International Journal of Clinical Nephrology最新文献

{"title":"Dual Glomerular Lesion in Hiv Patient","authors":"José Lucas. Daza","doi":"10.31579/2834-5142/016","DOIUrl":"https://doi.org/10.31579/2834-5142/016","url":null,"abstract":"HIV-associated nephropathy (HIVAN), the classic kidney disease associated with HIV infection, was first described in 1984 as a complication of AIDS although HIVAN may also occur in patients with less advanced HIV infection or following acute seroconversion Histologically, HIVAN is a collapsing form of focal segmental glomerulosclerosis (FSGS) accompanied by microcystic tubular dilatation and interstitial inflammation. HIV-immune complex kidney disease (HIVICK). Other immune complex diseases may also occur in HIV-infected patients, including IgA nephropathy and postinfectious glomerulonephritis, and are best diagnosed as those specific entities The pathophysiological mechanism of HIVAN injury is mediated by direct infection of renal epithelial cells by HIV, expression of intrarenal viral genes, and dysregulation of host genes by modulating cell differentiation and the cell cycle. In contrast, kidney disease by HIV immune complexes (HIVICK) involves a different immune mechanism with antibody deposits within glomerular structures. Both entities progressively present different degrees of proteinuria and progressive decrease in the glomerular filtration rate, depending on the commitment or histology suffered by the patient. In this case reports patient with clinical picture of 3 months of evolution of temporo-spatial disorientation and alteration of the state of consciousness associated with hyperthermia. We perform neuroimaging without alterations, a lumbar puncture performed with evidence of an infectious process by coconuts + in the GRAM of the cerebrospinal fluid, normochromic normocytic anemia and renal failure, sub nephrotic proteinuria, glomerular hematuria, HIV positive, recount of normal CD4, renal biopsy with diagnosis of immune-mediated glomerulonephritis (IgG and C3), in the immunofluorescence (HIVICK) and with membrano pattern proliferative and in two glomeruli focal segmental sclerosis collapsing variant (HIVAN)is observed.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127356145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Prognostic Factors for Survival of Clear Cell Renal Carcinomas","authors":"Pablo Francisco Colaci","doi":"10.31579/2834-5142/017","DOIUrl":"https://doi.org/10.31579/2834-5142/017","url":null,"abstract":"Tumor size, histologic grade, and TNM classification characterize kidney tumors and provide a useful prognosis for predicting survival in research and medicine. Our objective was to determine the postoperative survival of operated patients with a diagnosis of clear cell renal carcinomas (CCRC) and to evaluate its relationship with other prognostic factors. Age, sex, clinical presentation, size, Fuhrman nuclear grade, tumor-nodule-metastasis (TNM) stage, and the presence of local invasion were retrospectively analyzed in 66 patients operated on for clear cell renal carcinomas. Clinical follow-up was performed for 5 years to determine postoperative survival. During the follow-up period, 17 deaths occurred, with the cancer-specific survival rate being 77%. The presenting symptoms of the tumor that led to the diagnosis were not related to postoperative survival. The estimated survival for stages T2 was 100%, for T1 it was 93%, and for T3 it was 55%. No patients were found in stage T4. The lower Fuhrman grades (I and II) had an 85% survival rate, while the higher grades (III and IV) had a 53% survival rate. Survival rates also varied depending on the type of adjacent tissue that was affected. Specifically, survival decreased to 80% when infiltrating the renal capsule, 70% when infiltrating the perirenal tissues, and 28% when invading the renal vein. We can conclude that tumor size in CRCC is not a prognostic factor that allows determining postoperative survival independently, and for this reason, it should be considered as a variable that acquires importance when evaluated together with the presence of vascular invasion or adjacent tissues. We can confirm that the Fuhrman Histological Grade is useful as an independent parameter of survival when grouped into low and high grades.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130252787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glioblastoma in Vietnam War veterans and DU: a major example of brain contamination through inhalation – and general lessons of depleted uranium study and similar issues for nephrology","authors":"F. Pirot","doi":"10.31579/2834-5142/006","DOIUrl":"https://doi.org/10.31579/2834-5142/006","url":null,"abstract":"This paper makes a summary on the Vietnam War veterans and their particular pattern of cancer; it explains this pattern with earlier work of the author. Lessons for nephrology are drawn from the general research of the author on uranium in internal contamination.