ISSN:1660-8151    

DOI:10.1159/000183066

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Patients with early rejection of kidney allografts associated with anti-donor antibodies have been randomized in two groups which received, respectively, either the conventional corticosteroid/azathioprine treatment or extensive plasma exchanges (PE) plus the conventional treatment. Data on the monitoring of anti-T or anti-B donor lymphocytes, as well as anti-panel or autoreactive cytotoxicity are described. Although the titer of anti-donor antibodies is decreased in the PE-treated group there is no sustained improvement of graft function compared to the control group. Thus, in these stereotyped rejection episodes, which are likely to be antibody mediated, there is no significant effect of extensive and early plasma exchange.

ISSN:1660-8151    

DOI:10.1159/000183067

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The influence of aluminium in dialysate on the effects of 1α(OH)3 on hemodialyzed hypocalcemic patients with end-stage renal failure, was studied during a 24- to 42-month period. 51 hypocalcemic patients were divided into two groups; group 1 consisted of 28 patients who were dialyzed using dialysate prepared from reverse osmosed water; the 23 patients in group 2 used dialysate prepared from softened water. Aluminium concentration in the dialysate used for group 1 was less than the detectable limit (10 µg/l) in twelve times determinations, while that for group 2 was 23.1 ± 9.2 µg/l (mean ± SD, n = 14). By the administration of 1α(OH)D3, the serum concentration of calcium was increased, and that of iPTH and alkaline phosphatase activity was decreased in both groups. Subperiosteal resorption of the finger bone, evaluated by Jensen’s criteria, was significantly improved in group 1, while there was no improvement in group 2. Serum aluminium concentration in the patients of group 1 and group 2 were 46.6 ± 6.3 and 84.7 ± 13.9 µg/l, respectively, and the concentration of the latter was significantly higher than that of the former (p < 0.01). It was also shown that there is a positive correlation between the extent of subperiosteal resorption and the concentration of aluminium in serum. Serum aluminium concentration and bone aluminium content were increased according to the duration of hemodialysis in the patients who were dialyzed using dialysate from softened water, while there was no correlation between the duration of hemodialysis and serum aluminium concentration for the patients of group 1. After changing the supply of water for dialysate, prepared from softened water to reverse osmosed water, serum aluminium concentration significantly decreased. These results are consistent with, but do not prove, the hypothesis that aluminium plays a pathological role in renal oste

ISSN:1660-8151    

DOI:10.1159/000183068

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Serum concentrations of high density lipoproteins (HDL)-cholesterol, apoprotein A and apoprotein B has been studied in 13 patients with chronic renal failure treated with hemodialysis and in 12 patients with functioning renal graft. 5 patients on hemodialysis and 6 with a renal graft had hypertriglyceridemia. In the hemodialyzed patients, the increase in triglycerides was associated to a decreased concentration of serum apoprotein B. HDL-cholesterol was substantially reduced in the hemodialyzed patients without this being associated with a drop in serum apoprotein A concentration, thus suggesting that there are changes in the qualitative composition of the HDL. In renal graft recipients, the HDL-cholesterol and the apoprotein A concentration were increased. It is suggested that the risk of developing accelerated atheromatosis in patients carrying a renal graft cannot be related to changes in HDL. In patients undergoing hemodialysis, the development of atheromatosis would be related to decreased concentration and also qualitative changes in the HDL together with the increase in the VLDL and LDL.

ISSN:1660-8151    

DOI:10.1159/000183069

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The quantitative and qualitative characteristics of cells in the peritoneal dialysate from 12 patients were examined. The number of cells in each subsequent fraction of dialysate decreased, while the differential cell count remained relatively constant for each individual patient. Macrophages, lymphocytes, granulocytes and occasionally mesothelial cells were observed. In 1 patient, plasmocytes were also found. Evident differences in cellularity and cell composition were noticed in dialysate obtained from different patients, especially in 2 patients with bacterial peritonitis there was a rise in cellularity with neutrophilia. Cytochemical (peroxidase, nonspecific esterase activity) and functional (phagocytosis, receptor expression) tests revealed that macrophages form a heterogeneous population of cells.

