Acute renal failure--current concepts

The appalling mortality of acute renal failure in casualties in the Second World War has been reduced considerably by a better understanding of the clinical manifestations and improved therapeutic techniques which include early dialysis, better resuscitation measures, and maintenance of high urine flows in the high risk patients. The role of nephrotoxic antibiotics and other nephrotoxins especially radiographic contrast media, is increasing in importance. Non-oliguric acute renal failure is now a well documented clinical entity and although the mechanisms responsible for acute renal failure are still far from settled, the spectrum of acute renal failure in terms of clinical setting, predisposing factors and clinical features have changed since acute renal failure was first described.

Histopathological profile of adult nephrotic syndrome in Singapore

The renal biopsies of 100 patients presenting with the Nephrotic Syndrome were analysed. Eighty-seven percent were due to primary glomerulonephritis and the other 13% due to secondary glomerulonephritis of which Systemic Lupus Erythematosus was the commonest. Diffuse mesangial proliferative glomerulonephritis (DPGN) formed the largest group (60%). Minimal lesion occurred in 15% of patients and only 5% had Membranous Glomerulonephritis. 63% of patients with DPGN had negative staining on immunofluorescence. Even though Mesangial IgA Nephritis is prevalent in Singapore, it accounted for only 4% of glomerulonephritis causing the Nephrotic Syndrome.

Paraquat poisoning - management and prognosis

Paraquat poisoning has become a significant clinical problem since the early 1960s. Its high mortality has posed a major challenge to clinicians treating these patients. Two patients who survived and one who did not are reported. The management of these patients and the possible factors affecting their outcome are discussed.