ISSN:1660-8151    

DOI:10.1159/000186117

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

We analyzed the rebound pattern of plasma β2-microglobulin (β2-m) concentration from 4 h after completion of hemodiafiltration until the start of the next treatment according to the one-pool β2-m kinetic model so as to determine β2-m generation rate and whole-body β2-m clearance. Next, we obtained the whole renal β2-m clearance as the product of renal creatinine clearance and the glomerular sieving coefficient of β2-m. Then, extrarenal β2-m clearance was calculated as the difference between whole-body β2-m clearance and whole renal β2-m clearance, and renal β2-m clearance due to tubular absorption was taken to be the difference between whole renal β2-m clearance and renal β2-m clearance due to urinary excretion. The results showed that the β2-m generation rate was virtually the same for all patients and that the higher the patients and that the higher the patients’ plasma β2-m concentration was, the lower was the whole-body β2-m clearance. Moreover, in the present study, an inverse correlation was found between the following respective factors: plasma β2-m concentration and whole renal β2-m clearance; plasma concentration and renal clearance due to tubular absorption; plasma concentration and renal clearance due to urinary excretion. However, there was no correlation between plasma β2-m concentration and extrarenal β2-m clearance. The findings indicate that the variation of plasma β2-m concentration with the individual patient is solely attributable to the variation in residual renal function in terms of β

ISSN:1660-8151    

DOI:10.1159/000186118

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Plasma levels of follitropin (FSH), lutropin (LH) and testosterone (TE) were estimated in 5 anaemic haemodialyzed patients before and after 3 months of erythropoietin treatment (EPO group), in 5 male haemodialyzed patients with a haematocrit value of 33% (which was of the same magnitude as the post-treatment haematocrit value in the EPO group) and in 15 male healthy subjects. After EPO treatment, haematocrit values rose from 23.0 ± 0.9 to 34.6 ± 0.75%. EPO treatment induced a significant suppression of basal plasma FSH and LH levels, while plasma TE levels slightly increased. After EPO treatment, the response of plasma FSH and LH to luliberin administration was significantly reduced. As the endocrine profile of EPO-treated patients differed from that of haemodialyzed patients showing a similar haematocrit value, it seems that EPO-induced hormonal changes are not or not only related to improvement of anaemia. Normalization of the pituitary-gonadal feedback in EPO treatment seems to participate in the pathogenesis of improved sexual activity in these patient

ISSN:1660-8151    

DOI:10.1159/000186119

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Two new strains of Serratia marcescens were constructed by the gene manipulation method from the clinical isolate US 46, which has two kinds of pili – mannose-sensitive (MS) and mannose-resistant (MR) ones – on the cell surface. After cloning the genes of the MS and MR pili, either the MS or the MR gene was transferred to the nonpiliated Escherichia coli, and MS- or MR-piliated strains were obtained. In the experimental pyelonephritis model of rats, MS- or MR-piliated bacteria were inoculated directly to the renal parenchyma, and the following results were obtained. MS-piliated rather than MR-piliated strains stimulated severe scarring of the kidney, and this scarring was suppressed by treatment with colchicine or superoxide dismutase (SOD) during an early stage of the infection. These findings suggest that MS-piliated bacteria stimulated polymorphonuclear leukocytes, which released large amounts of superoxide resulting in renal scarring. SOD was hoped to be a drug capable of preventing renal scarring, and such a result was successfully obtai

ISSN:1660-8151    

DOI:10.1159/000186120

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The renal hemodynamic response to a meat meal (2 g/kg BW) was studied in 11 healthy children and in 10 children with a mean plasma creatinine concentration of 2.6 ± 0.1 mg/dl due to chronic renal failure (CRF) of various etiologies. In the healthy status, after a meat meal, the glomerular filtration rate (GFR) increased significantly from a baseline value of 119.0 ± 5.0 to a peak of 159 ± 5.8 ml/min× 1.73 m2; in CRF baseline GFR averaged 49 ± 4.0 and at peak 76.6 ± 7.2 ml/min × 1.73 m2 (p < 0.005). The peak GFR response was reached earlier in healthy subjects than in CRF (p < 0.05) and did not correlate with age or with baseline GFR. Renal plasma flow (RPF) in healthy controls increased from 532 ± 32 at baseline to 646 ± 42.9 ml/min × 1.73 m2 after the meat meal (p < 0.005). Also in CRF after a meat meal there was a significant increase in RPF from 278 ± 51 to 65 ± 66 ml/min × 1.73 m2 (p < 0.005). The filtration fraction was not affected. The percent increase over baseline values of GFR and RPF at the peak was significantly higher in diseased children. Renal reserve averaged 28.1 ± 5.3 ml/min in diseased children and 39.7 ± 5.2 ml/min (p < 0.01). The data indicate that (1) a meat meal is a suitable method to recruit renal reserve in normal children and in children with chronic renal failure, and (2) the renal reserve is normal in chronic

