scholarly journals Féloldali vese gyűjtőcsatornás daganatának eredményes palliatív kemoterápiás kezelése anuria mellett

2016 ◽  
Vol 157 (11) ◽  
pp. 436-439
Author(s):  
Tamás Kullmann ◽  
Tamás Pintér ◽  
Zsolt Szepesvári ◽  
Noémi Kránitz ◽  
Stéphane Culine
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Survival Benefit ◽  
Tumour Growth ◽  
Unilateral Nephrectomy ◽  
Supportive Treatment ◽  
Collecting Ducts ◽  
Contralateral Tumour ◽  
One Year ◽  
Anuric Renal Failure

The case of a 54-year-old woman is presented. She underwent right sided unilateral nephrectomy for metastatic bilateral renal tumour of the Bellini collecting ducts. Progression of the contralateral tumour resulted in acute complete anuric renal failure. Haemodialysis was started along with palliative gemcitabine (1000 mg/m2)–cisplatine (70 mg/m2) chemotherapy. In parallel, renal function was improving and dialysis could be stopped at the end of the chemotherapy line comprising 6 cycles. Half a year later the patient was lost of uncontrolled local and pulmonary progression. The potentially nephrotoxic cisplatine chemotherapy associated to complex supportive treatment improved the renal function by controlling diffusely infiltrative tumour growth and allowed a survival benefit over one year with active household keeping capacity. Orv. Hetil., 2016, 157(11), 436–439.

Influência do Tratamento Crônico com L-arginina na Função Renal de Ratos Submetidos a um Modelo Experimental de Doença Renal Crônica/ Influence of Chronic Treatment with L-arginine on Renal Function in Rats Subjected to an Experimental Model of Chronic Ki

1970 ◽  
Vol 4 (4) ◽  
pp. 40-48
Author(s):  
Letícia Pereira De Castro ◽  
Niara da Cunha Borges ◽  
Patrícia Benício Laira ◽  
Nilo César do Vale Baracho
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Total Protein ◽  
Standard Dose ◽  
Unilateral Nephrectomy ◽  
Control Groups ◽  
Continuous Administration ◽  
Significant Change ◽  
And Control

 Objective: To investigate possible improvements in renal function in rats undergoing chronic renal failure treated with L-arginine. Methods: 28 rats were divided into 4 groups: Control L1- (N=7): treatment with distilled water; L2 - Moderate Uremia (N=7): supplementation with L-arginine (100 mg/kg) with unilateral nephrectomy + nephrectomy ¾ kidney against side; L3 - Moderate Uremia (N=6): supplementation with L-arginine (200 mg/kg) with unilateral nephrectomy + nephrectomy ¾ kidney against side; L4 - Moderate Uremia (N=8): supplementation with L-arginine (500 mg/kg) with unilateral nephrectomy + nephrectomy ¾ kidney against side. Results: Continuous administration of arginine L produced no significant change in creatinine dosage, urea and total protein. In glycemia L2 and L2 albumin there were minor changes. In fluid intake there were specific changes on days 6 and 8, only between L2 and control groups. Analyzing food intake, there were only significant changes (p <0.05) spot, on 5, 7 and 9 between L2 and L1 compared with the control, respectively. Regarding the urinary debit, there were significant change (p <0.01) between L3 and control. Conclusion: It was observed that L-arginine supplementation has no effect on renal failure, does not produce improvements in urea, creatinine, total protein and urinary debit. However, it produces changes in blood glucose and albumin, finding a standard dose response in statistical analysis. Keywords: L-arginine, Chronic Renal Failure, Renal Function. Objetivo: Investigar possíveis melhorias na função renal de ratos submetidos à insuficiência renal crônica e tratados com L-arginina. Metodologia: Foram utilizados 28 ratos divididos em 4 grupos: L1 - Controle (N=7): tratamento com água destilada; L2 - Uremia Moderada (N=7): suplementação com L-arginina (100mg/ kg), com nefrectomia unilateral + nefrectomia ¾ do rim contra lateral; L3 - Uremia Moderada (N=6): suplementação com L-arginina (200mg/kg) com nefrectomia unilateral + nefrectomia ¾ do rim contra lateral; L4 - Uremia Moderada (N=8): suplementação com L-arginina (500mg/kg) com nefrectomia unilateral + nefrectomia ¾ do rim contra lateral. Resultados: A administração contínua de L-arginina não produziu alterações significativas nas dosagens de creatinina, ureia e proteína total. Nas dosagens de glicemia L2 e albumina L2 houve pequenas alterações. Na ingesta hídrica foram encontradas alterações pontuais nos dias 6 e 8, apenas entre os grupos L2 e controle. Analisando a ingesta alimentar, houve apenas alterações significativas (p<0,05) pontuais, nos dias 5, 7 e 9 entre L2 e L1, quando comparados ao controle, respectivamente. Em relação ao debito urinário, existiu alteração significativa (p<0,01) entres L3 e controle. Conclusão: Foi observada que a suplementação de L-arginina não possui efeitos na insuficiência renal, não produz melhorias em ureia, creatinina, proteínas totais e debito urinário. Porém, produz alterações em glicemia e albumina, não encontrando um padrão dose resposta nas análises estatísticas. Palavras-chave: L-arginina, Insuficiência Renal Crônica, Função Renal.

