Spontaneous renal artery dissection diagnosed by unenhanced magnetic resonance angiography: case report.

A 47-year-old patient is presented who was admitted to the emergency department with complaints of right-sided flank pain and hypertension. His creatinine and glomerular filtration rate were 2.5 mg/dl and 37 ml/min respectively, so that contrast media administration was contraindicated. The unenhanced magnetic resonance angiography image obtained with 3D in-flow inversion recovery sequence showed right renal artery dissection, without aortic dissection. Selective renal angiography confirmed the diagnosis and a stent was placed in the renal artery. The patient was free of pain after stenting, with normalized laboratory values and blood pressure

Comunicare tra medico e malato: aspettative e realtà

Il Convegno ha evidenziato il ruolo della comunicazione medico-malato ai fini di un corretto metodo di cura. In particolare è stato ribadito il significato della medicina di relazione e l'importanza del dialogo interdisciplinare e inter-professionale

Favourable outcome without need for haemodialysis in a pregnant patient with severe chronic renal failure

A case of favorable outcome of pregnancy without haemodialysis in a young woman with advanced chronic renal failure is described. Issues related to beginnig and timing of dialysis in these patients are discussed, in view of the controversial reports existing in the literature concerning pregnancy in patients with chronic glomerular disease and renal insufficiency. Our observation suggests the possibility of delaying dialysis treatment in pregnant patients lacking uremic symptoms

[Renal biopsy collection (2000-2008) from a single center, the Policlinico Umberto I, Sapienza University, Rome.].

AbstractThe collection of data about renal biopsies is an important starting point for clinical and epidemiological studies about kidney disease. The aim of this study was the evaluation of the frequency of the different kidney diseases, their clinical presentation and the demographic features of the population based on renal biopsies performed at our center during the years 2000-2008. Clinical presentations were defined as nephrotic syndrome (NS), urinary abnormalities, macroscopic hematuria, acute renal failure (ARF) and chronic renal failure (CRF). Kidney diseases were divided into five groups: 1) primary glomerulonephritis; 2) secondary glomerulonephritis; 3) tubulointerstitial nephritis (TIN); 4) vascular-disease-associated kidney disease; 5) miscellaneous. Primary glomerulonephritis was the most common (58.64%), followed by secondary glomerulonephritis (27.03%); TIN and vascular diseases were diagnosed in 1.46% and 7.78% of cases, respectively. The most common indications to perform renal biopsies were urinary abnormalities in 45.01% of cases, followed by CRF (21.51%) and NS (21.37%); macroscopic hematuria (6.41%) and ARF (5.70%) were less common. The most common kidney disease in men was IgA nephropathy (27.91%), while lupus nephritis was the most common in women (18.88%). In patients older than 65 years of age membranous glomerulonephritis (34.67%) was the most common kidney disease. The availability of these data is useful to assess the distribution and clinical presentation of kidney diseases among patients hospitalized at the Policlinico Umberto I in Rome