ISSN:1660-8151    

DOI:10.1159/000185374

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Triamterene (TA) is a mild ‘potassium-sparing’ diuretic usually employed in combination with other more potent diuretics in the treatment of hypertension. TA pharmacokinetics and pharmacodynamics in normal volunteers, elderly subjects and in patients with renal and hepatic dysfunction are reviewed. A variety of adverse renal effects, such as abnormalities in urinary sediment, nephrolithiasis, interstitial nephritis and acute renal failure, has been reported to occur and is also reviewed. Of particular concern with the increased availability of ‘over-the-counter’ nonsteroidal anti-inflammatory medications (NSAID) is the adverse interaction between TA and NSAID which may culminate in acute renal failure. Although a rare occurrence, the clinician should be aware of potential adverse reactions associated with the us

ISSN:1660-8151    

DOI:10.1159/000185375

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A prospective study was made of the evolution of serum ferritin levels in 112 renal transplant recipients with good graft function. The rise in hemoglobin value is accompanied by a decrease in basal serum ferritin levels which are lowest at the sixth month: 54.9 (2–1,516) vs. 109.6 (21–4,420) μg/l, p < 0.001 (Ẋg and range). After this time, ferritin values increase, although they do not reach basal levels. Evolution after transplantation is mainly determined by the previous state of iron stores at the time of transplantation. While in the patients with high basal serum ferritin values these gradually decreased during the follow-up period, patients with low basal serum ferritin levels tend to replenish their iron stores after renal transplantation. These differences disappear at the third year when serum ferritin values are similar in all groups. An association between persistence of posttransplant anemia and low serum ferritin levels is observed. This event is not clinically relevant as anemia disappears in almost all cases and dietary iron is enough to normalize serum ferritin

ISSN:1660-8151    

DOI:10.1159/000185376

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

It has been shown that the glomerular filtration rate increases after a meat meal. We examined in humans whether enalapril, which has been shown to decrease glomerular capillary pressure in rats with chronic renal failure, could attenuate the renal response to a meat meal. Twelve healthy volunteers were studied after an oral protein load, 1.5 g/kg body weight, as lean cooked beef meat, and on a separate day, after eating the same meal with prior oral intake of enalapril. On the control day, creatinine clearance increased from 114.3 ± 4.7 before the meal to 137.1 ± 4.7 ml/min/ 1.73 m2 after the meal (p < 0.001). On the enalapril intake day, creatinine clearance increased from 113.7 ± 5.6 before the meal to 128.3 ± 5.8 ml/min/1.73 m2 after the meal (p < 0.01). However, the mean increase in creatinine clearance was lower on the enalapril intake than on the control day (14.0 ± 4.3 vs. 21.0 ± 4.1%, p < 0.05). Mean arterial pressure before the meal was lower on the enalapril intake day than on the control day (76.2 ± 3.5 vs. 84.2 ± 3.6, p < 0.01). Likewise, postprandial mean arterial pressure was lower on the enalapril day compared with the control day (69.9 ± 2.8 vs. 78.5 ± 3.7, p < 0.01). We conclude that enalapril blunts the hyperfiltration which follows a

ISSN:1660-8151    

DOI:10.1159/000185377

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Using a recently described new technique, individual kidney filtration fraction was measured from the first 3 min of the Tc-99m DTPA renogram in a series of 11 subjects without evidence of renal disease and in 23 patients with hypertension. Fourteen of these hypertensives had angiographic evidence of renal artery stenosis (RAS) but only 2 had proven renovascular hypertension (RVH). In addition, renal blood flow (RBF), expressed as a fraction of cardiac output, was measured from the first pass time activity curves following bolus injection of Tc-99m DTPA, and individual kidney glomerular filtration rate (IKGFR) was measured from the subsequent plasma Tc-99m DTPA clearance and renographic divided function. An estimation of filtration fraction based on these measurements of RBF and IKGFR correlated rather poorly with that directly based on the renogram, although both showed directionally similar changes in the hypertensive patients following inhibition of angiotensin-converting enzyme (ACE) with captopril. Filtration fraction by both estimates fell significantly after ACE inhibition in patients with RAS and essential hypertension, while RBF increased. IKGFR showed no change in essential hypertension or in hypertensive patients with RAS but fell sharply in 3 renal units in 2 patients with RVH. This renographic method for measuring filtration fraction is worthy of further elaboration and might be a simple and useful discriminator of RVH in a hypertensive population.

