scholarly journals Hypertensive Retinopathy as the First Manifestation of Advanced Renal Disease in a Young Patient: Report of a Case

2015 ◽  
Vol 6 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Karen Janeth Arriozola-Rodríguez ◽  
Juan Carlos Serna-Ojeda ◽  
Virginia Alejandra Martínez-Hernández ◽  
José Luis Rodríguez-Loaiza

The purpose of this paper was to report the case of a 23-year-old patient suffering from bilateral acute visual loss who received the diagnosis of hypertensive retinopathy. After systemic evaluation, he was diagnosed with bilateral renal disease and chronic renal failure, requiring a kidney transplantation to manage the systemic illness, followed by gradual improvement of his visual acuity.

2018 ◽  
Vol 159 (46) ◽  
pp. 1898-1904
Author(s):  
Amanda Illés ◽  
Balázs Nemes ◽  
Sándor Kovács ◽  
Antal Bugán

Abstract: The patients’ attitudes towards kidney transplantation are significantly affected by the acceptance of the treatment to have a better quality of life. Exploration of the cognitive-emotional relation in patients with chronic renal failure. Our study included 285 kidney patients. We investigated three groups of patients: predialysis, dialysis and transplantation patients. In the framework of a pre-examination we have created an attitudinal questionnaire (85 items) that can be used to describe the cognitive and emotional attitude of kidney patients towards their illness and to measure scales. Negative attitudes towards transplantation were reported in dialysis and predialysis patients. In contrast, patients who had already undergone surgery were particularly positive about kidney transplantation. Many patients refuse transplantation which correlates with attitudes towards illness and healing. Our results showed that the exploration of the patients’ cognitive emotional relation along with the medical diagnosis would have a better adherence towards the kidney substitutional treatment which ensures a better quality of life. Orv Hetil. 2018; 159(46): 1898–1904.


Author(s):  
B. Z. Khubutiya ◽  
O. N. Rzhevskaya ◽  
A. A. Lisenok

Introduction. All over the world and in Russia, the number of patients requiring dialysis therapy and kidney transplantation for chronic renal failure in the end-stage of the renal disease is increasing. In many countries of the world, the number of dialysis patients over 60 years of age accounts for 30 to 45% of all patients with chronic renal failure. Meantime, taking into account the improved methods for early diagnosis of chronic renal failure and the treatment methods for chronic kidney disease, including the renal replacement therapy, we can expect an increase in the number of elderly potential kidney transplant recipients. The likelihood of receiving a renal graft in elderly patients is significantly lower than in young recipients. Elderly patients are known to have a higher risk of death while waiting for a kidney transplant due to higher morbidity and lethality on dialysis. For this reason, the urgency of increasing the availability of kidney transplantation in elderly patients is growing over time. One of the solutions can be the use of kidneys from suboptimal donors with a far from ideal graft quality, but which could meet the needs for transplant care of the older age group of patients. The older age of a recipient entails a certain risk of developing a graft dysfunction due to the presence of concomitant diseases, and the potential risk increases even more with kidney transplants from expanded criteria donors. If a reduced functional reserve of kidneys removed from donors with extended criteria is identified, two-kidney transplantation is possible, which provides fairly good long-term results. To reduce the risk of a kidney graft loss, a careful selection of recipients is necessary, taking into account their co-morbidities, including the presence of urological diseases that impair the function of the upper and lower urinary tract. Their timely identification and correction makes it possible to raise the availability of kidney transplantation for elderly patients and improve its results. This review presents the results of the studies conducted in various world transplant centers, covers the mortality rates, kidney graft and recipient survival rates.The study purpose was to summarize the actual data and the results of the study on kidney transplantation in elderly patients with urological pathology.


1990 ◽  
Vol 11 (9) ◽  
pp. 277-282
Author(s):  
Richard N. Fine

The prognosis of the infant, child, or adolescent with chronic renal failure, defined as an irreversible reduction in glomerular filtration rate, has improved during the past quarter century because of the use of dialysis and renal transplantation. These have prolonged lives in previously fatal situations. Because the potential not only to sustain life but also to effect full rehabilitation exists with the introduction of these treatments, it is now imperative that the multisystem consequences of uremia be either minimized or totally avoided in the pediatric patient with chronic renal failure. The role of the pediatrician in managing the infant, child, or adolescent with chronic renal failure should be directed toward minimizing the potentially devastating consequences of uremia so that the patient is in optimal clinical condition when end stage renal disease occurs. INCIDENCE It is difficult to know the incidence and prevalence of chronic renal failure and end stage renal disease in children. Surveys in Europe and North America have been conducted to obtain precise information regarding these issues; not only have the definitions included in these surveys differed, but the upper and lower age limits defining pediatric patients have not been uniform. The available data suggest a prevalence of chronic renal failure of 18.5 per 1 million child population and an incidence of end stage renal disease of from 3 to 6 children per 1 million total population.


