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Biomedical subjects

H Beaufils

Publications and source records attributed to H Beaufils.

At least 73 records · Page 4Linked to original sources
PubMed1990

Renal effects of radiocontrast agents in rats: a new model of acute renal failure.

The objectives of this study were first to develop a reproducible and reversible model of acute renal failure following contrast medium infusion in the rat; second to use that method to compare the nephrotoxicity of low- and high-osmolar contrast agents. Contrast media or saline were perfused in the aorta while a clamp was applied on the aorta just above the renal artery. Three minutes of renal ischemia with or without infusion of isotonic saline induced no change in serum creatinine and a slight and transient decrease in creatinine clearance at 24 h. Urinary N-acetyl glucosaminidase (NAG) excretion was not modified in this control group. All 17 kidneys which were examined were normal. 2,100 mosm/kg hypertonic saline induced a significant increase in serum creatinine and a significant decrease in creatinine clearance (from 1.8 +/- 0.1 to 0.8 +/- 0.1 and 1.0 +/- 0.2 ml/min at 24 and 48 h, respectively). Urinary NAG excretion increased from 23 +/- 18 to 48 +/- 20 and 8 +/- 4 mumol h-1/mmol creatinine at 24 and 48 h, respectively (p less than 0.05). Histologic analysis of 5 kidneys revealed acute tubular necrosis (n = 3) and no histologic abnormalities (n = 2). Diatrizoate induced an acute and reversible renal failure. Creatinine clearance decreased from 1.6 +/- 0.1 to 0.4 +/- 0.1 and 0.8 +/- 0.1 ml/min at 24 and 48 h, respectively (p less than 0.01). Urinary NAG excretion increased also significantly from 43 +/- 9 to 352 +/- 79 and 64 +/- 23 mumol h-1/mmol creatinine at 24 and 48 h, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗
PubMed1990

Hemolytic uremic syndrome in patients with Behçet's disease treated with cyclosporin A: report of 2 cases.

Hemolytic uremic syndrome (HUS) has been reported in patients treated with cyclosporin A (CsA) following bone, hepatic and kidney transplantation. We report two patients with Behçet's disease (BD) under CsA treatment because of severe uveitis, who developed HUS several months after the initiation of treatment. Renal biopsies showed lesions consistent with the diagnosis of the arterial form of thrombotic microangiopathy: vascular thrombosis with extensive glomerular ischemia. Renal failure persisted after withdrawal of CsA: one patient is in chronic renal failure (CRF) with a 4-year follow-up; the other died after refusal of chronic hemodialysis. In our two patients, excessive doses of CsA with high trough levels are likely to have contributed to the development of HUS. A rapid adjustment of CsA doses and an early detection of signs of the microangiopathic process might have prevented this severe complication of CsA treatment.

Adult↗
PubMed1989

Foscarnet nephrotoxicity: mechanism, incidence and prevention.

Foscarnet is a pyrophosphate analogue that has been successfully used in severe cytomegalovirus (CMV) infections. Little is known of the incidence and mechanisms of foscarnet-induced nephrotoxicity as most data comes from recipients of renal allografts or from patients with severe underlying disease or with other nephrotoxic drugs. We have retrospectively analyzed the evolution of renal function after 56 courses of foscarnet. In addition, we have prospectively studied the protective effects of hydration on foscarnet nephrotoxicity (2.5 liters of saline/day during the night before the foscarnet therapy and throughout the course of treatment). Foscarnet-induced acute renal failure was defined as a rise in serum creatinine of at least 25% from the basal value. An increase in serum creatinine occurred in 37 cases out of the 56 courses of foscarnet (66%). The mean serum creatinine prior to foscarnet was 80.5 +/- 3.3 mumol/l and the mean increase was 190 +/- 28.3 mumol/l (range 80-1,000). Peak serum creatinine was higher than 200 and 300 mumol/l in 16 and 13 patients, respectively. Kidney obtained at autopsy from a 30-year-old male with AIDS, CMV pneumonitis and acute renal failure secondary to foscarnet administration showed an extensive tubular necrosis. In the group which was prospectively hydrated only 1 patient had an acute renal failure. The mean serum creatinine at the peak (96 +/- 4 mumol/l) and at the end of the treatment (83 +/- 4 mumol/l) was significantly lower (p less than 0.05) than in non hydrated patients. In conclusion, foscarnet is a highly nephrotoxic drug which induces acute tubular necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1989

Idiopathic acute interstitial nephritis associated with anterior uveitis in adults.

