RESUMO
IgA nephropathy (IgAN) is the most common glomerulonephritis in the world, and currently is known to be an important cause of end stage renal disease (ESRD). Hypertension, proteinuria more than 1 g/d, and the presence of severe lesions on initial renal biopsy such as crescents and interstitial fibrosis are the most significant predictive factors for progression to ESRD. Despite its prevalence and clinical importance, there is no consensus for the treatment of patients with risk factors for a worse prognosis. Our aim is to describe here a case of crescentic IgAN, and to emphasize the effect of immunosuppressive treatment.
Assuntos
Autoanticorpos/imunologia , Glomerulonefrite/complicações , Imunoglobulina G/imunologia , Glomérulos Renais/patologia , Síndrome Nefrótica/etiologia , Proteinúria/etiologia , Membrana Basal , Biópsia , Diagnóstico Diferencial , Glomerulonefrite/patologia , Humanos , Glomérulos Renais/imunologia , Masculino , Síndrome Nefrótica/patologia , Proteinúria/patologia , Adulto JovemRESUMO
BACKGROUND: We aimed to show the impact of leukodepletion on renal function in patients undergoing on-pump coronary revascularization. PATIENTS AND METHODS: Fifty patients awaiting elective on-pump coronary revascularization with normal preoperative cardiac functions and with plasma creatinine levels ranging between 1.5 and 2.0 mg/dL were prospectively randomized into two groups: on-pump CABG with (group A: n = 25) and without leukodepletion (group B, n = 25). Renal glomerular and tubular injury were assessed by urinary alpha glutathione s-transferase (GST), plasma creatinine, and blood urea nitrogen (BUN) levels. RESULTS: The patients consisted of 14 females and 36 males with a mean age of 57.6 +/- 5.3 years. In the leukodepletion group, the mean levels of creatinine, BUN and urinary GST were found to be decreased on the first, third and fifth postoperative days compared with the control group. There was no mortality. Three patients in the control group needed postoperative dialysis. CONCLUSION: Patients with renal dysfunction undergoing on-pump CABG surgery seem to benefit from leukodepletion as a measure to prevent tubular damage and renal impairment compared with a control group.
Assuntos
Injúria Renal Aguda/prevenção & controle , Ponte de Artéria Coronária , Doença das Coronárias/cirurgia , Procedimentos de Redução de Leucócitos , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/metabolismo , Injúria Renal Aguda/fisiopatologia , Idoso , Análise de Variância , Biomarcadores/sangue , Biomarcadores/urina , Nitrogênio da Ureia Sanguínea , Ponte de Artéria Coronária/métodos , Creatinina/sangue , Feminino , Glutationa Transferase/urina , Humanos , Incidência , Isoenzimas/urina , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Potássio/sangue , Estudos Prospectivos , Diálise Renal , Projetos de Pesquisa , Resultado do Tratamento , Turquia , Equilíbrio HidroeletrolíticoRESUMO
Secondary oxalosis of bone is a complication of chronic renal failure. Its frequency and the mechanism of the deposition is unknown. We report the case of chronic renal failure patient on hemodialysis with deposition of oxalate in bone. Possible mechanisms and the significance of the depositions is also discussed.