phenanthrenes and Kidney-Tubular-Necrosis--Acute

Topics: Anti-Obesity Agents; Aristolochia; Aristolochic Acids; Atrophy; Biomarkers; Carcinogens; Carcinoma, Papillary; Carcinoma, Transitional Cell; DNA Adducts; DNA Damage; Drugs, Chinese Herbal; Female; Fibrosis; Humans; Kidney Neoplasms; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Kidney Tubules, Proximal; Male; Neprilysin; Phenanthrenes; Phytotherapy; Plant Preparations; Postoperative Complications; Urinary Bladder Neoplasms

To realize and classify the aristolochic acid nephropathy (AAN) according to its clinical and pathological manifestations.. Fifty eight cases in our Division during October 1998 to August 2001 were reviewed, and their clinical, laboratory and pathological manifestations as well as the response of therapy were analyzed. The aristolochic acid (AA) component in some Chinese traditional drugs taken by our patients was detected with thin-layer chromatography (TLC) scan.. AAN might be divided the following three types: (1) acute AAN (n = 4): acute tubular necrosis and acute renal failure were its pathological and clinical characters, respectively. (2) tubular dysfunctional AAN (n = 7): tubular degradation with atrophy, and renal tubular acidosis and/or Fanconi syndrome were its main pathological and clinical manifestations, respectively. (3) chronic AAN (n = 47): renal interstitial fibrosis with few infiltrated mononuclear cells, and chronically progressive renal failure were its dominant pathological and clinical findings, respectively. Steroid therapy was tried to treat some patients with AAN, and a few patients in the first two types obtained some good effects. AA component was demonstrated by the TLC scan in the drugs taken by our patients.. Chinese traditional drugs containing AA are able to cause a special tubulointerstitial nephropathy which may be classified three types with different outcome. To definite effects of steroid on AAN still need to be proved by further studies.

Topics: Adult; Aristolochic Acids; Carcinogens; Chronic Disease; Drugs, Chinese Herbal; Female; Humans; Kidney Tubular Necrosis, Acute; Male; Middle Aged; Nephritis, Interstitial; Phenanthrenes

Topics: Animals; Basement Membrane; Glycosides; Glycosuria; Guinea Pigs; Heart; In Vitro Techniques; Ketone Bodies; Kidney; Kidney Function Tests; Kidney Glomerulus; Kidney Tubular Necrosis, Acute; Kidney Tubules; Kidney Tubules, Proximal; Lethal Dose 50; Liver; Liver Function Tests; Natriuresis; Nephrosis; Oxidative Phosphorylation; Phenanthrenes; Potassium; Proteinuria; Rabbits; Rats; Time Factors