P < 0.05). Therapeutic measures were undertaken in 66% of the patients with the positive findings.CONCLUSION: According to our preliminary results, SB angiodysplasia was found in an increased prevalence among CRF patients with obscure bleeding. WCE is useful in diagnosis of gastrointestinal pathologies and in planning appropriate therapeutic intervention and, therefore, should be included in the work-up of this group of patients.

  3. Clinical significance of measurement of changes of plasma leptin and serum NPY levels after hemodialysis in patients with chronic renal failure

    International Nuclear Information System (INIS)

    Objective: To explore the clinical significance of changes of plasma leptin and serum NPY levels after hemodialysis in patients with chronic renal failure. Methods: Plasma leptin and serum NPY levels were measured with RIA both before and after hemodialysis in 31 patients with chronic renal failure as well as in 35 controls. Results: Before hemodialysis,plasma leptin and serum NPY levels were significantly higher in the patients than those in controls (P<0.01). After hemodialysis for 1 week the levels, though dropped markedly, still remained significantly higher than those in controls (P<0.05). Conclusion: The levels of leptin and NPY were significantly increased in patients with chronic renal failare. Hemodialysis could increase, the clearance rate of leptin and NPY and partially correct the levels with important clinical value. (authors)

  4. Effects of low-molecular-weight-chitosan on the adenine-induced chronic renal failure rats in vitro and in vivo

    Science.gov (United States)

    Zhi, Xuan; Han, Baoqin; Sui, Xianxian; Hu, Rui; Liu, Wanshun

    2015-02-01

    The effects of low-molecular-weight-chitosan (LMWC) on chronic renal failure (CRF) rats induced by adenine were investigated in vivo and in vitro. Chitosan were hydrolyzed using chitosanase at pH 6-7 and 37° for 24 h to obtain LMWC. In vitro, the effect of LMWC on the proliferation of renal tubular epithelial cells (RTEC) showed that it had no cytotoxic effect and could promote cell growth. For the in vivo experiment, chronic renal failure rats induced by adenine were randomly divided into control group, Niaoduqing group, and high-, medium- and low-dose LMWC groups. For each group, we detected serum creatinine (SCR), blood urea nitrogen (BUN), and total superoxide dismutase (T-SOD), glutathione oxidase (GSH-Px) activities of renal tissue, and obtained the ratio of kidney weight/body weight, pathological changes of kidney. The levels of serum SCR, BUN were higher in the adenine-induced rats than those in the control group, indicating that the rat chronic renal failure model worked successfully. The results after treatment showed that LMWC could reduce the SCR and BUN levels and enhance the activities/levels of T-SOD and GSH-PX in kidney compared to control group. Histopathological examination revealed that adenine-induced renal alterations were restored by LMWC at three tested dosages, especially at the low dosage of 100 mg kg-1 d-1.

  5. Evaluation of spinal bone changes in patients with chronic renal failure by CT and MR imaging with pathologic correlation

    International Nuclear Information System (INIS)

    To investigate bone changes in patients with chronic renal failure (CRF), bone mineral density (BMD) and T1 relaxation times were measured with CT and MR imaging and the results were correlated to histology. Excised lumbar vertebrae from 25 autopsy cases of CRF (18 males and 7 females), including 12 cases in which the patients had been receiving hemodialysis were examined. BMD and T1 relaxation times values were associated with specific histologic findings for cellularity, trabeculae, and peritrabecular fibrosis. Three vertebrae with low BMD showed incresed hematopoietic marrow content, a finding not observed in primary osteoporosis. The vertebrae with osteosclerosis showed prolonged T1 relaxation time, which was due to increased amount of hematopoietic marrow, and the presence of thickened or many small irregular trabeculae or perirabecular fibrosis. (orig.)

  6. An Unpredicted Side Effect of Bisphosphonates in a Patient with Chronic Renal Failure Due to Multiple Myeloma: Reversible Parkinsonism

    Directory of Open Access Journals (Sweden)

    Barış İşak

    2010-09-01

    Full Text Available In this report, we present a unique case in which the chemotherapeutic agent, i.e., zoledronic acid, deepened the hypocalcemia on the basis of chronic renal failure secondary to multiple myeloma and caused parkinsonism episodes. An 80-year-old female patient, who had been diagnosed as multiple myeloma and had been administered bisphosphonate therapy monthly for six months, was ad¬mitted to our emergency room with two parkinsonism episodes. Low serum calcium levels accompanied parkinsonism symptoms, which subsided with calcium replacement therapy in both episodes. Imaging did not reveal any pathology in the basal ganglia. The fact that the patient was cured both times with calcium replacement suggests that hypocalcemia was the actual cause. This can be interpreted as a unique case, reflecting the reversible functional impairment due to metabolic side effects of a chemotherapeutic agent rather than destructive changes in the basal ganglia.

  7. Effects of chronic renal failure rat serum on histone acetyltransferase p300 and activation of activating transcription factor 4 of arterial smooth muscle cells cultured in vitro

    Institute of Scientific and Technical Information of China (English)

    张耀全

    2014-01-01

    Objective To investigate the effects of the rat serum with chronic renal failure(CRF)on ubiquitin-proteasome pathway,histone acetyltransferase p300 and activation of activating transcription factor 4(ATF4)of rat arterial vascular smooth muscle cells(VSMCs)cultured in vitro,and explore the possible mechanism.Methods Objective To establish the rat model of

  8. Treatment of 5/6 nephrectomy rats with sulodexide:a novel therapy for chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Ping Li; Lin-lin MA; Ru-juan XIE; Yuan-sheng XIE; Ri-bao WEI; Min YIN; Jian-zhong WANG; Xiang-mei CHEN

    2012-01-01

    Sulodexide,a glycosaminoglycan,could reduce aibuminuria in diabetic patients.The aim of this study was to determine whether sulodexide could be used to treat chronic kidney failure in rats.Methods:Sixty Wistar rats undergone 5/6 nephrectomy,then were randomly divided into 4 groups:the model group,sulodexide group (sulodexide 5 mg/kg per day,im),irbesartan group irbesartan (20 mg/kg per day,ig) and sulodexide plus irbesartan group.Another 12 rats were enrolled into the sham operation group.After the treatments for 4,8 and 12 weeks,urinary protein and serum creatinine levels were measured.After 12 weeks,serum cholesterin and triglycerides levels were measured,and the degrees of glomerular sclerosis and renal tubulointerstitial fibrosis were scored.The expression of aminopeptidase P (JG-12) in the renal tissue was examined using immunohistochemical staining.The renal expressions of endothelial nitric oxide synthase (eNOS) and tissue type plasminogen activator (tPA) were detected with RT-PCR and Westem blot.Results:Proteinuria was markedly attenuated in the sulodexide-trested groups.After 4 and 8 weeks only the sulodexide-treated groups showed significant reduction in serum creatinine; while after 12 weeks all the three treatment groups showed significant reduction in serum creatinine.Furthermore,all the three treatment groups showed significant reduction in the scores of glomerular sclerosis and tubulointerstitial fibrosis.The glomerular expression of JG-12 was increased in both the sulodexide group and the sulodexide plus irbesartan group,but not in the irbesartan group.The eNOS mRNA and protein expression was decreased and the tPA mRNA and protein expression was significantly increased in the model group compared with Sham group.Sulodexide,irbesartan,and their combination reversed the decrease of eNOS expression but increased the tPA expression much more compared with model group.Conclusion:Sulodexide was similar to irbesartan that can decrease proteinuria and

  9. A Randomized Controlled Trial of Two Schedules of Hepatitis B Vaccination in Predialysed Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Farokhlagha Ahmadi

    2012-05-01

    Full Text Available Background: Patients with chronic renal disease should be vaccinated as soon as dialysis is forestalled, and this could improve the seroconversion of hepatitis B vaccination.Objectives: In this study, we aimed to compare seroconversion and immune response rates using 4 doses of 40 μg and 3 doses of 20 μg Euvax B recombinant Hepatitis B surface Antigen (HBs Ag vaccine administered to predialysis patients with chronic kidney disease (CKD.Patients and Methods: In an open, randomized clinical trial, we compared seroconversion rates in 51 predialysis patients with mild and moderate chronic renal failure who received either 4 doses of 40 μg or 3 doses of 20 μg of Euvax B recombinant hepatitis B vaccine administered at 0, 1, 2, 6 and 0, 1, 6 months, respectively.Results: Differences in seroconversion rates after 4 doses of 40 μg (80.88% compared to 3 doses of 20 μg (92% were not significant (P = 0.4124. The mean HBs antibody level after 4 doses of 40 μg at 0, 1, 2, and 6 months (182.2 ± 286.7 was significantly higher than that after 3 doses of 40 μg at 0,1, and 6 months (96.9 ± 192.1 (P = 0.004. Seroconversion after 4 doses of 40 μg (80.8% was also significantly higher than that after 3 doses of 40 μg (77% (P = 0.004. Multivariable analysis showed that none of the variables contributed to seroconversion.Conclusions: We found that 4 doses of 40 μg did not lead to significantly more seroconversion than 3 doses of 20 μg.

  10. Polyhydramnios and acute renal failure

    OpenAIRE

    Hamilton, D. V.; Kelly, Moira B.; Pryor, J. S.

    1980-01-01

    Acute renal failure secondary to ureteric obstruction is described in a primigravida with twin gestation and polyhydramnios. Relief of the obstruction occurred on drainage of the liquor and return to normal renal function following delivery.

  11. Effects of L-Carnitine Added to Erythropoietin in Anemic Chronic Renal Failure Patients on Hemodialysis.

    Directory of Open Access Journals (Sweden)

    N Taheri

    2006-10-01

    Full Text Available Introduction: Chronic renal disease (C.R.D is a pathophysiological process due to progressive and irreversible decrease in number and function of nephrons in the kidney. Anemia is one of the most important complications in CRD patients. Anemia is caused mainly due to diminished production of erythropoietin (EPO, which is treated by weekly injection of the EPO. L-carnitine added to EPO can increase the efficacy of EPO. Methods: Present study, from March 2003 until September 2004 (18 months, evaluates the effects of L-carnitine added to EPO in 30 patients at Shaheed Rahnemon hemodialysis center of Yazd. Each patient was administered one oral table (250 mg of L-carnitine, twice a day along with EPO for 90 days. EPO was in the form of injection 2000 iu/sc after dialysis.(three times per week. One questionnaire was completed for each patient, which included demographic characteristics, type of disease, duration of the hemodialysis, Hb and Hct levels, transferrin saturation and ferritin levels. Hb ,Hct and transferrin saturations were measured on days 1, 45 and 90. Results were analyzed by paired t test and analysis of variance. Results: Results of this study showed that the mean Hb levels and Hct were significantly raised up to 1.1 mg/dl (P.value<0.001 and 2.7% (P.Value<0.001, respectively. In addition, significant decrease of 5.75% in transferrin (P.Value< 0.001 and 121ng/ml in ferritin levels (P.Value< 0.001 was observed. Efficacy of EPO plus L-carnitine was affected only by duration of hemodialysis and not by age, sex or causes of CRD. Conclusion: L-carnitine added to EPO increases the efficacy of EPO after 3 months.

  12. Acute renal failure in children

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% ± 1.40 S.D.) and group B (5.95 mg% ± 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  13. Effect of enalapril on the progression of chronic renal failure. A randomized controlled trial

    DEFF Research Database (Denmark)

    Kamper, A L; Strandgaard, S; Leyssac, P P

    1992-01-01

    conventional antihypertensive treatment. The patients were followed for at least 2 years or until they needed dialysis. The groups were comparable with respect to age and sex distribution, etiology of renal diseases, initial levels of renal function and arterial blood pressure (BP), and protein intake. The...

  14. Chronic renal failure in Sri Lanka caused by elevated dietary cadmium: Trojan horse of the green revolution.

    Science.gov (United States)

    Bandara, J M R S; Wijewardena, H V P; Liyanege, J; Upul, M A; Bandara, J M U A

    2010-09-15

    The endemic of chronic renal failure (CRF) emerged in 2002 in the farming provinces of Sri Lanka. An estimate of dietary cadmium intake was between 15 and 28 microg/kg body weight per week. The mean urinary cadmium in patients diagnosed with stage 5 kidney failure was 7.6 microg/g creatinine and 11.6 microg/g for asymptomatic persons. The agrochemical triple superphosphate (TSP) fertilizer containing 23.5-71.7 mg Cd/kg was the source of cadmium added to soils. Mean Cd content in cultivated vs. uncultivated soils in Anuradhapura district was 0.02 +/- 0.01 vs. 0.11 +/- 0.19 mg/kg while in Polonnaruwa district, it was 0.005 +/- 0.004 vs. 0.016 +/- 0.005 mg/kg. Prior to the Green Revolution, the amount of fertilizer used in rice cultivation in 1970 was 32,000 metric tons (Mts) rising to 74,000 Mts in 1975. Up to 68.9 Mts of Cd could have entered into the rice-cascade reservoir environment from TSP use since 1973. Diversion of the Mahaweli River in 1970-1980 further increased cadmium input. Cadmium transfer from Upper Mahaweli water to Polgolla was 72.13 kg/day. Cadmium content of the sediments from reservoirs collecting cadmium from irrigated TSP fertilized crop fields (rice and vegetables) was 1.8-2.4 mg/kg. PMID:20430069

  15. Skeletal muscle digoxin binding in patients with renal failure.

    OpenAIRE

    Jogestrand, T; Ericsson, F

    1983-01-01

    For digoxin analyses blood and skeletal muscle samples were taken from seven digoxin-treated patients with chronic renal failure. The ratio between skeletal muscle and serum digoxin concentration in the patients with renal failure was not significantly different from the ratios in two control groups consisting of subjects with normal renal function. In the group of patients with renal failure there was no relationship between the glomerular filtration rate and muscle digoxin binding (specific...

  16. Acute Renal Failure and the Critically Ill Surgical Patient

    OpenAIRE

    Sykes, Eliot; Cosgrove, Joseph F

    2007-01-01

    Acute renal failure can occur following major surgery. Predisposing factors include massive haemorrhage, sepsis, diabetes, hypertension, cardiac disease, peripheral vascular disease, chronic renal impairment and age. Understanding epidemiology, aetiology and pathophysiology can aid effective diagnosis and management. A consensus definition for acute renal failure has recently been developed. It relates to deteriorating urine output, serum creatinine and glomerular filtration rate. In the surg...

  17. Danish Guidelines for Lipid-lowering Treatment in Patients with Chronic Renal Failure

    DEFF Research Database (Denmark)

    Dieperink, Hans; Christensen, Jeppe Hagstrup; Feldt-Rasmussen, Bo;

    2014-01-01

    Measurement of lipid profile in adults with CKD 1-5: We recommend measuring the lipid profile (T cholesterol, LDL cholesterol, HDL cholesterol and triglycerides) in all adults with newly diagnosed CKD 1-5 (including patients in renal replacement therapy). Monitoring of lipid profile in adults with...

  18. Danish guidelines for lipid-lowering treatment in patients with chronic renal failure

    DEFF Research Database (Denmark)

    Dieperink, Hans; Christensen, Jeppe Hagstrup; Feldt-Rasmussen, Bo;

    2014-01-01

    Measurement of lipid profile in adults with CKD 1-5: We recommend measuring the lipid profile (T cholesterol, LDL cholesterol, HDL cholesterol and triglycerides) in all adults with newly diagnosed CKD 1-5 (including patients in renal replacement therapy). Monitoring of lipid profile in adults with...

  19. SURGICAL TREATMENT OF VALVULAR DISEASE IN PATIENTS WITH END STAGE CHRONIC RENAL FAILURE AND RENAL TRANSPLANT RECIPIENTS. DEVELOPMENT OF AN OPERATION PROTOCOL AND POSTOPERATIVE CARE

    Directory of Open Access Journals (Sweden)

    M. L. Semenovsky

    2009-01-01

    Full Text Available Patients with terminal stage of chronic renal failure (CRF, treated by chronic hemodialysis, constitute severe group of patients whose cardiac valve replacement represents a separate problem. This article focuses on analysis of experience of 28 operations of cardiac valves replacement at the patients, suffering terminal stage of CRF taking into account international studies data. Isolated one valvular (mitral or aortic replacement was performed in 22 cases, including one repeated mitral valve replacement; in 4 cases – two valvular replacement, including in a combination with coronary artery bypass grafting in 1 case, and in 2 cases replacement of the ascending aorta and aortic valve. At the hospital 2 patients (7,4% died. In the remote period from the valve dependent complications 1 (3,7% patient died, and 4 (14,8% – from the non cardiac reasons. In 6 cases soon after operation kidney transplantation with good function of a transplant was performed, and in 4 cases transplantation of a kidney preceded heart operation. 

  20. EFFECTS OF CORDYCEPS SINENSIS PREPARATION ON BODY PROTEIN AND AMINO ACID METABOLISM IN PATIENTS AND RATS WITH CHRONIC RENAL FAILURE

    Institute of Scientific and Technical Information of China (English)

    朱淳; 刘强; 左静南; 朱汉威; 马济民

    2002-01-01

    Objective To study the effects of Cordyceps sinensis (CS) on the metabolism of body protein and intra-extracellular amino acids in patients with chronic renal failure( CRF) , and on the rates of protein synthesis in rats with CRF. Methods In patients with CRF, free amino acid concentrations in plasma and skeletal muscle before and after CS treatment were measured by the LKB-4400 amino acid automatic analytical instrument and the changes of body protein metabolism were observed by the method of 15 N-labeled glycine.Meanwhile, the rates of protein synthesis in liver ( SL % /d ) and muscle (SM%/d) of rats with CRF were determinedd by 3f-phenylalanine radioactive tracer. Results After patients with CRF were treated by CS, the Leu, lie, Thr , Lys, Cys, Tyr concentrations in plasma approached the normal levels. In one sample of skeletal muscle the Thr and Lys concentrations approached the normal, whereas both the intracellular and extracellular Val concentrations were still remarkably decreased as compared with the normal controls. Moreover, the nitrogen flow rate (Q) , rates of protein synthesis (S) and catabolism ( C) , and amino nitrogen utilization ratio (S/Q) in patients with CRF and the SL % /d and SM%/d in rats with CRF were significantly increased as compared with those before CS treatment. Conclusion CS can notably improve the amino acid metabolism, promote the body protein synthesis in patients with CRF , and increase the rates of SL % /d and SM%/d in rats with CRF.

  1. Recombinant human growth hormone treatment, using two dose regimens in children with chronic renal failure--a report on linear growth and adverse effects

    DEFF Research Database (Denmark)

    Hertel, Niels Thomas; Holmberg, Christer; Rönnholm, Kai A R;

    2002-01-01

    The aim of this study was to study the efficiency and the adverse effects of 2 or 4 IU/m2/day of growth hormone (GH) in the first year and 4 IU/m2/day in the second. Of 29 growth-retarded children with chronic renal failure (CRF) (aged 3.4-15.1 years), 23 completed the first year of therapy, and 16...

  2. Serum ferritin in normal individuals and in patients with malignant lymphoma and chronic renal failure measured with seven different commercial immunoassay techniques.

    OpenAIRE

    Grail, A; Hancock, B W; Harrison, P. M.

    1982-01-01

    A comparison of serum ferritin determination by seven different commercial immunoassay techniques gave mean coefficients of variation of 57% for normal individuals, 41 . 4% for patients with malignant lymphoma and 43 . 1% for patients with chronic renal failure. One of the immunoradiometric assays gave consistently higher serum ferritin values in both normal and patient groups; mean values were increased (greater than 100% for normal males, greater than 50% for normal females) with respect to...

  3. THE NARRATIVE OF A CHRONIC RENAL FAILURE CLIENT: ORAL HISTORY AS RESEARCH STRATEGY

    Directory of Open Access Journals (Sweden)

    Luciana Schleder Gonçalves Kobus

    2004-08-01

    Full Text Available The objective of this research was to understand the meanings of the failure kidney for a client whofor twelve years is in hemodialisys treatment. The study was developed from November, 2002 through March,2003.The Oral History as a research strategy showed the following categories: The failure kidney sick diagnosticdiscovery and the routine with it; The hemodialisy treatment and its limitation; The concerns about self image; Thehopeness for a kidney transplant; The relationship with health professionals team; The family support; Newprojects of life; Attempts to feel itself useful. The patient’s narrative showed how difficult is the treatment, dealingchallenges daily, discoveries and hopes, a constant effort to fight against the limits, but demonstrating capacity toexceed the suffering. It was evident the positive and trustful relationship established with the health professionalteam, strengthening its social and ethical commitment in co-responsibility relationship, involvement, cooperation,consensus, dialogue and participative feelings. This study presents how important is to perceive each person as asingular one and the way that this person lives and deals with illness situation.

  4. Imipenem-induced clostridium difficile diarrhea in a patient with chronic renal failure

    Directory of Open Access Journals (Sweden)

    R Enríquez

    2011-01-01

    Full Text Available An 80-year-old man was diagnosed to have pneumonia and advanced chronic kidney disease. He presented with anuria and hemodialysis, by temporary femoral catheter, was initiated. He was empirically treated with imipenem/cilastatin 500 mg/24 h after hemodialysis. After 10 days of antibiotic intake, he developed severe diarrhea. Diagnosis of Clostridium difficile (CD-associated diarrhea was confirmed by detection of the toxins A and B in his stool. Imipenem therapy was discontinued; Vancomycin 500 mg orally every 6 h and 1000 mg per rectum every day was added. After two weeks of this treatment, the patient reported complete resolution of the diarrhea and stool samples were negative for Clostridium toxin. In this case, the most possible cause of CD colitis was considered to be imipenem because of the temporal relationship between exposure to the drug and onset of symptoms.

  5. Modelo cirúrgico de insuficiência renal crônica: estudo em coelhos Surgical model of chronic renal failure: study in rabbits

    Directory of Open Access Journals (Sweden)

    Andrei Ferreira Nicolau da Costa

    2009-02-01

    Full Text Available OBJETIVO: Estabelecer um modelo de insuficiência renal crônica (IRC em coelhos, com perspectivas de seu uso para ações terapêuticas e reparadoras. MÉTODO: Foram utilizados 19 coelhos da linhagem Nova Zelândia, machos, adultos, aleatoriamente distribuídos em três Grupos: Grupo 1 - Controle (n =5, Grupo 2- Simulação (n =7, Grupo 3 - Experimental (n =7. Os animais foram anestesiados com Cetamina e Diazepam e Fentanil por via intramuscular e Sevorane, através de vaporizador. No Grupo 3 realizou-se uma nefrectomia bipolar esquerda e após quatro semanas, uma nefrectomia direita. Todas as amostras do parênquima renal foram pesadas. O Grupo 2 foi submetido a duas laparotomias, sem nefrectomia.. Em todos os grupos foram realizadas avaliações: bioquímicas com dosagens de uréia, creatinina, sódio e potássio; ultra-sonográficas abdominais; cintigráficas e histológicas. RESULTADOS: No Grupo 3 houve aumento progressivo da uréia (p=0.0001, creatinina (p=0,0001, sódio (p= 0,0002 e potássio (p=0,0003. A comparação destes resultados com os dos Grupos 1 e 2, nos diversos intervalos, também revelou elevação sérica, com significância estatística (p OBJECTIVES: To establish a model of chronic renal failure in rabbits, with perspectives of its use for therapeutic and repairing actions. METHODS: Nineteen males, adults rabbits (New Zealand randomly distributed into three groups were used: Group 1 - Control (n =5; Group 2-Sham (n =7; and Group 3 - Experimental (n =7. They were anaesthetized by using intramuscular Cetamine, Diazepam and Fentanyl followed by Sevorane with vaporizer device. In Group 3, a bipolar left nephrectomy was carried out and after four weeks, it was also done a right nephrectomy. All the samples of the renal tissue were weighed. The Group 2 was only submitted to both abdominal laparotomies, without nephrectomy. Biochemical evaluations, with urea, creatinina, sodium and potassium measurement; abdominal ultrasound scan

  6. Cardiac antiapoptotic and proproliferative effect of recombinant human erythropoietin in a moderate stage of chronic renal failure in the rat

    Directory of Open Access Journals (Sweden)

    M Teixeira

    2012-01-01

    Full Text Available Objective: Recombinant human erythropoietin (rhEPO therapy under circumstances of moderate chronic renal failure (CRF, with yet lower kidney and heart lesion, may have a protective cardiac effect beyond the correction of anemia, whose mechanism deserves better elucidation, namely by clarifying the impact on gene expression profile of markers of apoptosis, inflammation, proliferation, angiogenesis, and lesion/stress in the heart. Materials and Methods: Four groups of rats were studied over a period of 15 weeks (n=7 each: control-without surgery and without drug treatment; rhEPO-treated with 50 IU/kg/week of rhEPO-beta; CRF-submitted to partial nephrectomy (3/4; CRF + rhEPO-CRF with rhEPO treatment after the 3rd week of surgery. The heart was collected in order to evaluate the gene expression, by real-time qPCR, of markers of apoptotic machinery, inflammation/immunology, proliferation/angiogenesis, and lesion/stress. Results: The main findings obtained were (a CRF rats have demonstrated overexpression of EPO-R in the heart without changes on EPO expression, together with overexpression of Bax/Bcl2 ratio, PCNA, and IL-2; (b rhEPO therapy on the heart of the rats with CRF induced by partial 3/4 nephrectomy promoted nonhematopoietic protection, demonstrated by the apoptosis prevention, viewed by the Bax/Bcl2 balance, by the promotion of proliferation, due to PCNA increment, and by the immunomodulatory action, expressed by a trend to prevent the IL-2 increment. Conclusion: In this model of moderate CRF, rhEPO treatment showed important cardiac nonhematopoietic effects, expressed mainly by the antiapoptotic and the proproliferative action, suggesting that early rhEPO therapy in moderate stages of CRF might have further therapeutic benefits.

  7. Effect of probiotics on human blood urea levels in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Paola Vanessa Miranda Alatriste

    2014-03-01

    Full Text Available Introduction: Patients with chronic kidney disease (CKD show an increase in bowel aerobic bacteria that produce uremic toxins and decreased anaerobic bacteria as bifidobacteria and lactobacillus. The latter can be used as probiotics. The probiotic with greater availability in Mexico, is the lactobacillus casei shirota (LcS, currently there is no known LcS specified dose that produces a benefit to the patient with CKD. Objective: To determine the effectiveness of two different LcS doses in achieving a decrease in urea concentrations of at least 10% in patients with KDOQI stage 3 and stage 4 CKD. Metodology: A simple randomized, controlled clinical trial. Outpatients treated at the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico D.F. Patients were provided the LcS, as follows: Group A: 8 x 10(9 colony-forming units (CFU and Group B: 16 x 10(9 CFU. Patients were followed-up for eight weeks, and baseline and final samples were obtained to calculate the basal and final concentrations, respectively, of blood urea and serum creatinine (CrS. During the follow-up, both groups consumed a diet of 30 kcal/kg/weight and 0.8 g/kg/weight of protein, and a food diary was made to assess both the adherence to the diet and LcS. Results: Thirty patients with CKD were evaluated. When analyzing the percentage change between the different doses, a decrease > 10% was found in the blood urea concentrations for patients treated with the 16 x 10(9 dose, which was significant with respect to the baseline measurement. Conclusion: There was a > 10% decrease in the serum urea concentrations with LcS in patients with stage 3 and 4 CRF.

  8. Synchronous Urolithiasis in Orthotopic and Left to Right Crossed Ectopic Kidneys, without Fusion, presenting as Acute on Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    P. N. DOGRA, MS, MCh

    1999-07-01

    Full Text Available Presented here is a case of20 year old male with multiple calculi in orthotopic as well as in left toright crossed ectopic kidney without fusion, causing obstructive uropathy, leading to progressiverenal failure and uraemia, thus posing a challenge in management. After pre-operative preparationwith repeated haemodialysis, a complete clearance of stones from both kidneys was accomplishedat one operation. The post-operative course was uneventful with considerable improvement andstablization in renal functional status.

  9. 慢性肾衰竭与骨质疏松的相关因素分析%Analysis of correlation factors between chronic renal failure and osteoporosis

    Institute of Scientific and Technical Information of China (English)

    李桂英; 肖太玲; 秦燕

    2011-01-01

    Objective To study the osteoporosis condition of patients with middle and advanced stages of chronic renal failure, and to explore the correlation between osteoporosis and age, gender, body mass index,chronic renal failure, and the clinical manifestations.Methods 1 ) Dual energy X-ray absorptiometry was used to measure the bone mineral density (BMD) of the lumbar vertebra ( L1-L4), the femoral neck,Ward's triangle, and the femoral trochanter in 134 patients with chronic renal failure and in 154 controls.The case-control analysis was used to show the effect of chronic renal failure on the incidence of osteoporosis.2) Logistic multiple regression analysis was used to analyze the contributions of chronic renal failure, age,gender, and body mass index to the incidence of osteoporosis.Results 1) The incidence of osteoporosis in patients with chronic renal failure (85.3%) was significantly higher than in controls (41.2%),respectively; 2) By stage observation of chronic kidney disease (CKD) , the incidence of osteoporosis was positively correlated with the extent of renal failure ( P < 0.01 ) in the patients with stages 3,4, and 5 CKD;3 ) Osteoporosis was positively correlated with age and chronic renal failure, negative correlated with body mass index.The influence of chronic renal failure, gender, age, and body mass index to osteoporosis was statistically significant; 4) The occurrence of osteoporosis and bone loss in the femoral neck, Ward's triangle, and the femoral trochanter were higher than those in the lumbar vertebra (P < 0.01 ).Conclusion Chronic renal failure is an important predisposing factor of osteoporosis.The Ward's triangle can be used as the first detecting location for early diagnosis of osteoporosis.%目的 研究慢性肾衰竭中晚期患者骨质疏松情况,探讨骨质疏松与年龄、体重指数、性别及慢性肾衰竭的相关性及骨质疏松表现.方法 ①采用双能X线骨密度仪测定腰椎正位(L1~L4)和股骨颈

  10. High prevalence of nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent

    DEFF Research Database (Denmark)

    Rydahl, Casper; Thomsen, Henrik S; Marckmann, Peter

    2008-01-01

    OBJECTIVE: Nephrogenic systemic fibrosis (NSF) is a serious disease affecting renal failure patients. It may be caused by some gadolinium (Gd)-containing contrast agents, including gadodiamide. The study aimed at estimating the prevalence of NSF after gadodiamide exposure for patients with chronic......%, 95% CI: 6%-15%) were diagnosed with NSF within a mean follow-up period of 29 months (range 16-43 months). All 18 cases had stage 5 CKD (ie, estimated glomerular filtration rate less than 15 mL/min/1.73 m2 or in dialysis therapy) at the time of their gadodiamide exposure. The prevalence of NSF among...

  11. Nursing care of chronic renal failure and multiple organ failure patients%慢性肾衰及并发多脏器功能衰竭患者的护理

    Institute of Scientific and Technical Information of China (English)

    陈慧玉

    2011-01-01

    目的 探讨护理在肾衰及并发多脏器功能衰竭治疗中的作用.方法 对慢性肾衰及并发多脏器功能衰竭30例患者在正常治疗的同时配合以综合、饮食及心理护理.结果 29例患者积极配合治疗,1例患者因经济原因放弃治疗,治疗过程中无严重不良反应.结论 对慢性肾衰及并发多脏器功能衰竭患者在正常治疗的同时配合以综合、饮食及心理护理,极大地提高了患者的生活质量.%Objective To investigate the nursing care of chronic renal failure and multiple organ failure. Methods From Jun, 2008 to May 2010, 29 patients of chronic renal failure and multiple organ failure were involved in the present study. The synthesizing nursing, diet guidance,and psychological education were completed with regulate treatment. Results Twenty- nine patients coordinated to treatment positively, and one of them gave up treating because of economic reason, the others did not suffer serious adverse reactions. Conclusion The life quality of chronic renal failure and multiple organ failure patients enormously improved by synthesizing nursing, diet guidance, psychological education and regulated treatment.

  12. [Ultrasonographic study on kidneys in patients with chronic renal failure. Part II. Acquired cystic disease of the kidneys].

    Science.gov (United States)

    Yamaguchi, S; Fujii, H; Kaneko, S; Yachiku, S; Anzai, T; Inada, F; Kobayashi, T; Furuta, K; Ishida, H

    1990-08-01

    Ultrasonic examination of the kidney was performed on 280 patients undergoing chronic dialysis. Acquired cystic disease of the kidney (ACDK) was detected in 107 of 529 kidneys (20.2%). This paper presents an analysis of ultrasonotomograms of ACDK. Ultrasonic measurement of the size of ACDK was 72.5 +/- 15.2 mm in length and 41.7 +/- 9.8 mm in thickness. The size of ACDK was significantly greater than that of contracted kidneys by ultrasonographic diagnosis. With regard to sex distinction the length and thickness of ACDK were significantly greater in males than in females. As for laboratory data, patients with ACDK showed significantly higher values of red blood cell count, hematocrit and serum creatinine concentration compared with contracted kidneys. Prolongation of the dialysis peirod increased the incidence of ACDK. The size of ACDK showed a tendency to increase with duration of dialysis. However, no correlation was noted statistically between the incidence of ACDK and duration of dialysis and between the size of ACDK and duration of dialysis. There was a significantly lower incidence of ACDK in patients with diabetic nephropathy than those with chronic glomerulonephritis. A sonographic feature of ACDK is irregularity of the renal contour because of cystic transformation. Renal imaging, identification of the corticomedullary border, identification of the central echoes and increased parenchymal echogenicity were similar to other dialyzed kidneys. The main complications of ACDK are hemorrhage and tumor formation. We observed two retroperitoneal hematomas and one renal cell carcinoma developed within two years after this examination. The incidence of complications of ACDK was 5.1 per cent. We believe that patients with ACDK should be watched carefully by regular ultrasonic examination for early diagnosis and treatment of these complications. PMID:2232409

  13. COMPARED VALUES OF URINARY AND PERITONEAL FRACTIONAL EXCRETION OF MAGNESIUM AND PHOSPHORUS AMONG PATIENTS ON PERITONEAL DIALYSIS WITH RESIDUAL DIURESIS, CHRONIC RENAL FAILURE (STAGE III AND HEALTHY VOLUNTEERS

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    Musso CG

    2012-09-01

    Full Text Available Background: Magnesium and phosphorus are one of the electrolytes whose balance is altered during advanced chronic renal failure (CRD-V. It has already been reported in the literature that there is a progressive increase in urinary electrolyte excretion in CRD-V in relation with the glomerular filtration rate reduction, but it has not been extensively studied yet for these divalent ions. Therefore we decided to perform a study for evaluating compared values of urinary and peritoneal fractional excretion of these divalent ions (magnesium and phosphorus among patients on peritoneal dialysis with residual diuresis (CRD-V, stage III - chronic renal failure, and healthy volunteers. Results: Urinary fractional excretion (FEu of magnesium (Mg and phosphorus (P were significantly (p= < 0.05 lower in healthy volunteers (FEuMg: 3 ± 1%, FEuP: 9 ± 0.5%, and significantly higher in CRD-V (FEuMg: 30 ± 4%, FEuP: 40 ± 0.2%. Regarding peritoneal fractional excretion (FEp of magnesium and phosphorus, they were significantly higher (p= < 0.05 (FEpMg: 36 ± 5%, FEpP: 62 ± 9% than the urinary ones in the same population: CRD-V. Conclusion: Magnesium and phosphorus urinary fractional excretion values were significantly higher in the CRD-V group, while these values were significantly lower than the peritoneal ones in the same population: CRD-V.

  14. Chronic Renal Failure Self Management Behavior Scale Formulation%慢性肾功能衰竭自我管理行为量表的制定

    Institute of Scientific and Technical Information of China (English)

    寇琳; 官计; 张娅

    2011-01-01

    Objective: To make chronic renal failure self management behavior scale,And guidance in clinical .Method: Testing 60 chronic renal patients and 28 normal person as control group with a previously made well scale.Inspect the scale formulation, credibility and various effective degrees, analysis and develop chronic renal self management behavior scale.Results: The composite scores of the chronic renal patients and 5 and 6 factor were lower than healthy volunteer group, and the scores of the first, second, third, fourth factor were higher than healthy volunteers group.The factor scores by comparison, t test, P<0.05, the difference was statistically significant.Total Cronbach alpha coefficient was 0.7062, and their symptoms change factor alpha coefficient was 0.6569, and psychological factors alpha coefficient was 0.7952, life factors alpha coefficient was 0.5341, the understanding of chronic renal failure factor alpha coefficient was 0.6875, and the doctor's exchange factor alpha coefficient was 0.7543, the social help factor alpha coefficient was 0.8904. Conclusion: Scale validity, reliability, entries and factors of the results revealed that the disease, doctor's help, understanding social help and etc, and chronic renal failure patients need outside support.%目的:制定慢性肾功能衰竭自我管理行为量表并指导于临床.方法:选用预先制定好的量表对我院60 例慢性肾功能患者和作为对照组28 位正常患者,进行试验.对量表各条目的制定、可信度、有效度进行检验,分析并制定慢性肾功能自我管理行为量表.结果:慢性肾功能患者组的综合得分及第五、第六因子的得分比健康志愿组低,而第一、第二、第三、第四因子的得分高于健康志愿者组.各因子综合得分比较,经t检验,P<0.05,差异有统计学意义.总Cronbach,α系数是0.7062,自身症状变化因子α系数为0.6569,心理因素因子α系数为0.7952,生活因素因子α系数为0.5341,对慢

  15. Niacin as potential treatment for dyslipidemia and hyperphosphatemia associated with chronic renal failure: the need for clinical trials.

    Science.gov (United States)

    Ahmed, Mohamed H

    2010-06-01

    Niacin has profound and unique effects on lipid metabolism. In addition to increasing high-density lipoprotein cholesterol, it is also known to decrease total cholesterol, low-density lipoprotein cholesterol, and triglyceride. Interestingly, the plasma concentration of lipoprotein(a) [Lp(a)], which has been suggested to play a role as an independent risk factor for coronary heart disease, is also decreased by niacin. Therefore, it is not surprising that in the literature it was given unique description as broad-spectrum lipid drug. Its impact is referred to as desirable normalization of a range of cardiovascular risk factors. However, its clinical use is limited due to harmless but unpleasant unique side effect of cutaneous flushing. Interestingly, recent experimental and clinical studies suggest the potential benefit of niacin as a treatment of dyslipidemia and high plasma phosphate associated with chronic kidney disease (CKD). Both dyslipidemia and high serum phosphate levels are shown to be associated with higher cardiovascular mortality. Furthermore, niacin administration improves renal tissue lipid metabolism, renal function and structure, hypertension, proteinuria, and histological tubulointerstitial injury. Further studies are required before the use of niacin for the treatment of both dyslipidemia and hyperphosphatemia with CKD advocated. PMID:20486851

  16. Acute renal failure in rats

    International Nuclear Information System (INIS)

    It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40% (20-130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130% (70-350) after metrizoate, by 220% (50-380) after ioxaglate, by 290 % (60-420) after iopamidol and by 160% (50-330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure. (orig.)

  17. 慢性肾衰竭的四诊客观化研究进展%Objectification Progress of Four Diagnostic Methods of Chronic Renal Failure(CRF)

    Institute of Scientific and Technical Information of China (English)

    张宇; 金亚明; 王忆勤

    2013-01-01

    Traditional Chinese Medicine ( TCM ) four diagnostic methods (inspection, auscultation - olfaction, interrogation and palpation) ,are the basis of syndrome differentiation and treatment, and the objectification of four diagnostic methods is an effective approach to develop the TCM. Nowadays,researchers have observed and summarized significant a-mount of four diagnostic methods information against different types of diseases, and then objectified the four diagnostic methods through the analysis and research by using modern information technology. CRF is one of the late - stage clinical disorders of various types of chronic kidney diseases. This paper summarized the current situation of inspection, auscultation - olfaction, interrogation and palpation objectification researches about chronic renal failure within last two decades, proved the four diagnostic methods objectification development of CRF, which is meaningful for syndrome differentiation and prognosis of chronic renal failure.%中医四诊信息——“望、闻、问、切”是辨证论治的基础,而四诊客观化更是发展中医的一种有效途径.目前,学者们对大量疾病四诊信息进行观察总结,并利用现代信息技术进行分析研究,实现四诊客观化.慢性肾衰竭是各种慢性肾脏疾病后期的一种临床病症,综述了近20年来慢性肾衰竭在中医望闻问切四方面的客观化研究现状,发现慢性肾衰竭的四诊客观化取得了很大的进展,对慢性肾衰竭的辨证及预后产生了一定的意义.

