scholarly journals Edema in Renal Diseases – Current View on Pathogenesis

2016 ◽  
Vol 2 (1) ◽  
pp. pocj.5000204
Author(s):  
Irina Bobkova ◽  
Natalia Chebotareva ◽  
Lydiya Kozlovskaya ◽  
Evgenij Shilov
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Diuretic Therapy ◽  
Alternative Methods ◽  
Renal Diseases ◽  
Current View ◽  
Factors Affecting ◽  
Nephritic Syndrome ◽  
Effective Doses ◽  
Old Men

Edema is a common complication of numerous renal disease. In the recent past several aspects of the pathophysiology of this condition have been elucidated. We herein present a case of nephrotic syndrome in a 30 year-old men. The discussion revolves around the following key questions on fluid accumulation in renal disease: 1. What is edema? What diseases can cause edema? 2. What are the mechanisms of edema in nephrotic syndrome? 2a. The “underfill” theory 2b. The “overfill” theory 2c. Tubulointerstitial inflammation 2d. Vascular permeability 3. What are the mechanisms of edema in nephritic syndrome? 4. How can the volume status be assessed in patients with nephrotic syndrome? 5. What are therapeutic strategies for edema management? 6. What are the factors affecting response to diuretics? 7. How can we overcome the diuretics resistance? 7a. Effective doses of loop diuretics 7b. Combined diuretic therapy 7c. Intravenous administration of diuretics 7d. Albumin infusions 7e. Alternative methods of edema management 8. Conclusion.

scholarly journals Spectrum and Clinical Characteristics of Renal Diseases in Ghanaian Adults: A 13-Year Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Perditer Okyere ◽  
Isaac Okyere ◽  
Richard Kobina Dadzie Ephraim ◽  
Joseph Attakorah ◽  
Charlotte Osafo ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Teaching Hospital ◽  
Clinical Characteristics ◽  
Treatment Options ◽  
Renal Diseases ◽  
Chronic Glomerulonephritis ◽  
Randomized Sampling ◽  
Leg Edema ◽  
Stage Renal Disease

Background. Renal diseases over the years have become one of the leading causes of morbidity and mortality worldwide. In this study, we assessed the spectrum and clinical characteristics of Ghanaians with renal diseases at the nephrology unit of Komfo Anokye Teaching Hospital (KATH), Kumasi. Methods. This was a retrospective hospital-based study conducted at Komfo Anokye Teaching Hospital (KATH) from the years 2005 to 2017. A non-randomized sampling approach was used to include 1426 participants who were diagnosed with AKI, CKD, ESRD, and nephrotic syndrome at the nephrology unit of KATH during the years under review. All the 1426 patients were eligible for the study. Demographic characteristics as well as clinical data such as the kind of renal disease presentation, causes of the renal disease, and the treatment options were also obtained from their records. Results. Overall, 1009 of the total participants had CKD (70.76%), 295 participants had ESRD (20.69%), 72 participants had AKI (5.05%), and 50 participants had nephrotic syndrome (3.51%). Furthermore, 69 (23.4%) participants with ESRD were on dialysis whiles 6 (8.3) and 17 (1.7) participants with only AKI and CKD superimposed AKI, respectively, were on dialysis. 226 (76.6%) participants with ESRD were on conservative therapy. Hypertension emerged as the major cause of renal disease presentation (53.93%) with bilateral leg edema (13.46%) being the major complaint. There was a significant association between CKD and age (p≤0.001). Nephrotic syndrome also showed a significant association with age (p≤0.001). Conclusion. This study revealed that patients at the nephrology unit of KATH, Ghana, are mainly adults between ages 46–55. The clinical pattern of renal diseases is dominated by CKD and ESRD. We conclude that hypertension, chronic glomerulonephritis, diabetic nephropathy, and sepsis are the most common causes of renal diseases. The commonest clinical presentations are bilateral leg edema, palpitations, headache, breathlessness, dizziness, and vomiting. Early diagnosis and management of these conditions may prevent or delay the progress to end-stage renal disease.

