Metabolic Nephropathy

Tubulointerstitial disorders can result from a number of metabolic disorders.

Several metabolic disorders can cause tubulointerstitial nephritis.

Tubulointerstitial disorders can result from a number of metabolic disorders. Several metabolic disorders can cause tubulointerstitial nephritis. Acute urate nephropathy This disorder is not actually a form of acute tubulointerstitial nephritis, but rather an intraluminal obstructive uropathy caused by Uratkristallablagerungen in the lumen of the renal tubules. The result is an acute oliguria or anuric kidney damage. The most common cause of acute urate nephropathy is tumor lysis syndrome following treatment of lymphoma, leukemia, or other myeloproliferative disease (the most common cause) to the other causes of acute urate nephropathy include rare primary disorders of Uratüberproduktion (hypoxanthine-guanine phosphoribosyltransferase deficiency) and diseases caused by an over-secretion to a decrease in reabsorption in the proximal tubule (Fanconi-like syndromes). Disorders of uric acid overproduction and “overexcretion” are rare. Typically, there are no symptoms. The diagnosis results when acute kidney injury in patients with a significant hyperuricemia (> 15 mg / dl) occurs. The urine findings may be normal or show urate crystals. The prognosis for a complete recovery of renal function is excellent if treatment is started early. In patients with normal cardiac and renal function, treatment is usually done with allopurinol plus. Aggressive i.v. Hydration with normal saline. Supportive measures are indicated. Hemodialysis may be advisable to remove the excess of circulating urate in severe cases where diuresis not use a loop diuretic or i.v. NaCl can be set in motion a Alkalinization with a sodium bicarbonate infusion is not recommended because – though the solubility of uric acid is increased – the risk of a tubular precipitation of calcium phosphate salts. The prevention of acute urate nephropathy ( “urate nephropathy”) is indicated (with a Risikofür tumor lysis syndrome z. B. patients) for patients at high risk. Prevention consists p.o. in the use of allopurinol 300mg plus 2 times a day. supply of saline solution to> 2.5 to achieve a urine output l / day prior to chemotherapy or radiotherapy. Urate oxidase (rasburicase) catalyzes the uric acid to a much more soluble compound also has a preventive effect and is more commonly used in patients with severe hyperuricemia. However, patients who rasburicase is given to be carefully monitored because the drug i.v. must be administered and can cause anaphylaxis, hemolysis and other side effects. Chronic urate nephropathy This condition is a chronic tubulointerstitial nephritis, which is caused by deposition of monosodium in the medullary interstitium in patients with chronic hyperuricemia. The consequences are chronic inflammation and fibrosis in chronic renal failure and renal failure. Chronic urate nephropathy was once commonly observed in patients with chronic gout, but is now rare because gout is often treated effectively. Suggestive, but non-specific findings include a mild urinary sediment and hyperuricemia in proportion to the degree of renal insufficiency: urate> 9 mg / dL with serum creatinine <1.5 mg / dL urate> 10 mg / dl with serum creatinine 1.5 to 2 mg / dL urate> 12 mg / dl with serum creatinine> 2 mg / dl Many causes of tubulointerstitial disorders can have these findings, with lead nephropathy is probably the most common. Treatment of chronic urate nephropathy equivalent to that in Hyperuricosuria. Chronic urate nephropathy figure provided by Agnes Fogo, M.D., and the American Journal of Kidney Disease, Atlas of Renal Pathology (see www.ajkd.org). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/chronic_urate_nephropathy_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/chronic_urate_nephropathy_high_de.jpg?la = en & thn = 0 ‘, title:’ Chronic urate nephropathy ‘description:’ u003Ca id = “v38397000 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDie biopsy shows Mikrotophi with acicular crystals within the tubules with tubular degeneration and surrounding inflammation and fibrosis. Tophusbildung is now rare

Health Life Media Team

Leave a Reply