  18. A RETROSPECTIVE STUDY ON THE POTENTIAL DRUG INTERACTION BETWEEN ANGIOTENSIN CONVERTING ENZYME INHIBITOR OR ANGIOTENSIN RECEPTOR ANTAGONIST AND OTHER DRUGS IN END-STAGE CHRONIC RENAL FAILURE PATIENTS

    Directory of Open Access Journals (Sweden)

    Honey Iskandar

    2012-10-01

    Full Text Available Increasing number of chronic renal failure (CRF patients had reflected an increase in the number of patients with diabetes and hypertension. Therefore, health practitioners would be faced with management of complicated medical problems for the patients of chronic renal disease. In this way, various complications of chronic renal failure would lead to polypharmacy, where the patients receive three to five drugs in a dose. Development of polypharmacy had made the potential of drug interaction greater. The objective was to determine whether CRF patients admitted to hospital with specific adverse drug reactions were likely to have been prescribed with interacting drugs. Retrospective study was designed. The study was conducted at the General Practice Rooms Floor 1 – Floor VI of Central Army Hospital Gatot Soebroto Jakarta. The study was conducted from December 2011 – February 2012. The data were collected in a retrospective way for a year (January – December 2011. End-stage CRF patients who were having hemodialysis therapy and receiving ACE Inhibitor drugs or Angiotensin II Receptor Antagonist (AIIRA and receiving treatment at the General Practice Rooms at Central Army Hospital Gatot Soebroto Jakarta. During the period of January – December 2011, 84 patients were treated with end-stage CRF at the Central Army Hospital and having routine hemodialysis and 44 patients were receiving therapy with ACE Inhibitor and AIIRA. Other drugs simultaneously given with ACE Inhibitor and AIIRA were captopril-spironolactone, captopril-aspirin, captopril-allopurinol, captopril-KSR, captopril-furosemide, lisinopril-furosemide and valsartan-mefenemic acid. An increase in adverse effects of the drugs was found based on the clinical evaluation and laboratory examination. The adverse effects included hyperkalemia (9,09%, decrease in anti-hypertension effect (6,8%, acute hypotension (40%, and declining renal function (11,36%. The study identifies drug interaction

  19. Study on Effect of Baoyuan Qiangshen (保元强肾) Capsule No. Ⅱ on Tubular Interstitial Injury in Chronic Renal Failure Patients

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To explore the protective effect of Baoyuan Qiangshen Capsule No. Ⅱ (BYQS) and its mechanism in treating chronic renal failure (CRF). Methods: Sixty CRF patients were divided into 2 groups randomly, the treated group used BYQS combined with Lotensin and the control group administered with essential amino acid combined with Lotensin. Changes of renal functions and tubular labelled proteins were observed. Results: The markedly effective rate and total effective rate of the treated group were 63.3% and 93.3% respectively, and those of the control group were 30.0% and 56.7% respectively, the effect of the treated group was obviously better than that of the control group (P<0.01). In the treated group after medication, blood urea nitrogen, serum creatinine and clearance rate of creatinine were improved significantly (P<0.01), while Tamm-Horfau protein increased significantly (P<0.01). Conclusion: BYQS could alleviate tubular interstitial injury significantly so as to improve the renal function and enhance the effective rate in treating CRF.

  20. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    Directory of Open Access Journals (Sweden)

    Schols Jos MGA

    2008-05-01

    Full Text Available Abstract Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD, congestive heart failure (CHF and chronic renal failure (CRF continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will

  1. Malaria induced acute renal failure: A single center experience

    International Nuclear Information System (INIS)

    Malaria has protean clinical manifestations and renal complications, particularly acute renal failure that could be life threatening. To evaluate the incidence, clinical profile, ou come and predictors of mortality in patients with malarial acute renal failure, we retrospectively studied the last two years records of malaria induced acute renal failure in patients with peripheral smear positive for malarial parasites. One hundred (10.4%) (63 males, 37 females) malaria induced acute renal failure amongst 958 cases of acute renal failure were evaluated. Plasmodium (P). falciparum was reported in 85%, P. vivax in 2%, and both in 13% patients. The mean serum creatinine was 9.2 ± 4.2 mg%, and oligo/anuria was present in 82%; 78% of the patients required hemodialysis. Sixty four percent of the patients recovered completely, 10% incompletely, and 5% developed chronic kidney failure; mortality occurred in 21% of the patients. Low hemoglobin, oligo/anuria on admission, hyperbilirubinemia, cerebral malaria, disseminated intravascular coagulation, and high serum creatinine were the main predictors of mortality. We conclude that malaria is associated with acute renal failure, which occurs most commonly in plasmodium falciparum infected patients. Early diagnosis and prompt dialysis with supportive management can reduce morality and enhance recovery of renal function (Author).

  2. Expression of TLR4 protein is reduced in chronic renal failure: evidence from an experimental model of nephron reduction.

    Science.gov (United States)

    Kacsó, Ina Maria; Borza, Gabriel Mircea; Ciuce, Cătălin C; Bîrsan, Andrei; Apostu, Raluca Cristina; Dindelegan, George Călin; Bondor, Cosmina Ioana; Potra, Alina Ramona; Netea, Mihai G; Cătoi, Cornel

    2015-01-01

    Toll-like receptor 4 (TLR4) signaling is involved in various acute and chronic renal lesions and contributes to inflammation and fibrosis in several organs; the latter are important determinants to the progression of chronic kidney disease (CKD). We aimed to assess TLR4 expression in progressive CKD and relate it to severity of kidney damage, using an experimental nephron reduction model. Male Wistar rats were subjected to subtotal nephrectomy using the ligation technique, after 12 weeks of observation, serum creatinine and proteinuria were determined, animals were sacrificed, glomerulosclerosis and interstitial scarring were quantified histologically, and TLR4 expression was assessed by immunohistochemistry. Sham-operated rats served as controls. Case animals had significantly higher creatinine, proteinuria, glomerulosclerosis and tubulointerstitial involvement. TLR4 expression was prominent in proximal tubes, less staining was observed on infiltrating inflammatory cells. Percentage of TLR4-positive tubes was reduced in the subtotal nephrectomy animals, when compared to controls (0.67±0.09 versus 0.79±0.07, p=0.003). Percentage of TLR4-positive tubes correlated inversely to markers of kidney damage: to proteinuria (r=-0.55, p=0.02), serum creatinine (r=-0.53, p=0.01); percentage of glomeruli with glomerulosclerosis (r=-0.54, p=0.01) and tubulointerstitial score (r=-0.36, p=0.01). As TLR4 staining appears in tubular casts only in nephrectomy animals, shedding from damaged tubular cells is a very likely explanation for the reduced TLR4 expression in the kidneys of subjects with experimental nephron reduction. PMID:25826492

  3. Metastatic calcification demonstrated by Tc-99m HMDP chest SPECT imaging in patients with chronic renal failure and long-term dialytic treatment

    International Nuclear Information System (INIS)

    Chest SPECT using Tc-99m HMDP is the most suitable method assessing early metastatic calcification of the lung. In 68 chronic renal failure patients, the images were obtained by using 3 detecting element type camera. The positive rate with planar image was 14.7%. The positive rate of the case showing higher accumulation of Tl in lung field than in heart pool and was strongly suspected as calcification, was 48.5% in SPECT image, and the case showing similar accumulation between lung field and heart pool, was 44.1%. In the cases of diffuse accumulation in all lung (8 cases), i-PTH was less than 65 pg/ml (normal level), and in the case of anomaly cumulus (5 of 6 cases), i-PTH was also less than 65 pg/ml. (K.H.)

  4. Hemodynamics, functional state of endothelium and renal function, platelets depending on the body mass index in patients with chronic heart failure and preserved systolic function

    Directory of Open Access Journals (Sweden)

    Kushnir Yu.

    2014-03-01

    Full Text Available The aim of the study was to evaluate hemodynamics, endothelium function of kidneys and platelets depending on the body mass index (BMI in patients with chronic heart failure (CHF and preserved systolic function. 42 patients (mean age - 76,690,83 years with CHF II-III FC NYHA with preserved systolic function (LVEF>45% were enrolled. Echocardiography was performed, endothelial function, serum creatinine levels and microalbuminuria were determined in patients. BMI and glomerulation filtration rate were calculated by formulas. The morphological and functional status of platelets was estimated by electronic microscopy. It was defined that increased BMI in patients with CHF and preserved systolic function determines the structural and functional changes of the myocardium and leads to the endothelial and renal functional changes. An increased risk of thrombogenesis was established in patients with overweight and obesity.

  5. Twenty-one-year-old male with congenital anomalies, obstructive uropathy and chronic renal failure: is this a case of Townes Brocks syndrome?

    Science.gov (United States)

    Unuigbe, E I; Azubike, C A; Okaka, E I; Osarenkhoe, J O; Onuora, V C

    2007-03-01

    Townes Brocks syndrome is an autosomal dominant multiple malformations syndrome comprising of ear anomalies/hearing loss, limb defects, anal, genitourinary, eye, spine anomalies, heart defects and sometimes mental retardation. This report presents the case of a 21-year-old secondary school leaver as a likely case of Townes-Brocks syndrome. He was born with congenital abnormalities consisting of fixed flexion deformities of hands, wrist and elbows, urethral meatal stenosis, scoliosis and aortic stenosis. He was diagnosed with obstructive uropathy at the age of 19 years and subsequently developed chronic renal failure. The report aims to highlight the need for early recognition of potentially preventable conditions, which, if left unattended to, can lead to unnecessary fatality. PMID:17668723

  6. Acute renal failure due to rhabdomyolyisis

    Directory of Open Access Journals (Sweden)

    Nieto-Ríos, John Fredy

    2016-04-01

    Full Text Available Acute renal failure is a frequent cause of morbidity and mortality in emergency, hospitalization and critical care services. In 15 % of cases it is due to rhabdomyolysis, in which there is breakdown of skeletal muscle with massive necrosis and leakage of muscle cell contents into the circulation. It has many different etiologies. The rhabdomyolysis-induced acute kidney injury results from the combination of several mechanisms, including tubular obstruction, vasoconstriction and oxidative stress. The most important therapeutic measures are: Aggressive repletion of fluids, forced diuresis and avoidance of exposure to nephrotoxic substances. In cases of severe uremia, metabolic acidosis, hiperkalemia or fluid overload it is necessary to start renal replacement therapy. As a rule, kidney function is completely recovered, but these patients have higher risk of future chronic kidney disease.

  7. Treatment of renal failure in neonates.

    OpenAIRE

    Meeks, A C; Sims, D G

    1988-01-01

    Thirty neonates with acute renal failure were studied, 27 of whom died (90%) including nine of 12 treated by peritoneal dialysis. Three main aetiological groups were identified. Septicaemia was a principal cause of late onset acute renal failure, with an incidence equal to that of serious perinatal disorders. It is recommended that tolazoline should be used with caution in the treatment of hyperkalaemia as it may have a role in the aetiology of acute renal failure, the incidence of which is i...

  8. Intoxicação por carambola em paciente com insuficiência renal crônica: relato de caso Star fruit intoxication in a chronic renal failure patient: case report

    Directory of Open Access Journals (Sweden)

    Fábio Gonzaga Moreira

    2010-12-01

    Full Text Available A insuficiência renal crônica é doença de elevada morbidade e mortalidade e sua incidência e prevalência em estágio terminal têm aumentado progressivamente a cada ano. Segundo a Sociedade Brasileira de Nefrologia, as principais causas de insuficiência renal crônica são hipertensão arterial, glomerulonefrite e diabetes mellitus. Diversos fatores elevam o risco de mortalidade em pacientes com nefropatia crônica, principalmente idade, presença de diabetes e número de comorbidades associadas. Para pacientes com menos de 50 anos de idade a taxa de sobrevida em 5 anos é de 62% e para aqueles acima desta idade e com diagnóstico de diabetes mellitus a sobrevida é de apenas 23%. A carambola, fruta originária da Ásia e muito difundida na maioria dos países tropicais, tem sido reportada como contendo uma neurotoxina capaz de provocar graves alterações neurológicas em pacientes com histórico de nefropatia crônica. Dentre estas alterações podemos observar desde quadros leves, como soluços e confusão mental, até quadros mais sérios, como convulsões e morte. Essa neurotoxina parece apresentar especificamente inibição sobre o sistema de condução GABAérgico. Descrevemos o caso de um paciente nefropata crônico que, após ingestão de carambola, inicia quadro de mal-estar, náuseas e vômitos, seguidos de episódios convulsivos reentrantes e vai a óbito mesmo com o tratamento hemodialítico convencional.Chronic renal failure is a high morbidity and mortality condition, with its terminal phase incidence and prevalence steadily growing year after year. According to the Sociedade Brasileira de Nefrologia [Brazilian Society of Nephrology], the main causes of renal failure are arterial hypertension, glomerulonephritis and diabetes mellitus. Several factors are implied on chronic renal failure patients' risk of mortality, particularly age, diabetes and associated co-morbidities. For patients below 50 years old, the 5 years

  9. 241Am-photonabsorptiometry in patients with chronic renal failure, with particular reference to the effect of 1-alpha-hydroxyvitamin D3

    International Nuclear Information System (INIS)

    The study was undertaken in patients with chronic renal failure (CRF patients) in order to evaluate 1) the degree and course of skeletal demineralization and 2) the effect on the bone mineral content (BMC) of long-term treatment with 1α-hydroxyvitamin D3 (1α(OH)D3). BMC was measured on the radius by 241Am-photonabsorptiometry and the results were corrected for age, sex and bone width. In a cross-sectional study BMC was measured in 191 normal subjects and in 88 renal patients. In a controlled longitudinal trial 22 CRF patients were treated for 25.6 months with 1α(OH)D3, while 22 CRF patients did not receive vitamin D supplements. In non-treated CRF-patients an accelerated bone loss (approx. equal to 3%/year) and a significantly reduced BMC (mean 87.2% of normal) was found. In the 1α(OH)D3 treated patients BMC increased on an average 0.9%/year, significantly different from the continued bone loss recorded in the nontreated control patients. The data indicate that 1) CRF patients via accelerated bone loss develop reduced bone mass, and 2) cessation of this bone loss may be achieved by long-term treatment with 1α(OH)D3. (orig.)

  10. Role of alpha-lipoic acid in the management of anemia in patients with chronic renal failure undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    El-Nakib GA

    2013-08-01

    Full Text Available Gehad A El-Nakib,1 Tarek M Mostafa,2 Tarek M Abbas,4 Mamdouh M El-Shishtawy,3 Mokhtar M Mabrouk,2 Mohammed A Sobh41Mansoura University Hospitals, Mansoura, Egypt; 2Faculty of Pharmacy, Tanta University, Tanta, Egypt; 3Faculty of Pharmacy, Mansoura University, Mansoura, Egypt; 4Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Mansoura, EgyptIntroduction: Anemia associated with chronic kidney disease is a serious complication necessitating expenditure of huge medical efforts and resources. This study investigates the role of alpha-lipoic acid (ALA in end stage renal disease patients undergoing hemodialysis. By the virtue of its antioxidative effects, ALA is expected to act as an erythropoietin (EPO adjuvant, and also has extended beneficial effects on endothelial dysfunction.Methods: Forty-four patients undergoing hemodialysis and receiving EPO were randomized into two groups: the first group received ALA 600 mg once daily for 3 months; while the other group represented the control group. Parameters measured at baseline and at end of study were hemoglobin, EPO doses, EPO resistance index (ERI, iron store indices, malondialdehyde, oxidized low-density lipoprotein (ox-LDL, interleukin-6 (IL-6, tumor necrosis factor-α (TNF-α, and asymmetric dimethylarginine (ADMA, as well as routine laboratory follow-up.Results: EPO doses and ERI were significantly decreased in the treatment group, while they did not change in the control group. Hemoglobin, iron store indices, malondialdehyde, oxidized ox-LDL, IL-6, TNF-α, and ADMA were similar in both treatment and control groups at baseline, and did not change by the end of study period. Likewise, routine laboratory measures were not affected by the treatment.Conclusion: ALA could be used in hemodialysis patients to reduce requirements for EPO. However, larger and longer term studies are required to clarify the exact role of ALA in hemodialysis as well as in pre-hemodialysis patients

  11. Insulin resistance and hyperinsulinaemia in mild to moderate progressive chronic renal failure and its association with aerobic work capacity

    DEFF Research Database (Denmark)

    Eidemak, I; Feldt-Rasmussen, B; Kanstrup, I L;

    1995-01-01

    control subjects with normal renal function were studied. Fasting blood glucose was comparable and in the non-diabetic range in the two groups as was the oral glucose tolerance test. Patients demonstrated hyperinsulinaemia both during fasting (p

  12. Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    1999-01-01

    The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea.......The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea....

  13. Perfil de suscetibilidade a antifúngicos de dermatófitos isolados de pacientes com insuficiência renal crônica Antifungal susceptibility of dermatophytes isolated from patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Cibele Massotti Magagnin

    2011-08-01

    Full Text Available FUNDAMENTOS: As dermatofitoses apresentam alta prevalência na população em geral e, principalmente, em pacientes com insuficiência renal crônica, necessitando tratamento com antifúngicos tópicos e/ou sistêmicos, cuja eficácia precisa ser avaliada. Estudos in vitro para avaliar a ação de antifúngicos são raros, especialmente, em fungos filamentosos. OBJETIVO: Avaliar o perfil de suscetibilidade de diferentes espécies de dermatófitos, isolados de pacientes com insuficiência renal crônica, em relação a nove antifúngicos disponíveis comercialmente para o tratamento de dermatofitoses. MÉTODO: Analisaram-se 26 isolados de dermatófitos de pacientes com insuficiência renal crônica em relação a nove antifúngicos (cetoconazol, ciclopirox olamina, fluconazol, griseofulvina, itraconazol, miconazol, piroctona olamina, terbinafina e tioconazol pelo método de microdiluição em caldo proposto pelo Clinical and Laboratory Standards Institute (CLSI, com modificações para dermatófitos. RESULTADOS: Entre os antifúngicos testados, a terbinafina e o tioconazol obtiveram os melhores resultados de sensibilidade e o fluconazol apresentou baixa atividade, especialmente para as amostras da espécie M. gypseum. O ciclopirox olamina, apesar de menos eficaz que a terbinafina, também mostrou resultados satisfatórios. CONCLUSÕES: De modo geral, o perfil de sensibilidade dos antimicóticos testados seguiu o padrão de resultados mostrados por estudos anteriores, ratificando a necessidade de conhecimento da espécie causadora de dermatofitose, devido à variação do perfil de suscetibilidade entre as espécies. Além disso, nossos resultados demonstram a importância da realização de ensaios de sensibilidade in vitro, pois alguns isolados da mesma espécie apresentaram diferente perfil de sensibilidadeBACKGROUND: The prevalence of dermatophytosis in the general population is high, particularly in patients with chronic renal failure

  14. Lipopolysaccharide-induced acute renal failure in conscious rats

    DEFF Research Database (Denmark)

    Jonassen, Thomas E N; Graebe, Martin; Promeneur, Dominique;

    2002-01-01

    In conscious, chronically instrumented rats we examined 1) renal tubular functional changes involved in lipopolysaccharide (LPS)-induced acute renal failure; 2) the effects of LPS on the expression of selected renal tubular water and sodium transporters; and 3) effects of milrinone, a......-alpha and lactate, inhibited the LPS-induced tachycardia, and exacerbated the acute LPS-induced fall in GFR. Furthermore, Ro-20-1724-treated rats were unable to maintain MAP. We conclude 1) PDE3 or PDE4 inhibition exacerbates LPS-induced renal failure in conscious rats; and 2) LPS treated rats develop an...... phosphodiesterase type 3 (PDE3) inhibitor, and Ro-20-1724, a PDE4 inhibitor, on LPS-induced changes in renal function. Intravenous infusion of LPS (4 mg/kg b.wt. over 1 h) caused an immediate decrease in glomerular filtration rate (GFR) and proximal tubular outflow without changes in mean arterial pressure (MAP...

  15. Acute Renal Failure in Children: Etiology, Treatment and Outcome

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    Shaheen lhab

    2006-01-01

    Full Text Available Children with acute renal failure (ARF may be treated in pediatric renal or intensive care (PICU units where there is an increasing use of continuous renal replacement therapies such as hemofiltration (HF. Over three years, we prospectively recorded details of all patients with ARF treated both within our regional pediatric renal unit, in two local neonatal intensive care units (NICUs, and one PICU, which are all supported by our institution. Our study included eighty-three ARF patients (43% male with a median age of 5.7 years (range 1 day - 19.8 years; 41% of patients were < 2 years, 20% 2-5 years, 13% 5-10 years and 26% > 10 years of age. A total of 37 patients (45% were treated in the renal unit versus 46 (55% patients in NICU/PICU. The initial treatment modality was conservative in 33%, peritoneal dialysis (PD in 23%, hemodialysis (HD in 15%, HF in 28%, and isolated plasmafiltration in one percent of the patients. About 16% of the patients required more than one treatment modality. Outcome data at three months showed normal renal function in 49%, deaths in 20%, dialysis dependent disease in 14%, chronic renal failure (GFR < 60ml/min/1.73m 2 in eight percent, and proteinuria and/or hypertension in seven percent of the patients. Only one (3% death occurred in 37 patients treated in the renal unit compared to 16 deaths in 46 patients (35% treated in the NICU/PICU. Our findings further confirm the low mortality rate with isolated renal failure and the substantial mortality and renal workload in intensive care areas where renal failure is often part of multi-organ failure. Further prospective studies will be required to analyze the impact of early hemofiltration in such patients.

  16. RENAL REPLACEMENT THERAPY IN ACUTE KIDNEY FAILURE - AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Treesa P. Varghese

    2014-10-01

    Full Text Available Renal failure is the loss of renal function, either acute or chronic, that results in azotemia and syndrome of uremia. Acute renal failure, is also known as acute kidney injury (AKI, is defined as an abrupt (within 48 hours reduction in kidney function. The initial management of acute kidney failure involves treating the underlying cause, stopping nephrotoxic drugs and ensuring that the patient is euvolaemic with an adequate mean arterial blood pressure. However, no specific treatments have been shown to reverse the course AKF so Renal Replacement Therapy (RRT is the cornerstone of further management. RRT therapy can be administrated either intermittently or continuously. Multiple modalities of RRT are currently available. The purpose of this review is to familiarize different modalities of RRT for blood purification.

  17. Contrast-enhanced Ultrasound Assessment of Renal Perfusion in Patients with Chronic Renal Failure%超声造影评估慢性肾动能不全患者肾血流灌注的研究

    Institute of Scientific and Technical Information of China (English)

    李建华; 冯蕾; 孙琰; 蒋红樱; 陈坤; 张庶

    2012-01-01

    Purpose To explore the value of contrast-enhanced ultrasound in assessing renal perfusion in patients with chronic renal failure. Materials and Methods Thirty-six patients with chronic renal failure (study group) and 42 subjects without kidney diseases (control group) underwent contrast-enhanced ultrasound. QLAB image analysis software was used to obtain time-intensity curves (TIC) and perfusion parameters, including area under curve (AUC), slope rate of ascending curve (A), peak intensity (PI), time to peak (TTP), slope rate of descending curve (a); and the relationships between perfusion parameters and serum creatinine (Scr) and blood urea nitrogen (BUN) were also analyzed. Results In study group, renal cortex perfusion TIC showed slow ascending and descending; and TTP was delayed. Compared with control group, there were increased AUC and A, decreased PI, and delayed TTP in study group (P 0.05; r = 0.05, P> 0.05). Conclusion Quantitative analysis of contrast-enhanced ultrasound demonstrates the blood flow process in renal cortical in real-time. It is useful to diagnose, monitor and follow up renal failure.%目的 探讨超声造影定量分析技术评估肾功能不全患者肾血流灌注的应用价值.资料与方法 36例慢性肾功能不全患者(研究组)及42例无肾脏疾病者(对照组)行超声造影检查,使用随机QLAB分析软件获取肾脏超声造影血流灌注时间-强度曲线(TIC)及相关参数[曲线下面积(AUC)、曲线上升支斜率(A)、峰值强度(PI)、达峰时间(TTP)、曲线下降支斜率(α)],并分析其与血肌酐(Scr)及尿素氮(BUN)水平的关系.结果 研究组肾皮质血流灌注TIC上升、下降均缓慢,TTP延迟;与对照组比较,研究组肾皮质定量灌注参数中,AUC增大、PI减低、A增大、TTP延长(P<0.05).AUC、TTP、A与Scr(r=0.89、0.73、0.70,P<0.05)、BUN(r=0.84、0.77、0.65,P< 0.05)呈正相关,PI与Scr(r=-0.64,P<0.05)、BUN(r=-0.71,P<0.05)呈负相关;α与Scr(r=0.04,P

  18. Ultrasound-Guided Axillary Brachial Plexus Block in Patients with Chronic Renal Failure: Report of Sixteen Cases

    Directory of Open Access Journals (Sweden)

    Fu-Chao Liu

    2005-03-01

    Full Text Available In this report, 16 patients with end-stage renal disease undergoing forearm arteriovenousshunt surgery were subjected to an ultrasound-guided axillary approach for brachialplexus nerve block. Two doses of 15 ml lidocaine 1.5% were injected using a double-shottechnique The spread of the solution within the plexus sheath could be visualized using ahigh-resolution 12-MHz imaging probe. Most patients (94% experienced an excellent analgesiain the regions innervated by median, ulnar and radial nerves with a lower percentageof complete analgesia (63% in the areas innervated by musculocutaneous nerve. Threepatients, who complained of pain during the surgery required further supplements of narcotics.There were no complications such as, nerve injury, puncture of the axillary vessels orother systemic reactions. This technique provides adequate analgesia - without complicationsand without difficulty - for extremity surgery in patients with end-stage renal diseases.

  19. Vitaminas B y homocisteína en la insuficiencia renal crónica Vitamin B complex and homocysteine in chronic renal failure

    OpenAIRE

    C. Sánchez; E. Planells; P. Aranda; A Pérez de la Cruz; C. Asensio; Mataix, J.; LLopis, J.

    2007-01-01

    Durante la insuficiencia renal crónica ocurren cambios metabólicos, bioquímicos y hormonales que suelen ir acompañados frecuentemente de estados de malnutrición. En pacientes en prediálisis, conocer el estado nutricional en vitaminas hidrosolubles como la tiamina, riboflavina, piridoxina, cianocobalamaina y ácido fólico cobra cada vez más importancia ya que algunas de las manifestaciones de la insuficiencia renal crónica podrían deberse a la deficiencia de algunas de estas vitaminas hidrosolu...

  20. Transplantation for renal failure secondary to enteric hyperoxaluria: a case report

    Directory of Open Access Journals (Sweden)

    Rifkin Stephen I

    2007-06-01

    Full Text Available Abstract Enteric hyperoxaluria can lead to renal failure. There have only been a few reports of renal transplantation as treatment of endstage renal disease secondary to enteric hyperoxaluria and results have been mixed. This report describes a patient with Crohn's disease who developed chronic renal failure from enteric hyperoxaluria. He subsequently had a successful renal transplant without any post-operative oxalate related complications and has satisfactory renal function almost three years later. Aggressive pre-transplant hemodialysis was not done. The literature associated with renal transplantation for enteric hyperoxaluria is reviewed.

  1. CARDIORENAL INTERACTION IN DECOMPENSATED CHRONIC HEART FAILURE

    OpenAIRE

    Zh. D. Kobalava; S. V. Villevalde; M. A. Efremovtseva

    2016-01-01

    Aim. To investigate the prevalence of cardiorenal interactions, predictors of development, variants of clinical course, and outcomes of acute kidney injury (AKI) in patients with acute decompensation of chronic heart failure (ADCHF).Material and methods. Patients (n=278) with clinical manifestations of ADCHF were included into the study. All patients underwent clinical, laboratory and instrumental investigation. Renal function was assessed using the CKD-EPI formula to calculate glomerular fil...

  2. Chinese Drugs That Invigorate Spleen to Remove Dampness and Activate Blood Circulation to Eliminate Turbid for Retarding Progression of Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effect of Chinese drugs (CD) that invigorate Spleen to remove Dampness and activate the blood circulation to eliminate Turbid for retarding progression of chronic renal failure (CRF). Methods: Thirty-nine patients with CRF were divided into two groups at random: the 18 patients in group A (the control group) were treated with low protein diet and controlling blood pressure and 21 patients in group B (the treatment group) were treated similarly with that of the control group and additional CD. Levels of serous creatinine (SCr), blood urea nitrogen (BUN), blood albumin (Alb), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and hemoglobin (Hb) were checked every two months and the rate of progression of CRF was estimated by slope of the creatinine reciprocal (1/SCr) with time (months). Results: Levels of SCr and BUN in group B were lower and HDL higher than those in group A significantly, P<0.05. Mean slopes of the creatinine reciprocal with time in the two groups were markedly different, P<0.01. Conclusion: Additional CD treatment based upon the low protein diet and controlling blood pressure could retard the rate of progression of CRF evidently.

  3. Therapeutic effectiveness and safety parathyroid adenoma ablation with percutaneous ethanol injection under sonographic guidance in patients with chronic renal failure and secondary hyperparathyroidism refractory to medical treatment

    International Nuclear Information System (INIS)

    Secondary hyperparathyroidism unresponsive to medical treatment is a common complication in patients with chronic renal failure and prolonged dialysis therapy, which requires surgery of the parathyroid glands, with the risks and costs of surgery. Objective: To evaluate the therapeutic effectiveness and safety of ablation of parathyroid adenomas by percutaneous ethanol injection under ultrasound guidance. Method: After approval by the institutional medical ethics committee, informed written consent was obtained in 15 patients who met the inclusion criteria. Sonographically guided ethanol was injected consecutively into adenomas, with an interval of time less than six months. Results: Size, Doppler vascularity of adenomas, and the levels of parathyroid hormone, calcium and phosphorus were measured before and after ablation as criteria for treatment response in 15 patients. Of all patients, six (40%) had no therapeutic response. Therapeutic response was observed in nine patients (60%). In the latter group, five patients (33.3%) had successful response and symptomatic improvement, in two patients (13.3%), therapeutic response was suboptimal, and in two patients (13.3%), the response was unsatisfactory. The procedure was safe. Local pain, transient dysphonia and cough were considered minor complications and were the most common, with resolution in all cases. There were no major complications. Conclusion: Ablation of parathyroid adenomas with percutaneous ethanol injection and ultrasound guidance, in uremic patients with secondary hyperparathyroidism unresponsive to medical treatment is an effective and safe therapy. Studies involving more patients and longer follow up are needed in order to stablish more conclusive results

  4. Effects of r—HuEPO on the biophysical characteristics of erythrocyte membrane in patients with anemia of chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    SHIHONGLIAN; FAJUNYANG; 等

    1994-01-01

    Using electron spin resonance (ESR) spin labeling technique,we have studied the conformation of sulfhydryl groups(-SH) binding sites in membrane proteins and mem brane fluidity of red blood cells(RBCs) from two groups of patients with anemia of chronic renal failure(ACRF).One of the groups is composed of patients who were untreated with recombinant human erythropoietin(r-HuEPO),and the other is composed of patients who were treated with r-HuEPO.The results indicated:1)the conformation of SH group binding site in RBC membrane proteins from former group was different from those of healty people.2)the fluidity in the region near the surface of RBC membrane from former group was lower than those of healthy people.3)However,the above biophysical properties of RBC membrane from later group were normal.We concluded that RBC membrane in patients with ACRF was abnormal,and the treatment of r-HuEPO may promote the production of normal RBCs,thus ameliorate the biophysical properties of RBCs from the patients with ACRF.

  5. Determination of the bone-mineral content of the peripheral skeleton (ulna and calcaneus) in chronic renal failure patients on maintenance dialysis using 125 I-photon absorptiometry

    International Nuclear Information System (INIS)

    The bone-mineral content (BMC) of the peripheral skeleton was measured in 53 chronic renal-failure patients on maintenance dialysis using the 125 I photon absorptiometry according to Cameron. 39.6% of the patients were found to have a clearly pathological calcium content in calcaneus and ulna (33%). In total BMC assessments 43.4% of the patients examined showed strongly reduced BMC values at two measurement sites at least. Average bone-mineral content was below the value of the corresponding normal groups in all age groups of the dialysis patients. In addition, a significant correlation was verified to exist between the calcium contents of calcaneus and ulna. A significant correlation was found as well between reduced BMC values and dialysis duration. The correlation between the increased serum level of alkaline phosphatase and the reduced mineral content of the skeleton was significant as well. A minor but not significant correlation existed between the increase of the parathormone (PTH) level in the serum and the decrease of calcium content in calcaneus and ulna. A good correlation was found when contrasting the results of visual roentgenography and the BMC values established by photodensitometry: the median BMC value of patients with clear pathological X-ray findings was significantly below the one of patients without pathological X-ray findings. However, photon absorptiometry is superior to the subjective evaluation of X-ray pictures in the early diagnosis of bone diseases involving bone-mineral loss. (orig.)

  6. Anemia of renal failure. Use of erythropoietin.

    Science.gov (United States)

    Humphries, J E

    1992-05-01

    Chronic renal failure is almost invariably accompanied by symptomatic anemia. It has been demonstrated that the primary cause of this anemia is inadequate production of erythropoietin by the diseased kidneys. The isolation of erythropoietin, followed by the cloning and expression of the human erythropoietin gene, made possible clinical trials of rHuEPO in uremic patients. rHuEPO produced dramatic increases in the hematocrit in almost all patients treated and also ameliorated many symptoms, such as lethargy, dizziness, and poor appetite, that had long been attributed to the effect of uremic toxins. Adverse effects of treatment with rHuEPO noted in the early clinical trials included hypertension, seizures, arteriovenous fistula or shunt thrombosis, and hyperkalemia. Further study of rHuEPO has shown that many of these side effects may be no more frequent in patients receiving rHuEPO than in other uremic patients not receiving rHuEPO. Reduction of the rHuEPO dosage and subcutaneous administration produce less rapid increases in the hematocrit and may lessen the incidence and severity of these side effects. rHuEPO therapy places great demands on both the body's iron stores and the capacity to rapidly transfer iron from storage sites to the erythroid progenitor cells. Thus, almost all patients treated with rHuEPO become iron deficient and require oral or parenteral iron replacement. Response to rHuEPO in uremic patients is diminished if the anemia is complicated by iron deficiency, inflammatory disorders, aluminum overload, or deficiency of folate or vitamin B12. rHuEPO therapy is safe and effective in the treatment of the anemia of chronic renal failure. The use of rHuEPO leads to enhanced quality of life and eliminates the need for red cell transfusions. In addition to hemodialysis patients, predialysis patients and those on CAPD benefit from and are candidates for rHuEPO therapy. PMID:1578966

  7. [Chronic renal insufficiency. A permanent public health problem].

    Science.gov (United States)

    Legrain, M; Jacobs, C

    1999-01-01

    Chronic renal insufficiency raises an ever-increasing public-health problem due to its permanent growth among the general population and the escalating cost of renal replacement therapies. By the end of 1995 there were close to 33,700 patients with end-stage renal failure maintained alive with renal replacement methods in France. About 11,200 had a functioning kidney graft, whereas 22,500 were treated with various dialysis techniques, in and out-of-center hemodialysis and peritoneal dialysis. An optimal health policy should contribute both to prevent renal insufficiency and offer each patient his/her best specific mode of treatment at the lowest cost for the community. Renal transplantation should be much more widely promoted and utilized through measures aiming at reducing the too high refusal rates of organ donation in subjects with brain-death. Promotion and extension of out-of-center dialysis techniques are also necessary. Design of reliable epidemiological studies dealing not only with end-stage renal failure patients but with the early stage and time-course of renal insufficiency is also mandatory. A deeper investigation in the area of renal-risk factors and a qualified follow-up of patients with mild/moderate renal insufficiency are essential to avoid or delay an evolution towards end-stage renal failure. Prevention of renal fibrosis has a central role in such a long-term public health-policy. PMID:10371761

  8. Use of nonsteroidal anti-inflammatory drugs prior to chronic renal replacement therapy initiation

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Kamper, Anne-Lise; Køber, Lars;

    2012-01-01

    PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with severe renal complications, including acute renal failure, reduced glomerular filtration rate and interstitial nephritis. Caution against NSAIDs is therefore recommended in advanced chronic kidney disease. In this study...

  9. Renal imaging in children with chronic kidney disease

    OpenAIRE

    Wiwit Rahmawati; Heru Muryawan; Farah Prabowo

    2013-01-01

    Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were in...

  10. Prognostic factors in neonatal acute renal failure

    International Nuclear Information System (INIS)

    Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis

  11. Surgical Fracture Repair in Chronic Renal Failure Patients on Hemodialysis An Analysis of Complications and Hospital Quality Measures.

    Science.gov (United States)

    Vaswani, Ravi; Manoli, Arthur; Goch, Manoli; Egol, Kenneth

    2016-06-01

    In end stage renal disease (ESRD) patients on hemodialysis (HD), it is known that renal bone disease has a negative impact on postoperative complication rate of fracture repair compared to non-ESRD patients. Previous studies have examined complications following surgical hip fracture repair in ESRD patients on HD. However, there is paucity of information outside of hip fracture repair. This study was undertaken to investigate complications associated with surgical fracture repair in ESRD patients on hemodialysis and to compare quality measures with a control group for various fracture types. Data of all consecutive ESRD patients on HD was collected prospectively starting in 2013. Charts of 2,558 ESRD patients on HD from 2010 to 2013 were also reviewed. Thirty-four patients who underwent surgical fracture repair were included in the study. Additionally, 1,000 patients without ESRD who underwent fracture repair were also identified, and a random sample of 267 patients was selected for inclusion as a control group. Primary outcomes were major complications as defined by the Clavien-Dindo complication rating system for orthopaedic surgery. Secondary outcomes were minor complications, defined by the same method. Demographic information and hospital quality measures, such as hospital length of stay (LOS) and discharge disposition, were also collected. There were no differences between the two groups in terms of BMI, ethnicity, or gender distribution. The ESRD patients were older than control patients (62.6 versus 46.8 years; p > 0.01). Overall, the complication rate in the ESRD group was 14.7% compared to 3% in the control group (p payment initiatives for orthopaedic trauma patients. PMID:27281322

  12. Leptospirosis with acute renal failure and paraparesis

    OpenAIRE

    Ramakrishna, P.; Sai Naresh, V. V.; Chakrapani, B.; B.Vengamma; Kumar, V. Siva

    2008-01-01

    Leptospirosis is an important zoonosis with a worldwide distribution that is characterized by a broad spectrum of clinical manifestations ranging from inapparent infection to fulminant disease. The presentation of paraparesis in combination with acute renal failure is rare.

  13. Role of alpha-lipoic acid in the management of anemia in patients with chronic renal failure undergoing hemodialysis

    OpenAIRE

    El-Nakib GA; Mostafa TM; Abbas TM; El-Shishtawy MM; Mabrouk MM; Sobh MA

    2013-01-01

    Gehad A El-Nakib,1 Tarek M Mostafa,2 Tarek M Abbas,4 Mamdouh M El-Shishtawy,3 Mokhtar M Mabrouk,2 Mohammed A Sobh41Mansoura University Hospitals, Mansoura, Egypt; 2Faculty of Pharmacy, Tanta University, Tanta, Egypt; 3Faculty of Pharmacy, Mansoura University, Mansoura, Egypt; 4Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Mansoura, EgyptIntroduction: Anemia associated with chronic kidney disease is a serious complication necessitating expenditure of huge medical eff...

