PubMed Health⌕ Search

Biomedical subjects

G Deray

Publications and source records attributed to G Deray.

At least 55 records · Page 3Linked to original sources
PubMed2001

Retinopathy, hematuria, and diabetic nephropathy.

We have retrospectively analyzed the incidence of diabetic nephropathy in 21 diabetic patients who underwent renal biopsy between 1985 and 1995 for microscopic hematuria and/or proteinuria >2.5 g/day without retinopathy. Diabetic nephropathy was observed in 13 of 21 patients (62%). 50% of our patients with diabetic nephropathy had hematuria, the incidence being higher in type I as compared with type II diabetic patients (30 vs. 20%). Diabetic nephropathy without retinopathy but with hematuria was noted in 5 of 13 patients, and diabetic nephropathy without retinopathy and hematuria was also noted in 5 of 13 patients. We suggest from our retrospective analysis that renal-retinal diabetic syndrome really exists.

Adult↗
PubMed2001

Pharmacokinetics of abacavir in HIV-1-infected patients with impaired renal function.

BACKGROUND: Abacavir is a potent, novel 2'-deoxyguanosine analogue reverse transcriptase inhibitor (NRTI) which effectively suppresses HIV-1 replication. To date, there is no pharmacokinetic study in patients with renal impairment. METHODS: Five HIV-1-infected patients with various degrees of renal dysfunction (creatinine clearance 60, 40, 25, 20 and 1 haemodialyzed patient) were evaluated after being treated for at least 2 months with multi-antiretroviral therapy including abacavir. After an overnight fast, the subjects received their abacavir dosage (600 or 300 mg). Blood samples were withdrawn and plasma concentrations determined. A nonparametric pharmacokinetic analysis was then performed. The dialysability of abacavir was also evaluated. RESULTS: Time of maximum plasma concentration (T(max)) was constant among the subjects with a mean value of 0.7 +/- 0.27 h (range 0.33-1). Maximum plasma concentration (C(max)) ranged from 2.76 to 4.15 mg/l (mean 3.44 +/- 0.59). The elimination half-life ranged from 1.31 to 2.67 h (mean 2.08 +/- 0.51). Normalized C(max)/dose ranged from 0.007 to 0.014 mg/l and normalized AUC(0-inf)/dose ranged from 0.014 to 0.035 mg.h/l. In haemodialysis the dialysance was 60-80 ml/min with a fractional drug removal of 24% during a 4-hour haemodialysis session with a high permeability membrane. DISCUSSION: In our patients, absorption, elimination and distribution phases were not altered by renal insufficiency. Furthermore, our pharmacokinetic data are similar to those obtained in patients with normal renal function. Therefore, dosage adjustment is not necessary in patients with renal insufficiency. In haemodialyzed patients, treatment can be administered independently to the dialysis session because of the negligible elimination of abacavir in the dialysate.

Administration, Oral↗
PubMed2000

MR imaging features of acute bilateral renal cortical necrosis.

Bilateral renal cortical necrosis (BRCN) is an uncommon cause of acute renal failure. Kidney biopsy, arteriography, and contrast-enhanced computed tomography (CT) are usually used to diagnose BRCN. However, these methods can have potentially serious side effects. We report two cases in which magnetic resonance imaging (MRI) evidenced characteristic features of BRCN, which were confirmed by histological findings and arteriography and correlated with clinical evolution. In the first case report, the diagnosis of a massive and complete cortical necrosis variety was suggested on MRI that showed a thin rim of low signal intensity along border of kidneys. It was confirmed on kidney biopsy, and the renal function did not recover. The second case is an incomplete form with cortical patchy areas of low signal intensity. In these two patients, MRI helped to establish an early diagnosis of BRCN with characteristic representative findings, without the potential nephrotoxic effects of iodinated contrast that has to be used in CT and arteriography. Kidney biopsy, besides the risks of complications, provides only a parceled analysis of the renal tissue and therefore does not allow any conclusion as to the extension of cortical necrosis. MRI may be of great help for the diagnosis and follow-up of acute renal cortical necrosis.

