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Biomedical subjects

G Gordillo Paniagua

Publications and source records attributed to G Gordillo Paniagua.

At least 19 recordsLinked to original sources
PubMed1991

[DMF index in patients with end-stage kidney disease].

In order to demonstrate the role of saliva with high concentration of urea and alkalinity, preventing dental caries in the uremic patients, 4 groups of children were studied: I healthy controls, II children with successful renal transplantation, III uremic children in dialysis and IV uremic children with conservative treatment. The results show a direct correlation between increase of saliva urea concentrations and decrease in saliva hydrogen ion concentration. Higher values of urea and more alkaline pH were found in children with uremia, with or without dialysis. Despite that there was not a statistically significant difference in the caries-lost-obturation index: 0.252 was found in the group of healthy controls and the lowest was 0.119, in the patients with uremia and dialysis. The results suggest that a protector role of saliva in uremic children is possible.

Adolescent↗
PubMedDate not supplied

[Chronic interstitial nephritis caused by analgesics].

Interstitial nephritis secondary to analgesic ingestion is apparently an uncommon subject in pediatric literature. Two cases are reported in this article: case 1 is a girl followed for the last fifteen years when she had lipoid nephrosis which was treated initially with corticosteroids; she responded satisfactorily, but presented frequent relapses. After 8 years, she was given cyclophosphamide plus prednisone and lately, she responded and has remained well. Further on, her urinalysis showed specific gravity of 1,033 and no proteinuria. Five years ago, because of protracted headache due to psychological disturbance, she started to ingest a variety of analgesics in progressively increasing doses. For the last 2 years, abdominal pains, paleness, polydipsia and polyuria have been observed; at present, her blood pressure, serum chemistry, and urine sediment are normal, but there is a marked failure in the renal concentration capacity, as well as marked sodium urinary losses. A percutaneous renal biopsy showed tubulo-interstitial fibrosis and edema with normal glomeruli. Case 2 is a girl with rheumatoid arthritis which appeared 3 years ago; for over one year, the patient was given 15 mg/day prednisone plus 1.5 g. acetylsalycilic acid. She was admitted to the hospital because her osteoarticular problem did not improve. Her blood pressure, blood chemistries and urinary sediment were also normal. LE tests were negative. Renal concentrating capacity was reduced and the renal biopsy showed tubular atrophy; there was intestinal edema and mononuclear infiltration. Chronic interstitial nephritis, secondary to analgesics is supported in both cases; polyuria and a marked defect of renal concentrating capacity are the earliest and most characteristic features. Normal urinary sediment is a common finding leading to erroneous assessment of a lack of renal involvement. Pathological lesions are located in the interstice of the renal medulla and sometimes in the papilla. Early arrest of analgesic ingestion may stop and even reverse the renal lesion and the renal insufficiency.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Comparison between the 3- and the 24-hour urine collection for creatinine clearance].

Endogenous creatinine clearance was studied in thirty children with various renal diseases and variable degrees of functional deterioration. Two different procedures or urine collection were used on each child: 1) twenty-four-hour urine collection with one blood sample and immediately afterwards 2) three one-hour consecutive periods of urine collection, with one previous blood sample (the one used for the 24-hour procedure). Both procedures were carried out during hydration of the patient and creatinine was determined with the autoanalyzer in urine and blood samples. The results obtained with both procedures did not show significant difference. The three-hour periods procedure may be recommended for hospitalized patients, specially infants or young children, and also when the parents are not reliable enough for hydrating the patients and for performing a complete collection of urine in a 24 hour period.

Adolescent↗
PubMedDate not supplied

[Pyelonephritis and bacterial tubulointerstitial nephritis].