  14. Reversible renal failure after treatment with omeprazole.

    Science.gov (United States)

    Post, A T; Voorhorst, G; Zanen, A L

    2000-08-01

    Omeprazole is a proton pump inhibitor widely used in the treatment of gastro-esophageal reflux disease and peptic ulcer disease. In a 73-year-old man we describe renal failure due to acute interstitial nephritis after use of omeprazol during 4 months. Unexpected renal failure without signs of hydronephrosis should always provoke awareness of drug reaction, omeprazole being one of the possible drugs. PMID:10924942

  15. Renal and post-renal causes of acute renal failure in children

    International Nuclear Information System (INIS)

    Objective: To identify the causes of acute renal failure (ARF) in pediatric population along with the identification of the age and gender most affected by the failure. Subjects and Methods: The study included children under the age of 12 years who presented with signs and symptoms suggestive of ARF (oliguria/anuria, vomiting, acidotic breathing etc.) along with raised blood urea nitrogen (BUN) serum creatinine and metabolic acidosis as shown by arterial blood gases (ABGs). Patients were divided into two group on the basis of age; group A consisting of 0-2 years and group B from >2 years. Patients presenting with transient pre-renal azotaemia were excluded from the study. After providing initial emergency cover, detailed history, physical examination and investigations were carried out according to a proforma specially designed to ascertain the cause of ARF. Patients were managed for ARF as per standard recommendations and investigations completed or repeated as and when required. Results: A total of 119 patients with ARF were admitted in the ward over a period of two years constituting 1.36% of the total admissions and 16.39% of the admissions due to renal pathology. Mean age of presentation was 4.5 years 16.7% of the patients under the age of 5 years. Male predominance was noted in all ages with an overall male to female ratio of 2.3:1. Most common cause leading to ARF in younger age group was found to be hemolytic uremic syndrome [25(54.34%)] followed by septicemia [7(15.21 %)]. In older patients renal calculus disease was the most common [22(30.13%)] underlying pathology followed by pre-existing, undiagnosed chronic renal failure [16(21.91 %)]. Conclusion: ARF is fairly cotton in children especially under the age of 5 years showing a male predominance. More than 90% of the cases can be prevented by improving primary health care and by early and prompt treatment of infections. (author)

  16. Obstetrical acute renal failure: a challenging medical complication

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) is a syndrome characterised by rapid decline in glomerular filtration rate and retention of nitrogenous waste products such as urea and creatinine. The objective of this study was to study the prevalence, risk and outcome of women with obstetrical renal failure. Methods: This observational study was conducted in Department of Obstetrics and Gynaecology, Liaquat University Hospital, Hyderabad, Pakistan from October 2009 to September 2010. Thirty-five patients with obstetrical acute renal failure were included in the study, patients with chronic renal diseases, hypertension, diabetes mellitus and renal stones were excluded from the study. A detailed history was followed by thorough examination and investigation. Their clinical history, physical examination and intake/urine output was recorded. Routine laboratory investigations were done related to each case and specialised investigations like renal scan, renal ultrasonography and renal biopsies were performed in selected cases where recovery was delayed for more than 3 weeks. Results: Total numbers of admissions in obstetric ward were 3,285. Pregnancy related acute renal failure was found in 35 (1.065%) women. Age ranged from 18-40 years. Most of the women belonged to age group 30-35. Out of 35 women 31.42% had postpartum haemorrhage. Ante partum haemorrhage was found in 25.71%, Eclampsia in 17.14%, DIC in 14.28%, and sepsis in 11.42%. Anuria was observed in 25 patients, remaining presented with oliguria (28.57%). Haemodialysis was done in 75% of patients, others were managed conservatively. Complete recovery was observed in 53% cases. Maternal mortality was 25.71% and foetal mortality was 22.85%. Conclusion: Pregnancy related ARF is one of the most common causes of ARF, it is a dangerous complication of pregnancy which carries very high mortality and morbidity. (author)

  17. Depression, 5HTTLPR and BDNF Val66Met polymorphisms, and plasma BDNF levels in hemodialysis patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Wang LJ

    2014-07-01

    Full Text Available Liang-Jen Wang,1,* Chih-Ken Chen,2,3,* Heng-Jung Hsu,3,4 I-Wen Wu,3,4 Chiao-Yin Sun,3,4 Chin-Chan Lee3,41Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; 3Chang Gung University School of Medicine, Taoyuan, Taiwan; 4Department of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan *LJW and CKC are joint first authors and contributed equally to this manuscriptObjective: Depression is the most prevalent comorbid psychiatric disease among hemodialysis patients with end-stage renal disease. This cross-sectional study investigated whether depression in hemodialysis patients is associated with the polymorphism of the 5' flanking transcriptional region (5-HTTLPR of the serotonin transporter gene, the valine (Val-to-methionine (Met substitution at codon 66 (Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF gene, or plasma BDNF levels.Methods: A total of 188 participants (mean age: 58.5±14.0 years; 89 men and 99 women receiving hemodialysis at the Chang Gung Memorial Hospital were recruited. The diagnosis of major depressive disorder (MDD was confirmed using the Chinese version of the Mini International Neuropsychiatric Interview. The genotypes of 5-HTTLPR and BDNF Val66Met were conducted using polymerase chain reactions plus restriction fragment length polymorphism analysis. The plasma BDNF levels were measured using an enzyme-linked immunosorbent assay kit.Results: Forty-five (23.9% patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR criteria for a MDD. There were no significant effects of the 5-HTTLPR or BDNF Val66Met gene polymorphism on MDD among the hemodialysis patients. The plasma BDNF levels correlated significantly with age (P=0.003 and sex (P=0.047 but not with depression, the genotypes of 5

  18. Pollution of River Mahaweli and farmlands under irrigation by cadmium from agricultural inputs leading to a chronic renal failure epidemic among farmers in NCP, Sri Lanka.

    Science.gov (United States)

    Bandara, J M R S; Wijewardena, H V P; Bandara, Y M A Y; Jayasooriya, R G P T; Rajapaksha, H

    2011-10-01

    Chronic renal failure (CRF) associated with elevated dietary cadmium (Cd) among farming communities in the irrigated agricultural area under the River Mahaweli diversion scheme has reached a significantly higher level of 9,000 patients. Cadmium, derived from contaminated phosphate fertilizer, in irrigation water finds its way into reservoirs, and finally to food, causing chronic renal failure among consumers. Water samples of River Mahaweli and its tributaries in the upper catchment were analyzed to assess the total cadmium contamination of river water and the possible source of cadmium. Except a single tributary (Ulapane Stream, 3.9 μg Cd/l), all other tested tributaries carried more than 5 μg Cd/l, the maximum concentration level accepted to be safe in drinking water. Seven medium-sized streams carrying surface runoff from tea estates had 5.1-10 μg Cd/l. Twenty larger tributaries (Oya), where the catchment is under vegetable and home garden cultivation, carried 10.1-15 μg Cd/l. Nine other major tributaries had extremely high levels of Cd, reaching 20 μg Cd/l. Using geographic information system (GIS), the area in the catchment of each tributary was studied. The specific cropping system in each watershed was determined. The total cadmium loading from each crop area was estimated using the rates and types of phosphate fertilizer used by the respective farmers and the amount of cadmium contained in each type of fertilizer used. Eppawala rock phosphate (ERP), which is mostly used in tea estates, caused least pollution. The amount of cadmium in tributaries had a significant positive correlation with the cadmium loading of the cropping system. Dimbula Tea Estate Stream had the lowest Cd loading (495.9 g/ha/year), compared with vegetable-growing areas in Uma Oya catchment with 50,852.5 g Cd/ha/year. Kendall's τ rank correlation value of total Cd loading from the catchment by phosphate fertilizer used in all crops in the catchment to the Cd content in

  19. Changes of the cerebral metabolite patterns in patients undergoing hemodialysis due to chronic renal failure: evaluation with proton magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Hye Won; Yu, Hyeon; Yu, Soo Jeong; Kim, Gi Hyeon [Chung-Ang University Medical Center, College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    We wanted to evaluate the cerebral metabolites in patients with chronic renal failure (CRF) and who were undergoing hemodialysis by performing proton MR spectroscopy and were wanted to evaluate the correlation between the changes in the cerebral metabolite ratios and the duration after starting the initial hemodialysis. Proton MR spectroscopy was performed in 15 patients with CRF and who were undergoing hemodialysis and in ten healthy volunteers. The changes in N-acetylaspartate (NAA), choline-containing compounds (Cho), myo-inositol (Myo), glutamine/glutamate complex (Glx), and creatine (Cr) were analyzed. MR spectroscopy was performed before and after hemodialysis. For the patients with CRF before hemodialysis, the Cho/Cr ratio in the gray matter ({rho} < 0.001) and the Myo/Cr ratio in both the gray and white matter ({rho} < 0.01) were significantly elevated compared with those in the control subjects. For the patients with CRF after hemodialysis, their Cho/Cr ratios were significantly reduced in both the gray and white matter compared with that before hemodialysis ({rho} < 0.05). There was a significant positive correlation between the Cho/Cr ratio and serum Cr in the gray matter of CRF patients after hemodialysis (r = 0.54, {rho} < 0.05). The cerebral metabolite ratios were not significantly correlated with the duration after starting the initial hemodialysis. The cerebral metabolite patterns are significantly different between the patients with CRF and who are undergoing hemodialysis and the normal controls. The cerebral metabolite ratios are not significantly correlated with the duration after starting the initial hemodialysis.

  20. Influence of Enalapril on the progression of chronic renal failure in diabetic nephropathy and nephropathies of and other aethiology: A two-year study

    Directory of Open Access Journals (Sweden)

    Trbojević Jasna

    2002-01-01

    Full Text Available Chronic renal failure (CRF is almost always associated with high arterial blood pressure. Adequate control of hypertension slows down the progression of the disease, Inhibitors of angiotenzin-converting enzyme (ACE inhibitors have proved to be very efficacious in decreasing high blood pressure. The aim of this study was to assess the influence of ACE inhibitor enalapril on the progression of CRF in patients with diabetic nephropathy and nephropathies of other origin. During 1998 and 1999 thirty patients (20 males and 10 females, aged 525+1.3 have been followed-up at the Department of Nephrology, Clinical Centre of Serbia. On regular monthly controls serum creatinine, urea, calcium and protein levels, creatinine clearance, and blood pressure, were measured. All patients were suggested a low protein diet. Progression of the disease was expressed by the slope of the regression line showing reciprocal serum creatinine values. Proteinaemia was significantly higher in diabetic patients after 12 months (p<0.35 but in the next 12 months the difference between groups disappeared. The same patients had significantly lower serum urea (p<0.05 after 24 months and creatinine values (p<0.05 dur ing the whole study. Other variables changed in the same manner and with similar progression in both groups. The direction of slope lines suggested recovery of kidney function in both examined groups. However, a smaller slope in patients with diabetic nephropathy together with other results showed that enalapril had better influence on slowing down the progression of CRF in this group of patients.

  1. Treatment Status and Research Prospects of Chronic Renal Failure%慢性肾功能衰竭的治疗现状及研究前景

    Institute of Scientific and Technical Information of China (English)

    王磊; 王珏; 付强; 邱建新; 马建军; 保庭毅

    2012-01-01

    CRF is a threat to human health and life disease, In recently years, about 8 percent rate of average annual growth. Rely on the regeneration of the kidney and body potential repair and reconstruction of kidney structure and function in acellular matrix scaffold, this will be a new way the treatment of chronic renal failure. Extracellular matrix hi tissue engineering, stem cells and regenerative medicine of a large number of applications brought hope to address tissue and organ repair and reconstruction challenges. Article on the current status and treatment of CRF, kidney tissue engineering research prospects are briefly reviewed.%CRF是威胁人类健康及生命的常见病之一,近年来平均每年以约8%的速度在增长.依靠慢性肾功能衰竭肾脏母体及机体的再生潜能在脱细胞基质支架上修复重建肾脏结构与功能,这将是慢性肾功能衰竭治疗的一种全新的途径.而去细胞基质在组织工程、干细胞及再生医学的大量应用为解决组织器官的修复和重建等难题带来了希望.本文就目前CRF的治疗现状及、肾脏组织工程研究前景进行简要综述.

  2. A case-control study for influencing factors of chronic renal failure%基于病例对照研究的慢性肾功能衰竭影响因素分析

    Institute of Scientific and Technical Information of China (English)

    孙莉莉; 石月; 丁昕; 李胜开; 吴秀娟; 徐莉春; 张训保

    2015-01-01

    目的:探讨慢性肾功能衰竭的影响因素,为制定防制策略提供依据。方法采用1∶3病例对照研究,使用自行设计的调查问卷对140例新发慢性肾功能衰竭患者及420例对照进行调查。结果经单因素 logistic 分析,筛选出12个变量与慢性肾功能衰竭有关联,包括个人年收入、高血压病史、性格等,将这12个变量纳入模型进行多因素 logistic 分析表明,患有高血压(OR=11.417)、糖尿病(OR =4.105)、有高血压家族史(OR =3.002)、个人收入越高(OR =2.105)、性格急躁(OR =1.838)的人群患慢性肾功能衰竭的危险性较大(P 值均<0.05),而经常进行体育锻炼(OR =0.477)、居住在城镇较农村(OR=0.299)的居民患慢性肾功能衰竭的危险性较小(P 值均<0.05)。结论农村高血压、糖尿病患者为慢性肾功能衰竭高危人群,应对高血压、糖尿病患者开展针对性的干预措施,预防慢性肾功能衰竭的发生。%Objective To investigate influencing factors of chronic renal failure;to provide scientific basis for making pre-vention and treatment strategies.Methods A total of 140 newly identified chronic renal failure cases and 420 control subjects were recruited in a 1∶3 matched case-control study,in which self-designed questionnaires were used for survey.Results Univa-riate logistic regression analysis identified 12 variables associated with chronic renal failure,including personal annual income, history of hypertension,characters etc.Multivariate logistic analysis including above variables demonstrated that people with hypertension(OR=11.417),diabetes(OR=4.105),family history of hypertension(OR=3.002),high personal income(OR=2.105)or impatient character (OR = 1.838)had higher risk of chronic renal failure(all P < 0.05);people who had regular physical exercise(OR=0.477)or resided in urban area(OR=0.299)had lower risk of chronic renal failure(all P

  3. Pulmonary edema in renal failure

    International Nuclear Information System (INIS)

    Forty-nine cases of pulmonary edema in nephropatic patients were studied. The most frequent radiologic findings are discussed. The unreliability of a precise differentiation between ''cardiac'' and ''renal'' patterns of pulmonary edema in nephropatic patients is emphasized

  4. Early diagnosis of renal disease and renal failure.

    Science.gov (United States)

    Lees, George E

    2004-07-01

    The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately. Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small. PMID:15223206

  5. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases. PMID:27547136

  6. Periodontitis in Chronic Heart Failure

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A.; Zugck, Christian

    2016-01-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases. PMID:27547136

  7. Microrganismos cariogênicos em pacientes com insuficiência renal crônica em hemodiálise Cariogenic microorganisms in patients with chronic renal failure undergoing hemodialysis therapy

    Directory of Open Access Journals (Sweden)

    Mitsue FUJIMAKI

    1998-04-01

    Full Text Available Neste estudo comparativo, avaliaram-se a prevalência de cárie, o índice de cálculo, o fluxo salivar e as quantificações de microrganismos cariogênicos na saliva, em pacientes com insuficiência renal crônica submetidos à hemodiálise e em indivíduos normais, pareados quanto a idade e sexo. Não houve diferença significante entre os grupos em relação aos índices CPOD e CPOS, ao fluxo de saliva total estimulada ou às contagens de estreptococos mutans e lactobacilos em meios seletivos. Notável foi a verificação da grande necessidade de tratamento odontológico e de instruções para o controle de placa pelos pacientes. Estes apresentaram índices de superfícies e dentes cariados e perdidos significantemente maiores, índices de superfícies e dentes restaurados significantemente menores e índice de cálculo significantemente maior do que os indivíduos normais, demonstrando a necessidade da realização de um programa preventivo e curativo para esse grupo de pacientes especiais.Prevalence of dental caries, calculus index, stimulated salivary flow rate and levels of cariogenic microorganisms in saliva of patients with chronic renal failure undergoing hemodialysis were compared to those of normal subjects matched as to age and sex. No significant difference was detected regarding to DMF indexes, whole saliva flow or mutans streptococci and lactobacilli levels. However, when compared to the controls, patients showed a great need for dental treatment and dental plaque control instruction. They had higher indexes of decayed and missing surfaces and teeth; their filled surfaces and teeth indexes were lower and their calculus index was higher, demonstrating the necessity of a preventive and curative program to these special patients.

  8. Exercise-induced acute renal failure and patchy renal vasoconstriction

    International Nuclear Information System (INIS)

    This paper evaluates the CT and MR findings and to understand the pathophysiology of kidneys in patients with acute renal failure accompanied by loin pain after participation in a track event. The authors obtained CT scan of the kidney enhanced by contrast material and 24- to 72-hour delayed scans without further use of contrast media were performed in all six patients with acute renal failure accompanied by severe loin pain after participation in a track event. MR imaging of the kidney was also performed in one patient. Five patients received analygensics

  9. Effects of renal failure on drug transport and metabolism.

    Science.gov (United States)

    Sun, Hong; Frassetto, Lynda; Benet, Leslie Z

    2006-01-01

    Renal failure not only alters the renal elimination, but also the non-renal disposition of drugs that are extensively metabolized by the liver. Although reduced metabolic enzyme activity in some cases can be responsible for the reduced drug clearance, alterations in the transporter systems may also be involved in the process. With the development of renal failure, the renal secretion of organic ions mediated by organic anion transporters (OATs) and organic cation transporters (OCTs) is decreased. 3-Carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) and other organic anionic uremic toxins may directly inhibit the renal excretion of various drugs and endogenous organic acids by competitively inhibiting OATs. In addition, the expression of OAT1 and OCT2 was reduced in chronic renal failure (CRF) rats. Renal failure also impairs the liver uptake of drugs and organic anions, such as bromosulphophthalein (BSP), indocyanine green (ICG), and thyroxine, where organic anion transport polypeptides (OATPs) are the major transporters. Most previous studies have been done in animals or cell culture, very often in rat models, but these are presumed to reflect the presentation of advanced renal disease in humans as well. Recent studies demonstrate that the uremic toxins CMPF and indoxyl sulfate (IS) can directly inhibit rOatp2 and hOATP-C in hepatocytes. The protein content of the liver uptake transporters Oatp1, 2, and 4 were significantly decreased in CRF rats. Decreased activity of the intestinal efflux transporter, P-glycoprotein (P-gp), was also observed in CRF rats, with no significant change of protein content, suggesting that uremic toxins may suppress P-gp function. However, increased protein levels of multidrug resistance-associated protein (MRP) 2 in the kidney and MRP3 in the liver were found in CRF rats, suggesting an adaptive response that may serve as a protective mechanism. Increases in drug areas under the curve (AUCs) in subjects with advanced renal disease

  10. Growth hormone in chronic renal disease

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2012-01-01

    Full Text Available Severe growth retardation (below the third percentile for height is seen in up to one-third children with chronic kidney disease. It is thought to be multifactorial and despite optimal medical therapy most children are unable to reach their normal height. Under-nutrition, anemia, vitamin D deficiency with secondary hyperparathyroidism, metabolic acidosis, hyperphosphatemia, renal osteodystrophy; abnormalities in the growth hormone/insulin like growth factor system and sex steroids, all have been implicated in the pathogenesis of growth failure. Therapy includes optimization of nutritional and metabolic abnormalities. Failure to achieve adequate height despite 3-6 months of optimal medical measures mandates the use of recombinant GH (rGH therapy, which has shown to result in catch-up growth, anywhere from 2 cm to 10 cm with satisfactory liner, somatic and psychological development.

  11. The evaluation methodology and technology on clinical diagnosis and Nutrition therapy of Chronic Renal Failure%慢性肾脏病诊断及治疗效果评价新方法

    Institute of Scientific and Technical Information of China (English)

    曾倩; 丁健桦; 魏益平; 徐承云; 王海东; 李鹏辉

    2014-01-01

    慢性肾脏病发病率逐渐增多,早期肾功能不全的诊断和治疗具有重大意义。本文对慢性肾脏病的临床诊断方法和临床营养治疗及其效果的评价方法进行了概述,进而提出将呼出气体活体质谱分析新技术用于慢性肾脏病诊断和营养治疗效果的评价,展望其在慢性肾脏病的诊断、患者的康复及治疗效果评价的应用前景。%The morbidity of Chronic Kidney Disease has gradualy increased, so it is of great significance that we can early detect and early remedy Chronic Renal Failure. In this paper, the clinical diagnosis method of Chronic Kidney Disease, the evaluation methodology on the clinical nutrition therapy and the monitoring on the nutrition therapeutic effect are summarized. Moreover, a novel technology of in vivo analysis of exhaled breath by mass spectrometry is proposed and its application of clinical diagnosis and nutritional therapy of Chronic Renal Failure are discussed.

  12. Clinical Practice Guidelines for Acute Renal Failure.

    OpenAIRE

    Argelio Alberto Santana Cano; Marta Patricia Casanova González; Belkys Rodríguez Llerena.; Eddy Pereira Valdés

    2009-01-01

    Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration) and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.

  13. Clinical Practice Guidelines for Acute Renal Failure.

    Directory of Open Access Journals (Sweden)

    Argelio Alberto Santana Cano

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Acute Renal Failure. It a syndrome characterized by the abrupt deterioration of basal renal functions (abrupt reduction of glomerular filtration and the consequent increase of nitrogenous products in the blood as well as the homeostasis of the body. It aetiological agents, clinical presentation, therapeutic and diagnostic methods are described. It includes assessment guidelines focused on the most important aspects to be accomplished.

  14. Acute renal failure due to ciprofloxacin.

    Science.gov (United States)

    Allon, M; Lopez, E J; Min, K W

    1990-10-01

    Acute renal failure developed in three patients within a few days of starting ciprofloxacin hydrochloride therapy. An allergic interstitial nephritis was suggested by fever and eosinophiluria in one patient and by erythema multiforme in another. A kidney biopsy specimen confirmed this diagnosis in one patient. Renal function improved shortly after withdrawal of the drug in all three patients. Literature survey revealed an additional three patients with a similar complication. Allergic manifestations, such as fever or rash, were a feature in most reported cases. In view of this potential complication, renal function should be closely monitored in patients receiving ciprofloxacin therapy, especially if other potentially nephrotoxic drugs are prescribed concomitantly. PMID:2222106

  15. Prevention of renal failure: the Malaysian experience.

    Science.gov (United States)

    Hooi, Lai Seong; Wong, Hin Seng; Morad, Zaki

    2005-04-01

    Renal replacement therapy in Malaysia has shown exponential growth since 1990. The dialysis acceptance rate for 2003 was 80 per million population, prevalence 391 per million population. There are now more than 10,000 patients on dialysis. This growth is proportional to the growth in gross domestic product (GDP). Improvement in nephrology and urology services with widespread availability of ultrasonography and renal pathology has improved care of renal patients. Proper management of renal stone disease, lupus nephritis, and acute renal failure has decreased these as causes of end-stage renal disease (ESRD) in younger age groups. Older patients are being accepted for dialysis, and 51% of new patients on dialysis were diabetic in 2003. The prevalence of diabetes is rising in the country (presently 7%); glycemic control of such patients is suboptimal. Thirty-three percent of adult Malaysians are hypertensive and blood pressure control is poor (6%). There is a national coordinating committee to oversee the control of diabetes and hypertension in the country. Primary care clinics have been provided with kits to detect microalbuminuria, and ACE inhibitors for the treatment of hypertension and diabetic nephropathy. Prevention of renal failure workshops targeted at primary care doctors have been launched, opportunistic screening at health clinics is being carried out, and public education targeting high-risk groups is ongoing. The challenge in Malaysia is to stem the rising tide of diabetic ESRD. PMID:15752245

  16. Analysis of bone mineral density in 143 middle- and elder-aged patients with chronic renal failure%143例中老年慢性肾衰竭患者双能X线骨密度结果分析

    Institute of Scientific and Technical Information of China (English)

    李桂英; 邸彬; 肖太玲

    2011-01-01

    目的 研究中老年慢性肾衰竭CKD3期~CKD5期患者骨质疏松情况,分析骨质疏松与慢性肾衰竭、年龄、体重指数及性别的相关性,探讨慢性肾衰竭所致骨质疏松的早期表现。方法 ①采用双能X线骨密度仪测定腰椎正位(L1~L4)和股骨颈、Ward's三角、大粗隆的骨密度;②测量143例中老年慢性肾衰竭患者及对照组165例骨密度(BMD)值,采用病例对照法分析慢性肾衰竭对骨质疏松发病率的影响;③采用Logistic多元回归法分析慢性肾衰竭、年龄、性别及体重指数对骨质疏松的影响。结果 ①中老年慢性肾衰竭患者的骨质疏松发病率为79.02%,明显高于对照组(47.88%);②CKD3、4、5期患者中,骨质疏松患病率随肾功能减退而逐渐增加;骨质疏松与慢性肾衰竭及年龄正相关,与体重指数负相关;④Ward's三角的骨质疏松患病率及骨量减少程度高于股骨其他部位及腰椎。结论 慢性肾衰竭是骨质疏松的重要影响因素。Ward's三角可作为早期诊断骨质疏松的首选检查部位。%Objective To study the osteoporosis status in middle- and elder-aged patients with stage 3-5 of chronic renal failure, and to analyze the correlation among osteoporosis and chronic renal failure, age, body mass index, and gender, and to explore the early manifestations of osteoporosis in chronic renal failure patients. Methods 1 ) Dual-energy X-ray absorptiometry was used to measure the bone mineral densities (BMD) of the lumbar vertebra (L,-L4), the femoral neck, the Ward' s triangle, and the femoral trochanter. 2) BMDs were measured in 143 middle- and elder-aged patients with chronic renal failure and 165 controls. Case-control analysis was used to show the effect of chronic renal failure on the incidence of osteoporosis. 3) Logistic multiple regression analysis was used to analyze the contributions of chronic renal failure, age, gender, and body mass index to

  17. Esvaziamento gástrico nos pacientes com insuficiência renal crônica submetidos à hemodiálise Gastric emptying study in patients with chronic renal failure on hemodialysis

    Directory of Open Access Journals (Sweden)

    Eunice Sizue Hirata

    2008-09-01

    Full Text Available RACIONAL: Queixas dispépticas são comuns em pacientes com insuficiência renal crônica. As mais frequentemente relatadas são anorexia, náusea, vômito, sensação de plenitude gástrica e dor epigástrica. A possibilidade destes sinais e sintomas estarem associadas ao retardo no esvaziamento gástrico é atraente. OBJETIVO: Estudar o esvaziamento gástrico de uma refeição sólida padronizada, em pacientes com insuficiência renal crônica em tratamento dialítico. MÉTODO: Foram estudados 31 pessoas de ambos os sexos com idade variável de 18 à 60 anos, sendo 14 com insuficiência renal crônica em hemodiálise há mais de 6 meses e 17 sadios. Foram excluídos pacientes com diabetes mellitus, amiloidose, doenças do colágeno, doenças dispépticas e/ou submetidos à operação gástrica, pacientes em uso de drogas pró-cinéticas gástricas e grávidas. O método do esvaziamento gástrico foi a cintilografia, através de câmara de cintilação de dois cabeçotes. A refeição teste padronizada consistiu de omelete de três ovos de galinha preparado com mistura de enxofre coloidal marcado com 185 MBq de tecnécio-99m. Foram estudados a curva de retenção gástrica total e o T½ do esvaziamento gástrico. Os testes estatísticos utilizados foram o de c2 e o de Kruskal Wallis. RESULTADOS: Os resultados confirmaram a homogeneidade dos grupos quanto à idade e o sexo. Não houve diferença estatisticamente significativa em relação às curvas de retenção gástrica total e o T½, semelhantes nos dois grupos. CONCLUSÃO: O esvaziamento gástrico de pacientes urêmicos em tratamento hemodialítico há mais de seis meses é igual ao de indivíduos sadios.BACKGROUND: Dyspeptic symptoms are frequent in renal patients. They are anorexia, nausea, vomit, pain and epigastric distension. These symptoms can be related to the delay in gastric emptying. AIM: To investigate gastric emptying in patients with chronic renal failure on hemodialysis

  18. Etiology of acute renal failure in a tertiary center

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    Rabbani Malik

    2008-01-01

    Full Text Available Acute renal failure (ARF occurs commonly in developing countries. Our aim was to assess the etiologies and outcomes of ARF in a tertiary care hospital in Pakistan and compare them with data from developed and developing countries. All patients admitted to the Aga Khan University Hospital, Karachi from January 1991 to December 2000 fulfilling the criteria of acute renal failure were reviewed retrospectively. Acute renal failure for the purpose of this study was defined as persistent elevation of serum creatinine to above 2 mg/dL (177 umol/L on two consecu-tive occasions despite correction of any abnormal hemodynamic or mechanical factors. We studied 898 patients fulfilling the criteria of ARF, 61% (551 were males, and the mean age was 53% ± 17.6 (range 15-91 years. Medical causes accounted for (88% of ARF cases and surgical causes for (11%. Majority of the patients had pre-renal ARF, and 5% had drug related ARF. The base line creatinine was 1.9 ± 1.8 mg/dL, while 27% of the patients had pre-existing chronic kidney disease. The mean rise in creatinine was 7.18 ± 3.8 mg/dL. We conclude that ARF resulted from pre-renal etiologies in majority of the patients and early recognition and management may improve the prognosis of these potentially preventable causes.

  19. STUDY OF RENAL FAILURE IN MALARIA

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    Girish Pamappa

    2016-01-01

    Full Text Available Renal failure is a serious complication of malaria, with a mortality of 14 to 33%. In view of the significant morbidity and mortality due to acute renal failure in malaria, there is need to identify patients at an early stage and to intensify care given to reduce morbidity and mortality. AIMS  To evaluate the clinical profile of Acute Renal Failure (ARF in malaria.  To evaluate the factors associated with adverse outcome, relation of severity of renal impairment on final outcome in patients with ARF due to malaria. MATERIAL AND METHODS This study was conducted at a tertiary care hospital over a period of 12 months. STUDY DESIGN  Type of study: Prospective Analytical, Observational Study.  Sample Size: 50 patients admitted to ICU, Kidney Unit, and the Medicine Wards with Malaria and ARF. Inclusion Criteria Clinically screened patients with evidence of malarial parasites in the blood smears or by antigen detection with clinical features or biochemical evidence of acute renal failure. Exclusion Criteria  Presence of any disease or condition leading to ARF or affecting the outcome of malarial ARF.  Other causes of Fever, Jaundice and Oliguria, like Leptospirosis, Dengue. METHODOLOGY Fifty patients who fulfilled the inclusion criteria were interrogated with regards to the complaints, clinical signs. Blood tests were sent on admission. Details were recorded as per the clinical proforma. The patients were followed until their discharge/death. RESULTS Oliguria was present in only 30% of patients. 30% of patients received haemodialysis. The mortality was 12% for severe renal failure. On Univariate analysis, Acidosis and Cerebral malaria were highly significant predictors of mortality. Other significant predictors were Renal failure, Oliguria, Shock, DIC, Hyperparasitemia, Leukocytosis (TLC. On Multivariate analysis, Oliguria, Cerebral malaria, Acidosis, Shock and two or more complications were the independent predictors of mortality

  20. Influence of Diet Balanced with Essential Amino Acids / Keto Acid Analogs and High-Nutrient Blend on the Progression of Renal Failure in Patients in the Pre-Dialysis Stage of Chronic Kidney Disease Caused by Systemic Autoimmune Diseases

    OpenAIRE

    I I Aleksandrova; Mikhailov, A. A.; Lyudmila Y. Milovanova; Yury S. Milovanov

    2013-01-01

    The aim of the study was to evaluate the effect of a low protein diet (LPD) balanced with essential amino acids (EAA) / keto acid analogs (KAA) and protein “SUPRO-XT 219D” in the composition of the high-energy nutrient blend (HENB) for slow down of renal failure in patients in the pre-dialysis stage of chronic kidney disease (CKD) induced by systemic autoimmune diseases (SAD).Material and Methods: In this study, 46 patients (35 with systemic lupus erythematosus and 15 with various forms of sy...

  1. Avaliação do estado nutricional de crianças e adolescentes com insuficiência renal crônica Nutritional status of children and teenagers with chronic renal failure

    Directory of Open Access Journals (Sweden)

    M.P. ZAMBOM

    2001-06-01

    Full Text Available A desnutrição está freqüentemente relacionada com doenças crônicas. O diagnóstico precoce realizado por técnicas práticas e simples favorece o tratamento, minimizando as complicações. OBJETIVO: avaliar a situação nutricional de crianças e adolescentes com insuficiência renal crônica (IRC utilizando parâmetros antropométricos. MÉTODOS: Foram avaliadas 41 crianças e adolescentes com IRC ("clearance" de creatinina abaixo de 50 ml/min/1,73m2 acompanhadas no Ambulatório de Nefrologia Pediátrica do HC-Unicamp, de janeiro de 1995 a novembro de 1996, pelas medidas do perímetro braquial (PB e da prega cutânea tricipital (PCT, com as quais calculou-se a área de gordura braquial (AGB e área muscular braquial (AMB e os respectivos escores z. Estas medidas foram realizadas pelo menos duas vezes, com intervalo de 0,21 a 1,3 anos (0,88 ± 0,04. RESULTADOS: Os escores z obtidos tanto para PB, como para PCT, AGB e AMB apresentaram valores muito baixos, sendo que, na evolução, apenas o escore z de AMB apresentou melhora estatisticamente significativa (p= 0,03 teste de Wilcoxon. Quando selecionados quanto ao tratamento de substituição renal, apenas os transplantados renais apresentaram melhora estatisticamente significativa para o escore z de PB (p= 0,02 teste de Wilcoxon. CONCLUSÃO: Estes dados mostram uma situação nutricional comprometida tanto em relação à reserva de gordura, quanto de músculo, com melhora no acompanhamento apenas em relação à área muscular.BACKGROUND: the purpose of this study is to evaluate the nutritional status of children and teenagers with chronic renal (CRF failure using anthropometric measurements. MATERIAL AND METHODS: 41 children and adolescents with (CRF (creatinine "clearance" < 50 ml/min/1,73m2 followed at the Pediatric Nephrology Unit (HC-UNICAMP, between January 1995 and November 1996, were evaluated by the assessment of anthropometric measurements, mid upper arm circunference (MUAC and

  2. Concentração sérica de paratormônio intacto em cães com insuficiência renal crônica Serum concentration of intact parathormone in dogs with chronic renal failure

    Directory of Open Access Journals (Sweden)

    P. Lazaretti

    2006-08-01

    Full Text Available Estudou-se a ocorrência de hiperparatireoidismo secundário renal e determinaram-se as concentrações séricas de paratormônio intacto (PTHi-c, cálcio total e fósforo em 30 cães com insuficiência renal crônica (IRC e em 40 cães sadios. Para a determinação do PTHi-c, foi utilizado o método imunofluorométrico, com o emprego de anticorpos anti-aminoterminal (extraídos de gema de ovo da galinha e de anticorpos monoclonais anti-carboxiterminal (H5P10, marcados com Europium. As concentrações séricas de PTHi-c (717,23±469,13pg/ml no grupo IRC e 36,76±34,40pg/ml no grupo-controle; P=0,0001, cálcio total (11,46±2,03mg/dl no grupo IRC e 10,11±0,91mg/dl no grupo-controle; P=0,003 e fósforo (12,01±8,06mg/dl no grupo IRC e 4,33±0,74mg/dl no grupo-controle; P=0,0001 foram mais altas nos cães com IRC. Observou-se estreita correlação entre PTHi-c e fósforo (r=0,56; P=0,0006, o que não ocorreu entre PTHi-c e cálcio. Hipercalcemia em cães com alta concentração de PTHi-c demonstrou a possível ocorrência de hiperparatireoidismo terciário em 11 animais. A hiperfosfatemia pode indicar, de forma indireta, a ocorrência de hiperparatireoidismo secundário nos cães com IRC.The occurrence of renal secondary hyperparathyroidism was studied and serum intact parathormone (PTHi-c, total calcium and phosphorus were measured in thirty dogs with chronic renal failure (CRF and in forty healthy dogs. The imunnofluorometric method was used for the PTHi-c assay, using anti-aminoterminal antibodies (obtained from chicken yolk and anti-carboxiterminal monoclonal antibodies (H5P10, marked with Europium. Mean value ± SD of serum concentration of PTHi-c was 717.23±469.13pg/ml in CRF group and 36.76±34.40pg/ml in control group (P=0.0001; for total calcium it was 11.46±2.03mg/dl in CRF group and 10.11±0.91mg/dl in control group (P=0.003; and for phosphorus it was 12.01±8.06mg/dl in CRF group and 4.33±0.74mg/dl in control group (P=0.0001. The

  3. Acute renal failure in Yemeni patients

    Directory of Open Access Journals (Sweden)

    Muhamed Al Rohani

    2011-01-01

    Full Text Available Acute renal failure (ARF is defined as a rapid decrease in the glomerular filtration rate, occurring over a period of hours to days. The Science and Technology University Hospital, Sana′a, is a referral hospital that caters to patients from all parts of Yemen. The aim of this study is to have a deeper overview about the epidemiological status of ARF in Yemeni patients and to identify the major causes of ARF in this country. We studied 203 patients with ARF over a period of 24 months. We found that tropical infectious diseases constituted the major causes of ARF, seen in 45.3% of the patients. Malaria was the most important and dominant infectious disease causing ARF. Hypotension secondary to infection or cardiac failure was seen in 28.6% of the patients. Obstructive nephropathy due to urolithiasis or prostate enlargement was the cause of ARF in a small number of patients. ARF was a part of multi-organ failure in 19.7% of the patients, and was accompanied by a high mortality rate. Majority of the patients were managed conservatively, and only 39.9% required dialysis. Our study suggests that early detection of renal failure helps improve the outcome and return of renal function to normal. Mortality was high in patients with malaria and in those with associated hepatocellular failure.

  4. Solving the conundrum of Job: a probable biblical description of chronic renal failure with neurological symptoms Resolvendo o enigma de Jó: uma provável descrição bíblica de insuficiência renal crônica com sintomas neurológicos

    Directory of Open Access Journals (Sweden)

    Luiz Antonio de Lima Resende

    2009-06-01

    Full Text Available The disease described in the Bible' Book of Job is controversial and had been of interest of theologists, psychiatrists, and dermatologists for many years. We describe several signs and symptoms compatible with chronic renal failure with neurological alterations.A doença descrita no livro bíblico de Jó é controversa, e tem interessado a teólogos, psiquiatras e dermatologistas, há tempos. Neste trabalho os autores apontam para evidências do diagnóstico de insuficiência renal crônica com alterações neurológicas.

  5. Renal imaging in children with chronic kidney disease

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    Wiwit Rahmawati

    2013-04-01

    Full Text Available Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were inpatients at Dr. Kariadi Hospital from January 2008 to June 2011. Data were taken from medical records. Chronic kidney disease was confirmed by clinical manifestations, laboratory findings, and radiologic imaging. Renal ultrasound findings were determined by the radiologist responsible at that time. Results were presented as frequency distributions. Results Of 37 chronic kidney disease cases, 27 were males and 10 were females. Subjects’ most common complaints were dyspnea (7 out of 37 and edema (30 out of 37. Renal ultrasound imaging of subjects with chronic kidney disease yielded the following findings: reduced cortico-medullary differentiation (30 out of 37, bilateral echogenic kidneys (21 out of 37, reduced renal cortex thickness (4 out of 37 and small-sized kidneys (4 out of 37. Eight of the 37 children died. These 8 subjects had the following radiologic imaging findings: both kidneys appeared small in size (4 out of 8, reduced ‘renal cortex’ thickness (4 out of 8, echogenic kidneys (6 out of 8, and reduced cortico-medullary differentiation (8 out of 8. Conclusion Renal ultrasound imaging of pediatric subjects with chronic kidney disease revealed findings of reduced cortico-medullary differentiation, bilateral echogenic kidneys, reduced renal cortex thickness, and small kidneys bilaterally. [Paediatr Indones. 2013;53:193-9.].