ISSN:1660-8151    

DOI:10.1159/000185378

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The response rate and HBsAG antibody concentrations were examined after hepatitis B vaccination in 78 hemodialysis patients aged between 29 and 79 years. The values were related to age, duration of hemodialysis, body weight, creatinine, urea nitrogen, serum concentrations of β2 3,000 mU/ml; p < 0.05). Discriminant multivariate analysis (p = 0.032) revealed the influence (62%) of IL-2R on the response rate while other factors were similar in all patient groups. It is concluded that preactivation of T cells with an increased release of IL-2R may contribute to impaired immune response after hepatitis B vaccinati

ISSN:1660-8151    

DOI:10.1159/000185379

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The aim of the study was to establish normal values for parameters of parathyroid (PT) function in childhood and to examine whether a correlation could be found between these parameters and tubular phosphate (P) reabsorption. Values for PTH (carboxyl terminal) and urinary cAMP (UcAMP) throughout childhood were found to be significantly lower than in adults, with mean values of 0.3 ng/ml (30 pmol/l) and 1.96 nmol/dl glomerular filtrate (GF) respectively. A significant correlation was found between UcAMP and tubular P reabsorption (TP), expressed by the equation: TP = 5.5-(0.5 × UcAMP) mg/dl GF ( = 1.78-(0.16 × UcAMP)) mmol/dl GF, with a scatter of 10.6 mg/dl around the mean ( ± 1 SD). These data appear to permit the evaluation of primary tubular components in patients with defects of renal P handling, as opposed to those related to PT activi

ISSN:1660-8151    

DOI:10.1159/000185380

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A total of 1,026 patients undergoing haemodialysis as the only chronic treatment were studied in all the dialysis units of the Veneto region, Italy. Aluminium was determined in water, dialysis fluids, and patients’ serum. Aluminium mean concentration was 9.1 µg/l in tap water and 13.3 and 15.7 µg/l in bicarbonate and acetate haemodialysis fluids, respectively. Patients’ serum aluminium mean level was 52.0 µg/l with the following frequency distribution: 59.2% below 60 µg/l, 25.5% between 60 and 100 µg/l, and 15.3% above 100 µg/l. The mean serum aluminium level was higher in patients undergoing haemodialysis with aluminium concentration in fluids over 10 µg/l. This was true also in patients not receiving aluminium hydroxide. Furthermore, we found higher average serum aluminium in those treated with aluminium hydroxide more than 3 g/day. No relationship was found between serum aluminium and sex, age, dialytic age, parathyroid hormone, and vitamin D treatment. Moreover, the patients with serum aluminium above 100 µg/l had higher serum alkaline phosphatase and lower mean cell volume values. Thus, in our haemodialysis population aluminium overloading occurred in spite of low concentration in water and fluid, and it was a result more of fluid pollution (over 10 µg/l) than aluminium hydroxide ingestion (o

ISSN:1660-8151    

DOI:10.1159/000185381

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

In healthy women during moderate hydrosaline retention we have evaluated the antagonistic effects of sulpiride – enantiomers and racemic – on the renal action of a low-dose dopamine (DA) infusion (0.1 μg/kg/min). The studies were performed, in hypotonic polyuria, by the clearance (Cl) method in (1) hydrosaline retention (n = 23), (2) retention + dl-sulpiride (n = 8), (3) retention +d-sulpiride and (4) retention +l-sulpiride (in the latter two cases n = 7 subjects submitted to paired studies). Hydrosaline retention was induced by deoxycorticosterone acetate treatment. A common pattern of sulpiride treatment was applied. The DA renal hyperemia is abolished by l-sulpiride while it is transitorily attenuated by d-sulpiride. In both conditions 3 and 4 the increase in glomerular filtration rate, the inhibition of fractional isosmotic sodium reabsorption and the increase in urinary sodium excretion – induced by DA in condition 1 – are suppressed. On the contrary, DA inhibition of fractional anisosmotic sodium reabsorption is not affected by sulpiride. The data indicate that DA renal hyperemia results from the action of DA on DA2 receptors; the DA inhibition of sodium transport by the diluting segments does not appear to be mediated by typical DA r

ISSN:1660-8151    

DOI:10.1159/000185382

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Serum secretory IgA was measured to elucidate the significance of secretory IgA in patients with IgA nephropathy. The levels of serum secretory IgA and IgA were, respectively, 6.8 ± 3.5 μg/ml and 231.0 ± 69.2 mg/dl in the controls and 11.8 ± 3.2 μg/ml and 385.3 ± 78.7 mg/dl in the patients. The levels of serum secretory IgA and IgA in the patients were significantly higher than those in controls (p < 0.01). Elevated serum secretory IgA may reflect the excessive state of the IgA-secreting system in IgA nephropathy pat

ISSN:1660-8151    

DOI:10.1159/000185383

出版商:S. Karger AG    

年代:1989

数据来源: Karger