ISSN:1660-8151    

DOI:10.1159/000183285

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000183286

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The aim of the study was to investigate the atherosclerosis risk factors related to hyperlipidemia in renal transplanted children. Plasma cholesterol, triglycerides, apolipoproteins (Apo) AI, All and B, and the major lipoprotein classes separated by gradient ultracentrifugation were compared in 30 renal transplanted patients and 14 healthy children. Hyperlipidemia was present in 66% of the transplanted children. ‘Positive’ risk factors for atherosclerosis (high plasma cholesterol and Apo B) were present in hypercholesterolemic and combined hyperlipidemic subgroups. All transplanted children, whether normo- or hyperlipidemic, presented essentially ‘negative’ risk factors for atherosclerosis, i.e. significantly higher levels of Apo AI and All in plasma and in high-density lipoprotein HDL2 and higher Apo AI/Apo B and/or Apo AII/B ratios. Repeated evaluations (over a 12-month period) in transplanted children indicated relatively frequent individual changes in the lipid pattern, but not in Apo AI and All content. These results suggest that the risks for accelerated atherosclerosis related to hyperlipidemia may be considered as moderate in transplanted c

ISSN:1660-8151    

DOI:10.1159/000183287

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

With real-time sonography, 120 nondialyzed uremic patients prior to hemodialysis, 108 patients on maintenance hemodialysis and 9 patients postdialysis after successful homotransplantation were examined for the presence of renal cysts. Even in incipient renal failure, multiple cysts were demonstrable in some patients (at a serum creatinine of 3 mg/dl in 22% of patients), particularly in patients with analgesic nephropathy. When hemodialysis was started (serum creatinine approximately 10 mg/dl), 35% of the patients had multiple cysts. On hemodialysis, the prevalence, number and size of cysts rose progressively with time. After 8 years of hemodialysis, 92% of the patients had multiple cysts. However, enlargement of the kidneys was observed in only 2/108 patients. No major clinical complications were noted with the possible exception of 1 case of renal cell carcinoma. No correlation was noted between hematocrit and presence or extent of cystic transformation, but the 2 patients with cystic enlargement of the kidneys were polyglobulic. In 8/9 patients after transplantation, cysts were demonstrable in the patient’s own kidneys after a median follow-up of 16 months. On light microscopy, cysts were lined by cuboidal or columnar epithelial cells with frequent papillary or adenomatous proliferations. The cyst lumen was filled with amorphous or lamellated organic material, which exhibited microfibrillar structure on electron microscopy. One kidney examined after ex vivo perfusion fixation showed multiple interconnected cavities on scanning electron microscopy. Ultrastructural studies showed epithelia with either the characteristics of proximal tubular cells (i.e. numerous microvilli, interdigitations and abundant lysosomes or mitochondria) or distal tubular cells (i.e. highly interdigitating processes) or finally collecting duct cells (i.e. no interdigitations and few microvilli

ISSN:1660-8151    

DOI:10.1159/000183288

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

To determine the natural history of mesangial proliferative glomerulonephritis (MesPGN) with IgM deposits and its relationship to minimal change disease (MC) and focal segmental glomerulosclerosis (FGS), we studied the clinical characteristics and outcome in 20 patients with MesPGN, 8 with MC, and 10 with FGS. IgM deposits were present in glomeruli of all MesPGN patients. Progression to FGS was documented in 2 patients with MesPGN, 1 of whom developed renal failure. Transition from MC to MesPGN occurred in 1 patient. 2 MC patients developed FGS, with decline in renal function in 1 of them. These data suggest the possibility of histologic transition from MC to FGS directly or through the stage of MesPGN.

ISSN:1660-8151    

DOI:10.1159/000183289

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

With oral furosemide administration and salt loading, urinary calcium was significantly increased in 8 normal subjects, accompanied by parallel natriuresis. In spite of the excessive calcium loss in the urine, total and ionized serum calcium remained unchanged. All subjects had significant increases in nephrogenous cyclic AMP, suggesting that parathyroid activity is elevated in subjects with furosemide-induced hypercalciuria. With furosemide, fecal calcium was significantly decreased, and resultantly, there was no significant change in the cumulative calcium balance. It is suggested that urinary calcium loss with furosemide is compensated for by secondary hyperparathyroidism via increased intestinal calcium absorption in order to maintain serum calcium at a normal level. The experimental model thus mimics the condition of the renal type of idiopathic hypercalciuria.

