<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422017000600019</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Lesión renal rápidamente progresiva como presentación de necrosis tubular aguda de origen incierto en un maratonista. Diagnóstico diferencial n&#1086; siempre sencillo]]></article-title>
<article-title xml:lang="en"><![CDATA[Rapidly progressive renal injury as a manifestation of acute tubular necrosis with an uncertain origin in a marathonist: A differential diagnosis is not always simple]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castillo Ramírez]]></surname>
<given-names><![CDATA[Rogelio Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montalvo Domínguez]]></surname>
<given-names><![CDATA[Gonzalo Anuar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Enríquez Román]]></surname>
<given-names><![CDATA[Lizbeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Uribe Uribe]]></surname>
<given-names><![CDATA[Norma Ofelia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales-Buenrostro]]></surname>
<given-names><![CDATA[Luis Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Clínica Médica Sur Departamento de Medicina Interna ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundación Clínica Médica Sur Especialidad en Medicina Interna ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Patología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Nefrología y Metabolismo Mineral ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>60</volume>
<numero>6</numero>
<fpage>19</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422017000600019&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422017000600019&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422017000600019&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El síndrome de deterioro rápidamente progresivo de la función renal, corresponde a una forma de lesión renal aguda que cursa con un decremento acelerado y progresivo de la tasa de filtrado glomerular en horas a días o semanas. Una vez descartadas las causas prerrenales, es necesario establecer el diagnóstico diferencial con causas glomerulares, vasculares renales (trombosis), obstructivas, nefritis intersticial y necrosis tubular aguda. Se presenta un caso de deterioro rápidamente progresivo de la función renal, que fue manejado con esteroide intravenoso y plasma fresco congelado, por la probabilidad diagnóstica de microangiopatía trombótica, nefritis intersticial y glomerulonefritis rápidamente progresiva (GNRP). Posteriormente, se confirmó el diagnóstico de necrosis tubularaguda mediante biopsia renal, sin habertenidoalgún antecedente evidente que sugiriera la presencia y etiología de dicha entidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The rapidly progressive renal failure syndrome corresponds to an acute kidney injury that causes an accelerated decrease of the glomerular filtration rate in hours to days or weeks. After pre-renal causes were dismissed, a differential diagnosis with glomerularcauses, vascularcauses (thrombosis), obstructive causes, interstitial nephritis and acute tubular necrosis must be established. We describe the case of a rapidly progressive decline of the renal function that was managed with intravenous steroids and freshly frozen plasma due to the diagnostic probability of thrombotic microangiopathy, interstitial nephritis and rapidly progressive glomerulonephritis. Subseguently, an acute tubular necrosis was confirmed by a renal biopsy without any previous clinical evidence suggesting a clear presence or etiology of this entity.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Lesión renal]]></kwd>
<kwd lng="es"><![CDATA[necrosis tubular]]></kwd>
<kwd lng="es"><![CDATA[esteroides]]></kwd>
<kwd lng="en"><![CDATA[Renal injury]]></kwd>
<kwd lng="en"><![CDATA[tubular necrosis]]></kwd>
<kwd lng="en"><![CDATA[steroids]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Charles Jennette]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rapidly progressive crescentic glomerulonephritis]]></article-title>
<source><![CDATA[Kidney International]]></source>
<year>2003</year>
<volume>63</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1164-77</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ostermann]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Joannidis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute kidney injury 2016: diagnosis and diagnostic workup]]></article-title>
<source><![CDATA[Critical Care]]></source>
<year>2016</year>
<volume>20</volume>
<page-range>299</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[George]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Nester]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Syndromes of Thrombotic Microangiopathy]]></article-title>
<source><![CDATA[New England Journal of Medicine]]></source>
<year>2014</year>
<volume>371</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>654-66</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Picazo García]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez-Mies]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Esteban Rodríguez]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[El riñon como órgano diana en la microangiopatía trombótica]]></article-title>
<source><![CDATA[Revista española de patología]]></source>
<year>2002</year>
<volume>35</volume>
<page-range>3</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Praga]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute interstitial nephritis]]></article-title>
<source><![CDATA[Kidney International]]></source>
<year>2010</year>
<volume>77</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>956-61</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muriithi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nasr]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Leung]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Utility of Urine Eosinophils in the Diagnosis of Acute Interstitial Nephritis, Clinical Journal of the American Society of]]></article-title>
<source><![CDATA[Nephrology]]></source>
<year>2013</year>
<volume>8</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1857-62</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antineutrophil Cytoplasmic Autoantibody-Negative Pauci-immune Crescentic Glomerulonephritis]]></article-title>
<source><![CDATA[Journal of the American Society of Nephrology]]></source>
<year>2007</year>
<volume>18</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>599-605</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Radhakrishnan]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cattran]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The KDIGO practice guideline on glomerulonephritis reading between the guidelines-application to the individual patient]]></article-title>
<source><![CDATA[Kidney International]]></source>
<year>2012</year>
<volume>82</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>840-56</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pons]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Lautrette]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Oziel]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic accuracy of early urinary index changes in differentiating transient from persistent acute kidney injury in critically ill patients multicenter cohort study]]></article-title>
<source><![CDATA[Critical Care]]></source>
<year>2013</year>
<volume>17</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>R56</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zarieh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fang]]></surname>
<given-names><![CDATA[LST]]></given-names>
</name>
<name>
<surname><![CDATA[Diamond]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fractional Excretion of Sodium Exceptions to Its Diagnostic Value]]></article-title>
<source><![CDATA[Archives of Internal Medicine]]></source>
<year>1985</year>
<volume>145</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>108-12</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
