ABSTRACT
We report a case of aloe induced acute interstitial nephritis in a 66-year old man. He had been taken aloe as a healthy foodstuff for 6 weeks prior to admission. He complained poor oral intake and developed nonoliguric acute renal failure. Renal biopsy revealed focal tubular atrophy and interstitial infiltration of neutrophils, and lymphocytes. After discontinuation of aloe and high dose prednisolone therapy, acute renal failure of the patient improved and serum creatinine level decreased.
Subject(s)
Aged , Humans , Acute Kidney Injury , Aloe , Atrophy , Biopsy , Creatinine , Lymphocytes , Nephritis, Interstitial , Neutrophils , PrednisoloneABSTRACT
Anti-glomerular basement membrane disease is an autoimmune disorder characterized progressive renal failure and/or lung hemorrhage. Most of patients present with acute renal failure or acute nephritic feature such as hematuria, proteinuria, and leukocyturia in urinalysis. A part of patients present with pulmonary hemorrhage, anemia, tachypnea, and cyanosis. It is accompanied with transient fever and myalgia but fever of unknown origin (FUO) is very rare condition. We report the atypical case of anti-glomerular basement membrane mediated rapidly progressive glomerulonephritis which presented with FUO and shock after methylprednisolone pulse therapy.
Subject(s)
Humans , Acute Kidney Injury , Anemia , Anti-Glomerular Basement Membrane Disease , Basement Membrane , Cyanosis , Fever of Unknown Origin , Fever , Glomerulonephritis , Hematuria , Hemorrhage , Lung , Methylprednisolone , Myalgia , Proteinuria , Renal Insufficiency , Shock , Tachypnea , UrinalysisABSTRACT
BACKGROUND: We investigated the frequency and clinical impact on vesicoureteral reflux (VUR) in the transplanted kidney. METHODS: In this study 55 CsA - treated patients were enrolled who received kidney transplantation between 1993 and 1997. They survived for at least one year while taking Voiding cystourethrography. With the results, we divided into two classes, with and with out VUR, where we found such as graft survival, prevalence of hypertension, frequency of urinary tract infection (UTI), creatinine clearance (Ccr) and proteinuria (mg/day) at 1, 5, 7 years after transplantation. RESULTS: VUR was detected in 39 (71%) patients. Patients with no VUR, the prevalence of hypertension, graft failure, the number of UTI episodes/patient were 16 (100%), 1 (6.25%), 2.14+/-0.40 (mean+/-SEM) and patients with VUR were 33 (84.6%), 2 (5.12%), 1.37+/-0.26 respectively. There was no significant difference between the two groups (p>0.2). Patients with no VUR, Ccr (mean+/-SEM) at 1, 5, 7 years after transplantation were 69.9+/-9.1 (mL/ min), 59.4+/-3.6, 57.3+/-3.5 and proteinuria were 171+/-48.2 (mg/day), 188+/-74.5, 249+/-119.6 respectively. Patients with VUR, Ccr were 72.0+/-7.2, 55.5+/-2.6, 54.1+/-2.8 and proteinuria were 192+/-33.8, 148+/-29.0, 207+/-74.4 respectively. Also, there was no significant difference between the two groups (p>0.4). CONCLUSION: Our study showed that the presence of VUR did not harm graft function or survival.
Subject(s)
Humans , Creatinine , Graft Survival , Hypertension , Kidney , Kidney Transplantation , Prevalence , Proteinuria , Transplantation , Transplants , Urinary Tract Infections , Vesico-Ureteral RefluxABSTRACT
BACKGROUND: The thickness of the renal cortex is useful in all aspects of nephrology but no normal range has been established. Therefore, we investigated the renal cortex thickness by ultrasonography in normal Korean adults and chronic renal failure (CRF) patients before renal replacement therapy. For the purpose of evaluating the normal range then, we are going to predict the threshold range of cortex thickness in irreVersible renal failure status. METHODS: In 243 healthy Korean adults and 57 CRF patients with the creatinine level, or =30 mL/min was 0.63+/-0.10 cm, 0.79+/-0.11 cm (p or =30 mL/min in CRF patients. But the cortex thickness alone is not a sufficient marker to predict reversibility. We should consider other invasive procedure such as kidney biopsy.
Subject(s)
Adult , Female , Humans , Male , Biopsy , Creatinine , Kidney Failure, Chronic , Kidney , Nephrology , Reference Values , Renal Insufficiency , Renal Replacement Therapy , UltrasonographyABSTRACT
The purpose of this study was to elucidate whether the molecular defect of acid-base transporters in renal tubules is related to the functional defect of urinary acidification in distal renal tubular acidosis(RTA). We performed NH4Cl, furosemide, or bicarbonate loading test to evaluate renal acidification function, and immunohistochemistry using antibodies to H+- ATPase, Cl-/HCO3- exchanger(band-3 protein), and Na+/K+-ATPase in kidney tissue in 6 patients with RTA and renal cell carcinoma patients as normal controls. Kidney tissue was obtained either by percutaneous needle biopsy(RTA) or nephrectomy(NC). The results were as follows; 1) In all six RTA patients, proton secretory defect of distal acidification was shown by a failure to lower the urine pH after NH4Cl loading or furosemide test or abnormally low urine-blood pCO2 difference during bicarbonate loading. In two patients with RTA, proximal acidification defect was combined, which was demonstrated by increased fractional excretion of bicarbonate. 2) In normal control, intense H+-ATPase and band-3 protein staining was observed in collecting ducts. 3) In distal RTA patients, H+-ATPase and band- 3 protein staining was not demonstrable or markedly decreased in the intercalated cells of distal nephron. 4) In two patients who had both proximal and distal RTA, H+-ATPase staining was markedly decreased in the brush border of proximal tubules as well as the distal nephron. In conclusion, the defect of acid-base transporters in renal tubule was related with the functional defect of urinary acidification in distal RTA.