摘要:

Since platelet factor 4 (PF4), a cationic (pI 7.6) platelet secretory protein, binds avidly to glomerular polyanions both in vitro and in vivo, and is implicated in neutrophil chemotaxis, we studied by indirect immunofluorescence microscopy the presence of PF4 deposits in glomeruli of patients with poststreptococcal nephritis (APSGN). Goat antihuman PF4 serum was used as primary antibody and fluorescein-conjugated IgG fraction of rabbit antigoat IgG as second antibody. Controls consisted of nonimmune goat serum or anti-PF4 serum preabsorbed with human PF4, as primary antibodies. Glomerular deposits of PF4 were demonstrated in renal tissues obtained by biopsy in 14 of 20 patients studied; the deposits were particularly intense in 9 patients. PF4 was bound to the mesangium and to the capillary walls. There was a significant positive correlation between intraglomerular deposits of PF4 and the levels of proteinuria (p = 0.024). These findings provide further evidence for a role of platelets in the pathogenesis of APSGN and suggest that PF4 may contribute to alter the glomerular permeability in this disease.

ISSN:1660-8151    

DOI:10.1159/000186835

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Pseudouridine (Ψ) is a unique nucleoside accumulated in the sera of renal failure (RF) patients. Surprisingly data on its excretion are lacking. To get an overview, the Ψ serum level and urinary excretion were investigated in 73 healthy subjects (C), 16 patients not on dialysis (ND) and 12 hemodialysis patients (D). It was found: (a) Ψ accumulates in the sera of both ND and D patients. An inverse power correlation fits best with the relationship between serum Ψ and the clearance of endogenous creatinine (CCr)· The amount of Ψ filtered in glomeruli of ND patients increases while it remains practically unchanged in D patients. However, the Ψ filtration load of residual nephrons increases with the decreasing CCr as a consequence of its increased serum concentration, (b) Both Ψ net resorption and secretion have been found in C subjects. The increased Ψ resorption diminishes the necessary increase of Ψ urinary excretion both in ND and D patients. The increase of Ψ resorption is marked if calculated on residual nephrons. (c) The slightly decreased Ψ excretion excludes the participation of its increased synthesis in its accumulation in RF. It is concluded that Ψ accumulation in RF is caused by the impairment of its kidney excretion and the increased Ψ resorption participates markedly in

ISSN:1660-8151    

DOI:10.1159/000186836

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In our previous studies, we found increased levels of urinary trypsin inhibitory activity in gentamicin-induced nephrotoxicity in rats. Following administration of the Bowman-Birk trypsin and chymotrypsin inhibitor (BBI), no proteinuria was detected in gentamicin-treated rats, and a decrease in creatinine clearance was noted in only 50% of the injected rats. In the present study, we examined the antimicrobial activity of gentamicin against Escherichia coli in the presence of BBI in gentamicin-induced nephrotoxicity in rats. We found that 50% of rats with E. coli-positive blood cultures died of septicemia. All the rats injected with E. coli plus gentamicin or E. coli plus gentamicin plus BBI survived, the latter showing no proteinuria or deterioration in creatinine clearance. In conclusion, BBI, which is an effective inhibitor of gentamicin-induced nephrotoxicity, does not affect the antimicrobial activity of gentamicin sulfate.

ISSN:1660-8151    

DOI:10.1159/000186837

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

To better define the relative role of metabolic factors in the recurrence of stone formation, we studied the 24-hour urinary excretion of calcium (uCa), citrate (uCit), oxalic acid (uOx) and uric acid (uUa) in 73 male patients with primary calcium oxalate urolithiasis. According to the episodes of stone formation per year, we identified 51 recurrent stone formers (RSF) and 22 single stone formers (SSF). 20 normal adult males constituted the control group (C). uCa and uOx were higher in RSF than in C, but quite similar in SSF and RSF. The only difference between RSF and SSF was uCit, significantly lower (2.06 ± 1.04 mmol/24 h) in RSF than in SSF (3.22 ± 1.18 mmol/24 h, p < 0.001) and in C (3.42 ± 1.33 mmol/24 h, p < 0.001). Hypocitraturia (uCit < 1.5 mmol/24 h) was found in 16 of 51 RSF (31.4%) and in 1 of 22 SSF (4.5%). These data confirm that high levels of uCa and uOx represent a risk factor for lithogenesis, but also strongly indicate the low uCit excretion as the most important urinary abnormality accounting for the recurrence of calcium oxalate ston

ISSN:1660-8151    

DOI:10.1159/000186838

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied in vivo biochemical effects of insulin in the skeletal muscle of chronically uremic and control rats. The rate of disappearance of blood glucose (determined with a short intravenous test) was reduced by 38% in uremia (p < 0.05). Intraperitoneal treatment with insulin plus glucose for 30 min caused a 3-fold increase in the activity of insulin receptor tyrosine kinase in the skeletal muscle of both rat groups. Conversely, pyruvate dehydrogenase activity increased by 115% in controls but only by 26% in uremics (p < 0.01). Exercise (swimming for 30 min) increased muscle pyruvate dehydrogenase activity approximately 2-fold in both groups of animals. These experiments show that in uremic rats, insulin binds normally to its muscle receptors and adequately activates receptor tyrosine kinase but fails to activate an otherwise responsive pyruvate dehydrogenase.

