ISSN:1660-8151    

DOI:10.1159/000190132

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Recently, involvement of remnant-like particle cholesterol (RLP-C) in atherosclerosis was reported, but this parameter has not been adequately investigated in hemodialysis (HD) patients. The present study investigated the relationship between the RLP-C level and total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), lipid peroxides (malone dialdehyde, MDA), apolipoprotein (Apo) A-I, and ApoB. In addition, the fractions of very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), LDL, and HDL in serum lipoproteins were determined by disk polyacrylamide gel electrophoresis. The relationship between the RLP-C level and three atherogenic indices was also studied. The RLP-C level in HD patients (8.2 ± 6.7 mg/dl) was significantly higher than that in normal controls (2.7 ± 1.3 mg/dl). The RLP-C level showed a significant positive correlation with the levels of TC, TG, LDL-C, MDA, ApoB, VLDL(%, and IDL(%, as well as a negative correlation with HDL(%. However, there was no correlation with age or the duration of HD. RLP-C also showed significant positive correlations with the (TC – HDL-C)/HDL-C ratio and the (VLDL + LDL)/HDL ratio, as well as a negative correlation with the ApoA-I/ApoB ratio. These results suggest that RLP-C may be a potential indicator of atherogenic risk in HD patie

ISSN:1660-8151    

DOI:10.1159/000190133

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

To study whether the activated clotting time (ACT) is a sensitive parameter to monitor anticoagulation with low molecular weight heparin (LMWH) during hemodialysis, ACT, polymorphonuclear granulocyte-elastase, and anti-factor Xa activity were studied during 30 dialysis treatments with LMWH (35 IU/kg body weight bolus; 10 IU/h/kg). Twenty treatments were performed with Hemophan, ten with polysulfone dialyzers. No clinically relevant clotting of dialyzers was observed, but minimal fibrin deposition was found more often in the Hemophan group (50 vs. 30%). Despite continuously elevated anti-factor Xa levels (Hemophan 0.49 ± 0.03, polysulfone 0.62 ± 0.01 IU/ml), a significant increase of ACT was only demonstrated 10 min after bolus application in the Hemophan group. Elevated polymorphonuclear granulocyte-elastase levels were demonstrated in the Hemophan group but were linked to the presence of minimal fibrin deposits and not to the dialyzer material. We conclude that ACT is not a sensitive parameter to monitor anticoagulation with standard doses of LMW

ISSN:1660-8151    

DOI:10.1159/000190134

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Low intracelluiar free magnesium concentrations ([Mg2+]i) are associated with essential hypertension and may reflect a disordered cellular ionic environment. 31P magnetic resonance spectroscopy was used to study skeletal muscle [Mg2+]i in a group of chronic renal failure (CRF) patients and data were compared with a group of control subjects of similar age. Other data including the patients’ blood pressure, medication and plasma biochemistry were collected. There was a significant inverse correlation of [Mg2+]i with systolic (p < 0.001) and diastolic blood pressure (p < 0.05) in the CRF population. In CRF [Mg2+]i was similar (0.52 ± 0.01 mM, SEM) to controls (0.53 ± 0.01 mM; p = 0.20), even if just the normotensive patients and controls were compared. There was no correlation of [Mg2+]i with plasma parathyroid hormone, total [Mg2+] or [Ca2+]. Similar to studies in subjects with essential hypertension, these data support a role for [Mg2+]j specifically, and an abnormal intracelluiar enviroment more generally, in the pathophysiology of hypertension in

