摘要:

A 61-year-old man developed renovascular hypertension characterized by nephrotic-range proteinuria. When he was treated with a calcium channel blocker, glomerular filtration fraction was 0.26 and massive proteinuria ranging from 10 to 15 g/day persisted. An angiotensin-converting enzyme inhibitor markedly reduced the proteinuria to 1-2 g/day with a filtration fraction of 0.20. After the antihypertensive drug was switched to a β-blocker, the filtration fraction was 0.23 and urinary protein excretion was 3-4 g/day. Blood pressure control was comparable by each drug. These findings suggest a role of intraglomerular hydraulic mechanism in the etiology of massive proteinuria in renovascular hypertension

ISSN:0250-8095    

DOI:10.1159/000168687

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We report a patient with presumed recurrence of IgA nephropathy in three successive cadaver transplants. Failure to recognize the cause of progressive renal failure in the first two transplants may have been associated with less than optimal treatment for his hypertension and nephrotic syndrome. His course illustrates the importance of biopsy-documented diagnosis of progressive dysfunction in kidney transplants.

ISSN:0250-8095    

DOI:10.1159/000168688

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe 2 sisters who presented with the hemolytic uremic syndrome (HUS) almost simultaneously. In both patients an upper airway infection with Haemophilus influenzae immediately preceding HUS may have been the environmental trigger. Fresh plasma infusion had only minor therapeutic effects but plasma exchange was followed by hematological remissions. One patient stayed dialysis dependent, the other had slow recovery of renal function on prolonged plasma exchange. These case histories suggest that in genetically predisposed patients HUS can be triggered by an infection with H. influenzae. Furthermore, when there is a poor response to plasma infusion recovery may be accelerated by plasma exchange.

ISSN:0250-8095    

DOI:10.1159/000168689

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe acute focal bacterial nephritis (AFBN) presented as acute renal failure and hepatic dysfunction in a renal transplant recipient. He had received a renal transplantation 5 years previously and maintained good renal function without an episode of acute rejection or any urinary abnormalities. He had been an HBsAg carrier and showed mild elevation of liver enzymes after renal transplantation. For 5 days before admission, the patient suffered from fever, graft kidney swelling, tenderness and oliguria. On admission, renal biopsy was performed and solumedrol pulse therapy was started under the impression of acute rejection. The following laboratory findings revealed acute renal failure and hepatic dysfunction. From the abdomen CT and renal biopsy findings this case was confirmed as AFBN in a grafted kidney. With successive hemodialysis and antibiotic therapy clinical symptoms and renal function improved promptly. In acute hepatic dysfunction we discontinued cyclosporine (CsA) to prevent irreversible fulminant hepatic failure until the normalization of liver function. It should be considered that AFBN must be included in the differential diagnosis of acute rejection, and the early diagnosis and treatment of AFBN is important to save the grafted kidney. In addition, early withdrawal of CsA is essential to prevent irreversible hepatic failure when infection triggers hepatic dysfunction in HBsAg-positive renal transplant recipients.

ISSN:0250-8095    

DOI:10.1159/000168690

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Cat-eye syndrome is a rare congenital anomaly involving the kidney. It is rarely reported in literature, while renal function has never been studied up to now. Shown here are the morphofunctional renal alterations observed in a female patient affected by cat-eye syndrome.

ISSN:0250-8095    

DOI:10.1159/000168691

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168692

出版商:S. Karger AG    

年代:1994

数据来源: Karger