[The kidney and drugs. Disorders of the metabolism and kinetics of drugs in renal insufficiency].
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Biomedical subjects
Publications and source records attributed to B Devulder.
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The occurrence of renal manifestations of Hodgkin's disease may result from multiple physio-pathological processes: mechanical, by obstruction of the vessels or excretory systems of the kidneys; specific, by lymphogranulomatous infiltration of the parenchyma; immunological, as immunune complex glomerulonephritis or, more frequently, as amyloid disease; infective or metabolic as a complication of long term corticosteroid or immunodepressive therapy. These various causes of renal problems during Hodgkin's disease lead to the observation of three principal clinical pictures: acute renal failure, chronic renal failure and permanent proteinuria with or without nephrotic syndrome. Acute renal failure generally results from a severe infection with toxi-infective shock. More rarely it is related to thrombosis of the renal veins, with a grave prognosis, or to unreteral compression with anatomical or functional exclusion of the contralateral kidney. Chronic renal failure may be caused either by distension of the excretory pathways, progressively obstructed or invaded by the Hodgkin's process and requiring specific therapy to relieve the obstruction (cobaltotherapy, chemotherapy), by specific infiltration of the renal parenchyma or by amyloid disease. Permanent proteinuria, with or without nephrotic syndrome, may be the presenting feature of renal vein thrombosis, amyloidosis or paraneoplastic nephrotic syndrome.
Vitamin A, a good adjuvant to immunologic reactions, has in this aspect an interesting therapeutic effect, especially in immunotherapy. On the other hand, in diseases caused by circulating immunocomplexes or in auto-immune diseases, vitamin A can prolong the pathologic immunologic process. This experimental study shows that vitamin A in high doses has an adjuvant effect, that is aggravating considerably the immunologic arthritis induced in the Wistar rat.
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