  6. Renal dysfunction prevalence and clinical impact in heart failure

    Directory of Open Access Journals (Sweden)

    Palazzuoli A

    2011-09-01

    Full Text Available Alberto Palazzuoli, Susanna Benincasa, Stefanie Grothgar, Pasquale Di Sipio, Giovanni Paganini, Marco Pellegrini, Ranuccio NutiDepartment of Internal Medicine and Metabolic Diseases, Cardiology Section, Le Scotte Hospital, University of Siena, ItalyAbstract: Chronic kidney disease (CKD is associated with a significant increase in death and cardiovascular mortality. However the exact mechanism by which CKD impairs the cardiovascular outcome is not well established. Some reasons may lie in the association of CKD with several other cardiovascular and noncardiovascular disorders including accelerated systemic atherosclerosis, endothelial dysfunction, increased levels of inflammatory factors, anemic status, bone mineral dysfunction, electrolyte imbalance, and renin–angiotensin–aldosterone system (RAAS activation. Therefore several risk factors such as hypertension, diabetes, lipid disorders, and older age are common in both conditions. In patients affected with heart failure (HF a key role is represented by the neurohormonal activation. This condition causes fluid and sodium retention, peripheral vasoconstriction, as well as increased congestion and cardiac workload. Moreover, HF during the decompensated phases is often associated with a worsening renal function that leads to further RAAS activation, microvascular damage, and intrarenal flow redistribution. In order to clarify the interactions between these factors, several questions need to be answered: the universal definition of “worsening renal function,” the identification of the best laboratory parameters to investigate renal function in terms of sensitivity and specificity, and a better definition of the comorbidities’ role in the determination of the outcome, especially in patients with chronic HF. A clarification of these key points could lead to the individualization of new specific therapeutic targets and to a reduction in mortality and hospitalization in patients with HF and

  7. Ancient literature research of tonifying the kidney and purging the turbidity method in treating chronic renal failure%补肾泄浊法治疗慢性肾衰竭的古代文献研究

    Institute of Scientific and Technical Information of China (English)

    张蕾; 刘旭生

    2012-01-01

    Objective: to comb ancient literature about filling kidney and turbidity relief treatment on chronic renal failure. Method; using ehinese Medical Tantras as literature retrieval tool, analyzing ancient literature by content analytical method. Result; Filling kidney and turbidity relief is the basic treatment method of chronic renal failure. Prescription in ancient has big quantity , rich dosage form and various use methods. Conclusion; modern application of ancient formulas of filling kidney and turbidity relief still needs to be further exploration and research.%目的:对补肾泄浊法治疗慢性肾衰竭相关古籍文献进行梳理.方法:采用《中华医典》第四版为文献检索工具,应用内容分析法对检索到的条文进行归纳总结.结果:补肾泄浊法是慢性肾衰竭的基本治疗大法.补肾泄浊古代方药拟方较多,剂型丰富,使用方法多样.结论:古代补肾泄浊方药的现代应用仍有待进一步探索和研究.

  8. 慢性肾衰病人椎体骨质变化的MRS研究进展%Progress of magnetic resonance spectroscopy in chronic renal failure patients with vertebral bone change

    Institute of Scientific and Technical Information of China (English)

    高才良; 董国礼; 曾南林

    2013-01-01

    慢性肾功能衰竭病人的骨质改变目前已成为影响其生存质量的突出问题.如何更好地评估其骨质变化情况,进而早期进行有效干预及治疗已成为重要的研究内容.MR波谱成像(MRS)作为MR功能成像的一种已成功应用于中枢神经系统、乳腺及前列腺等的检测,而在评价骨质变化中的价值亦在研究中.现就MRS评估慢性肾功能衰竭病人椎体骨质变化情况予以综述.%Bone changes caused by kidney diseases affect the quality of life in the patients with chronic renal failure.How to improve evaluation of the bone change,and consequently start early intervention and treatment is an important topic.Magnetic resonance spectroscopy (MRS) has been successfully used in the evaluations of central nervous system,breast and prostate,etc.Evaluation of bone changes with MRS is under studied.This article reviewed the MRS in evaluation of vertebral body bone changes in patients with chronic renal failure.

  9. Acute renal failure secondary to rhabdomyolysis

    International Nuclear Information System (INIS)

    MR imaging of the kidney was performed in 6 patients with acute renal failure (ARF) secondary to rhabdomyolysis caused by snake bite (n = 4), crush injury (n = 1), and carbon monoxide poisoning (n = 1). A test for urine myoglobin was positive in all 6 patients and MR imaging was done 6 to 18 days after the causative event of the rhabdomyolysis. MR images in all 6 patients showed globular swelling of the kidneys, preserved corticomedullary contrast on T1-weighted images, and obliteration of corticomedullary contrast on T2-weighted images. Unlike other medical renal diseases in which corticomedullary contrast is lost on T1-weighted images, preservation of the corticomedullary contrast on T1-weighted MR images with globular renal swelling was a constant finding in patients with ARF secondary to rhabdomyolysis. (orig.)

  10. Insomnia and chronic heart failure.

    Science.gov (United States)

    Hayes, Don; Anstead, Michael I; Ho, Julia; Phillips, Barbara A

    2009-09-01

    Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. PMID:18758945

  11. Acute Renal Failure in a Renal Center, Iraq

    International Nuclear Information System (INIS)

    We evaluated retrospectively the etiology and outcome of acute renal failure (ARF) in 84 patients in Rasheed Renal Center in Baghdad, Iraq from June 1998 through March 1999. They were 82 males and 2 females with ages that ranged between 5 and 80 years. Prerenal ARF was the commonest type found in 45 (53.6%) patients followed by renal ARF in 33 (39.3%) patients and acute obstructive uropathy six (7.1%) patients. Clinically, 74 patients presented with oligo-anuria, while 10 patients presented with non-oliguria. Of the oligo-anuria group, 61 ( 82.4%) patients required required renal replacement therapy (RRT) and 50 (67.6%) had complete recovery. The mortality rate was 25.67% in the oliguric group, while none in the non-oliguric group required RRT and the complete recvery rate was 100%. The overall survival in both groups was (77.4%). The patterns of ARF in our center were mostly compatible with the previous reports from the region. (author)

  12. Serious bleeding as a consequence of accumulation of dabigatran caused by renal failure

    DEFF Research Database (Denmark)

    Skjødt-Jensen, Anne Mette; Hvas, Anne-Mette

    2014-01-01

    A 77-year-old male was hospitalized due to haematuria and developed septicaemia. He received dabigatran due to chronic atrial fibrillation. Doses were reduced because of renal failure according to guidelines. The patient showed extensive changes in his entire coagulation system. Due to renal...... failure forced diuresis was not possible, and continuous dialysis was performed. Patients with renal failure should be monitored closely - if there are any sign of bleeding it is important to consider change of anticoagulant therapy as long as an antidote does not exist....

  13. Renal replacement therapy in sepsis-induced acute renal failure

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    Rajapakse Senaka

    2009-01-01

    Full Text Available Acute renal failure (ARF is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

  14. 28 CFR 79.67 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.67... renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... claimant. A conclusion that a claimant developed chronic renal disease must be supported by...

  15. Acute renal failure caused by contrast media

    International Nuclear Information System (INIS)

    Acute renal complications occurring in response to intravascular administration of iodinated contrast media may remain restricted to clinically irrelevant, transient elevations of serum creatinine, but just as well manifest themselves in the form of severe oliguric renal failure giving rise to the need of life-long hemodialysis. It was the aim of this study to determine the frequency of those renal hazards by a) systematic screening of the literature for relevant cases and b) retrospective and prospective examination of patients chosen by the author. The mean frequency of incidents determined on the basis of data from the relevant literature was 5% for non-stratified populations. A separate analysis of no risk patients showed this to be as low as 0.5%. In a prospective study of 69 patients receiving the non-ionic contrast medium Iopamidol, for the purposes of phlebography, serum creatinine determinations carried out at 24 and 48 hours did in no case reveal increases exceeding 25%, even though 11 patients of this cohort were at a particular risk of developing renal complications. The remote possibility of nephrophaty occurring as a result of contrast medium administration could be further reduced by the use of non-ionic materials. (orig./GDG)

  16. 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging to evaluate split renal GFR of unilateral renal function failure patient

    International Nuclear Information System (INIS)

    Objective: To explore the use of evaluating split glomerular flow rate (GFB) in patients with unilateral renal function failure by 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging. Methods: Split GFR of 82 cases with unilateral renal function failure was evaluated by 99Tcm- DTPA renal dynamic imaging, and was correlated with serum creatinine (SCr). Beside, causes of renal function failure were analyzed. Results: Split CFR were negatively correlated with SCr(r=-0.643, P99Tcm-DTPA renal dynamic imaging to treat early and reserve renal function. (authors)

  17. Analysis of the Effect of Music on the Complication of Hemodialysis in Patients with Chronic Renal Failure%音乐对慢性肾衰患者血透并发症的效果研究

    Institute of Scientific and Technical Information of China (English)

    蔡影

    2015-01-01

    Objective To investigate the ef ect of music on the complications of hemodialysis in patients with chronic renal failure.Methods In September 2014 suf ering from chronic renal failure (CRF)of 60 patients with hemodialysis,were randomly divided to observation group and control group.Observe the beginning of the group in the hemodialysis process of the 3 hours to 30 minutes of music,while control group was not given.The use of questionnaire and visual analog scale to assess the patient's blood dialysis process pain,nausea,vomiting,cramps.Results The pain and nausea scores in the observation group were lower than those in the control group, the dif erence was statistical y significant ( <0.05).Conclusion Music can reduce the complications of hemodialysis in patients with chronic renal failure.%目的:探讨音乐对慢性肾衰患者血液透析过程中并发症的效果。方法选取2014年6月~9月患慢性肾衰的进行血液透析的患者60例,随机分为对照组和观察组,观察组在血液透析过程中的第3h开始时听30min音乐,对照组不给予。使用调查表和视觉模拟评分法评估患者血液透析过程中疼痛、恶心、呕吐、痉挛。结果观察组疼痛和恶心得分均低于对照组,差异有统计学意义(<0.05)。结论音乐可以减少慢性肾衰患者的血液透析中的并发症。

  18. 延续护理在慢性肾衰竭患者血液透析中的应用%Application on transitional care in hemodialysis of chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    蔡晓燕; 潘蓉; 刘玉玲

    2013-01-01

    Objective To study the application effect of transitional care in hemodialysis of chronic renal failure patients. Methods 45 patients with chronic renal failure were treated by transitional care in the process of hemodialysis, and follow—upping the self care ability, level attained of disease's knowledge and changes of each index. Results There were significant difference in inurine, blood urea nitrogen, serum creatinine, systolic blood pressure in 24 h, 1 month, 3 months after patients leave hospital (P 0.05). There were significant differences in the self nursing competencies of patients between different times (P < 0.01). Conclusion Transitional care can improve the self—care ability of chronic renal failure, and promote the health of patients. It is worthy in clinical promotion and application.%目的 探讨延续性护理在慢性肾衰竭患者血液透析中的应用效果.方法 对我院收治的45例慢性肾衰竭血液透析患者采用延续护理,并对患者的自我护理能力、疾病知识的掌握情况和各指标的变化情况进行随访.结果 患者出院24 h、1个月、3个月时尿量、血肌酐、尿素氮、收缩压的比较,差异有统计学意义(P < 0.05);舒张压比较差异无统计学意义(P > 0.05).患者不同时段的自我护理能力测定情况比较,差异均有高度统计学意义(均P < 0.01).结论 延续护理可提高慢性肾衰竭患者的护理自理能力,促进患者的健康,值得临床推广应用.

  19. Parenteral nutrition in patients with renal failure – Guidelines on Parenteral Nutrition, Chapter 17

    Science.gov (United States)

    Druml, W.; Kierdorf, H. P.

    2009-01-01

    Partial EN (enteral nutrition) should always be aimed for in patients with renal failure that require nutritional support. Nevertheless PN (parenteral nutrition) may be necessary in renal failure in patient groups with acute or chronic renal failure (ARF or CRF) and additional acute diseases but without extracorporeal renal replacement therapy, or in patients with ARF or CRF with additional acute diseases on extracorporeal renal replacement therapy, haemodialysis therapy (HD), peritoneal dialysis (PD) or continuous renal replacement therapy (CRRT), or in patients on HD therapy with intradialytic PN. Patients with renal failure who show marked metabolic derangements and changes in nutritional requirements require the use of specifically adapted nutrient solutions. The substrate requirements of acutely ill, non-hypercatabolic patients with CRF correspond to those of patients with ARF who are not receiving any renal replacement patients therapy (utilisation of the administered nutrients has to be monitored carefully). In ARF patients and acutely ill CRF patients on renal replacement therapy, substrate requirements depend on disease severity, type and extent/frequency of extracorporeal renal replacement therapy, nutritional status, underlying disease and complications occurring during the course of the disease. Patients under HD have a higher risk of developing malnutrition. Intradialytic PN (IDPN) should be used if causes of malnutrition cannot be eliminated and other interventions fail. IDPN should only be carried out when modifiable causes of malnutrition are excluded and enhanced oral (like i.e. additional energy drinks) or enteral supply is unsuccessful or cannot be carried out. PMID:20049069

  20. Acute renal failure in children. An ultrasonographic-clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Vergesslich, K.A.; Balzar, E.; Weninger, M.; Ponhold, W.; Sommer, G.; Wittich, G.R.

    1987-11-01

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +- 1.40 S.D.) and group B (5.95 mg% +- 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  1. Renal failure in cirrhosis: Emerging concepts

    Institute of Scientific and Technical Information of China (English)

    Paulo; Lisboa; Bittencourt; Alberto; Queiroz; Farias; Carlos; Terra

    2015-01-01

    Acute renal failure, now termed acute kidney injury(AKI), is frequently found in patients with cirrhosis. The occurrence of AKI, irrespective of the underlying cause, is associated with reduced in-hospital, 3-mo and 1-year survival. Hepatorenal syndrome is associated with the worst outcome among AKI patients with cirrhosis. Several definitions for AKI that have been proposed are outlined and evaluated in this paper. Among these, the International Club for Ascites-AKI criteria substantially strengthen the quality of early diagnosis and intervention according to underlying cause of AKI.

  2. [Treatment with (131)I of thyroid remnants in a patient with papillary thyroid carcinoma and end-stage chronic renal failure].

    Science.gov (United States)

    Andres, A; Tardín, L; Santapau, A; Razola, P; Prats, E; Parra, A; Rivas, M A; Ruiz, P; Alvarez, R; Camara, A; Banzo, J

    2010-01-01

    The follow-up and treatment of thyroid cancer presents several aspects subject to discussion, such as its management in patients with End-Stage Renal Failure (ESRF). We present a patient with ESRF and papillary thyroid carcinoma, which had to be coordinated among different departments (Endocrinology, Nuclear Medicine, Nephrology and Physics and Radiation Protection). Both the diagnostic scintigraphy with (123)I and the ablative treatment with (131)I performed later were performed with the administration of rh TSH. The room in which the metabolic therapy was to be performed was prepared for the patient's periodic hemodialysis. The (131)I dose used was 80% of the usual dose. This made it possible to assure the therapeutic effect and that the patient's stay in hospital would only be for 5 days. Throughout the whole diagnostic and therapeutic process, no adverse effects attributable to rh TSH or radioiodine were observed. The coordination among the departments involved enabled an effective and safe process for the patient. PMID:20018412

  3. Calciphylaxis in chronic, non-dialysis-dependent renal disease

    Directory of Open Access Journals (Sweden)

    Paschke Ralf

    2003-09-01

    Full Text Available Abstract Background Calciphylaxis cutis is characterized by media calcification of arteries and, most prominently, of cutaneous and subcutaneous arterioles occurring in renal insufficiency patients. Case Report A 53-year-old woman with chronic cardiac and renal failure complained of painful crural, non-varicosis ulcers. She was hospitalized in an immobilized condition due to both the crural ulcerations and the existing heart-failure state (NYHA III-IV having pleural and pericardial effusions, atrial fibrillation and weight loss of 30 kg over the past year. Despite normalization of calcium-phosphorus balance and improvement of renal function, the clinical course of crural ulcerations deteriorated during the following 3 months. After failure of surgical debridements, multiple courses of sterile-maggot therapy were introduced at a late stage to stabilize the wounds. The patient died of recurrent wound infections and sepsis paralleled by exacerbations of renal malfunction. Conclusions The role of renal disease in vascular complications is discussed. Sterile-maggot debridement may constitute a therapy for the ulcerated calciphylaxis at an earlier stage, i.e. when first ulcerations appear.

  4. Sympatho-renal axis in chronic disease

    OpenAIRE

    Sobotka, Paul A.; Mahfoud, Felix; Schlaich, Markus P; Hoppe, Uta C.; Böhm, Michael; Krum, Henry

    2011-01-01

    Essential hypertension, insulin resistance, heart failure, congestion, diuretic resistance, and functional renal disease are all characterized by excessive central sympathetic drive. The contribution of the kidney’s somatic afferent nerves, as an underlying cause of elevated central sympathetic drive, and the consequences of excessive efferent sympathetic signals to the kidney itself, as well as other organs, identify the renal sympathetic nerves as a uniquely logical therapeutic target for d...

  5. Incidence and Predictors of End-Stage Renal Disease in Outpatients With Systolic Heart Failure

    DEFF Research Database (Denmark)

    Bosselmann, Helle Skovmand; Gislason, Gunnar; Gustafsson, Finn;

    2013-01-01

    Background- Renal dysfunction is an important prognostic factor in heart failure (HF), but whether this dysfunction progresses to end-stage renal disease (ESRD) is unknown. Therefore, we examined incidence and predictors of ESRD in outpatients with HF. Methods and Results- Patients with systolic HF...... were identified in The Danish Heart Failure database and new-onset ESRD from the Danish Registry on Dialysis. Renal function was estimated by The Chronic Kidney Disease Epidemiology Collaboration equation and patients grouped by estimated glomerular filtration rate (eGFR)-group I: ≥60 mL/min per 1.73 m...

  6. Acute Renal Failure in Liver Transplant Patients: Indian Study

    OpenAIRE

    Naik, Pradeep; Premsagar, B.; Mallikarjuna, M.

    2013-01-01

    The acute renal failure is the frequent medical complication observed in liver transplant patients. The objective of this study was to determine the cause of acute renal failure in post liver transplant patients. A total of 70 patients who underwent (cadaveric 52, live 18) liver transplantation were categorized based on clinical presentation into two groups, namely hepatorenal failure (HRF, n = 29), and Hepatic failure (HF, n = 41). All the patients after the liver transplant had received tac...

  7. Acute renal failure in pregnancy: our experience.

    Science.gov (United States)

    Aggarwal, Rohina S; Mishra, Vineet V; Jasani, Anil F; Gumber, Manoj

    2014-03-01

    Acute renal failure (ARF) is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during pregnancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH), post-partum hemorrhage (PPH), septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8). The first trimester, second trimester and puerperal groups comprised of four (8%), 25 (50%) and 21 patients (42%), respectively. Hemorrhage was the etiology for ARF in 15 (30%), APH in ten (20%) and PPH in five (10%) patients. Eleven (22%) patients had lower segment cesarian section (LSCS) while 36 (78%) patients had normal vaginal delivery. In 20 (40%) patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36%) patients. Two (4%) patients had disseminated intravascular coagulation on presentation while one (2%) patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n = 6

  8. Acute renal failure in pregnancy: Our experience

    Directory of Open Access Journals (Sweden)

    Rohina S Aggarwal

    2014-01-01

    Full Text Available Acute renal failure (ARF is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during preg-nancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH, post-partum hemorrhage (PPH, septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8. The first trimester, second trimester and puerperal groups comprised of four (8%, 25 (50% and 21 patients (42%, respectively. Hemorrhage was the etiology for ARF in 15 (30%, APH in ten (20% and PPH in five (10% patients. Eleven (22% patients had lower segment cesarian section (LSCS while 36 (78% patients had normal vaginal delivery. In 20 (40% patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36% patients. Two (4% patients had dissemi-nated intravascular coagulation on presentation while one (2% patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n

  9. 28 CFR 79.57 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.57... disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... conclusion that a claimant developed chronic renal disease must be supported by medical documentation. (b)...

  10. Medicamentos excepcionais para doença renal crônica: gastos e perfil de utilização em Minas Gerais, Brasil Dispensing of exceptional drugs for chronic renal failure: expenditures and patients' profile in Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Grazielle Dias da Silva

    2011-02-01

    Full Text Available No Brasil, os medicamentos para o tratamento da doença renal crônica são disponibilizados gratuitamente pelo Sistema Único de Saúde (SUS. Este estudo teve como objetivos descrever os gastos públicos com esses medicamentos em Minas Gerais, Brasil, e o perfil dos usuários; objetivou, também, analisar os fatores associados ao gasto médio mensal individual. Observou-se que o gasto total com os medicamentos estudados (R$ 41,6 milhões representa uma parcela significativa do gasto total com procedimentos ambulatoriais no SUS (9,6%. A maioria dos usuários é do sexo masculino, adultos jovens e teve como causa principal de doença renal crônica a hipertensão arterial. A análise multivariada indicou tendência de menor gasto entre indivíduos que eram mais idosos, que tinham como causa principal da doença o diabetes, que fizeram uso de hidróxido de ferro e que residiam em municípios de menor IDH-M (p In Brazil, medicines for treatment of chronic renal failure are available free of cost from the Unified National Health System (SUS. This study's objectives were to describe government spending on these drugs in Minas Gerais State, Brazil, and the patients' profile, as well as to analyze the factors associated with individual average monthly costs. Spending on medication for chronic renal failure (R$ 41.6 million, or U$25 million represents a significant portion of total spending on outpatient procedures in the National health System (9.6%. Most patients are young adult males with arterial hypertension as the main cause of chronic renal failure. Multivariate analysis showed a trend towards lower spending on elderly patients, those with diabetes as the main underlying disease, those using iron hydroxide, and in municipalities with a lower human development index, or HDI (p < 0.05. Finally, the study indicated the importance of management tools that allow monitoring the trajectory of individual patients in the health system and support

  11. Renal failure as a result of mesenteric cyst.

    Science.gov (United States)

    Cain, William C; Kennedy, Shalyn; Evans, Neil; Goldthorne, Jane; Tsikouris, James; Anuras, Julia; Varma, Surendra; Meyerrose, Gary E

    2004-09-01

    The authors report a rare case of renal failure secondary to abdominal cyst in a newborn girl. The clinical presentation was one of a largely distended abdomen coupled with anuria. The histopathologic and clinical findings suggest mesenteric cyst causing renal failure by mass effect. PMID:15359411

  12. [Acetaminophen (paracetamol) causing renal failure: report on 3 pediatric cases].

    Science.gov (United States)

    Le Vaillant, J; Pellerin, L; Brouard, J; Eckart, P

    2013-06-01

    Renal failure secondary to acetaminophen poisoning is rare and occurs in approximately 1-2 % of patients with acetaminophen overdose. The pathophysiology is still being debated, and renal acetaminophen toxicity consists of acute tubular necrosis, without complication if treated promptly. Renal involvement can sometimes occur without prior liver disease, and early renal manifestations usually occur between the 2nd and 7th day after the acute acetaminophen poisoning. While therapy is exclusively symptomatic, sometimes serious metabolic complications can be observed. The monitoring of renal function should therefore be considered as an integral part of the management of children with acute, severe acetaminophen intoxication. We report 3 cases of adolescents who presented with acute renal failure as a result of voluntary drug intoxication with acetaminophen. One of these 3 girls developed severe renal injury without elevated hepatic transaminases. None of the 3 girls' renal function required hemodialysis, but one of the 3 patients had metabolic complications after her acetaminophen poisoning. PMID:23628119

  13. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  14. Rhabdomyolysis and Acute Renal Failure after Gardening

    Directory of Open Access Journals (Sweden)

    Zeljko Vucicevic

    2015-01-01

    Full Text Available Acute nontraumatic exertional rhabdomyolysis may arise when the energy supply to muscle is insufficient to meet demands, particularly in physically untrained individuals. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden. Although specifically asked, the patient denied any hard physical work or gardening, and heteroanamnestic data were not available. The diagnosis of rhabdomyolysis was easy to establish, but until reliable anamnestic data were obtained, the etiology remained uncertain. Four days after arrival, the patient recalled working hard in the garden. The etiology of rhabdomyolysis was finally reached, and the importance of anamnestic data was once more confirmed.

  15. Rhabdomyolysis and acute renal failure after gardening.

    Science.gov (United States)

    Vucicevic, Zeljko

    2015-01-01

    Acute nontraumatic exertional rhabdomyolysis may arise when the energy supply to muscle is insufficient to meet demands, particularly in physically untrained individuals. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden. Although specifically asked, the patient denied any hard physical work or gardening, and heteroanamnestic data were not available. The diagnosis of rhabdomyolysis was easy to establish, but until reliable anamnestic data were obtained, the etiology remained uncertain. Four days after arrival, the patient recalled working hard in the garden. The etiology of rhabdomyolysis was finally reached, and the importance of anamnestic data was once more confirmed. PMID:25954536

  16. Estatinas na doença renal crônica Statins in chronic renal disease

    Directory of Open Access Journals (Sweden)

    Soraia R. C. Ferreira

    2005-10-01

    Full Text Available Hipertrigliceridemia e o HDL baixo são aspectos comuns em pacientes com insuficiência renal crônica. A mortalidade cardiovascular está substancialmente aumentada na presença de doença renal crônica (10-20 vezes maior. Existem evidências de estudos clínicos com estatinas sugerindo uma ação protetora dessas drogas na progressão da doença renal. Além disso, pacientes pós-transplante renal recebendo fluvastatina, experimentaram redução na incidência de infartos não fatais e de mortalidade cardíaca. Entretanto, um estudo recente com atorvastatina não demonstrou reduções na morbi-mortalidade cardiovascular entre pacientes diabéticos em hemodiálise. Estudos em andamento definirão o preciso papel das estatinas neste grupo especial de pacientes.Hypertriglyceridemia and low HDL-c are common features in patients with chronic renal failure. Cardiovascular mortality is substantially increased in the presence of chronic renal disease (10-20 times higher. There is evidence from clinical trials with statins suggesting their protective role in the progression of renal disease. In addition, reduced rates of non-fatal myocardial infarction and cardiac mortality were seen after renal transplant in patients receiving fluvastatin. However, a recent study with atorvastatin failed to demonstrate reduction in cardiovascular morbidity and mortality among diabetic patients on hemodyalisis therapy. Ongoing trials will define the precise role of statins in this subset of patients.

  17. Symptom management in patients with established renal failure managed without dialysis.

    Science.gov (United States)

    Murtagh, F E M; Addington-Hall, J M; Donohoe, P; Higginson, I J

    2006-01-01

    Increasing numbers of patients with chronic kidney disease Stage 5 (GFR capsaisin cream, antihistamines, thalidomide and ondansetron may be helpful, according to the extent and pattern of pruritus. Symptoms may frequently be due to co-morbid conditions, not renal disease itself, and managing them is difficult because of the constraints on the use of medication which kidney failure imposes. Collaboration between renal and palliative specialists can help identify ways to achieve best care for these patients. PMID:16898102

  18. Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction

    DEFF Research Database (Denmark)

    McAlister, Finlay A; Ezekowitz, Justin; Tarantini, Luigi;

    2012-01-01

    Prior studies in heart failure (HF) have used the Modification of Diet in Renal Disease (MDRD) equation to calculate estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease-Epidemiology Collaboration Group (CKD-EPI) equation provides a more-accurate eGFR than the MDRD when compared...... against the radionuclide gold standard. The prevalence and prognostic import of renal dysfunction in HF if the CKD-EPI equation is used rather than the MDRD is uncertain....

  19. Heat-processed ginseng saponin ameliorates the adenine-induced renal failure in rats

    OpenAIRE

    Kim, Eun Jin; Oh, Hyun-A; Choi, Hyuck Jai; Park, Jeong Hill; Kim, Dong-Hyun; Kim, Nam Jae

    2013-01-01

    To evaluate the effect of the saponin of heat-processed ginseng (Sun ginseng, SG), we investigated the protective effect of SG total saponin fraction against adenine-induced chronic renal failure in rats. SG saponin significantly decreased the levels of urea nitrogen and creatinine in the serum, but increased the urinary excretion of urea nitrogen and creatinine, indicating an improvement of renal function. SG saponin also inhibited adenine-induced kidney hypertrophy and edema. SG saponin red...

  20. Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

    Directory of Open Access Journals (Sweden)

    Samia Rafael Yamashita

    2015-02-01

    Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

  1. Agentes calciomiméticos en el tratamiento del hiperparatiroidismo secundario a la insuficiencia renal crónica Calcimimetic agents in the treatment of hyperparathyroidism secondary to chronic renal failure

    Directory of Open Access Journals (Sweden)

    A. L. Negri

    2003-04-01

    molecules that act as allosteric activators of the CaSR and they are in their initial face of clinical development. Although the experience with these drugs is limited, they have shown to effectively lower parathyroid hormone levels in patients with hyperparathyroidism secondary to end-stage renal failure without inducing important side-effects. Thus calcimimetic compounds have considerable potential as new drugs for the treatment of secondary hyperparathyroidism and uremic bone disease.

  2. Renal Cell Protection of Erythropoietin beyond Correcting The Anemia in Chronic Kidney Disease Patients

    OpenAIRE

    Hamid Nasri

    2013-01-01

    Currently many patients with chronic renal failure have profited from the use of erythropoietin to correct anemia (1,2). In chronic kidney disease, anemia is believed to be a surrogate index for tissue hypoxia that continues preexisting renal tissue injury (1-3). Erythropoietin is an essential glycoprotein that accelerates red blood cell maturation from erythroid progenitors and facilitates erythropoiesis. It is a 30.4 kD glycoprotein and class I cytokine containing 165 amino acids (3,4). App...

  3. Systematic Evaluation on Jinshuibao Capsule for Chronic Renal Failure%金水宝胶囊治疗慢性肾功能衰竭的系统评价

    Institute of Scientific and Technical Information of China (English)

    聂玲辉; 孙升云; 伍志勇; 徐梅; 颜显欣; 黄少君

    2012-01-01

    目的:评价金水宝胶囊治疗慢性肾功能衰竭(CRF)的疗效和安全性,为指导临床获得更好的循证医学依据.方法:按Cochrane标准,运用系统评价方法,全面检索图书馆PubMed(1966 - 2011年),中国生物医学文献数据库(1977 - 2011年11月)和中国期刊全文数据库(1994 - 2011年11月)等数据库,收集以金水宝胶囊为干预措施治疗慢性肾功能衰竭的随机对照试验(RCT).按Cochrane系统评价方法,由2位研究者独立地对符合纳入标准的试验进行资料提取,并进行研究方法的质量评估和对提取的有效数据进行Meta分析.结果:有8个试验,共710例CRF患者符合纳入标准,Meta分析结果显示,在常规治疗的基础上加用金水宝胶囊治疗CRF能更好改善肾功能,提高患者的生存质量.其改善指标数据如下:血尿素氮[ MD-2.23,95% CI(-2.60,-1.85),P<0.000 01];血肌酐[MD-40.71,95%CI(-45.68,-35.75),P<0.000 01];24 h尿蛋白定量[ MD-0.17,95%CI(-0.31,-0.03),P=0.02];内生肌酐清除率[MD-25.71,95% CI(- 26.36,- 25.06),P<0.00001].结论:现有证据表明,在常规治疗的基础上联合金水宝胶囊可有效延缓慢性肾功能衰竭患者肾功能的进展且副作用较小.由于本研究样本量小,又缺乏高质量的多中心、双盲、随机对照实验,故对金水宝胶囊治疗慢性肾功能衰竭的有效性及安全性做出全面肯定的评价还有待进一步研究.%Objective: To obtain the effect and safety of Jinshuibao capsule in treatment of patients with chronic renal failure (CRF). Method; We searched PubMed (1966?006), CNKI (1994?011) databases and so on, and retrieved by computer and manual search to collect randomized controlled trial ( RCT) on Jinshuibao capsule in treatment of chronic renal failure from 1979 to 2011. Two researchers independently executed a data extraction according to the inclusion criteria of Trials and quality assessment, Meta analysis was carried out. Result; A total of

  4. 慢性肾衰竭合并肺部感染176例临床分析%Clinical analysis of hospitalized patients with chronic renal failure complicated by pulmonary infection

    Institute of Scientific and Technical Information of China (English)

    商进春

    2011-01-01

    Objective To determine the causative organism and antimicrobial susceptibility of community and hospital acquired pneumonia (CAP and HAP) in chronic renal failure complicated by pulmonary infection in hospital. Methods The data of bacteria and spectrum and their drug susceptibility in patients with chronic renal failure complicated by pulmonary infection were retrospectively analyzed. Results The isolated bacteria of spectrum cultural of 176 cases included 62 gram negative bacilli (48. 4%), 42 fungus (32. 8%) and 24 gram-positive cocci (18. 8%), G+ cocci mainly included staphylococci, G-bacilli mainly included Klebiella pneumoniae, Bowman immovability bacillus and Pseudomonas aeruginosa. In both CAP and HAP. Fungus and G-bacilli were the dominant pathogens. The pathogenic bacteria were resistant to multi-antibiotics, and the resistant rates from HAP patients was higher than those from CAP. Conclusion Fungus and G-bacilli were the dominant pathogens. Phlegm culture and drug sensitive test are helpful for reasonable use of antibiotics for patients with chronic renal failure complicated by pulmonary infection in clinical practice.%目的 了解慢性肾衰竭合并肺部感染患者的致病菌分布及药敏情况,比较社区获得性肺炎(CAP)和医院获得性肺炎(HAP)的病原谱差异和耐药强弱.方法 分析176例慢性肾衰竭合并肺部感染患者的痰培养和药敏测定结果.结果 176倒痰培养致病菌分布为:革兰阴性杆菌62株(48.4%),真菌42株(32.8%),革兰阳性球菌24株(18.8%),革兰阳性球菌主要包括葡萄球菌,革兰阴性杆菌主要包括肺炎克雷伯杆菌、鲍曼不动杆菌和铜绿假单胞菌.CAP和HAP组均以革兰阴性杆菌和真菌为主,两组对多种抗生素耐药性较高,HAP组明显高于CAP组.结论 慢性肾衰竭患者合并CAP与HAP病原菌均以革兰阴性杆菌和真菌多见,两组病原谱差异和耐药情况存在统计学差异,临床应重视慢性肾衰竭合并肺部感

  5. CPAP in chronic heart failure

    Directory of Open Access Journals (Sweden)

    F. Lari

    2013-05-01

    Full Text Available BACKGROUND Chronic Heart Failure (CHF represents worldwide a clinical condition with increasing prevalence, high social, economical and epidemiological impact. Even if new pharmacological and non-pharmacological approachs have been recently used, mortality remains high in general population and quality of life is poor in these patients. DISCUSSION The association between CHF and sleep disorders is frequent but still undervalued: sleep apnoeas in CHF produce negative effects on cardiovascular system and an aggravation of prognosis. CPAP (Continuous Positive Airway Pressure is commonly used to treat sleep apnoeas in patients without cardiac involvement and it is also used in first line treatment of acute cardiogenic pulmonary oedema thanks to its hemodynamic and ventilatory effects. The addition of nightly CPAP to standard aggressive medical therapy in patients with CHF and sleep apnoeas reduces the number of apnoeas, reduces the blood pressure, and the respiratory and cardiac rate, reduces the activation of sympathetic nervous system, the left ventricular volume and the hospitalization rate; besides CPAP increases the left ventricular ejection fraction, amd the oxygenation, it improves quality of life, tolerance to exercise and seems to reduce mortality in patients with a higher apnoeas suppression. CONCLUSIONS These implications suggest to investigate sleep apnoeas in patients with CHF in order to consider a possible treatment with CPAP. Further studies need to be developed to confirm the use of CPAP in patients with CHF without sleep disorders.

  6. Acute renal failure from rhabdomyolysis by heroin use: nursing approach

    Directory of Open Access Journals (Sweden)

    Evangelia Prevyzi

    2013-04-01

    Full Text Available Rhabdomyolysis is caused by muscle breakdown resulting in the release of myoglobin into the systemic circulation. Acute renal failure results from the nephrotoxicity of myoglobin. Heroin use is one of the causes of rhabdomyolysis and acute renal failure. Aim: The aim of this literature review was highlight the importance of early recognition and treatment by a nurse of acute renal failure from rhabdomyolysis after heroin. Method: The method followed in this review was based on retrospective studies and research, conducted during the period 2000-2012 and retracted from the international databases Medline, Pubmed, Cinahl and the Greek database Iatrotek on acute renal failure from rhabdomyolysis after heroin use. Key-words were used: acute renal failure, rhabdomyolysis, heroin, international guidelines, based-evidence nursing care. Results: The clinical presentation occurs with muscle pain, muscle weakness, and brown-redish urine. High values of CPK and myoglobin make the diagnosis. Toxicology tests confirm heroin use. For the treatment is required naloxone administration, the rapid hydration of the patient, alkalinization of urine, good diuresis, regulation of electrolyte disturbances and dialysis if necessary. Conclusions: Early recognition and treatment of acute renal failure from rhabdomyolysis after heroin use is vital for the survival of the patient. It is necessary to educate nurses on specific issues such as acute renal failure from rhabdomyolysis after heroin use and the implementation of protocols for the treatment and cure.

  7. Low-dose captopril in the treatment of severe refractory hypertension associated with renal failure

    OpenAIRE

    Bell, G. M.; Doig, A.; Watson, M. L.; Muir, A L; Winney, R. J.

    1982-01-01

    Six patients with severe refractory hypertension and chronic renal failure were treated with a low dose of captopril (mean daily dose 75 mg) in combination with dietary sodium restriction, frusemide and either metoprolol, labetalol or prazosin. Sustained control of blood pressure was achieved in all six patients. Adverse effects noted were severe hyperkalaemia (2 patients), skin rashes (2 patients) and taste disturbance (1 patient).

  8. Chronic renal failure patients' causes of death and influencing factors%慢性肾功能衰竭患者死亡原因和影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘兵; 朱吉莉

    2013-01-01

    Objectives:To investigate the cause of death and the influencing factors of patients with chronic renal failure in order to improve the prognosis of patients.Methods:We reviewed the information of 87 chronic renal failure clinical cases in the hospital from August of 2009-August of 2012 to analyze causes of death and the influencing factors.Results:Among 78 patients,19 of them died,accounting for 21.84% ; the top three causes of death were serious infection,arrhythmia and myocardial infarction,accounting for 36.84%,21.06%,15.79% respectively; the single-factor analysis showed high risk factors,including age,hypertension,diet,serious infection,sexual life,arrhythmia,myocardial infarction and malnutrition (P < 0.05).Condusions:Therapeutic intervention and health guidance are helpful in improving the prognosis of the patients.%目的:对慢性肾功能衰竭患者死亡原因和影响因素进行分析,为改善患者预后提供参考依据.方法:回顾性分析本院2009年8月~ 2012年8月收治的87例慢性肾功能衰竭的临床资料,对患者的死亡原因及影响因素进行分析.结果:死亡19例患者,占21.84%;死亡原因前三位是严重感染、心律失常、心肌梗塞,分别占36.84% (7/19)、21.06% (7/19)、15.79%(3/19);通过单因素结果分析,年龄、高血压、控制饮食、严重感染、性生活、心律失常、心肌梗塞、营养不良是慢性肾功能衰竭患者死亡的危险因素(P<0.05).结论:对高危因素患者进行干预治疗及健康指导,有助于改善患者预后.

