Biomedical subjects
Publications and source records attributed to C Guérin.
Among surgical complications following kidney transplantation, the colonic perforation should be known. We reported a fatal case of perforation occurring on a colonic diverticulosis in the first month week post-transplantation. We emphasized on the difficulty to assess the diagnosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report a case of renal macroangiopathy occurring after transplantation in a 50-year-old woman who received a cadaveric kidney and who was immunosuppressed with cyclosporin A. Accelerated hypertension at 3 months led to renal angiography which revealed diffuse narrowing of the two main renal arteries and their intrarenal branches. The patient returned to regular haemodialysis four months post-transplantation. These angiographic cyclosporin A-ascribed findings are similar to those recently reported by Sawaya.
In a 22 years old woman with recent hypertension, a timed intravenous pyelogram revealed an asymptomatic obstructive ureteropelvic junction. Preoperative renal vein catheterization demonstrated excessive renin release from the diseased kidney and low release from the other one, suggesting that corrective ureteral surgery should return blood pressure to normal levels. Moderately impaired glomerular filtration rate improved after surgery as a consequence of suppressed hydronephrosis and bilateral renal ischemia. Thus we conclude that in young people, asymptomatic unilateral hydronephrosis can lead to hypertension and renal failure like renal artery stenosis. In the other cases of urinary flow obstruction, secondary hypertension remains to be explained by both inappropriate production of renin and water chronic retention.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The effects of surgical renal revascularization on both hypertension and kidney function was assessed in 16 patients with renovascular hypertension (14 unilateral). We have taken a special interest to the split renal function studied with DTPA renogram. The function of the operated kidney was improved in 9 patients and not improved (worsened or unchanged) in 7. Hypertension was cured in 25% and improved in 56% of the patients, without correlation with split renal function outcome.
The authors report two patients with renal failure due to total procidentia. Surgical repair led to an improvement in renal function. Mild chronic renal failure persisted. Thus the renal status must be assessed in cases of uterine prolapse.
Explore the source record for details and available documents.
A 46 years old patient with IgA nephritis developed an acute renal failure due to enalapril, without renal artery abnormality. A similar impairment of renal function was found during an acute test with 50 mg Captopril.
We reported 3 cases of male patients with isolated dissecting aneurysm of the renal artery. The clinical presentation included lumbar pain followed by hypertension (malignant in 2 cases) in the next 3 months. These three patients have underwent surgical renal artery repair. At maximal follow-up (4, 5, 11 years after surgery), the blood pressure was normalized in these 3 patients (with one antihypertensive drug in 2) and the renal function remained stable.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Allopurinol is widely used in the treatment of hyperuricemia. Unusual (78 cases published up to 1984) but severe toxicity includes renal, skin and hepatic involvement. We report a new case of serious toxic manifestations with acute interstitial nephritis. We stress the need to adapt the daily dosage of the drug to the glomerular filtration rate and to interrupt drug administration rapidly if allergic manifestations develop.
Four patients with recent central deep vein thrombosis (pelvis-superior mediastinum) were treated by local low dose infusions of urokinase (500 to 1000 IU/kg/h for 6 to 9 hours) followed by plasminogen (20 to 30 microkatals/h for 2 to 3 hours) associated with simultaneous anticoagulation with heparin. The treatment was continued for 83 to 160 hours until control phlebography showed dissolution of the thrombus. There were no haemorrhagic complications despite the presence of a number of risk factors which contraindicated treatment by a systemic route. Fibrinogen and FDP levels did not alter significantly. This therapeutic approach is worth considering and should be integrated among the therapeutic options available for cases of central deep vein thrombosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.