Assuntos
Fibronectinas/sangue , Doença , Feminino , Fibronectinas/imunologia , Homeostase , Humanos , Masculino , Valores de Referência , Caracteres SexuaisRESUMO
Differential diagnosis between essential hypertension and secondary arterial hypertension (AH) that developed in the presence of chronic pyelonephritis was made in 12 patients with AH and the urinary syndrome (leukocyturia and bacteriuria). With that purpose in view for revealing functional renal asymmetry, a study was made of the effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in each kidney separately based on computation of 99Tc-DTPA and 131I-hippuran clearances. Some patients in whom AH was later regarded as essential manifested practically equal values of the ERPF and GFR from both sides, with the real characteristics of the latter ones being little different from the respective populational values calculated by computer bearing in mind the body surface of those patients. The other patients' group showed, along with a decrease of the total ERPF and GFR, a dramatic asymmetry of the intrarenal hemodynamics of both ERPF and GFR, which is fairly characteristic of chronic pyelonephritis. This allows the syndrome of AH to be regarded in those patients as secondary.
Assuntos
Hipertensão Renal/diagnóstico , Rim/fisiopatologia , Idoso , Doença Crônica , Diagnóstico Diferencial , Feminino , Taxa de Filtração Glomerular , Hemodinâmica/fisiologia , Humanos , Hipertensão Renal/etiologia , Hipertensão Renal/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pielonefrite/complicações , Pielonefrite/diagnóstico , Pielonefrite/fisiopatologia , Circulação RenalRESUMO
The authors analyzed the frequency of chronic renal insufficiency (CRI) and the level of serum creatinine (200 mumol/l and more) in 10,350 outpatients aged over 60 (I group), 2400 persons of the same age in need of episodic hospitalization (II group), and in 1840 patients who died in hospital (III group). In the 1st group CRI frequency was 0.98%, in the 2nd group--6.9%, in the 3rd group--14.6%. Pyelonephritis (76.1%) and myelonephropathy (7.5%) were among CRI main causes. The authors underlined the multitude of factors causing CRI in middle-aged patients and the prospects of adequate therapy even in terminal states; CRI syndromes were considered for persons of this age group.
Assuntos
Envelhecimento/fisiologia , Nefropatias/complicações , Falência Renal Crônica/etiologia , Rim/fisiopatologia , Fatores Etários , Idoso , Feminino , Humanos , Nefropatias/fisiopatologia , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
A study of the level of beta 2-microglobulin (beta 2-MG) in the blood serum and urine was conducted in 67 patients: 22 with chronic pyelonephritis, 13 with gout with renal lesion, 25 with chronic glomerulonephritis (5 without hyperuricemia, 20 with hyperuricemia) and 7 with amyloidosis accompanied mainly by renal lesion. A raised level of beta 2-microglobulin was found in the patients with chronic pyelonephritis, gout, latent glomerulonephritis with hyperuricemia, and in over half of the cases its raised level was found in the urine. The results obtained indicate a frequent and in some cases predominant involvement of the tubules as well as interstition in the patients with hyperuricemia.