With the purpose of establishing the clinicopathologic correlation in pyelonephritis and to discard other interstitial nephrites, with present day morphologic criteria we analysed 63 casos that had been diagnosed as pyelonephritis, following Weiss and Parker's histologic criterion. The clinicopathologic diagnosis of pyelonephritis was confirmed in 12 cases; all of them showed obstructive uropathy and in most of them, there was chronic renal failure. Interstitial nephritis was established in 27 cases, all of them showing septicemia and almost half of the cases showed acute renal failure. Other 20 cases showed tubulointerstitial nephritis secondary to different types of glomerulopathies, fetal glomerulosclerosis, dysplasias, nephrophthisis, radiation nephritis and renal infarct. In 4 cases, the study of sections finer than the original, showed absence of histopathologic lesions. The results of the present study point out the main causes of confusion with the pathological diagnosis of pyelonephritis, the necessity to investigate predisposing uropathy in patients with urinary infection and stresses the importance to establish correlation with clinical and laboratory findings in cases with tubulointerstitial lesions.

Autopsy↗
PubMedDate not supplied

[Evaluation of the urinary and plasma urea ratio and osmolarity in newborn infants and malnourished children with pathological and normal renal function].

Previous evaluation of diagnostic tests for acute renal failure in children demonstrated that osmolality urine/plasms (U/P) ratio below 1.3, urea ratio below 4.8 and a negative mannitol test (absence of a diurteic response within one hour after intravenous administration of 60 ml/m2 of 12.5% mannitol solution) may be considered as valuable factors in this diagnosis. However, the validity of those ratios were in doubt in selected populations such as newborns and in severe malnourished children in whom an impairment in concentrating urine capacity can be anticipated. With the purpose to test the validity of these parameters, a group of 53 newborns and 68 children with severe malnutrition were studied. They were admitted to the hospital with dehydration secondary to acute diarrhea presenting oliguria and hyperpnea and before any treatment was given, urine and blood samples were taken to determine urea and osmolality U/P ratios besides routine chemistries. Mannitol test was performed when urine could not be obtained and in some cases in whom U/P results deserved confirmation with the biological test. Seven of the 53 newborn patients developed acute renal failure with negative mannitol test and further clinical course of persistent oliguria. Urea and osmolality U/P ratios were 3.0 +/- 1.5 and 1.07 +/- 0.01 respectively, whereas the remaining 46 newborns had afterwards an uneventful recovery presenting U/P ratios of 12.4 +/- 8.5 for urea and 1.32 +/- 0.57 for osmolality. The difference between the average values of urea U/P ratio of the patients with acute renal failure and those with functional oliguria, were statistically significant at the level of p less than 0.01, but there was no significant difference between osmolality ratio values.

Acute Kidney Injury↗
PubMedDate not supplied

[Hypocalcemic vitamin D-dependent renal rickets].

Two siblings, female 10 years old, and male 15 years old, with the diagnosis of vitamin D-dependent rickets were studied. Another sibling, also with the same diagnosis, died of bronchopnemonia at about 7 months of age. Both patients developed rachitic manifestations since the first year of life, which persisted despite the administration of massive doses of vitamin D intermitently. Severe hypocalcemia, moderate hypophosphatemia and elevated serum alkaline phosphatase were the most characteristic biochemical findings. Both patients showed diminished renal tubular reabsorption of amino acids and phosphates. These alterations were reversible during I.V. calcium gluconate administration. The clinical biochemical and X-ray manifestations disappeared completely after one year of treatment with dihydrotaquisterol. Vitamin D-dependent rickets is an autosomal recessive disease, characterized by a hydroxylation defect of 25 hydroxycholecalciferol at the carbon 1 level, due to abscence of 25 hydroxy-D1-hydroxylase. Thus 1-25 Dihydroxycholecalciferol, the active form of vitamin D3 is not formed, resulting in depression of intestinal calcium absorption and reabsorption from the bones.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗
PubMedDate not supplied

[Infection of the urinary tract, its association with local predisposing factors].