  9. Escore de cálcio coronariano prediz estenose e eventos na insuficiência renal crônica pré-transplante Score de calcio coronario predice estenosis y eventos en la insuficiencia renal crónica pre trasplante Coronary calcium score as predictor of stenosis and events in pretransplant renal chronic failure

    Directory of Open Access Journals (Sweden)

    Miguel Abraão Rosário

    2010-02-01

    este grupo. La evaluación del score de calcio coronario (SCC por tomografía computarizada ha estado comprobando valor pronóstico en la población sin enfermedad renal. OBJETIVO: Evaluar la exactitud del SCC para detectar EAC obstructiva y prever eventos cardiovasculares en candidatos a trasplante renal comparada a la angiografía coronaria invasiva (ACI cuantitativa. MÉTODOS: Se evaluaron a 97 pacientes con IRC y edad > 35 años. Se consideró como EAC obstructiva la presencia de estenosis > 50% o > 70% por la ACI. Datos descriptivos, concordancia, pruebas diagnósticas, Kaplan-Meier y análisis multivariado se utilizaron. RESULTADOS: El score de Agatston promedio fue de 580,6 ± 1.102,2; los valores mínimos y máximos fueron 0 y 7.994, y mediana de 176. Solamente 14 pacientes tenían score de calcio de cero. No hubo diferencias entre las etnias y la mayor presencia de calcio regional se asoció a la mayor probabilidad de estenosis coronaria en el mismo segmento. El score de calcio de Agatston presentó buena exactitud para el diagnóstico de estenosis, > 50% y > 70% con área bajo la curva ROC de 0,75 y 0,70, respectivamente. En el umbral de 400, el score de calcio identificó el subgrupo con mayor tasa de eventos cardiovasculares en tiempo promedio de seguimiento de 29,1 ± 11,0 meses. CONCLUSIÓN: El SCC en la evaluación de EAC presentó una buena performance diagnóstica y pronostica para eventos cardiovasculares en pacientes con insuficiencia renal crónica (IRC.BACKGROUND: Coronary artery disease (CAD is the major cause of death among chronic renal failure (CRF patients. Traditional, non-invasive exams to detect CAD and to predict events have shown insufficient results in this group. CT Scan evaluation of Coronary Calcium Score (CCS has proven to be of prognostic value for the population reporting no renal condition. OBJECTIVE: To investigate CCS accuracy in detecting obstructive CAD and in predicting cardiovascular events in candidates to renal transplant

  10. Antibody Response Against Perlecan and Collagen Types IV and VI in Chronic Renal Allograft Rejection in the Rat

    OpenAIRE

    Joosten, Simone A.; van Dixhoorn, Mieneke G. A.; Borrias, Maria C.; Benediktsson, Hallgrimur; van Veelen, Peter A.; van Kooten, Cees; Paul, Leendert C.

    2002-01-01

    Chronic rejection is the leading cause of late renal transplant failure. Various structural lesions are observed in grafts undergoing chronic rejection including glomerular basement membrane (GBM) duplications. The well-established Fisher (F344) to Lewis (LEW) rat renal transplant model for chronic rejection was used to assess the presence and role of the humoral immune response against graft antigens during chronic rejection. LEW recipients of F344 allografts develop transplant glomerulopath...

  11. Inconsequence of membrane choice in acute renal failure?

    Science.gov (United States)

    Mujais, S K; Ivanavich, P

    1996-05-01

    The choice of hemodialysis membrane in acute renal failure has caused a heated debate, principally because of the dogmatism with which the results of preliminary clinical studies have been translated into prescription dictum. The issue, however, is not merely the limitations of these two studies, but rather the shift in emphasis they may have engendered in the approach to dialytic therapy in acute renal failure. Dogmatism based on limited or flawed data does not serve the interests of our patients, and the issue of hemodialysis in acute renal failure is far more complex than the exaggerated importance of membrane choice. PMID:8725627

  12. Renal failure after operation for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Olsen, P S; Schroeder, T; Perko, M;

    1990-01-01

    Among 656 patients undergoing surgery for abdominal aortic aneurysm, 81 patients (12%) developed postoperative renal failure. Before operation hypotension and shock occurred in 88% of the patients with ruptured aneurysm, whereas none of the patients operated electively were hypotensive. Dialysis......-up. In six cases the death was caused by renal failure only or in combination with failure of other organs. Analysis of the cumulative survival shows that, if the patients survive the postoperative period, their life expectancy is comparable to that of patients without renal complications....

  13. Hepatocyte growth factor prevents acute renal failure and accelerates renal regeneration in mice.

    OpenAIRE

    Kawaida, K; Matsumoto, K.; Shimazu, H.; Nakamura, T.(International Center for Elementary Particle Physics and Department of Physics, The University of Tokyo, Tokyo, Japan)

    1994-01-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppre...

  14. 中医中药治疗慢性肾衰竭临床进展%Clinical Progress of the Traditional Chinese Medicine and Herbats in Treating Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    郑淑婷; 苏竞

    2012-01-01

    Chronic renal failure( CRF ), is a major hazard seriously threatening human health in the 21 st century,following cardiovascular and cerebrovascular disease,cancer and diabetes. But modern medical treatment of CRF effects are less than ideal,the traditional Chinese medicine and herbals has a prominent therapeutic effect on releasing symptoms, protecting residual renal function and postponing disease progression. Here is to make a detailed overview on the pathogenesis, therapeutic methods including dialectical therapy, enema of Chinese herbals,therapy in Chinese patent medicine and single herb and external therapy,micro-inflammatory behavior and effective anti-inflammatory treatment of traditional Chinese drug.%慢性肾衰竭(CRF)是21世纪继心脑血管疾病、肿瘤和糖尿病后严重威胁人类健康的一大公害.但现代医学治疗CRF效果不甚理想,中医中药在缓解症状、保护残余肾功能、延缓病情进展等方面有显著的作用.现从中医学角度就近几年对CRF的病因病机、治疗方法 (包括辨证论治、中药灌肠、中成药和单味药治疗及外治法等)、CRF的微炎症状态及有效的中药抗感染治疗研究进展进行综述.

  15. Post-renal acute renal failure due to a huge bladder stone

    Directory of Open Access Journals (Sweden)

    Orcun Celik

    2014-06-01

    Full Text Available A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography scan showed a huge bladder stone (5 cm x 6 cm x 5 cm with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

  16. Observe Curative Effect of Using Calcitriol to Treat Chronic Renal Failure Renal Osteopathy Patients%慢性肾功能衰竭肾性骨病患者采取骨化三醇治疗的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴勇; 林克宣

    2013-01-01

      目的:关于将骨化三醇用于治疗慢性肾功能衰竭肾性骨病患者所取得的疗效进行分析探讨。方法:选取在笔者所在医院接受治疗的66例慢性肾功能衰竭肾性骨病患者,将患者随机分成两组。对照组患者进行常规治疗。实验组患者在进行常规治疗的同时采用骨化三醇治疗。比较并观察两组患者治疗后各指标的变化情况,以及观察治疗后两组患者出现不良反应的情况。结果:两组患者进行不同方法治疗后,实验组血清钙(2.46±0.39)mmol/L明显高于对照组(1.99±0.37)mmol/L,比较差异有统计学意义(P<0.05)。实验组血磷、碱性磷酸酶、尿素氮、肌酐明显低于对照组,比较差异有统计学意义(P<0.05)。结论:采用骨化三醇用于治疗慢性肾功能衰竭肾性骨病比常规治疗的效果好,可以加快钙的吸收,降低患者体内血磷、碱性磷酸酶、尿素氮、肌酐水平,可有效改善肾性骨病,且不良反应发生率低,在临床上可以广泛运用。%Objective:To discuss and analyze curative effect of using calcitriol to treat chronic renal failure renal osteopathy patients.Method:Chose 66 cases of these chronic renal failure renal osteopathy patients who have been treated at our hospital,divided them into control group and experimental group randomly.Proceeded conventional treatment to control group’s patients,while added calcitriol to experimental group’s patients on the basis of conventional treatment.Compared and observed these two groups’patients’change situations of various indexes after treatment,and observed their happening conditions of adverse reactions after treatment.Result:After these two groups patients received different treatments,experimental group’s serum calcium content(2.46±0.39)mmol/L was obviously higher than control group’s(1.99±0.37)mmol/L,it has statistics meaning(P<0.05). Experimental group’s blood

  17. [Acute renal failure caused by phenazopyridine].

    Science.gov (United States)

    Vega, Jorge

    2003-05-01

    A 27 years old woman was admitted due to abdominal cramps, jaundice and oligoanuria, starting 48 hours after eating Chinese food. Hepatic biochemical tests, abdominal ultrasound and retrograde pyelography were normal. The urine was intensely orange colored and microscopic analysis was normal. The serum creatinine and urea nitrogen on admission were 4.59 and 42.5 mg/dl and rose to 13.5 and 72.4 mg/dl, respectively, at the 6th hospital day. Oliguria lasted only 48 hours. Dialysis was not used, since the patient was in good general condition and uremic symptoms were absent. On the 7th day, azotemia began to subside and at the 14th day, serum creatinine was 1.0 mg/dl. Before hospital discharge, she confessed the ingestion of 2.000 mg of phenazopyridine, during a nervous breakdown, aiming to sleep deeply. Remarkable was the persistence of the orange color of her urine during several days and the dissociation between the rate of increase of serum creatinine with respect to urea nitrogen. This is an unusual case of acute renal failure caused by an overdose of a drug, commonly prescribed for urinary tract infections. PMID:12879816

  18. Rapid improvement in renal function in patients with multiple myeloma and renal failure treated with bortezomib

    Directory of Open Access Journals (Sweden)

    Qayum Abdul

    2010-01-01

    Full Text Available Multiple Myeloma (MM frequently presents with renal dysfunction apart from other manifestations. Development of renal failure in patients with MM carries a poor prognosis. Bortezo-mib is a new addition to drugs used in MM and has shown good efficacy and safety profiles. Previous trials have shown its efficacy in relapsed and refractory MM as well. Studies have also shown that bortezomib is also effective in patients with MM who present with renal failure. We report here six cases of renal failure secondary to MM treated with bortezomib. All patients had poor performance status of 3-4 on ECOG scale. Five out of six patients showed satisfactory anti-myeloma response to bortezomib. Reversal of renal failure was observed in all six patients. Adverse effects to bortezomib were mild and manageable. Reversal of renal failure persisted despite incomplete response to MM in two cases, and progression of disease in one patient. It appears that bortezomib may have an effect on the kidneys in reversal of renal failure, other than its anti-myeloma effect. In conclusion, borte-zomib appears to be an effective treatment for patients with advanced MM and renal failure irres-pective of performance status and age.

  19. Nourishing Kidney, Invigorating Spleen and Clearing away Turbidity Therapy for Chronic Renal Failure%益肾健脾清利化浊法治疗慢性肾功能不全

    Institute of Scientific and Technical Information of China (English)

    叶景华; 张彤; 盖云; 蔡艳

    2011-01-01

    The dysfunction of spleen and kidney is the fundamental pathogenesis of chronic renal failure (CRF) and its pathology manifests mixture of asthenia and sthenia, and deficiency in the root and excess in the branch.The deficiency in the root is asthenia of spleen and kidney and the excess in the branch is the retention of dampness, turbid and stasis.So nourishing kidney and invigorating spleen are the key of treatment based on syndrome differentiation of CRF, and clearing away turbidity is the emphasis for dispelling pathogenic factor.%脾肾功能失常是慢性肾功能不全的根本病机,病变过程为虚实夹杂、本虚标实.本虚为脾肾虚衰,标实为湿、浊、瘀毒留滞,因此,益肾健脾为慢性肾衰辨证论治的关键,而清利化浊为消除慢性肾功能不全增恶因素的重点.

  20. Synthetic cannabinoid hyperemesis resulting in rhabdomyolysis and acute renal failure.

    Science.gov (United States)

    Argamany, Jacqueline R; Reveles, Kelly R; Duhon, Bryson

    2016-04-01

    Synthetic cannabinoid usage has increased in the past decade. Concurrently, emergency management of associated adverse effects due to synthetic cannabinoid usage has also risen. Reported toxicities include psychosis, seizures, cardiotoxicity, acute kidney injury, and death. While cannabis was first described as a cause of acute hyperemesis in 2004, a more recent case series also describes the association between cannabinoid hyperemesis and risk of acute renal failure. Synthetic cannabinoids have also been reported to cause acute hyperemesis and acute renal failure; however, the risk of rhabdomyolysis-induced renal failure has yet to be elucidated. In this article, we report the first known case of synthetic cannabinoid hyperemesis leading to rhabdomyolysis and acute renal failure. PMID:26422191

  1. Multimodality Renal Failure in a Patient with OEIS Complex

    Directory of Open Access Journals (Sweden)

    Jonathan D. Santoro

    2015-10-01

    Full Text Available Omphalocele-exstrophy of the bladder-imperforate anus-spinal defect (OEIS complex is a rare constellation of clinical abnormalities with wide phenotypic presentation. We describe a case of a preterm neonate with OEIS complex with acute renal failure, and the challenges in diagnosis and management of this patient as renal failure can be a multifactorial process when encountered with this rare complex.

  2. Diabetes mellitus and renal failure: Prevention and management.

    Science.gov (United States)

    Nasri, Hamid; Rafieian-Kopaei, Mahmoud

    2015-11-01

    Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices. PMID:26941817

  3. Diabetes mellitus and renal failure: Prevention and management

    Directory of Open Access Journals (Sweden)

    Hamid Nasri

    2015-01-01

    Full Text Available Nowadays, diabetes mellitus (DM and hypertension are considered as the most common causes of end-stage renal disease (ESRD. In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices.

  4. 指甲肌酐ROC曲线下面积对急慢性肾衰竭的鉴别诊断%Assessment of receiver operating characteristic curve on diagnostic value of nail creatinine in acute and chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    秦小琪; 李惊子; 王海燕

    2001-01-01

    Objective:To search for diagnostic critical value of nail creatinine (NCr) for acute renal failure (ARF) and chronic renal failure (CRF).Methods:Using receiver operating characteristic (ROC) curve method,we analyzed the diagnostic index for ARF and CRF——diagnostic critical value of NCr.Results:Because of individual distributing overlap of the NCr in ARF and CRF and because of the different determinate value for each selected cut-off point,the sensitivity (Se) and specificity (Sp) might vary,there would be differences in area under the ROC curve.The ROC curve area was 78.9 under the 5 cut-off point,and at peak point of the ROC curve the NCr was 84.9.Conclusions:Because ROC curve method combines Se and Sp to estimate the diagnostic critical value of disease index and determine the veracity by the area under the curve,this method has the practical value for clinical diagnosis when ROC curve area is 0.7-0.9 and NCr was 84.9.%目的:寻找指甲肌酐(NCr)鉴别急慢性肾衰竭的诊断界值。方法:应用ROC曲线的方法评价NCr作为鉴别诊断急慢性肾衰竭指标的界值及其优劣。结果:由于急慢性肾衰竭时NCr个体分布的重叠,选取各截断点下判定值的不同,其灵敏度、特异度发生变化,并使得ROC曲线下的面积不同。本研究所取5个截断点下曲线面积为78.9,NCr取值84.9处为曲线最凸点。结论:ROC曲线的面积在0.7~0.9之间有一定的准确性;以NCr测值84.9作为急慢性肾衰竭NCr的鉴别诊断界值有一定的临床价值。

  5. What physicians need to know about renal function in outpatients with heart failure.

    Science.gov (United States)

    Waldum-Grevbo, Bård

    2015-01-01

    The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction. PMID:25966919

  6. Avaliação da suscetibilidade à varicela no paciente pediátrico portador de insuficiência renal crônica Evaluation of chickenpox susceptibility in children with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evandro Roberto Baldacci

    2008-03-01

    Full Text Available OBJETIVO: Avaliar a suscetibilidade natural à varicela de crianças e adolescentes portadores de insuficiência renal crônica (IRC. MÉTODOS: Estudo transversal de 83 pacientes com idade acima de 18 meses e inferior a 18 anos, durante 2000 e 2001, com ritmo de filtração glomerular (RFG abaixo de 70mL/min/1,73m², portando cartão vacinal preconizado pela Fundação Nacional de Saúde e que não receberam nenhuma dose da vacina específica. Do total, três pacientes (3/83 foram excluídos, por terem recebido doses da vacina por meio de órgãos não governamentais. A sorologia foi realizada pelo método Enzyme-Linked Immuno Sorbent Assay, considerando-se títulos sorológicos protetores acima de 100mUA/mL. RESULTADOS: Os pacientes renais crônicos tinham idade mediana de 11 anos, 66% eram masculinos, 60% procedentes do próprio município de São Paulo, com RFG médio de 33,6mL/min/1,73m². O diagnóstico clínico de varicela por profissional médico ocorreu em 39 pacientes; destes, 10% se mostraram soronegativos. Dos 80 pacientes restantes, 21 (26% apresentaram títulos não protetores para varicela. A prevalência de suscetibilidade em menores de seis anos foi 7,93 (IC95%=3,29-19,12 vezes superior à de maiores de seis anos. CONCLUSÕES: Houve diminuição da suscetibilidade à varicela com a idade. Pacientes abaixo de seis anos foram cerca de oito vezes mais suscetíveis à varicela que os renais crônicos com idade mais avançada e duas vezes mais suscetíveis do que a população pediátrica brasileira de mesma idade.OBJECTIVE: To evaluate the immune response to chickenpox natural infection in pediatric patients with chronic renal insufficiency. METHODS: This cross-sectional study enrolled 83 patients between 18 months and 18 years old, with glomerular filtration rate below 70mL/min/1.73m², during the years 2000 and 2001, who did not received specific immunization according to official documentation. Three patients (3/83 had been

  7. Radioablative therapy with Iodine-131 on a patient with thyroid cancer and chronic renal failure in hemodialysis first experience in Peru

    Science.gov (United States)

    Apaza Veliz, D. G.; Herrera Vera, R. D.; Cardenas Abarca, C. A.; Oporto Gonzales, C. A.; Aguilar Ramírez, C.; Vega Ramírez, J. L.; Urquizo Baldomero, R. M.

    2016-07-01

    The Iodine-131 (I-131) is a radioisotope used as a standard treatment for radioablation of thyroid remnants. Among thyroid cancer patients, the ones undergoing hemodialysis represent a specific group. The dose of I-131 is given orally to these patients, part of it is absorbed by the thyroid remnants and the rest of it, largely not incorporated, is excreted primarily by renal excretion. The use of a high dose of radioactivity in the process, and the inability of excretion, represents a high risk of exposure to the patient, medical staff and hemodialysis equipment. This work describes the procedure applied on the radioablation therapy for thyroid cancer while receiving hemodialysis, minimizing the risks for the patient and the staff involved. This clinical procedure will establish the dosimetric measures, a plan on radiation protection and a treatment protocol for this specific type of patients.

  8. Ovine corticotropin-releasing hormone stimulation test in patients with chronic renal failure: pharmacokinetic properties, and plasma adrenocorticotropic hormone and serum cortisol responses.

    Science.gov (United States)

    Siamopoulos, K C; Eleftheriades, E G; Pappas, M; Sferopoulos, G; Tsolas, O

    1988-01-01

    The data on the status of the hypothalamic-pituitary-adrenal (HPA) axis in haemodialysis (HD) patients are conflicting. Moreover, a state reminiscent of Cushing's syndrome has been reported in this group of patients. Corticotropin-releasing hormone (CRH), that is produced by the hypothalamus and modulates the secretion of adrenocorticotropic hormone (ACTH), has been shown to be useful as a provocative test of the HPA axis. We investigated the effect of exogenous ovine CRH (oCRH) on plasma levels of ACTH and cortisol in 13 chronic HD patients. The plasma concentrations of immunoreactive CRH following oCRH administration were similar in patients and controls. In all patients, oCRH given intravenously as bolus injection caused a further increase in the already elevated levels of cortisol. The mean basal plasma levels of ACTH were within the normal range. There was, however, a blunted ACTH response to oCRH. We conclude that the HPA axis in chronic HD patients retains the ability to respond to exogenous oCRH. The patterns of the ACTH and cortisol response to this peptide resemble those observed in chronic stress (depression, anorexia nervosa). Besides, the kinetics of disappearance of oCRH indicate that the kidney may not be the major organ that metabolizes oCRH. PMID:2851525

  9. Bardet-biedl syndrome presenting with end stage renal failure

    International Nuclear Information System (INIS)

    A young male presented in the Nephro-Urology Department with advanced renal failure, blindness in early childhood, polydactaly,obesity, decreased mentation and hypogonadism. With these phenotypical features and renal ultrasonographic findings, he was diagnosed as a case of Bardet-Biedl syndrome. Only one younger sister of patient had similar features. Renal impairment is frequent and an important cause of death. End stage renal disease (ESRD) is rarely seen in younger patient of Bardet-Biedl syndrome. However, ESRD in early age is associated with substantially reduced survival. (author)

  10. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  11. Renal Biopsy Findings in Acute Renal Failure in the Cohort of Patients in the Spanish Registry of Glomerulonephritis

    OpenAIRE

    López-Gómez, Juan M.; Rivera, Francisco

    2008-01-01

    Background and objectives: Renal biopsy in acute renal failure of unknown origin provides irreplaceable information for diagnosis, treatment, and prognosis. This study analyzed the frequency and clinicopathologic correlations of renal native biopsied acute renal failure in Spain during the period 1994 through 2006.

  12. Using continuous renal replacement therapy to manage patients of shock and acute renal failure

    Directory of Open Access Journals (Sweden)

    Soni Sachin

    2009-01-01

    Full Text Available Background: The incidence of acute renal failure (ARF in the hospital setting is increasing. It portends excessive morbidity and mortality and a considerable burden on hospital resources. Extracorporeal therapies show promise in the management of patients with shock and ARF. It is said that the potential of such therapy goes beyond just providing renal support. The aim of our study was to analyze the clinical setting and outcomes of critically ill ARF patients managed with continuous renal replacement therapy (CRRT. Patients and Methods: Ours was a retrospective study of 50 patients treated between January 2004 and November 2005. These 50 patients were in clinical shock and had concomitant ARF. All of these patients underwent CVVHDF (continuous veno-venous hemodiafiltration in the intensive care unit. For the purpose of this study, shock was defined as systolic BP < 100 mm Hg in spite of administration of one or more inotropic agents. SOFA (Sequential Organ Failure Assessment score before initiation of dialysis support was recorded in all cases. CVVHDF was performed using the Diapact ® (Braun CRRT machine. The vascular access used was as follows: femoral in 32, internal jugular in 8, arteriovenous fistula (AVF in 4, and subclavian in 6 patients. We used 0.9% or 0.45% (half-normal saline as a prefilter replacement, with addition of 10% calcium gluconate, magnesium sulphate, sodium bicarbonate, and potassium chloride in separate units, while maintaining careful monitoring of electrolytes. Anticoagulation of the extracorporeal circuit was achieved with systemic heparin in 26 patients; frequent saline flushes were used in the other 24 patients. Results: Of the 50 patients studied, 29 were males and 21 females (1.4:1. The average age was 52.88 years (range: 20-75 years. Causes of ARF included sepsis in 24 (48%, hemodynamically mediated renal failure (HMRF in 18 (36%, and acute over chronic kidney disease in 8 (16% patients. The overall mortality was

  13. Intoxicação por carambola em paciente com insuficiência renal crônica: relato de caso Star fruit intoxication in a chronic renal failure patient: case report

    OpenAIRE

    Fábio Gonzaga Moreira; Rodrigo Lerário Iervolino; Silvia Zanon Dall'Orto; Antonio Claudomiro Aparecido Beneventi; José Licinio de Oliveira Filho; Aécio Flávio Teixeira de Góis

    2010-01-01

    A insuficiência renal crônica é doença de elevada morbidade e mortalidade e sua incidência e prevalência em estágio terminal têm aumentado progressivamente a cada ano. Segundo a Sociedade Brasileira de Nefrologia, as principais causas de insuficiência renal crônica são hipertensão arterial, glomerulonefrite e diabetes mellitus. Diversos fatores elevam o risco de mortalidade em pacientes com nefropatia crônica, principalmente idade, presença de diabetes e número de comorbidades associadas. Par...

  14. Perfil de suscetibilidade a antifúngicos de dermatófitos isolados de pacientes com insuficiência renal crônica Antifungal susceptibility of dermatophytes isolated from patients with chronic renal failure

    OpenAIRE

    Cibele Massotti Magagnin; Cheila Denise Ottonelli Stopiglia; Fabiane Jamono Vieira; Daiane Heidrich; Madeline Machado; Gerson Vetoratto; Flávia Maria Lamb; Maria Lúcia Scroferneker

    2011-01-01

    FUNDAMENTOS: As dermatofitoses apresentam alta prevalência na população em geral e, principalmente, em pacientes com insuficiência renal crônica, necessitando tratamento com antifúngicos tópicos e/ou sistêmicos, cuja eficácia precisa ser avaliada. Estudos in vitro para avaliar a ação de antifúngicos são raros, especialmente, em fungos filamentosos. OBJETIVO: Avaliar o perfil de suscetibilidade de diferentes espécies de dermatófitos, isolados de pacientes com insuficiência renal crônica, em re...

  15. Using continuous renal replacement therapy to manage patients of shock and acute renal failure

    OpenAIRE

    Soni Sachin; Nagarik Amit; Adikey Gopal; Raman Anuradha

    2009-01-01

    Background: The incidence of acute renal failure (ARF) in the hospital setting is increasing. It portends excessive morbidity and mortality and a considerable burden on hospital resources. Extracorporeal therapies show promise in the management of patients with shock and ARF. It is said that the potential of such therapy goes beyond just providing renal support. The aim of our study was to analyze the clinical setting and outcomes of critically ill ARF patients managed with continuous renal r...

  16. Canine renal failure syndrome in three dogs

    OpenAIRE

    Jeong, Won-Il; Do, Sun Hee; Jeong, Da-Hee; Chung, Jae-Yong; Yang, Hai-Jie; Yuan, Dong-Wei; Hong, Il-Hwa; Park, Jin-Kyu; Goo, Moon-Jung; Jeong, Kyu-Shik

    2006-01-01

    Three dead dogs were brought to the College of Veterinary Medicine, Kyungpook National University for study. Clinically, all the dogs showed emaciation, anorexia, depression, hemorrhagic vomiting and diarrhea for 7~10 days before death. All the clinical signs were first noted for about one month after feeding the dogs with commercial diets. At necropsy, all 3 dogs had severe renal damage with the same green-yellowish colored nephroliths in the renal pelvis. They also showed systemic hemorrhag...

  17. 超声对慢性肾功能衰竭继发甲状旁腺增生的诊断价值%Diagnostic value of ultrasonography on parathyroid hyperplasia secondary to chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    陈晓波; 陈宇辉; 王玉玲; 郭辉

    2014-01-01

    目的:探讨超声检查在慢性肾功能衰竭患者继发甲状旁腺增生的应用价值。方法58例行维持性血液透析的慢性肾功能衰竭患者,超声检查其甲状旁腺,观测增生甲状旁腺的数目、位置、大小、形态、内部回声及血供情况,弹性成像分析其硬度。对病灶行病理学检查。结果超声检出甲状旁腺增生病灶88枚,病理诊断81枚为甲状旁腺增生,7枚为淋巴结反应性增生;超声诊断符合率为92.05%。超声显示增生甲状旁腺79枚血供较丰富。其中37枚直径<15 mm病灶,呈类圆形占81.08%;44枚直径>15 mm病灶,呈分叶状或不规则形占70.45%。79枚病灶弹性评分为3~4分,占97.53%。结论超声检查对甲状旁腺增生具有较高的检出率,可作为首选的影像学筛查方法。%Objective To explore the value of ultrasonography in the diagnosis of parathyroid hyperplasia secondary to chronic renal failure. Methods Fifty eight patients with chronic renal failure and maintenance hemodialysis were examined for parathyroids by ultrasonography. The number, location, size, shape, internal echo and blood supply of parathyroid hyperplasia were observed, and the hardness was analyzed by elastic imaging. The lesions were examined by pathology. Results Among 88 lesions diagnosed as parathyroid hyperplasia by ultrasonography, 81 of them were confirmed by pathology, the rest 7 lesions were reactive hyperplasia of lymph nodes from pathological diagnosis. The diagnostic accordance rate of ultrasonography was 92.05%. Seventy nine lesons had rich blood supply as shown by ultrasonography. Thirty seven lesions had a diameter15 mm, accounting for 70.45%. There were 79 lesions with elastic imaging score as 3~4, accounting for 97.53%. Conclusion Ultrasonography has a high detection rate for parathyroid hyperplasia and could be used as the preferred screening method.

  18. Depressão em idosos portadores de insuficiência renal crônica em tratamento hemodialítico Depresión en personas ancianas con insuficiencia renal crónica en tratamiento de hemodiálisis Depression in the elderly on hemodialysis for chronic renal failure

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    Rita de Cássia Helú Mendonça Ribeiro

    2009-01-01

    ón estadísticamente significativa entre el ingreso mensual familiar y la escolaridad (valor p=0, 004 y escore GDS y analfabetismo (p=0,028, mostrando que los analfabetos presentaron más respuestas depresivas, sugiriendo menor capacidad de adaptabilidad/resiliencia de esas personas a la enfermedad y sus implicancias.OBJECTIVES: This study aimed to characterize the elderly on hemodialysis for chronic renal failure in a teaching hospital and to describe their levels of depression. METHODS: This is a descriptive exploratory study with 61 patients. A socio-demographic questionnaire and the geriatric depression scale (GDS were used to collect the data. Data analysis consisted of descriptive statistics and Spearman rho correlations. RESULTS: The mean age of patients was 69.97±7.51. The majority was white (79%, married (72%, and male (57%. Approximate a quarter of the patients (26% were illiterate. The mean depression score was 10.43±4.37, suggesting the presence of normal to slightly depressive symptoms. CONCLUSIONS: There were statistically significant correlation coefficients between family monthly income and education (p value=0.004 and between depressive symptoms and illiteracy (p=0.028. This last finding indicates that the illiterate patients had more depressive symptoms, suggesting they have less adaptation capacity or resilience to cope with the disease and its implications.

  19. Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional Negative effects of chronic kidney failure on lung function and functional capacity

    Directory of Open Access Journals (Sweden)

    Juliana L. Cury

    2010-04-01

    Full Text Available OBJETIVO: Avaliar a função pulmonar e a capacidade funcional em pacientes com insuficiência renal crônica (IRC em hemodiálise e em pacientes após transplante renal. MÉTODOS: Foram avaliados 72 indivíduos, sendo 32 pacientes com IRC em hemodiálise (GD há mais de 6 meses, 10 pacientes transplantados renais (GT há, pelo menos, 6 meses e 30 sujeitos saudáveis para grupo controle (GC. Todos os grupos foram avaliados utilizando espirometria, pressões inspiratória (PImax e expiratória (PEmax máximas e teste da caminhada em seis minutos (TC6min. Para análise estatística, foi utilizado o programa SPSS 12.0, com nível mínimo de significância αOBJECTIVE: To evaluate lung function and functional capacity in patients with chronic kidney failure (CKF undergoing dialysis and in patients after kidney transplant. METHODS: Seventy-two participants were evaluated: 32 patients with CKF on dialysis (DG for at least six months, ten patients who had kidney transplants (TG at least six months earlier, and 30 healthy subjects as a control group (CG. All groups were evaluated using spirometry, with maximum inspiratory pressure (MIP and maximum expiratory pressure (MEP, and using the six-minute walking test (6MWT. The SPSS 12.0 software was used for statistical analysis, with a minimum significance level of α<0.05. RESULTS: There was a decreased lung function in the DG for FVC, FEV1, MVV, VC, MIP and MEP, and decreased FEV1 and MVV in the TG compared to the CG (one-way ANOVA/Fisher's post-hoc; p<0.01. There was also an association (chi-square between decreased MIP and belonging to the DG (α=0.5, p<0.001, between lower performance in the 6MWT for the DG and TG (p<0.01 compared to the CG (one-way ANOVA/Fisher's post-hoc, and between MIP and MEP (Pearson's coefficient; r=0.752; p<0.01. CONCLUSIONS: Patients with CKF undergoing dialysis showed impaired functional capacity and lung function that were not completely reverted in the kidney transplant

  20. INTERMEDIATE SYNDROME: A TYPICAL PATTERN OF PRE-RENAL ACUTE RENAL FAILURE IN THE ELDERLY

    OpenAIRE

    Greloni G; Algranati L; Pidoux R; Reynaldi J; Musso CG; Luque K,

    2004-01-01

    Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatib...

  1. Religião e espiritualidade: experiência de famílias de crianças com Insuficiência Renal Crônica Religiosidad y espiritualidad: la experiencia de familias de niños con Insuficiencia Renal Crónica Religion and spirituality: the experience of families of children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Érica Simpionato de Paula

    2009-02-01

    Full Text Available OBJETIVO: Descrever as manifestações de religiosidade e espiritualidade de famílias de crianças com Insuficiência Renal Crônica em diálise peritoneal. MÉTODO: Trata-se de uma pesquisa qualitativa, com a característica de estudo de caso com múltiplos sujeitos. A análise de conteúdo adotada foi a de significados, optando-se pelo tipo temático, tendo como referência a promoção de saúde em enfermagem familiar. RESULTADOS: Participaram do estudo quatro famílias, totalizando quatorze participantes. A religião e a espiritualidade se apresentam como recursos importantes para os familiares no enfrentamento da doença crônica, principalmente diante de prognósticos ameaçadores. CONCLUSÃO: Destacamos a importância de compreender a religião e a espiritualidade da família no processo de adoecimento, para o enfermeiro atuar na promoção da saúde.OBJETIVO: Describir las manifestaciones de religiosidad y espiritualidad de familias de niños con Insuficiencia Renal Crónica en diálisis peritoneal. MÉTODOS: Se trata de una investigación cualitativa, con la característica de estudio de caso con múltiples sujetos. El análisis de contenido adoptado fue el de significados, eligiendo el tipo temático, teniendo como referencia la promoción de salud en enfermería familiar. RESULTADOS: Participaron del estudio cuatro familias, totalizando catorce participantes. La religión y la espiritualidad se presentan como recursos importantes para familiares en el enfrentamiento de la enfermedad crónica, principalmente ante pronósticos amenazadores. CONCLUSIÓN: Destacamos la importancia de comprender la religión y la espiritualidad de la familia en el proceso de adolecer, para el enfermero actuar en la promoción de la salud.OBJECTIVE: To describe the manifestations of religiosity and spirituality in families of children with Chronic Kidney Failure undergoing peritoneal dialysis. METHODS: This qualitative research is a case study with

  2. Hepatocyte Growth Factor Prevents Acute Renal Failure of Accelerates Renal Regeneration in mice

    Science.gov (United States)

    Kawaida, Kouichi; Matsumoto, Kunio; Shimazu, Hisaaki; Nakamura, Toshikazu

    1994-05-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppressed increases in blood urea nitrogen and serum creatinine caused by administration of cisplatin, a widely used antitumor drug, or HgCl_2, thereby indicating that HGF strongly prevented the onset of acute renal dysfunction. Moreover, exogenous HGF stimulated DNA synthesis of renal tubular cells after renal injuries caused by HgCl_2 administration and unilateral nephrectomy and induced reconstruction of the normal renal tissue structure in vivo. Taken together with our previous finding that expression of HGF was rapidly induced after renal injuries, these results allow us to conclude that HGF may be the long-sought renotropic factor for renal regeneration and may prove to be effective treatment for patients with renal dysfunction, especially that caused by cisplatin.

  3. Chronic Heart Failure: Contemporary Diagnosis and Management

    OpenAIRE

    Ramani, Gautam V.; Uber, Patricia A.; Mehra, Mandeep R.

    2010-01-01

    Chronic heart failure (CHF) remains the only cardiovascular disease with an increasing hospitalization burden and an ongoing drain on health care expenditures. The prevalence of CHF increases with advancing life span, with diastolic heart failure predominating in the elderly population. Primary prevention of coronary artery disease and risk factor management via aggressive blood pressure control are central in preventing new occurrences of left ventricular dysfunction. Optimal therapy for CHF...

  4. Renal cell carcinoma in a setting of chronic lithium toxicity

    OpenAIRE

    Zardawi, Ibrahim; Nagonkar, Santoshi; Patel, Purvish

    2013-01-01

    Patient: Female, 72 Final Diagnosis: Renal cell carcinoma Symptoms: — Medication: — Clinical Procedure: — Specialty: Oncology Objective: Challenging differential diagnosis Background: Lithium salts are widely used in the treatment of affective disorders of the bipolar type. Lithium is a nephrotoxic substance which can cause both acute and chronic renal disease, including cyst formation. Cysts appear to predispose the kidney to renal cell carcinoma. Case Report: A case of renal cell carcinoma ...

  5. Telopéptido carboxilo terminal del colágeno tipo I (b-CTX sérico y compromiso óseo en la insuficiencia renal crónica Serum b-Type I collagen carboxyterminal telopeptide (b-CTXs and bone involvement in chronic renal failure

    Directory of Open Access Journals (Sweden)

    Beatriz Oliveri

    2005-08-01

    Full Text Available La osteodistrofia renal (ODR se caracteriza por alteraciones óseas. Se evaluaron métodos bioquímicos alternativos a la biopsia ósea en pacientes renales para determinar cambios rápidos del remodelamiento óseo en 43 pacientes predialíticos (PD y 49 hemodializados (HD. Los PD presentaron fosfatemia, fosfatasa alcalina ósea (FAO, hormona paratiroidea intacta (PTHi y b-telopéptido carboxilo terminal del colágeno tipo I (bCTXs mayores y clearence de creatinina (Ccr menores (p40 ml/min. En PD, bCTXs (pAn increase in parathyroid hormone (PTH levels in chronic renal failure (CRF induces bone abnormalities known as renal osteodystrophy (ROD. The aim of the present study was to evaluate alternative biochemical methods to bone biopsy, to evaluate changes in bone remodeling in renal patients. Intact PTH (iPTH and bone markers were measured in 43 predialysis (PD, 49 hemodialysis patients (HD and 185 controls. bCTXs, bone alkaline phosphatase (bAL, iPTH were higher and creatinine clearance (Ccr was lower in PD and HD compared with controls (p40 ml/min. bCTXs (p<0.05 in PD and bCTXs and bAL in HD patients were higher than controls, even when iPTH was within normal range (<65 pg/ml. Patients with severe secondary hyperparathyroidism showed higher bone markers than patients with normal or moderately increased iPTH (p<0.001. These results suggest that even when there is no increase in iPTH, bone remodeling increases (possibly due to other factors exhibiting higher bone resorption, and bCTXs would seem to be an adequate non-invasive tool to assess early bone changes in CRF and prevent future fractures. Bone marker measurements in ROD would be useful to identify patients who may require bone biopsy. However, further studies comparing both methods must be performed before replacing bone biopsy with serum b-CTX.

  6. Laboratory Markers of Ventricular Arrhythmia Risk in Renal Failure

    Directory of Open Access Journals (Sweden)

    Ioana Mozos

    2014-01-01

    Full Text Available Sudden cardiac death continues to be a major public health problem. Ventricular arrhythmia is a main cause of sudden cardiac death. The present review addresses the links between renal function tests, several laboratory markers, and ventricular arrhythmia risk in patients with renal disease, undergoing or not hemodialysis or renal transplant, focusing on recent clinical studies. Therapy of hypokalemia, hypocalcemia, and hypomagnesemia should be an emergency and performed simultaneously under electrocardiographic monitoring in patients with renal failure. Serum phosphates and iron, PTH level, renal function, hemoglobin and hematocrit, pH, inflammatory markers, proteinuria and microalbuminuria, and osmolarity should be monitored, besides standard 12-lead ECG, in order to prevent ventricular arrhythmia and sudden cardiac death.

  7. Acute renal failure and severe thrombocytopenia associated with metamizole

    Directory of Open Access Journals (Sweden)

    Maria Dolores Redondo-Pachon

    2014-01-01

    Full Text Available Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diag-nosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously.

