ISSN:1660-8151    

DOI:10.1159/000187019

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Experimental evidence suggests a pathogenetic role for lipids in focal glomerulosclerosis (FGS) analogous to atherosclerosis. As foam cells (FC) are an important factor in atherosclerosis, a retrospective comparative study was done to evaluate the significance of intraglomerular FC in human FGS. Glomerular FC infiltration was evaluated in 115 biopsies of FGS, 120 biopsies of membranous glomerulonephritis (MGN) and 50 biopsies of minimal-change disease (MCD). Selected clinical and laboratory data collected at about the time of biopsy were reviewed. The proportion of biopsies showing glomerular FC was much higher in FGS (70%) than in either MGN (12%) or MCD (0%) p < 0.001. The mean percent ( ± SD) of glomeruli with FC per biopsy was significantly greater in FGS (7.9 ± 9.9) than in MGN (2.0 ± 7.8; p < 0.0001). Of the 14 MGN biopsies with FC, 13 showed superimposed FGS. Mean serum total cholesterol and triglyceride were not significantly higher in FGS than in either MGN or MCD. The results demonstrate a close association of glomerular FC infiltration with F

ISSN:1660-8151    

DOI:10.1159/000187020

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A complete examination of the skin was performed in 53 kidney transplant recipients. Cutaneous lesions were detected in almost all patients. Papillomavirus infections, premalignant and malignant lesions represent the greatest risk for these patients. Our study underlines the importance of a continuous observation to facilitate early diagnosis and treatment of these lesions.

ISSN:1660-8151    

DOI:10.1159/000187021

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Serum and 24-hour urinary phosphate levels in primary gout patients and control subjects were measured. About 45% of gouty patients showed mild hypophosphatemia. However, mean 24-hour urinary excretion of phosphate was significantly elevated as compared with that of controls. Gouty patients showed a significantly decreased tubular reabsorption of phosphate and renal phosphate threshold. It seems that tubular phosphate transport in gouty patients is impaired, and this is the major cause of hypophosphatemia.

ISSN:1660-8151    

DOI:10.1159/000187022

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The effects of hemodialysis on the levels of serum prealbumin (pA) were studied on a crossover basis in 17 uncomplicated patients. Bicarbonate dialysate was used exclusively, and two different membranes, cuprophane and polysulfone, were compared. We aimed to prove the induction of an acute-phase response during the procedure. Serum pA, corrected for hemoconcentration, decreased significantly 24 h after the start of cuprophane hemodialysis and returned to the initial value within 48 h. No such change was observed using polysulfone membranes. These results were seemingly correlated with the effects of the membranes on complement activation. It is concluded that cuprophane hemodialysis is indeed associated with an acute-phase response, probably due to interleukin-1 release during the treatment, and that the membrane composition has some role in inducing it. Thus, serum pA analysis may prove useful as an indicator of the biocompatibility of the dialysis procedure.

ISSN:1660-8151    

DOI:10.1159/000187023

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The dose of recombinant human erythropoietin (r-HuEpo) required to correct anemia of end-stage renal disease varies among patients. The possible factors that interfere with the responsiveness to r-HuEpo were not completely known. In 32 patients on regular hemodialytic treatment with marked anemia (Hb 5.6 ± 0.7 g/dl), we evaluated circulating erythroid progenitor cells [burst-forming-unit erythroid (BFU-E)], erythropoietin, ferritin, folate and 1-84-parathormone levels before r-HuEpo therapy. In 12 patients, the aluminum levels after deferoxamine were also evaluated. The possible correlation between these factors and the response to r-HuEpo therapy was then evaluated. The number of circulating (c) BFU-E was highly variable (521 ± 447 colonies/ml of blood; normal level 742 ± 192) and does not correlate with erythropoietin, ferritin, folate, 1-84-parathormone or aluminum levels. A direct correlation between basal cBFU-E and the responsiveness to r-HuEpo therapy was recorded while no correlation was found with the other analyzed parameters. We hypothesized that low basal cBFU-E (interleukin-3 deficiency?) could reduce the response to r-HUEpo because of failure of this hematopoietic stem cell compartment to replenish the pool of more mature erythropoietic progenitor cells during the phase of accelerated maturation induced by r-HuE