Concomitant renal and ocular lesions have been described in a few systemic diseases. The association of acute interstitial nephritis (AIN) and anterior uveitis without determined cause was first described in children. Recently, the same clinical association has been reported in adults. We report 3 cases of this association and present a review of the literature. Including our 3 patients, 7 cases of this association have been reported in adults. All patients were females aged 27-74 years. Initial symptoms were either ocular, or pseudoviral (fever, myalgia and fatigue). Histological renal studies revealed acute interstitial nephritis with tubular lesions. Immunofluorescence and electron microscopy were not contributive. Ocular prognosis was always good. In 5 patients, the evolution of renal function was excellent with complete resolution of acute renal failure within a few weeks. Chronic renal failure developed in two of the four patients who did not receive systemic steroid therapy (with evolution towards terminal renal failure in one patient). Three of the patients received 60 mg per day of prednisone and none of them developed chronic renal failure. Despite the small number of patients reported and the possibility of spontaneous regression, these data suggest a beneficial effect of systemic steroid therapy to prevent or reduce interstitial inflammation and subsequent fibrosis.

Acute Disease↗
PubMed1988

Effects of nifedipine on cisplatinum-induced nephrotoxicity in rats.

The effects of calcium channel blockade with nifedipine (N) on cis-diammine dichloroplatinum II (CDDP)-induced nephrotoxicity were tested in male Sprague-Dawley rats. Renal function was evaluated before and five days after CDDP administration (5 mg/kg). The rats were treated with various doses of N (0.1; 0.3; 0.6 mg/kg/day) 2 days before CDDP administration and throughout the study. The severity of CDDP-induced acute renal failure was markedly modified in N-treated animals according to the daily dosage of N. At 0.3 and 0.6 mg/kg BW/day, N enhanced CDDP nephrotoxicity. Serum creatinine was 637 +/- 45 and 611 +/- 71 mumoles/liter, respectively, 5 days after CDDP administration (vs. 313 +/- 24 mumoles in animals treated with CDDP alone; p less than 0.05). In these animals the plasma potassium level was significantly elevated at day 7 when compared with CDDP-treated and control rats. In contrast, at the dose of 0.1 mg/kg BW/day N attenuated CDDP nephrotoxicity with a serum creatinine of 214 +/- 35 mumoles at the end of the study. The pathologic changes were also more severe in the groups receiving 0.3 and 0.6 mg/kg of nifedipine. We postulate that at the higher doses (0.3 and 0.6 mg/kg) the systemic hemodynamic effects of nifedipine may override the potentially beneficial intrarenal effect which may account for the favorable results recorded with a dosage of 0.1 mg/kg.

Acute Kidney Injury↗
PubMed1988

[Renal disease associated with heroin abuse].

Thirteen patients developed a renal disease after using heroin alone or in combination with other drugs, for a period of 3 to 12 years. Eleven were IV drug addicts, 2 were sniffers. Six patients had acute tubular necrosis, due to rhabdomyolysis in 5 and to prolonged gentamicin therapy for bacterial endocarditis in 1. Five patients manifested a nephrotic syndrome, and renal biopsy showed various types of glomerulonephritis (GN) without glomerular sclerosis. The two last patients had hypertension with intrarenal vascular lesions and HBsAg was present in their serum. Chronic hemodialysis and/or renal transplantation were required in 2 cases with GN; all other patients recovered normal serum creatinine. There was no specific pathologic picture of heroin abuse in this series.

Adult↗
PubMed1987

[Late onset cystinosis. Apropos of a case].

This report concerns a new case of late onset cystinosis with heavy proteinuria. Renal biopsy showed focal segmental glomerular hyalinosis and the usual tubular and glomerular lesions of cystinosis. The pathogenesis of glomerular hyalinosis remains unclear.

Adolescent↗
PubMed1986

[Renal and digestive amyloidosis and Behçet's disease. Apropos of a case].

The authors report the case of a 33-year old male Tunisian who, 7 years after the onset of complete Behçet's disease (diagnosed on international criteria) developed a nephrotic syndrome diagnosed as renal amyloidosis on histological evidence. Attenuation of Congo red staining by potassium permanganate pointed to AA type amyloidosis. Despite treatment with colchicine and cyclophosphamide the patient's condition deteriorated. Amyloid deposits were found in a small bowel biopsy performed for persistent diarrhoea. The patient died 3 years after amyloidosis was diagnosed. The authors have reviewed the literature concerning this exceptional association: in all cases where it was typed the amyloidosis was AA. Attention is drawn to the failure of colchicine in this patient.

Adult↗
PubMed1986

Influence of the uremic state on the development of malignancy. An experimental study in the rat.