scholarly journals Acute Renal Failure due to Obstructive Uropathy Secondary to Ureteral Endometriosis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jeong In Choi ◽  
Jee Geun Yoo ◽  
Sa Jin Kim ◽  
Hae Nam Lee ◽  
Min Jeong Kim
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Differential Diagnosis ◽  
Ureteral Obstruction ◽  
Obstructive Uropathy ◽  
Complete Loss ◽  
Unilateral Nephrectomy ◽  
Significant Morbidity ◽  
Ureteral Endometriosis

Ureteral involvement by endometriosis is a rare and often silent disease but capable of producing significant morbidity and leading to hydronephrosis and to renal failure. Surgery is the treatment of choice to remove endometriotic lesions and relieve ureteral obstruction if the kidney is still functional or a nephrectomy is performed if there is a complete loss of renal function. We report a case of acute renal failure induced ureteral endometriosis managed with laparoscopic unilateral nephrectomy and endometrioma cystectomy. Differential diagnosis is important to confirm diagnosis for patients with ureteral obstruction presenting nonspecific symptoms.

scholarly journals P0315SUCCESFUL TREATMENT OF A STRETOCOCCUS-PNEUMONIAE-ASSOCIATED HAEMOLYTIC URAEMIC SYNDROME BY A SHORT COURSE OF ECULZIMAB

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Silvius Frimmel ◽  
Michael Hinz ◽  
Joerg Henschel ◽  
Steffen Mitzner ◽  
Sebastian Koball
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Clinical Picture ◽  
Therapeutic Option ◽  
Rare Complication ◽  
Clinical Situation ◽  
Penicillin G ◽  
Severe Thrombocytopenia ◽  
Streptococcus Pneumonia ◽  
Anuric Renal Failure

