ISSN:1660-8151    

DOI:10.1159/000186825

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The number of mast cells in the skin was evaluated in 25 patients with end-stage renal failure on different treatment modality (conservative, hemodialysis and peritoneal dialysis). According to the presence of pruritus, uremic patients were divided into two groups: group A, 13 patients with diffuse pruritus, and group B, 12 patients without pruritus. Controls were 6 age- and sex-matched healthy subjects. In comparison with patients without pruritus, patients with pruritus had mainly degranulated, diffusely spread and more numerous mast cells in the skin; significantly higher levels of plasma middle molecular weight substances, serum histamine and PTH and significantly lower serum iron levels. However, no differences were noted in observed parameters between groups on different treatment modalities. Favorable therapeutic effects in patients with pruritus were achieved either with iron supplementation in those with hypoferremia or with antihistamines, mast cell membrane stabilizers and high-permeability membranes.

ISSN:1660-8151    

DOI:10.1159/000186826

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Renal function studies were performed in 41 patients with sickle cell-β thalassaemia (S/b thai) and compared to 14 normal controls and 8 sickle cell (SS) patients. Polyuria, hyposthenuria and mild proteinuria were common in both S/b thai and SS patients. A renal concentrating defect was manifest in all patients studied, and in 4 of the 7 S/b thai patients tested, an abnormal acidification test was found. A statistically significant negative correlation (n=19, r = -0.48, p < 0.05) was noted between creatinine clearance (CCr) and age for the patients over 30 years. There was no correlation between hemoglobin and CCr; on the contrary, a statistically significant negative correlation was found between CCr and hemoglobin F (n = 29, r=-0.428, p < 0.05) Our S/b thai and SS patients showed a decreased daily excretion of sodium, calcium, phosphate and magnesium and lower serum magnesium levels than the controls. One third of the S/b thai patients showed hyperuricosuria, and a statistically significant negative correlation was noted between serum uric acid and its fractional excretion in all S/b thai patients (n = 41, r = -0.450, p < 0.01). Serum phosphate levels were independent of age. A statistically significant positive correlation was found between the tubular reabsorptive capacity for phosphate and the number of painful crises per year (n = 33, r = 0.836, p < 0.001). We conclude that renal involvement in the double heterozygous state is as severe as in homozygous sickle cell disease

ISSN:1660-8151    

DOI:10.1159/000186827

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Vacuoles in glomerular visceral epithelial cells were found in 149 of 254 patients with idiopathic membranous glomerulonephritis (IMGN). In the whole population studied, 115 patients were nephrotic, 88 (76.5%) of which were found to have intraepithelial vacuoles. Fifty (35.9%) of 139 non-nephrotic patients had vacuolated podocytes (p < 0.01). Vacuolation occurred most frequently in stages II and III of IMGN. A few intraepithelial vacuoles were observed in stage IV. Increase in vacuolation tended to correlate with subepithelial deposits which were larger in size. From these results, we concluded that the appearance of epithelial vacuolation coincides with an increased filtration of protein in IMGN and that it is an important histological marker when diagnosing the level of severity of glomerular lesions. It was not, however, prognostic.

