Assuntos
Granulomatose com Poliangiite/complicações , Pneumonia por Pneumocystis/etiologia , Idoso , Anticorpos Antibacterianos/análise , Diagnóstico Diferencial , Evolução Fatal , Granulomatose com Poliangiite/diagnóstico , Humanos , Masculino , Pneumocystis/imunologia , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/microbiologia , Índice de Gravidade de DoençaAssuntos
Amiloidose/etiologia , Enteropatias/etiologia , Nefropatias/etiologia , Sarcoma de Kaposi/complicações , Neoplasias Cutâneas/complicações , Idoso , Amiloidose/diagnóstico , Amiloidose/terapia , Terapia Combinada , Diagnóstico Diferencial , Humanos , Enteropatias/diagnóstico , Enteropatias/terapia , Nefropatias/diagnóstico , Nefropatias/terapia , Masculino , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/terapia , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapiaRESUMO
AIM: To elucidate the role of some renal diseases, pyelonephritis in particular, in elderly patients with type 2 diabetes mellitus (DM). MATERIALS AND METHODS: The trial included 150 patients with diabetes mellitus type 2 aged over 60 years with DM duration 16.6 +/- 7.8 years. All the patients underwent general clinical examination, Reberg-Tareev test, urine seeding, renal ultrasonography. RESULTS: The diagnoses associated with renal pathology were made in 75% of patients, the specific renal parenchymal damage (diabetic nephropathy-DN) proper was much less common (73 patients with type 2 DM). 16 of them were found to have chronic renal failure. The concurrent abnormalities included pyelonephritis (21%), urolithiasis (14%), renal cysts (19%), their combination (43%). Concomitant pyelonephritis had the most significant impact on renal function. Essential hypertension occurred in 65% of patients. CONCLUSION: In old age, renal damage specific for DM develops in the presence of pyelonephritis, cystic degeneration of the parenchyma, involutional processes, atherosclerotic and hypertensive arteriolosclerosis.
Assuntos
Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/complicações , Rim/patologia , Pielonefrite/complicações , Idoso , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/fisiopatologia , Humanos , Hipertensão/complicações , Rim/diagnóstico por imagem , Rim/fisiopatologia , Testes de Função Renal , Pessoa de Meia-Idade , Pielonefrite/diagnóstico , Pielonefrite/fisiopatologia , UltrassonografiaAssuntos
Nefropatias/etiologia , Nefropatias/prevenção & controle , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/fisiopatologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes , Progressão da Doença , Feminino , Hemodinâmica , Humanos , Hipercalcemia/complicações , Nefropatias/terapia , Falência Renal Crônica/etiologia , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Síndromes Paraneoplásicas , Prognóstico , Fatores de Risco , UrodinâmicaRESUMO
The authors have conducted an epidemiological study for multiple myeloma morbidity and mortality among 80,000 patients of the Medical Center examined in 1988-1995. Myeloma was diagnosed in 65 cases. Standard incidence rate was 4.09, 3.18 and 3.5 per 100,000 for myeloma in males, females and both sexes, respectively. Standard mortality was 2.76 and 1.73 per 100,000 for males and females, respectively. The above rates do not differ much from those of other countries. In terminal myeloma renal insufficiency occurred in 39 of 41 cases. In 8 cases chronic pyelonephritis was an independent course of renal failure thus indicating the importance of its persistent treatment.
Assuntos
Nefropatias/epidemiologia , Mieloma Múltiplo/epidemiologia , Adulto , Distribuição por Idade , Idoso , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Federação Russa/epidemiologia , Distribuição por SexoAssuntos
Nefrite/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/imunologia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Glomerulonefrite/diagnóstico , Glomerulonefrite/etiologia , Glomerulonefrite/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Nefrite/etiologia , Nefrite/imunologia , PrognósticoRESUMO
Besides the known factors contributing to the pathogenesis of diabetic nephropathy, the role of immune mechanisms in types I and II diabetes is discussed of late; the contribution of autoimmune mechanisms to pathogenesis of noninsulin-dependent diabetes (NIDDM) is virtually unknown. Seventy-six patients with NIDDM and 48 with insulin-dependent condition were examined. Under study were levels of antibodies to FxIA and renal glomerular basal membrane antigens in the blood sera of donors and patients with types I and II diabetes, as well as concentrations, size, and pathogenicity of immune complexes. Antibodies to FxIA antigen were detected in patients with both types of diabetes with diabetic nephropathy. Detection of circulating antibodies to FxIA antigen in more than 70% of diabetics in the absence of protein in the urine may be used as a test system for the laboratory diagnosis of diabetic nephropathy prestage and as a criterion for prescription as early as at the initial stages of nephroprotective agents.
