Renal disease chronic parenchymal

RPGN, poor response to therapy and an ominous renal survival are expected if the patient presents with oliguria, has a serum creatinine concentration greater than 6 or 7 mg/dL, is dialysis dependent, or has a renal biopsy showing advanced chronic parenchymal disease. ... 

Patients with chronic parenchymal renal disease show a fall in RBF and GFR during treatment with NSAID, including aspirin . In chronic glomerulonephritis, afferent arteriolar dilatation may be a compensatory mechanism in the maintenance of filtration. A study of patients with systemic lupus erythematosus revealed an abnormal increase in basal PGE2 excretion consistent with the postulated means of compensation. In other aetiologies of renal insufficiency, including diabetes, hypertension and interstitial nephritis, there is acute worsening of renal function with NSAID " ... 

Oxaluria is a rare disease occuring mainly between one and four years of age and most often in white males. The patient is usually afflicted with a chronic renal disease associated with normal blood pressure. Renal failure results from the deposition of pure calcium oxalate calculi into the pelvis and calices. The lithiasis causes chronic inflammation of the kidney with parenchymal involution, fibrosis, and formation of thick capsules that strip off with difficulty. Microscopic examination of the kidney demonstrates the presence of oxalate calculi in the tubules. Calcium oxalate is also frequently found in the arterial walls, but usually the glomeruli remain free of salt. Histologically, the calculi appear as globular or rhomboidal crystals they are slightly yellowish and doubly refrac-tile under polarized light [98-104]. 

Thus, in general, most hypertensive patients have essential hypertension or other better known forms of secondary hypertension that could include renovascular h5 ertension (due to renal artery stenosis), or chronic renal insufficiency (due to renal parenchymal disease), adrenal or steroid abnormalities (due to... 

Furthermore the clinician may expect additional information for differential diagnosis and disease status as provided by renal size, e.g., acute versus chronic disease and renal parenchymal echogenicity/ sonomorphology (Table 19.2), or by renal perfusion... 

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