ISSN:1660-8151    

DOI:10.1159/000186508

出版商:S. Karger AG    

年代:1991

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000186509

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The ratios creatinine clearance (Crcl)/inulin clearance (INcl) obtained in 523 measurements and reported in 14 papers have been analyzed and the values of CRcl corresponding to those of INcl have been evaluated. The day-to-day coefficient of variation of CRcl has also been measured in 123 persons, including patients with stable chronic renal failure and patients with normal renal function. The data obtained indicate that CRcl is not less sensitive than INcl, and that its changes are not blunted, if compared with similar changes of INcl. The day-to-day coefficient of variation has been found not to be greater than that of INcl. In conclusion, CRcl is not a misleading method to obtain approximate information on renal function, if it is correctly executed and interpreted.

ISSN:1660-8151    

DOI:10.1159/000186510

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Serum and urinary concentrations of NCI, the non collagenous globular domain of collagen IV, were used as markers for turnover of basement membranes. NCI levels were studied in membranous glomerulonephritis and diabetic nephropathy. Thirteen patients with membranous glomerulonephritis and 8 insulin-dependent diabetic patients with diabetic nephropathy were compared to 16 apparently healthy control subjects. The patients with membranous glomerulonephritis had lower levels of NCI in serum and urine compared to the control subjects. In comparison, the patients with diabetic nephropathy had similar levels of NCI in serum and urine as the control subjects. Furthermore, among patients with membranous glomerulonephritis, those with hypertension had higher serum levels of NCI than those without, which may indicate that hemodynamic factors influence the basement membrane collagen metabolism. It is suggested that there are differences in basement membrane turnover in membranous glomerulonephritis and diabetic nephropathy although there are similarities in glomerular histopathological features. Other possible mechanism are discussed. Further studies are needed to confirm the suggested mechanism.

ISSN:1660-8151    

DOI:10.1159/000186511

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We studied 14 patients (11 women and 3 men) from 18 to 33 years old, suffering from type I diabetes mellitus with normal renal function (creatinine clearance 106.91 ± 28.73 ml/min) and serum uric acid below 2.5 mg/dl (2.34 ± 0.11 mg/dl) as well as a high uric acid clearance (23.04 ± 5.92 ml/min) and fractional urate excretion (21.4 ± 2.6) versus urate clearance 9.82 ml/min and fractional urate excretion 8.80 ± 1.3 in 14 normal control subjects. The study of the uricosuric mechanisms was conducted by the combination of probenecid (PB) test which inhibits the reabsorption of secreted urate, and pyrazinamide (PZA) test, which inhibits its tubular secretion. The results of studies indicate that the increase in urate clearance was accounted for by increased PZA-nonsuppressible urate suggesting a decreased reabsorption of filtered urate. Increased PZA-suppressible urate excretion combined with impaired response to a uricosuric drug is consistent with impaired reabsorption of secreted urate. According to our findings, increased urate excretion in diabetic patients may be attributed to the inhibition of both filtered and secreted reabsorption. This reabsorptive tubular abnormality is consistent with the view of an interference of tubular reabsorption of glucose with the tubular capacity for uric acid reabsorp

ISSN:1660-8151    

DOI:10.1159/000186512

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

To evaluate renal terminal complement activation in patients with glomerular diseases, we measured terminal complement complexes (TCCs) in plasma and urine with sandwich enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody against a C9 neoepitope expressed on TCC and a polyclonal antihuman C7 antibody. TCCs were detectable in plasma but not in urine in most of normal controls. In plasma, TCC levels were elevated in 4 of 22 patients with lupus nephritis and in 6 of 12 with membranoproliferative glomerulonephritis. However all patients with IgA nephritis, focal glomerulosclerosis, idiopathic membranous nephritis and idiopathic minimal change nephrotic syndrome (MC) showed normal values. In urine, TCCs were detectable in almost all patients with heavy proteinuria (≥ 100 mg/ml) except MC. The TCCs present in urine were partially purified by gel filtration using Sepharose 6B and were found to contain C5, C6, C7, C8, C9 and S protein by ELISA. Although the molecular weight of TCC is similar to that of IgM, the fractional excretion rate of TCC was about 100 times higher than that of IgM. These results suggest that TCCs detectable in urine contain SC5b-9 complexes and are mostly of renal origi

