ISSN:1660-8151    

DOI:10.1159/000185282

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We previously found that virtually all patients with nephrotic syndrome (NS) excrete supranormal amounts of urinary kallikrein; it is known that activity of the renin-angiotensin system (RAS) is increased in some such patients. We therefore studied the relationship between urinary kallikrein excretion (UKa) and plasma renin activity (PRA) in 16 patients with NS. Compared with healthy controls, PRA was normal in 8 subjects and elevated in 8; UKa was elevated in the high-renin group (40.4 ± 5.2 nkat/24 h, normals 12.0 ± 1.1). UKa was also elevated in the normal renin group (25.7 ± 2.4 nkat/24 h) but to a significantly lesser degree. Significant activity in plasma against a specific substrate of glandular and renal kallikreins was observed in 8 of 10 patients with NS. Such activity was not found in plasma of 17 patients with glomerulonephritis without NS, or in 10 healthy controls. The results are in keeping with previous suggestions of a functional link between the renal kallikrein-kinin system (KKS) and the RAS, but indicate that the renal KKS is activated in NS, in some cases independently of the RAS. It is possible that renal kallikrein reaches the systemic circulation in some patients with

ISSN:1660-8151    

DOI:10.1159/000185283

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We show the results of treatment with percutaneous transluminal angioplasty on 38 occasions for vascular access for hemodialysis. Our study includes 22 patients with A-V internal fistulas (Cimino type), 1 autologous saphenous vein shunt and 7 synthetic polytetrafluoro-ethylene shunts. Twenty patients have had a follow-up period over 24 months. Four patients required a second and 2 of them a third transluminal dilatation. Only on two occasions were complications related to the technique. The microscopic findings of the venous wall after percutaneous transluminal angioplasty are shown.

ISSN:1660-8151    

DOI:10.1159/000185284

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Five patients with symptomatic osteomalacia undergoing chronic hemodialysis took 24R,25-dihydroxycholecalciferol, 10 μg/day, for periods of 6–20 months. Four patients took calcitriol simultaneously in doses consistent with normocalcemia, but the 5th was unable to do so because of recurrent hypercalcemia. In the group as a whole, despite achievement of physiologic plasma concentrations of 24,25-dihydroxyvitamin D, we could demonstrate no metabolic or histologic benefit of therapy. Substantial osteomalacia persisted in all posttreatment biopsy specimens, appearing more severe in some cases and less severe in others. At the doses prescribed, the results of treatment of dialysis osteomalacia with 24R,25-dihydroxycholecalciferol were clinically unsatisfacto

ISSN:1660-8151    

DOI:10.1159/000185285

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Infection with verotoxin producing Escherichia coli has been strongly implicated in the etiology of the hemolytic uremic syndrome (HUS). We have previously shown that this toxin specifically binds to a glycolipid receptor-globotriosyl ceramide (Gb3). We have therefore quantitated the level of this glycolipid by HPLC in human renal cortex and medulla as a function of age. We have also measured the binding of verotoxin to Gb3 isolated from each renal tissue sample. Gb3 was a major component of the glycolipid fraction of all renal samples analyzed. The levels were found to be higher in the cortex than medulla, correlating with the clinical incidence of renal lesions in HUS, but reduced in the kidneys of infants as compared to adults. Verotoxin binding was directly proportional to the renal Gb3 content. Thus, human renal tissue is a rich source of the verotoxin receptor glycolipid. However, changes in receptor concentration cannot explain the age-related incidence of HUS.

ISSN:1660-8151    

DOI:10.1159/000185286

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The origins of acquired cysts, hyperplastic epithelia of cyst walls, and renal cell carcinomas were investigated by evaluating their lectin conjugate reactivity. Paraffin-embedded blocks from 9 patients with acquired cystic disease were examined by the high-sensitivity lectin-antilectin immune peroxidase method. 11–176 lesions in each patient, 690 lesions in total, were stained both with Tetragonolobus lotus lectin (T) and peanut lectin (P); the former is specific for proximal tubules and the latter for distal tubules and collecting ducts. Out of 606 acquired cysts with single-layered epithelia, 559 (92.2%) were positive for T and negative for P, and 66 out of 75 (88.0%) cysts with hyperplastic multilayered epithelia were positive for T and negative for P. Three out of 4 solid adenomas and, to varying degrees, 5 renal carcinomas revealed the same reaction. These results suggest that almost all cysts accompanying acquired cystic disease of the kidney, including those with single-layered and multilayered epithelia, as well as solid adenomas and renal cell carcinomas, are derived from proximal tubule