2006 ◽  
Vol 60 (6) ◽  
pp. 734-739 ◽  
Author(s):  
Ana C Simões E Silva ◽  
José Silvério S Diniz ◽  
Regina M Pereira ◽  
Sérgio V Brant Pinheiro ◽  
Robson Augusto S Santos

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
A. Laviano ◽  
Z. Krznaric ◽  
K. Sanchez-Lara ◽  
I. Preziosa ◽  
A. Cascino ◽  
...  

Protein energy wasting is frequently observed in patients with advanced chronic renal failure and end-stage renal disease. Anorexia and reduced food intake are critical contributing factors and negatively impact on patients' survival. Ghrelin is a prophagic peptide produced by the stomach and acting at the hypothalamic level to increase the activity of orexigenic neurons. In patients with chronic renal disease, plasma levels are increased as a likely effect of reduced renal clearance. Nevertheless, patients' food intake is significantly reduced, suggesting inflammation-mediated resistance of hypothalamic nuclei to peripheral signals. A number of forms of evidence show that ghrelin resistance could be overcome by the administration of exogenous ghrelin. Therefore, ghrelin has been proposed as a potential strategy to improve food intake in chronic renal failure patients with protein energy wasting. Preliminary data are encouraging although larger prospective clinical trials are needed to confirm the results and to identify those patients who are likely to benefit most from the administration of exogenous ghrelin.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1631-1631
Author(s):  
Shigehiko Imagawa ◽  
Takahisa Tarumoto ◽  
Makoto Kobayashi ◽  
Keiya Ozawa

Abstract Erythropoietin (EPO) gene expression is positively regulated by hypoxia-inducible factor-1, which binds to the 3′ enhancer of the EPO gene. EPO expression is negatively regulated by GATA, which binds to the GATA site in the 5′ promoter. Anemia of renal disease is believed to be caused by damage to the EPO-producing cells in the kidney as a result of renal failure. However, even mild renal failure can reduce the serum concentrations of EPO, suggesting that, in addition to the damage to EPO-producing kidney cells, uremic toxin(s) may play an important role in the pathogenesis of the anemia of renal disease. NG-monomethyl-L-arginine (L-NMMA), which competes with L-arginine as a substrate for nitric oxide synthase (NOS), is undetectable in nonuremic subjects, but is markedly elevated in patients with chronic renal failure. We have previously shown in the Hep3B cell line that L-NMMA suppresses EPO expression by upregulating GATA through the suppression of NOS activity, and that inhibition of EPO production with NG -nitro-L-arginine methyl ester (L-NAME) is reversed by pretreatment with L-arginine in mice. In this study, eight patients with anemia of renal disease, who were in the predialysis state of chronic renal failure, were enrolled in a nonrandomized study. All patients were anemic, and had hemoglobin (Hb) levels ranging between 7.9 and 10.8 g/dL. Patients with iron deficiency anemia, hemolytic anemia, and hematological malignancies were excluded. Blood urea nitorgen (BUN) levels were 29.7–90.1 mg/dL, and creatinine (Cre) levels were 1.1–3.8 mg/dL. Eight patients with anemia of renal disease were treated orally with L-arginine at 1.3 g/day for 8 to 22 wks. During this period, patients did not receive blood transfusions, or treatment with iron, vitamins or recombinant human EPO. Six patients responded to the treatment with increased levels of Hb and EPO, and three of these showed improved renal function. The EPO concentrations decreased in two nonresponders. There were no significant adverse effects. These limited data suggest that oral administration of 1.3 g/day of L-arginine can significantly improve EPO production and reverse anemia without adverse effects in patients with anemia of renal disease who are in the predialysis state of chronic renal failure. More studies including younger patients with severe renal dysfunction are in progress.


Sign in / Sign up

Export Citation Format

Share Document