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Biomedical subjects

R S Nanra

Publications and source records attributed to R S Nanra.

At least 19 recordsLinked to original sources
PubMed1994

Eosinophils in acute renal allograft rejection.

Tissue eosinophils have been previously implicated in allograft rejection and graft loss. The aim of this study was to evaluate the role of eosinophils in acute renal allograft rejection. Data from 71 patients with 114 renal biopsies with acute allograft rejection were compared with those from 26 controls. The median tissue eosinophil density (0.4-1.1 eosinophils per micron2 x 10(6)) and the median peripheral blood eosinophilia (1.5-3.0%) in all grades of acute interstitial rejection and in acute vascular rejection were higher than in controls (0.0 eosinophils per micron2 x 10(6), p < 0.0023, and 0.9%, p < 0.035). In all grades of rejection, 36-54% of biopsies had tissue eosinophil density > or = 1 eosinophil per micron2 x 10(6), and 20-36% of patients had peripheral blood eosinophilia > or = 4%, compared with 0% and 4%, respectively, in controls (p < 0.000 and p = 0.0245). The sensitivity, specificity and overall accuracy of predicting acute rejection with tissue eosinophil density > or = 1 eosinophil per micron2 x 10(6) is 41%, 100% and 52%, and for peripheral blood eosinophila > or = 4% is 23%, 96% and 40%, respectively. The median tissue eosinophil density in acute rejection with graft loss was 1.9 eosinophils per micron2 x 10(6) compared to 0.2 eosinophils per micron2 x 10(6) in acute rejection without graft loss (p = 0.014), and 67% of acute rejection with graft loss had tissue eosinophil density > or = 1 eosinophil per micron2 x 10(6) compared with 28% of acute rejection without graft loss (p = 0.028).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1994

The hypo-echoic cortical rim in lupus nephritis.

Hypo-echoic cortical rims are an unusual ultrasound finding in patients with renal disease. A case report is presented of a patient with lupus nephritis who demonstrated hypo-echoic cortical rims. A brief review of the pathological causes of hypo-echoic cortical rims is given.

Adolescent↗
PubMed1993

Analgesic nephropathy in the 1990s--an Australian perspective.

Analgesic nephropathy or analgesic abuse-associated analgesic nephropathy (AA-AAN) is a disease of the twentieth century. The emergence of AA-AAN was due to aggressive marketing of analgesics and the susceptibility of individuals with addictive personalities to analgesic abuse. Analgesic abuse resulted in major morbidity and mortality from renal disease and renal failure, premature atherogenesis with cardiovascular diseases, and the other aspects of the analgesic syndrome; these conditions have had heavy demands upon health budgets. Legislative restriction of analgesic sales in Australia has resulted in a decline in analgesic abuse and end-stage renal failure from AA-AAN. There have also been changes in the analgesic syndrome. However, the long-term risks of transitional cell carcinoma of the uroepithelium remain as a legacy of analgesic abuse and AA-AAN. Nonsteroidal anti-inflammatory drug-associated analgesic nephropathy (NSAID-AAN) has emerged as a distinct clinical syndrome, and may become a significant health problem in view of the widespread use and misuse of NSAIDs.

Analgesics↗
PubMed1992

Pattern of renal dysfunction in analgesic nephropathy--comparison with glomerulonephritis.

Comprehensive renal function tests were performed in 84 patients with analgesic nephropathy, 33 glomerulonephritis patients matched for creatinine clearance, and 30 control subjects. A system of 1-day renal function tests including urine microscopy, creatinine clearance, phenolsulphonphthalein excretion, urine concentration and acidification, and electrolyte excretion, was used. Patients with analgesic nephropathy were found to have significant sterile pyuria and haematuria, even those with mild renal insufficiency, significantly reduced concentrating ability and a distal acidifying defect, and a tendency to impaired sodium conservation. These function defects are consistent with the primary lesion of renal papillary necrosis in analgesic nephropathy; the detection of these defects have implications in patient management.

Adult↗
PubMed1991

Use of the fistula assessment monitor to detect stenoses in access fistulae.

Twenty-three unselected hemodialysis patients with functioning access arteriovenous fistulae were studied prospectively to determine the best technique for detecting stenoses within the fistulae. Combined clinical assessment and fistula assessment monitoring were compared with transbrachial angiography. Fistula assessment monitoring was more accurate (96%) than combined clinical assessment (accuracy, 52%) in stenosis detection. Complications of angiography occurred in 17% of patients; there were no complications of fistula assessment monitoring. Fistula assessment monitoring was better than combined clinical assessment in predicting clinical outcome for arteriovenous fistulae over 6 months and was as good as angiography. Routine fistula assessment monitoring could reduce inappropriate angiography and detect clinically significant silent stenoses. It is an ideal method for monitoring arteriovenous access fistulae.

