[Acute tubular necrosis in kidney transplantation]

The acute tubular necrosis [ATN] is common after kidney transplantation. Acute tubular necrosis [ATN] is multifactorial and represents one of the main causes of the delayed graft function. Its impact on graft and patients survival is documented. To study the prevalence of the ATN in kidney transplanted patients, the acute rejection rate and their impact on the graft and the patient survival. We retrospectively studied the frequency of ATN, its causes and its impact on patient and graft survival in 255 kidney transplanted patients between1986-2006. Thirty-nine patients had ATN [15.29%]. They are 25 men and 14 women with mean age of 30.1 +/- 12.6 years [8-61] followed for an average of 98 +/- 61.76 months. The majority was treated by hemodialysis [79.48%] and half of them were transplanted from kidney of deceased donor. All patients received anti lymphocyte serum and the majority anticalcineurins [69.23%].The outcome was favorable in 26 patients [66.66%] with recovery of diuresis and normalization of renal function after 6 weeks on average. An acute rejection was diagnosed in 21 patients [53.48%]. The mean creatinine at 1, 5 and 10 years was 135.3, 159.9 and 121.4 micromol / l. Eight patients had creatinine

TINU syndrome and lymphoid interstitial alveolitis: a new observation

TINU syndrome is a rare entity known Dobrin disease, combining uveitis mostly bilateral and recurrent with acute tubulo interstitial nephritis [AIN] occurring in young adults. The etiology and pathogenesis of this syndrome remain unknown. Aim: To report a new case of TINU syndrome and to discuss its etiopathogenesis. This 33 year old women is hospitalized for exploration of acute renal failure, in a context of deterioration of general condition, associated with a unilateral anterior uveitis. The bronchoalveolar lavage showed lymphoid interstitial alveolitis with CD4 and the renal biopsy found lesions characteristic of AIN. Evolution under cortico'id treatment was favorable. Lymphoid interstitial alveolitis associated with TINU syndrome has been reported only twice before. The discovery of a TINU syndrome must practice bronchoalveolar lavage in search of sub clinical pulmonary involvement

[Renal involvement in the Behcet's disease]

Renal involvement in the Behcet's disease is rare. The clinical features vary from urinary sediment's abnormalities to ESRD. We propose to study the clinical, biological and histological data, the therapeutic management and the prognosis of patients. We report a retrospective study including 8 patients representing 1.23% of cases. The average age of the patient was of 37 +/- 12. 35 years with a clear male prevalence. Urinary signs were discovered fortuitously by the strips in the majority of the cases after an average of 18 months. It's about proteinuria and hematuria. Renal insufficiency and hypertension were rare. Pathological study highlighted 3 cases of amyloidosis, 2 cases of IgA nephropathy, 1 case of minimal change disease, 1 case of endo and extracapillary glomerulonephritis and 1 case of interstitial nephropathy. Patients having GN were treated by corticoids and immunosuppressive agents and those having an interstitial nephropathy were treated symptomatically with good evolution in the majority of the cases. Only one patient is dead, he had amyloidosis. Prognosis depended on the precocity of the diagnosis, the histological type and the treatment. The renal involvement during Behcet's disease is rare. Amyloidosis and Ig A nephropathy are the most frequent. Treatment is still controversial