摘要:

In 17 out of 29 hospitalized patients (58.6%) with internal arteriovenous fistula (AVF) thrombosis a systemic streptokinase infusion was used as an alternative to urgent surgical declotting. In the remaining 12 patients (41.4%) fibrinolytic treatment was contraindicated due to the necessity for immediate dialysis, uncontrolled hypertension, active peptic ulcer, known multilevel stenoses of the fistula, or operation 8 days prior to the thrombosis. The systemic streptokinase therapy alone was successful in 9 of 17 patients treated (52.9%), 5 of 17 patients (29.4%) needed the combined therapy (streptokinase plus surgery) and in 3 of 17 patients (17.6%) the fibrinolytic therapy was unsuccessful. No serious complications attributable to the streptokinase infusion were observed. Systemic streptokinase treatment for acute AVF declotting followed by the radiological evaluation of the vessels can be a reasonable alternative to ‘blind’ surgical emergency reconstruction. The method makes it possible to identify those underlying anatomic abnormalities of the draining vein which may be localized at some distance from the anastomosis and so overlooked during surg

ISSN:1660-8151    

DOI:10.1159/000187768

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Dialysate contents of 17-hydroxycorticosteroids (17-OHCS) in hemodialysis patients were studied as a potential measure of adrenocortical function. Dialysate 17-OHCS contents after a 2-day interval of hemodialysis in 15 hemodialysis patients were determined. Dialysate 17-OHCS increased after intravenous injection of cortisol the evening prior to hemodialysis (n = 4). Dialysate 17-OHCS content was suppressed, as was plasma cortisol, after a standard dexamethasone (Dex) suppression test (n = 1). Their plasma cortisol was suppressible or nonsuppressible by an overnight Dex suppression test, as reported previously. However, basal dialysate 17-OHCS contents were not different between them, indicating that the nonsuppressible patients with overnight Dex seem not to have hypercortisolism. We conclude that determination of dialysate 17-OHCS seems a useful noninvasive technique for the evaluation of adrenocortical function in hemodialysis patients.

ISSN:1660-8151    

DOI:10.1159/000187769

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In this study, activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) enzymes were determined in the erythrocytes from patients with chronic renal failure (CRF) and from healthy subjects. In the conservative drug management group and intermittent ambulatory peritoneal dialysis group, CAT activity was lower than in the control group. However, SOD and GSH-Px activities of these groups were not statistically different from the control values. In the continuous ambulatory peritoneal dialysis group and the hemodialysis group, SOD, GSH-Px and CAT activities were lower than control values. In the patient groups, correlation coefficients between the enzyme activities were also found to be different from the control values. Results suggested that enzymatic antioxidant defense mechanisms were suppressed in the erythrocytes from the patients with CRF, in particular in the erythrocytes from those who were under hemodialysis and continuous ambulatory peritoneal dialysis management. It is proposed that reduced antioxidant defense mechanisms in the erythrocytes is one of the important factors leading to peroxidation in the membrane lipid structure of the erythrocytes and thereby to hemolysis and anemia in the patients with CRF.

ISSN:1660-8151    

DOI:10.1159/000187770

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Immunofluorescence studies were carried out to determine whether the expression of extracellular matrix (ECM) in glomeruli of ddY mice, a model for IgA nephropathy (Berger’s disease), is influenced by treatment with a rat monoclonal antibody to murine CD4 molecules (mAb CD4). This mAb CD4 showed a selective decrease in the number of CD4+ T cells in the peripheral blood of ddY mice as described previously. The ddY mice were initially treated with intravenous injections, followed by weekly intraperitoneal injections of mAb CD4. In immunofluorescence, the mean intensity of IgA deposits in the renal glomerular mesangial areas and capillary walls of the treated ddY mice was significantly lower than that in saline-treated control mice at comparable ages. There was no significant difference in the distribution or intensity of ECM components, i.e. type IV collagen, fibronectin and heparan sulfate proteoglycan, in glomeruli between the mAB CD4-treated and the control ddY mice. In light microscopy, mesangial expansion in the treated ddY mice was milder than that found in the saline control mice. No significant differences in the average number of intraglomerular cells, levels of serum IgA and urinary protein between the treated and control ddY mice were observed. Thus, it appears that although CD4+ T cells modulate the amounts of glomerular IgA deposits, other factors may be involved in the expression of ECM in glomeruli of IgA nephropathy in ddY mic