  8. Acute renal failure and severe thrombocytopenia associated with metamizole.

    Science.gov (United States)

    Redondo-Pachon, Maria Dolores; Enriquez, Ricardo; Sirvent, Ana Esther; Millan, Isabel; Romero, Alberto; Amorós, Francisco

    2014-01-01

    Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diagnosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously. PMID:24434395

  9. Factors predicting the outcome of acute renal failure in pregnancy

    International Nuclear Information System (INIS)

    To determine the factors predicting renal outcome in patients developing acute renal failure in pregnancy. Study Design: Descriptive cohort study. Place and Duration of Study: Study was conducted at Nephrology Unit of Sindh Institute of Urology and Transplantation, Karachi, from October 2006 to March 2007. Methodology: Patients with acute renal failure due to complications of pregnancy, with normal size of both the kidneys on ultrasound were enrolled, and followed for a period of 60 days or until recovery of renal function. Patient's age and parity, presence of antenatal care, type of complication of pregnancy, foetal outcome and duration of oliguria were compared between patients who remained dialysis dependent and those who recovered renal function. Chi-square/Fisher's exact test and student's t-test, were used for determining the association of categorical and continuous variables with dialysis dependency. Results: The mean age was 29 +- 6 years. Most patients came from rural areas of interior Sindh. Sixty eight percent did not have antenatal checkups. Antepartum haemorrhage (p=0.002) and prolonged duration of oliguria (35 +- 15.7 days, p= < 0.001) were associated with dialysis dependency, which was observed in 50% of the study group. Conclusion: Ante-partum haemorrhage and prolonged oliguria were strong predictors of irreversible renal failure. This highlights the need for early recognition and referral, and the importance of trained birth attendants and antenatal care. (author)

  10. Ceftriaxone-related hemolysis and acute renal failure.

    Science.gov (United States)

    Demirkaya, Erkan; Atay, Abdullah Avni; Musabak, Ugur; Sengul, Ali; Gok, Faysal

    2006-05-01

    A 5-year-old girl with no underlying immune deficiency or hematologic disease was treated with a combination of ceftriaxone and ampicilline-sulbactam for pneumonia. On the ninth day of the therapy, she developed oliguria, paleness, malaise, immune hemolytic anemia (IHA) and acute renal failure (ARF). Laboratory studies showed the presence of antibodies against ceftriaxone. Acute interstitial nephritis (AIN) was diagnosed by renal biopsy. The patient's renal insufficiency was successfully treated with peritoneal dialysis without any complications. The patient recovered without any treatment using steroids or other immunosuppressive agents. PMID:16491410

  11. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  12. Acute Renal Failure due to Rhabdomyolysis Caused by Hypokalemia

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    Ghacha Reda

    2001-01-01

    Full Text Available Rhabdomyolysis is not an uncommon cause of acute renal failure (ARF. It is usually caused by severe traumatic crush injury, severe exercise, septicemia, drug abuse, alcoholic intoxication, heat stroke and myopathy. In this case, we present a patient who developed rhabdomyolysis after severe hypokalemia (serum potassium 1.9mmol/L. This is an unusual cause of rhabdomyolysis even though hypokalemia is a common medical problem. This patient developed acute oliguric renal failure that required daily hemodialysis for 12 days, before start of recovery. This case demonstrates that hypokalemia is a preventable cause of rhabdomyolysis and ARF.

  13. Acute Renal Failure due to Non-Traumatic Rhabdomyolysis

    Directory of Open Access Journals (Sweden)

    Nagehan Aslan

    2016-04-01

    Full Text Available Rhabdomyolysis is a musculoskeletal clinical and biochemical syndrome which is seen associated with traumatic and non-traumatic causes and is known as muscular dystrophy. Rhabdomyolysis which develops following crush-type trauma (Crush syndrome is rarely seen but is a well-known clinical event in the etiology of acute renal failure. Non-traumatic rhabdomyolysis is rare. The case is here presented of a patient who was diagnosed with rhabdomyolysis on presentation with acute renal failure and to whom repeated dialysis was applied.

  14. Post-infectious glomerulonephritis presenting as acute renal failure in a patient with Lyme disease

    OpenAIRE

    Rolla, Davide; Conti, Novella; Ansaldo, Francesca; Panaro, Laura; Lusenti, Tiziano

    2013-01-01

    Introduction: We report a case of a patient with acute renal failure in Lyme disease-associated focal proliferative mesangial nephropathy. Lyme disease is a vector-borne disease caused by Borrelia burgdorferi, transmitted by the bite of an infected ixodes tick. Post-infectious glomerulonephritis (GN)secondary to Borrelia burgdorferi infection in man could be fatal, as it is in canine Lyme borreliosis. Case: A 61-year old man with chronic ethanolic hepatitis was admitted to a provincial hospit...

  15. Advanced glycation endproducts in chronic heart failure

    NARCIS (Netherlands)

    Smit, Andries J.; Hartog, Jasper W. L.; Voors, Adriaan A.; van Veldhuisen, Dirk J.; Schleicher, E; Somoza,; Shieberle, P

    2008-01-01

    Advanced glycation endproducts (AGEs) have been proposed as factors involved in the development and progression of chronic heart failure (CHF). Cross-linking by AGEs results in vascular and myocardial stiffening, which are hallmarks in the pathogenesis of CHE Additionally, stimulation of receptors b

  16. Body mass index in chronic heart failure

    DEFF Research Database (Denmark)

    Christensen, Heidi M; Schou, Morten; Goetze, Jens P; Faber, Jens; Frystyk, Jan; Flyvbjerg, Allan; Kistorp, Caroline

    2013-01-01

    Low body mass index (BMI) is associated with a poor outcome in chronic heart failure (CHF). An inverse association between BMI and adiponectin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been reported. The aim of the present study was to investigate whether novel markers of...

  17. Renal Bleeding Due to Extramedullary Hematopoiesis in a Patient With Chronic Myelogenous Leukemia

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    Stephanie Zettner

    2014-11-01

    Full Text Available Chronic myelogenous leukemia (CML is a myeloproliferative disorder that normally presents in middle-aged adults. Renal infiltration and extramedullary hematopoiesis in renal tissue has been rarely reported. This case report presents a patient with CML and renal insufficiency who developed gross hematuria. Efforts at controlling the hematuria led to a cascade of events propelled by the underlying disorder that ultimately led to a radical nephrectomy, multiorgan failure, and prolonged hospitalization. We suggest that management of gross hematuria in clinically stable patients with CML, suspected of having extramedullary hematopoiesis, should prioritize treatment of the myeloproliferative disorder over efforts to control bleeding.

  18. Values of multi-parameter renal ultrasound in the differential diagnosis of acute and chronic kidney failure%多项肾脏超声参数评分法在急慢性肾功能衰竭鉴别中的价值

    Institute of Scientific and Technical Information of China (English)

    刘金祥; 丁勇; 吴晓峰; 单薇; 曹翠云; 任迎

    2014-01-01

    Objective To explore the values of scoring kidney size,medulla echo,blood perfusion and other ultrasound parameters in the differential diagnosis of acute and chronic kidney failure.Methods Forty-three cases of acute renal failure,forty-five cases of chronic renal failure,forty-three cases of kidney disease with normal renal function and forty cases of healthy controls were enrolled in this study.Size of kidney,form (lotus-root sign),blood flow (firework sign)and other indicators were observed and scored.Then,the scores of the parameters were used to draw ROC curve for seeking an optimal diagnostic cutoff.Results The renal cortex echo enhancement and medulla echo reduction,forming a lotus root sign,were characteristic changes of acute renal failure for distinguishing acute kidney failure from the chronic.Although blood perfusion in kidney was negatively correlated with creatinine in kidney failure,the reduction of blood flow showing as firework sign was mostly acute renal failure in class Ⅰ and Ⅱ,while chronic renal failure was mostly in class Ⅲ and Ⅳ.The size of kidney increased in acute renal failure but decreased in chronic renal failure.However,the normal size of kidney was meaningless for the differential diagnosis.For patients with renal failure but without diabetics,total score ≥ 10 can be used to diagnose acute kidney failure with a sensitivity of 83.7% and specificity of 95.6%.Conclusion Multi-parameter analysis of renal ultrasound plays an important role in the diagnosis of acute renal failure,especially for the patients with normal size of the kidney.%目的:采用肾脏大小、髓质回声、血流灌注等多种超声参数的评分来探讨其在急性肾功能衰竭中诊断及与慢性肾功能衰竭鉴别诊断的价值。方法171例患者分成4组,即急性肾功能衰竭组、慢性肾功能衰竭组、肾功能正常的肾病组和正常对照组,观察4组患者的肾脏大小、形态(藕片征)、血流(烟花征)等

  19. Renal Response to Chronic Centrifugation in Rats

    Science.gov (United States)

    Ortiz, Rudy M.; Wang, T. J.; Corbin, B. J.; Wade, C. E.; Hargens, Alan R. (Technical Monitor)

    1996-01-01

    Previously reported effects of chronic centrifugation on renal function in mammals are contradictory. The present study was conducted as an effort to provide a comprehensive analysis of renal response to chronic centrifugation (12 days at +2 Gz). Sixteen male Sprague-Dawley rats (210-230 g) were used: eight centrifuged (EC) and eight off centrifuge controls (OCC). During centrifugation EC had lower body weight and food consumption. EC showed a decrease (72%) in water intake for the first two days (T1 and T2) followed by significant increases from T4-T6. EC urine output increased two-fold over the first four days, returning to baseline by T9. EC urea excretion was elevated on T3 through T5. Creatinine, Na(+), K(+), and osmolar excretion were lower than OCC over the last four days of the study. Assuming constant plasma osmolarity and creatinine levels, EC free water clearance (C(sub H2O)) was elevated significantly on T4 when the peak urine output was exhibited. EC also had a greater C(sub H2O) over the last four days, associated with a significantly lower osmolar clearance and GFR. The initial diuresis exhibited during centrifugation can be attributed to a reduced water resorption and increased urea excretion. This diuresis was mediated independent of changes in GFR over the first eight days. However, differences in excretion seen after eight days of centrifugation are probably GFR mediated which would imply animals established a new homeostatic setpoint by that time. Centrifugation elicites an acute alteration in fluid homeostasis followed by adaptation within a week.

  20. Acute dengue myositis with rhabdomyolysis and acute renal failure

    Directory of Open Access Journals (Sweden)

    Acharya Sourya

    2010-01-01

    Full Text Available Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK, serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.

  1. Calciphylaxis after Parathyroidectomy in Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Wahab Muhammad

    2008-01-01

    Full Text Available A 33-year-old man, who was maintained on hemodialysis for more than 9 years, was diagnosed to have secondary hyperparathyroidism with a nodule in a parathyroid gland revealed with ultrasound and CT scan. He underwent parathyroidectomy and presented with bilateral lower limb painful ulcers two months later. Skin biopsy from these ulcers was consistent with calciphylaxis.

  2. Microrganismos cariogênicos em pacientes com insuficiência renal crônica em hemodiálise Cariogenic microorganisms in patients with chronic renal failure undergoing hemodialysis therapy

    OpenAIRE

    Mitsue FUJIMAKI; ROSA Odila Pereira da Silva; Sérgio Aparecido TORRES

    1998-01-01

    Neste estudo comparativo, avaliaram-se a prevalência de cárie, o índice de cálculo, o fluxo salivar e as quantificações de microrganismos cariogênicos na saliva, em pacientes com insuficiência renal crônica submetidos à hemodiálise e em indivíduos normais, pareados quanto a idade e sexo. Não houve diferença significante entre os grupos em relação aos índices CPOD e CPOS, ao fluxo de saliva total estimulada ou às contagens de estreptococos mutans e lactobacilos em meios seletivos. Notável foi ...

  3. Watershed Cerebral Infarction in a Patient with Acute Renal Failure

    Directory of Open Access Journals (Sweden)

    Ruya Ozelsancak

    2016-02-01

    Full Text Available Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl and she was discharged. Dysarthria continued for 20 days.

  4. [Strategies of age-adapted pharmacotherapy in renal failure].

    Science.gov (United States)

    Lenssen, R; Liekweg, A

    2016-08-01

    Many geriatric patients with multimorbidities have an increased risk for impaired renal function due to age and often the presence of comorbidities, such as diabetes mellitus, hypertension and heart failure. This impairment in kidney function in turn necessitates adjustments in drug therapy. A successful strategy for treating these patients includes treatment of the underlying diseases, a comprehensive review of the indications, selection of appropriate pharmacotherapeutic alternatives and for some drugs dose adjustment to the renal function. To achieve therapeutic success many patient individual factors, such as potentially complex medication regimens, polypharmacy, cognitive function and functional disabilities need to be considered when prescribing medications. This article describes the problems associated with drug therapy that is not adjusted to renal function and provides guidelines for assessment of the benefits and risks in patients with kidney failure. The characteristic features of geriatric patients in particular are considered and discussed. PMID:27447457

  5. Study on Chinese Syndromes of Chronic Renal Failure%基于证素辨证原理的慢性肾功能衰竭中医证候研究

    Institute of Scientific and Technical Information of China (English)

    唐娟; 魏仲南

    2014-01-01

    目的:“证素”辨证体系将辨证通过确定证候要素(即病位和病性)进行分析。本研究运用证素辨证原理,对福建省慢性肾功能衰竭(CRF)患者进行证素研究。方法:收集 CRF 患者141例,研究本病主要病位、病性及其主次。结果:原发病以慢性肾炎为主,其次为糖尿病肾病、高血压肾病;病位以肾、脾、肝、胃、肺等为主,病性以气虚、阳虚、湿、血虚、阴虚、痰、气滞等为主。结论:本病原发病以慢性肾炎为主,糖尿病肾病为第2大致病因素;病位以肾、脾为主,涉及肝、肺表、心、经络、筋骨等;病性虚实相兼夹杂,以虚为主,同时病性病位间相互影响。总病机为脾肾衰败、气血阴阳不足,湿热瘀毒内蕴,气机逆乱。%To research the elements syndrome evolution in chronic renal failure(short for CRF)of Fujian patients,this re-search studies base on syndrome elements differentiation principle,who studies symptom complex through determining the locations and natures of diseases,namely element of Symptom Complex. Methods:This study collects 141 cases,and studies the locations and natures of diseases by collectivity,and also desides the main element. Results:The primary disease constitutes chiefly by chronic glomerulone-phritis,secondly by diabetic nephropathy(DN)and hypertention nephritis;the main locations of deseases are kidney,spleen,liver,stom-ach and lung,the main natures of diseases are Qi deficiency,Yang ddficiency,pathogenic dampness,blood deficiency,Yin deficiency, Sputum,Qi stagnation,and there are significant differences between each Syndrome elements. Conclusions:Chronic glomerulonephritis is mainly primary disease of CRF,which is followed by DN. The main locations of deseases are kidney and spleen,involve many Zang Fu visceras,such as liver,lung,exterior,heart,meridians,tendons and bones. And its natures of diseases is intermingled deficiency and ex

  6. Clostridium difficile causing acute renal failure: Case presentation and review

    OpenAIRE

    Arrich, Jasmin; Sodeck, Gottfried H.; Sengölge, Gürkan; Konnaris, Christoforos; Müllner, Marcus; Laggner, Anton N; Domanovits, Hans

    2005-01-01

    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population. Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.

  7. Acute renal failure associated with nonfulminant acute viral hepatitis A

    OpenAIRE

    Sarawgi, S.; Gupta, A. K.; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  8. Hearing impairment and renal failure associated with RMND1 mutations

    DEFF Research Database (Denmark)

    Ravn, Kirstine; Neland, Mette; Wibrand, Flemming;

    2016-01-01

    RMND1 homopolymeric complex was highly impaired. The two siblings had a markedly milder phenotype and longer survival compared to previously reported patients. In addition, they had renal failure and hearing impairment. These two newly described patients contribute to delineation of the clinical...

  9. Cognitive dysfunction in patients with renal failure requiring hemodialysis

    Directory of Open Access Journals (Sweden)

    Rohini Thimmaiah

    2012-01-01

    Full Text Available Background and Objectives: Renal failure patients show significant impairment on measures of attention and memory, and consistently perform significantly better on neuropsychological measures of memory and attention, approximately 24 hours after hemodialysis treatment. The objectives are to determine the cognitive dysfunction in patients with renal failure requiring hemodialysis. Materials and Methods: A total of 60 subjects comprising of 30 renal failure patients and 30 controls were recruited. The sample was matched for age, sex, and socioeconomic status. The tools used were the Standardized Mini-Mental State Examination and the Brief Cognitive Rating Scale. Results: The patients showed high cognitive dysfunction in the pre-dialysis group, in all the five dimensions (concentration, recent memory, past memory, orientation and functioning, and self-care, and the least in the 24-hour post dialysis group. This difference was found to be statistically significant (P=0.001. Conclusion: Patients with renal failure exhibited pronounced cognitive impairment and these functions significantly improved after the introduction of hemodialysis.

  10. Acute Renal Failure Induced by Chinese Herbal Medication in Nigeria

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    Effiong Ekong Akpan

    2015-01-01

    Full Text Available Traditional herbal medicine is a global phenomenon especially in the resource poor economy where only the very rich can access orthodox care. These herbal products are associated with complications such as acute renal failure and liver damage with a high incidence of mortalities and morbidities. Acute renal failure from the use of herbal remedies is said to account for about 30–35% of all cases of acute renal failure in Africa. Most of the herbal medications are not usually identified, but some common preparation often used in Nigeria includes “holy water” green water leaves, bark of Mangifera indica (mango, shoot of Anacardium occidentale (cashew, Carica papaya (paw-paw leaves, lime water, Solanum erianthum (Potato tree, and Azadirachta indica (Neem trees. We report a rare case of a young man who developed acute renal failure two days after ingestion of Chinese herb for “body cleansing” and general wellbeing. He had 4 sessions of haemodialysis and recovered kidney function fully after 18 days of admission.

  11. Severe acute renal failure in a patient with diabetic ketoacidosis

    Directory of Open Access Journals (Sweden)

    Al-Matrafi Jamila

    2009-01-01

    Full Text Available Acute renal failure (ARF is a rare but potentially fatal complication of diabetic ketoacidosis (DKA. Early recognition and aggressive treatment of ARF during DKA may im-prove the prognosis of these patients. We present a case report of a 12 year old female admitted to the hospital with severe DKA as the 1s t manifestation of her diabetes mellitus. She presented with severe metabolic acidosis, hypophosphatemia, and oliguric ARF. In addition, rhabdomyolysis was noted during the course of DKA which probably contributed to the ARF. Management of DKA and renal replacement therapy resulted in quick recovery of renal function. We suggest that early initiation of renal replacement therapy for patients with DKA developing ARF may improve the potentially poor outcome of patients with ARF associated with DKA.

  12. Renal complications in chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis: the Mayo Clinic experience.

    Science.gov (United States)

    Strati, Paolo; Nasr, Samih H; Leung, Nelson; Hanson, Curtis A; Chaffee, Kari G; Schwager, Susan M; Achenbach, Sara J; Call, Timothy G; Parikh, Sameer A; Ding, Wei; Kay, Neil E; Shanafelt, Tait D

    2015-09-01

    While the renal complications of plasma cell dyscrasia have been well-described, most information in patients with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis is derived from case reports. This is a retrospective analysis of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who underwent kidney biopsy for renal insufficiency and/or nephrotic syndrome. Between January 1995 and June 2014, 49 of 4,024 (1.2%) patients with chronic lymphocytic leukemia (n=44) or monoclonal B-cell lymphocytosis (n=5) had a renal biopsy: 34 (69%) for renal insufficiency and 15 (31%) for nephrotic syndrome. The most common findings on biopsy were: membranoproliferative glomerulonephritis (n=10, 20%), chronic lymphocytic leukemia interstitial infiltration as primary etiology (n=6, 12%), thrombotic microangiopathy (n=6, 12%), and minimal change disease (n=5, 10%). All five membranoproliferative glomerulonephritis patients treated with rituximab, cyclophosphamide and prednisone-based regimens had recovery of renal function compared to 0/3 patients treated with rituximab with or without steroids. Chronic lymphocytic leukemia infiltration as the primary cause of renal abnormalities was typically observed in relapsed/refractory patients (4/6). Thrombotic microangiopathy primarily occurred as a treatment-related toxicity of pentostatin (4/6 cases), and resolved with drug discontinuation. All cases of minimal change disease resolved with immunosuppressive agents only. Renal biopsy plays an important role in the management of patients with chronic lymphocytic leukemia or monoclonal B-cell lymphocytosis who develop renal failure and/or nephrotic syndrome. PMID:26088927

  13. Renal Vasodilatory Action of Dopamine in Patients With Heart Failure: Magnitude of Effect and Site of Action.

    Science.gov (United States)

    Elkayam, Uri; Ng, Tien M H; Hatamizadeh, Parta; Janmohamed, Munir; Mehra, Anilkumar

    2008-01-15

    BACKGROUND: A "renal dose" of dopamine is often used to increase renal blood flow; however, data on the magnitude of effect and site of action in patients with heart failure are scarce. METHODS AND RESULTS: Renal effects of intravenous dopamine (1, 2, 3, 5, and 10 mug . kg(-1) . min(-1)) were evaluated in 13 patients with chronic heart failure. Renal blood flow was calculated from renal artery cross-sectional area measured with intravascular ultrasound and renal blood flow velocity-time integral measured by the intravascular Doppler technique. Cross-sectional area increased and was significantly higher than baseline (0.30+/-0.04 cm(2)) at 5 mug . kg(-1) . min(-1) (0.36+/-0.05 cm(2)) and 10 mug . kg(-1) . min(-1) (0.38+/-0.06 cm(2)). The velocity-time integral was significantly higher than baseline (22+/-3 cm) at doses of 3 and 5 mug . kg(-1) . min(-1) (both 31+/-4 cm). Renal blood flow increased, whereas renal vascular resistance decreased, reaching statistical significance at 2 mug . kg(-1) . min(-1) through 10 mug . kg(-1) . min(-1). Cardiac output gradually increased, reaching statistical significance at doses of 5 and 10 mug . kg(-1) . min(-1) (5.5+/-0.5 and 6.1+/-0.7 versus 4.5+/-5.2 L/min at baseline), but the increase in renal blood flow appeared proportionately larger than corresponding increases in cardiac output. CONCLUSIONS: Dopamine is associated with an increase in renal blood flow in patients with heart failure. This effect is due to dilation of both the large conductance and small resistance renal blood vessels. Further evaluation of the efficacy and safety of dopamine for improvement of renal function in hospitalized patients with heart failure is warranted. PMID:18172028

  14. Clinical Significance of Measurement on the Changes of Plasma Leptin and Serum VEGF, HGF Levels After Hemodialysis in Patients with Chronic Renal Failure%慢性肾功能衰竭患者血透前后血浆leptin和血清VEGF、HGF检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    顾涛

    2012-01-01

    Objective To explor the clinical significance of changes on plasma leptin and serum VEGF,HGF levels after hemodi-alysis in patients with chronic renal failure. Methods Plasma leptin (with RIA) , serum VEGF, HGF(with ELISA) levels were measured in 32 patients with chronic renal failure both before and after hemodialysis as well as in 35 normal healthy controls. Results Before hemodialysis plasma leptin and serum VEGF,HGF levels were significantiy higher in the patients than those in controls (P < 0.05). Conclusion The levels of leptin, VEGF and HGF were significantly increased in patients with chronic renal failure. Hemodialysis could increase the clearance rate of leptin, VEGF and HGF and might be useful for clinical assessment.%目的:探讨了慢性肾功能衰竭(CRF)患者血透前后血浆leptin和血清VEGF、HGF水平的变化及意义.方法:应用放射免疫分析和酶联法对32例CRF患者进行了血透前后血浆leptin和血清VEGF、HGF检测,并与35名正常健康人作比较.结果:CRF在血透前血浆leptin和血清VEGF、HGF水平非常显著地高于正常人组(P<0.01).结论:CRF患者存在高leptin、VEGF、HGF血症.血透可增加leptin、VEGF和HGF的清除率,具有重要的临床价值.

  15. Avaliação da condição bucal em pacientes renais crônicos submetidos à hemodiálise Evaluation of oral condition of patients with chronic renal failure submitted to hemodialysis

    Directory of Open Access Journals (Sweden)

    Cláudia Régia de Souza Dias

    2007-01-01

    Full Text Available OBJETIVOS: Avaliar a condição bucal dos pacientes com insuficiência renal crônica submetidos à hemodiálise, no município de São Luís, comparando os três centros de referência da cidade e os tempos de hemodiálise. MÉTODOS: A amostra foi constituída por 107 pacientes, nos quais analisou-se o índice de placa (IP e a prevalência de cárie dentária (CPO-D. Os pacientes foram categorizados em três grupos, de acordo com o tempo de hemodiálise (3 meses a 3 anos. Os dados obtidos foram submetidos aos testes estatísticos ANOVA e Kruskal-Wallis, com nível de significância de 5%. RESULTADOS: As médias/desvios padrão do IP nos grupos foram, respectivamente, 0.91±0.61; 1.04±0.60 e 1.25±0.67. Quanto ao CPO-D destes grupos, as médias/desvios padrão foram 13.63±8.91; 13.89±8.12 e 16.79±7.31. Não houve diferenças significativas entre os centros, nem entre os tempos de hemodiálise estudados. CONCLUSÃO: O tempo de tratamento da doença não alterou ou interferiu no acúmulo de placa bacteriana e na prevalência de cárie dentária. Houve uniformidade na condição bucal dos pacientes nos três centros estudados.BACKGROUND: Evaluate the oral conditions of patients with chronic renal failure submitted to hemodialysis in the city of São Luís, by comparing three reference centers and the times of hemodialysis. METHODS: The sample consisted of 107 patients, distributed among the centers. Plaque Index (IP and Dental Caries Prevalence (DMF-T were evaluated. Patients were subdivided into three groups according to time of hemodialysis (3 months to 3 years. Data were analyzed using the ANOVA and the Kruskal-Wallis test with a level of significance of 5%. RESULTS: Plaque index averages in the groups were respectively, 0.91±0.67; 1.04±0.60; 1.25±0.61. The averages of DMF-T in the respective groups were 13.63±8.91; 13.89±8.12; 16.79±7.31. There were no significant differences between the centers of reference and the times of

  16. [Morphological and biochemical features of fungi isolated from patients with renal failure].

    Science.gov (United States)

    Drozdowska, Agata

    2007-01-01

    Patients with renal failure are more frequently at risk of fungal infections than the healthy individuals. The aim of the study was: (1) Evaluation of the prevalence of fungi in biological materials obtained from different ontocenoses from patients with end-stage and chronic renal failure undergoing haemodialysis and conservative treatment, respectively. (2) Species determining of isolated fungal strains and evaluation their morphological and biochemical features with regard to biotyping. (3) Examining the connection between intraspecies features of fungal strains isolated from different ontocenoses of the same patient. The study group comprised 136 persons, including 56 patients with end-stage renal failure dialysed for the mean period of 36.2 (+/- 1.62) months--all patients were on chronic haemodialysis therapy (4 hours sessions, 3 times per week), 50 patients with chronic renal failure undergoing conservative treatment and 30 persons with the negative history of any renal disease--control group. At the moment of the evaluation and collection of samples all patients were in good condition, none of the patients revealed symptoms suggesting possible fungal infection. Material for mycological examinations included washings from the oral cavity and samples of urine and faeces. In order to evaluate morphological and biochemical features of fungi the following methods were applied: (1) macrocultures in solid Sabouraud medium, (2) direct microscopic slides, (3) API 20 C AUX test and (4) API ZYM test (bioMérieux). Totally 385 samples for mycological examinations were collected from different ontocenoses, from which 161 fungal strains were isolated and classified to 17 species from 5 genera. Most strains belonged to the genus Candida 96.9% and the most frequently occurring species was C. albicans (60.3%). Other species from this genus composed 39.7%, among which in 11.8% of cases C. parapsilosis was determined, and the following were: C. guilliermondii and C. humicola

  17. Prospective memory and chronic heart failure

    OpenAIRE

    Habota, Tina; Cameron, Jan; McLennan, Skye N; Ski, Chantal F; Thompson, David R; Peter G Rendell

    2013-01-01

    Background Patients with chronic heart failure (CHF) experience a number of debilitating symptoms, which impact on activities of daily living and result in poor quality of life. Prospective memory, which is defined as memory to carry out future intentions, has not been investigated in this group. However, emerging evidence suggests CHF patients have difficulties with cognitive processes related to prospective memory. Self-care, which partly relies on prospective memory, is essential in sympto...

  18. Is Serum Transforming Growth Factor beta-1 Superior to Serum Creatinine for assessing Renal Failure and Renal Transplant Rejection

    Directory of Open Access Journals (Sweden)

    Gyanendra Kumar Sonkar, Usha

    2009-04-01

    Full Text Available A sustained overexpression of Transforming Growth Factor beta1 (TGF beta1, a cytokine has beenimplicated in the pathogenesis of fibrosis of kidney leading to end stage . The main aim of present studywas to find the utility of TGF beta1 and serum creatinine in differentiating chronic renal failure (CRFfrom acute renal failure (ARF, renal transplant rejection (Tx Rej and stable renal transplant (Tx Stband to study has attempted histopathological correlation of rejection cases with TGF beta1 and serumcreatinine. TGF beta1 was determined by using ELISA and serum creatinine was done by autoanalyser.In normal healthy controls (NHC, in majority of cases (80.0% TGF beta1 was below 25 ng/ml while in6.0% cases it was upto 34 ng/ml. Rise of TGF beta1 was significant in CRF patients as compared to ARFand NHC (p<0.05 .In rejection cases, TGF beta1 level was significantly raised as compared to NHCand stable graft cases (p<0.05. In rejection cases, it was raised above 40 ng/ml in only 50% cases. In twocases inspite of more than 70% glomerular fibrosis, the patient had TGF beta1 level of only 5 ng/ml and inother three cases of acute cellular rejection the level was 70, 35 and 28 ng/ml respectively.Contrary to itserum creatinine was raised above 2 mg/dl in all cases of transplant rejection but in stable transplant casesin majority (70.6% it was below 1.5 mg/dl and in 5 cases it was between 1.5 – 1.9 mg/dl.Thus the studysuggests that TGF beta1 may not be a good marker for chronic transplant rejection, as it does notcorrelate well with glomerular fibrosis, probably it is more associated with interstitial inflammation but itcan differentiate CRF from ARF if cut off of 40 ng/ml is taken.

  19. Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure

    DEFF Research Database (Denmark)

    Gabrielsen, A; Bie, P; Holstein-Rathlou, N H;

    2001-01-01

    To examine if the neuroendocrine link between volume sensing and renal function is preserved in compensated chronic heart failure [HF, ejection fraction 0.29 +/- 0.03 (mean +/- SE)] we tested the hypothesis that intravascular and central blood volume expansion by 3 h of water immersion (WI) elicits...... (by sustained angiotensin-converting enzyme inhibitor therapy, n = 9) absolute and fractional sodium excretion increased (P < 0.05) to the level of control subjects (108 +/- 34 micromol/min and 0.70 +/- 0.23%, respectively). Renal free water clearance increased during WI in control subjects but not in...... HF, albeit plasma vasopressin concentrations were similar in the two groups. In conclusion, the neuroendocrine link between volume sensing and renal sodium excretion is preserved in compensated HF. The natriuresis of WI is, however, modulated by the prevailing ANG II and Aldo concentrations. In...

  20. Long term outcome of treatment of end stage renal failure.

    OpenAIRE

    Henning, P.; Tomlinson, L.; Rigden, S P; Haycock, G B; Chantler, C.

    1988-01-01

    The most common causes of end stage renal failure in 46 children (mean age 11 years, range 4-14) treated between January 1972 and June 1977 were: reflux nephropathy (n = 12), cystinosis (n = 7), focal and segmental glomerulosclerosis (n = 6), and Schönlein-Henoch disease (n = 5). The quality of life, degree of renal function, and height attainment of the 31 survivors were assessed in June 1985, when their mean age was 22 years (range 14-27), using hospital records and a questionnaire designed...

  1. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-01

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  2. Effect on hemo-dialysis on concentration of lactate dehyrogenase, creatine kinase and a-amylase in renal failure

    International Nuclear Information System (INIS)

    This study was conducted to compare the concentration of plasma enzymes in chronic renal failure pre dialysis (group A) and post dialysis (group B), and evaluate the concentration of these enzymes between pre and post dialysis. The study was performed in 25 samples of Sudanese patients (chronic renal failure) and compared with 15 samples as the control groups. plasma samples were analyzed using spectrophotometric methods, plasma concentration of these enzymes showed increase in chronic renal failure pre and post dialysis. The mean values of lactate dehydrogenase pre dialysis was 259IU/L, post dialysis was 276IU/L, the mean of creatine kinase pre dialysis was 252IU/L, and post dialysis was 241 IU/L but the mean of amylase pre and post dialysis was the same 144 IU/L. This study showed that there was no difference of concentration of amylase enzyme, but the different in concentration of CK and LDH between pre and post dialysis during chronic renal failure depend on normal range of this enzyme in control groups.(Author)

  3. Green tea inhibited the elimination of nephro-cardiovascular toxins and deteriorated the renal function in rats with renal failure.

    Science.gov (United States)

    Peng, Yu-Hsuan; Sweet, Douglas H; Lin, Shiuan-Pey; Yu, Chung-Ping; Lee Chao, Pei-Dawn; Hou, Yu-Chi

    2015-01-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are highly protein-bound nephro-cardiovascular toxins, which are not efficiently removed through hemodialysis. The renal excretions of IS and PCS were mediated by organic anion transporters (OATs) such as OAT1 and OAT3. Green tea (GT) is a popular beverage containing plenty of catechins. Previous pharmacokinetic studies of teas have shown that the major molecules present in the bloodstream are the glucuronides/sulfates of tea catechins, which are putative substrates of OATs. Here we demonstrated that GT ingestion significantly elevated the systemic exposures of endogenous IS and PCS in rats with chronic renal failure (CRF). More importantly, GT also significantly increased the levels of serum creatinine (Cr) and blood urea nitrogen (BUN) in CRF rats. Mechanism studies indicated that the serum metabolites of GT (GTM) inhibited the uptake transporting functions of OAT1 and OAT3. In conclusion, GT inhibited the elimination of nephro-cardiovascular toxins such as IS and PCS, and deteriorated the renal function in CRF rats. PMID:26552961

  4. Terapia com inibidor da ECA com dosagens relativamente altas e risco de agravamento renal na insuficiência cardíaca crônica ACE-inhibitor therapy at relatively high doses and risk of renal worsening in chronic heart failure

    Directory of Open Access Journals (Sweden)

    Renato De Vecchis

    2011-12-01

    Full Text Available FUNDAMENTO: O efeito renoprotetor dos inibidores da ECA vem sendo questionado no caso de diminuição do volume circulante efetivo, como na insuficiência cardíaca crônica direita ou biventricular. Objetivo: Detectar os preditores clínicos de agravamento renal na população de pacientes com ICC, caracterizado por dois tipos de regime de dosagem de inibidores da ECA. MÉTODOS: De acordo com um desenho de coorte retrospectiva, seguimos dois grupos de pacientes com ICC - tanto direita quanto biventricular -, todos na classe III da NYHA, tratados com inibidores da ECA (enalapril ou lisinopril, e com fração de ejeção do ventrículo esquerdo (FEVE 10 mg por dia de enalapril ou lisinopril. A disfunção renal agravada (ARD foi definida pelo aumento de Cr > 30% com relação ao segmento basal. O modelo de risco proporcional de Cox foi utilizado para identificar os preditores da ARD entre as seguintes variáveis: os inibidores da ECA com "alta" dosagem, idade, FEVE basal, histórico de repetidas terapias intensivas com diuréticos de alça por via intravenosa (diurético intravenoso, diabete, Cr basal, histórico de hipertensão, pressão arterial sistólica BACKGROUND: Renoprotective effect of ACE-inhibitors has been questioned in case of decreased effective circulating volume, like in right or biventricular chronic heart failure. OBJECTIVE: To detect clinical predictors of renal worsening in CHF patient population characterized by two types of ACE-inhibitor dosing regimens. METHODS: According to a retrospective cohort design, we followed 2 groups of patients with CHF - whether right or biventricular -, all in III NYHA class treated with ACE-inhibitors (enalapril or lisinopril, and with left ventricular ejection fraction (LVEF 10 mg per day of enalapril or lisinopril. Worsened renal failure (ARD was defined by Cr increase >30% from baseline. Cox proportional hazards model was used to identify the predictors of ARD among the following variables

  5. 不同剂量大黄附子细辛汤治疗慢性肾功能衰竭疗效对比观察%Effect of Different Doses of Dahuang Fuzi Xixin Decoction on Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    李燕敏; 占永立; 连凤梅; 仝小林

    2011-01-01

    Objective To observe the effect and safety of different doses of Dahuang Fuzi Xixin Decoction [Decoction of Dahuang (.Radix et Rhizoma Rhei), Fuzi (Radix Aconiti Praeparata), and Xixin (Herba Asari)2 on chronic renal failure (CRF) patients. Methods Thirty CRF patients were randomized into large-dose group and small-dose group with 15 in each. After the basic treatment for 4~6 weeks, they were administered large-dose or small-doses of modified Dahuang Fuzi Xixin Decoction respectively. The TCM symptom scores, indices of renal function, and after scores of quality of life of between the two groups was compared 4,8, and 12 weeks treatment. Results After treatment, the TCM symptom scores of both groups decreased, and the comparison of each time points with before treatment showed statistical difference (P<0. 05 or P<0. 01). After 8 and 12 weeks' treatment, the TCM symptom score of the large-dose group was significantly lowered than that of the small-dose group, and the difference between the two groups was statistically significant (P<0. 05 or P<0. 01). After 12 weeks' treatment, the serum creatinine was significantly lowered (P<0. 01) and the estimated glomerular filtration rate (Eg~ FR) was significantly increased (P<0. 05) in the large dose group. After 12 weeks' treatment, the comparison of creatinine and Egfr between the two groups was statistically different (P<0. 05). After 12 weeks' treatment, the scores of quality of life of both groups were significantly increased (P<0. 01) compared with before treatment. After 12 weeks' treatment, the comparison between the two groups showed that the score of quality of life of the large-dose group was higher than that of the small-dose group, and the difference was statistically significant (P<0. 05). There was not adverse events related with treatment. Conclusion The modified Dahuang Fuzi Xixin Decoction is effective in improving the TCM symptoms, stabilizing the renal function, and improving quality of life of the

  6. Malarial hepatitis and renal failure: a study of two cases

    Directory of Open Access Journals (Sweden)

    Shivaraj Gowda

    2011-03-01

    Full Text Available

    Abstract:
    We report two cases of severe malaria who presented with non-specific clinical features. One of the cases is a 50 year old female who was brought to our hospital with high grade fever and severe abdominal pain, whereas the other case was a 20 year old male presented with high grade fever and headache. Both the cases presented with abnormal liver and renal function tests. P.malariae and P.falciparum are responsible for clinically important renal disease the former causes chronic progressive syndrome and the latter causes acute renal disease. Severe malaria may present with non specific clinical features making it difficult to distinguish from other febrile illness.

  7. Reversible renal failure after combined treatment with enalapril and frusemide in a patient with congestive heart failure.

    OpenAIRE

    Funck-Brentano, C; Chatellier, G.; Alexandre, J. M.

    1986-01-01

    A patient with congestive heart failure and moderate renal insufficiency developed severe reversible non-oliguric renal failure while on frusemide and enalapril. Renal failure developed when enalapril was given in the presence of pronounced sodium depletion. When positive sodium balance was restored the plasma creatinine concentration began to fall while angiotensin converting enzyme inhibition remained effective and blood pressure was stable. These observations suggest that the degree of sod...

