alpha-chymotrypsin and Acute-Kidney-Injury

Topics: Acute Disease; Acute Kidney Injury; alpha 1-Antichymotrypsin; Blood Proteins; C-Reactive Protein; Chymotrypsin; Haptoglobins; Hemopexin; Humans; Immunodiffusion; Kidney Diseases; Kidney Neoplasms; Latex Fixation Tests; Multiple Myeloma; Nephelometry and Turbidimetry; Orosomucoid; Protease Inhibitors

To explore the management of fungal pyelonephritis in infants.. Data from 5 cases with fungal pyelonephritis, including the clinical situation, laboratory examination, feature of imaging, and treatment were analyzed.. All the 5 cases were preterm and low birth weight infants. In 3 cases the disease was unilateral, in 2 cases were bilateral, and acute renal failure occurred. Fungus balls presented on imaging. Urine culture was positive of Candida albicans. Treatment with percutaneous nephrostomy, irrigation and antifungal agent were associated with good prognosis. Only 1 case died. The surviving patients were followed up for 10 - 20 months and the results showed normal growth and development. B-mode ultrasound examination did not show any malformation of the urinary system.. Fungal pyelonephritis was commom in preterm infants. Candida albicans was the major pathogenic microorganism. Percutaneous nephrostomy and drainage were effective in patients with urinary obstruction in relief of obstruction, early diagnosis and control of infection.

Topics: Acute Kidney Injury; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Chymotrypsin; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Male; Nephrostomy, Percutaneous; Pyelonephritis; Treatment Outcome; Ultrasonography, Doppler, Color; Ureteral Obstruction; Urine

An inhibitor of transepithelial sodium transport was found in a low molecular weight fraction obtained from serum of patients with far advanced chronic renal disease. In 18 nondialyzed patients, the mean inhibition of short circuit current (SCC) was 24.9 +/-2.2% (SE). With a comparable fraction from 11 normal subjects. SCC decreased by only 5.3 +/-1.5%. There was significantly greater inhibition with the serum fractions of patients with end stage renal disease being maintained on chronic hemodialysis than in the normal control group; but the degree of inhibition in the dialyzed population was significantly less than that observed in the nondialyzed chronically uremic patients. The inhibition of SCC produced by the serum fractions of a group of seven patients with acute renal failure was not significantly different from the control group despite the presence of high grade uremia in the former. The inhibitory fraction has characteristics identical with the uremic serum fraction which previously has been shown to inhibit p-aminohippurate (PAH) uptake by rabbit kidney cortical slices. With gel filtration through Sephadex G-25, the active fraction appears after the major peaks of substances as small as urea and sodium; hence it may have been retarded on the column. But its ultrafiltration characteristics suggest that its molecular weight may be less than 1000. The inhibitory capability was not destroyed by boiling, freezing, or digestion with chymotrypsin or pronase. Neither methylguanidine nor guanidinosuccinic acid in concentrations well above those present in the serum of uremic patients inhibited sodium transport in the frog skin. The data suggest that there is an inhibitor of sodium transport in the serum of patients with chronic uremia. The role of this material in the regulation of sodium excretion in uremia as well as its possible role as a uremic toxin are subjects of both theoretical and practical interest.

Topics: Acute Kidney Injury; Animals; Anura; Biological Transport; Chemical Phenomena; Chemistry; Chromatography, Gel; Chymotrypsin; Cold Temperature; Guanidines; Hot Temperature; Humans; Kidney Failure, Chronic; Molecular Weight; Peptide Hydrolases; Potentiometry; Renal Dialysis; Skin; Sodium; Succinates; Uremia