Adult↗
PubMed2000

Transjugular versus percutaneous renal biopsy for the diagnosis of parenchymal disease: comparison of sampling effectiveness and complications.

PURPOSE: To compare the effectiveness and safety of transjugular renal biopsy with those of percutaneous renal biopsy for diagnosis of renal parenchymal disease. MATERIALS AND METHODS: Results and complications of 400 consecutive transjugular renal biopsies performed between 1993 and 1998 with a modified Colapinto transjugular hepatic biopsy system were compared retrospectively with those of 400 percutaneous renal biopsies performed during the same period. Transjugular renal biopsy was associated with 14 cardiac and 35 hepatic biopsies. Number of glomeruli per tissue core, adequacy of tissue core for histopathologic diagnosis, and rate and severity of complications were analyzed. RESULTS: Renal tissue was obtained with percutaneous renal biopsy in 382 (95.5%) of 400 patients and with transjugular renal biopsy in 383 (95.8%) of 400 patients. The mean numbers of intact glomeruli per tissue core with optical microscopy were 11.2 +/- 7.7 (SD) and 9.8 +/- 7.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. With immunofluorescent microscopy, the mean numbers were 6.4 +/- 5.3 and 4.6 +/- 4.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. Tissue cores were adequate for histopathologic diagnosis in 98.2% with both techniques. Major complications occurred with transjugular renal biopsy in four patients and with percutaneous renal biopsy in three patients. CONCLUSION: Use of transjugular renal biopsy provides diagnostic yield and safety similar to those of percutaneous renal biopsy and allows multiorgan biopsy during the same procedure. It can be recommended in patients with percutaneous renal biopsy contraindication or failure.

Adult↗
PubMed2000

Retroperitoneal fibrosis and membranous nephropathy.

We report on a patient with a past history of Pott's abscess who suffered both from a retroperitoneal fibrosis and a membranous glomerulonephritis. Five cases of retroperitoneal fibrosis and immune complex glomerulonephritis are already reported in the literature. These associations might result from a particular systemic immune response to an unknown antigen. Consequently, we consider the role of tuberculosis in our case.

Adult↗
PubMed1999

[Nephro-protective effect of calcium antagonists].

ACTION OF CALCIUM ANTAGONISTS: In patients with chronic renal failure, controlling hypertension is an integral part of the therapeutic scheme aimed at preventing further degradation of renal function. Hypertension accelerates such degradation and inversely the renal disease aggravates hypertension. Normal blood pressure is thus crucial. Several studies have elucidated the action of calcium antagonists in these patients. KIDNEY TRANSPLANT RECIPIENTS: Calcium antagonists have several highly favorable effects on the transplanted kidney. These effects are explained by the attenuation of the ischemic effects of cyclosporin on the kidney. These patients should be given a calcium antagonist which does not raise the serum level of cyclosporin. DIABETIC NEPHROPATHY: In acute regimens, all calcium antagonists do not appear to have the same effect in patients with diabetic nephropathy. With the notable exception of nifedipine, calcium antagonists can lower acute proteinuria in these patients. Three controlled sudies conducted for more than 6 months have shown that the proteinuria lowering effect of calcium antagonists is equivalent to that of CEIs. Combined CEI and a calcium antagonist is probably the prescription of choice for these patients. Besides the antihypertensive synergism, this combination reduces the side effects of each class prescribed alone. In addition, there is experimental evidence supported by several clinical trials showing an improved nephroprotector effect compared with single prescription of each drug class alone. MECHANISMS OF NEPHROPROTECTION: Chronic renal failure results form intricated hemodynamic and cellular mechanisms. A lower intraglomerular hydrostatic pressure is a crucial element in nephroprotection. All the intrarenal effects of calcium antagonists have not been identified. Certain effects concern preglomerular vasodilatation alone while others have pre- and post-glomerular effects and thus have a potentially greater nephroprotector effect.

Calcium Channel Blockers↗