A total of 167 cases of children with the diagnosis of urinary infection seen through the last five at the Hospital Infantil de México were studied with the purpose of investigating the frequency of the association of obstructive urologic malformations or vesicoureteral reflux with urinary infection and their role in the infection. Out of this number, there were 127 cases with urologic malformations, especially of the upper urinary tract. The most frequent symptoms were enuresis, lumbar pain and hematuria. Out of this group, 53 patients (41%) showed recurrent infections in contrast with only 4 out of 40 cases (10%) without malformation. Out of 167 cases, 64 recovered: 30 of the total of 40 who showed no malformations and only 34 out of 127 with malformations. Twelve cases in this group showed chronic renal insuficiency as final outcome, but none of the patients without malformation followed this course. Analysis of this clinical material shows a high incidence of urologic malformations in patients complaining of urinary infection which has an important role in mortality and lethality of this process. Thus, it is concluded that obstructive uropathy must be investigated in every case of urinary infection, especially if enuresis, lumbar pain or hematuria are present.

Adolescent↗
PubMedDate not supplied

[Renal failure and rickets].

Acute renal failure secondary to interstitial nephritis caused by therapeutic ingestion of sodium diphenylhydantoins has been reported recently. The interference of sodium diphenylhydantoins on Vitamin D metabolism causing or aggravating ricketts has also been reported. This communication deals with an infant girl who was admitted to the hospital due to seizures. Four months before, she had convulsions and she was treated with diphenylhydantoins until admission. She was found to have renal failure and ricketts. Histological diagnosis of interstitial nephritis was established by means of percutaneous renal biopsy. Clinical and radiological improvement of ricketts was observed after dehydrotachysterol treatment. Clinical and biochemical alterations of renal failure slowly subsided. She had a clear-cut history of vitamin D defficiency ricketts. Seizures were due to hypocalcemia tetany but was erroneusly treated as "grand mal" epilepsy, with diphenylhydantoins. Interstitial nephritis complicated with acute renal failure was probably caused by diphenylhydantoins administration.

Acute Kidney Injury↗
PubMedDate not supplied

[Serum immunoglobulins in the idiopathic nephrotic syndrome].

In 78 children with idiopathic nephrotic syndrome, the levels of serum immunoglobulins were studied. In 45 cases with lipoid nephrosis, 7 with segmentary and focal sclerosis and in 26 with membranoproliferative glomerulonephritis, a reduction in per centum values of IgG were found in similar magnitude in the groups. Levels for IgA were not found abnormal and there was an increase in values for IgM exclusively in cases of lipoid nephrosis. There was no difference between disorders shown by cases of active lipoid nephrosis at the beginning or following relapse after some time of evolution. On the other hand it was found that disorders that appeared significantly in magnitude in cases undergoing remission, but specially in those with a greater time of evolution. The difference in these findings with those reported by other authors are attributed to multifactorial causes of lipoid nephrosis and it is supposed that disorders of immunoglobulins represent a functional defect of the lymphocytes T similar to that described as "immunodeficiency linked to chromosome X with high IgM". The association of lipoid nephrosis with certain types of locus HL-A suggest that these immunity alterations might signify a predisposing factor genetically transmitted and suggest the systematic study of these abnormalities in parents and siblings of patients with this disease.

Adolescent↗
PubMedDate not supplied

[Familial juvenile nephronopthisis].

For the last 20 years, 11 patients with clinicopathologic diagnosis of nephronopththisis or medullary cystic disease, have been studied at the Nephrology Department of the Hospital Infantil de México. The initial manifestations took place at ages from 3 to 12 years and consisted of polyuria and polydipsia with reduction of vasopressin resistant urinary concentration capacity. Most cases showed anemia and pondostatural delay even at periods previous to renal insufficiency initiation. All cases showed normal urinary sediment with persistently negative urine cultures and progressed to chronic renal insufficiency after 1 to 10 years of evolution. Eight cases showed familial character. Histopathologic findings were similar and consisted of tubular disorders with alternation of atrophic tubuli having thickened basal and dilated tubuli having normal or flattened epithelium; renal medullary cysts were shown in some cases.

Age Factors↗