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
Hauptverfasser: Cameron, Mary Ann, Peri, Usha, Rogers, Thomas E., Moe, Orson W.
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creator Cameron, Mary Ann
Peri, Usha
Rogers, Thomas E.
Moe, Orson W.
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.
doi_str_mv 10.1093/ndt/gfh332
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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. 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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). 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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. 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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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