摘要:

In 17 elderly patients, 19 angioplasties (17 nonostial, 2 ostial) were performed to treat acute decreases in renal function caused by high-grade renal artery stenosis in patients considered to be high-risk surgical candidates. Seventeen angioplasties (percutaneous transluminal renal angioplasty, PTRA) were technically successful and 7 patients showed improved renal function, as reflected by a fall in mean serum creatinine from 566 to 180 μmol/l (6.4 to 2.1 mg/dl). Four others had stabilization of function and 3 out of 4 with acute oliguria improved. Complications included femoral hematoma (4), minor peripheral embolism (3), renal artery thrombosis (1) renal artery dissection (1). One fatal complication was thrombosis of the aortic bifurcation due to catheterization. Four other patients died of cardiovascular causes unrelated to PTRA. Eleven patients experienced stabilization or improvement in renal function, but five out of six PTRA failures required maintenance hemodialysis and died in the hospital. Percutaneous transluminal angioplasty may offer the best chance of favorable outcome in selected severely ill elderly patients with uremia, hypertension and renal artery stenosis

ISSN:1660-8151    

DOI:10.1159/000186737

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The effect of experimental acute renal failure on the intestinal permeability measured by differently sized polyethylene glycols (PEG) was studied in rats. The permeability was assessed by analysing the 24-hour urinary recovery of PEG molecules (size 326-1,162 D). Acute renal failure was induced by clamping the left renal artery and right-sided nephrectomy. The overall urinary recovery of PEG was decreased in the uremic rats. However, the relative recovery of larger molecules (range 590-1,162 D) was further reduced in the uremic rats. The results which are compared with a computer simulation by a multicompartment model, suggest that the intestinal permeability especially towards larger PEG is decreased in acute uremic rats.

ISSN:1660-8151    

DOI:10.1159/000186738

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A single intravenous injection of adriamycin (ADR) results in marked proteinuria and glomerular morphological changes that are similar to minimal-change disease in humans. We examined the effect of superoxide dismutase (SOD) on ADR-induced proteinuria. ADR in a dose of 7.5 mg/kg body weight significantly increased urinary protein by day 14; proteinuria rapidly increased thereafter. Concurrent administration of SOD (50 mg/kg) over 30 min prior to and 30 min following ADR injection markedly reduced proteinuria. Twenty-one days after the treatment with SOD, the amount of urinary protein was 108.6 ± 43.1 mg/24 h in the experimental animals, while it was 221.6 ± 102.9 mg/24 h in the ADR control group (p < 0.05). There were also less severe glomerular morphologic changes in the SOD group versus ADR controls. The protective effects of SOD provide indirect evidence that oxygen free radicals are important mediators of ADR-induced proteinuri

ISSN:1660-8151    

DOI:10.1159/000186739

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The role of the reactive oxygen species (ROS) in the induction of tissue injury has been well documented. Regarding glomerular injury, the focus of past studies has been on superoxide, hydrogen peroxide, hydroxyl radical and C10-. However, whether singlet oxygen, an exceptionally reactive oxygen metabolite, may cause glomerular lesions has not been investigated. In the present study we documented the effects of locally generated singlet oxygen in the kidney. To generate singlet oxygen, kidneys were perfused with the pigment pheophorbide a, which was followed by exposure to light. One hour after irradiation, severe morphological damage of the glomerular cell had developed. Extensive deposits of fibrin and accumulation of platelets were seen in the glomerular capillary lumina. By contrast, kidneys not exposed to light showed no, or only minimal, abnormalities. Glomerular injury was not inhibited by pretreatment with superoxide dismutase. These results suggest that singlet oxygen produced by pheophorbide a by photodynamic reaction leads to tissue injury in vivo.

ISSN:1660-8151    

DOI:10.1159/000186740

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Renal scars have been considered to occur in later stages of chronic pyelonephritis. In our experimental pyelonephritis model, bacteria which possessed mannose-sensitive (MS) pili on the surface promoted renal scarring following inoculation to the renal parenchyma. Polyethylene glycol-modified superoxide dismutase (PEG-SOD) and 2-O-octadecylascorbic acid (CV3611) significantly suppressed scarring when administered orally or parenterally during the early stage of kidney infection with MS-piliated bacteria. These findings suggest that the superoxide and other active oxygens play an important role in renal scarring following infection and that PEG-SOD and CV3611 may be agents capable of preventing renal scarring following bacterial pyelonephritis.