COVID-19 related hospitalization costs; assessment of influencing factors

2021 ◽  
Author(s):  
Mohammad Haji Aghajani ◽  
Mohammad Sistanizad ◽  
Amirmohammad Toloui ◽  
Arian Madani Neishaboori ◽  
Asma Pourhoseingholi ◽  
...  
Keyword(s):  
Renal Disease ◽  
Teaching Hospital ◽  
Chronic Renal Disease ◽  
Renal Diseases ◽  
Loss Of Consciousness ◽  
Factors Affecting ◽  
Hospitalization Costs ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Objective: Our aim is to assess the effective factors on hospitalization costs of COVID-19 patients. Methods: Data related to clinical characteristics and cost of hospitalized COVID-19 patients from February 2020 until July 2020, in a public teaching hospital in Tehran, Iran was gathered in a retrospective cohort study. The corresponding factors influencing the diagnostic and therapeutic costs were evaluated, using a generalized linear model. Results: The median COVID-19 related diagnostic and therapeutic costs in a public teaching hospital in Iran, for one hospitalized COVID-19 patient was equal to 271.1 US dollars (USD). In patients who were discharged alive from the hospital, the costs increased with patients’ pregnancy (P<0.001), loss of consciousness during hospitalization (P<0.001), a history of drug abuse (P=0.006), history of chronic renal disease (P<0.001), end stage renal disease (P=0.002), history of brain surgery (P=0.001), history of migraine (P=0.001), cardiomegaly (P=0.033) and occurrence of myocardial infarction during hospitalization (P<0.001). In deceased patients, low age P<0.001), history of congenital disease (P=0.024) and development of cardiac dysrhythmias during hospitalization (P=0.044) were related to increase in therapeutic costs. Conclusion: Median diagnostic and therapeutic costs in COVID-19 patients, hospitalized in a public teaching hospital in Iran were 271.1 USD. Hoteling and medications made up most of the costs. History of cardiovascular disease and new onset episodes of such complications during hospitalization were the most important factors contributing to the increase of therapeutic costs. Moreover, pregnancy, loss of consciousness, and renal diseases are of other independent factors affecting hospitalization costs in COVID-19 patients.

scholarly journals Pattern of glomerular disease in a tertiary care hospital in Nepal: A Shree Birendra Hospital experience

2012 ◽  
Vol 7 (4) ◽  
pp. 48-52
Author(s):  
A Sharma ◽  
RK Deo ◽  
RR Shahi
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Glomerular Disease ◽  
Renal Diseases ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Glomerular Diseases ◽  
Patient Profile ◽  
Nephritic Syndrome ◽  
Number Of Patients

The incidence of renal diseases varies greatly in various parts of the world. Percutaneous renal biopsy is an important procedure for many patients with renal disease. This hospital based retrospective study evaluated the pattern of various glomerular diseases in Shree Birendra hospital. Hospital records were searched for all the patients undergoing renal biopsy for all indication and patient profile and histopathological examination record were obtained. All the patients undergoing renal biopsy for any cause from January 2007 to December 2010 were included in the study. A total of 46 patients underwent renal biopsy in the study period. The number of patients in the various age groups were - <16 years – 5 patients, 16-50 years – 34 patients and > 50 years – 7 patients. The number of male and female patients was 34 and 12 respectively. Major indication for undergoing renal biopsy in this study was Nephrotic Syndrome (n=29, 63%), followed by RPGN (n=8, 17%), Persistent proteinuria (n=6, 13%) and Nephritic syndrome (n=3, 7%). The most common histopathological diagnosis in the study was Membranous nephropathy (n=10, 22%), followed by Focal Segmental Glomerulosclerosis (n=9, 20%), Membranoproliferative glomerulonephritis (n=9, 20%) and Minimal change disease (n=6, 13%). USG guided renal biopsy is safe in adults and is a very useful tool for the diagnosis of renal disease. The pattern of glomerular disease varies in different settings. There is a need for further evaluation of glomerular disease with larger sample size to determine the pattern of glomerular disease in Nepal. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 48-52 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6742

scholarly journals Assessment of Clinical Spectrum of Renal Diseases in children – A Descriptive Study at Benazir Bhutto Hospital, Rawalpindi

2021 ◽  
Vol 25 (1) ◽  
pp. 42-47
Author(s):  
Maria Shamsher ◽  
Sadaf Ijaz ◽  
Mobeen Tabassum ◽  
Rai Muhammad Asghar
Keyword(s):  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Kidney Diseases ◽  
Heart Diseases ◽  
Health Planning ◽  
Kidney Injury ◽  
Descriptive Study ◽  
Renal Diseases ◽  
Institutional Review