ISSN:1660-8151    

DOI:10.1159/000186828

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The course of left ventricular hypertrophy was investigated in anemic hemodialysis patients treated with recombinant human erythropoietin (r-huEPO). 12 patients, aged 60.8 ± 9.9 years (mean ± SD) were treated for 18.8 ± 2.7 months. Left ventricular size was estimated by echocardiography performed before treatment and at least 12 months after relieving anemia. Patients had signs of left ventricular and/or asymmetric septal hypertrophy when compared with a nonanemic and normotensive control group matched for sex and age. At baseline, hemoglobin (Hb) was 8.6 ± 0.7 g/dl; interventricular septum thickness (IVST) was 1.75 ± 0.34 cm, left ventricular posterior wall thickness (LVPWT) 1.32 ± 0.19 cm, left ventricular muscle mass index (LVMI) 222.7 ± 41 g/m2 and blood pressure (BP) 146.4 ± 10/81.6 ± 6 mm Hg. Hb rose to 11.4 ± 1.2 g/dl (p < 0.001); IVST and LVMI decreased to 1.42 ± 0.35 cm (p < 0.02) and 155.4 ± 25.1 g/m2 (p < 0.001); LVPWT and BP remained unchanged (1.30 ± 0.26 cm and 146.8 ± 16.9/81.2 ± 7.8 mm Hg) at the end of the study. During the observation period, two groups of 5 and 7 patients differed from each other. The group of 5 patients had higher BP values (158.9 ± 9.8/86.5 ± 5.3 vs. 140.0 ± 9.5/79.2 ± 6.8 mm Hg, p < 0.01nd the period with Hb values above 10 g/dl was shorter (14.5 ± 2.4 vs. 17.8 ± 2.4 months, p < 0.05). These 5 patients failed to show a significant decrease in IVST and LVMI. We conclude that long-term amelioration of anemia in hemodialysis patients is able to induce a regression of left ventricular hypertrophy. However, inadequate BP control may compromise this effect in patients

ISSN:1660-8151    

DOI:10.1159/000186829

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The aim of the study was to determine the influence of ciclosporin (Cs) on prostacyclin and thromboxane generation. Four groups of patients were studied. Group 1: Controls, n = 10. Group 2: Patients without kidney disease treated with Cs, n = 10. Group 3: Patients after transplantation treated with azathioprine, n = 10. Group 4: Renal transplant recipients receiving Cs, n = 10. Parameters investigated: CIn, CPAH TxB2 in plasma, serum and urine; 6-oxo-PGF1α in plasma and urine, urinary 2,3-dinor-TxB2 excretion. CPAH and CIn were significantly decreased during Cs treatment. Plasma TxB2 levels were enhanced in patients without kidney disease receiving Cs (group 2) amounting to 189 ± 106 pg/ml as compared to 12 ± 4 pg/ml in controls (group 1). In patients without kidney disease (group 2), plasma 6-oxo-PGF1α was increased (20 ± 9 pg/ml) as compared to controls in group 1. Plasma TxB2 and plasma 6-oxo-PGF1α were increased in renal graft recipients without any difference due to different immunosuppressive drugs. Treatment with Cs was associated with impaired renal function and resulted, in patients without kidney disease, in elevated plasma TxB2 and plasma 6-oxo-PGF1α. This effect could not be proven in renal graft recipients. We suggest that the deleterious effect of Cs on kidney function is presumably not paralleled by corresponding changes in prostaglandin and thromboxane for

ISSN:1660-8151    

DOI:10.1159/000186830

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Norepinephrine (NE) content, release and uptake by brain synaptosomes are reduced in chronic renal failure (CRF), and this has been attributed to the state of secondary hyperparathyroidism. The decrease in NE content in CRF could not be explained by changes in NE uptake or release since in normal circumstances, NE content usually remains unchanged despite fluctuation in NE uptake and release. Since NE content is determined by its production and degradation, we examined the effect of CRF with and without excess parathyroid hormone (PTH) on the Michaelis-Menton constant (Km,) and Vmax of tyrosine hydroxylase (TH), the rate-limiting enzyme for NE production, and monoamine oxidase (MAO), an enzyme involved in NE degradation of brain synaptosomes. Brain synaptosomes from rats with a 21-day CRF have a significantly (p < 0.01) lower Vmax of TH (39.5 ± 5.3 pmol tritiated H2O/mg protein/min) than that of normal rats (61. ± 7.5 pmol tritiated H2O/mg protein/min) and a higher Km of MAO (59 ± 2.9 nM tyramine) than normal animals (46 ± 1.7 nM tyramine). Parathyroidectomy (PTX) in CRF rats normalized Vmax of TH (54 ± 4.5 pmol tritiated H2O/mg protein) and Km of MAO (48.4 ± 2.3 nMtyramine). Cytosolic calcium, [Ca2+]i, in brain synaptosomes is significantly (p < 0.01) higher in rats with CRF (488 ± 8.5 nM) than in normal (355 ± 6.0 nM) or PTX-CRF (360 ± 8.1 nM) rats. The data show that: (1) the synaptosomal activity of the key enzymes involved in NE production (TH) and degradation of MAO are impaired, and [Ca2+]i is elevated in CRF, and (2) PTX in CRF rats corrected these abnormalities, implying that they are mediated by excess PTH in CRF. The results indicate that the decrement in NE production is greater than in NE degradation leading to a reduced NE content in brain synaptosome

