ISSN:1660-8151    

DOI:10.1159/000183050

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We transplanted 6 anatomically abnormal kidneys: a horseshoe kidney that after division was transplanted into 2 recipients; 1 kidney with ureteral stones and hydronephrosis; 1 ectopic and 1 hydronephrotic kidney; 2 kidneys with extensive ureteric lesions, donated as free organs. All these kidneys ultimately had normal function in the recipients, long-term in 4. 2 patients died but in neither was the death caused by the renal abnormality.

ISSN:1660-8151    

DOI:10.1159/000183051

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We studied the efficacy of long loop diuretics in the treatment of hyponatremia associated with inappropriate secretion of antidiuretic hormone (SIADH) in 12 patients, and in 2 healthy volunteers with Pitressin®-induced SIADH. In the 2 volunteers and in all but 1 patient, the serum sodium concentration was normalized by furosemide or ethacrynic acid despite free access to water, but provided salt intake was high enough to compensate for the urinary sodium losses. The patient who did not respond had only a slight increase in his diuresis after 40 mg of furosemide, probably because creatinine clearance was initially low (44–55 ml/min). He achieved a good control with urea. The usual diuretic dose was 40 mg furosemide or 50 mg ethacrynic acid/day; only 2 patients required higher doses, 80 mg furosemide and 100 mg ethacrynic acid, respectively. Supplementary salt in tablets (3–6 g daily) had to be administered to 9 of the 11 responding patients. Hypokalemia developed in 7 patients but was easily corrected either by KCl supplements (30–40 mmol/day) in 3 patients, or triamterene administration (50 mg/day) in the remaining 4. It is concluded that treatment with long loop diuretics is a valuable alternative for the treatment of patients with SIADH syndrome in whom hyponatremia persists despite acceptable water restriction. Long loop diuretics are likely to be preferable to urea if urine osmolality and creatinine clearance are high, since a high-urea dose should then be necessary to obtain a sufficiently osmotic diuresis. On the contrary, urea will be the preferred drug if creatinine clearance is relatively low and urine osmolality is lo

ISSN:1660-8151    

DOI:10.1159/000183052

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The nature of uremic nephrocalcinosis was studied by means of X-ray microanalysis in 5/6 nephrectomized rats. The data show that calcified deposits in the renal parenchyma of uremic rats contained substantial amounts of calcium, magnesium, aluminum and silicon. Since calcificates did not reveal a uniform composition they were arbitrarily divided into 3 categories: ‘high-calcium’ with Mg: Al: Si: Ca molar ratios 7:3:8:37; ‘low-calcium’ particles were characterized by Fe:Mg:Al:Ca:Si molar ratios 7:3:5:6:13; while ‘intermediate-calcium’ particles showed Al: Mg: Si: Ca molar ratios equivalent to 2:4:6:7. The variability of calcified deposits in the renal parenchyma of 5/6 nephrectomized rats might be due to different sources, different environmental conditions along the nephron and different stages of calcification process. It is suggested that aluminum and silicon content of deposits may be of value in further characterization of uremic nephr

ISSN:1660-8151    

DOI:10.1159/000183053

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The localization of intrarenal cross-linked fibrin was examined by the effect of monochloroacetic acid treatment on the kidney sections. In acute glomerulonephritis or in mild diffuse or focal proliferative type of nephritis, cross-linked fibrin was observed mainly within glomerular capillary walls. Extension of cross-linked fibrin deposit over the mesangium or sclerotic area was seen in moderate to severe proliferative type of nephritis or in membranoproliferative glomerulonephritis. In hemolytic uremic syndrome or disseminated intravascular coagulation syndrome, cross-linked fibrin was detected within glomeruli and vessels.