ISSN:1660-8151    

DOI:10.1159/000186513

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The body composition of 62 haemodialysis patients (41 males) and 63 controls (30 males) was assessed using anthropometry and in vivo neutron activation analysis of body nitrogen. There was no significant difference between patients and controls in body mass index (BMI) and percentage body fat. Arm muscle circumference was significantly reduced in males. Lean body mass was strongly correlated with body nitrogen in controls (r = 0,951) but less so in patients (r = 0,876). The mean standardised body nitrogen index (NI) was reduced in male patients by 13% (95% confidence interval -9 to -17%) and in females by 4% (95% confidence interval + 4 to -12%). Of the 16 patients with a NI below the control range, arm muscle circumference was below the control range in only 3 and BMI less than 18 kg/m2 in 2. NI was correlated negatively with the duration of renal replacement therapy, duration of haemodialysis, the number of previous failed transplants and the total dose of steroids received but not with current energy or protein intakes. Steroid dose was the only significant independent variable. Anthropometry underestimates body protein depletion in haemodialysis patients and the degree of protein loss is related to the cumulative dose of corticosteroids previously received.

ISSN:1660-8151    

DOI:10.1159/000186514

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Elevated plasma concentrations of complement split product C3d have been reported to represent activation of the complement system. In the present study the effect of renal function on C3d concentrations was investigated in patients with various degrees of renal impairment, in patients with chronic renal failure and in CAPD patients. It appeared that elevated plasma C3d concentrations were present in patients with plasma creatinine concentrations in excess of 200 μmol/l regardless of the type of kidney disease. It is very likely that this can be attributed to renal handling (i.e. glomerular filtration, tubular reabsorption and renal catabolism) of C3d in a similar way as has been demonstrated for other low molecular weight proteins. The peritoneal permeability to C3d was slightly less than could be expected on the basis of its molecular weight without evidence of local production of C3d. Renal function should be taken into account in the interpretation of elevated plasma concentrations of C3d

ISSN:1660-8151    

DOI:10.1159/000186515

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

23 patients (16 women, 7 men) with rheumatoid arthritis (RA) and renal biopsy-proven mesangial glomerulopathy (MGP) were followed for 4–117 months (median 42) in order to evaluate the clinical course of their renal disease. Urinalysis was made, and 24-hour urine protein excretion and serum creatinine were determined. At the time of renal biospy, the clinical renal findings of the patients were isolated hematuria (n = 10), isolated proteinuria (n = 6) and hematuria combined with proteinuria (n = 7). Hematuria persisted and renal function remained normal in all patients with isolated hematuria. A possible association between the presence of hematuria and the use of antirheumatic drugs was not established in this study. Proteinuria was clinically closely associated with the use of antirheumatic drugs in 9 out of 13 cases (6 with gold sodium thiomalate, 2 with D-penicillamine and 1 with auranofin) suggesting that antirheumatic drugs are important contributors to proteinuria in these patients. Renal function, although initially reduced in some patients, remained stable in all but 1 patient with IgA glomerulonephritis who developed the nephrotic syndrome and died of uremia. In conclusion, the clinical course of MGP in RA patients is benign in most patients. Moreover, this nephropathy may not represent a clinical entity. Proteinuria was related to antirheumatic drugs in most patients whereas microhematuria was constant even after stopping the antirheumatic drug

ISSN:1660-8151    

DOI:10.1159/000186516

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Urinary kallikrein excretion (UKE) was measured in 20 patients before and after hemodialysis (HD). When compared to the values of normal subjects (136 ± 56 μg/24 h, n = 100), UKE was decreased in all patients before HD (6.6 ± 5.8 μg/24 h, p < 0.001, n = 20). After HD a significant increase in 24-hour UKE was observed in all patients (18.6 ± 7.2 μg/24 h, p < 0.05, n = 20). Expressed as the individual percent increase, the UKE enhancement ranged from 16 to 670%. It was due to an enhancement in the excretion of the active form which represented 52 ± 6.8% before HD and reached 76.3 ± 7.5% of the total form after HD (p < 0.01). The excretion of the inactive form remained unchanged. The increase in UKE was found to be significantly correlated with reductions in urinary sodium, potassium, and osmolality (r =-0.826, r =-0.568, r =-0.847, respectively, p < 0.01, n = 20). The increase in UKE following HD could not be explain by an increase in aldosterone as urinary aldosterone decreased. A transient improvement in intracellular homeostasis (removal of inhibitory toxins and normalization of osmotic pressure) could be evoked. The increase in UKE 24 h after HD points out a new situation confirming the relations of UKE with changes in osmolality and extracellular

ISSN:1660-8151    

DOI:10.1159/000186517

出版商:S. Karger AG    

年代:1991

数据来源: Karger