ISSN:1660-8151    

DOI:10.1159/000186857

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000186858

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Plasma levels of interleukin-6 (IL-6), a cytokine known to be involved in lymphocyte activation and in inflammation, were studied in 10 normal volunteers, 21 continuous ambulatory peritoneal dialysis (CAPD) patients and 41 hemodialysis patients. Plasma IL-6 levels in hemodialysis patients were significantly higher than those in normal volunteers and CAPD patients (p < 0.05). The means of plasma IL-6 concentrations before and after hemodialysis did not change significantly. While IL-6 in peritoneal dialysate was detectable in only 3 of the 21 CAPD patients without peritonitis, it was extremely high in 2 patients with bacterial peritonitis. IL-6 levels decreased as peritonitis subsided.

ISSN:1660-8151    

DOI:10.1159/000186859

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The systemic production of tumor necrosis factor (TNF)-α was evaluated in uremic patients before and after hemodiafiltration (HDF) and paired filtration dialysis (PFD) and in the interdialytic period. Both HDF and PFD were performed using polysulfone dialyzers with either standard or ultrapure dialysis fluid. TNF-α was quantitated by using a specific biological assay based on its cytotoxic effect on a TNF-sensitive human melanoma cell line SK-MEL-109. Postdialytic mean plasma TNF-α levels decreased, albeit not significantly, in regard to predialytic values. These results differ from those obtained in patients on HDF using other high-permeability membranes such as polymethylmethacrylate and polyacrylonitrile (AN 69) as recently described by us. Of interest, the adoption of ultrapure dialysis fluid resulted in a marked reduction in the interdialytic production of TNF-α. These results suggest that the enhanced production of TNF-α in patients dialyzed with high-permeability membranes is mainly dependent upon the bacteriological purity of dialysis f

ISSN:1660-8151    

DOI:10.1159/000186860

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The selenium (Se) concentration in plasma, serum and whole blood was determined in 29 healthy persons, 19 nondialyzed patients with chronic renal disease (9 proteinuric but with otherwise normal renal function, 10 with chronic renal failure), and 10 dialyzed end-stage renal disease patients. No differences in Se concentrations of plasma, serum or whole blood were determined between patients and their matched controls. Total Se concentrations did not correlate with any of the Se carriers except with α2-globulin. However, α2-globulin concentrations were not different between patients and controls. Within the dialyzed patient group, Se concentrations did not change during dialysis. Se supplementation is not indicated in these patients. Within all groups analyzed, serum Se concentrations (12.7 ± 2.5 μg/dl) were significantly (p < 0.0001) lower than comparable plasma concentrations (15.3 ± 3.9 μg/dl). These data suggest normal concentrations of blood Se in the groups of patients evaluated; and they are not Se-deficient. Serum Se concentrations cannot be equated with plasma v

ISSN:1660-8151    

DOI:10.1159/000186861

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Formation of agglomerates of calcium oxalate monohydrate (COM) crystals on semi-batch precipitation peformed at conditions relevant to urolithiasis (37°C, pH = 6, initial ratio [Ca]/[Ox] = 10), but without any specific admixture, was followed by both optical and electron microscopy. COM crystals formed on precipitation developed into large agglomerates consisting of intergrown crystals by a mechanism of primary agglomeration. Primary agglomeration of COM crystals represents an important mechanism of COM renal calculi growth

ISSN:1660-8151    

DOI:10.1159/000186862

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The use of noninvasive diagnostic tools, like the deferoxamine (DFO) test and serum iPTH, to identify aluminum-related bone disease has proved to be inadequate due to false-negative cases; therefore, bone biopsy becomes a necessary diagnostic procedure. Our purpose was to verify whether these non-invasive parameters, appropriately used, may result valid in the identification of patients not at risk of A1 toxicity, therefore restricting the need for histologic evaluation. We studied 68 hemodialyzed patients, aged 49.0 ± 11.6 years, with a M/F ratio of 37/31 and a dialytic age of 85.0 ± 47.0 months, by means of bone biopsy, DFO test and serum C-PTH. 19.1% of the cases had positive stainable Al and/or high bone Al content ( > 60 mg/kg/dw) and could be intoxicated. To obtain the highest sensitivity, we selected the following limit values: the lower limit of increment so far proposed for DFO test positivity ( > 150 µg/l) and a value capable of selecting patients with pathologic osteoclasia for C-PTH ( > 15 ng/ml). With these limits, four different groups of patients were recognized: group A, DFO test positive and PTH high, n = 12; group B, DFO test positive and PTH low, n = 6; group C, DFO test negative and PTH high, n = 30; group D, DFO test negative and PTH low, n = 20. In group B, which could be anticipated as being at higher risk, we actually found the highest (p < 0.05) bone Al content as compared to other groups, associated with a reduced bone formation rate. However, also in group A and D cases with high A1 content and/or positive A1 stain togheter with low bone formation rate were recorded. On the contrary, all patients in group C invariably showed low bone Al content, negative A1 stain and high-normal bone formation rates, therefore representing a category of patients not a risk of A1 toxicity. We suggest that the use of DFO test and serum C-iPTH assay, at the selected threshold levels, may be suitable to identify patients without an important Al burden, not requiring a bone biopsy to rule out the risk of A1 toxici