Abstract Background and Aims Hemolytic uraemic syndrome (HUS) is a known rare complication of Streptococcus pneumonia infections (SP-HUS) and is characterized by microangiopathic hemolytic anemia, thrombocytopenia and renal failure. In adults it is associated with a higher mortality than HUS due to other etiologies. Method Case Report Results A 33-years old female patient with a history of alcohol abuse was referred to hospital with hypotension and symptoms of infection, including high fever and diarrhea, which had occurred since three days. On admission the patient presented with septic shock and was transferred to the intensive care unit. There she showed signs of hemolytic uraemic syndrome, including severe thrombocytopenia (11 Gpt/l), schistocytosis, elevated lactate-dehydrogenase (LDH; max. 2300 U/l), low haptoglobine (&lt;0,3g/l) and acute anuric renal failure with need of continuous renal replacement therapy. Severe confusion and necrotic lesions of the extremities completed the clinical picture. Plasma exchange (PE) was initiated under suspected thrombocytopenic thrombotic purpura (TTP). Under PE the clinical situation did not ameliorate and signs of severe HUS persisted. A total of four PE were realized, TTP was excluded by Factor VIII-ADAMTS13-activity above the diagnostic limit. In the peripheral blood cultures Streptococcus pneumonia was detected, and antimicrobial was deescalated from piperacillin/tazobactam to penicillin G. Under the clinical picture of a persistent severe pneumococcal associated HUS, without clinical benefit of PE, we decided to start therapy with eculizumab, a monoclonal anti-C5-antibody, approved for the therapy of aHUS and with anecdotical evidence of efficacy in SP-HUS. We started with 1200 mg of ECZ, followed by doses of 900 mg weekly with a total of four doses. Under therapy thrombocyte count normalized, renal function ameliorated and dialysis could be discontinued, the levels of haptoglobin and LDH normalized. The patient could be referred to a rehabilitation clinic, where renal function normalized and no further signs of hemolysis were seen three months after discontinuation of therapy under monitoring. The forefoot remained necrotic with need of surgery in future, the ischemic lesions of the hands completely disappeared. Conclusion Eculizumab could provide a therapeutic option of pneumococcal associated HUS. Therapy could be safely discontinued after 1 month under strict monitoring of signs of HUS. Further studies are required to document the benefit of complement blockade therapy in severe forms of SP-HUS.

Abstract 2503: The Influende of Renal Function on Clinical Outcome and Response to Beta-Blockade in Systolic Heart Failure: Insights from MERIT-HF

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jalal Ghali ◽  
John Wikstrand ◽  
Dirk V Veldhuisen ◽  
Bjorn Fagerberg ◽  
Sidney Goldstein ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Absolute Risk ◽  
Systolic Heart Failure ◽  
Beta Blockade ◽  
List Type ◽  
Severe Renal Failure ◽  
Clinical Events ◽  
One Year ◽  
The Impact

Objective: We analyzed the data from MERIT-HF in order to determine the impact of renal function on absolute risk for and type of clinical events, and to study any interaction between renal function and the risk reducing effect and tolerability of metoprolol CR/XL in systolic HF Methods: Glomerular filtration rate was estimated using the simplified MDRD formula (eGFR MDRD ). Patients were divided in four subgroups according to defined cut off points for renal dysfunction: Normal renal function: eGFR MDRD ≥ 90 (n = 411); mild renal failure ≥ 60 < 90 (n = 2085); moderate renal failure ≥30 < 60 (n = 1387); and severe renal failure < 30 ml/min/1.73m 2 BSA (n = 82). Results : Table shows one year risk per patient year of follow-up (placebo). Risk reduction with metoprolol CR/XL was consistent regardless of renal function Metoprolol CR/XL was well tolerated in renal failure. Conclusion: The risk for death and hospitalizations from worsening HF increased steeply with a decrease in renal function. The beneficial effect of metoprolol CR/XL on outcomes was maintained regardless of renal function. Metoprolol CR/XL was well tolerated in renal failure.

Acute Renal Failure Following Accidental Cutaneous Absorption of Phenol: Application of NMR Urinalysis to Monitor the Disease Process

1989 ◽  
Vol 8 (6) ◽  
pp. 491-496 ◽  
Author(s):  
P. J. D Foxall ◽  
M.R. Bending ◽  
K.P.R. Gartland ◽  
J.K. Nicholson
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Clinical Chemistry ◽  
Recovery Period ◽  
Disease Process ◽  
Analytical Techniques ◽  
H Nmr ◽  
One Year ◽  
Amino Aciduria

An unusual case of acute renal failure is reported following accidental cutaneous absorption of phenol and exposure to dichloromethane. Renal function during the onset of the nephrotoxic episode and the subsequent recovery period was monitored using a combination of standard clinical biochemical techniques and high resolution 1H-NMR urinalysis. The initial urine biochemical patterns (up to 2 weeks following exposure) showed amino aciduria, glycosuria and lactic aciduria consistent with renal cortical necrosis. There followed a period of polyuria revealing a biochemical pattern (succinic aciduria,dimethylaminuria and N,N-dimethylglycinuria) consistent with renal papillary damage. Haemodialysis was required for a period of 3 weeks and the patient was discharged 42 days after admission to hospital when renal function was normal by standard clinical chemistry criteria (urea, potassium, sodium, creatinine, calcium, phosphate, urine glucose and protein). 1H-NMR spectroscopic urinalysis revealed residual renal biochemical abnormalities consistent with renal papillary damage that were not detected by conventional analytical techniques. One year after the incident the patient is still polyuric, passing up to 3 1 of urine a day.

scholarly journals Amelioration of ischemic acute renal failure by dietary fish oil administration in conscious dogs.

