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Biomedical subjects

R D Wagoner

Publications and source records attributed to R D Wagoner.

6 recordsLinked to original sources
PubMed1979

Unilateral essential hematuria.

At the Mayo Clinic between 1961 and 1975, 54 patients presenting with gross hematuria had "essential hematuria" of unilateral origin diagnosed. Criteria for this diagnosis included normal findings on excretory urogram, unilateral bleeding demonstrated at cystoscopic examination, the absence of infection, and a negative history for bleeding diathesis, analgesic abuse, renal surgery, or trauma. Of these patients, 52 responded to follow-up inquiry; 2 died of unrelated causes. Ancillary studies such as renal arteriography, renal biopsy, and repeated excretory urography and cystoscopic examinations were not helpful in establishing a cause, and no explanation for the hematuria was ever found in any of these patients. Although contributing no information as to the cause of unilateral essential hematuria, the study suggests that the patient who fulfills the above criteria need not undergo an extensive workup beyong excretory urography and cystoscopy and that repeated examinations are unnecessary and unrewarding. Most patients continue to do well despite intermittent or persistent hematuria. Essential unilateral hematuria probably is a benign condition that seldom requires surgical intervention.

Adolescent↗
PubMed1976

Analgesic nephropathy--a continuing problem.

Analgesic-induced renal disease occurs more commonly than is recognized; unless specific inquiry is made, it is seldom diagnosed. Patients with chronic pain, especially those with hypertension, urinary tract infection, or renal insufficiency, should be suspect. The condition is preventable and even in the late stages is manageable if recognized. Analgesic abuse may result in end-stage renal disease; it accounts for a significant percentage of patients entering chronic hemodialysis or renal transplant programs.

Analgesics↗
PubMed1975

Fanconi syndrome in adults. A manifestation of a latent form of myeloma.

From a review of 17 cases of Fanconi syndrome with Bence Jones proteinuria and myeloma or amyloidosis, including three new cases reported here in detail, there emerges a well defined set of characteristics. In most cases, the diagnosis of Fanconi syndrome preceded the development of myeloma or amyloidosis. Myeloma preceding the development of Fanconi syndrome has not been reported. All the patients had Bence Jones proteinuria, but in some it could be detected only by electrophoresis or immunoelectrophoresis, In the seven cases in which the Bence Jones protein was typed, it was of kappa type. There were no serum protein monoclonal abnormalities. In the bone marrow and renal samples of half of the patients, crystalline cytoplasmic inclusion bodies were present in lymphoplasmacytic elements and renal tubular cells. It is proposed that patients with Fanconi syndrome and Bence Jones proteinuria have a distinct type of plasma cell disorder or variant of the monoclonal gammopathies, characterized by a slow progression of the tumor and by an early phase dominated by the metabolic complications of the renal proximal tubular dysfunction. Adult patients with Fanconi syndrome should be carefully investigated for the presence of Bence Jones protein and a plasmacytic dyscrasia should be excluded.

Aged↗
PubMed1975

Acute renal failure after excretory urography in diabetic patients.

Currently used contrast media for excretory urography are generally considered safe even in the presence of renal insufficiency. Isolated reports of acute oliguric renal failure in diabetic patients after excretory urography have been documented. We describe eight such patients who developed this complication. The approximate incidence of recognized acute oliguric renal failure in diabetics undergoing excretory urography was 2 in 1000 as compared with none in more than 100 000 procedures done in nondiabetic patients. Six of the diabetic patients with acute renal failure recovered; two required hemodialysis, never regaining self-sustaining renal function. If detected early, acute renal failure in this setting can often be managed conservatively. Attempts to induce diuresis have been discouraging.

Acute Kidney Injury↗