An Overview of Drug-Induced Nephropathies *
Robin S. Goldstein in Mechanisms of Injury in Renal Disease and Toxicity, 2020
Information from the follow-up of gold-induced, membranous glomerulonephritis after the withdrawal of the drug was available in 49 patients (Fillastre et al., 1988). Of these, 24 were not treated; the remaining 25 received low-dose steroids (5 to 15 mg/d), high-dose steroids (1 mg/kg/d), or immunosuppressive agents. Proteinuria disappeared in 23 (95.8%) of the untreated patients and in 21 (84%) of the treated. Treatment did not hasten a favorable outcome, and proteinuria disappeared both in treated and untreated patients within 4 to 18 months. A similar, favorable outcome occurred in patients with minimal glomerular changes and nephrotic syndrome. There is little information about the clinical course and prognosis of those with gold-induced, mesangial glomerulonephritis. The hematuria usually resolves when treatment is stopped (Horden et al., 1984; White et al., 1984), but persists while treatment is continuing (White et al., 1984). Thus the prognosis of this glomerulopathy is spontaneously favorable after withdrawal of the drug. Treatment with corticosteroids is therefore not indicated in gold-associated nephrotic syndromes. Because gold has always been stopped when proteinuria was detected, it is not known whether or not the proteinuria could disappear spontaneously if treatment is continued, as is the case with some other drugs (see below).
Practical Guide to Diagnosis and Follow-up of Patients with Neurogenic Bladder Dysfunction
Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg in Essentials of the Adult Neurogenic Bladder, 2020
Cystoscopy is an important, office-based evaluation of the lower urinary tract. It can detect bladder outlet obstruction due to urethral stricture or prostatic hypertrophy, and bladder abnormalities such as bladder tumor, trabeculation, and bladder stones, although the value of cystoscopy at initial evaluation has been questioned.18–22 We recommend doing cystoscopy at initial evaluation, and as a diagnostic tool for patients who present with difficult catheterization to diagnose urethral stricture and false passage, or when presenting with recurrent urinary tract infection, increased incontinence, bladder spasticity, and/or dysreflexia for the possibility of finding a bladder stone. It should be noted that cystoscopy is a mandatory investigation for hematuria workup.23 Screening cystoscopy for patients on a chronic indwelling catheter is recommended for early diagnosis of bladder cancer, although the value of such an approach has not been proven.24
Hereditary Causes for Plasma Clotting Bleeding
Harold R. Schumacher, William A. Rock, Sanford A. Stass in Handbook of Hematologic Pathology, 2019
Other sites of hemorrhage may occur, and no site is immune. Hemorrhages have been seen in the throat, chest, abdomen, wall of intestines, testes, kidneys, and brain. Hematuria may be particularly perplexing and resistant to factor replacement (1). Adequate hydration is important, and corticosteriods may help stop the hemorrhage. Epsilon-aminocaproic acid (EACA) should not be used to treat hematurias for fear of causing lytic-resistant clots in the renal collecting system with subsequent renal shutdown. If hematuria is persistent, it may be worthwhile investigating the urinary tract for causes other than the hemophilia. This need be done only if the hematuria is persistent. Analgesic nephropathy may occur if analgesics are abused and was a common complication in hemophiliacs in the past.
Association between selective serotonin and serotonin–noradrenaline reuptake inhibitor therapy and hematuria
Published in Nordic Journal of Psychiatry, 2023
Mehmet Sarier, Meltem Demir, Mestan Emek, Ali Özgen, Hasan Turgut, Candan Özdemir
Hematuria is one of the most common urologic diagnoses, estimated to account for over 20% of urologic evaluations [9]. However, it is one of the most difficult to manage findings. Hematuria may occur in the form of asymptomatic microscopic hematuria (AMH) or as macroscopic hematuria, a sign of serious bleeding in the urinary tract. AMH is the first sign of many diseases, especially urologic malignancies; therefore, a comprehensive investigation to determine the etiology of AMH is warranted. Despite the many improvements in imaging and laboratory methods, a definitive cause still cannot be identified in 9%–18% of patients with AMH [10,11]. In this respect, we believe that there has been inadequate research into the relationship between hematuria and SSRI/SNRIs, given their widespread use in society. The aim of this study was to determine the frequency of hematuria in patients using SSRI/SNRIs and to compare the results with a control group.
The inFlow intraurethral valve-pump for women with detrusor underactivity: A summary of peer-reviewed literature
Published in The Journal of Spinal Cord Medicine, 2022
Siobhan M. Hartigan, Roger R. Dmochowski
As with any indwelling device within the urinary system, adverse events such as encrustation, infection, and migration are a concern. Despite the indwelling nature of the inFlow urinary prosthesis compared to the very short indwelling time of CIC, the pivotal trial showed no significant differences in adverse event rates between the CIC baseline and inFlow treatment periods except for clinically minor events. During the treatment phase, 8% of patients reported hematuria, all of which were mild or moderate in severity and did not warrant treatment or device removal. Asymptomatic bacteriuria was found in 56% of patients and UTIs, all mild in severity, were noted in 30% of patients. There were no instances of failure of the inFlow device due to encrustation. Compared to baseline, discomfort and leakage were found to increase during the inFlow treatment period and, while all cases were mild in severity, this was noted to be the reason for discontinuation of device use a combined 60% of subjects.
An updated review on primary signet-ring cell carcinoma of the urinary bladder and report of a case
Published in Scandinavian Journal of Urology, 2018
Maria Elisabeth Lendorf, Line Hammer Dohn, Bara Á Dunga, Anand C. Loya, Helle Pappot
Primary SRCC of the urinary bladder normally arises in the sixth decade of life and shows a male predominance (approximate M:F ratio 3:1) [8,9]. Patients are usually diagnosed with advanced tumor stage demonstrating an aggressive clinical course and a subsequently poor prognosis [27]. The clinical presentation does not differ significantly from that of the much more common urothelial carcinoma of the bladder. The most common presenting symptom is hematuria, with an incidence of 65% [12]. Complaints including dysuria, urgency and suprapubic pain appear to be other frequent symptom. In cases of rapid growth in the trigone area, oliguria, bladder irritation, flank pain and renal failure due to urethral obstruction can be the initial presenting signs [28,29]. Staging of urinary bladder cancer including SRCC uses the tumor, node, metastasis (TNM) classification as described by the Union for International Cancer Control (UICC) [30]. At the time of diagnosis, about 25% of patients have distant metastases and approximately 50% have stage IV disease (i.e. T4b primary tumor, node positivity or distant metastases) [8,9].