ISSN:1660-8151    

DOI:10.1159/000184940

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

One hundred and sixteen (3.5%) of 3,300 specimens submitted by 72 patients as urinary stones were artifacts, i.e. not formed of accepted constituents of urinary calculi. The laboratory diagnostic methods included infrared and wet chemical analysis, and X-ray diffraction. Twenty-eight were of organic origin and some of these were undoubtedly submitted by accident as calculi. Eighty-eight were of mineral origin, mainly quartz and feldspar, and it is believed that the great majority were submitted for secondary gain or for psychiatric reasons. Ten patients each submitted from 2 to 10 artifacts. Five case studies are presented which illustrate some confounding clinical and laboratory findings. Spurious stones can lead to difficult clinical and laboratory problems.

ISSN:1660-8151    

DOI:10.1159/000184941

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The renal handling of calcium and phosphate in relationship to the renal handling of sodium was studied in 7 healthy male volunteers under steady state metabolic conditions during prolonged (10 days) mineralocorticoid treatment. Calcium excretion was reduced together with sodium excretion during the early phase of mineralocorticoid treatment, whereas it increased independent of sodium excretion following the escape. Phosphate excretion did not change throughout. These results suggest that when there is extracellular volume expansion without increase in sodium intake and/or excretion, there is a dissociation of calcium and sodium excretion, suggesting that extracellular volume can affect the renal tubular handling of calcium probably as a result of mechanism(s) operating in the distal nephron.

ISSN:1660-8151    

DOI:10.1159/000184942

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Posttransfusion alloimmunization to red cell antigens was studied in a group of 98 chronic renal disease patients treated solely with hemodialysis. Clinically significant red cell antibodies were formed in only 6.1% of transfused patients, and only 1 patient formed more than one antibody. We do not recommend extended red cell phenotyping, beyond ABO and Rh(D), in patients with end-stage renal disease who may require transfusion.

ISSN:1660-8151    

DOI:10.1159/000184943

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In 35 initially normotensive patients with chronic glomerulonephritis and lupus nephritis (including 27 patients with nephrotic syndrome; NS), blood pressure (BP), urinary sodium excretion, plasma renin activity (PRA), plasma aldosterone level (PA), urinary aldosterone excretion (Au and blood volume were measured before and during prednisolone treatment. In 7 patients (all with NS) steroid-induced hypertension has developed. The patients prone to develop hypertension were hypervolemic nephrotics with initial depression of PRA, PA, Au, and severe sodium retention. In these patients prednisolone did not produce diuresis of natriuresis nor did it decrease proteinuria. In normo- and hypovolemic patients prednisolone produced significant diuresis and natriuresis and failed to induce hypertension. Thus, two types of response to prednisolone could be observed in patients with NS.

ISSN:1660-8151    

DOI:10.1159/000184944

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The incidence and severity of hyperkalemia and azotemia was investigated in a prospective randomized study involving 74 patients receiving either sulindac 200 mg p.o. b.i.d. or indomethacin 25 mg p.o. t.i.d. and 100 mg p.r. The mean ± SE posttreatment increment in serum potassium was 0.8 ± 0.1 mmol/l in patients treated by indomethacin compared to 0.5 ± 0.1 in those receiving sulindac (p < 0.025). The mean ± SE posttreatment increment in blood urea nitrogen (BUN) was 3.1 ± 0.4 mmol/l in patients on indomethacin compared to only 0.9 ± 0.3 in patients on sulindac (p < 0.001). In 5 patients who developed hyperkalemia while on indomethacin, changing to sulindac resulted in a sharp reduction of serum potassium in 3, and normalization of BUN in all patients. These data support the claim of a reduced risk of impaired renal function associated with the use of sul

ISSN:1660-8151    

DOI:10.1159/000184945

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Seven patients on chronic hemodialysis were given alphacalcidol (1α-OH-vitamin D3) intravenously in a pilot study during 3 months. Before treatment all patients had serum calcium values within the normal range, but elevated levels of parathyroid hormone (PTH). When serum calcium was raised above the normal range by treatment with alphacalcidol, all patients displayed marked suppression of PTH levels with a mean reduction of 40 ± 20% (SD; p < 0.01). When the dose of alphacalcidol was reduced so that the serum calcium values were kept at the upper limit of the normal range, a partial return towards pretreatment values of PTH was seen but the levels were still lowered (p < 0.05). Thus, intravenous administration of the vitamin D compound appeared to be useful for the management of secondary hyperparathyroidism in patients on dialysis. A direct effect of alphacalcidol on the parathyroid glands could, however, not be distinguished from the calcemic actio

ISSN:1660-8151    

DOI:10.1159/000184946

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Nephrotoxicity of radio-opaque contrast media (CM) is generally believed to involve toxic injury of proximal tubular cells. Measurement of urinary tubular enzyme excretion has been advocated as a sensitive marker of such toxic injury. It has been claimed that the new low-osmolality or nonionic CM reduce the incidence of nephrotoxicity but this remains uncertain. We studied 23 patients with normal renal function undergoing coronary angiography; patients were randomized into three groups receiving either diatrizoate (1,800 mmol/kg H2O), ioxaglate (600 mmol/kg H2O) or iohexol (850 mmol/kg H2O). Urinary excretion of a panel of enzymes increased significantly in all groups by 20 h (p < 0.05 to < 0.005). Alanine aminopeptidase excretion at 20 h was greater after the administration of high osmolality ionic CM than with the others but all three CM produced a similar pattern of enzyme excretion. No significant change in glomerular filtration rate was found in any group so the significance of the enzymuria remains uncertain.

ISSN:1660-8151    

DOI:10.1159/000184947

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The present work was performed on uninephrectomized rabbits recovering from ischemic acute renal failure (ARF) in an attempt to elucidate whether or not intraglomerular events are a determinant factor in the development of resistance to ARF. 14 days after a 2-hour clamping of the renal artery (the recovery phase), the animals did not show resistance to an additional ischemia. On the other hand, glomeruli derived from normal kidneys displayed a contractile response to angiotensin II, arginine vasopressin or norepinephrine in Eagle’s minimum essential medium, whereas glomeruli from rabbits recovering from ischemic ARF were refractory to the vasoconstrictor agents. The findings suggest that glomerular refractoriness to contractile stimuli does not provide resistance to an additional renal ischemia in the ischemic model of A

ISSN:1660-8151    

DOI:10.1159/000184948

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A major endogenous ligand substance, 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF), accumulated in the sera of uremic patients, inhibited phenytoin binding to pooled serum obtained from healthy subjects and to human serum albumin in a concentration usually observed in the sera of patients with uremia. This suggests that CMPF is a major drug-binding inhibitor present in uremic serum and may be one of the so-called ‘uremic toxins

ISSN:1660-8151    

DOI:10.1159/000184949

出版商:S. Karger AG    

年代:1988

数据来源: Karger