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PubMed1991

[Kimura disease with minimally proliferative glomerulonephritis].

A 45-year-old Turk had a year ago noticed a submandibular and a retroauricular node-like swelling, about 2 cm in diameter each, firm and freely mobile. During the preceding two months he had polydipsia and polyuria. Recently he developed a nephrotic syndrome with lower-leg oedema and proteinuria (14 g albumin in 24-hour urine). The concentrations of IgE (250 IE/ml) and IgA (745 mg/dl) were raised, and there was eosinophilia of 14%. Renal needle biopsy revealed glomerulonephritis with minimal proliferation. Excision of part of the nodular tumour revealed histologically the typical signs of Kimura's disease (eosinophilic follicular lymphadenitis of the skin; subcutaneous angiolymphoid hyperplasia with eosinophilia). During treatment with prednisolone, 20 mg daily by mouth, the clinical and biochemical findings regressed within two weeks. But eight weeks later, after dose reduction to 10 mg daily, the nephrotic syndrome recurred so that the dosage had to be increased again to 20 mg prednisolone daily. On this treatment the patient has now been symptom-free for six months. This case demonstrates the unusual association of Kimura's disease with minimally proliferative glomerulonephritis.

Angiolymphoid Hyperplasia with Eosinophilia↗

PubMed1988

[Alcoholic ketoacidosis. An important differential diagnosis from diabetic ketoacidosis].

Ketoacidosis developed in two patients, a woman aged 36 and a man aged 55 years, 48 and 36 hours, respectively, after a bout of drinking alcohol to excess. Both were dehydrated with hyperventilation and signs of cachexia. Other findings were polydipsia, polyuria, loss of weight and (in the woman) abdominal pain. Biochemical tests revealed a marked metabolic acidosis (pH 7.00 and 7.09, respectively), base deficit of -25 and -20 mmol/l, hyperglycaemia (210 and 297 mg/dl) and hyperkalaemia (6.3 and 6.0 mmol/l). Treatment with insulin and fluids, as well as normalization of the electrolytes, brought about rapid regression of the metabolic disorder and restoration of the carbohydrate metabolism. Both patients were discharged without medication or dietary prescription, other than abstinence from alcohol.

Acidosis↗

PubMed2005

Nephrogenic diabetes insipidus in mice lacking all nitric oxide synthase isoforms.

Nitric oxide (NO) is produced in almost all tissues and organs, exerting a variety of biological actions under physiological and pathological conditions. NO is synthesized by three different isoforms of NO synthase (NOS), including neuronal, inducible, and endothelial NOSs. Because there are substantial compensatory interactions among the NOS isoforms, the ultimate roles of endogenous NO in our body still remain to be fully elucidated. Here, we have successfully developed mice in which all three NOS genes are completely deleted by crossbreeding singly NOS-/- mice. NOS expression and activities were totally absent in the triply NOS-/- mice before and after treatment with lipopolysaccharide. Although the triply NOS-/- mice were viable and appeared normal, their survival and fertility rates were markedly reduced as compared with the wild-type mice. Furthermore, these mice exhibited marked hypotonic polyuria, polydipsia, and renal unresponsiveness to an antidiuretic hormone, vasopressin, all of which are characteristics consistent with nephrogenic diabetes insipidus. In the kidney of the triply NOS-/- mice, vasopressin-induced cAMP production and membranous aquaporin-2 water channel expression were reduced associated with tubuloglomerular lesion formation. These results provide evidence that the NOS system plays a critical role in maintaining homeostasis, especially in the kidney.

Analysis of Variance↗

PubMed2006

Congenital progressive hydronephrosis (cph) is caused by an S256L mutation in aquaporin-2 that affects its phosphorylation and apical membrane accumulation.

Congenital progressive hydronephrosis (cph) is a spontaneous recessive mutation that causes severe hydronephrosis and obstructive nephropathy in affected mice. The mutation has been mapped to the distal end of mouse chromosome 15, but the mutated gene has not been found. Here, we describe the identification of a single base pair change in aquaporin-2 (Aqp2) in cph mutants through genetic linkage mapping. The C-T change led to the substitution of a Ser (S256) by a Leu in the cytoplasmic tail of the Aqp2 protein, preventing its phosphorylation at S256 and the subsequent accumulation of Aqp2 on the apical membrane of the collecting duct principal cells. The interference with normal trafficking of Aqp2 by this mutation resulted in a severe urine concentration defect. cph homozygotes demonstrated polydipsia and produced a copious amount of hypotonic urine. The urine concentration defect could not be corrected by [deamino-Cys1,D-Arg8]-vasopressin (DDAVP, a vasopressin analog), characteristic of nephrogenic diabetes insipidus. The nephrogenic diabetes insipidus symptoms and the absence of developmental defects in the pyeloureteral peristaltic machinery in the mutants before the onset of hydronephrosis suggest that the congenital obstructive nephropathy is most likely a result of the polyuria. This study has revealed the genetic basis for the classical cph mutation and has provided direct genetic evidence that S256 in Aqp2 is indispensable for the apical accumulation, but not the general glycosylation or membrane association, of Aqp2.