ISSN:1660-8151    

DOI:10.1159/000186839

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Clinicohistopathologically, we observed 109 patients with asymptomatic urinary abnormalities found via the Japanese school medical screening process. Follow-up was for a mean period of 9.3 ± 4.0 years. More than 80% of the patients had either IgA nephropathy (IgAN, 47 cases, 43.1%), thin membrane disease (TMD; 21 cases, 19.3%) or normal glomerulus (NG; 20 cases, 18.3%). Complete remission appeared in 60.0% of the NG cases, 14.3% of the TMD cases and in 19.1% of the IgAN cases, and remission was significantly high in the NG group (p < 0.01). No patient with TMD and NG ever progressed to the extent of pronounced proteinuria or renal failure. One patient deteriorated and required hemodialysis, and 2 patients developed renal insufficiency in IgAN. All of these cases possessed severe glomerular sclerotic change when the initial biopsies were performed. All IgAN cases that went into remission, however, had minor glomerular abnormalities. A positive family history of urinary abnormality was observed in 14.1% of both the IgAN group and the NG group, whereas we observed 71.4% in the TMD group, which was significantly high (p < 0.01). Other cases included 4 each with non-IgA proliferative glomerulonephritis, focal segmental glomerular sclerosis, membranoproliferative glomerulonephritis and Alport’s nephritis. It was concluded that the majority of patients (80.7%) with urinary abnormalities found via the school screening program had IgAN, NG or TMD. 74.5% of the IgAN group and 85.7% of the TMD group had long histories of urinary abnormalities extending into adulthood with no deterioration of the renal functi

ISSN:1660-8151    

DOI:10.1159/000186840

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

While serum magnesium (Mg) level is increased in patients with end-stage renal disease (ESRD), it is decreased in renal transplant recipients (TR) receiving ciclosporin. This study was performed to examine the cation metabolism of red blood cells (RBC) in these patients. Intracellular free Mg was measured with 31P-nuclear magnetic resonance spectrometry, and ouabain-sensitive sodium (Na) efflux rate (Eos) was measured from the increase in RBC-Na concentration when RBC were incubated in the presence of ouabain. The ouabain-sensitive Na efflux rate constant (ERCos) was obtained by dividing Eos by RBC-Na concentration. RBC free Mg and ERCos were significantly higher in the TR group than in the ESRD group. There was a significant correlation beetween RBC free Mg and ERCos (r = 0.474, p < 0.01). These results support the views that the regulation mechanism for intracellular free Mg is different from that for extracellular Mg in patients with renal disease, and intracellular free Mg modulates Na pump activity of RBC.

ISSN:1660-8151    

DOI:10.1159/000186841

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

To determine the prevalence of increased urinary albumin excretion (UAE) in essential hypertension and to establish whether this abnormality is associated with deranged renal function, we have measured UAE in a group of 123 patients with essential hypertension and in 110 normal subjects. Mean arterial pressure (MAP) was 96 ± 0.6 mm Hg in normal subjects and 121 ± 0.3 mm Hg in patients with essential hypertension (p < 0.01). Mean UAE was 8.6 ± 0.5 in normal subjects and 32.9 ± 3.3 mg/24 h in patients with essential hypertension (p < 0.01). Forty percent of patients with essential hypertension manifested a UAE exceeding 30 mg/24 h and had an average UAE of 72.0 ± 4.7 mg/24 h. MAP in patients with increased UAE was similar to that in subjects with normal UAE (121 ± 0.5 vs. 121 ± 0.4 mm Hg). Creatinine clearance was also not different between these two groups (91 ± 1.8 vs. 94 ± 1.5 ml/min). No correlation was found between UAE and MAP or creatinine clearance. Long-term prospective studies are needed to extablish whether an increase in UAE may predict future nephrosclerosis in essential hype

ISSN:1660-8151    

DOI:10.1159/000186842

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We report a case of a diabetic renal transplant patient with candiduria who developed repeated elevations in serum creatinine concentration due to an intermittently obstructing Candida ball in the urinary tract. After unsuccessful attempts to place a nephrostomy tube for local irrigation and debulking, the renal graft artery ruptured secondary to extensive perirenal Candida infection. Percutaneous nephrostomy may increase the risks of renal and extrarenal tissue infection with the potential for fatal complications such as infection of the vascular anastomosis.

ISSN:1660-8151    

DOI:10.1159/000186843

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We describe a patient with gross hematuria, severe renal failure and symptoms suggestive of systemic vasculitis. Renal biopsy showed very focal and segmental necrotizing glomerulonephritis without crescents. A few C3 deposits were seen by immunofluorescence. The tubular lesions, on the contrary, were very severe, consisting of tubular cell necrosis and ruptured tubular basement membrane, associated with large numbers of intraluminal erythrocytes and erythrocytic casts. After gross hematuria had cleared, renal function slowly recoverd. Because of biopsy findings and clinical course, acute renal failure in this patient was considered to be due to the tubular lesions caused by gross hematuria.

ISSN:1660-8151    

DOI:10.1159/000186844

出版商:S. Karger AG    

年代:1992

数据来源: Karger