muramidase and Acute-Kidney-Injury

Topics: Acute Kidney Injury; Animals; Body Fluids; Cell Wall; Clinical Enzyme Tests; Humans; Hydrolysis; Immunodiffusion; Kidney Diseases; Kidney Tubules; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Micrococcus; Molecular Weight; Muramidase; Rats; Spectrophotometry

Lysozyme-induced nephropathy is a rare and unknown complication of chronic myelomonocytic leukemia with overproduction of lysozyme by tumoral cells leading to proximal tubular cells injuries. The present case reports a lysozyme nephropathy secondary to chronic myelomonocytic leukemia.. We reported a case of a 82-years-old woman who presented an acute renal failure in a context of diarrhea and vomiting. Her background was characterized by untreated chronic myelomonocytic leukemia and high blood pressure. Despite rehydration, renal function deteriorated. Renal biopsy revealed a tubulo-interstitial lysozyme-induced nephropathy with a vacuolization of the tubular epithelium by eosinophilic droplets stained by anti-lysozyme antibody, without tumoral infiltration of the renal parenchyma.. Lysozyme-induced nephropathy is a rare disease which can be suspected biologically and needs histologic confirmation. Other causes of renal failure secondary to chronic myelomonocytic leukemia have to be eliminated first in these patients. The treatment is symptomatic and is associated with treatments of the underlying hematologic pathology.

Topics: Acute Kidney Injury; Aged, 80 and over; Female; Humans; Kidney; Leukemia, Myelomonocytic, Chronic; Muramidase

Topics: Acute Kidney Injury; Aged; Comorbidity; Diagnosis, Differential; Fanconi Syndrome; Glycosuria; Humans; Kidney Diseases; Kidney Tubules, Proximal; Male; Muramidase; Renal Insufficiency; Sarcoidosis

Lysozyme in the urine in concentrations greater than 3 micrograms per milligram of creatinine reflects renal tubular disease or dysfunction in patients without bowel disease or leukemia. We therefore used urine lysozyme assays to assess renal response to percutaneous nephrostomy and stone removal in 42 patients. Eight patients had striking increases (4.2-21.1 [mean 7.58] micrograms/mg creatinine) immediately after nephrostomy puncture in urine obtained directly from the punctured kidney. Lysozyme declined sharply thereafter and was within normal limits in all cases by postoperative day 3. This increase appeared to result from bleeding into the urine from the tract. Five other patients had lysozymuria on admission, only 1 of whom had a sharp increase after nephrostomy puncture. In the remaining patients, the lysozyme levels remained within normal limits throughout the hospital course. These data are further evidence of the absence of significant deleterious effects of nephrostomy puncture on the kidney.

Topics: Acute Kidney Injury; Adult; Aged; Clinical Enzyme Tests; Dilatation; Evaluation Studies as Topic; Humans; Kidney Calculi; Middle Aged; Muramidase; Nephrostomy, Percutaneous; Specimen Handling

Topics: Acetylglucosaminidase; Acute Kidney Injury; Adult; Aged; Aminopeptidases; CD13 Antigens; Diatrizoate; Female; gamma-Glutamyltransferase; Humans; Iopamidol; Kidney Glomerulus; Kidney Tubules; Male; Middle Aged; Muramidase

Unilateral nephrectomy (UNX) induces a dramatic change in single-kidney structure and function. Therefore, the effects of nephrotoxins may be altered. To evaluate this possibility, mercuric chloride (2 mg/kg, sc) was given to male, Sprague-Dawley rats 2 days following either UNX or sham surgery. Nonoliguric acute renal failure developed and was qualitatively similar in both groups. Glomerular filtration rate (GFR) reached a nadir on Day 2 and was reduced to a greater extent in the UNX group. Furthermore, recovery of GFR was slower and occurred to a lesser extent by Day 10 in the animals subjected to UNX. Evidence of significant tubular dysfunction was present during the acute phase in both groups, as reflected by changes in the fractional excretion of sodium or lysozyme. Persistent tubular dysfunction was noted on Day 10 in both the sham and UNX groups, but the degree of dysfunction was greater in the UNX animals. The in vitro uptake of organic ions by renal cortical slices was reduced 24 hr following the injection of mercuric chloride although no difference was seen between the experimental groups. Mercury content within renal cortex was not increased in the UNX group at 1 or 3 hr but was higher 24 hr postinjection. Total urinary mercury excretion during the first day was not altered by UNX although single-kidney excretion was increased dramatically. These studies suggest that rats are more susceptible to mercuric chloride-induced nephrotoxicity 2 days following UNX. Although the mechanism(s) of this enhanced injury remains unclear, it does not appear to be completely related to an increase in renal cortical mercury content.