Introduction: Childhood kidney diseases are a frequent presentation. Most of the affected pediatric populations are from under-developed and developing countries. Noting the epidemiology of childhood renal diseases is very important as it helps in health planning, allows for adequate resource allocation, and enables adequate renal services provision. This study aimed to determine the etiological spectrum of renal disease in pediatric patients. Material and Methods: A descriptive study was conducted in Benazir Bhutto Hospital, Rawalpindi over a period of 6 months. Ethical clearance was taken from the institutional review board and written informed consent was administered before enrollment of subject per study criteria. A total of 100 children of both genders, aged up to 12 years with the diagnosis of any renal disease condition were included in the study. Patients having other comorbidities like chronic liver disease and heart diseases were excluded. The study information as age, sex, detailed history, and physical examination, and details of laboratory investigations. Statistical analysis was conducted in SPSS version 20.0. Results: Mean age of patients was 2.1 years. Most patients had a fever, edema, burning micturition, and high blood pressure. In two-thirds of the children RFTs were deranged and 19.0% had positive urinary culture reports. The common kidney diseases were UTI (42.0%), nephrotic syndrome (29.0%), acute kidney injury/ disease (19.0%), and chronic kidney disease (6.0%). Conclusion: UTIs and nephrotic syndrome along with acute kidney injury were the main kidney conditions. Females were more likely to have UTIs whereas nephrotic syndrome was common in male children.  

scholarly journals Lifetime risk of cardiovascular-renal disease in type 2 diabetes: a population-based study in 473399 individuals

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Zhang ◽  
J Mamza ◽  
T Morris ◽  
G Godfrey ◽  
F Asselbergs ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Disease ◽  
Population Based ◽  
Lifetime Risk ◽  
Disease Stage ◽  
Renal Diseases ◽  
Funding Source ◽  
Private Company ◽  
Risk Of Death

Abstract Background Lifetime risks of cardiovascular (CV) and renal diseases are high, particularly in type 2 diabetes (T2D), but rarely studied together, and relative disease contributions are unknown. Knowledge of lifetime risk of cardiovascular-renal disease (CVRD) will better reflect disease burden in T2D. Purpose To investigate the lifetime risks (LTRs) of composite and individual components of major adverse reno-cardiovascular events, MARCE in T2D patients. Method In a population-based cohort study using national electronic health records, we studied 473399 individuals aged 45–99 years with T2D in England 2007–2018. The LTR of composite and individual components of MARCE (including CV death and CVRD: heart failure, HF; chronic kidney disease stage 3 and above, CKD; myocardial infarction, MI; stroke or peripheral artery disease, PAD) were estimated. LTRs by baseline CVRD comorbidity status were compared with individuals free from CVRD at baseline, accounting for the competing risk of death. Results Among T2D patients aged ≥45 years, the LTR of MARCE was 80% for individuals free from CVRD at baseline. LTR of MARCE was 97%, 93%, 98%, 89% and 91% for individuals with specific CVRD comorbidities for HF, CKD, MI, stroke and PAD, respectively at baseline. Within the CVRD-free cohort, LTR of CKD was highest at 54%, followed by CV death (41%), HF (29%), stroke (20%), MI (19%) and PAD (9%). Compared to CVRD-free, HF, MI and CKD at baseline were associated with the highest LTR of MARCE and its component diseases (Table). Conclusion The lifetime risk of CV disease and CKD in T2D patients is estimated to be over 60% and 50% respectively (1–3). When considered together, the LTR of MARCE is 80% in CVRD-free T2D patients, while nearly all those with T2D and HF will develop MARCE over their lifetime. Of the individual components of MARCE, LTR of CKD and HF were the highest among CVRD-free T2D patients. Preventive measures in T2D patients should be a priority in clinical practice to mitigate the burden of these complications. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): AstraZeneca

Obstructive nephropathy and renal fibrosis

2002 ◽  
Vol 283 (5) ◽  
pp. F861-F875 ◽  
Author(s):  
Saulo Klahr ◽  
Jeremiah Morrissey
Keyword(s):  
Renal Disease ◽  
Renal Fibrosis ◽  
Interstitial Fibrosis ◽  
Rodent Model ◽  
Renal Diseases ◽  
Obstructive Nephropathy ◽  
Therapeutic Approaches ◽  
Cellular Events ◽  
The Impact ◽  
Made In