ISSN:1660-8151    

DOI:10.1159/000190135

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We investigated the cell content and production of IL-1β and IL-1 receptor antagonist (Ra) by unstimulated and lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMC) obtained from 15 undialyzed patients with chronic renal failure (CRF; estimated GFR < 10ml/min), 15 patients on chronic hemodialysis (HD) and 15 healthy controls. These cytokines were measured by ELISA. The cell content of IL-1β in freshly obtained PBMC was not detectable in any group. In contrast, that of IL-1Ra in CRF (1,807 ± 370 pg/ml, p < 0.05) as well as in HD( 1,791 ± 151 pg/mlp < 0.001) was significantly higher than that of the controls (907 ± 156 pg/ml). In unstimulated cultured PBMC, spontaneous production of IL-1β in CRF (66 ± 13 pg/ml, p < 0.05) and in HD (81 ± 29 pg/ml, p < 0.05) was significantly higher than that of the controls (26 ± 3 pg/ml). In contrast, comparison of spontaneous production of IL-1Ra in the three groups was not significantly different. In LPS-stimulated PBMC, IL-1β production in CRF (10,896 ± 1,359 pg/ml, p < 0.01) and in HD(11,441 ± 1,400 pg/ml, p < 0.01) was significantly higher than that of the controls (6,117 ± 572 pg/ml). However, IL-1Ra production by LPS-stimulated PBMC in the three groups was not significantly different. Moreover, the spontaneous IL-lRa/IL-1β production ratio in CRF (140 ± 16, p < 0.01) and in HD (142 ± 19, p < 0.01) was significantly lower than that of the controls (294 ± 41). The present study demonstrates that cytokine production by PBMC in undialyzed CRF patients as well as in hemodialyzed patients is heightened and may induce impaired function of the immunological system before CRF patients are introd

ISSN:1660-8151    

DOI:10.1159/000190136

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Increased oxidative stress can be correlated with glomerular injury. By immunohistochemical studies, we found expression of glomerular antioxidant enzymes (AOEs), including CuZn-superoxide dismutase (SOD), Mn-SOD, and catalase, in a wide variety of glomerular diseases. The distribution of the AOEs was either localized the in mesangial region or along the luminal surface or epithelial surface of the glomerular capillary wall. There was no significant difference of glomerular AOE expression among minimal change disease (MCD), IgM nephropathy (IgM N), focal segmental glomerulosclerosis, and membranous glomerulonephritis (MGN). However, when compared with MCD, IgM N and MGN, the glomerulus of lupus nephritis and IgA nephropathy expressed a significantly higher positive rate of AOEs (p = 0.04-0.002). The expression of AOEs had a trend to be associated with increased proliferative cell nuclear antigen-positive cells in the glomerulus of diffuse proliferative lupus nephritis (p = 0.056). No association was found between infiltrating leukocytes and AOE expression in all the disease groups. The glomerulus in kidneys with renal cell carcinoma expressed a significantly higher positive rate of AOEs and therefore could not be regarded as a normal control group. In summary, the immunohistochemical evidence of glomerular AOE expression in this study provides supporting evidence of oxidative stress in a wide variety of glomerular diseases.

ISSN:1660-8151    

DOI:10.1159/000190137

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Background: Djenkolism is djenkol bean poisoning, characterized by acute renal failure, urinary obstruction and spasmodic pain. The effects of djenkol bean consumption on the urinary tract without overt symptoms and long-term outcome are not established. This paper examines the association between djenkol bean ingestion and urine abnormalities in school children. Method: 609 school children aged 7-11 years in five urban Hat-Yai schools were interviewed, and had their urine analyzed. All children included in the study had normal blood pressure for age, no illness (including respiratory tract symptoms) and were not taking medication. Results: 78% of the children had a history of eating djenkol bean and of these 31% had done so in the past 24 h. Children with hematuria were almost four times (crude odds ratio = 3.7) as likely to have a history of eating djenkol beans as those with normal urine. Crystaluria and pyuria were not significantly more common among those eating the beans. The risk of having hematuria did not change with increasing consumption, or time since last eaten, or type of preparation even after adjustment for sex and age. Conclusion: Djenkol bean consumption may be defined as one of the probable causes of hematuria in the area where the djenkol tree grows.

