Primary renal disease

M13. McPhaul, J. J., Cryoimmunoglobulinaemia in patients with primary renal disease and systemic lupus erythematosus. I. IgG and DNA binding assessed by coprecipitation. Clin. Exp. Immunol. 31, 131-140 (1978). 

In the prospective Swiss Analgesic Study the risk of bac-teriuria was about three times higher in those who abused analgesics heavily than in matched controls (51). The primary causes of mortality in this study were tumors and cardiovascular disease only 7.5% died from primary renal disease due to pyelonephritis. 

In a retrospective case control study, however, examining both patients with inflammatory (IgA glomerulonephritis) and non-inflammatory (ADPKD) primary renal disease, Orth et al. [38] found an increased odds ratio of progression to end stage renal disease in patients with 5-15 pack years [odds ratio 3.5 (1.3-9.6)] and in patients with > 15 pack years [5.8 (2.0-17.0 p < 0.001)]. Interestingly the increased odds ratio was found only in patients who were not on ACE inhibitors (Table 1). 

The adverse effect of smoking on renal function in patients without primary renal disease has also been well documented. Smoking was the most powerful predictor of progression in patients with severe essential hypertension in the study of Regalado [40] and, as reflected by an increase of serum creatinine > 3 mg/dl, also in the study of Bleyer [41]. 

Orth SR, Stockmann A, Conradt C, Ritz E, Ferro M, Kreusser W, Piccoli G, RambausekM, Roccatello D, Schafer K, Sieberth HG, Wanner C,Watschinger B, Zucchelli P Smoking as a risk factor for end-stage renal failure in men with primary renal disease./Gdney /nf 54 926-931,1998. 

Primary renal diseases Primary renal diseases... 

Noels LM, Elseviers MM, De Broe ME. Impact of legislative measures on the sales of analgesics and the subsequent prevalenceof analgesic nephropathy a comparative study in France, Sweden and Belgium. Nephrol Dial Transplant 1995 10 167-174. Primary renal disease. ANZDATA Registry 2000 Report. 

It is difficult on clinical grounds to separate unequivocally three groups of patients (i) those with renal disease due to lead (ii) those with renal disease due to gout and (iii) those with gout due to primary renal disease, and such a differentiation is necessary if one is to define a lead etiology. 

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