Topics: Acute Kidney Injury; Animals; Diuresis; Erythrocytes; Glomerular Filtration Rate; Kidney; Liver; Male; Mercuric Chloride; Mercury; Muramidase; Natriuresis; Nephrectomy; Rats; Rats, Inbred Strains

Gentamicin has been shown to induce renal tubular damage in man and laboratory animals and to result in elevated urinary excretion of some enzymes associated with specific cell regions in the kidney. In the present investigation, the possible protective effect of selenium against gentamicin-induced renal damage was tested by measuring the urinary excretion of some enzymes in the presence and absence of selenium. Our results show that a prior subcutaneous injection of selenium to rats for two days followed by a simultaneous S.C. injection of gentamicin and selenium resulted in a marked reduction in the excretion of such biochemical systems as the urine volume, urinary proteins, alkaline and acid phosphatases, beta-glucuronidase, muramidase, and glutamate dehydrogenase. Renal functional studies revealed that selenium-treated rats suffered less adverse effects compared to rats treated with gentamicin alone. Urinary acid phosphatase, beta-glucuronidase and muramidase, the three lysosomal enzymes tested, appeared to respond most readily to protection by selenium.

Topics: Acid Phosphatase; Acute Kidney Injury; Alkaline Phosphatase; Animals; Gentamicins; Glucuronidase; Glutamate Dehydrogenase; Kidney; Kidney Function Tests; Male; Muramidase; Rats; Selenium

In clearance experiments, egg white lysozyme was intravenously infused into male Wistar and Wistar/Furth rats over different periods of time to achieve plasma concentrations of lysozyme in the range of 30 to 8000 micrograms per ml. The glomerular filtration rate and the appearance of glomerular and tubular epithelia were comparable to those of control rats below 3000 micrograms per ml. of plasma concentration of lysozyme and up to 60 minutes' infusion time when investigated by scanning electron microscopy. A 50 per cent drop in blood pressure occurred at a plasma lysozyme concentration of 3000 micrograms per ml., which could be prevented by the intravenous injection of an antihistamine or by using Wistar/Furth rats; however, the decrease of the glomerular filtration rate and of the fractional lysozyme reabsorption as well as the increase in sodium and potassium excretion could not be avoided. After 30 minutes of lysozyme infusion, the epithelial foot processes exhibited slight regional effacement, and in more than 50 per cent of the tubules protein cast formation was noted. Occurrence of foot process effacement and tubular casts increased with further increase of plasma lysozyme concentration and lysozyme infusion time. These morphologic changes were common for Wistar rats, antihistamine-pretreated Wistar rats, Wistar/Furth rats, and in situ-perfused rat kidneys. These results indicate that the cationic low molecular weight protein lysozyme induced functional and structural alterations that were correlated with plasma lysozyme concentration and lysozyme infusion time and caused acute renal failure.

Topics: Acute Kidney Injury; Animals; Glomerular Filtration Rate; Infusions, Parenteral; Kidney Glomerulus; Kidney Tubules; Male; Microscopy, Electron, Scanning; Muramidase; Potassium; Rats; Rats, Inbred Strains; Sodium

Measurements of urinary lysozyme were used to evaluate renal tubular integrity in 34 patients with cirrhosis or fulminant hepatic failure who had developed renal impairment. In 18 of the patients the lysozyme values were normal but in the remaining 16 were increased, supporting previous concepts that renal failure complicating hepatocellular disease may occur both without and with tubular necrosis. The lysozyme values were inversely related to the creatinine clearance, suggesting that the development of tubular necrosis may be determined by the level of renal perfusion. The validity of simpler laboratory tests often used to assess renal tubular integrity--namely, the urine sodium concentration, the urine:plasma osmolality ratio, and casts in the urine sediment--was evaluated by comparison with the lysozyme measurements. The urine sodium concentration was of most value and the findings in the sediment were of no value at all.