Amino Acid Sequence↗

PubMed1970

Renal damage associated with silicon compounds in dogs.

A number of oral preparations of various forms of silicon were fed to young adult Beagle dogs and young rats of both sexes for a period of four weeks. During the test period the animals were observed for clinical symptoms and urine and blood measurements were made. At the end of the experimental period all animals were sacrificed and subjected to a complete necropsy and histopathologic study. Polydipsia, polyuria, and soft stools in some animals fed sodium silicate and magnesium trisilicate were the only untoward clinical signs observed; all clinical tests on blood and urine were within normal limits. Gross and microscopic renal lesions were observed in dogs fed sodium silicate and magnesium trisilicate but no changes were seen in those animals fed silicon dioxide or aluminium silicate. Lesions were not observed in any of the rats. In view of the large number of commercial preparations which contain sodium silicate and magnesium trisilicate used in human medicine, these compounds deserve further study.

Aluminum Silicates↗

PubMed2002

Impaired renal NaCl absorption in mice lacking the ROMK potassium channel, a model for type II Bartter's syndrome.

ROMK is an apical K(+) channel expressed in the thick ascending limb of Henle (TALH) and throughout the distal nephron of the kidney. Null mutations in the ROMK gene cause type II Bartter's syndrome, in which abnormalities of electrolyte, acid-base, and fluid-volume homeostasis occur because of defective NaCl reabsorption in the TALH. To understand better the pathogenesis of type II Bartter's syndrome, we developed a mouse lacking ROMK and examined its phenotype. Young null mutants had hydronephrosis, were severely dehydrated, and approximately 95% died before 3 weeks of age. ROMK-deficient mice that survived beyond weaning grew to adulthood; however, they had metabolic acidosis, elevated blood concentrations of Na(+) and Cl(-), reduced blood pressure, polydipsia, polyuria, and poor urinary concentrating ability. Whole kidney glomerular filtration rate was sharply reduced, apparently as a result of hydronephrosis, and fractional excretion of electrolytes was elevated. Micropuncture analysis revealed that the single nephron glomerular filtration rate was relatively normal, absorption of NaCl in the TALH was reduced but not eliminated, and tubuloglomerular feedback was severely impaired. These data show that the loss of ROMK in the mouse causes perturbations of electrolyte, acid-base, and fluid-volume homeostasis, reduced absorption of NaCl in the TALH, and impaired tubuloglomerular feedback.

Animals↗

PubMed2004

Tubulopathy consecutive to tenofovir-containing antiretroviral therapy in two patients infected with human immunodeficiency virus-1.

Tenofovir disopril fumarate, a new nucleotide analogue against human immunodeficiency virus-1 (HIV-1), can induce hypophosphataemia, the mechanism of which is unclear. Moreover, a renal tubulopathy can occur in long-term treated patients, as observed in 2 HIV-1-infected patients after 12 months of tenofovir therapy, with polyuria-polydipsia, proteinuria, glycosuria and amino-aciduria, which resolved after discontinuation of tenofovir. The risk of renal tubulopathy symptoms in patients on long-term tenofovir therapy should be noted.

Adenine↗

PubMed1989

Familial progressive nephropathy in young Bull Terriers.

The clinical, clinicopathological and pathological findings are described in three Bull Terrier bitches with advanced renal disease. The bitches were less than four years old and showed variable presenting signs but anorexia, lethargy and polydipsia were the most frequent. All three dogs were azotaemic and isosthenuric. Urinary protein was measured in two of the three cases. Both were proteinuric. At necropsy all dogs had shrunken kidneys. Histological examination revealed nephron loss, atrophy of glomerular tufts, interstitial fibrosis, and mineralisation of basement membranes. The progressive renal disease in these dogs was similar to the condition reported in Bull Terriers in Australia, and is probably familial and inherited.

Journal Article↗

PubMed1990

Chronic renal failure in young Old English Sheepdogs.