Angiography↗
PubMed1991

Acute renal failure due to acute pyelonephritis.

We report a case of biopsy-proved acute pyelonephritis which caused acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function was slow and incomplete. Renal papillary necrosis was an apparent complication, which the patient may have been predisposed to by alcoholism. Although rare, acute pyelonephritis is an important consideration in the differential diagnosis of acute renal failure because of the need for specific therapy.

Acute Kidney Injury↗
PubMed1989

Xanthogranulomatous pyelonephritis in a renal allograft: a case report.

We report a case of xanthogranulomatous pyelonephritis in a renal allograft. The kidney was not removed and there was an initial response to antibiotic therapy, with amelioration of toxicity and improvement in renal function. However, the kidney failed 10 months later in association with histological changes of chronic rejection.

Anti-Infective Agents, Urinary↗
PubMed1984

Gangrenous colitis in the haemolytic-uraemic syndrome.

The cases of two children with the haemolytic-uraemic syndrome (HUS) in whom clinical signs of intussusception necessitated emergency surgical intervention are reported. Both patients had bilateral renal cortical necrosis and haemorrhagic gangrenous colitis; both subsequently died. The early recognition and appropriate management of HUS is advocated.

Child, Preschool↗
PubMed1983

Renal effects of antipyretic analgesics.

Most antipyretic analgesics can cause acute nephrotoxic effects, including acute tubular necrosis, acute interstitial nephritis, glomerular toxicity, and functional changes, such as "salicyl edema," following large doses of sodium salicylate. Most functional changes are related to acute suppression of prostaglandin synthesis, "the acute prostaglandin-effect," and have been primarily noted with the use of indomethacin. The association between prolonged and excessive consumption of compound analgesics and the development of renal disease and renal failure, characterized by renal papillary necrosis, is now well established. Studies in several countries have shown that the incidence of analgesic nephropathy as an indication for dialysis and transplantation corresponds to the per capita consumption of phenacetin in compound analgesics. Analgesic nephropathy, which is part of a wider clinical syndrome, the analgesic syndrome, is uncommon following the use of single analgesics. Analgesic nephropathy and the analgesic syndrome are discussed in detail, including the development of uroepithelial tumors.

Animals↗
PubMed1983

Post-obstructive diuresis.

A patient with post-obstructive diuresis is described. Inappropriate losses of salt and water occurred, with urine volume exceeding half the glomerular filtration rate. Additionally, excessive urinary excretion of potassium, bicarbonate, calcium, phosphate, magnesium and urate took place in the presence of subnormal blood levels. Transient proteinuria was also observed. This case demonstrates that serious electrolyte disturbances can occur after relief of urinary tract obstruction and the evidence suggests these may be due to disordered proximal tubule function.

Diuresis↗
PubMed1982

Unusual radiological changes associated with probable Bartter's syndrome.

We report 2 cases that fulfill some of the criteria for the diagnosis of Bartter's syndrome and were associated with marked radiological changes. Both patients demonstrated distortion of the caliceal pattern with medullary cavities and loss of cortical substance in the absence of vesicoureteral reflux. However, the glomerular filtration rate was well preserved. It seems unlikely that known organic renal disease was responsible for these changes and the potassium-losing state. These radiological findings also do not appear to be a consequence of hypokalemia and their pathogenesis remains uncertain.

Adult↗
PubMed1981

Consequences of legislative restriction on the sale of compound analgesics in Newcastle (N.S.W., Australia).

In June 1979 legislation was enacted in New South Wales to restrict the sale of compound analgesics. The consequences of this legislation were assessed by a household survey in Newcastle, New South Wales, during November 1979. This survey followed an identical survey in the same community in November 1977. After legislation, a marked decrease was found in the proportion of homes having compound analgesics. A small decrease in total analgesic usage was also observed, though this was not necessarily related to the legislative restrictions. The legislative restrictions did not result in any substantial increase in use of the doctor to obtain prescriptions for compound analgesics, or any substantial increase in reported health problems. The results suggest that legislation is an effective method of inducing rapid change in health-related behavior.

Adolescent↗