摘要:

Thirty-eight renal allograft recipients who had persistent hyperlipidemia and stable renal function 27.8 ± 18.2 months after renal transplantation were treated with gemfibrozil. Gemfibrozil therapy resulted in a decrease in the levels of total cholesterol (TC; 297.6 ± 41.0 mg/dl to 249.2 ± 43.7 mg/dl, -16.3%; p < 0.0001), triglyceride (TG; 231.9 ± 116.8 to 125.7 ± 58.4 mg/dl, -45.8%, p < 0.0005), and LDL-cholesterol (LDL-C; 203.8 ± 37.4 to 174.5 ± 42.5 mg/dl, -14.4%; p = 0.001), which were sustained for 29.1 ± 16.0 months. Comparison of sequential lipid profiles between gemfibrozil-treated individuals and untreated hyperlipidemic controls matched for age, sex, time after transplantation, and the degree of hyperlipidemia, showed that gemfibrozil-treated patients had lower levels of TC (239.9 ± 39.5 vs. 272.8 ± 34.1 mg/dl; p < 0.005), TG (125.7 ± 67.3 vs. 167.3 ± 69.0 mg/dl; p < 0.05), and LDL-C (160.2 ± 41.3 vs. 185.3 ± 26.6 mg/dl; p < 0.05) on serial follow-up. No significant side-effect was observed with gemfibrozil therapy. Our data showed that gemfibrozil was a safe and effective drug for the treatment of hyperlipidemia in renal allograft recipients, which could reduce these patients’s long-term cardi

ISSN:1660-8151    

DOI:10.1159/000187986

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We examined 58 patients (38 men, 20 women; mean age: 45 ± 12 years; body mass index: 24 ± 4 kg/m2) with a glomerular filtration rate (GFR) ranging from 3 to 32 ml/min, in order to determine the effects of a progressive decline in renal function on total hemoglobin (THb) and exercise capacity. The THb ranged from 185 to 759 g and the hemoglobin concentration ranged from 66 to 151 g/l. Maximal exercise capacity ranged from 50 to 260 W (40-143% of the expected norm). Nearly all the patients interrupted their exercise tests due to general fatigue, leg tiredness or a combination of these factors. There was a sigificant partial correlation between THb and GFR after sex and age had been accounted for (r = 0.39; p < 0.005). Maximal exercise capacity and THb showed a significant partial correlation after sex, age and GFR had been accounted for (r = 0.27; p < 0.05). Maximal exercise capacity showed a significant partial correlation with GFR after sex, age and THb had been accounted for (r = 0.30; p < 0.05). In conclusion, there is a gradual decline in THb and maximal exercise capacity as uremia progresses. Anemia appears to be a contributory cause responsible for the decrease in maximal exercise capacity along with other factors pertinent to uremia per s

ISSN:1660-8151    

DOI:10.1159/000187987

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Hyperlipidemia, especially hypercholesterolemia, may contribute to glomerulosclerosis as it does to atherosclerosis. Low density lipoprotein (LDL) stimulates the production of extracellular matrix by mesangial cells in culture as well as the proliferation of mesangial cells. This study was carried out to examine the effects of LDL on the type IV collagen (CIV) production by cultured rat mesangial cells (CRMC). Subconfluent CRMC monolayers which were grown in RPMI with 20% lipid-free fetal calf serum for 48 h were challenged with LDL (0, 50,100,150 and 200 μg/ml) for another 48 h. LDL was prepared from normal human plasma. Mesangial cell proliferation was examined by [3H]-thymidine uptake. Production of CIV was evaluated as the expression of CIV on the cell surface by flow-cytometric analysis. The collagen synthesis was measured by the [3H]-proline uptake. Total RNA was extracted from CRMC at 6 and 24 h of incubation with 150 μg/ml LDL, and Northern blotting and hybridization was performed with cDNAs for αrCIV, for 72-kD collagenase and for tissue inhibitor of metalloproteinase (TIMP)-2. The amount of total mRNA was corrected with β-actin mRNA. Mesangial cell proliferation increased in all concentrations studied and had a peak value of 221% with 150 μg/ml of LDL. Expression of CIV increased by 30-60% in 100-200 μg/ml of LDL. Collagen synthesis also increased by 50-70% in 150-200 μg/ml of LDL. The mRNA ratio (procollagen α1(IV)/β-actin) increased to 133% at 24 h. The mRNA ratio (TIMP-2/β-actin) increased to 137% at 24 h. mRNA ratios at 6 h showed no change. LDL had little effect on collagenase mRNA expression. These results show that LDL stimulates, in addition to stimulated mesangial cell proliferation, collagen production through a combination of increased collagen synthesis and possibly decreased collagen degradation. Hyperlipidemia may contribute to the pathogenesis of glomerulosclerosis through the direct effect of LDL on mesang