1992 ◽  
Vol 3 (6) ◽  
pp. 1312-1320
Author(s):  
H H Neumayer ◽  
M Heinrich ◽  
M Schmissas ◽  
H Haller ◽  
K Wagner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Fish Oil ◽  
Urine Volume ◽  
Cytosolic Calcium ◽  
Unilateral Nephrectomy ◽  
Dietary Fish ◽  
Ischemic Acute Renal Failure

The hypothesis that dietary fish oil would protect dogs from ischemic acute renal failure was tested. Fish oil (eicosapentaenoic acid, 55 mg/kg per day, and docosahexaenoic acid, 40 mg/kg per day was given to eight instrumented, female, beagle dogs for 6 wk, while seven control dogs received vehicle. After 3 wk, unilateral nephrectomy was performed and a pneumatic cuff with flow probe was placed around the remaining renal artery of each dog. Three weeks thereafter, the cuff was inflated for 120 min. Renal function, RBF, and prostanoid excretion were measured 24 and 72 h after ischemia. In dogs receiving fish oil, blood pressure, GFR, RBF, renal vascular resistance (RVR), cholesterol, triglycerides, and prostanoid excretion were measured weekly for 6 wk. Further, cytosolic calcium was measured before and five times after fish oil. Blood pressure decreased, serum cholesterol and triglycerides decreased, and the cytosolic calcium within platelets decreased. The urinary excretion (expressed as picograms per milligram of creatinine) of the thromboxane (TX) metabolite TXB2 and the excretion of prostaglandin (PG)E2, as well as the excretion of the PGI2 metabolite 6-keto PGF1 alpha were decreased. GFR, RBF (Cl inulin and Cl para-aminohippuric acid), and RVR were not influenced by fish oil. Unilateral nephrectomy decreased GFR and RBF and increased RVR as expected, whereas it further decreased prostanoid excretion. Acute renal ischemia caused a significant, reversible decrease in GFR and urine volume in vehicle-treated animals, whereas no significant effect on renal function or urine volume was observed in animals pretreated with fish oil.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic renal failure as a complication of hemorrhagic fever with renal syndrome in 17 years’ old boy

Open Medicine ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. 617-620
Author(s):  
Vesna Stojanovic ◽  
Aleksandra Doronjski ◽  
Slobodan Spasojevic
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Fluid Overload ◽  
Hemorrhagic Fever ◽  
Haemorrhagic Fever ◽  
Serologic Test ◽  
Subconjunctival Hemorrhage ◽  
Multisystemic Disease ◽  
Anuric Renal Failure

AbstractHemorrhagic fever with renal syndrome (HFRS) is an acute infective multisystemic disease that commonly presents with fever, hemorrhage and acute renal failure. A 17-year-old boy presented with thrombocytopenia, profuse subconjunctival hemorrhage and anuric renal failure with fluid overload. The patient required continuous ambulatory peritoneal dialysis. He developed diuresis but did not recover renal function during reconvalescent period. Hantaan, Puumala, Seoul, Belgrade virus infection with haemorrhagic fever with renal syndrome was confirmed by serologic test.

Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

1989 ◽  
Vol 61 (03) ◽  
pp. 522-525 ◽  
Author(s):  
M P Gordge ◽  
R W Faint ◽  
P B Rylance ◽  
H Ireland ◽  
D A Lane ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Monoclonal Antibodies ◽  
Diabetic Nephropathy ◽  
Renal Disease ◽  
Plasma Concentrations ◽  
Significant Negative Correlation ◽  
Healthy Controls ◽  
D Dimer

SummaryD dimer and other large fragments produced during the breakdown of crosslinked fibrin may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients with renal disease and varying degrees of renal dysfunction, plasma D dimer showed no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which is known to be cleared in part by the kidney, showed a significant negative correlation with creatinine clearance. Plasma concentrations of D dimer were, however, increased in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml), and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The results indicate an increase in fibrin formation and lysis, and not simply reduced elimination of D dimer by the kidneys, and are further evidence of activated coagulation in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal failure.

