ABSTRACT
We studied production of erythropoietin (EPO) in long-term renal allograft recipients with posttransplant erythrocytosis (PTE). Among 951 recipients we found 74 patients with persistent elevation of hematocrit (Htc) value (female > 50%, male > 55%). However, only 63.5% of them had increased red-cell mass ( = "true" erythrocytosis). In all recipients with PTE known causes of secondary erythrocytosis were not found. EPO titer in peripheral blood was significantly higher in recipients with PTE (median 13.5 mIU/mL, range: 0.1-71.5 mIU/mL) as compared to healthy blood donors (median 5.75 mIU/mL, range: 0.1-19.5 mIU/mL) but not different from the group of renal allograft recipients without PTE (median 13.0, range 0.1-71.7 mIU/mL). However, EPO level measured in pretransplant sera was significantly higher in patients who developed PTE (median 16.4 mIU/mL, range: 1.0-281.2 mIU/mL) than in recipients without PTE (median 8.3, range: 1.0-50.3 mIU/mL). A significant difference in EPO level between systemic and effluent blood from native kidneys was found in 6 out of 14 recipients with PTE who underwent catheterization. After phlebotomy patients with PTE responded with higher increase in peak EPO titer than healthy blood donors (527 +/- 473% versus 194.5 +/- 44.2%, p < 0.05). Our results suggest that PTE develops spontaneously due to increased EPO production. Despite elevated EPO levels, regulation of EPO release remains preserved.
Subject(s)
Erythropoietin/biosynthesis , Kidney Transplantation/physiology , Polycythemia/blood , Adult , Blood Donors , Drug Therapy, Combination , Erythropoietin/blood , Female , Hematocrit , Histocompatibility Testing , Humans , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/immunology , Male , Middle Aged , Postoperative Complications , Reference Values , Retrospective Studies , Sex CharacteristicsSubject(s)
Graft Rejection , Kidney/pathology , Adolescent , Adult , Biopsy , Child , Diagnostic Errors , Female , Humans , Kidney Transplantation , Male , Middle Aged , UltrasonographySubject(s)
Pulmonary Embolism/diagnostic imaging , Adult , Aged , Angiography , False Negative Reactions , Female , Humans , Male , Middle Aged , Pulmonary Artery/diagnostic imaging , Radionuclide ImagingSubject(s)
Adrenal Gland Neoplasms/diagnosis , Catecholamines/blood , Pheochromocytoma/diagnosis , Adolescent , Adult , Catheterization , Female , Humans , Male , Middle Aged , Vena Cava, InferiorABSTRACT
The authors report three cases of complications of renal artery embolization in patients with renal carcinoma. In two cases renal artery embolization was followed by paraparesis with loss of sphincter control. In these cases nephrectomy was performed on the side of the neoplasm and neurological disturbances disappeared after pharmacological treatment and rehabilitation. The third patient was not treated surgically. Embolization was followed by development of spinal cord damage at the level Th12. The patient died of neoplastic cachexia and cardiorespiratory failure.
Subject(s)
Embolization, Therapeutic/adverse effects , Kidney Neoplasms/therapy , Renal Artery , Spinal Cord Injuries/etiology , Aged , Female , Humans , Infarction , Middle Aged , Muscle Hypotonia/etiology , Paralysis/etiology , Sensation , Spinal Cord/blood supply , Urinary Bladder, Neurogenic/etiologyABSTRACT
In view of the possible role of prostaglandins /PG/ in the pathogenesis of hypertension we have determined PGE2 and PGF2 alpha levels simultaneously with plasma renin activity/PRA/ in renal venous and caval venous blood in 13 patients with unilateral renal artery stenosis/RAS/ and in six untreated patients with unilateral parenchymal renal disease/PRD/. Four patients with essential hypertension were the control group. PG levels and PRA were estimated by RIA. In patients with RAS the mean PGE2 level as well as PRA was higher on the side of the stenosis. No such difference was found in the PGF2 alpha level. There was a significant correlation between the renal vein PGE2 ratio and renin ratio /stenotic side versus contralateral side/ r=0.520, 0.02 less than p less than 0.05. In patients with PRD prostaglandin levels in venous blood of the affected kidney were similar to that of venous caval blood, but markedly elevated in the venous blood of the contralateral kidney. PRA was similar on both sides. The data obtained in this study indicate, that prostaglandins in renal venous blood behave differently in hypertensive patients with RAS and PRD. In patients with RAS augmented PGE2 release may serve as a protective mechanism. In patients with PRD, the increased PG level in the non-affected kidney may reflect a compensatory mechanism in spite of the atrophic process in the affected kidney.
Subject(s)
Hypertension, Renal/blood , Prostaglandins E/blood , Prostaglandins F/blood , Renal Artery Obstruction/blood , Renin/blood , Adolescent , Adult , Female , Humans , Male , Middle Aged , Renal VeinsSubject(s)
Kidney/diagnostic imaging , Polycystic Kidney Diseases/congenital , Adolescent , Adult , Aged , Angiography/methods , False Negative Reactions , Female , Humans , Kidney Function Tests/methods , Male , Middle Aged , Polycystic Kidney Diseases/diagnosis , Polycystic Kidney Diseases/genetics , Renal Artery/diagnostic imaging , Urography/methodsSubject(s)
Lung/diagnostic imaging , Phlebography/instrumentation , Thromboembolism/diagnostic imaging , Adult , Aged , Female , Humans , Leg/blood supply , Male , Middle Aged , Radionuclide ImagingABSTRACT
Observations of 17 embolizations of the renal artery carried out in cases of renal neoplasms are reported. In the light of intraoperative observations the optimal timing of the operation after embolization was established to be 48-72 hours. Attention is called to the possibility of complications in the form of spinal cord damage after renal arterial embolization.
Subject(s)
Embolization, Therapeutic/methods , Kidney Neoplasms/therapy , Renal Artery , Adult , Aged , Embolization, Therapeutic/adverse effects , Female , Humans , Male , Middle Aged , Palliative Care , Preoperative Care , Spinal Cord Injuries/etiologyABSTRACT
12 cases of 'avascular tumour' of the kidney are discussed. Percutaneous renal puncture revealed: 7 cases of malignant tumour; 3 cases of hydronephrosis of the upper segment of a duplicated kidney; 1 case of abscess of the kidney, and 1 case of renal tuberculosis. 10 out of 12 patients were operated on and the histological examination confirmed the diagnosis established by puncture.