ISSN:1660-8151    

DOI:10.1159/000183054

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The phenotypes of the haptoglobin (Hp), ceruloplasmin (Cp), group-specific component (Gc), transferrin (Tf), and third component of complement (C3) were determined simultaneously in the serum and urine of patients with proteinuria secondary to nephrotic syndrome of various types. In a large number of cases the patterns of Hp, Cp, and C3 phenotypes in the urine showed marked deviations from those in the corresponding serum either in the mobility or the number of their electrophoretic bands. The monomeric Hp and the Cp were found to have a very augmented urine/ serum ratio in some cases. Such differences were not detected in the electrophoretic appearance of the Gc and Tf phenotypes. Our results imply that in the proteinuria of the nephrotic syndrome, factors other than molecular weight interfere in the passage of proteins through the glomerular wall.

ISSN:1660-8151    

DOI:10.1159/000183055

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

During a period of 2 years, bone mineral content (BMC) was measured regularly in patients undergoing regular dialysis treatment (RDT). Low BMC values were found to be correlated to long duration of uremia, raised alkaline phosphatase activity, hyperaluminemia, hypermagnesemia, hypophosphatemia and clinical osteodystrophy. High levels of BMC loss were found among patients with relatively high initial BMC levels and severely calciopenic patients actually gained bone density during the investigation. Serum alkaline phosphatase activity and serum immunoreactive parathyroid hormone (PTH) levels were positively related to bone loss. It is suggested that the low BMC among RDT patients is caused by a predialytic loss that is arrested by entrance into a dialysis programme. Investigations using BMC or total body calcium as a measure of therapeutic effect must take account of this. The role of hypermagnesemia and hyperaluminemia remains undefined. Patients with BMC reduced below ca. 80% of normal may be candidates for treatment with active vitamin D metabolites.

ISSN:1660-8151    

DOI:10.1159/000183056

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We report 5 cases of acute reversible renal failure coinciding with the onset of treatment with captopril in patients with severe drug-resistant hypertension. There was no clinical or laboratory evidence for an immunologic or toxic insult, although in 1 patient we found a transient leukocyturia and mild proteinuria. A mere hypoperfusion of the kidney does not seem sufficient to account for all 5 observations: in 3 of them changes in blood pressure did not parallel changes in renal function. We propose that, in addition to hypoperfusion, captopril alters renal function by an additional intrarenal hemodynamic effect. The 5 patients had severe renovascular disease which might thus represent a significant risk factor in the development of captopril-induced acute renal failure.

ISSN:1660-8151    

DOI:10.1159/000183065

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Platelet aggregation inhibitors were isolated from the blood of dialyzed patients by high-performance liquid chromatography. At least two inhibitors exist in the blood of dialyzed patients. These inhibitors not only inhibit platelet aggregation, but also suppress the chemiluminescence response of platelet. The chromatographic behaviors and the results of enzymatic digestion suggested that these inhibitors are relatively low molecular weight nonpeptidic substances.

ISSN:1660-8151    

DOI:10.1159/000183057

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Impaired urinary concentrating ability in Bartter’s syndrome may result in part from overproduction of prostaglandins and from the defect in chloride reabsorption by the loop of Henle, or both. To assess the role of prostaglandins, concentration of the urine before and after treatment with prostaglandin inhibitors was studied in 3 patients with this syndrome, taking a constant metabolic diet. Maximal urinary osmolality was determined after overnight fluid deprivation and during infusion of Pitressin. The studies were repeated after 4 days of treatment with the prostaglandin inhibitors, indomethacin and ibuprofen. The maximal urinary osmolality was 694 ± 39 and 717 ± 78 mosm/kg, and solute clearance was 1.3 ± 0.3 and 1.2 ± 0.5 ml/min for the control and treatment periods, respectively. Prostaglandin inhibitors failed to increase the maximal urinary osmolality or solute clearance. The data thus suggest that factors other than prostaglandin overproduction cause the impairment in urinary concentration in Bartter’s syndrome. The defective chloride transport with a loss of interstitial hyperosmolality may be one such

ISSN:1660-8151    

DOI:10.1159/000183058

出版商:S. Karger AG    

年代:1983

数据来源: Karger