ISSN:1660-8151    

DOI:10.1159/000186741

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Rat kidney mesangial cells were procured from 5 sham-operated and 10 previously uninephrectomized rats. They were grown in cell culture medium supplemented with 20% fetal calf serum. Cell free conditioned medium was collected on the 10th day. Tubular cell cultures were then prepared from 18 normal unoperated 3-week-old rats. Tubular cells from each separate kidney sample were grown in pooled-mesangium conditioned medium from sham-operated or from nephrectomized rats, supplied with 20% pooled serum from either sham-operated or nephrectomized animals, 3H-thymidine incorporation of normal tubular cell cultures grown in nephrectomy mesangium conditioned medium supplemented with sera from nephrectomized animals proved to be significantly greater than that of any of the other three experimental variations. No statistically significant difference was evident when either preconditioned medium of postnephrectomy mesangial cells or postnephrectomy serum were used alone.

ISSN:1660-8151    

DOI:10.1159/000186742

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Effects of L-arginine (ARG) infusion on renal and systemic hemodynamics were studied in 12 anesthetized dogs. The experiment was performed in two groups of dogs. The dogs of group 1 (n = 6) received intravenous ARG at 2.5 mmol/kg followed by indomethacin (IND) injection (10 mg/kg) and were rechallenged with ARG at the same amount. The dogs of group 2 (n = 6) received intravenous ARG at 5 mmol/kg followed by IND injection (10 mg/kg) and were later infused with ARG at the same dose. In group 1, the first ARG infusion caused no significant changes in renal and systemic hemodynamics. During the second ARG infusion, glomerular filtration rate (GFR) and renal plasma flow (RPF) were significantly increased when compared with the IND-treated period. In group 2, the first ARG infusion increased cardiac output (CO) and decreased total peripheral resistance (TPR) without significant changes in GFR and RPF. The second ARG infusion induced acute rise of both GFR and RPF approximately twofold, compared with the IND-treated period. CO was also increased significantly. Plasma glucagon levels determined in 2 dogs showed an increase following both ARG infusions. These results indicate that an acute ARG loading induces renal and systemic vasodilatation in a dose-dependent manner despite IND effect, and would indicate that increased renal hemodynamics are not prostaglandin-mediated.

ISSN:1660-8151    

DOI:10.1159/000186743

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In order to study why the diagnostic sensitivity of 123I-hippurate renography for a renal artery stenosis is improved by angiotensin converting enzyme (ACE-) inhibition we used the model of the conscious chronically instrumented two-kidney, one-clip Goldblatt hypertensive dog. Urine flow (UV), renal blood flow (RBF), glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured (with constant infusion of 125I-iothalamate and 131I-hippurate, respectively) for both kidneys separately before and after a bolus injection of a mild unilateral renal artery stenosis (approximately 30% reduction of RBF). During ACE-inhibition, there were remarkable falls in poststenotic GFR (from 37 ± 5 to 4 ± 2 ml/min, p < 0.05), ERPF (from Ill ± 13 to 21 ± 10 ml/min, p < 0.05) and UV (from 0.86 ± 0.15 to 0.075 ± 0.045 ml/min, p < 0.05), whereas RBF of the poststenotic kidney slightly increased (from 193 ± 18 to 237 ± 27 ml/min, p < 0.05). The concentration of hippurate and thalamate in the blood remained remarkably constant while the excretion of the tracers by the poststenotic kidney diminished and renal retention of 123I-hippurate was seen on the renogram. In 2 dogs, the experiments were repeated during mannitol infusion. In that situation, there was a much smaller decrease of poststenotic UV and GFR whereas ERPF even showed a small increase comparable to the RBF changes. These results suggest that the dramatic decreases in thalamate and hippurate excretion of the poststenotic kidney after acute ACE-inhibition are not due to a similarly dramatic fall in GFR or ERPF but mainly to tubular retention of the

ISSN:1660-8151    

DOI:10.1159/000186744

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Adenine nucleotide concentrations and energy charge ratios were measured in muscle samples collected during transplant surgery of 7 patients suffering from chronic renal failure and undergoing haemodialysis. The energy charge ratio of 0.75 in the muscle of transplant patients was significantly lower (p < 0.01) than that of 0.89 found in muscle from controls. The lower energy charge ratio and increased concentrations of adenosine diphosphate and adenosine monophosphate may contribute to the patients’ reduced exercise ability and their poor metabolic stat

ISSN:1660-8151    

DOI:10.1159/000186745

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000186746

出版商:S. Karger AG    

年代:1992

数据来源: Karger