Chronic renal failure was diagnosed in three young Old English Sheepdogs. Clinical signs were characterised by ill-thrift, polydipsia, polyuria, nervous signs and behavioural changes. Laboratory findings showed azotaemia, non-regenerative anaemia, hyperphosphataemia and isosthenuria. The kidneys were characterised histologically by interstitial fibrosis, and thickening and calcification of the tubular and glomerular basement membrane. A familial incidence could not be confirmed in these cases.

Journal Article↗

PubMed1991

Adrenal adenoma in a cross-bred terrier.

An adrenal tumour was diagnosed in a 12-year-old female cross-bred terrier. The dog was presented to the veterinary clinic because she had been gaining weight and had started urinating in the owners' house. Clinical findings included obesity, abdominal enlargement, thinning of the hair coat, seborrhoea sicca, and polydipsia and polyuria. The diagnosis was made by clinical pathology, endocrine function tests and abdominal radiography. Surgical removal of the neoplastic right adrenal gland resulted in resolution of the clinical signs, including regrowth of the hair coat.

Journal Article↗

PubMed1993

Canine hyperadrenocorticism.

Hyperadrenocorticism is a common endocrinopathy which results from the excessive production of cortisol by the adrenal cortex. In the majority of cases, this increased secretion of cortisol results from stimulation of the adrenal cortex by adrenocorticotrophic hormone secreted from the pituitary gland. In a smaller number of cases adrenal tumours are present. Clinical signs are variable but commonly include polydipsia and polyuria, polyphagia, obesity, a pendulous abdomen, hepatomegaly, alopecia, lethargy, weakness and anoestrus. Haematology, serum chemistry analysis and urinalysis should be performed on a dog with suspected hyperadrenocorticism. Finding a significant number of changes that are consistent with hyperadrenocorticism often allows a presumptive diagnosis to be made. Other tests can then be used to confirm the diagnosis and to help localise the cause, including liver biopsy, radiology, ultrasonography, gamma camera imaging, computed tomography, and measurement of blood and urine hormone levels. The ACTH stimulation test, low dose dexamethasone suppression test and measurement of the urine cortisol:creatinine ratio are used to assess whether hyperadrenocorticism is present. The high dose dexamethasone suppression test, measurement of plasma ACTH, corticotropin-releasing hormone stimulation test, and a modification of the urinary cortisol:creatinine ratio test are then implemented to determine the aetiology. The treatment of choice for adrenal neoplasia is surgical removal of the affected adrenal. On the other hand, pituitary hyperplasia or neoplasia may be treated either surgically, by bilateral adrenalectomy or hypophysectomy, or medically. The drug which is chosen most commonly for medical management is 1,1-dichloro-2(O-chlorophenyl)-2-(P-chlorophenyl) ethane (op'-DDD), which can be used to suppress adrenal function or to completely destroy the adrenal cortex. The antifungal agent ketoconazole also suppresses adrenal steroid synthesis and provides an alternative form of medical treatment for hyperadrenocorticoid dogs.

Journal Article↗

PubMed2006

Long-term survival after combination chemotherapy for bilateral renal malignant lymphoma in a dog.

CASE HISTORY: A 6-year-old, entire male Flat-coated Retriever was presented with a history of lethargy, polydipsia and seizures. Clinical chemistry had shown marked azotaemia. CLINICAL FINDINGS AND DIAGNOSIS: Radiography and ultrasonography revealed bilateral renomegaly, and cytology of fine needle aspirates from the kidneys was diagnostic of malignant lymphoma. The dog was treated with a modified high-dose cyclophosphamide-, vincristine-, and prednisolone-based chemotherapy protocol, achieved remission, and returned to normal quality of life. Survival time was 346 days from the time of diagnosis. CLINICAL RELEVANCE: Malignant lymphoma in the kidneys of dogs has been considered to carry a uniformly poor prognosis. Long-term remission after medical treatment has not previously been reported. The favourable outcome in this case illustrates the limitations of clinical staging in determining the outcome for individual patients.

Animals↗

PubMed2004

New findings on animal diseases published since 2003. 1. Dogs.

This is the first article of a series of papers reviewing "new findings" on animal diseases. The articles are arranged in order of animal species. This article reviews seven publications on new findings on or directly related to dog diseases. The following seven cases are discussed: Canine sarcocystosis in Central America. Copper accumulation in a Skye terrier: Antemortem diagnosis and cytoprotective bile acid therapy. Keratinocyte culture and use of a cultured epidermal autograft. Line 1 insertion mutation in Factor IX of dogs with hemophilia B. Not previously described localization of the lesions in stifle osteochondritis dissecans. Panniculitis associated with pancreatitis: Antemortem diagnosis. Primary polydipsia associated with (and induced by?) gastrointestinal disease. After a short introduction, the bibliographical data, the abstract of the author(s) and some additional information derived from the article are given.

