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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Tubulo-interstitial Nephritis

My wife was last year diagnosed with Chronic Kidney disease during the first trimester of her second pregnancy. Her first pregnancy was anembryonic pregnancy that resulted in a D&C. During her second pregnancy, she was diagnosed with elevated BP. Upon findings, her creatinine and other renal levels were found to be high. She was kept on strict watch with regular nephrological and gynecological followup. However, in the 7th month, she had an intrauterine fetal death. Post delivery, she continued followup with her nephrologist. Recently, she had a needle biopsy. The impression is significant glomerular obsolescence. I want to know what will be the course of this disease now. The nephrologist has advised against pregnancy. Following is more information from her recend kidney (needle) biopsy and lab results from last month. Her most recent serum creatinine level is 2.2. Urine protein is 2+ It has been 6 months since the fetal demise (Aug 20, 2010). Her biopsy reports gives the following impression. Serum sections studied show two cores of renal cortex, one with adjoining medulla with upto 38 glomeruli. 30 glomeruli are small, sclerosed, obsolescent and crowded. The viable glomeruli appear normal with no increase in cellularity, basement membrane thickening, or segmental sclerosis. The tubules show wide zones of atrophy involving 40-50% of cortex and are predominantly small with few cysts within. Interstitium is widened with patchy moderately dense lymphomononuclear infiltrate seen scattered and small aggregates. Vessels show mild hyalinosis, medial hyperplasia, and intimal sclerosis. Diagnosis/Comments: Kidney (needle) biopsy shows significant glomerular obsolescence (30/38) and vessel changes with a chronic tubulo-interstitial nephritis.
Mon, 25 Aug 2014
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Suggest Treatment For Tubulo-interstitial Nephritis