Minimal change disease with acute renal failure: a case against the nephrosarca hypothesis
An unusual but well-documented presentation of minimal change disease is nephrotic proteinuria and acute renal failure. One pathophysiological mechanism proposed to explain this syndrome is nephrosarca, or severe oedema of the kidney. We describe a patient with minimal change disease who presented w...
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Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2004-10, Vol.19 (10), p.2642-2646 |
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description | An unusual but well-documented presentation of minimal change disease is nephrotic proteinuria and acute renal failure. One pathophysiological mechanism proposed to explain this syndrome is nephrosarca, or severe oedema of the kidney. We describe a patient with minimal change disease who presented with heavy proteinuria and acute renal failure but had no evidence of renal interstitial oedema on biopsy. Aggressive fluid removal did not reverse the acute renal failure. Renal function slowly returned concomitant with resolution of the nephrotic syndrome following corticosteroid therapy. The time profile of the clinical events is not compatible with the nephrosarca hypothesis and suggests an alternative pathophysiological model for the diminished glomerular filtration rate seen in some cases of minimal change disease. |
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One pathophysiological mechanism proposed to explain this syndrome is nephrosarca, or severe oedema of the kidney. We describe a patient with minimal change disease who presented with heavy proteinuria and acute renal failure but had no evidence of renal interstitial oedema on biopsy. Aggressive fluid removal did not reverse the acute renal failure. Renal function slowly returned concomitant with resolution of the nephrotic syndrome following corticosteroid therapy. The time profile of the clinical events is not compatible with the nephrosarca hypothesis and suggests an alternative pathophysiological model for the diminished glomerular filtration rate seen in some cases of minimal change disease.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfh332</identifier><identifier>PMID: 15388821</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acute Kidney Injury - etiology ; Acute Kidney Injury - therapy ; acute renal failure ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Edema - complications ; Emergency and intensive care: renal failure. Dialysis management ; Glomerular Filtration Rate ; Glucocorticoids - therapeutic use ; Hemodiafiltration ; Humans ; Intensive care medicine ; Kidney Diseases - complications ; Male ; Medical sciences ; Middle Aged ; minimal change disease ; Models, Biological ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; nephrosarca ; Nephrosis, Lipoid - complications ; Nephrosis, Lipoid - drug therapy ; Nephrosis, Lipoid - physiopathology ; Prednisone - therapeutic use ; proteinuria ; Proteinuria - etiology ; Renal Dialysis ; Renal failure ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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Dial. Transplant</addtitle><description>An unusual but well-documented presentation of minimal change disease is nephrotic proteinuria and acute renal failure. One pathophysiological mechanism proposed to explain this syndrome is nephrosarca, or severe oedema of the kidney. We describe a patient with minimal change disease who presented with heavy proteinuria and acute renal failure but had no evidence of renal interstitial oedema on biopsy. Aggressive fluid removal did not reverse the acute renal failure. Renal function slowly returned concomitant with resolution of the nephrotic syndrome following corticosteroid therapy. The time profile of the clinical events is not compatible with the nephrosarca hypothesis and suggests an alternative pathophysiological model for the diminished glomerular filtration rate seen in some cases of minimal change disease.</description><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - therapy</subject><subject>acute renal failure</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Edema - complications</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Glomerular Filtration Rate</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Hemodiafiltration</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney Diseases - complications</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>minimal change disease</subject><subject>Models, Biological</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>nephrosarca</subject><subject>Nephrosis, Lipoid - complications</subject><subject>Nephrosis, Lipoid - drug therapy</subject><subject>Nephrosis, Lipoid - physiopathology</subject><subject>Prednisone - therapeutic use</subject><subject>proteinuria</subject><subject>Proteinuria - etiology</subject><subject>Renal Dialysis</subject><subject>Renal failure</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0MFu1DAQBmALgei2cOEBkC9wqJR2HMdxzK2qYItU2gvQqhdr4ow3hmx2sROVvj1e7YqeLPn_NPb8jL0TcCbAyPOxm85XvpeyfMEWoqqhKGWjXrJFDkUBCswRO07pFwCYUuvX7Ego2TRNKRbs4VsYwxoH7nocV8S7kAgT8ccw9RzdPBGPNObcYxjmSJ84crcDuMIwpolPPfGRtn3cJIwOef-03eS7FNIb9srjkOjt4TxhP758_n55VVzfLr9eXlwXTgozFbp1zhjw2HpypEswCnzbeQPQadBtpUrVlFI7p4CcrI3Jy7WyrLvOCBRGnrCP-7nbuPkzU5rsOiRHw4AjbeZk69qAVqbK8HQPXf5siuTtNubd45MVYHdN2tyk3TeZ8fvD1LldU_dMD9Vl8OEAMDkcfMTRhfTsatGYEnavFnsX0kR__-cYf9taS63s1f2DXd7dLH_e3Ve2kv8AknuMfg</recordid><startdate>20041001</startdate><enddate>20041001</enddate><creator>Cameron, Mary Ann</creator><creator>Peri, Usha</creator><creator>Rogers, Thomas E.</creator><creator>Moe, Orson W.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041001</creationdate><title>Minimal change disease with acute renal failure: a case against the nephrosarca hypothesis</title><author>Cameron, Mary Ann ; Peri, Usha ; Rogers, Thomas E. ; Moe, Orson W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-7bcc990fabfece720950fbdf900d707b45258237cc50ec3699385b326dd91a193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - therapy</topic><topic>acute renal failure</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Edema - complications</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Glomerular Filtration Rate</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Hemodiafiltration</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney Diseases - complications</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>minimal change disease</topic><topic>Models, Biological</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>nephrosarca</topic><topic>Nephrosis, Lipoid - complications</topic><topic>Nephrosis, Lipoid - drug therapy</topic><topic>Nephrosis, Lipoid - physiopathology</topic><topic>Prednisone - therapeutic use</topic><topic>proteinuria</topic><topic>Proteinuria - etiology</topic><topic>Renal Dialysis</topic><topic>Renal failure</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cameron, Mary Ann</creatorcontrib><creatorcontrib>Peri, Usha</creatorcontrib><creatorcontrib>Rogers, Thomas E.</creatorcontrib><creatorcontrib>Moe, Orson W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cameron, Mary Ann</au><au>Peri, Usha</au><au>Rogers, Thomas E.</au><au>Moe, Orson W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimal change disease with acute renal failure: a case against the nephrosarca hypothesis</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2004-10-01</date><risdate>2004</risdate><volume>19</volume><issue>10</issue><spage>2642</spage><epage>2646</epage><pages>2642-2646</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>An unusual but well-documented presentation of minimal change disease is nephrotic proteinuria and acute renal failure. One pathophysiological mechanism proposed to explain this syndrome is nephrosarca, or severe oedema of the kidney. We describe a patient with minimal change disease who presented with heavy proteinuria and acute renal failure but had no evidence of renal interstitial oedema on biopsy. Aggressive fluid removal did not reverse the acute renal failure. Renal function slowly returned concomitant with resolution of the nephrotic syndrome following corticosteroid therapy. The time profile of the clinical events is not compatible with the nephrosarca hypothesis and suggests an alternative pathophysiological model for the diminished glomerular filtration rate seen in some cases of minimal change disease.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>15388821</pmid><doi>10.1093/ndt/gfh332</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
subjects | Acute Kidney Injury - etiology Acute Kidney Injury - therapy acute renal failure Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Edema - complications Emergency and intensive care: renal failure. Dialysis management Glomerular Filtration Rate Glucocorticoids - therapeutic use Hemodiafiltration Humans Intensive care medicine Kidney Diseases - complications Male Medical sciences Middle Aged minimal change disease Models, Biological Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure nephrosarca Nephrosis, Lipoid - complications Nephrosis, Lipoid - drug therapy Nephrosis, Lipoid - physiopathology Prednisone - therapeutic use proteinuria Proteinuria - etiology Renal Dialysis Renal failure Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system |
title | Minimal change disease with acute renal failure: a case against the nephrosarca hypothesis |
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