Interstitial fibrosis has a major role in the progression of renal diseases. Several animal models are available for the study of renal fibrosis. The models of aminonucleoside-induced nephrotic syndrome, cyclosporin nephrotoxicity, and passive Heyman nephritis are characterized by molecular and cellular events similar to those that occur in obstructive nephropathy. Additionally, inhibition of angiotensin-converting enzyme exerts salutary effects on the progression of renal fibrosis in obstructive nephropathy. Unilateral ureteral obstruction (UUO) has emerged as an important model for the study of the mechanisms of renal fibrosis and also for the evaluation of the impact of potential therapeutic approaches to ameliorate renal disease. Many quantifiable pathophysiological events occur over the span of 1 wk of UUO, making this an attractive model for study. This paper reviews some of the ongoing studies that utilized a rodent model of UUO. Some of the findings of the animal model have been compared with observations made in patients with obstructive nephropathy. Most of the evidence suggests that the rodent model of UUO is reflective of human renal disease processes.

RENAL HISTOLOGY DURING TREATMENT WITH OXAZOLIDINE-DIONES (TRIMETHADIONE, ETHADIONE, AND PARAMETHADIONE)

PEDIATRICS ◽  
1962 ◽  
Vol 30 (4) ◽  
pp. 601-607
Author(s):  
A. Bergstrand ◽  
C. G. Bergstrand ◽  
N. Engström ◽  
K. M. Herrlin
Keyword(s):  
Electron Microscopy ◽  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Present Knowledge ◽  
Short Report ◽  
Renal Histology ◽  
Renal Changes

Seven patients with petit mal seizures treated with trimethadione, ethadione, or paramethadione for long periods were subjected to renal biopsy at the age of 14½ 16½ years. None of the patients had clinical signs of renal disease at the time of the biopsy, but three of them had previously shown transient hematuria or proteinuria. The renal histology was studied by conventional methods and by electron microscopy, the latter method only including the glomeruli. The changes found must with the present knowledge be regarded as physiological. A short report is given of a patient with phenylketonuria and epilepsy who developed a nephrotic syndrome during treatment with tridione. No definite pathologic renal changes were demonstrated at the when the clinical symptoms had disappeared.

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 287-296
Author(s):  
W. F. Dodge ◽  
C. W. Daeschner ◽  
J. C. Brennan ◽  
H. S. Rosenberg ◽  
L. B. Travis ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Importance ◽  
Renal Diseases ◽  
Renal Lesion ◽  
Bleeding Tendency ◽  
Percutaneous Renal Biopsy ◽  
The One ◽  
Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

Physiology of Local Renin-Angiotensin Systems

2006 ◽  
Vol 86 (3) ◽  
pp. 747-803 ◽  
Author(s):  
Martin Paul ◽  
Ali Poyan Mehr ◽  
Reinhold Kreutz
Keyword(s):  
Large Body ◽  
Prenatal Development ◽  
Renal Diseases ◽  
Current View ◽  
Ang Ii ◽  
Knock Out ◽  
Renin Angiotensin ◽  
Ras Genes ◽  
Organ Systems ◽  
Functional Components

Since the first identification of renin by Tigerstedt and Bergmann in 1898, the renin-angiotensin system (RAS) has been extensively studied. The current view of the system is characterized by an increased complexity, as evidenced by the discovery of new functional components and pathways of the RAS. In recent years, the pathophysiological implications of the system have been the main focus of attention, and inhibitors of the RAS such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin (ANG) II receptor blockers have become important clinical tools in the treatment of cardiovascular and renal diseases such as hypertension, heart failure, and diabetic nephropathy. Nevertheless, the tissue RAS also plays an important role in mediating diverse physiological functions. These focus not only on the classical actions of ANG on the cardiovascular system, namely, the maintenance of cardiovascular homeostasis, but also on other functions. Recently, the research efforts studying these noncardiovascular effects of the RAS have intensified, and a large body of data are now available to support the existence of numerous organ-based RAS exerting diverse physiological effects. ANG II has direct effects at the cellular level and can influence, for example, cell growth and differentiation, but also may play a role as a mediator of apoptosis. These universal paracrine and autocrine actions may be important in many organ systems and can mediate important physiological stimuli. Transgenic overexpression and knock-out strategies of RAS genes in animals have also shown a central functional role of the RAS in prenatal development. Taken together, these findings may become increasingly important in the study of organ physiology but also for a fresh look at the implications of these findings for organ pathophysiology.

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