  8. Tsutsugamushi infection-associated acute rhabdomyolysis and acute renal failure.

    Science.gov (United States)

    Young, Park Chi; Hae, Chung Choon; Lee, Kim Hyun; Hoon, Chung Jong

    2003-12-01

    Rhabdomyolysis is a rare complication that emerges in a variety of infectious diseases, such as tsutsugamushi infection. In this study, we report a 71-year-old female patient with tsutsugamushi infection who exhibiting rhabdomyolysis and acute renal failure. On admission, an eschar, which is characteristic of tsutsugamushi infection, was found on her right flank area. Moreover, her tsutsugamushi antibody titer was 1:40960. The elevated values of serum creatinine phosphokinase (CPK), aldolase, creatinine and dark brown urine secondary to myoglobinuria are consistent with indications of rhabdomyolysis and acute renal failure due to tsutsugamushi infection. Her health improved without any residual effects after treatment with doxycyclin and hydration with normal saline. PMID:14717236

  9. Paroxysmal nocturnal hemoglobinuria: rare cause of acute renal failure

    Directory of Open Access Journals (Sweden)

    Vilma Takayasu

    2012-12-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria is a rare acquired disease, characterized by hemolytic anemia, recurrent infections, cytopenias, and vascular thrombosis. It occurs by non-malignant clonal expansion of one or more hematopoietic stem cells that acquired somatic mutations in PIG-A gene linked to chromosome X. This mutation results in lower erythrocyte expression of CD55 and CD59 surface proteins and consequently increased susceptibility to the complement system. The renal involvement is generally benign, resulting in mild impairment in urinary concentration. Acute renal failure requiring hemodialytic support accompanying PNH is rarely observed. The authors report a case of a 37-year-old male who presented with bicytopenia (hemolytic anemia and thrombocytopenia associated with acute renal failure requiring dialysis. Diagnosis was challenging because of the rarity and unfamiliarity with this entity, but was confirmed by flow cytometry. In the course of the disease, acute pyelonephritis with multiple renal abscesses was diagnosed requiring prolonged antibiotic therapy. Patient outcome was favorable after the control of hemolysis and the infection treatment.

  10. Nephroprotective effect of ethanolic extract of abutilon indicum root in gentamicin induced acute renal failure

    OpenAIRE

    Jacob Jesurun RS; Lavakumar S.

    2016-01-01

    Background: The term acute renal failure (ARF) is at present called acute kidney injury (AKI). AKI is a reversible condition in which there is a sudden decline in renal function, manifested by elevated SCr and BUN which occurs in hours to days to weeks. The present study was to evaluate the nephron protective effect of abutilon indicum root in gentamicin induced acute renal failure in wistar albino rats. Methods: Experimental evaluation was done in gentamicin induced acute renal failure. 2...

  11. [Acute oliguric renal failure and haemolytic anaemia following infectious mononucleosis].

    Science.gov (United States)

    Brkovic, Natasa; Jørgensen, Kit Riegels; Rosenbæk, Jeppe Bakkestrøm; Pedersen, Erling Bjerregaard

    2015-11-01

    A 19-year-old man was admitted to hospital due to fatigue, nausea, abdominal pain and faint. He was pale and icteric, awake with sufficient respiration and circulation. He had infectious mononucleosis complicated with acute oliguric renal failure and severe haemolytic anaemia with a positive Coombs test. He had a cold agglutinin syndrome. The treatment comprised intermittent haemodialysis, plasmapheresis and heating. He recovered completely after two months. PMID:26573947

  12. Tsutsugamushi Infection-Associated Acute Rhabdomyolysis and Acute Renal Failure

    OpenAIRE

    Young, Park Chi; Hae, Chung Choon; Lee, Kim Hyun; Hoon, Chung Jong

    2003-01-01

    Rhabdomyolysis is a rare complication that emerges in a variety of infectious diseases, such as tsutsugamushi infection. In this study, we report a 71-year-old female patient with tsutsugamushi infection who exhibiting rhabdomyolysis and acute renal failure. On admission, an eschar, which is characteristic of tsutsugamushi infection, was found on her right flank area. Moreover, her tsutsugamushi antibody titer was 1:40960. The elevated values of serum creatinine phosphokinase (CPK), aldolase,...

  13. Abdominal distention and renal failure in a neonate

    OpenAIRE

    Bedri, Badreldin; Goodwin, Julie E.

    2013-01-01

    A term male neonate presented to his paediatrician for a routine follow-up after hospital discharge. Prenatal care had been excellent and labour and delivery had been unremarkable. He had been feeding, gaining weight and was not in distress though significant abdominal distention was noted. Lab tests revealed electrolytes derangements, metabolic acidosis and renal failure. An ultrasound revealed severe unilateral hydronephrosis and echogenic kidneys. A voiding cystourethrogram revealed the de...

  14. Disseminated lymphoma presenting as acute thigh pain and renal failure.

    LENUS (Irish Health Repository)

    Brown, Catherine

    2009-01-01

    A 66-year-old diabetic man presented with severe right thigh swelling and pain together with acute renal failure. At autopsy, this was found to be due to disseminated high grade B cell lymphoma invading the psoas muscle and multiple organs, including the kidneys. The unique presentation of this case emphasizes the need for increased awareness of the variety of ways in which lymphoma can manifest itself.

  15. 慢性肾功能衰竭患者血清粒系集落刺激因子水平观察%Serum granulocyte colony-stimulating factor in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    吴文; 孙关林; 王振义; 田国雄

    2001-01-01

    目的探讨粒系集落刺激因子(G-CSF)的调节机制及代谢途径。 方法本文运用酶联免疫吸附试验(ELISA)检测61例慢性肾功能衰竭(CRF)+/-血液透析患者血清G-CSF水平。 结果 CRF患者血清G-CSF水平明显升高。CRF非血透患者血清G-CSF检出率为80.65%,血清G-CSF水平为566.40±207.98ng/L。CRF血透患者G-CSF检出率为93.33%,血透前和血透后G-CSF水平分别为1255.36±611.25ng/L和1151.61±599.47ng/L。血透组G-CSF水平略高于非血透组,但两组无明显差异。血透前与血透后患者G-CSF水平无明显差异。进一步分析表明,G-CSF水平与WBC,BUN或Scr水平无关(P>0.05)。 结论 CRF患者血清G-CSF水平升高可能是由于肾功能不全导致G-CSF清除减少或/和G-CSF产生增加。%Objective To gain a better understanding of the regulatory mechanism and kinetic behaviour of granulocyte colony-stimulating factor (G-CSF). Methods An enzyme-linked immunosorbent assay (ELISA) method was used to detect serum G-CSF in 61 patients with chronic renal failure±long-term hemodialysis and 30 normal controls. Results Serum G-CSF levels in CRF patients were significantly higher than in normal controls. Eighty percent of patients had detectable G-CSF and serum G-CSF levels were 566.40±207.98?ng/L in non-hemodialyzed (non-HD) patients. The detectable percentage in hemodialyzed patients was 93.33%, serum G-CSF levels in pre-HD and post-HD patients were 1255.36±611.25?ng/L and 1151.61±599.47?ng/L respectively. Serum G-CSF levels in HD patients were slightly higher than in non-HD patients, but no significant difference was found between the two groups. No difference was found between the G-CSF values obtained in pre-HD and post-HD patients. There was no relationship between G-CSF levels and WBC, BUN or Scr (P>0.05). Conclusion The high value of G-CSF in patients with CRF may be caused by a decrease in G-CSF clearance and/or an increase in G-CSF release.

  16. Roles of renalase and renal sympathetic nerve activity in patients with chronic heart failure%肾胺酶与肾交感神经活性在慢性心力衰竭中的作用

    Institute of Scientific and Technical Information of China (English)

    陈平安; 李韶南; 雷晓明; 刘震

    2014-01-01

    Objective To assess the roles of renalase and renal sympathetic nerve activity in patients with chronic heart failure (CHF). Methods Plasma renin activity (PRA), angiotensinⅠ (AngⅠ), angiotensin Ⅱ(AngⅡ),adrenaline (E), noradrenaline (NE) and renalase were determined in 60 patients with CHF (CHF group) and in 42 healthy cases (control group). Data were compared between patients with mild and serious CHF. Results PRA, E, NE and AngⅠincreased and renalase decreased in CHF group than those in control group. Compared with mild CHF, renalase and left ventricular ejection fraction decreased (P < 0.01, 0.034), while N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PRA significantly increased (P<0.01). Linear correlation analysis showed that renalase was inversely correlated with Log NT-proBNP (r = -0.400, P = 0.002) and Log NE (r=-0.314, P = 0.014). Logistic regression analysis showed that NT-proBNP (OR = 6.963, 95%CI = 1.223 to 39.638), PRA (OR = 3.736, 95%CI = 1.031 to 13.540) and renalase (OR = 0.253, 95%CI = 0.069 to 0.927) were associated with increased NYHA classes. Conclusions PRA would increase while renalase would decrease in patients with CHF. PRA and renalase were correlated to the severity of CHF.%目的:探讨肾胺酶与局部肾交感活性在慢性心力衰竭中的作用。方法:测定60例慢性心力衰竭患者和42例对照组血浆肾素(PRA)、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)、肾上腺素(E)、去甲肾上腺素(NE)及肾胺酶活性。观察不同纽约心功能分级(NYHA)心衰患者间PRA及肾胺酶等指标间的差异及相关关系。结果:心衰组PRA、E、NE、AngⅠ活性增高,肾胺酶活性降低。与轻微心衰组相比,严重心衰组肾胺酶活性及左室射血分数降低(P分别为<0.01、0.034),N末端脑钠尿肽前体(NT-proBNP)及PRA增高(均P<0.01)。线性相关分析显示肾胺酶活性与Log NT-proBNP(r=-0

  17. Managing acute and chronic renal stone disease.

    Science.gov (United States)

    Moran, Conor P; Courtney, Aisling E

    2016-02-01

    Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones. CT KUB should be the primary mode of imaging for all patients with colic unless contraindicated. In such instances, or if a CT KUB is not available, an ultrasound KUB is an alternative. This has advantages in terms of radiation exposure and cost, but is limited in sensitivity, particularly for ureteric stones. Once diagnosed, a plain film KUB can be used for follow-up of radiopaque stones. For most patients diclofenac is a reasonable first choice of analgesia, e.g. 50-100 mg rectally, or 75 mg IM. Opioid medication can worsen nausea and be less effective, but should be used if there is a contraindication to NSAIDs. A combination of diclofenac, paracetamol, and/or codeine regularly can provide adequate pain control in many cases. Failure of this analgesic combination should prompt consideration of secondary care support. If a ureteric stone 10 mm in diameter should be discussed with the urology service as they are unlikely to pass spontaneously. PMID:27032222

  18. Chronic Renal Transplant Rejection and Possible Anti-Proliferative Drug Targets.

    Science.gov (United States)

    Bhatti, Adnan Bashir; Usman, Muhammad

    2015-01-01

    The global prevalence of renal transplants is increasing with time, and renal transplantation is the only definite treatment for end-stage renal disease. We have limited the acute and late acute rejection of kidney allografts, but the long-term survival of renal tissues still remains a difficult and unanswered question as most of the renal transplants undergo failure within a decade of their transplantation. Among various histopathological changes that signify chronic allograft nephropathy (CAN), tubular atrophy, fibrous thickening of the arteries, fibrosis of the kidney interstitium, and glomerulosclerosis are the most important. Moreover, these structural changes are followed by a decline in the kidney function as well. The underlying mechanism that triggers the long-term rejection of renal transplants involves both humoral and cell-mediated immunity. T cells, with their related cytokines, cause tissue damage. In addition, CD 20+ B cells and their antibodies play an important role in the long-term graft rejection. Other risk factors that predispose a recipient to long-term graft rejection include HLA-mismatching, acute episodes of graft rejection, mismatch in donor-recipient age, and smoking. The purpose of this review article is the analyze current literature and find different anti-proliferative agents that can suppress the immune system and can thus contribute to the long-term survival of renal transplants. The findings of this review paper can be helpful in understanding the long-term survival of renal transplants and various ways to improve it. PMID:26677426

  19. Aortic Dissection and Renal Failure in a Patient with Severe Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Valerie Brooke

    2012-01-01

    Full Text Available Acute aortic dissection (AAD is a life-threatening condition associated with high morbidity and mortality. The most important recognized acquired cause that leads to dissection is chronic arterial hypertension. With respect to the anuria and renal failure, aortic dissection is not something that is always considered and is still not a very common presentation unless both renal arteries come off the false lumen of the dissection. However, when present, preoperative renal failure in patients with acute type B dissection has been noted to be an independent predictor of mortality. Early recognition and diagnosis is the key and as noted by previous studies as well, almost a third of these patients are initially worked up for other causes until later when they are diagnosed with aortic dissection. Here we present a case of a patient presenting with severe hypothyroidism, long-standing hypertension, and anuria. Through the case, we highlight the importance of having aortic dissection as an important differential in patients presenting with anuria who have a long standing history of uncontrolled hypertension. Pathophysiology relating to severe hypothyroidism-induced renal dysfunction is also discussed.

  20. Cambios en la presión sanguínea causados por falla renal aguda o crónica, en una población de mascotas caninas de Bogotá D.C. Colombia - Sanguine Pressure Changes Caused By Acute Or Chronic Renal Failure, In Canine Pets Population In Bogotá D.C. Colombia

    Directory of Open Access Journals (Sweden)

    Sánchez Klinge Marta Elena.

    2006-08-01

    Full Text Available .- La insuficiencia renal es señalada como la causa más importante de la hipertensión arterial, ( Ettinger & Feldman 1997. Debido a la hipertensión en insuficiencia renal, se debe medir la misma en todos los perros sospechosos. La determinación de la presión arterial, común en humanos, no lo es en veterinaria, debido a la disposición anatómica de los miembros y a la baja intensidad de los sonidos producidos por la onda de pulso. En la primera fase se emplearon 20 perros, a los cuales se les tomo la presión arterial en tres sitios: arteria humeral, arteria tibiocraneal y arteria coccígea, colococando una manga de presión y escuchando los sonidos del paso de la sangre con un estetoscopio de muy buena resolución y otro de no tan buena resolución, comprobándose que sólo se escuchan con el estetoscopio de buena resolución. Después, se inyecto 0.5 ml de adrenalina para causar un hipertensión pasajera y comprobar los sonidos del paso de la sangre (korokoff, los cuales se escucharon mucho más fuerte y el valor numérico aumento considerablemente; el mejor resultado se obtuvo en la arteria humeral, ya que los sonidos se escuchan más claros. En la segunda fase se tomaron 33 pacientes de diferentes clínicas de Bogota; 15 presentaban Falla Renal Aguda y 18 presentaban Falla Renal Crónica. A dichos pacientes se les confirmar la falla renal, con un examen del BUN y de creatinina, encontrándose azotemia, luego se les tomaba la presión arterial en la arteria humeral encontrandose mayor hipertensión en la Falla renal crónica. The renal inadequacy or renal failure, is pointed out as the cause but important of the arterial hypertension (Ettinger & Feldman 1997. Due to the hypertension in the renal inadequacy, the same one should be measured in all the suspicious dogs. The determination of the arterial pressure, common in human, it is not it in the veterinary one , due to the anatomical disposition of the members and to the drop intensity

  1. Cambios en la presión sanguínea causados por falla renal aguda o crónica, en una población de mascotas caninas de Bogotá D.C. Colombia - Sanguine Pressure Changes Caused By Acute Or Chronic Renal Failure, In Canine Pets Population In Bogotá D.C. Colombia

    Directory of Open Access Journals (Sweden)

    Sánchez Klinge Marta Elena

    Full Text Available La insuficiencia renal es señalada como la causa más importante de la hipertensión arterial, ( Ettinger & Feldman 1997. Debido a la hipertensión en insuficiencia renal, se debe medir la misma en todos los perros sospechosos. La determinación de la presión arterial, común en humanos, no lo es en veterinaria, debido a la disposición anatómica de los miembros y a la baja intensidad de los sonidos producidos por la onda de pulso. En la primera fase se emplearon 20 perros, a los cuales se les tomo la presión arterial en tres sitios: arteria humeral, arteria tibiocraneal y arteria coccígea, colococando una manga de presión y escuchando los sonidos del paso de la sangre con un estetoscopio de muy buena resolución y otro de no tan buena resolución, comprobándose que sólo se escuchan con el estetoscopio de buena resolución. Después, se inyecto 0.5 ml de adrenalina para causar un hipertensión pasajera y comprobar los sonidos del paso de la sangre (korokoff, los cuales se escucharon mucho más fuerte y el valor numérico aumento considerablemente; el mejor resultado se obtuvo en la arteria humeral, ya que los sonidos se escuchan más claros. En la segunda fase se tomaron 33 pacientes de diferentes clínicas de Bogota; 15 presentaban Falla Renal Aguda y 18 presentaban Falla Renal Crónica. A dichos pacientes se les confirmar la falla renal, con un examen del BUN y de creatinina, encontrándose azotemia, luego se les tomaba la presión arterial en la arteria humeral encontrandose mayor hipertensión en la Falla renal crónica. The renal inadequacy or renal failure, is pointed out as the cause but important of the arterial hypertension (Ettinger & Feldman 1997. Due to the hypertension in the renal inadequacy, the same one should be measured in all the suspicious dogs. The determination of the arterial pressure, common in human, it is not it in the veterinary one , due to the anatomical disposition of the members and to the drop intensity of

  2. [Treatment of acute renal failure--concepts and controversies. 2. Extracorporeal renal replacement and peritoneal dialysis].

    Science.gov (United States)

    Gabriel, A; Müller, E; Tarnow, J

    2001-04-01

    Therapy of prolonged acute renal failure regularly requires a renal replacement therapy. This can be achieved by different extracorporal renal replacement therapies (ERRT) or by peritoneal dialysis. ERRT are classified according to the physical principle underlying toxin elimination as hemodialysis (diffusion) and hemofiltration (convection). Another classification refers to intermittent or continuous application modes. Biocompatibility of membranes is judged according to their activation of the complement system. Prospective randomized studies did not consolidate the assumptions about the benefit of particular modalities proposed on theoretical foundations. Mortality, duration and complication rates of acute renal failure are not significantly decreased by use of biocompatible membranes. Continuous modalities are not generally preferable but optimize treatment in hemodynamically unstable patients, in whom they endorse fluid balancing and maintenance of sufficient arterial blood pressure. The use of demanding hemofiltration techniques for cytokine removal should be limited to clinical studies. The effects of ERRT-"intensity" and the best timing for initiation of ERRT have not been evaluated sufficiently. The choice of the ERRT modality is subject to clinical judgement (criterion: hemodynamic situation), practical aspects (criteria: availability of equipment and handling experience), and costs. Prior to their general use new and expensive technical modalities and membrane types should be thoroughly evaluated in studies with regard to outcome-related aspects such as patient survival and preservation of renal function. PMID:11386089

  3. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  4. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease

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    Houda Mbarki

    2015-01-01

    Full Text Available Fasting during Ramadan is prohibited when an individual′s health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD. We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years. All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF, active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of <60 mL/min/1.73 m 2 . However, the small sample size does not allow us to draw any firm conclusions on fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended.

  5. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease.

    Science.gov (United States)

    Mbarki, Houda; Tazi, Nada; Najdi, Adil; Tachfouti, Nabil; Arrayhani, Mohamed; Sqalli, Tarik

    2015-03-01

    Fasting during Ramadan is prohibited when an individual's health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD). We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years). All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF), active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended. PMID:25758882

  6. Renal Tissue Oxygenation in Essential Hypertension and Chronic Kidney Disease

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    Menno Pruijm

    2013-01-01

    Full Text Available Animal studies suggest that renal tissue hypoxia plays an important role in the development of renal damage in hypertension and renal diseases, yet human data were scarce due to the lack of noninvasive methods. Over the last decade, blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI, detecting deoxyhemoglobin in hypoxic renal tissue, has become a powerful tool to assess kidney oxygenation noninvasively in humans. This paper provides an overview of BOLD-MRI studies performed in patients suffering from essential hypertension or chronic kidney disease (CKD. In line with animal studies, acute changes in cortical and medullary oxygenation have been observed after the administration of medication (furosemide, blockers of the renin-angiotensin system or alterations in sodium intake in these patient groups, underlining the important role of renal sodium handling in kidney oxygenation. In contrast, no BOLD-MRI studies have convincingly demonstrated that renal oxygenation is chronically reduced in essential hypertension or in CKD or chronically altered after long-term medication intake. More studies are required to clarify this discrepancy and to further unravel the role of renal oxygenation in the development and progression of essential hypertension and CKD in humans.

  7. Congestive heart failure in patients with chronic kidney disease

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    Poskurica Mileta

    2014-01-01

    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  8. [Congestive heart failure in patients with chronic kidney disease].

    Science.gov (United States)

    Poskurica, Mileta; Petrović, Dejan

    2014-01-01

    Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF). Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP) are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°). In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable. PMID:25731010

  9. Characteristics of cadaveric renal allograft recipients developing chronic rejection.

    OpenAIRE

    Foster, M. C.; Rowe, P. A.; Dennis, M J; Morgan, A G; Burden, R. P.; Blamey, R. W.

    1990-01-01

    As the early results of renal transplantation improve, chronic rejection is increasing in relative importance as a cause of graft loss. The aetiology of the condition is unknown. In order to identify possible predisposing factors, the characteristics of 22 patients with chronic rejection were compared with those of 50 patients with stable graft function 2 years or more after transplantation. Patients with chronic rejection had significantly more acute rejection episodes in the first 6 months ...

  10. Salud oral en pacientes con insuficiencia renal crónica hemodializados después de la aplicación de un protocolo estomatológico Oral health in patients with chronic renal failure under hemodialysis after the implementation of an stomatological protocol

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    M. Rebolledo Cobos

    2012-04-01

    Full Text Available Objetivo: Evaluar la salud oral de los pacientes con insuficiencia renal crónica (IRC hemodializados antes y después de aplicar un protocolo de atención estomatológica basado en la evidencia, en una unidad renal de Cartagena. Metodología: Estudio cuasiexperimental con 120 pacientes, se aplicó una encuesta determinando las características socio demográficas e información que tenían acerca de asociación de IRC con lesiones orales. Posteriormente se efectuó un examen clínico y se aplicó el protocolo de manejo, con posteriores controles clínicos determinando cambios estomatológicos resultantes. La información se condensó mediante paquete estadístico Epi Info versión 5.0 y se realizó un análisis descriptivo para las variables nominales y ordinales. Transcurrido 3 meses se ejecutó una nueva valoración clínica para determinar los cambios. Se valoró el efecto de la intervención mediante la prueba estadística de McNemar. Resultados: En la valoración inicial se diagnosticaron en promedio 7 lesiones estomatológicas asociadas por paciente y en la reevaluación 3, (pObjective: To evaluate the oral health of patients with chronic renal failure (CRF under hemodialysis treatment before and after applying a dental care protocol based on the evidence in a renal unit in the city of Cartagena. Methodology: A quasi-experimental study with 120 patients, a survey determined the sociodemographic characteristics and information they had about CRF association with oral lesions. Subsequently it was performed a clinical examination and applied management protocol, with subsequent monitoring dental changes resulting determining clinical. The information was condensed by statistical package Epi Info version 5.0 and performed a descriptive analysis of nominal and ordinal variables. After 3 months, implemented a new clinical assessment to determine changes. Were evaluated the effect of intervention by the McNemar test statistic. Results: In the

  11. Tempo até o transplante e sobrevida em pacientes com insuficiência renal crônica no Estado do Rio de Janeiro, Brasil, 1998-2002 Time to kidney transplantation in chronic renal failure patients in the State of Rio de Janeiro, Brazil, 1998-2002

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    Cynthia Braga da Cunha

    2007-04-01

    Full Text Available Neste estudo, descreveram-se as características dos 14.419 pacientes com insuficiência renal crônica tratados por hemodiálise no Estado do Rio de Janeiro, Brasil, e analisou-se o tempo até a primeira realização do transplante no período de 1998 a 2002. Técnicas de análise de sobrevida como a análise não paramétrica de Kaplan-Meier e a modelagem semiparamétrica com o modelo de riscos proporcionais de Cox foram utilizadas. Além do modelo de sobrevida para transplante, o tempo até o óbito foi estimado para a comparação das estimativas dos dois modelos. Os resultados mostraram que, no período estudado, apenas 6,3% dos pacientes foram transplantados, 32,4% foram indicados e 6,3% inscritos na lista de espera. Observa-se que a probabilidade de transplante dos pacientes indicados, inscritos para o transplante e os que estão em uma faixa etária reduzida é maior. A diabetes mellitus possui um efeito redutor de 35% no risco de realização de transplante. Todas as estimativas apresentaram direções contrárias às obtidas pelo modelo de sobrevida para óbito.This study analyzes the characteristics of 14,419 chronic renal failure patients treated with hemodialysis and time to first kidney transplantation in the State of Rio de Janeiro, Brazil, from 1998 to 2002. Survival analysis methods were used, such as the Kaplan-Meier non-parametric method and the semi-parametric method with the Cox proportional hazards model. Besides the survival model for transplantation, time to death was analyzed to compare the two models' estimates. During the period studied, only 6.3% of patients received transplants, 32.4% were referred for transplantation, and 6.3% were included on the waiting list. Odds of transplantation were greater for those who had been referred, those on the waiting list, and younger patients. Diabetes mellitus reduced the probability of conducting transplantation by 35%. All the estimates showed directions opposite to those

  12. A dimensão educativa da equipe de nefrologia na promoção de saúde bucal de crianças e adolescentes portadores de doença renal crônica Educational dimension of the nephrology team in promoting oral health for chronic renal failure children and adolescents

    Directory of Open Access Journals (Sweden)

    Glaucia Athayde Gonçalves

    2009-09-01

    Full Text Available INTRODUÇÃO: Objetivou-se avaliar a dimensão educativa das percepções e atitudes de médicos, enfermeiros e auxiliares de enfermagem na saúde bucal de crianças e adolescentes portadores de insuficiência renal crônica (IRC em três hospitais do Rio de Janeiro. MÉTODOS Realizou-se uma entrevista com perguntas abertas e fechadas com 43 profissionais de saúde. Os dados foram coletados e tabulados no programa SPSS 13.0. Empregou-se o teste Qui-quadrado, com nível de significância estatística p OBJECTIVE: To assess the educational dimension through the perceptions and attitudes of physicians, nurses, and nursing assistants in relation to oral health of chronic renal failure (CRF children and adolescents at three hospitals of Rio de Janeiro. METHODS: An interview was conducted using open and closed questions with 43 health professionals. An interview was conducted by 43 health professionals using open and closed questions. Data were collected and uploaded into the SPSS 13.0 program. The chi-square test was used, with statistical significance level of p < 0.05. RESULTS: Mean age was 36.5 ± 11.3 years, and 80.0% of the interviewees were female. Most physicians (71.4%, n = 10 and nurses (72.4%, n = 21 believed CRF patients could have some degree of oral alteration due to the disease, loss of enamel and decalcification being the most cited. In regard to oral hygiene care, more than half of the interviewees answered that they used to inform their patients about dental brushing (72.7%, n = 16, flossing (9.0%, n = 2, mouth rinsing (18.1%, n = 4, and tongue cleaning (9.0%, n = 2. Only 9% (n = 2 recommended oral hygiene after the use of oral medicines. According to 65.5% of the nurses and nursing assistants, CRF patients require special care. Most physicians (57.1%, n = 8 do not think this is necessary. Nevertheless, 78.6% (n = 11 of physicians often refer CRF patients to dental services. CONCLUSIONS: According to the methodology used, it was

  13. Acute renal failure by ingestion of Euphorbia paralias

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    Karima Boubaker

    2013-01-01

    Full Text Available Euphorbia paralias is known in traditional medicine as an anti-inflammatory agent, a purgative and for its local anesthetic property. To the best our knowledge, renal toxicity of this substance has not been previously reported. In this paper, we report the case of a 29-year-old male who developed renal damage following ingestion of Euphorbia paralias. He had been on follow-up for nephrotic syndrome since 1986, although irregularly, with several relapses but each responding well to steroid therapy. A kidney biopsy had not been performed earlier due to refusal by the patient. He was off steroids since April 2008 because the patient developed osteoporosis. He was admitted with general malaise and oliguria to our department in May 2009, following repeated vomiting and watery diarrhea for three days. On examination, he was edematous but had normal vital signs except for a pulse rate of 120/min. Hemoglobin was only 5.5 g/dL but with normal white cell and platelet counts. Blood biochemistry showed evidence of advanced renal failure with a serum creatinine level of 1835 μmol/L and urea at 44.6 mmol/L, sodium of 132 μmol/L and potassium at 4.3 mmol/L. He had features of nephrotic syndrome with severe hypoproteinamia and 24-h urinary protein of 10.45 g. Ultrasonography revealed enlarged kidneys with a reduced echogenecity of the medulla and the papillae. Subsequently, after hemodialysis with blood transfusion, a kidney biopsy was performed that showed focal segmental glomerulosclerosis associated with an acute tubular injury. On intensive interrogation, the patient gave a history of ingesting boiled Euphorbia paralias as a native treatment for edema, ten days prior to the onset of the current illness. A diagnosis of acute renal failure (ARF resulting from the possible nephrotoxic effect of Euphorbia paralias poisoning was made. He was treated with intermittent hemodialysis and corticosteroids. Serum creatinine values improved after 48 days. At six

  14. Acute renal failure: Nephrosonographic findings in asphyxiated neonates

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    Mohd. Ashraf

    2011-01-01

    Full Text Available To determine the incidence of acute renal failure (ARF and nephrosonographic findings among asphyxiated neonates, and to correlate this with uric acid levels and the severity of hypoxic encephalopathy, we studied 80 full-term appropriate-for-date singleton neonates with perinatal asphyxia, and 30 healthy full-term neonates as controls from March 2006 to February 2007. A detailed history, thorough clinical examination along with investigations, including urine examination, 24-h urine collection, ultrasonography of abdomen and cranium, serum electrolytes, blood urea nitrogen, serum creatinine, and serum uric acid were obtained. ARF developed in 45% (36/80 of the asphyxiated neonates. Forty-eight (60% neonates showed significant elevation of blood urea and 41 (51.3% neonates had significant elevation of serum creatinine than the control group (P < 0.001. Sixty-two (77.5% neonates developed significant elevation of serum uric acid levels, and nephrosonography revealed hyperechogenicity in all of them, while only two among the healthy neonates showed the raised uric acid levels (P < 0.001. Nonoliguric renal failure was seen 28/36 (77.8% of the neonates with ARF, whereas eight (22.2% neonates had oliguric renal failure. Eight (27.8% patients among ARF patients maintained abnormal biochemical parameters after 2 weeks, and of whom four patients died after variable lengths of time with a mortality rate of 11.11%. Kidneys are the most common organs involved in perinatal asphyxia, and uric acid might be a causative factor for failure in addition to hypoxic insult. Routine use of kidney function test, along with abdominal ultrasonography form an important screening tool to detect any additional morbidity in these patients.

  15. Concurrent neutral endopeptidase and ACE inhibition in experimental heart failure: renal and hormonal effects

    DEFF Research Database (Denmark)

    Helin, K

    1993-01-01

    Neutral endopeptidase (NEP) inhibitors have been shown to strengthen the effects of endogenous atrial natriuretic peptide (ANP). It has been well documented that angiotensin I-converting enzyme (ACE) inhibitors act beneficially in chronic congestive heart failure (CHF). In the present study, renal...... and hormonal effects of SCH 34826, an orally active NEP inhibitor, were studied in a coronary-ligation model of experimental CHF in the rat. The effects were compared to those of captopril. The drugs were also administered in combination. In anaesthetized rats with CHF, SCH 34826 (90 mg kg-1 sc) elevated...

  16. 17-Year-Old Boy with Renal Failure and the Highest Reported Creatinine in Pediatric Literature

    Directory of Open Access Journals (Sweden)

    Vimal Master Sankar Raj

    2015-01-01

    Full Text Available The prevalence of chronic kidney disease (CKD is on the rise and constitutes a major health burden across the world. Clinical presentations in early CKD are usually subtle. Awareness of the risk factors for CKD is important for early diagnosis and treatment to slow the progression of disease. We present a case report of a 17-year-old African American male who presented in a life threatening hypertensive emergency with renal failure and the highest reported serum creatinine in a pediatric patient. A brief discussion on CKD criteria, complications, and potential red flags for screening strategies is provided.

  17. Acute airway failure secondary to thyroid metastasis from renal carcinoma

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    Lastilla Gaetano

    2008-02-01

    Full Text Available Abstract Background Secondary involvement of the thyroid gland by malignant metastases is uncommon. Acute respiratory crisis due to infiltration of the upper airways is a recognised complication of anaplastic thyroid carcinoma or thyroid lymphoma. Renal cell carcinoma is a tumour that metastasizes diffusely and in an unpredictable manner. Case presentation We report a case of a 73-year-old man with a painful neck mass, dyspnoea, stridor and dysphonia that was evaluated in emergency. A right radical nephrectomy for renal cell carcinoma was performed 8 years previously. An emergency endotracheal intubation was followed by total thyroidectomy. Histological examination confirmed the diagnosis of thyroid metastasis from renal cell carcinoma. Conclusion A literature review regarding emergency treatment for acute respiratory compromise resulting from secondary thyroid tumours was undertaken. Only two cases of metastatic colon cancer and one case of metastatic meningioma requiring emergency thyroidectomy for acute respiratory failure are reported in the literature. This appears to be the first case of emergency surgery performed for acute respiratory compromise due to thyroid metastasis from renal cell carcinoma.

  18. Leukocytic acetylcholine in chronic rejection of renal allografts

    OpenAIRE

    Wilczynska, Joanna

    2011-01-01

    Leukocytes, which accumulate in graft blood vessels during fatal acute rejection of experimental renal allografts, synthesise and release acetylcholine (ACh). In this study, I tested the hypothesis that ACh produced by leukocytes accumulating in graft blood vessels contributes to the pathogenesis of chronic renal allograft vasculopathy (CAV). Kidneys were transplanted in the allogeneic Fischer 344 to Lewis rat strain combination. Isogeneic transplantations were performed in Lew...

  19. Impaired renal function in relatives of chronic kidney disease patients

    OpenAIRE

    Pradip Kumar Dutta; Md Shafiul Haider; Abul Kashem

    2015-01-01

    Background: Chronic kidney disease (CKD) is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR) and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD). Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional compa...

  20. Determinación de los factores condicionantes en la adhesión y cumplimiento de la dieta de protección renal en pacientes con insuficiencia renal crónica: estudio previo para la elaboración de una guía dietética Determination of factors conditioning adherence and accomplishment of renal protection diet in patients with chronic renal failure: pilot study for the elaboration of a dietary guideline

    Directory of Open Access Journals (Sweden)

    M.ª T. Orzáez Villanueva

    2006-04-01

    Full Text Available Son escasos los estudios sobre el comportamiento alimentario en los pacientes con Insuficiencia Renal Crónica (IRC. El objetivo de este estudio, a través de una encuesta previamente validada, ha sido conocer cuales son los factores psico-socio-culturales, y en que grado inciden a la hora de asumir y cumplir el tratamiento dietoterápico, determinando, además, el grado de percepción de la enfermedad y de los diversos factores relacionados con ella. La población estudiada estaba formada por 81 pacientes de la consulta de nefrología del hospital "12 de Octubre" de Madrid, con IRC en prediálisis. A las preguntas relacionadas con el autoconocimiento y percepción de la enfermedad el 77,74% respondió dentro de los niveles "bien o muy bien". Los factores emocionales y de autocontrol tienen escasa relevancia, según afirma el 69,87% de los pacientes. El 59,26% siente en alto grado el apoyo familiar y el 35,77% altera el seguimiento dietético cuando cambian las condiciones medioambientales. La gran mayoría de los entrevistados, un 87,65%, no tienen dificultad en encontrar los alimentos pautados y para el 70,37% de la población su coste no es excesivo. Para casi la mitad de los pacientes (48,76% la dieta de protección renal supone una variación de sus hábitos alimentarios, un porcentaje similar expresa, además, dificultad con la preparación. La palatabilidad de los alimentos no es un problema en el 67,90% de los casos. El 51,24% no percibe dificultad en los procesos culinarios. El 70,99% se siente apoyado, deuna u otra forma, por el personal sanitario, aunque sólo un 56,79% refiere que no le ha sido explicada la dieta. Únicamente el 18,51% cuestiona la efectividad de la dieta en relación con la evolución de su enfermedad. Dentro de la variable sexo, se observaron diferencias significativas (p There are seldom studies on dietary behavior of patients with chronic renal failure (CRF. The aim of this study has been to know, by means of a

  1. Unexpected recovery from longterm renal failure in severe diffuse proliferative lupus nephritis

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    Ross Sophia

    2012-08-01

    Full Text Available Abstract Background Severe renal manifestation of systemic lupus erythematosus (SLE is not uncommon and is associated with an indeterminate prognosis. Complete remission can be obtained, however, at least in the young when chronic lesions are absent and adequate anti-inflammatory therapy is immediately initiated. Case presentation We report the unusual case of a 12-year-old girl who presented with severe oliguric renal failure, macrohematuria and skin rash. Renal biopsy revealed the diagnosis of severe diffuse proliferative glomerulonephritis (GN with cellular crescents in 15 out of 18 glomeruli and full-house pattern in immunofluorescence indicating lupus nephritis IVB according to WHO, IV-G(A according to ISN/RPS classification. The serological parameters confirmed the diagnosis of SLE and the patient was immediately treated with methylprednisolone, cyclophosphamide and immunoadsorption. Initially, despite rapid amelioration of her general condition, no substantial improvement of renal function could be achieved and the patient needed hemodialysis treatment for 12 weeks. Unexpectedly, in the further follow-up at first diuresis increased and thereafter also creatinine levels substantially declined so that hemodialysis could be discontinued. Today, 6 years after the initial presentation, the patient has normal renal function and a SLEDAI score of 0 under a continuous immunosuppressive therapy with Mycophenolate mofetil (MMF and low dose steroid. Conclusion Despite the severity of the initial renal injury and the unfavourable renal prognosis the kidney apparently has a tremendous capacity to recover in young patients when the damage is acute and adequate anti-inflammatory therapy is initiated without delay.

  2. ANAESTHESIA FOR CHRONIC RENAL DISEASE AND RENAL TRANSPLANT: AN UPDATE

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    Vinod Kumar

    2015-03-01

    Full Text Available Patients with chronic k idney disease have unique pathophysiology relating to both CKD and its underlying cause and therefore present a challenge to anaesthesiologists & surgeons . The aim of this article is to present the features of chronic kidney disease (CKD that influence th e conduct of anaesthesia and to introduce some of the anaesthetic techniques used for this challenging group of patients.