ISSN:1660-8151    

DOI:10.1159/000187771

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Copper (Cu) and zinc (Zn) were measured in urine, serum and tissues from rats with nephrotic syndrome (NS) induced with a single subcutaneous dose of puromycin aminonucleoside (PAN; 15 mg/l00 g BW). Control animals were pair-fed. Urine was collected daily, and the rats were sacrificed on day 10. PAN-nephrotic rats had proteinuria (days 3-10), high urinary Cu (days 1,2,4-10) and Zn (days 3-10) excretion. On day 10, nephrotic rats had: (a) albuminuria, hypoalbuminemia, hypoproteinemia, high urine and low serum levels of ceruloplasmin; (b) low Cu and Zn serum levels; (c) high clearance and fractional excretion of Cu and Zn, and (d) low kidney and liver Cu content and essentially normal tissue Zn levels. The alterations in Cu metabolism were more intense than those in Zn metabolism. Urine Cu and Zn showed a positive correlation with urine total protein on days 3-10 which suggests that high urinary excretion of Cu and Zn may be due to the excretion of its carrier proteins. In conclusion, these rats did not show a typical Zn deficiency but a clear decrease in Cu in the liver and kidney.

ISSN:1660-8151    

DOI:10.1159/000187772

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The typical renal histopathological changes in proximal tubules of rats consuming food containing shredded wheat moulded by Penicillium aurantiogriseum did not occur in neonates of rats ingesting the nephrotoxic diet during pregnancy nor in pups fed only by lactation from a treated dam. In contrast, weanlings consuming the moulded diet consistently showed within a few days densely staining mitosis-like structures in the proximal tubules which was the first step leading to development of the prominent tubular cytomegaly and karyomegaly seen when 16 weeks old. Karyomegaly and cytomegaly became evident also when mouldy shredded wheat constituted only 1% of a diet consumed on 45 days during the first 8 weeks after weaning, demonstrating the potency of the active component. Relevance to the putative involvement of nephrotoxic mycotoxins in human renal disease is discussed, as is the apparent absence of a renal histopathological response in adult rats during pregnancy and lactation.

ISSN:1660-8151    

DOI:10.1159/000187773

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

An 18-year-old man suffering from uremia was hospitalized because of severe skeletal pain and multiple exostoses. The patient had been treated for 5 years by regular hemodialysis; primary oxalosis was the suspected cause of uremia. Transiliac bone biopsy and subsequent histomorphometric analysis of undecalcified bone specimen as well as specific aluminum staining revealed a picture of oxalosis combined with osteomalacia and a marked accumulation of aluminum at the front of mineralization. This combination of histological features of oxalosis and aluminum bone disease suggests a new type of mixed renal osteodystrophy.

ISSN:1660-8151    

DOI:10.1159/000187774

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Acute renal failure due to angiotensin-converting enzyme inhibitors (ACEI) usually results from a marked fall in renal perfusion pressure in patients with renovascular disease. We report herein one case of acute kidney transplant artery thrombosis in a patient with renovascular hypertension. The thrombosis occurred immediately after a single dose of ACEI for evaluation of a renal transplant artery stenosis by renal scintigraphy. The dramatic fall of arterial pressure observed in our patient probably played an important role in the thrombosis. The risk of the administration of a single dose of ACEI coupled with renal scintigraphy in diagnosing renovascular hypertension is stressed.

ISSN:1660-8151    

DOI:10.1159/000187775

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187776

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187777

出版商:S. Karger AG    

年代:1994

数据来源: Karger