Biomedical subjects

A Rodríguez Jornet

Publications and source records attributed to A Rodríguez Jornet.

At least 19 recordsLinked to original sources

PubMed2005

[Ischemic renal disease: revascularization or conservative treatment?].

Ischemic nephropathy is recognized as a distinct cause of renal insufficiency and it is defined as a significant reduction in glomerular filtration rate in patients with hemodynamically significant renovascular occlusive disease. We argue the epidemiologic and clinical manifestations of atherosclerotic renovascular disease, and we evaluate the pronostic agents. Published studies of the outcome of revascularization for renal-artery stenosis have been excellent, offering a durable patency and functional improvement but they have had numerous limitations. The atherosclerosis is a systemic disease and it provides the general prognosis of patients. We conclude that ischemic renal disease is a nephropathy of smoker men, with proteinuria excretion similar to nephropathy with unilateral stenosis. The age of patients is the clinical feature that decide the treatment: surgery, angioplasty/stent or medical management. Comparative analysis of percutaneous transluminal angioplasty and operation for renal revascularization and medically treated patients have proved that the advanced chronic renal insufficiency is associated with an unfavourable response of treatment of the ischemic nephropathy. But, in this nephropathy the revascularization can be the better therapy for selected patients. The revascularization with angioplasty/stent for patients with unilateral renal stenosis and chronic renal insufficiency has a doubtful effectiveness, as the chronic renal failure is result of nephroangiosclerosis.

Adult↗

PubMed2005

[Diagnosis and prognosis of atheroembolic disease].

Atheroembolic disease is recognized as an iatrogenic complication from an invasive vascular procedure, such as manipulation of the aorta during angiography or vascular surgery, and after anticoagulant and fibrinolytic therapy. Cholesterol crystal embolism is caused by showers of cholesterol crystals from an atherosclerotic aorta that occlude small arteries. The kidney is a frequent target organ for cholesterol emboli because of proximity of the renal arteries to abdominal aorta and it receive an enormous amount of blood flows. We describe the epidemiologic agents of 19 cases that were diagnosed by histologic sections of the affected tissues; the eosinophilia and the renal failure are the clinical features that guide to the diagnosis, in patients with ischemic nephropathy and general atherosclerosis. 53% among patients had a previous invasive procedure and 26% occurred spontaneously. We remark the importance of the kidney's biopsy in diagnosis of the atheroembolic disease and their bad prognosis with 63% of death rate in 18 months of average follow-up. We report patients with the multiple cholesterol emboli syndrome mimicking systemic vasculitis: they died by multivisceral acute failure. The subacute presentation of atheroembolic disease with progressive renal failure treated with hemodialysis is a sign of bad prognosis. The knowledge of the disease and their prevention are the better treatment.

Adult↗

PubMed2004

[Acute renal insufficiency associated to cocaine consumption].

Acute renal insufficiency associated to cocaine consumption is well known, and normally secondary to rhabdomyolisis. The possibility that renal failure is related to hypertension and to renal histopathological findings indistinguishable of other malignant hypertension conditions is a not as well known fact. Certain derivatives of cocaine are powerful vasospasm inducers, which could be the key of the origin of the ischemic lesions that appears not only in the kidney but in other organs, especially in the nervous system. We present four patients with acute renal insufficiency, two of them because of malignant hypertension, another one because of cocaine consumption with very severe ischemic neurological lesions, but reversible with the withdrawal of the drug, and another one because of rhabdomyolisis. The latest patient had a different evolution probably related to the different habit of consumption and perhaps as a consequence of different derivatives of cocaine.

Acute Kidney Injury↗

PubMed2004

[Arteriovenous fistula: complication of renal biopsy. Superselective embolization].

The arteriovenous fistula can be a major and late complication of percutaneous renal biopsies of native kidneys. The incidence of arteriovenous fistulas appears to be low and has been infrequently mentioned in large series of biopsies although there are a number of individual reports. In most part of cases, no systemic effects of the arteriovenous fistulas were observed, so they close by themselves. Optimization of renal biopsy techniques aims not only at obtaining kidney tissue technically adequate for diagnosis, but at reducing biopsy-induced complications. When these complications are done, the new transvascular techniques can get the healing of fistula with the embolism by catheters. We describe the case of a 37-year-old woman who had chronic renal failure by a possible chronic glomerulonephritis. She developed deterioration of renal function after the percutaneous renal biopsy. An arteriovenous fistula of high flow was detected by Doppler ultrasound. Then, it was confirmed angiographically and closed by embolism's catheter without damage of renal tissue.

Adult↗

PubMed2002

[40-year-old man with primary antiphospholipid syndrome].

We report the case o a 40-year-old male patient with "primary antiphospholipid syndrome" who developed ischemic cerebral infarctions and renal microangiopathy with infarction. A review of the literature on renal involvement in the primary antiphospholipid syndrome disclosed the differences from the antiphospholipid syndrome in the systemic lupus erythematosus. We describe the evolution of the patient at eight years, and we emphasize the importance of the treatment with warfarin. Also, we review the pathophysiology of severe secondary arterial hypertension.

Adult↗

PubMed1991

[Necrotizing vasculitis with predominant kidney involvement].

We report five patients with necrotizing vasculitis with predominant renal involvement; the diagnostic and therapeutics was effected completely at regional hospital. We detach: a) the clinical presentation's forms with rapidly progressive renal failure with microscopic hematuria and minimal proteinuria; b) the biopsy of kidney with necrotizing vasculitis or necrotizing glomerulonephritis (microscopic polyarteritis). We review the necrotizing vasculitis with predominant renal involvement in its pathogenic, clinical and histological aspects, and we insist that the diagnostic and early treatment are fundamental for prognostic's improvement of these patients. We conclude that this diagnostic and treatment can be made in regional hospitals with sensible physicians by the theme.

Aged↗

PubMed1988