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Biomedical subjects

A Ahsan Ejaz

Publications and source records attributed to A Ahsan Ejaz.

9 recordsLinked to original sources
PubMed2007

Effect of elevated serum uric acid on cisplatin-induced acute renal failure.

Marked hyperuricemia is known to cause acute renal failure via intrarenal crystal deposition. However, recent studies suggest mild hyperuricemia may have vasoactive and proinflammatory effects independent of crystal formation. We therefore tested the hypothesis that mild hyperuricemia might exacerbate renal injury and dysfunction in a model of cisplatin-induced acute renal failure in the rat. Cisplatin was administered to normouricemic and hyperuricemic rats (the latter generated by administering the urate oxidase inhibitor, oxonic acid). Recombinant urate oxidase (rasburicase) was administered in a third group to assess the effect of lowering uric acid on outcomes. Other control groups include normal rats and hyperuricemic rats without cisplatin-induced injury. Cisplatin induced injury of the pars recta (S3) segment of the proximal tubule in association with a mild monocyte infiltration. Hyperuricemic rats showed significantly greater tubular injury and proliferation with significantly greater macrophage infiltration and increased expression of monocyte chemoattractant protein-1. However, renal function was not different between normouricemic and hyperuricemic rats with cisplatin injury. Treatment with rasburicase reversed the inflammatory changes and lessened tubular injury with an improvement in renal function (relative to the hyperuricemic group). No intrarenal crystals were observed in any groups. These data provide the first experimental evidence that uric acid, at concentrations that do not cause intrarenal crystal formation, may exacerbate renal injury in a model of acute renal failure. The mechanism may relate to a proinflammatory pathway involving chemokine expression with leukocyte infiltration.

Acute Kidney Injury↗
PubMed2006

Characteristic findings on 24-h ambulatory blood pressure monitoring in a series of patients with Parkinson's disease.

BACKGROUND: Patients with Parkinson's disease frequently present with orthostatic hypotension, prompting testing with 24-h ambulatory blood pressure monitoring (ABPM). The aim of our study was to identify characteristic patterns of blood pressure changes present on ABPM in a series of patients with Parkinson's disease. METHOD: We retrospectively identified 13 patients with Parkinson's disease who had undergone ABPM for evaluation of symptomatic orthostatic hypotension. The ABPM tracings were analyzed for the presence or absence of reversal of circadian pattern, postprandial hypotension, noncompensatory heart rate variability, and average daytime and nocturnal blood pressure values. RESULTS: Reversal of circadian rhythm was identified in 92.3%, postprandial hypotension in 100% and nocturnal hypertension in 100% of the cases. Some 61.5% of the patients exhibited daytime blood pressures in the prehypertensive range, and 23% had blood pressures in the stage 1 hypertension range per JNC 7 classification. CONCLUSION: The characteristic findings on 24-h ABPM in this series of patients with Parkinson's disease were the presence of reversal of circadian rhythm (93%), postprandial hypotension (100%) and nocturnal hypertension (100%).

Journal Article↗
PubMed2006

Regional citrate anticoagulation in continuous venovenous haemofiltration using commercial preparations.

AIM: The aim of the present study was to test the feasibility of using commercial preparations of replacement and citrate anticoagulation solution in continuous venovenous haemofiltration (CVVH) in a safe, efficient and simple manner. METHODS: Retrospective review of the database of a large continuous renal replacement therapy programme that uses a standardized prescription of high ultrafiltrate CVVH with commercial solutions for replacement fluid and regional citrate anticoagulation was performed. RESULTS: Records of 28 patients who underwent 91 CVVH sessions were analysed. Median circuit survival time was 37 (59.5-15.5) h and the 48 h survival probability was 40%. Bleeding or metabolic complications were not noted, and the procedure was simple to administer. CONCLUSION: Continuous venovenous haemofiltration using commercial preparations of replacement fluid and citrate anticoagulation can be safe, efficient and simple.

Acute Kidney Injury↗
PubMed2005

Focal segmental glomerulosclerosis in kidney resected for renal cell carcinoma.

A diagnosis of renal dysfunction is usually made on the basis of clinical, biochemical, radiologic, and renal tissue analysis. Accurate diagnosis often requires a renal biopsy, but that procedure is contraindicated in certain clinical circumstances, particularly in patients who have only one kidney. We describe a patient who previously had undergone left nephrectomy for a renal clear cell carcinoma, in whom the diagnosis of focal segmental glomerulosclerosis was made on retrospective analysis of remnant renal tissue from the patient's nephrectomy specimen.

