摘要:

The present study was performed to clarify the possibility of IGF-I as an early indicator of malnutrition in patients with end-stage renal disease. Thirty-two patients (19 males, 13 females; mean age 49.6 ± 10.0 years) undergoing dialysis were enrolled in the study. Body weight, skinfold thickness, and midarm muscle circumferences (MAMCs) were measured for anthropometric nutritional indices. Blood samples were collected to measure the following endocrinological, biochemical and hematological indices: IGF-I, growth hormone, (GH), total protein, prealbumin, albumin, transferrin, hematocrit, and lymphocyte count. Nutritional indices were measured again 1 month later to calculate the percent difference among them. Moreover, 2 patients who showed a decrease in IGF-I and suffered from malnutritional complications, such as hypoproteinemia and emaciation, which could not be successfully treated by conventional therapies were selected in order to confirm the nutritional role of IGF-I mediated by recombinant human GH (r-hGH). The serum IGF-I concentration distribution ranged from 22 to 225 ng/ml. In 15 patients (10 males, 5 females), it fell from 22 to 82 ng/ml below the normal range. Partial correlation coefficient analysis demonstrated that baseline IGF-I and the percent difference of each the body weight, MAMC, prealbumin and albumin were highly significantly correlated (r = 0.431, 0.641, 0.624 and 0.348, respectively; p = 0.014, 0.001, 0.001 and 0.028, respectively). The percent difference of IGF-I did not correlate significantly with that of any other nutritional index during the 1-month observation without administration of r-hGH. However, the correction of serum IGF-I by the short-term administration of r-hGH obviously increased plasma protein and albumin, peripheral erythrocate and lymphocyte counts, and body weight. From these results, we conclude that IGF-I is a good indicator which may reflect the initiation of a malnutritional state in patients with chronic renal failure

ISSN:1660-8151    

DOI:10.1159/000187891

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Lithium and free water clearance (CLi and CH2O) were measured simultaneously in 5 patients with Bartter’s syndrome (BS), and the results were compared with values obtained in a large group of healthy control subjects. In line with the literature, fractional diluting segment reabsorption estimated from CH2O appeared to be subnormal in BS (82.4 ± 4.7 versus 89.4 ± 4.4% in controls, p < 0.01). Fractional delivery to this segment, expressed as the maximum urine flow during water diuresis (Vmax/glomerular filtration rate, GFR), also appeared to be reduced (11.3 ± 1.6 versus 13.8 + 2.5%, p < 0.05), suggesting compensatory increased proximal reabsorption. In disagreement with the latter, CLi/GFR, alleged to be a measure of fractional sodium and water output from the proximal tubules, was increased (36.2 ± 1.8 versus 30.7 ± 5.1% in controls, p < 0.01), suggesting that suppressed proximal reabsorption could be the primary reabsorption defect in BS. During chronic converting enzyme inhibition with enalapril, given to treat hypokalemia (3 patients), the concordance between the two methods was restored because CLi/GFR fell by approximately 50%, whereas VMax/GFR did not change; the alleged diluting segment rabsorption defect remained present. These contradictory results lead to the conclusion that one of the two methods reflected the pattern of tubular sodium handling in BS incorrectly. However, the present study does not unequivocally indicate which method yielded erroneous results in this con

ISSN:1660-8151    

DOI:10.1159/000187892

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Urine contains high concentrations of epidermal growth factor (EGF), and EGF is a potent growth promoter for proximal tubular cells. In the present study, urinary and whole-kidney EGF levels were investigated in rats with mercuric chloride (HgCl2)-induced acute renal failure (ARF) using a specific radioimmunoassay for rat EGF to clarify changes in EGF after toxic injury. Male Wistar rats were given HgCl2 (2 mg/kg, subcutaneously) or saline. Serum urea nitrogen and creatinine levels were measured for 4 days after toxin administration. Forty-eight hours after toxic injury, urinary immunoreactive EGF levels in HgCl2-treated rats decreased significantly compared with control rats (1.62 ± 0.15 versus 3.78 ± 0.21 ng/mg creatinine; p < 0.01). Urinary immunoreactive EGF was at its lowest level 96 h after toxic injury (0.64 ± 0.06 ng/mg creatinine; p < 0.001). Twenty-four hours after toxic injury, renal immunoreactive EGF levels increased significantly compared with control rats (22.04 ± 2.12 versus 4.84 ± 0.70 ng/g wet weight tissue; p < 0.001), and the increase persisted for as long as 48 h (13.36 ± 1.61 ng/g wet weight tissue; p < 0.05). In summary, urinary immunoreactive EGF levels decreased and renal EGF levels increased in rats with HgCl2-induced ARF. These findings suggest that there is an impairment in the excretion of EGF in rats with HgCl2-induced ARF and that local paracrine production of EGF continues i

ISSN:1660-8151    

DOI:10.1159/000187893

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 44-year-old man was diagnosed with cutaneous T-cell lymphoma characterized by a proliferation of CD4-positive cells. In response to α-interferon therapy, he experienced rapid regression of his cutaneous disease. This improvement was associated with development of renal failure, characterized by nephrotic-range proteinuria with interstitial nephritis and minimal-change nephropathy. The remarkable finding of renal biopsy was marked proliferation of visceral epithelial cells (podocytes). Renal disease improved significantly in response to discontinuation of interferon and initiation of prednisone therapy. Nephrotic range proteinuria regressed, but never completely resolved. This case is illustrative of the probable role for lymphokine-mediated nephrotoxicity in the setting of lymphoproliferative disease

ISSN:1660-8151    

DOI:10.1159/000187894

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Pseudohypertension has ben reported in elderly, diabetic and uraemic patients. A variety of diagnostic methods have been used, generally with poor results with the exception of arterial catheterisation. We report a case of pseudohypertension that developed in the year following a renal transplant and was diagnosed by the use of oscillometric and photoplethysmographic blood pressure measurement.

ISSN:1660-8151    

DOI:10.1159/000187895

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe a case, seemingly sporadic, in which ocular and acral malformations were associated with an interstitial nephropathy; we made a diagnosis of acro-renal-ocular syndrome. There was no stasis, reflux, or urinary tract infection in our patient. We believe that interstitial nephritis in acro-renal-ocular syndrome may not always be pyelonephritis, as previously reported.

ISSN:1660-8151    

DOI:10.1159/000187896

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 54-year-old woman presented proteinuria and severe hyperlipoproteinemia, She had type III hyperlipoproteinemia with the phenotype E2/2. Renal biopsy specimen revealed lipoprotein thrombi within the glomerular capillary lumina without tubulointerstitial lesion and deposition of IgA in the mesangium and peripheral capillary loops, indicating lipoprotein glomerulopathy with IgA nephropathy. Treatment with probucol resulted in the improvement of both hyperlipoproteinemia and proteinuria with the disappearance of the lipoprotein thrombi in the glomerular capillary without any change in the mesangial IgA deposition. The data suggest that probucol may be effective against the early stage of lipoprotein glomerulopathy with less lipoprotein thrombi and without tubulointerstitial damage.

ISSN:1660-8151    

DOI:10.1159/000187897

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187898

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187899

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187900

出版商:S. Karger AG    

年代:1994

数据来源: Karger