ISSN:1660-8151    

DOI:10.1159/000185287

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Korean hemorrhagic fever (KHF) is an epidemic viral disease characterized by high fever, hemorrhagic tendency and renal failure, and by hemorrhages of right atrium and renal medulla as well as necrosis of anterior hypophysis. Plasma immunoreactive atrial natriuretic peptide (irANP) levels of 15 patients in the oliguric phase was 94.8 ± 8.4 pg/ml (mean ± SEM), 80% higher than of the normal control group (53.0 ± 4.7 pg/ml; n = 28). In the diuretic phase it declined to 63.7 ± 5.3 pg/ml (n = 26). Plasma renin activity (PRA) in the oliguric phase was 19.0 ± 1.3 ng Al/ml/h, and in the diuretic phase 5.3 ± 0.9 ng Al/ml/h, significantly higher than the control value (2.5 ± 0.1 ng Al/ml/h). Elevations of irANP and PRA were not correlated in each group. Also systemic blood pressure as well as heart beats were significantly increased in the oliguric phase. These findings suggest that the increased irANP may have resulted from increased circulatory volume and that the ANP secretory process may not be affected by the d

ISSN:1660-8151    

DOI:10.1159/000185288

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The daily loss of apohpoproteins into the dialysate from 5 patients on continuous ambulatory peritoneal dialysis (CAPD) was measured. The mean excretion of apolipoprotein (apo) AI and apo AII, major proteins of high-density lipoproteins (HDL), were 84 and 17 mg/day, respectively, while that of apo B, a major protein of low-density lipoproteins (LDL) was 39 mg/day. The peritoneal clearance of apo AI and apo All were similar; both being significantly greater than that of apo B. The fractional catabolic rates of various proteins found in the CAPD dialysate showed molecular sieving effects of the peritoneal membrane and indicated that the apohpoproteins were excreted as lipoproteins. These findings suggest that there is continuous and selective loss of HDL compared to LDL which may also indicate an increased predisposition of these patients to atherosclerosis.

ISSN:1660-8151    

DOI:10.1159/000185289

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The timing and circumstances of changes in renal energetics during the gradual induction of haemorrhagic hypotension were studied in anaesthetised rats by phosphorus-31 nuclear magnetic resonance. Animals were bled at a constant rate of 0.1 ml/min via the femoral artery. Whenever changes in renal energetics were seen, a similar pattern was observed. A decrease in adenosine triphosphate occurred rapidly and was always associated with aceumulation of inorganic phosphate and tissue acidosis. Profound oliguria, reflecting a markedly decreased rate of glomerular filtration preceded the changes in metabolite levels. Such a fall in glomerular filtration rate and consequently in the energy requirement for tubular reabsorption could be viewed as a mechanism by which energy demands of the kidney are reduced before a critical limitation of energy supply is reached. During uncomplicated haemorrhage in Wistar rats, mean arterial pressures as low as 25–40 mm Hg were reached before changes in renal energetics developed. In contrast, spontaneously hypertensive rates subjected to uncomplicated haemorrhage, and Wistar rats subjected to haemorrhage during concurrent stimulation of the ipsilateral sciatic nerve, developed changes in renal energetics at higher and more variable blood pressures and in response to the withdrawal of lesser but more variable quantities of blood. The sudden onset and severe degree of energy depletion at varying blood pressures during bleeding and its more ready occurrence in animals in which sympathetic nervous activity could be expected to be increased, suggests that sudden renal vasoconstriction is responsible for the unpredictable occurrence of tubular ischaemia in haemorrhagic hypotensio

ISSN:1660-8151    

DOI:10.1159/000185290

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The increase of glomerular filtration rate after a 90-gram oral protein load was determined in 9 healthy individuals by simultaneous measurements of both creatinine (Ccr) and inulin (Cin) clearances, performed before and every 30 min during 4 h after the meat meal. This protein load resulted in a short 26% increase of Cin at 90 min, and a sustained 29% increase of Ccr from 90 to 240 min after load. Individual peak values of Ccr occurred later than those of Cin (Ccr: 189 ± 19 vs. Cin: 127 ± 19 min;p = 0.023). These discrepancies were related to an increase of serum creatinine, and a subsequent increase of the net tubular excretion of creatinine which accounted for up to 15% of the urinary creatinine. The creatinine content of red meat could lead to overestimation of renal functional reserve when measured by creatinine clearance onl

ISSN:1660-8151    

DOI:10.1159/000185291

出版商:S. Karger AG    

年代:1989

数据来源: Karger