ISSN:1660-8151    

DOI:10.1159/000186831

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Destructive spondyloarthropathy (DSA) has recently been recognized in hemodialysis patients. This study was undertaken to assess the prevalence, preferred sites, risk factors, early radiological manifestations, magnetic resonance imaging (MRI) and relation to other radiological features and biochemical variables in DSA. In 405 patients undergoing dialysis for 0.2-20.5 years (average 8.2) with a mean age of 51.9 years (range 24-84), a diagnosis of DSA was made for 37 (9.1%). The preferred site of DSA was the lower cervical spine. MRI indicated a low signal intensity of the involved vertebral regions on both T1 and T2-weighted images and thus appeared useful in the exclusion of osteomyelitis showing high-intensity T2-weighted images. The patients were divided into three groups according to radiological findings: those showing (A) the presence of DSA, (B) vertebral rim erosion (VRE) without DSA, and (C) the absence of DSA and VRE. Patient age at onset of dialysis (p < 0.01) and duration of hemodialysis (p < 0.05) appeared to be the associated risk factors for DSA. DSA was found correlated with carpal tunnel syndrome (p < 0.01), carpal bone cystic radiolucency (p < 0.01), and amyloid deposit (p < 0.01). All the groups were essentially the same with respect to the incidence of ectopic calcification, secondary hyperparathyroidism, biochemical markers and sex distribution. The results of this study show DSA to be associated with dialysis amyloidosis.

ISSN:1660-8151    

DOI:10.1159/000186832

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Effects of hemodialysate of patients with chronic renal failure (CRF) on blastogenesis of human peripheral blood lymphocytes in the presence of concanavalin A or phytohemagglutinin was investigated. Hemodialysates from 11 CRF patients significantly promoted lymphocyte blastogenesis when compared with control dialysis fluids (p < 0.01). The strongest activity (39% promotion of the lymphocyte blastogenesis) was observed with a hemodialysate obtained at 0.5 h after beginning dialysis. The activity decreased thereafter. On the contrary, the blastogenesis-promoting activity in plasma decreased significantly after hemodialysis (p < 0.01, n = 11). To further confirm the presence of low-molecular-weight factor(s) in CRF, ultrafiltration of plasma obtained from CRF and healthy subjects was conducted using a membrane filter with a molecular cutoff of 3,000 D. The filtrate of CRF plasma significantly promoted lymphocyte blastogenesis when compared to that of healthy subjects (p < 0.01). Heat treatment (100°C, 40 min) did not abolish the activity of the hemodialysate. None of the drugs taken by the patients nor creatinine accumulated in CRF promoted the lymphocyte blastogenesis. Chromatographic analysis of a hemodialysate demonstrated several peaks which were absent in the control dialysis fluid. These results showed the presence of a novel lymphocyte-stimulating factor(s) in CRF, which is heat stable and has a low molecular weight ( < 3,000 D)

ISSN:1660-8151    

DOI:10.1159/000186833

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the significance of free erythrocyte protoporphyrin (FEP) in relation to iron status, aluminum levels and anemia in uremic patients on chronic dialysis. All but 1 patient showed high FEP values closely related to the degree of anemia. Increased FEP levels are due to a defective heme synthesis, not related to iron deficiency or aluminum overload. Treatment of anemia with recombinant human erythropoietin reduced FEP values. We therefore hypothesize that recombinant human erythropoietin ameliorates an enzymatic defect in heme synthesis.

ISSN:1660-8151    

DOI:10.1159/000186834

出版商:S. Karger AG    

年代:1992

数据来源: Karger