  3. Functional genomics in renal transplantation and chronic kidney disease

    International Nuclear Information System (INIS)

    For the past decade, the development of genomic technology has revolutionized modern biological research. Functional genomic analyses enable biologists to study genetic events on a genome wide scale. Examples of applications are gene discovery, biomarker determination, disease classification, and drug target identification. Global expression profiles performed with microarrays enable a better understanding of molecular signature of human disease, including acute and chronic kidney disease. About 10 % of the population in western industrialized nations suffers from chronic kidney disease (CKD). Treatment of end stage renal disease, the final stage of CKD is performed by either hemo- or peritoneal dialysis or renal transplantation. The preferred treatment is renal transplantation, because of the higher quality of life. But the pathophysiology of the disease on a molecular level is not well enough understood and early biomarkers for acute and chronic kidney disease are missing. In my studies I focused on genomics of allograft biopsies, prevention of delayed graft function after renal transplantation, anemia after renal transplantation, biocompatibility of hemodialysis membranes and peritoneal dialysis fluids and cardiovascular diseases and bone disorders in CKD patients. Gene expression profiles, pathway analysis and protein-protein interaction networks were used to elucidate the underlying pathophysiological mechanism of the disease or phenomena, identifying early biomarkers or predictors of disease state and potentially drug targets. In summery my PhD thesis represents the application of functional genomic analyses in chronic kidney disease and renal transplantation. The results provide a deeper view into the molecular and cellular mechanisms of kidney disease. Nevertheless, future multicenter collaborative studies, meta-analyses of existing data, incorporation of functional genomics into large-scale prospective clinical trials are needed and will give biomedical

  4. Exenatide-Induced Acute Renal Failure: A Case Report

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    Mustafa Ünübol

    2013-09-01

    Full Text Available Exenatide is a glucagon-like peptide-1 receptor agonist that is commonly used in the treatment of type II diabetes mellitus for its effects on the incretin system. The use of exenatide is also related to weight loss and it has reportedly been known to induce acute renal failure (ARF according to clinical reports. We observed ARF and severe weight loss two months after beginning the treatment with exenatide in a 59-year-old female patient with type II diabetes mellitus. We present this case in which ARF was considered to be a rare adverse effect of exenatide use. In conclusion, renal functions should be closely monitored, especially in patients prescribed nephrotoxic agents and for those with a high risk of nephropathy and dehydration due to their treatment with exenatide. The usage of this drug should also be carefully planned in these patients. Turk Jem 2013; 17: 68-70

  5. Aetiology, maternal and foetal outcome in 60 cases of obstetrical acute renal failure

    International Nuclear Information System (INIS)

    %) while 28 (46.66%) fully recovered. Among the rest 6 (30%) had partial recovery and 5 (8.33%) had dialysis dependent chronic kidney disease. Obstetrical acute renal failure not only results in foetal loss but also causes significant maternal morbidity and mortality. (author)

  6. Long term outcome of treatment of end stage renal failure.

    Science.gov (United States)

    Henning, P; Tomlinson, L; Rigden, S P; Haycock, G B; Chantler, C

    1988-01-01

    The most common causes of end stage renal failure in 46 children (mean age 11 years, range 4-14) treated between January 1972 and June 1977 were: reflux nephropathy (n = 12), cystinosis (n = 7), focal and segmental glomerulosclerosis (n = 6), and Schönlein-Henoch disease (n = 5). The quality of life, degree of renal function, and height attainment of the 31 survivors were assessed in June 1985, when their mean age was 22 years (range 14-27), using hospital records and a questionnaire designed to highlight social and psychological problems. Twenty six patients had a functioning transplanted kidney. Average growth during treatment for all survivors was normal, but most were disappointed with their 'final height'. Though five patients had some form of disabling bone disease, all 31 could walk and 27 could run. Sixteen (67%) were in full or part time employment and nine were living independently. A group of 32 patients with juvenile onset diabetes treated at this hospital for at least five years were also asked to complete the questionnaire and of these, 17 responded. On average, their data could usefully be compared with those of cases of end stage renal failure. More of the diabetics had jobs, but most sexually mature patients with renal disease were concerned about their physical appearance and had not achieved any stable long term sexual relationships. We suggest that a poor body image resulting in low self esteem may be responsible for the deficiency and believe that further study in this group is warranted. PMID:3126713

  7. Severe renal failure in acute bacterial pyelonephritis: Do not forget corticosteroids

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    Sqalli Tarik

    2010-01-01

    Full Text Available Acute renal failure (ARF is a rare complication of acute pyelonephritis in adult immunocompetent patients. Recovery of renal function usually occurs if antibiotics are promptly initiated. However, long-term consequences of renal scarring due to acute pyelonephritis are probably underestimated, and some patients present with prolonged renal failure despite adequate antibiotic therapy. We report two cases of severe ARF complicating bacterial pyelonephritis successfully treated with corticosteroids in association with conventional antibiotics.

  8. Risk following hospitalization in stable chronic systolic heart failure

    DEFF Research Database (Denmark)

    Abrahamsson, Putte; Swedberg, Karl; Borer, Jeffrey S; Böhm, Michael; Kober, Lars; Komajda, Michel; Lloyd, Suzanne M; Metra, Marco; Tavazzi, Luigi; Ford, Ian

    2013-01-01

    We explored the impact of being hospitalized due to worsening heart failure (WHF) or a myocardial infarction (MI) on subsequent mortality in a large contemporary data set of patients with stable chronic systolic heart failure (HF).......We explored the impact of being hospitalized due to worsening heart failure (WHF) or a myocardial infarction (MI) on subsequent mortality in a large contemporary data set of patients with stable chronic systolic heart failure (HF)....

  9. 认知行为干预对慢性肾衰竭患者生活方式及生活质量的影响%Effect of cognitive behavior intervention on life style and life quality in patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    吴琳; 周东; 屈红; 刘红

    2014-01-01

    目的:探讨认知行为干预对慢性肾衰竭中的应用效果。方法将60例慢性肾衰竭患者随机分为观察组和对照组,对照组采用常规护理,观察组采用认知行为干预,比较2组护理效果。结果观察组在自我实现、健康责任、营养等生活方式方面的评分高于对照组,健康信念优于对照组,2组比较差异有统计学意义(P<0.05);观察组在躯体功能、角色功能、社会功能等方面的生活质量及护理满意度高于对照组,2组比较差异有统计学意义(P<0.05)。结论认知行为干预能够有效地改善慢性肾衰竭患者的生活方式,提高生活质量。%Obj ective To explore yhe effecy of cogniyive behavior inyervenyion in payienys wiyh chronic renal failure.Methods 60 payienys wiyh chronic renal failure were randomly divided inyo yhe observayion group and yhe conyrol group,yhe conyrol group was received rouyine nursing, yhe observayion group was given cogniyive behavior inyervenyion,nursing effecys were compared be-yween yhe ywo groups.Results Life syyle score in yhe aspecy of self realizayion,healyh responsibili-yy,nuyriyion and oyhers in yhe observayion group was higher yhan yhay in yhe conyrol group;Healyh belief was beyyer yhan yhay in conyrol group,yhe resulys revealed yhay yhe difference was syayisyically significany (P<0 .05 ).Life qualiyy in physical funcyion,role funcyion and social funcyion in yhe ob-servayion group was higher yhay in yhe conyrol group;Nursing sayisfacyion was higher yhan yhay in yhe conyrol group,so yhe difference was syayisyically significany(P<0.05).Conclusion Cogniyive behavioral inyervenyion can effecyively improve life syyle and life qualiyy in payienys wiyh chronic renal failure.

  10. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe

    DEFF Research Database (Denmark)

    Nielsen, Lene Ryom; Kirk, O; Lundgren, J D;

    2013-01-01

    Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death.......Knowledge about advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in HIV-positive persons is limited. The aim of this study was to investigate incidence, predictors and outcomes for advanced CKD/ESRD and renal death....

  11. Association of dyslipidemia with renal outcomes in chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Szu-Chia Chen

    Full Text Available Dyslipidemia is highly prevalent in patients with chronic kidney disease (CKD and the relationship between dyslipidemia with renal outcomes in patients with moderate to advanced CKD remains controversial. Hence, our objective is to determine whether dyslipidemia is independently associated with rapid renal progression and progression to renal replacement therapy (RRT in CKD patients. The study analyzed the association between lipid profile, RRT, and rapid renal progression (estimated glomerular filtration rate [eGFR] slope <-6 ml/min/1.73 m(2/yr in 3303 patients with stages 3 to 5 CKD. During a median 2.8-year follow-up, 1080 (32.3% participants commenced RRT and 841 (25.5% had rapid renal progression. In the adjusted models, the lowest quintile (hazard ratios [HR], 1.23; 95% confidence interval [CI], 1.01 to 1.49 and the highest two quintiles of total cholesterol (HR, 1.25; 95% CI, 1.02 to 1.52 and HR, 1.35; 95% CI, 1.11 to 1.65 respectively increased risks for RRT (vs. quintile 2. Besides, the highest quintile of total cholesterol was independently associated with rapid renal progression (odds ratio, 1.36; 95% CI, 1.01 to 1.83. Our study demonstrated that certain levels of dyslipidemia were independently associated with RRT and rapid renal progression in CKD stage 3-5. Assessment of lipid profile may help identify high risk groups with adverse renal outcomes.

  12. Dermatomyositis presenting with rhabdomyolysis and acute renal failure; an uncommon manifestation

    Directory of Open Access Journals (Sweden)

    Joshi Deepika

    2009-01-01

    Full Text Available Rhabdomyolysis and myoglobinuria are a rare complication of dermatomyositis. Such patient can land up in acute renal failure. Recognition of this fact has important therapeutic implications as patients require immunotherapy in addition to the symptomatic treatment for renal failure. We report a case of dermatomyositis with evidence of rhabdomyolysis and myoglobinuria presenting with acute renal failure. The patient responded dramatically to corticosteroid therapy.

  13. Home monitoring of chronic heart failure

    Directory of Open Access Journals (Sweden)

    Bockeria O. L.

    2012-06-01

    Full Text Available Being a common syndrome chronic heart failure (CHF results in high mortality among cardiosurgical patients and requires very high expenditures for the treatment. All over the world the number of patients with CHF syndrome is about 22 millions. Heart failure is difficult to treat because of high level of hospitalization due to decompensation. Care aimed at constant home observation of patients could have been more efficient and not only symptomatic and as a response to complications induced. There are methods controlling CHF patients at home. These methods vary from increase of self-care and telephone support to telemonitoring and remote monitoring of implantable devices. Self-care includes such components as maintenance of drug intake, keeping to a diet, physical exercises and active control over edemas. Telephone calls are also a source of monitoring and treatment of heart failure at home. Meta-analysis of programs for structured phone support showed that telephone support could reduce the level of readmission of HF patients approximately by 25%. Telemonitoring implies transmission of such physiological data as blood pressure, body weight, electrocardiographic signals or oxygen saturation using phone lines, broadband and satellite or wireless networks. Having cardiac pacemakers, implantable cardioverter defibrillators and cardiac resynchronization therapy devices that are placed in HF patients, it is possible to use their opportunities for the further evaluation of the patient. Some regularly controlled parameters can show the clinical state of the patient and predict the following heart failure. For example, atrial fibrillation, decrease of cardiac rhythm variability and decrease of the level of the patient`s activity (according to integrated accelerometer can predict clinical decompensation. Also, implantable hemodynamic monitors for immediate pressure measuring in the left atrium, sensor system of pressure measuring in the right atrium are

  14. Exercise training attenuates chemoreflex-mediated reductions of renal blood flow in heart failure.

    Science.gov (United States)

    Marcus, Noah J; Pügge, Carolin; Mediratta, Jai; Schiller, Alicia M; Del Rio, Rodrigo; Zucker, Irving H; Schultz, Harold D

    2015-07-15

    In chronic heart failure (CHF), carotid body chemoreceptor (CBC) activity is increased and contributes to increased tonic and hypoxia-evoked elevation in renal sympathetic nerve activity (RSNA). Elevated RSNA and reduced renal perfusion may contribute to development of the cardio-renal syndrome in CHF. Exercise training (EXT) has been shown to abrogate CBC-mediated increases in RSNA in experimental heart failure; however, the effect of EXT on CBC control of renal blood flow (RBF) is undetermined. We hypothesized that CBCs contribute to tonic reductions in RBF in CHF, that stimulation of the CBC with hypoxia would result in exaggerated reductions in RBF, and that these responses would be attenuated with EXT. RBF was measured in CHF-sedentary (SED), CHF-EXT, CHF-carotid body denervation (CBD), and CHF-renal denervation (RDNX) groups. We measured RBF at rest and in response to hypoxia (FiO2 10%). All animals exhibited similar reductions in ejection fraction and fractional shortening as well as increases in ventricular systolic and diastolic volumes. Resting RBF was lower in CHF-SED (29 ± 2 ml/min) than in CHF-EXT animals (46 ± 2 ml/min, P hypoxia, and this was prevented in CHF-EXT animals. Both CBD and RDNX abolished the RBF response to hypoxia in CHF. Mean arterial pressure increased in response to hypoxia in CHF-SED, but was prevented by EXT, CBD, and RDNX. EXT is effective in attenuating chemoreflex-mediated tonic and hypoxia-evoked reductions in RBF in CHF. PMID:26001414

  15. Multi-factor analysis of failure of renal replacement therapy in acute renal failure developed after cardiac surgery

    Science.gov (United States)

    Szwedo, Ireneusz; Tyc, Joanna; Hawrysz, Anna; Janiak, Kamila; Cichoń, Romuald

    2015-01-01

    Introduction Acute renal failure (ARF) is a rare (2-15%), but severe complication of cardiac surgery with overall mortality reaching 40-80%. In order to save patients’ lives they are treated with renal replacement therapy (RRT). The aim of our study was to assess the impact of different perioperative factors on mortality among patients treated with RRT because of acute renal failure, which occurred as a complication of a heart surgery. Material and methods Retrospective analysis included 45 patients, operated in the years 2009-2013, who underwent renal replacement therapy in order to treat postoperative ARF. The perioperative factors were analysed in two groups: group 1 – patients who died before discharge; and group 2 – those who survived until hospital discharge. Results Forty-five of 3509 cardiac surgical patients (1.25%) required RRT after the surgery. A total of 23 (51.11%) died before discharge (group 1). Patients in group 1 were characterised by older age (70.21 vs. 67 years), higher mean EuroSCORE value (9.28 vs. 7.15) (p < 0.05), higher percentage of concomitant surgery (63.63% vs. 28.57%) (p < 0.05) and of admission of catecholamines in the postoperative period (100% vs. 68.42%) (p < 0.005), and higher mean urea blood level prior to RRT initiation (156.65 vs. 102.54 mg/dl) (p < 0.05). Conclusions The statistically relevant death predictors proved to be: high EuroSCORE, concomitant surgery, and high urea level at RRT initiation and admission of catecholamines in the postoperative period. After conformation in further studies, those factors may prove useful in stratification of death risk among surgical patients requiring RRT. PMID:26702273

  16. Overview of management of acute renal failure and its evaluation; a case analysis

    Directory of Open Access Journals (Sweden)

    Nazar Chaudhary Muhammad Junaid

    2015-01-01

    Full Text Available The annual incidence is about 150 per million in the UK, but this figure is six times greater in the >80 years old group. Prerenal azotemia is considered as the most serious reason in community or hospital acquired acute renal failure (ARF. A 67-year-old middle age male was admitted to the hospital with a chief complaint of generalized weakness, volume depletion and dysuria. He has treated with metronidazole for diarrhoea caused by Clostridium difficile considered as the precipitating factor for the ARF. The patient has severe osteoarthritis and takes high dose non-steroidal anti-inflammatory drugs from the last two years. He also complains for obstructive sleep apnea (OSA and obesity. He has controlled hypertension was on lisinopril to control blood pressure. ARF is quite common, occurring in 80 million populations. Urinary obstruction should be excluded (a cause in around 5-10 of cases because this is readily reversible if it is diagnosed early. A renal US will be sufficient to identify obstruction in 95 of cases. Most cases of ARF are expected to pre renal failure/acute tubular necrosis (ATN 70-80%. Risk factor for development for at ATN are old age, drugs (non-steroidal anti-inflammatory drugs, gentamicin, sepsis, and chronic kidney disease and must be considered.

  17. Central role of carotid body chemoreceptors in disordered breathing and cardiorenal dysfunction in chronic heart failure

    OpenAIRE

    Marcus, Noah J.; Del Rio, Rodrigo; Schultz, Harold D.

    2014-01-01

    Oscillatory breathing (OB) patterns are observed in pre-term infants, patients with cardio-renal impairment, and in otherwise healthy humans exposed to high altitude. Enhanced carotid body (CB) chemoreflex sensitivity is common to all of these populations and is thought to contribute to these abnormal patterns by destabilizing the respiratory control system. OB patterns in chronic heart failure (CHF) patients are associated with greater levels of tonic and chemoreflex-evoked sympathetic nerve...

  18. Pattern of failure following surgical resection of renal cell carcinoma

    International Nuclear Information System (INIS)

    Purpose/objective: To identify the pattern of failure in patients with resected renal cell carcinoma (RCC). Materials and Methods: The records of 116 patients with unilateral non-metastatic RCC, who were treated with definitive surgery and referred to the Ottawa Regional Cancer Centre between 1977 and 1988, were reviewed. Distribution by stage included: T1 = 3 patients, T2 = 42 patients, T3 =71 patients. The median follow-up was 44 months, with a range of 4-267 months. Results: Loco-regional failure (LRF) developed in 8 patients, yielding a 7-year actuarial incidence of 8% for LRF, as first event. Nine patients developed local or regional recurrence + distant failure, and 58 patients had distant metastases only. Seven-year actuarial incidence of distant failure was 55%. The overall 7-year actuarial survival rate was 40%, and cause-specific survival was 45%. Conclusion: LRF was rare following nephrectomy. This data does not support the role of adjuvant radiation therapy in this disease

  19. INTERMEDIATE SYNDROME: A TYPICAL PATTERN OF PRE-RENAL ACUTE RENAL FAILURE IN THE ELDERLY

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    Greloni G

    2004-01-01

    Full Text Available Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatible with parenchymal renal insufficiency (elevated urinary sodium, plasma urea and creatinine, but with a positive response to hydration. The main characteristics of the aged kidney that predispose to the development of an intermediate syndrome are: the vascular dysautonomy and reduced capability of sodium and water reabsorption. The intermediate syndrome is a typical pattern of pre-renal insufficiency in the elderly. RESUMEN: La insuficiencia renal aguda es frecuente en el anciano. Esto se debe por un lado a los cambios estructurales y funcionales propios del riñón senil, y por otro a la gran exposición que esta población tiene a la polifarmacia, y su reducida capacidad para metabolizar los medicamentos. En este reporte presentamos el caso de una mujer de 70 años que desarrolló una insuficiencia renal aguda secundaria a severa deshidratación, mostrando un patrón clínico y de laboratorio propio de un sindrome intermedio: laboratorios compatibles con una insuficiencia renal parenquimatosa (sodio urinario, uremia y creatininemia elevadas, pero con una respuesta favorable a la hidratación. Las principales características del riñón senil que predisponen al desarrollo del sindrome intermedio: son la disautonomía vascular y la reducida capacidad en la recuperación de sodio y agua El sindrome intermedio es un patrón típico de insuficiencia prerrenal en el anciano.

  20. Management of chronic heart failure in the older population

    Institute of Scientific and Technical Information of China (English)

    Nahid Azad; Genevieve Lemay

    2014-01-01

    Chronic heart failure (CHF) is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

  1. the Pathogenesis of acute on Chronic Hepatitis B liver Failure

    Institute of Scientific and Technical Information of China (English)

    Zhao-chun Chi; Quan-jiang Dong; Chang-xin Geng

    2014-01-01

    Acute-on-chronic liver failure is a characteristic clinical liver syndrome, which should be differentiated from acute liver failure, acute decompensated liver cirrhosis and chronic liver failure. The pathogenesis of ACLF is not fully understood yet. Viral factors and immune injury have been reported to be the two major pathogenesis. This paper reviewed the researches on the pathogenesis of acute on chronic hepatitis B liver failure in recent years, to provide theoretical basis for prompt and accurate diagnosis and treatment of this syndrome. This would beneift for the prognosis and raise the survival rate of patients.

  2. Clinical significance of determination of plasma leptin, NPY and serum Hcy levels in patients with chronic renal diseases

    International Nuclear Information System (INIS)

    Objective: To study the relationship between progress of disease and blood levels of leptin, NPY, Hcy in patients with chronic renal diseases. Methods: Plasma leptin, NPY (with RIA) and serum Hcy (with CLIA) were determined in (1) 32 patients with chronic pyelonephritis (2) 28 patients with dibetic nephropathy (3) 30 patients with chronic renal failure and (4) 30 controls. Results: Blood levels of leptin, NPY and Hcy were slightly higher in patients with chronic pyelonephritis than those in controls but without significance (P>0.05). In patients with diabetic nephropathy, the plasma leptin and serum Hcy levels were significantly higher than those in controls (P0.05). In patients with chronic renal failure,the blood levels of NPY (P<0.05) and leptin, Hcy (P<0.01) were all significantly higher than those in controls. Conclusion: Blood levels of these three parameters especially leptin and Hcy, were increased in patients with chronic renal diseases and the increase was most significant in advanced cases. (authors)

  3. Potential benefits of renal diets on cardiovascular risk factors in chronic kidney disease patients.

    Science.gov (United States)

    Cupisti, Adamasco; Aparicio, Michel; Barsotti, Giuliano

    2007-01-01

    Dietary manipulation, including protein, phosphorus, and sodium restriction, when coupled with the vegetarian nature of the renal diet and ketoacid supplementation can potentially exert a cardiovascular protective effect in chronic renal failure patients by acting on both traditional and nontraditional cardiovascular risk factors. Blood pressure control may be favored by the reduction of sodium intake and by the vegetarian nature of the diet, which is very important also for lowering serum cholesterol and improving plasma lipid profile. The low protein and phosphorus intake has a crucial role for reducing proteinuria and preventing and reversing hyperphosphatemia and secondary hyperparathyroidism, which are major causes of the vascular calcifications, cardiac damage, and mortality risk of uremic patients. The reduction of nitrogenous waste products and lowering of serum PTH levels may also help ameliorate insulin sensitivity and metabolic control in diabetic patients, as well as increase the responsiveness to erythropoietin therapy, thus allowing greater control of anemia. Protein-restricted diets may have also anti-inflammatory and anti-oxidant properties. Thus, putting aside the still debatable effects on the progression of renal disease and the more admitted effects on uremic signs and symptoms, it is possible that a proper nutritional treatment early in the course of renal disease may be useful also to reduce the cardiovascular risk in the renal patient. However, conclusive data cannot yet be drawn because quality studies are lacking in this field; future studies should be planned to assess the effect of renal diets on hard outcomes, as cardiovascular events or mortality. PMID:17654313

  4. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    International Nuclear Information System (INIS)

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  5. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Urbania, Thomas H. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Ave., Box 0628, San Francisco, CA (United States); Kammen, Bamidele F.; Nancarrow, Paul A. [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Morrell, Rose Ellen [Children' s Hospital and Research Center Oakland, Department of Nephrology, Oakland, CA (United States)

    2009-02-15

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  6. Costo-utilidad del trasplante renal frente a la hemodiálisis en el tratamiento de la insuficiencia renal crónica terminal en un hospital peruano Cost utility of renal transplant vs. hemodialysis in the treatment of end stage chronic kidney failure in a peruvian hospital

    Directory of Open Access Journals (Sweden)

    Ricardo E. Loza-Concha

    2011-09-01

    Full Text Available Objetivos. Determinar y comparar las razones de costo-utilidad de los trasplantes renales con donante cadavérico (TRDC practicados en el Hospital Nacional Guillermo Almenara Irigoyen los años 2000-2001, frente a hemodiálisis (HD, cinco años después del inicio del tratamiento. Material y métodos. Se realizó un estudio de costo utilidad, estudiando a todos los pacientes continuadores cinco años post TRDC, a quienes se asignó como controles, dos pacientes con cinco años de HD pareados por edad, sexo y tiempo de enfermedad. Se evaluaron los costos de cada procedimiento, los años de vida ajustados a la calidad (AVAC utilizando el cuestionario SF-36v2TM y se calcularon las razones de costo utilidad (CU y costo utilidad incremental (CUI. Resultados. Se realizaron 58 TRDC los años 2000-2001. Cinco años después, 17 (29 % pacientes fallecieron y 27 (47 % continuaron con su tratamiento post-TRDC. Treinta y uno (53 % TRDC fracasaron; 26 % por rechazo al trasplante, 55 % por complicación y 19 % por tratamiento irregular. Los puntajes SF-36v2TM promedio obtenidos por los TRDC y HD fueron 95±13 y 87±18 puntos respectivamente. En ambos años, los AVAC obtenidos por los TRDC y HD fueron de 251 y 229 puntos respectivamente; las razones de CU para los TRDC y los HD fueron de USD 11 984 y USD 9243, y la razón de CUI fue de USD 40 669. Conclusiones. Los TRDC realizados los años 2000-2001, cinco años después resultaron menos costo útiles que las HD; y los TRDC realizados el 2000 tuvieron una menor razón de costo utilidad incremental que los efectuados el 2001, probablemente por su mayor razón de tratamientos irregulares.Objectives. To assess and compare the cost utility of the cadaveric donor renal transplant (CDRT at the Hospital Nacional Guillermo Almenara Irigoyen between 2000 to 2001, against haemodialysis (HD, 5 years after treatment initiation. Materials and Methods. A cost utility study design was used, which evaluated every patient

  7. ADVANCE: Study to Evaluate Cinacalcet Plus Low Dose Vitamin D on Vascular Calcification in Subjects With Chronic Kidney Disease Receiving Hemodialysis

    Science.gov (United States)

    2014-07-14

    Chronic Kidney Disease; End Stage Renal Disease; Coronary Artery Calcification; Vascular Calcification; Calcification; Cardiovascular Disease; Chronic Renal Failure; Hyperparathyroidism; Kidney Disease; Nephrology; Secondary Hyperparathyroidism

  8. Hiperpigmentação cutânea em pacientes com insuficiência renal crônica em hemodiálise infectados pelo vírus da hepatite C Increased skin pigmentation in patients with chronic renal failure undergoing hemodialysis infected with the hepatitis C virus

    Directory of Open Access Journals (Sweden)

    Humberto Kukhyun Choi

    2003-01-01

    Full Text Available OBJETIVO: A hiperpigmentação cutânea é comumente encontrada em pacientes portadores de insuficiência renal crônica (IRC, sendo também uma das manifestações mais evidentes da Porfiria Cutânea Tarda (PCT. Essa doença, que tem sido relatada em pacientes em hemodiálise (HD, tem como um dos fatores precipitantes a infecção pelo vírus da hepatite C (HCV. Este estudo tem como objetivo avaliar a prevalência de hiperpigmentação cutânea difusa em pacientes com IRC infectados pelo HCV. MÉTODOS: Foi desenvolvido um estudo transversal com 47 pacientes (idade média de 50,35 ± 15,16 anos, 31 homens e 16 mulheres que estavam realizando hemodiálise na Unidade de Diálise do Hospital de Clínicas de Porto Alegre. Os pacientes foram divididos em dois grupos: grupo 1, anti-HCV positivos (n=17, e grupo 2, anti-HCV negativos (n=30. RESULTADOS: A prevalência de pacientes com hiperpigmentação cutânea relacionada a HD foi de 36,2% (n=17. Havia 10 pacientes (58,8 % no grupo 1 e sete pacientes (23,3% no grupo 2 (Razão de Risco de 2,52 e Intervalo de Confiança de 95% de 1,18 a 5,4; pBACKGROUND: Skin pigmentation is commonly found in patients with chronic renal failure (CRF. This symptom is also one of the most evident features of Porphyria Cutanea Tarda (PCT. Hepatitis C virus (HCV is an important precipitating agent of this disease, which has been described in patients undergoing hemodialysis (HD. In this paper, we intend to evaluate the prevalence of difuse skin hyperpigmentation in patients with CRF infected with the HCV. METHODS: We developed a transversal study with 47 patients (mean age 50,35 + 15,16 years; 31 men and 16 women who were on hemodialysis in march of 2001 at the Unit of Dialysis of Hospital de Clínicas de Porto Alegre. Patients were divided in two groups: group 1, anti-HCV positives (n=17, and group 2, anti-HCV negatives (n=30. RESULTS: The prevalence of skin hyperpigmentation related to HD was 36,2% (n=17. There were 10

  9. Prognostic significance of cardiovascular biomarkers and renal dysfunction in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Bosselmann, Helle; Egstrup, Michael; Rossing, Kasper;

    2013-01-01

    To assess whether the prognostic significance of cardiovascular (CV) biomarkers, is affected by renal dysfunction (RD) in systolic heart failure (HF).......To assess whether the prognostic significance of cardiovascular (CV) biomarkers, is affected by renal dysfunction (RD) in systolic heart failure (HF)....

  10. Two cases of cisplatin-induced permanent renal failure following neoadjuvant chemotherapy for esophageal cancer

    Directory of Open Access Journals (Sweden)

    Tomohiko Sasaki

    2016-01-01

    Conclusion: Although cisplatin-related nephrotoxicity is a well-recognized complication, there have been few reports of renal failure requiring hemodialysis in cancer patients. In this report, we present their clinical courses and the pathological findings of cisplatin-related renal failure.

  11. X-ray changes of children with chronic renal insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W.; Balzar, E. (Vienna Univ. (Austria). Kinderklinik)

    1983-01-01

    The typical changes of renal osteopathy are shown in the X-rays of 7 children with end-stage renal disease treated with chronic intermittent hemodialysis. The exact evaluation of the granular structural changes of the cranium, the evidence of osteomalacia because of the hazy appearance of the vertebrae and the broadening of the sacroilical joints depend highly on subjective judgement and the technical X-ray procedures used. Unmistakable radiological diagnoses can be made when a broadening of the metalphyseal zones, epiphysioloysis as well as characteristic changes in the finder phalanges (acroosteolyses, spiculae, tunnelation) are present.

  12. Risks of Death and Graft Failure After Surgical Versus Percutaneous Coronary Revascularization in Renal Transplant Patients

    OpenAIRE

    Charytan, David M.; Li, Shuling; Liu, Jiannong; Qiu, Yang; Herzog, Charles A.

    2013-01-01

    Background Reliable data regarding absolute and relative risks of death and graft failure after coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in renal transplant patients are unavailable. Methods and Results Renal transplant patients undergoing inpatient CABG (n=1400) or PCI (n=4097) were identified from United States Renal Data System data. Cumulative incidence of nonfatal graft failure and death was reported for observed events. A Cox model with th...

  13. HFRS with Severe Heart Liver and Renal Failure:a Case Report

    Institute of Scientific and Technical Information of China (English)

    Qing; Zhou; Meng-Hou; Lu; Lei; Fu; De-Ming; Tan

    2012-01-01

    Hemorrhagic fever with renal syndrome(HFRS) is caused by hantavirus infection,which was characterized by abrupt high fever,systemic hemorrhage,hypotension and renal damage.Although multiple system organ damage was not uncommon,but multiple organ system failure were rare.Hereafter we report one case with simultaneous renal,heart and liver failure.In this case,we received some experience and lessons.

  14. Bilateral renal cortical necrosis with end-stage renal failure following envenoming by Proatheris superciliaris: a case report.

    Science.gov (United States)

    Pourreau, François; Pinsard, Michel; Goyffon, Max; Plasse, Florent; Desport, Estelle; Thierry, Antoine; Touchard, Guy; Bridoux, Frank

    2014-06-01

    Acute bilateral renal cortical necrosis (BRCN) has been reported following envenoming by exotic venomous snakes. Proatheris superciliaris is a rare viper with restricted distribution in east Africa. Very little information is available on envenoming by this species. We herein describe the case of a 60-year-old professional wildlife photographer who was bitten on his thumb while photographing an adult specimen of P. superciliaris that he held at home in France. On admission, physical examination revealed severe hypertension and bruising with edema at the bite site. Within the following 24 h, he developed vomiting, diarrhea, acute lumbar pain and anuria. Laboratory tests showed acute kidney injury (serum creatinine 4.6 mg/dL), with thrombocytopenia, anemia and severe coagulopathy. Contrast-enhanced computed tomography scan revealed hypodense areas in the cortex of both kidneys consistent with diffuse BRCN. As no appropriate antivenom existed, only symptomatic care was given to the patient. Coagulation tests returned to normal within 48 h. The patient was placed on chronic hemodialysis, until he underwent successful kidney transplantation 18 months later. In developed countries, severe complications provoked by snake bites tend to be more frequent with the number of trendy exotic pets. Acute kidney injury, including BRCN, is a classic complication of viper bites. The present case of end-stage renal failure related to diffuse BRCN illustrates the potentially devastating effects of envenoming by P. superciliaris. Clinicians in developed countries should be informed about renal disorders and other potentially fatal complications of venomous snake bites and seek urgent expert advice for optimizing clinical management. Education and coaching of envenomed patients and exotic snake owners is mandatory to prevent dramatic accidents. PMID:24709757

  15. FUROSEMIDE TEST: ITS PATTERN IN NOT SEVERE CHRONIC RENAL DISEASE

    Directory of Open Access Journals (Sweden)

    Carlos G. Musso

    2008-01-01

    Full Text Available Furosemide test is a simple and useful test of renal physiology used to evaluate the capability of the collecting tubules to secrete potassium under the effect of serum aldosterone. Its behaviour pattern has already been established in children and young adults but not described in chronic renal disease patients yet, which we explored in this study.Material & Method: Twenty-six young volunteers (between 20 and 40 years old, chronically on a low potassium diet (40 mmol of K day were studied: twenty of them were healthy young ( they were neither suffering form diseases nor on any medication, and the rest were young patients suffering from stage II / III chronic renal disease (damaged kidney with GFR between 83.1 ml-min to 39.2 ml-min secondary to glomerular diseases documented by kidney biopsy. None of the studied chronic renal disease patients were suffering from diabetes mellitus, urinary obstruction, nor treated with dyskalemia generating drugs, such as: diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, etc. Before, while the test was being carried out and after 180 minutes of a single dose of intravenous furosemide (1 mg/kg, urine and blood samples were obtained, for creatinine and potassium levels. From these data we calculated fractional excretion (FE of potassium. Statistical analysis was performed applying Student´s t-test.Results: There was no significant difference neither in pre-furosemide (basal and post-furosemide average FE of potassium between the healthy and chronic renal disease (CRD group: 16.4 ± 8.6% (CRD vs 11.5 ± 4.6% (healthy (p = NS ; 40.8 ± 3.2 % (CRD vs 35.4 ± 8.9% (healthy (p = NS respectively. Conversely, there was a significant difference in post-furosemide peak FE of potassium value, which was higher and delayed in the CRD group compared to the healthy one: 49.5 ± 8.2 % at 118 mins (CRD vs 31.6 ± 11% at 30 mins (healthy (p = 0.001.Conclusion: Furosemide test showed a

  16. 石榴皮鞣质对腺嘌呤性慢性肾衰大鼠保护作用的研究%Protective Effect of Tannin in Punica granatum L.on Chronic Renal Failure in Rats Induced by Adenine

    Institute of Scientific and Technical Information of China (English)

    周本宏; 郭志磊; 王慧媛; 冯琪

    2009-01-01

    目的 观察石榴皮鞣质对腺嘌呤性慢性肾功能衰竭(CRF)大鼠的影响.方法 用250 mg·kg~(-1)腺嘌呤溶液连续灌胃21 d使Wistar大鼠产生类似慢性肾袁的症状.21d后,治疗组大鼠每天用石榴皮鞣质(40,20,10mg·kg~(-1).d~(-1))灌胃,阳性组用20%尿毒清混悬液按2.1 g·kg~(-1)·灌胃.60 d后收集尿液,处死大鼠,取血、留取肾组织,测定血Ca~(2+)、P~(3+)及血肌酐(Scr)、尿素氮(BUN),血脂和24h尿蛋白定量、尿Ca~(2+)、P~(3+),进行统计学处理,并进行形态学观察.结果 石榴皮鞣质对慢性肾衰竭大鼠的血Ca~(2+)、P~(3+)及Scr、BUN和24 h尿蛋白定量、尿Ca~(2+)、P~(3+)有不同程度的改善.结论 石榴皮鞣质对腺嘌呤导致的大鼠慢性肾衰竭有一定的保护作用.%OBJECTIVE To observe the effeets of tannin in Punica granatum L.on chronic renal failure(CRF)in rats induced by adenine.METHODS The Wistar rats were administered intragastrically with adenine(200 mg·kg~(-1)·d~(-1))for 21 d to induce the symptoms similar to chronic renal failure.Then,the rats were administered intragastrically with tannin(40,20 and 10 blood urea nitrogen(BUN),calcium ion(Ca~(2+)),phosphorus ion(P~(3+)),blood lipids and urine protein of 24 h were determined and analyzed.Meanwhile morphology was observed.RESULTS Serum levels of Scr,BUN and P~(3+) were decreased but Ca~(2+) level was increased by tannin in Punica granatum L.CONCLUSION Tannin in Punica granatum L can improve the renal function injuried by metabolic products in adenine-modeled CRF rats.

  17. Prophages in Enterococcal Isolates from Renal Transplant Recipients: Renal Failure Etiologies Promote Selection of Strains

    Directory of Open Access Journals (Sweden)

    Agnieszka Daca

    2014-01-01

    Full Text Available Infections caused by commensal bacteria may be fatal for the patients under immunosuppressive therapy. This results also from difficulty in identification of high risk strains. Enterococcal infections are increasingly frequent but despite many studies on virulence traits, the difference between commensal and pathogenic strains remains unclear. Prophages are newly described as important elements in competition between strains during colonization, as well as pathogenicity of the strains. Here we evaluate a difference in presence of pp4, pp1, and pp7 prophages and ASA (aggregation substance gene expression in enterococcal isolates from renal transplant recipients (RTx with different etiology of the end-stage renal failure. Prophages sequence was screened by PCR in strains of Enterococcus faecalis isolated from urine and feces of 19 RTx hospitalized at Medical University of Gdansk and 18 healthy volunteers. FLOW-FISH method with use of linear locked nucleic acid (LNA probe was used to assess the ASA gene expression. Additionally, ability of biofilm formation was screened by crystal violet staining method. Presence of prophages was more frequent in fecal isolates from immunocompromised patients than in isolates from healthy volunteers. Additionally, both composition of prophages and ASA gene expression were related to the etiology of renal disease.

  18. The Analysis of Anemia in Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Yuan Guiyi; Wu Wei; Luo Yilong; Li Yiqing; Zhou Shuxian; Fang Chang

    2006-01-01

    objectives To demonstrate the phenomena and explore the causes of anemia in patients with chronic heart failure (CHF). Methods To observe the phenomena of anemia in patients with CHF, a total of 276 patients with CHF were included in this retrospective study. The clinical characteristics of the patients are: mean age 69.2±11.0 years; male 151,female 125; NYHA Ⅲ and Ⅳ 115 (41.7%). Results ①Among the 276 patients with CHF, 81 (29.4%)had anemia (Mean hemoglobulin concentration 101.5±13.0g/L). ② Patients with Anemia were more likely to be female and to have greater NYHA (Ⅲ or Ⅳ) (P<0.05), higher serum creatinine, as well as lower serum albumin and low-density lipoprotein levels (P<0.01).③ A weak negative correlation was also noted between the level of NYHA and hemoglobulin. ④ There was no significant difference in age, the primary cardiac etiology of the CHF, the history of diabetes, left ventricular end diastolic diameter, and left ventricular ejection fraction between CHF patient with and without anemia. Conclusions The prevalence of anemia is high among patients with CHF. The anemia patients with CHF tend to be female, have greater cardiac and renal functional impairment, but with lower serum albumin and LDL that suggests some degree of malnutrition.

  19. 安素对慢性肾功能不全患者低蛋白饮食的营养补充效果观察%Effect of Enteral nutrition powder supplement for chronic renal failure patients with low protein diet

    Institute of Scientific and Technical Information of China (English)

    陆琪红; 顾艳艳; 马莉; 童本德; 沈霞; 熊金萍

    2013-01-01

    目的 观察安素对慢性肾功能不全(chroric renal failure CRF)患者低蛋白饮食(Low-protein dietary LPD)的营养补充效果.方法 通过比较2011、2012年度120例给予LPD的CRF患者在补充(60例)与没有补充(60例)安素情况下的营养状况和肾功能情况,判断安素对CRF患者LPD进食依从性差的营养改善意义.结果 LPD进食依从性差,会导致部分CRF患者营养状况下降甚至恶化.在LPD的基础上适量补充安素,能有效地维持患者的营养状况同时对患者的肾功能没有明显的负面影响.结论 给予LPD进食依从性差的CRF患者一定量的安素补充是可行而且有益的.%Objective To assess the effect of enteral nutrition powder (ENP) supplement for chronic renal insufficiency (CRF) patients with low protein diet (LPD).Methods One hundred and twenty CRF patients underwent LPD treatment,among whom 60 were supplemented with ENP (test group)and another 60 without supplemental ENP (control group).The nutritional status before and after LPD treatment was measured and compared between two groups.Results The nutritional status was declined or deteriorated in CRF patients of control group; while that was effectively maintained in patient of test group and there was no apparent negative impact on renal function.Conclusion Enteral nutrition powder supplement is feasible and beneficial for CRF patients with low protein diet treatment.

  20. Chronic Renal Allograft Dysfunction Antibody-Mediated: An Update

    Directory of Open Access Journals (Sweden)

    Maurizio Salvadori,

    2014-07-01

    Full Text Available This paper reviews the most important studies on chronic antibody-mediated rejection (cABMR, which is an important cause of late graft dysfunction after renal transplantation. Several antibodies seem to be responsible for chronic rejection; new techniques have allowed us to identify these antibodies in circulation. The pathogenetic role of the antibodies generally includes the complement pathway, but may also be complement-independent. This paper also examines the pathogenesis of chronic endothelial lesions, as well as the histopathological aspects. Antibodies responsible for chronic rejection may preexist before transplantation or may develop after transplantation. The possible therapeutic approaches are poor and principally based on early identification and desensitisation techniques. New B cell targeting drugs are aimed at an improved control of the relevant condition.