ISSN:1660-8151    

DOI:10.1159/000187988

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Plasma levels of guanidine (G) are reported to be increased in uremic patients and are synthesized from various guanidino compounds via a chemical reaction involving the hydroxyl radical in vitro. To identify both the metabolic precursor and the synthesizing organ of G, we investigated the concentrations of G in various organs of rats administered several guanidino compounds and we attempted to synthesize G biologically using isolated rat hepatocytes or perfused rat liver. In addition, we investigated the effect of the peroxidative state on the G synthesis in isolated hepatocytes using various reagents which alter this condition. Results show that the concentration of G increased in the kidney, liver and muscle following the administration of L-canavanine. In addition, G increased in the kidney at 90 min after the administration of guanidinoacetic acid (GAA). Moreover, G is synthesized from L-canavanine in isolated rat hepatocytes and perfused rat liver, and G synthesis in hepatocytes is partially inhibited by the addition of superoxide dismutase, catalase, glutathione or ethylenediaminetetraacetic acid. These results suggest that L-canavanine is possibly a biological precursor and GAA is an endogenous precursor of G. Furthermore, it is suggested that these reactions are closely related to the peroxidative state.

ISSN:1660-8151    

DOI:10.1159/000187989

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We describe a method for detecting virus-specific RNA sequences using a nonradioactive enzyme system, and analyze coxsackie B4 virus (cox. B4) RNA sequences in infected mouse kidney with pathological changes. Diffuse mesangial proliferation was observed transiently 24 h after inoculation of cox. B4 virus in glomeruli. OCT-treated thin sections of the same tissue were hybridized in situ using a digoxigenin-labeled oligonucleotide probe. The strongest signal was observed in the mesangial sample. These findings suggest that the transient proliferative mesangial changes were caused by direct injury following virus infection without immune complex.

ISSN:1660-8151    

DOI:10.1159/000187990

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We evaluated the effect of 6 days of intraperitoneal saline infusion on peritoneal peroxidation and permeability in rats. Peroxidation of the peritoneum as measured by malondialdehyde concentration in the omentum was increased and there was a concomitant augmented membrane permeability to glucose and resulted in a loss of ultrafiltration. In vitro experiments with mesothelial cells showed that glycosaminoglycan chondroitin sulphate appears to act as a scavenger of free radicals and so protects the mesothelial cells against injury. Thus, in rats, supplementation of the infused saline with chondroitin sulphate reduces peroxidation of the peritoneum and prevents loss of ultrafiltration during peritoneal dialysis. These results suggest that chondroitin sulphate may be effective in preventing the deterioration of peritoneal permeability during chronic peritoneal dialysis. This beneficial effect probably derives from the scavenging of free radicals by chondroitin sulphate.

ISSN:1660-8151    

DOI:10.1159/000187991

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Renal artery thromboembolism is a rare event in native kidneys and has never been reported to occur in allograft kidney. We report a case of allograft kidney infarction secondary to embohsation from thrombus in the hypogastric artery supplying the allograft on two separate occasions 1 and 2 years after transplant. Anticoagulation therapy alone was given and the patient responded well with partial recovery of renal function.

ISSN:1660-8151    

DOI:10.1159/000187992

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 62-year-old man with chronic renal failure secondary to Wegener’s granulomatosis received a cadaveric renal graft in December 1990 after 2 years’ treatment with continuous ambulatory peritoneal dialysis. Early graft function was good and serum creatinine fell steadily. On day 5 he became anuric and the graft became swollen and tender. Isotope renography showed no perfusion and the kidney was removed. Pathological examination showed widespread acute arteritis consistent with recurrent Wegener’s granulomatosis. Recurrence of Wegener’s granulomatosis in renal grafts is rare. The 4 previously reported cases are r

ISSN:1660-8151    

DOI:10.1159/000187993

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Interleukin-1 receptor antagonist (IL-1Ra) is a specific inhibitor of interleukin-1 (IL-1). It is structurally similar to IL-1 and binds to IL-1 cell surface receptors, but does not transduce a signal. To examine the relationship between the production of IL-1Ra and IL-1, we incubated peripheral blood mononuclear cells (PBMC) with endotoxin (10 ng/ml) and after 24 h measured the total synthesis (intra- and extracellular) of IL-1Ra, IL-lα and IL-1β. PBMC from 25 patients with chronic renal failure were studied. The total synthesis of IL-1Ra closely correlated with that of IL-1β (R = 0.786, p 0.05). These results suggest that in dialysis patients, the endogenous production of IL-1Ra is a ‘footprint’ of IL-1β production and can probably be used as a marker of the level of production

ISSN:1660-8151    

DOI:10.1159/000187994

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187995

出版商:S. Karger AG    

年代:1994

数据来源: Karger