Selective nephroangiography in the dog causing renal platelet aggregation and irregular nephrographic phase.

Selective renal artery injections of large single doses of the ionic contrast medium metrizoate produced an irregular nephrographic phase, 'patchy contrast medium retention', in 14 of 16 dogs. The irregular nephrographic phase was associated with a transient accumulation of platelets and fibrinogen in the kidney and with microscopically demonstrable transient thrombi in afferent arterioles and glomerular capillary tufts. These effects were followed by tubular damage, which was demonstrated in 4 of 6 dogs examined 48 hours after injection. Formation of thrombi was not demonstrated in 6 dogs given small single doses, which produced a homogeneous nephrographic phase. It is suggested that contrast medium induced endothelial damage is a pathogenetic mechanism in the development of thrombi and patchy contrast medium retention.

Renin-secreting renal tumour with severe hypertension. case report with tumour renin analysis, histopathological and ultrastructural studies.

A 25-year-old man presented with severe hypertension associated with hypokalemia, elevated plasma renin level and secondary hyperaldosteronism. Malignant phase hypertension and renal artery stenosis were ruled out, and a preoperative diagnosis of renin-secreting renal tumour was made on the basis of higher concentrations of renin in the left than in the right renal venous plasma in spite of normal findings on selective renal arteriography. By removal of the affected kidney the tumour was found and it had a very high content of renin. Following the operation the plasma renin level, serum aldosterone concentration and BP became normal. We present a histopathological description and an ultrastructural study of the tumour.

Glomerulonephritis in dermatitis herpetiformis. A case study.

A patient with dermatitis herpetiformis, proteinuria and reduced renal function is described. A renal biopsy studied by light and immunofluorescence microscopy revealed a glomerulonephritis with deposits of predominantly IgA and complement C3. Deposits of IgA and C3 were also demonstrated in a biopsy from normal skin, and a common pathway for the skin and renal lesions is suggested.

A renal biopsy study with light and immunofluorescent microscopy in rheumatoid arthritis.

REnal biopsies were performed on 14 patients with active rheumatoid arthritis an proteinuria of whom 7 patients had reduced creatinine clearance. Glomerular hypercellularity was found in six and amyloid in seven biopsies. Immunofluorescence microscopy revealed glomerula deposits of immunoglobulins and complement in 10 of 12 biopsies, indicating an active immunologic process causing the impaired renal function.