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American Journal of Kidney Diseases | 1984

IgA Nephropathy: Presentation, Clinical Course, and Prognosis in Children and Adults

Robert J. Wyatt; Bruce A. Julian; Dinyar Bhathena; Bonnie Mitchell; Nancy H. Holland; Hartmut H. Malluche

Eighty-two patients, 56 male and 26 female, biopsied since 1972 had IgA nephropathy. At the time of kidney biopsy, 24 patients were children and 58 were adults. In both groups the clinical course was documented in sufficient detail to allow prediction of disease outcome. Twenty-six (45%) of the adult patients had chronic renal insufficiency either at first evaluation or subsequently. Fourteen eventually required chronic hemodialysis. Hypertension as the initial sign of disease was seen more frequently in patients with chronic renal insufficiency. Adult males were more likely to have chronic renal insufficiency. The life table method was used to predict age at initiation of dialysis and kidney survival from date of onset of clinically apparent disease. Thirty-five percent of the male patients were predicted to require dialysis by age 40. Kidney death was predicted at 10 years from onset for 33% of male and 22% of all patients biopsied as adults. While all patients with progressive disease had over 2.0 g/24 h urinary protein excretion at least once, many individuals with serum creatinine concentration below 1.5 mg/dL showed marked fluctuation in degree of proteinuria, often exceeding 2.0 g/24 h. Thus, in some cases, degree of proteinuria was not a reliable predictor of outcome.


Antimicrobial Agents and Chemotherapy | 1976

Can mannitol reduce amphotericin B nephrotoxicity? Double-blind study and description of a new vascular lesion in kidneys.

Ward E. Bullock; Robert G. Luke; Charles E. Nuttall; Dinyar Bhathena

Eleven patients with systemic mycotic infections were treated with amphotericin B, 1 mg/kg, on alternate days. Five patients also received mannitol (M), 1 g/kg, in the amphotericin infusion, while six served as controls (C). Renal function studies prior to therapy were repeated at a total cumulative amphotericin B dosage of 25 mg/kg; renal biopsies were obtained from 10 patients. Inulin and creatinine clearances decreased in both the C and M groups, significantly so in the latter. Urinary concentrating ability of five patients (2C, 3M) decreased as did the capacity of three (1C, 2M) to acidify urine after an acid load. Neither the peak and valley levels of amphotericin B in serum nor the urinary excretion thereof differed between the C and M groups. Striking vacuolization of smooth muscle cells, previously unrecognized, was observed in the media of arterioles and arteries in all renal biopsies. Tubular calcification was present in both groups. In summary, M therapy (1 g/kg) did not protect against the nephrotoxicity of amphotericin B. A unique lesion of the renal vasculature secondary to amphotericin B is described. Images


Nephron | 1978

A Possible Relationship between Henoch-Schonlein Syndrome and IgA Nephropathy (Berger’s Disease)

Jay H. Weiss; Dinyar Bhathena; John J. Curtis; Bruce A. Lucas; Robert G. Luke

A 29-year-old white male with the Henoch-Schonlein syndrome and rapidly progressive glomerulonephritis received a kidney transplant. Postransplant, a glomerulonephritis histologically and immunologica


Annals of Internal Medicine | 1975

Severe Vascular Complications in Oxalosis After Bilateral Nephrectomy

Blackburn We; McRoberts Jw; Dinyar Bhathena; Martha Vazquez; Robert G. Luke

Abstract Oxalosis is a rare metabolic disorder that has no satisfactory modality for long-term therapy. A case of oxalosis with a fulminating vascular syndrome after bilateral nephrectomy is presen...


The American Journal of Medicine | 1976

Goodpasture's syndrome in a patient with the Nail-Patella syndrome.

John J. Curtis; Dinyar Bhathena; Richard P. Leach; John H. Galla; Bruce A. Lucas; Robert G. Luke

A patient with the nail-patella syndrome in whom end-stage renal failuure developed as the result of Goodpastures syndrome is described. Lesions characteristic of both rare diseases were seen on renal morphology. It is postulated that the glomerular membrane alteration of the nail-patella syndrome predisposed to the development of antiglomerular basement membrane antibody and hence Goodpastures syndrome. A review of the incidence of renal failure in the nail-patella syndrome suggests that renal involvement can no longer be regarded as benign and that immune mechanisms may be related to progressive renal disease in some cases.


Cancer | 1972

Primary renal vein leiomyosarcoma

Dinyar Bhathena; Martha Vazquez

A case of renal vein leiomyosarcoma is presented. The patient presented with a left upper quadrant abdominal mass. Pyelographic and angiographic studies localized it to the left renal hilum. Pathologic examination revealed part of the tumor within the renal vein lumen. Structural transition of renal vein wall into tumor was demonstrated.


Urology | 1979

Lymphangioma of scrotum.

John J. Mulcahy; Grigore Schileru; Mehmet A. Donmezer; Dinyar Bhathena

A case of lymphangioma of the scrotum is reported. The presenting symptoms of this unusual tumor are an increase in size of the lesion with tenderness or persistent lymphorrhea. Total surgical excision is the definitive treatment.


The Journal of Urology | 1978

Hydronephrosis with Ureteral Valve: Diagnosis by Ultrasonography and Antegrade Pyelography

Andrew M. Fried; John J. Mulcahy; Dinyar Bhathena; Michael Oliff

A case of massive hydronephrosis secondary to a ureteral valve was discovered upon evaluation of mild trauma. The orderly diagnostic studies, including ultrasonography and antegrade pyelography, led to the correct diagnosis and appropriate therapy. Ultrasonography as a diagnostic tool in urology is discussed and characteristics of the 18 cases of ureteral valves reported to date are reviewed.


Nephron | 1976

Role of Heparin Therapy in the Outcome of Adult Hemolytic Uremic Syndrome

B. T. Khanh; Dinyar Bhathena; Martha Vazquez; Robert G. Luke

Intravenous heparin therapy was associated with complete recovery of renal function in a young woman who developed adult hemolytic uremic syndrome while taking oral contraceptive agents. No controlled study is yet available but a review of an additional 36 reported patients who fulfill adequate criteria for the diagnosis of adult hemolytic uremic syndrome suggests that consideration should be given to a trial of heparin therapy in patients with this syndrome in whom renal biopsy shows recoverable glomeruli in the presence of persistent severe impairment of renal function.


The American Journal of Medicine | 1980

Focal and segmental glomerular sclerosis in reflux nephropathy

Dinyar Bhathena; Jay H. Weiss; Nancy H. Holland; R. Greg McMorrow; John J. Curtis; Bruce A. Lucas; Robert G. Luke

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Robert G. Luke

University of Alabama at Birmingham

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John J. Curtis

University of Alabama at Birmingham

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John H. Galla

University of Alabama at Birmingham

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Robert J. Wyatt

University of Tennessee Health Science Center

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