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125740156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Bariatric Surgery Improve Kidney Function in obese Patients? A Cohort Study","authors":"Juliana Amaro Borborema Bezerra","doi":"10.31579/2834-5142/013","DOIUrl":"https://doi.org/10.31579/2834-5142/013","url":null,"abstract":"Introduction: Obesity is a global epidemic that may cause renal dysfunction. Weight loss in the postoperative follow-up of bariatric surgery may improve renal function in these patients. Thus, the purpose of this study was to give insight on the subject using a sensible biomarker: cystatin C. Materials and methods: This cohort was performed in the Obesity Department from Campina Grande – Paraiba, Brazil. It was recruited 35 obese (25 women and 10 men) who underwent bariatric surgery with follow-up of at least one year. The ages ranged from 24 and 57 years. Those with thyroid disease and with microalbuminuria ≥ 30mg/g were excluded. Serum levels of creatinine and cystatin C were measured, and the glomerular filtration rate (GFR) was estimated using the CKD Epi (Chronic Kidney Disease Epidemiology Collaboration) equation creatinine- cystatin C. The investigation was approved by the Ethics Committee. The sample was of convenience. Quantitative variables were expressed by the mean and standard deviation. Paired tests were used for assessing difference between means. Chi square test and exact Fisher were used for difference among frequencies. p ≤ 0.05 was used for rejecting the null hypothesis. Results:The most frequent associated morbidities were: sexual dysfunction (n = 17 – 48.5%); hypertension (n =15 – 42.8%); type II diabetes (n =13 – 37.1%); anxiety (n = 14 – 40.0%); and depression (n = 12 – 34.2%). Twenty-three (65.7%) patients underwent sleeve technique and 12 (34.2%) bypass surgery. It was observed a significant reduction in the mean of body mass index (BMI) in the post-operative follow-up – p < 0.0001. The mean concentrations of cystatin C were similar, regarding to pre- and post-operative periods – p = 0.1614. There was a significant improvement of glomerular filtration rates - p= 0.0091. The improvement of renal function was more significant among those who underwent sleeve surgery as compared to bypass - p = 0.0008. Conclusion: It was observed improvement of the majority of morbidities after bariatric surgery, as well as renal function, in obese individuals. Despite these results, larger and longer-term outcome cohorts are required for better answer of the main purpose of this health issue.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114382756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Medullary Fibroma- A Histopathological Surprise in a Patient With an Asymptomatic Abdominal Mass","authors":"A. Cherukumudi","doi":"10.31579/2834-5142/002","DOIUrl":"https://doi.org/10.31579/2834-5142/002","url":null,"abstract":"Renal medullary fibroma is a fairly common, but unusual benign mass lesion of the kidney. These are often small in size, and rarely produce symptoms; hence they frequently go unnoticed, diagnosed only during autopsy in most cases. Very rarely, they achieve large enough sizes to produce compressive symptoms or a clinically palpable mass. This tumour, however, poses a radiological dilemma, as it cannot be differentiated from malignant lesions of the renal parenchyma. Here we present a unique case of an asymptomatic, incidentally detected left renal mass, which was reported as renal medullary fibroma, a benign disease.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127387310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Painful Killer; Calciphylaxis: Let No Disease Pull You Down So Low So As You Quit In Despair","authors":"A. Magbri","doi":"10.31579/2834-5142/001","DOIUrl":"https://doi.org/10.31579/2834-5142/001","url":null,"abstract":"The patient is 72 years old Caucasian male with end-stage renal disease on hemodialysis, type-2 diabetes mellitus, obstructive sleep apnea with respiratory insufficiency, calcific aortic stenosis and congestive heart failure. He developed ulcers in the upper thighs, and lower abdomen with violations skin around the ulcers.","PeriodicalId":382890,"journal":{"name":"International Journal of Clinical Nephrology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127305732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}