ISSN:1660-8151    

DOI:10.1159/000186863

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

To evaluate the influence of body iron stores on the serum aluminum (Al) level, we studied the correlation between iron status (the serum ferritin, serum iron and transferrin saturation) and serum Al levels in 68 severely anemic hemodialysis patients. Among them, 36 underwent the desferrioxamine (DFO) mobilization test. These 68 patients were divided into three groups according to their serum ferritin level. The basal Al level in the patient group was 41.4 ± 37.4 μg/l (control, 4.1 ± 2.4 μg/l). The serum Al level after DFO infusion of the patient group was Ill.1 ± 86.8 μg/l. A significantly higher basal Al and peak Al level after DFO infusion were found in group 1 patients (serum ferritin 1,000 μg/l) patients. A significant negative correlation between serum ferritin and basal serum Al (r = -0.544, p = 0.0001), as well as peak serum Al after DFO infusion (r =-0.556, p = 0.0001), was noted. Similarly, a negative relationship between serum Al (both basal and peak) and either serum iron or transferrin saturation was noted. However, there was no correlation between the serum Al level and the dosage of aluminum hydroxide. In conclusion, serum ferritin, serum iron and transferrin saturation were inversely correlated with serum Al in our hemodialysis patients. Iron deficiency may probably increase Al accumulation in these

ISSN:1660-8151    

DOI:10.1159/000186864

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the expression of Mac-1 on granulocytes (flow cytometry) from 9 patients (27 examinations) during hemodialysis with cuprophane membranes (CuM). Samples were drawn before dialysis and from the arterial and venous lines at 5,15 and 180 min. Granulocytopenia was most pronounced after 15 min of treatment. Mac-1 expression on granulocytes increased during dialysis, and a pronounced enhancement occurred across the dialyzer. Mac-1 expression on granulocytes increased 116% across the dialyzer at 5 min, and the degree of Mac-1 mobilization at 5 min correlated with the degree of subsequent granulocytopenia at 15 min. In in vitro experiments, granulocytes from healthy blood donors were incubated with plasma drawn from the arterial and venous lines at 5 min. Plasma drawn from the venous line at 5 min had a greater ability to mobilize Mac-1 than plasma from the arterial line (p < 0.002). This difference correlated with the degree of granulocytopenia at 15 min (r = 0.76, p = 0.01). Pieces of a washed CuM were incubated in normal human serum (NHS) preparations for different times. Inactivation of the alternative pathway of complement activation (NHS-50°) did not alter the generation of Mac-1-mobilizating capacity compared to NHS. In contrast, inactivation of the classical pathway (NHS-EGTA) decreased the early but not the late generation of Mac-1-mobilizating capacity. Our results indicate that the early mobilization and not the absolute expression of Mac-1 correlates with granulocytopenia, and that sera in vitro attain Mac-1-mobilizating capacity more rapidly when the classical pathway of complement activation is intact

ISSN:1660-8151    

DOI:10.1159/000186865

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Of 13 chronic hemodialysis end-stage renal disease (ESRD) patients undergoing open-heart surgery, 7 received intraoperative hemodialysis (IHD) during cardiopulmonary bypass and 6 received hemodialysis on a routine basis (RHD). Within the groups, IHD patients had significantly lower post-operative mean serum potassium and mean plasma creatinine concentrations compared to mean preoperative values. Postoperative mean BUN tended to decrease and mean serum bicarbonate concentration was unchanged as compared to mean preoperative values. In the RHD group, however, post-operative mean serum potassium concentration tended to increase, mean serum bicarbonate concentration significantly declined and mean BUN was unchanged as compared to mean preoperative values. An average of 2.1 ± 0.5 liters of fluid was removed from the IHD patients during cardiopulmonary bypass. Post-operatively, 0 of 7 IHD patients versus 4 of 6 RHD patients required parenteral sodium bicarbonate therapy (eχ2, p < 0.01). On average, RHD patients required hemodialysis 1 day after surgery, whereas IHD patients were hemodialyzed 2 days after surgery (p = 0.009). We conclude that IHD lessened postoperative hyperkalemia and metabolic acidosis and delayed postoperative hemodialysis by an additional day. IHD should be considered as an adjunct to RHD therapy in the management of ESRD patients undergoing open-heart surger

ISSN:1660-8151    

DOI:10.1159/000186866

出版商:S. Karger AG    

年代:1992

数据来源: Karger