ISSN:1660-8151    

DOI:10.1159/000187024

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Phosphate dialytic removal (PDR) depends in part on the type (acetate or bicarbonate) and the concentration of the buffer dialysate. Plasma phosphate reduction or PDR during a dialysis treatment is the algebraic sum, of phosphate cellular flux (removal or captation) and of phosphate tissular precipitation. High bicarbonate levels induce an intracellular shift of phosphate, thus not available for dialytic removal. On the contrary, acidosis prevents P shifting into the intracellular space, thus more P is available for dialytic removal. In order to evaluate cellular phosphate sequestration (CPS) we tested PDR in a crossover study. Three children were dialyzed (18 sessions) successively using either biofiltration with free buffer dialysate and a constant bicarbonate fluid infusion rate (BF) or using sequential biofiltration (SBF) with an initial controlled acidosis period realized by bicarbonate reinjection fluid rate modelling. PDR was higher in SBF (32 ± 4 mmol/session) than in BF (24 ± 6 mmol/session). SBF seemed to be efficient against CPS; it clearly demonstrates that bicarbonate modelling is a promising dialytic approach to enhance PDR. The real clinical relevance of these biological results needs clinical long-term evaluatio

ISSN:1660-8151    

DOI:10.1159/000187025

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

From a total of 81 patients on maintenance hemodialysis who underwent coronary angiography, 8 patients fulfilled the criteria: significant coronary artery disease, hematocrit < 27%, reproducible (ECG) positive treadmill test, no disturbance of repolarization in ECG at rest. Exercise stress testing was performed at a hematocrit of 25 ± 2% and following erythropoietin therapy at a hematocrit of 34 ± 0.5%. Symptom-limited exercise performance increased in all patients (1.10 ± 0.3 W/kg b.w. vs. 1.44 ± 0.31 W/kg b.w., p < 0.01) as well as exercise duration (489 vs. 362 s, p ± 0.01). ST segment depression during maximal exercise was reduced from a mean of 2.1 to 0.4 mm (p < 0.01). It is concluded that amelioration of renal anemia by erythropoietin in dialysis patients with significant coronary artery disease reduces exercise-induced myocardial isch

ISSN:1660-8151    

DOI:10.1159/000187026

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Viruses are thought to play a role in the occurrence of IgA nephropathy. In fact, cytomegalovirus (CMV) antigens have been detected in the glomerular mesangium. To clarify this relationship, we used in situ hybridization with biotin-labeled DNA probes of CMV and adenovirus (AV) in 40 patients with IgA nephropathy to determine the presence or absence of virus in affected renal tissue. Renal tissue DNA from these patients did not hybridize with the CMV or AV probes. Our results fail to support the theory that consecutive regional renal infections with CMV and/or AV are involved in the pathogenesis of IgA nephropathy.

ISSN:1660-8151    

DOI:10.1159/000187027

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In order to clarify intraglomerular cellular activation and cytokine involvement in IgA nephropathy, the glomerular expression of MHC class II antigens (HLA-DR and DQ) and cellular proliferative nuclear antigen (Ki-67), and serum γ-interferon (γ-IFN) levels were evaluated in 49 patients with IgA nepropathy. HLA-DR was detected in all but 4 patients in whom glomerular sclerosis was present. HLA-DQ and Ki-67 were observed in 51 and 38% of the patients, respectively. Proteinuria, recent macroscopic hematuria, mesangial proliferation, and extracapillary and endocapillary lesions were more frequent and more severe in HLA-DQ-positive than in HLA-DQ-negative patients. In 10 patients with acute exacerbation, endocapillary lesions and HLA-DQ and Ki-67 expression were present in 70,80 and 88%, respectively. Serum γ-IFN levels were high in the patients (2.0 ± 0.3 U/ml, n = 40), especially during acute exacerbation (3.4 ± 1.1 U/ml, n = 9). Glomerular HLA-DQ and Ki-67 expression correlated with serum γ-IFN levels (r = 0.73, p < 0.01 for HLA-DQ; r = 0.75, p < 0.01 for Ki-67). Renal biopsy specimens taken before and after prednisolone and/or urokinase therapy were available from 4 patients. There was strong reactivity to HLA-DQ in the glomerular tufts of all 4 pretreatment samples. However, HLA-DQ reactivity disappeared after treatment in 3 samples, concomitant with normalization of serum γ-IFN levels. We conclude that serum γ-IFN levels are related to glomerualr HLA-DQ and Ki-67 expression and acute exacerbation in patients with IgA nephropathy. These data suggest that γ-IFN and MHC class II antigens play an important role in the immune-mediated glomerular injury of IgA nep

ISSN:1660-8151    

DOI:10.1159/000187028

出版商:S. Karger AG    

年代:1992

数据来源: Karger