Cystic renal disease

This observation is related to that made by us (P4a) that kynurenine alone, or sometimes together with 3-hydroxykynurenine and 3-hydroxy-anthranilic acid, was found to be abnormally elevated in 17 of cases with renal tumors, in 3 of 6 cases with pelvic tumors, and in 1 of 2 cases with cystic renal disease. 

Chaparral has also been associated with cystic renal disease in rats (Grice et al., 1968 Goodman et al., 1970 Evan et al., 1979) and humans (Smith et al., 1994 see Section 16.5). Toxicity studies revealed that cystic nephropathy could be reliably induced in rats fed a 2% by wt concentration of NDGA for 6 wk (Evan et al., 1979). Renal toxicity may stem from the accumulation of theo-quinone metabolite. NDGA is converted to this metabolite in the rat ileum and cecum, absorbed into the bloodstream, and excreted by the kidney, where it is reabsorbed by the epithelial cells of the proximal convoluted tubules. In the rat, tubular changes are thus confined to the tubules in the outer cortex (i.e., the proximal convoluted tubules) (Grice et al., 1968). 

Several reports suggest that repeated exposure to chaparral is associated with adverse liver effects. There are isolated reports of renal failure, and of cystic renal disease and cystic adenocarcinoma of the kidney in individuals taking chaparral tea for periods ranging from 3 to 10 months. However, because of the limited amount of data, it is not possible to attribute the findings of renal effects to ingestion of chaparral tea. Cases of acute allergic dermatitis from dermal exposure to the creosote bush have been reported. 

Creosote Bush. A 56-year-old woman who had been consuming 3-4 cups daily of chaparral tea (an infusion of the leaves of the creosote bush) for a period of 3 months approximately 1.5 years prior to surgery was found to have cystic renal disease and cystic adenocarcinoma of the kidney (Smith et al. 1994). One of the components of chaparral tea is nordihydroguaiaretic acid. This chemical has been shown to produce cystic nephropathy in rats fed a 2% concentration for 6 weeks (Evan and Gardner 1979 Goodman et al. 1970). The concentration of nordihydroguaiaretic acid in chaparral tea is considerably... 

Table 10.3. Cystic renal diseases. Classification according to the proposal of the American Academy of Pediatrics, Uro-logic Section (Glassberg et al. 1987)...

Renal hypoplasia, dysplasia and cystic renal diseases comprise many entities that sometimes are diagnostically challenging. However, there is increasing evidence that on a cellular and genetic level many or most of them have a common pathogenetic pathway centered at the cilium-centrosome complex. With the help of the clinical information, the onset and patient age, the family history and the genetic results, diagnosis can be made in the majority of cases without invasive procedures such as renal biopsy. The location and size, distribution and onset of cysts and parenchymal abnormalities can help to... 

Abnormal Urinary Tract in Utero 253 Abnormal Renal Number 253 Abnormal Renal Location 254 Abnormal Renal Echogenicity 254 Abnormal Renal Size 254 Urinary Tract Dilatation 254 Cystic Renal Diseases 258 Tumors 258... 

Multicystic dysplastic kidney disease is by far the most common cystic renal disease that can be detected in utero. The condition is usually unilat-... 

Nonpeptide receptors Adenosine Aj Human cDNA Cardiac arrhythmia, asthma, myocardial ischemia, obesity, pain, renal disease, sleep apnea, stroke, cancer, inflammation, glaucoma, cystic fibrosis, Alzheimer s disease, Parkinson s disease Bradycardia, lipolysis inhibition, reduction of glomerular filtration and natriuresis, tubero-glomerular feedback, antinociception, renal vasodilatation-constriction, reduction of central cholinergic and noradrenergic nerve activity, presynaptic inhibition of excitatory neuro transmission... 

Angiotensin-II AT, Human cDNA Artherosderosis, cardiac hypertrophy, congestive heart failure, hypertension, myocardial infarction, renal disease, cancer, diabetes, obesity, glaucoma, cystic fibrosis, Alzheimer s disease, Parkinson s disease Smooth muscle contraction, cell proliferation and migration, aldosterone and ADH release, central and peripheral sympathetic stimulation, extracellular matrix formation, tubular sodium retention, neuroprotection... 

Renal diseases such as uremia may result in decreased renal clearance of certain drugs.13 Gastrointestinal diseases, such as Crohn s disease, result in increased plasma protein binding of several drugs due to increased levels of binding proteins. Further, respiratory diseases such as cystic fibrosis increase the renal clearance of some drugs. 

A cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea has been reported (7). 

Smith AY, Feddersen RM, Gardner KD Jr, Davis CJ Jr. Cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea a case report. J Urol 1994 152(6 Pt 1) 2089-91. 

Because most drugs are either metabolized by the liver or eliminated by the kidney, hepatic and renal diseases are expected to decrease the dosage requirements in patients. Nevertheless, not all diseases require lower doses of drugs for instance, patients with cystic fibrosis require larger doses of certain drugs to achieve therapeutic concentrations. ... 

Achilles tendon rupture or tendinitis has occurred rarely. Renal disease, hemodialysis, and glucocorticoid use may be predisposing factors. Traditionally, the use of quinolones in children has been contraindicated because they have produced arthropathy in animal jnodels. However, children with cystic fibrosis given ciprofloxacin, norfloxacin, and nalidixic acid have had few, and reversible, joint symptoms. Therefore, the benefits may outweigh the risks in some children. 

In offspring of rats with inherited cystic kidney disease administered a diet of 7% flaxseed oil during pregnancy and lactation, with offspring then administered the same diet until 10 weeks of age, decreases in creatinine clearance and proteinuria were observed. The authors concluded that exposure to flax oil during pregnancy and lactation produced beneficial changes in adult renal disease (Sankaran etal.2006). 

Esophageal varices in children are a manifestation of portal hypertension that causes hepatofugal flow through esophageal collateral veins to drain into the superior vena cava. The most common children s diseases that cause portal hypertension include umhilical venous catheterization, biliary atresia, alpha-1 antitrypsin deficiency, autosomal recessive polycystic renal disease and cystic fibrosis. 

This disease group is defined by renal cysts at the corticomedullary junction and classified into a recessive form (nephronophthisis) and dominant form (medullary cystic kidney disease) (OMIM 256100 and 174000). Nephronophthisis is genetically heterogeneous, four genes have been mapped and identified (NPHPl-4). Additional genes can be expected. 

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