Topics: Acute Kidney Injury; Humans; Kidney Tubular Necrosis, Acute; Kidney Tubules; Liver Cirrhosis; Liver Diseases; Muramidase; Sodium

Topics: Acute Kidney Injury; Alkaline Phosphatase; Arylsulfatases; Enzymes; gamma-Glutamyltransferase; Glomerulonephritis; Glucosidases; Glucuronidase; Humans; Kidney Transplantation; L-Lactate Dehydrogenase; Muramidase; Nephrotic Syndrome; Pyelonephritis; Transplantation, Homologous

The kidneys of 18 autopsy cases of myelomonocytic leukemia (MML) were examined for MML-specific features. Nine cases of chronic lymphocytic leukemia (CLL) served as controls. The kidneys of the cases of MML showed macroscopically detectable signs of hemorrhagic diathesis and secondary uric acid diathesis more often than those of CLL. In the MML group most of the kidneys weighed more than the normal average for the corresponding age group, but the average renal weights for the 2 groups were about the same. Renal weight and grade of leukemic infiltration, particularly in MML, revealed no significant positive correlation. In most of the cases of MML there were unevenly distributed poorly defined leukemic, infiltrates in the renal cortex and medulla. The histology resembled that of pyelonephritis. In CLL, on the other hand, the leukemic infiltrates were usually sharply defined and localized in foci in the outer cortex and the corticomedullary border region. Renal dysfunction in cases of MML has been attributed by others to hyperlysozymemia. It was found occasionally but there was no MML-typical morphological substrate in our material. Hyaline droplet change of the tubular epithelium was more frequent and more pronounced in MML than in CLL. However, we also determined that it was nonspecific and that it was not a parameter of cell damage. Tubular hyaline droplet change and the morphological criteria of acute renal failure were not positively correlated with the degree of leukemic infiltration of the kidneys or with the leukemic proliferation as a whole. Instead, they were considered to be signs and symptoms of accompanying or secondary diseases which complicated the leukemia.

Topics: Acute Kidney Injury; Adult; Aged; Edema; Female; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Leukemia, Lymphoid; Leukemia, Myeloid; Liver; Male; Middle Aged; Muramidase; Nephrocalcinosis; Organ Size; Pyelonephritis; Spleen; Uric Acid

Topics: Acute Kidney Injury; Alkaline Phosphatase; Aminopeptidases; Animals; Enzymes; Humans; Kidney Tubular Necrosis, Acute; Muramidase; Oxidoreductases; Rats

Topics: Acute Kidney Injury; Female; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Middle Aged; Muramidase

Topics: Acute Kidney Injury; Anuria; Creatinine; Graft Rejection; Humans; Kidney Transplantation; Muramidase; Proteinuria; Transplantation Immunology; Transplantation, Homologous; Urea

Topics: Acute Kidney Injury; Clinical Enzyme Tests; Diagnosis, Differential; Glomerulonephritis; Humans; Kidney Diseases; Kidney Tubules; Muramidase; Nephritis; Nephrosclerosis; Proteinuria

Topics: Acute Kidney Injury; Diagnosis, Differential; Female; Glomerulonephritis; Humans; Kidney Diseases; Kidney Tubules; Male; Muramidase; Nephritis, Interstitial

Topics: Acute Kidney Injury; Diagnosis, Differential; Glomerular Filtration Rate; Humans; Kidney Diseases; Kidney Failure, Chronic; Kidney Tubules; Muramidase

Topics: Acute Kidney Injury; Blood Urea Nitrogen; Glomerulonephritis; Humans; Kidney Diseases; Kidney Tubules; Leukemia; Muramidase; Nephritis; Nephrocalcinosis; Nephrotic Syndrome; Urinary Calculi

Topics: Acute Kidney Injury; Adult; Humans; Male; Muramidase