Rapid renal failure in AIDS-associated focal glomerulosclerosis
Article Abstract:
The most common kidney abnormality in patients with acquired immunodeficiency syndrome (AIDS) is focal glomerulosclerosis (FGS), the formation of fiber-like tissue within the glomeruli, the blood-filtering units of the kidney. Patients with AIDS-related FGS develop proteinuria, or the abnormal presence of proteins in the urine, and uremia, a toxic condition associated with retention in the blood of toxic nitrogen-containing substances. Patients with moderate proteinuria and slightly impaired kidney function develop hyperplasia or overgrowth of the mesangial cells that provide structural support for the glomeruli. The clinical and laboratory findings and disease progression were assessed in 18 patients with AIDS or AIDS-related complex complicated by glomerular disease. Fifteen patients developed FGS, characterized by the partial or complete collapse of the walls of the capillaries, the small blood vessels of the glomeruli; two patients developed mesangial hyperplasia; and one, membranous nephropathy, another form of glomerular disease leading to kidney capillary wall damage. Patients with FGS had proteinuria and rapidly developed kidney failure within a year of diagnosis. This type of FGS was characterized by a rapid disease progression and uremia. The lack of extensive glomerular sclerosis (hardening of tissue) and the rapid disease course suggest that AIDS-related kidney disease may be due to disorders of circulation within the kidney. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
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Multiple rheumatoid nodules of the renal cortex
Article Abstract:
Rheumatoid arthritis (RA) is a disease characterized by joint inflammation, stiffness, swelling, overgrowth of cartilage tissue, and pain. A case is described of a 63-year-old man with RA, who developed rheumatoid granulomas, or granular growths, within the cortex or outer portion of the kidney. The patient had a 37-year history of RA, characterized by disease involving several joints, nodules on the elbows and hands, inflammation of the sclera, or white portion of the eye, and pericarditis, inflammation of the membrane surrounding the heart. He was treated with several anti-arthritic agents, such as methotrexate, but later died of complications involving the heart. Rheumatoid nodules or aggregations of cells occur most often in the connective tissue of joints and subcutaneous tissue, underlying the skin, but rarely develop in the kidney. The formation of nodules in the kidney may be caused by several factors: the use of gold to treat RA; chronic pyelonephritis or chronic inflammation of the kidney due to bacterial infection; inflammation of small blood vessels resulting from the deposition of abnormal immune factors; or the use of methotrexate. The formation of rheumatoid nodules in the kidney may be a rare complication of rheumatoid arthritis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
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