Effect of Curcuma longa and Galega orientalis on renal function in rats with experimental diabetes mellitus and acute renal failure

2019 ◽  
pp. 88-95
Author(s):  
Р.И. Айзман ◽  
А.П. Козлова ◽  
Е.И. Гордеева ◽  
М.С. Головин ◽  
Г.А. Корощенко ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Experimental Diabetes ◽  
Curcuma Longa ◽  
Diabetic Rats ◽  
Standard Diet ◽  
Experimental Diabetes Mellitus ◽  
Galega Orientalis

Цель - исследование влияния куркумы длинной и галеги восточной на осмо- и ионорегулирующую функции почек крыс при аллоксан-индуцированном сахарном диабете и острой почечной недостаточности в эксперименте. Методика. Эксперименты выполнены на самцах крыс Wistar (n=70) с моделью сахарного диабета (1-я серия) и острой почечной недостаточности (2-я серия). В обеих сериях животные были поделены на 3 группы: крыс 1-й группы содержали на стандартном корме, крысам остальных групп в корм добавляли куркуму (2-я группа) или галегу (3-я группа) (2% от массы корма). На 7-е сут эксперимента проводили исследование диуретической и ионоуретической функций почек натощак и после 5% водной нагрузки. Концентрацию ионов в моче и плазме определяли методом пламенной фотометрии; осмотическую концентрацию биологических жидкостей - методом криоскопии; биохимические показатели крови - колориметрическим методом. Результаты. У животных с сахарным диабетом фоновый диурез, а также экскреция натрия и калия были статистически значимо выше, чем у контрольных животных. При острой почечной недостаточности наблюдался более низкий уровень диуреза и ионоуреза, особенно после водной нагрузки. Прием куркумы и галеги вызывал улучшение осмо- и ионорегулирующей функции почек у крыс с сахарным диабетом, и практически не влиял на эти функции почек при острой почечной недостаточности. Заключение. При сахарном диабете оба фитопрепарата вызывали понижение концентрации глюкозы, креатинина, мочевины и улучшение ионно-осмотических показателей плазмы крови, при этом эффект куркумы был выражен отчетливее. При острой почечной недостаточности эти фитопрепараты не давали описанного эффекта. Aim. To study effects of the phytomedicines, Curcuma longa and Galega orientalis, on osmosis- and ion-regulating renal functions in rats with experimental diabetes mellitus (DM) and acute renal failure (ARF). Methods. Experiments were performed in two series on Wistar male rats (n=70) with modeled diabetes mellitus (series 1) and acute renal failure (series 2). In each series, the animals were divided into 3 groups, 1) rats of group 1 receiving a standard diet; 2) rats of groups 2 and 3 receiving a standard diet supplemented with turmeric or galega (2% of food weight), respectively. On the 7th day of the experiment, the diuretic and ionuretic renal function was studied in fasting state and after 5% water loading. Concentrations of ions in urine and plasma were determined by flame photometry; osmotic concentrations of biological fluids were measured by cryoscopy; blood biochemical parameters were measured by colorimetry. Results. In diabetic rats, background diuresis and sodium and potassium excretion were significantly higher than in the control animals. In rats with acute renal failure, diuresis and ionuresis were significantly lower, particularly after the water loading. Turmeric and galega supplementation improved the osmotic and ion-regulating renal function in diabetic rats and left practically unchanged these functions in rats with acute renal failure. Conclusion. In rats with diabetes mellitus, both herbal remedies reduced concentrations of glucose, creatinine, and urea and improved ion-osmotic parameters of blood plasma with a more pronounced effect of turmeric. In acute renal failure, these phytomedicines did not produce the described effects.

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