ISSN:1660-8151    

DOI:10.1159/000186121

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Although many patients taking ciclosporin (CS) for the long term develop hypertensive side effects, a proportion do not. We have studied the blood pressure response to graded upright bicycle exercise while continuously recording the metabolic rate in 18 normotensive renal transplant recipients whose mean age was 30.8 years (range 16–54). Nine were treated with CS alone and 9 with azathioprine and a steroid, prednisolone (AzS). Both groups performed a progressive exercise test, with work increasing by 25 W every 4 min from rest. All patients completed a workload of at least 75 W during the test. A group of 8 normal subjects whose mean age was 29 years (range 19–44) were exercised with the same protocol. The CS group had a significantly higher mean systemic blood pressure at both 50 and 75 W (124 and 132 mm Hg, respectively), compared with the AzS group (103 and 108 mm Hg; p < 0.01). The blood pressure response to exercise in the AzS group was similar to that observed in the normal group. This was despite a higher metabolic rate at each stage of work in the AzS group as compared with the CS or normal groups. Despite being normotensive at rest, renal transplant patients who are treated with CS have evidence of a vasopressor effect, with systemic vascular resistance inappropriately high for exercise, implying reduced compliance of the vascular

ISSN:1660-8151    

DOI:10.1159/000186122

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Eight patients with end-stage renal disease secondary to systemic lupus erythematosus (SLE) received 8 cadaveric renal allograft. Patient and graft survival was 100 and 87%, respectively. None of them showed extrarenal manifestations of SLE or recurrence of lupus nephritis after grafting. One graft was lost because of chronic rejection. In another patient, an episode of graft function deterioration due to bad control of arterial hypertension was observed. Three patients were transplanted during their first year on hemodialysis. Two women became pregnant after successful kidney transplantation; one suffered a spontaneous abortion and the other had a successful delivery. In neither of them, was SLE observed during or after pregnancy. Morbidity was low in this series, and infections were the most frequent complication. In summary, our experience with renal transplantation in SLE patients compares, favorably with the general nodiabetic transplanted population.

ISSN:1660-8151    

DOI:10.1159/000186123

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The sera of 64 patients with extracapillary glomerulonephritis were investigated by enzyme-linked immunosorbent assay for the presence of antibody to human neutrophil myeloperoxidase (MPO). In all, circulating anti-MPO were found in 30% and antineutrophil cytoplasm antibodies (ANCA) detected by indirect immunofluorescence in 44% of the patients. Autoantibody to components of neutrophil granulocytes was not found in patients with other forms of glomerulonephritis. The incidence of ANCA (16/23) was higher than that of anti-MPO (5/23) in patients with a dignosis of Wegener’s granulomatosis. By contrast, anti-MPO was found in a majority of vasculitis patients without extrarenal symptoms (6/9), including 3 patients treated with hydralazine. One of the patients treated with hydralazine had circulating ANCA in combination with anti-MPO. Anti-MPO was also found in 1 out of 6 patients with Goodpasture’s syndrome. The findings emphasize that autoantibodies to distinct components of neutrophil granulocytes partly differ with regard to diagnostic specific

ISSN:1660-8151    

DOI:10.1159/000186124

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Serum concentrations of soluble interleukin 2 receptor (IL-2R) were measured in 65 hemodialysis patients and compared with serum levels of β2-microglobulin and tissue polypeptide antigen (TPA). Elevated IL-2R levels, found in 85% of examined patients, correlated with elevated TPA serum concentrations (p < 0.05). Patients with high IL-2R levels were significantly younger (p < 0.05) than patients with low levels. Primary renal disease and residual renal function had no significant influence on TPA or IL-2R serum concentrations. In 16 patients with carpal tunnel syndrome, increased serum concentrations of IL-2R (p < 0.005) and TPA (p < 0.001) were found. We conclude that a non-specific dialysis-induced activation of epithelial and lymphóid cells rather than a specific immune response could explain the concomitant elevation of IL-2R and TPA serum concentrations in hemodialyzed patients. Patients with pronounced cell turnover, reflected by elevated IL-2R and TPA levels, may show an increased susceptibility to dialysis-associated amyloidosi

ISSN:1660-8151    

DOI:10.1159/000186125

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

We examined the influence of uremic serum on antigen receptor triggered T cell proliferation in dialysis patients with impaired immune function, i.e., 12 nonresponders to hepatitis B vaccination. The dialysis patients showed a monocyte dysfunction and an increased responsiveness to interleukin 2 (IL-2) according to our previous findings. In vitro the addition of IL-2 completely reconstituted the defect. Uremic serum inhibited monocyte-dependent T cell proliferation of patients and of healthy controls. Contrary, monocyte-independent steps of T cell proliferation were not impaired by uremic serum. When IL-2 was added to cultures, the T cell proliferation in the presence of uremic serum was even enhanced. We conclude that uremic immunodeficiency may be enhanced by soluble factors present in uremic serum which inhibit monocyte-dependent steps of T cell proliferation.

ISSN:1660-8151    

DOI:10.1159/000186126

出版商:S. Karger AG    

年代:1990

数据来源: Karger