ISSN:1660-8151    

DOI:10.1159/000190138

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to assess whether the transplanted nephronic mass plays a role in the progression of chronic graft dysfunction, 83 well-functioning renal transplants were investigated. Plasma creatinine, creatinine clearance, renal volume, blood flow and renal vascular resistance were measured. The weight of the donor was considered as an index of the transplanted renal parenchyma and the weight of the recipient as an index of the required nephronic mass. To evaluate the adequacy of the transplanted nephronic mass, the ratio between the donor and the recipient’s weight was calculated. This ratio showed a mean of 1.06 ± 0.18 and a range between 0.63 and 1.6, indicating that a parenchymal mass between 30 and 80% of the physiologic one was transplanted in these subjects. Patients were divided into two groups: group A patients with a ratio > 1 group B patients with a ratio < 1. In group A, a regression analysis did not show any relationship between transplant age and creatinine clearance, renal volume, blood flow and renal vascular resistance as assessed by echo-color-Doppler ultrasonography. In patients with reduced nephronic mass, group B, there was a negative relationship between renal blood flow and transplant duration (p = 0.03) and a positive relationship between transplant age and renal vascular resistance (p = 0.01) and renal volume (p = 0.01). These data support the hypothesis that the difference in weight between donor and recipient may influence the outcome of the gra

ISSN:1660-8151    

DOI:10.1159/000190139

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Cytomegalovirus (CMV) infection is a major cause of morbidity and occasionally of mortality in immunosuppressed allograft recipients. At the University of Cincinnati Medical Center, ganciclovir has been administered for the prevention of CMV infection since July 1992. Forty-six recipients of cadaveric renal allografts (Group I) received ganciclovir at a dose of 2.5 or 5 mg/kg/day (adjusted for renal function) for 14-21 days, during induction treatment and during antirejection treatment with monoclonal or polyclonal antilymphocyte preparations. In this retrospective study, these 46 patients were compared with 77 recipients of cadaveric renal allografts transplanted prior to July 1992 (Group II) for the prevalence, severity and time of CMV occurrence after transplantation. CMV diagnosis was based on clinical evaluation and was confirmed by blood cultures, CMV antigen immunofluorescence assay and/or histology. Patients were stratified according to CMV serology (+) or (-) in donor and recipient. CMV infection developed in 16 of 46 (35%) patients in Group I vs. 27 of 77 (35%) patients in Group II (p = 0.97). A total of 25 episodes of CMV infection occurred in Group I compared to 44 in Group II (p = 0.76). CMV infection was diagnosed an average of 97.4 days after transplant in Group I compared to 48.3 days in Group II (p = 0.0003). Tissue-invasive CMV infection occurred in 3 patients in Group I (19%) vs. 12 in Group II (44%) (p = 0.5). In conclusion, ganciclovir prophylaxis resulted in a delayed onset of clinical CMV infection with a trend towards less severe infection in patients treated with antilymphocyte antibody preparations.

ISSN:1660-8151    

DOI:10.1159/000190140

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

To investigate abnormalities in the hemostatic and fibrinolytic system in CAPD patients, parameters of coagulation, anticoagulation, fibrinolysis, and platelet function were measured in 21 CAPD patients and 20 healthy controls. The CAPD patients had significantly higher levels of factor (F) IX, FVII, FX, antithrombin III, thrombin/antithrombin III complex, protein C, protein S, thrombomodulin, fibrinogen, fibrinopeptide A, plasminogen, FXIII, α2-plasmin inhibitor, α2-plasmin inhibitor/plasmin complex, D-dimer, fibrinopeptide B β 15-42, and β-thromboglobin than the healthy controls. The CAPD patients also showed a shorter prothrombin time. However, tissue plasminogen activator, plasminogen activator inhibitor-1 and platelet factor-4 did not show any significant differences from the levels in healthy controls. There was a significant positive correlation between many of the blood parameters and serum lipids. These results demonstrate that hypercoagulability and secondary hyperfibrinolysis occur in CAPD patients, and suggest that these changes may be related to abnormalities in lipid metabol

ISSN:1660-8151    

DOI:10.1159/000190141

出版商:S. Karger AG    

年代:1997

数据来源: Karger