Animals↗

PubMed1998

Familial juvenile nephronophthisis. An ultrasonographic follow-up of seven patients.

PURPOSE: To evaluate progressive US changes in the kidneys of patients with familial juvenile nephronophthisis (NPH), an autosomal recessive progressive kidney disease with polyuria, polydipsia, anemia and growth retardation. MATERIAL AND METHODS: The data from 29 US investigations of 5 boys and 2 girls comprised findings relating to kidney size, echogenicity of the kidney parenchyma, visualization of the corticomedullary junction, and the parameters of renal cysts. RESULTS: In the early stages of NPH, when the serum creatinine values were between 134 and 370 micromol/l, the corticomedullary differentiation was weak in 6 patients, the echogenicity of the kidney parenchyma was equal to or greater than that of the liver in 5 patients, and 6 patients had developed renal cysts. The findings became more intensive with the progression of NPH. The size of the kidneys remained normal in 4 patients. CONCLUSION: Renal US reveals characteristic changes already in the early stages of NPH and should therefore be an important part of the diagnostics of NPH because no specific diagnostic test is as yet available.

Adolescent↗

PubMed2006

Salicylate- and quinine-induced tinnitus and effects of memantine.

CONCLUSION: Memantine, an antiglutamatergic drug, has been proposed as a treatment for tinnitus. OBJECTIVES: The purpose of this study was to determine if memantine would prevent salicylate-induced tinnitus. Local field potentials were also recorded from auditory cortex to determine what effect salicylate, memantine, and the combination of both drugs would have on evoked potential amplitudes. MATERIALS AND METHODS: Schedule induced polydipsia-avoidance conditioning was used to identify the doses of salicylate or quinine that reliably induced tinnitus in rats. Rats were trained to lick for water during quiet intervals and avoid licking during sound intervals. RESULTS: Rats injected with saline or a low dose of sodium salicylate or quinine failed to develop tinnitus-like behaviors. However, high doses of salicylate (150-300 mg/kg/day) or quinine (100-150 mg/kg/day) greatly reduced licks-in-quiet, behavior consistent with the presence of tinnitus. Licks-in-quiet increased slightly when memantine (1.5 or 3 mg/kg/day) was co-administered with salicylate; however, the effect was not statistically significant or dose-dependent. These results indicate that memantine does not completely suppress salicylate-induced tinnitus. Cortical auditory evoked potential amplitude increased after salicylate treatment; co-administration of memantine failed to block this salicylate-induced increase.

Analgesics, Non-Narcotic↗

PubMed1996

Respiratory distress, weakness, and electrolyte abnormalities.

A 56-year old man was admitted to the hospital with malaise, weakness, and fatigue. He was short of breath and had bilateral foot edema. Even though he had been very active a month earlier, he could no longer climb stairs. For the last two weeks, he had had a cough producing green sputum, a "tight feeling" in his chest, polyuria, and polydipsia. He had not had radiating chest pain, palpitations, leg pain or erythema, hemoptysis, diaphoresis, flushing, fever, chills, nausea, vomiting, diarrhea, or a loud snore.

Adrenocorticotropic Hormone↗

PubMed1998

A woman with sudden paralysis.

A 37-year-old Hispanic woman complained of having awakened with a tingling sensation, followed by sudden weakness, in both legs. A month earlier, she had experienced heart palpitations but had not had chest pain or dyspnea. She had lost 10 lb in the last two months despite an increased appetite and no polyuria, polydipsia, vomiting, or diarrhea.

Adult↗

PubMed2003

Transient gestational diabetes insipidus: report of two cases and review of pathophysiology and treatment.

Gestational diabetes insipidus is a rare disorder characterized by polyuria and polydipsia due to the inability of the kidneys to concentrate urine. We report two cases of transient gestational diabetes insipidus in which patients responded to intranasal DDAVP (1-deamino-8-D-arginine vasopressin) with greater than 50% increase in urine osmolality and marked reduction in urine output. Intranasal DDAVP was discontinued after their discharge and both patients maintained normal urine output and appropriate urine osmolality. In determining whether diabetes insipidus is present in a patient who is polyuric and hypernatremic, a urine osmolality below that of the plasma suggests the presence of diabetes insipidus. Understanding of the pathophysiology may soon lead to improved methods of prevention, diagnosis and treatment.

Adult↗