Hypertension and nephrology

[Tubulointerstitial nephritis and uveitis syndrome]

BAJCSI Dóra, FEJES Imre, KEMÉNY Éva

APRIL 20, 2015

Hypertension and nephrology - 2015;19(02)

[Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare and underdiagnosed oculorenal disorder that is characterized by the development of acute tubulointerstitial nephritis and uveitis. The median age of onset is 15 years, but it may occur at any age. There is a female predominance. Uveitis might occur before, after, and also concomitantly with tubulointerstitial nephritis. The symptoms are typically non-specific, including fever, loss of appetite, weight loss, nausea and vomiting, weakness, abdominal pain, arthralgias and myalgias. Laboratory findings reveal an acute impairment of renal function, anaemia and elevated inflammatory parameters. Urinary findings are consistent with tubulointerstitial nephritis including subnephrotic proteinuria, sterile leucocyturia, microhaematuria, and tubular dysfunction (e.g. normoglycemic glycosuria). The prognosis appears to be good, especially in children. Persistent renal dysfunction only develops in a small proportion of cases. In this paper, we present the case of a 39-year-old female patient with TINU syndrome, and review the literature.]

COMMENTS

0 comments

Further articles in this publication

Hypertension and nephrology

[Positive Experience with the Long-Term Administration of Statins]

CSÁSZÁR Albert

Hypertension and nephrology

[Inhibition of the Renin-Angiotensin-Aldosterone System in Hypertensive Patients with Chronic Renal Disease]

Hypertension and nephrology

[Article Reports]

Hypertension and nephrology

[Therapy of hypertension in mirror of the newest recommendations]

STUDINGER Péter, BARNA István

[Hypertension guidelines published by various societies in the previous year follow two distinct trends regarding recommendations about treatment. The European Society of Hypertension and the European Society of Cardiology (ESH/ESC) gives the clinician free hand to select the antihypertensive drug, mentioning the optimal treatment regime for various associated clinical conditions. Guidelines published by the American Society of Hypertension and the International Society of Hypertension (ASH/ISH) or by the Eighth Joint National Committee (JNC8) are far less permissive, recommend the first drug of choice from a narrower circle of antihypertensive agents and describe the initiation and escalation of therapy in algorithms. This article displays some of the corresponding and disparate recommendations of the three guidelines.]

Hypertension and nephrology

[The 14th MOMOT Congress]

SIMONYI Gábor

All articles in the issue

Related contents

Hypertension and nephrology

[Prominents in Hungarian nephrology Professor Gyula Petrányi (1912-2000). Part II]

SZALAY László

[A nation can only survive and keep its identity through its traditions. This is why the initiative to launch this series coming from professor János Radó is worthy of attention. Gyula Petrányi is an outstanding personality in 20th century internal medicine, to be more precise in nephrology and immunology, his activity being wide-ranging. The first part of the current summary of his work deals with a tribute to his personality, and his role in immunomodularity treatment in glomerulonephritis. The second part shall cover his role in spreading renal biopsy, screening and caring kidney patients, dialysis, in developing kidney patients’ care, furthermore in clinicopharmacology and renal transplantation.]

Hypertension and nephrology

[How can we improve the chronic renal patient care?]

KULCSÁR Imre

[The author summarizes on the base of forty year’s experience in the field of Hungarian nephrological care, that which are the main developmental problems and possibilities in the clinical nephrology and in dialysis therapy in Hungary recently. There is a clear claim to change in the training of nephrological nurses and nephrologists, and it is very important the organized education of predialysis patients, improving capacity of outpatient nephrological care in his opinion. He recommends organizing the total nephrological care in every county (except nephropathology and renal transplantation) and changing the relevant health law. He emphasizes the importance of conservative care in chronic kidney diseases and home renal replacement therapies. Highly educated nurses must play much more important role in care of dialyzed patients (with more competencies). It is very important planned start in dialysis, and instead of uniform regimes, the therapy provided individually. He suggests measuring of the health-related quality of life regularly and the survival of patients on renal replacement therapy, also. It would be important to determine the residual renal function in dialysis program, monthly. He is considering the phenomenon of “recovery of renal function” and the problem of withdrawal of dialysis.]

Hungarian Immunology

[The outcome of the renal involvement in primary Sjögren’s syndrome]

POKORNY Gyula, IVÁNYI Béla, SONKODI Sándor, KOVÁCS LÁSZLÓ, KOVÁCS Attila, CSÁTI Sándor, LÁZÁR Máté, MAKULA Éva

[OBJECTIVE - Kidney function re-evaluation in primary Sjögren’s syndrome (P-SS) patients years after the first signs of renal involvement. PATIENTS - Of 75 primary SS patients followed up for various periods between 1990 and 1999, 11 had overt kidney involvement. The mean age of these 11 at the time of diagnosis of renal manifestations (first examination) was 39.6 years. In nine of the 11, the renal function was re-examined (second examination: NH4CL loading, determination of urinary concentrating ability, proteinuria and technetium99m-mercaptoacetyltriglycine clearance) on average 8.8 years later. RESULTS - At the first examination overt renal tubular acidosis (RTA) was diagnosed in 11 patients (proximal in one and distal in 10), accompanied by hyposthenuria in five, and proteinuria >0.5 g/24 h in four. Tubulointerstitial nephritis (TIN) was diagnosed in all four biopsied patients with proteinuria, and cryoglobulinaemic glomerulonephritis in one of them. Seven of the 11 were treated with moderate or low doses of glucocorticosteroids, and two with repeated methylprednisolone pulse therapy. The acidification capacity of the kidneys and degree of proteinuria mostly improved significantly (p<0.001), but the degree of hyposthenuria did not change essentially between the examinations. CONCLUSIONS - The outcome of the kidney manifesztation in primary Sjögren’s syndrome is usually favourable, but end-stage renal failure can develop rarely.]

Hypertension and nephrology

[Prominents in Hungarian nephrology Professor Gyula Petrányi (1912–2000). I. part]

SZALAY László

[A nation can only survive and keep its identity through its traditions. This is why the initiative to launch this series coming from professor János Radó is worthy of attention. Gyula Petrányi is an outstanding personality in 20th century internal medicine, to be more precise in nephrology and immunology, his activity being wide-ranging. The first part of the current summmary of his work deals with a tribute to his personality, and his role in immunomodularity treatment in glomerulonephritis. The second part shall cover his role in spreading renal biopsy, screening and caring kidney patients, dialysis, in developing kidney patients’ care, furthermore in clinicopharmacology and renal transplantation.]

Hypertension and nephrology

[Role of nephroclinicopathology in the nephrological diagnosis]

NAGY Judit, KEMÉNY Éva, IVÁNYI Béla

[In cases where a definitive diagnosis of a renal disease cannot be established on the basis of the clinical and laboratory data as well as imaging techniques the histological examination of the renal biopsy can be useful for establishing a pathological diagnosis, assessing the prognosis and can give etiopathogenetic information to guide the further management. The description and the degree of the active and chronic changes may influence the rationale treatment and the likelihood of the response. However, discussion between the nephrologist and the nephropathologist is indispensable at the decision to take the biopsy and at the evaluation of the result of the histological examination.]