ISSN:1660-8151    

DOI:10.1159/000183070

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Pyrazinamide and probenecid tests were used to study the renal mechanisms for urate excretion in 10 normal subjects in the state of low serum uric acid levels (below 3.5 mg/dl), normal serum urate concentrations (between 3.6 and 6.4 mg/dl) and high serum uric acid levels (above 6.5 mg/dl). Presecretory reabsorption of urate was above 99% in all three conditions of uricemia, indicating that filtered urate is nearly completely reabsorbed in the proximal tubule regardless of serum uric acid concentrations. Urate secretion was significantly higher and postsecretory reabsorption was significantly lower when serum uric acid was raised than when serum urate levels were normal or low. The findings indicate that both urate secretion and postsecretory reabsorption play a role in urate homeostasis in states of hyperuricemia.

ISSN:1660-8151    

DOI:10.1159/000183071

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

This communication reports on the excellent results achieved with Ulex europaeus agglutinin I staining of glomerular capillary endothelium using a highly sensitive lectin-antilectin immunoperoxidase method in routine paraffin sections. This staining method will be very useful for detailed morphological or retrospective studies of glomerular endothelia in various renal diseases.

ISSN:1660-8151    

DOI:10.1159/000183072

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In 71 patients (41 men, 30 women) with advanced renal failure maintained on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), or within 8 weeks after the commencement of dialysis therapy (ED), studies were performed searching for evidence of serositis and the blood levels of circulating immune complexes (CIC), measured by the polyethylene glycol precipitation method. Mean CIC levels were elevated in these patients compared to the 58 healthy subjects (mean ± SEM 725 ± 40, and 260 ± 34 µg/ml, respectively). Serositides were significantly more prevalent in ED patients compared to both remaining groups, and tended to occur less frequently in CAPD than in HD patients. CIC levels were significantly lower in CAPD than in ED patients. The levels of CIC were significantly higher in patients with serositis compared to those without evidence of serosal inflammation (mean ± SEM 868 ± 71 and 677 ± 53 µg/ml, respectively). In addition, immune complex-like materials were found in all of 4 effusate samples and in 10 of 27 peritoneal dialysates. It is suggested that immune complexes may be the ‘uremic toxins’ responsible for the serositis of renal failure, and may be secreted into serous effusions. Immune complex-like material can be removed in peritoneal dialysate, which may contribute to the lower CIC levels and lower incidence of serositis in the CA

ISSN:1660-8151    

DOI:10.1159/000183073

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The diagnostic usefulness of bone marrow hemosiderin, serum ferritin, transferrin saturation, mean corpuscular volume (MCV) and red cell protoporphyrin (EPP) in the evaluation of iron status in patients on chronic hemodialysis was studied in 39 subjects. The correlation between serum ferritin and the number of transfusions received per month was slightly higher (r = 0.717; p < 0.001) than the correlation between bone marrow hemosiderin and transfusions (r = 0.685; p < 0.01). Serum ferritin was useful in identifying subjects with both increased or reduced iron stores. In contrast, transferrin saturation could only be used for indicating iron overload. MCV for indicating iron deficiency, and EPP was not useful in either case. The abnormal increase of EPP in chronic uremia has not been previously described. It is unrelated to iron deficiency and is most probably explained by the known reduction in red cell ferrochelatase activity associated with chronic uremia. Serum ferritin is clearly the most useful diagnostic aid for assessing iron stores in patients on chronic hemodialysis. Whether ferritin is also the best predictor of response to iron therapy, cannot be determined on the basis of the present data.

ISSN:1660-8151    

DOI:10.1159/000183074

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The application of percutaneous transluminal angioplasty to vascular access stenosis is described. These access problems were discovered by the technique of retrograde venous fistulography. 13 dilatations were attempted in 12 patients. Functional success was achieved in seven attempts. This resulted in a significant prolongation of access survival in these patients. Angioplasty is recommended as a nonsurgical approach to vascular access stenosis.

ISSN:1660-8151    

DOI:10.1159/000183075

出版商:S. Karger AG    

年代:1983

数据来源: Karger