Assuntos
Diabetes Mellitus Tipo 2/imunologia , Nefropatias Diabéticas/imunologia , Adulto , Idoso , Complexo Antígeno-Anticorpo/sangue , Autoanticorpos/sangue , Autoantígenos/sangue , Diabetes Mellitus Tipo 1/imunologia , Complexo Antigênico da Nefrite de Heymann , Humanos , Glomérulos Renais/imunologia , Glicoproteínas de Membrana/imunologia , Pessoa de Meia-IdadeAssuntos
Homicídio , Lesões por Radiação/diagnóstico , Autopsia , Diagnóstico Diferencial , Doenças do Esôfago/complicações , Doenças do Esôfago/etiologia , Doenças do Esôfago/patologia , Evolução Fatal , Raios gama/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/etiologia , Úlcera Péptica Hemorrágica/patologia , Lesões por Radiação/complicações , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Úlcera Gástrica/complicações , Úlcera Gástrica/etiologia , Úlcera Gástrica/patologia , Úlcera/complicações , Úlcera/etiologia , Úlcera/patologiaRESUMO
28 patients treated by programmed hemodialysis (PH) were followed up from 1985 to 1991. All the patients were over 60 years old. 16 patients died within month 1-60 since PH initiation. Overall PH duration for the whole group reached 24.6 +/- 3.58 months. Pretreatment urea and creatinine in plasma of senile patients were significantly lower than in young patients not resulting, though, in uremia reduction. The findings show that it is not valid to consider creatinine a determinant for starting hemodialysis in senile patients. Despite multimorbidity, more rapid progression of atherosclerosis and complicated establishment of the vascular approach, senile patients successfully adapt to PH regimen, need less numerous weekly PH hours. By anemia manifestations, incidence of hyperparathyroidism and polyneuropathy, senile patients did not differ much from their younger counterparts.
Assuntos
Diálise Renal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/etiologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Diálise Renal/instrumentação , Diálise Renal/métodos , Diálise Renal/estatística & dados numéricosAssuntos
Hipertensão/fisiopatologia , Prostaglandinas/biossíntese , Pielonefrite/fisiopatologia , Idoso , Envelhecimento/fisiologia , Volume Sanguíneo/fisiologia , Doença Crônica , Humanos , Hipertensão Renal/fisiopatologia , Rim/metabolismo , Pessoa de Meia-Idade , Sistema Renina-Angiotensina/fisiologia , Síndrome , Equilíbrio Hidroeletrolítico/fisiologiaAssuntos
Complexo Antígeno-Anticorpo/análise , Artrite Reumatoide/diagnóstico , Doenças do Complexo Imune/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Polietilenoglicóis , Artrite Reumatoide/imunologia , Sedimentação Sanguínea/efeitos dos fármacos , Humanos , Doenças do Complexo Imune/imunologia , Técnicas Imunoenzimáticas , Lúpus Eritematoso Sistêmico/imunologia , Polietilenoglicóis/farmacologiaRESUMO
The incidence of podagric nephropathy in different age groups was studied on a large populational material (41,452 persons over 30 years). The number of patients suffering from podagra was shown to increase with each decade of life. In 122 patients with podagric nephropathy, deviations in urinalyses were recorded in 80 cases (65.5%). Of these, 53 patients (72.6%) were ot 60 years of age and older. In patients over 60, derangement of nitrogen-excretory renal function was seen more frequently (in 64.4%) than in other age groups. The greater incidence of podagra and podagric nephropathy over the recent decade may be related not to the changes in the nutrition pattern and hypodynamia but also, and possibly to a larger measure, with deterioration of the environmental conditions and alterations in radiation background.
Assuntos
Envelhecimento/fisiologia , Gota/fisiopatologia , Nefropatias/fisiopatologia , Adulto , Fatores Etários , Idoso , Feminino , Gota/epidemiologia , Humanos , Rim/fisiopatologia , Nefropatias/epidemiologia , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Cálculos Urinários/epidemiologia , Cálculos Urinários/fisiopatologiaRESUMO
Eighteen patients with senile pyelonephritis and nephrogenic arterial hypertension were examined for the effect of trental monotherapy (600 mg/day) on intrarenal hemodynamics, the rate of glomerular filtration (effective renal blood flow, the intensity of blood flow in the medullary layer of the kidney), activity of the renin-angiotensin-aldosterone system (plasma renin activity, plasma and urine aldosterone), prostaglandin synthetic capacity of the kidneys (PGE and PGF2 alpha), water-electrolyte balance (circulating blood volume, sodium content in the serum and its excretion with urine), and on arterial pressure and general vascular peripheral resistance. Prolonged administration of the drug (from 3 weeks to 6 months) led to a significant improvement of the medullary blood flow, increase (p less than or equal to 0.05) of excretion of natriuretic PGE [correction of RGE] and lowering (p less than or equal to 0.05) of diurnal excretion of PGF2 alpha, which was accompanied by a rise of natriuresis (p less than or equal to 0.05) and diuresis.