Carcinoma, Renal Cell↗
PubMed2005

Glomerular tip lesion associated with nonsteroidal anti-inflammatory drug-induced nephrotic syndrome.

Glomerular tip lesion and its relation to different glomerular diseases is a subject of controversy. The therapeutic and prognostic clinical implications of glomerular tip lesions are ambiguous. We present a case of glomerular tip lesion associated with nonsteroidal anti-inflammatory drug-induced nephrotic syndrome that further complicates this issue. To our knowledge, this is the first case report of glomerular tip lesion associated with nonsteroidal anti-inflammatory drug-induced nephrotic syndrome.

Accidents, Traffic↗
PubMed2004

Bisalbuminemia in chronic kidney disease.

Hereditary and acquired bisalbuminemia, in which the serum contains an albumin variant differing from albumin A by single amino-acid substitutions, have been reported in different races or ethnic groups and in association with various pathologic states. The importance of this rare condition in the pathophysiology of established diseases is uncertain. We evaluated a 68-year-old woman with chronic kidney disease who presented with worsened serum creatinine concentration despite lack of dietary or medical changes. Serum protein electrophoresis was performed with an automated rapid electrophoresis system. Bisalbuminemia was noted as an incidental finding on serum protein electrophoresis. The serum creatinine level stabilized with dietary protein restriction and a beta-blocking agent/diuretic combination for blood pressure control. Although the possibility that some physiologic or pharmacologic substances may not bind to abnormal albumin variants as well as they bind to normal albumin should not be discounted, the finding of bisalbuminemia did not influence the diagnosis, management, course, or prognosis of chronic kidney disease. The role of persistent bisalbuminemia in renal disease is uncertain.

Acute Kidney Injury↗
PubMed2004

Erythema multiforme associated with candesartan cilexetil.

Candesartan cilexetil is an angiotensin II receptor antagonist that is widely used in the treatment of hypertension. It is generally well tolerated and rarely has adverse effects. We report the case of a 50-year-old man with a 3-year history of hypertension that was difficult to manage because of intolerance to multiple medications. Treatment with candesartan cilexetil was initiated, and blood pressure control improved markedly. Five weeks later, the patient presented with a 2 x 3-cm ulcerative plaque covered with a fibrinous exudate on the right upper lip. Findings from a biopsy of the upper lip were diagnostic for erythema multiforme. Treatment with candesartan cilexetil was discontinued, and the lesions resolved completely within a few weeks. To our knowledge, this is the first report of erythema multiforme induced by the antihypertensive medication candesartan cilexetil.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2004

Characteristics of 100 consecutive patients presenting with orthostatic hypotension.

OBJECTIVE: To elucidate the demographic and clinical characteristics of a consecutive series of patients who presented for evaluation of orthostatic hypotension. PATIENTS AND METHODS: From January 1, 1997, through September 30, 2001, we assessed retrospectively the demographic and clinical characteristics, antihypertensive medication use, and blood pressure variability in 100 consecutive patients with orthostatic hypotension who underwent 24-hour ambulatory blood pressure monitoring (OH group) and in a convenience sample of 100 age-matched patients who underwent 24-hour ambulatory blood pressure monitoring for evaluation of hypertension (HTN group). RESULTS: The OH group had a mean +/- SD age of 71.6 +/- 9.4 years, and 42% were women. The most common symptoms were light-headedness and weakness. Comorbid conditions included neurologic diseases (38%), preexisting hypertension (36%), hyperlipidemia (31%), cardiac arrhythmias and coronary artery disease (45%), and neoplasm (28%). During ambulatory blood pressure monitoring, postprandial decreases in blood pressure were noted in 83% of the OH group, supine or sleep hypertension in 84%, and noncompensatory heart rate variability in 75%. Findings on autonomic testing were abnormal in 99% of patients, serum creatinine value was increased in 30%, proteinuria was present in 27%, and left ventricular hypertrophy was present in 20%. CONCLUSIONS: Orthostatic hypotension is present in a heterogeneous group of disease states, is usually symptomatic, and is often associated with an abnormal blood pressure profile of reversal of circadian pattern, postprandial hypotension, and noncompensatory heart rate variability. Consequent target organ (kidney) damage can be as frequent as in patients who undergo 24-hour ambulatory blood pressure monitoring for evaluation of hypertension.

Adult↗