The effect of chronic uremia on the development of subcutaneously injected malignant tumoral cells was evaluated in 213 male Wistar AG rats made chronically uremic by simultaneous right nephrectomy and partial ligation of the left renal artery. The tumoral cells injected were stemming from a parental rhabdomyosarcoma (9-4/0) induced by intramuscular injection of 20 mg of colloidal nickel suspended in oil to a male Wistar rat. 54 sham-operated rats and 43 nonoperated animals served as control-groups. Renal function and tumoral growth were checked weekly up to the 60th postoperative day, at which time the surviving rats were sacrificed and submitted to autopsy. At day 15 after cell grafting, a tumoral lump could be felt by finger touch in 68% of the uremic rats, but in only 11% of the sham-operated and 14% of the nonoperated controls (p less than 0.0001). Throughout the study, the tumoral lumps which developed in the uremic animals were of significantly larger size than in the nonuremic controls. Pulmonary tumoral metastases were evidenced at autopsy in 95% of the uremic rats, but in only 50% of the sham-operated and in 54% of the nonoperated controls (p less than 0.005). These results indicate an apparently accelerating and amplifying effect of uremia on the development of a malignant tumor in the rat, for which a decrease in cell-mediated immunity associated with the uremic state still remains a questionable hypothesis.

Animals↗
PubMed1986

Membranoproliferative glomerulonephritis associated with pulmonary sarcoidosis.

A 34-year-old woman with pulmonary and ganglionary sarcoidosis developed a nephritic syndrome. The renal biopsy demonstrated a type-1 membranoproliferative glomerulonephritis. Clinical and histological remission of the renal disease following indomethacin treatment was associated with the remission of sarcoidosis. Prior reports have emphasized the association of a membranous glomerulonephritis with sarcoidosis. Temporal sequence of events and biological data suggest that hypocomplementemic membranoproliferative glomerulonephritis may be linked to sarcoidosis. The role of immune complexes in the pathogenesis of the 2 diseases is also discussed.

Adult↗
PubMed1986

[Renal lesions induced by cyclosporin. Apropos of 4 renal biopsies and 22 necropsies of recipients of heart transplant].

The morphological study of kidney in patients without any preexistent renal disease and treated by cyclosporine corroborated the nephrotoxicity of this immunosuppressive drug. 4 biopsies (in 2 patients with Behçet's disease, in 1 recipient of allogenic medullary graft and 1 recipient of heart transplant) were performed for acute renal failure observed in a variable time after the beginning of treatment (7th day to 14 months). In two cases, they demonstrated obvious vascular lesions (arteriolar or glomerular thrombosis, fibrinoïd necrosis) and they detected constantly changes of proximal convoluted tubules (epithelial vacuolization or necrosis, calcifications). In addition, the ultrastructural study performed in all cases showed a striking increase of lysosomes and some giant mitochondria. The 8 autopsies of recipients with heart transplants treated by cyclosporine for more than 1 month corroborated also these renal changes which were always correlated with biological perturbations of the renal function (increase of level of serum creatinine). Besides the proximal convoluted tubular lesions (vacuolization, necrosis and calcifications), an obvious increase of the interstitial tissue proportional to the long time of treatment was always detected.

Adolescent↗
PubMed1985

[Anuria caused by tight stenosis of the renal arteries. 2 cases].

Two patients developed anuria associated with tight stenosis, though not complete obstruction, of the renal arteries. This rare and little known accident is found in atheromatous patients with severe arterial hypertension of renovascular origin. It usually occurs when blood pressure falls under the influence of a precipitating factor. Diagnosis rests on angiography. Diuresis is resumed immediately after surgical revascularization. The operation must be performed in every case, even after a long delay, since the kidneys remain viable for a long time due to the development of an extensive collateral circulation. Such anurias are particularly severe in patients with poor underlying condition and when vascular lesions are diffuse.

Acute Kidney Injury↗
PubMed1985

Kidney and cancer: results of immunofluorescence microscopy.

Kidneys obtained at autopsy were studied by immunofluorescence in order to detect the presence of glomerular deposits in 129 patients who had presented with solid tumors, and in 55 patients without carcinoma utilized as controls. Deposits were observed in 22 of the neoplastic patients (17%), but only in 3 of the others (5.4%) (p less than 0.05). Among all solid tumors, glomerular deposits were most often observed in digestive carcinoma (p less than 0.02). These deposits were usually mesangial and they were never subepithelial. IgG and/or IgM and/or C3 deposits were demonstrated in 14 of 22 patients, IgA deposits were present in the 8 others (36%). Thus malignant neoplastic diseases should be taken into account as a possible etiologic factor in IgA nephropathy and they should be looked for in older patients with Berger's disease.

Adult↗