ISSN:1660-8151    

DOI:10.1159/000183290

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

8 Zimbabwean children are discussed in whom the nephrotic syndrome (NS) was a manifestation of membranous glomerulonephritis (GN) which was associated in every case with hepatitis B antigenaemia. This marks the first occasion that such an association has been reported in African children, although it has been thoroughly documented in children in Europe, the Far East and America. Microhaematuria, hypertension and mild to moderate renal insufficiency were frequent early associated findings, and every child exhibited hypocomplementaemia and a markedly diminished immunoglobulin G (IgG) level. The disease followed a benign course in the majority, and only 1 child died in renal failure.

ISSN:1660-8151    

DOI:10.1159/000183291

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Uremic patients undergoing chronic hemodialysis demonstrate a secondary systemic carnitine deficiency. We studied the effect of carnitine replacement with high doses (L-carnitine, 3 g/day) similar to those used in the treatment of primary systemic carnitine deficiency. 10 uremic patients on hemodialysis were randomly selected into a control group (4 patients) treated by placebo and a treatment group (6 patients) treated by L-carnitine. Plasma lipoprotein concentration and composition as well as platelet aggregation were studied before and after treatment. Following carnitine administration, a paradoxical rise in plasma triglyceride concentration from 180 ± 66 to 219 ± 88 mg% (p < 0.05) was noted. No other significant changes in lipoprotein concentration and composition or in plasma apoprotein A-I and B concentration were observed. Carnitine treatment caused a significant rise in platelet aggregation induced by epinephrine, ADP, and thrombin. These findings suggest a harmful effect of L-carnitine replacement therapy when given in high doses, causing aggravation of uremic hypertriglyceridemia and increased platelet aggregation in patients predisposed to thromboembolic phenomen

ISSN:1660-8151    

DOI:10.1159/000183292

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

1 day after bilateral ureteral occlusion (BUO), the extracellular fluid (ECF) volume of rats was increased by 2.8 ml/l00 g body weight above those values observed after either a sham operation or after 1 day of unilateral ureteral occlusion (UUO). The plasma urea concentration of BUO rats averaged about five times the values of either sham or UUO groups. The release of BUO of 1-day duration resulted in post-obstructive diuresis and natriuresis, whereas oliguria was observed after the release of UUO of 1-day duration. Contralateral nephrectomy of the normal kidney after the release of UUO 1-day duration (UUO-RN) resulted in an improvement of the damaged kidney functions, possibly due to an elevation of renal blood flow. Polyfructosan clearance of the UUO kidney was increased to a level significantly above the corresponding BUO value, 147 ± 34 as compared to 101 ± 8 μl/min/100 g body weight. However, post-obstructive diuresis was not observed. When the ECF volume of UUO-RN rats was elevated, towards those values observed in BUO rats by saline infusion, the rate of urine formation was insignificantly elevated above the nontreatment group, even though the sodium excretion rate was increased about three times the values of both the UUO-RN and BUO groups. When the plasma urea concentration of the UUO-RN group was elevated towards the BUO value, moderate diuresis was observed. But when both the ECF volume and plasma urea concentration of UUO-RN rats were increased towards the level of the BUO rats, post-obstructive natriuresis and diuresis were evident. Thus, the elevation of both the plasma urea concentration and the ECF volume contribute significantly to post-obstructive diuresis. However, the role of the natriuretic factors may not be eliminated due to the differences among the functioning nephrons between the BUO and UUO kidneys. The present studies were carried out to quantitate the contribution of ECF volume expansion and the elevation of plasma urea concentration on the induction of post-obstructive diuresis in ra

ISSN:1660-8151    

DOI:10.1159/000183293

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

This case report describes a patient who initially had a pleuritis and arthalgias. During the follow-up he developed first a membranous glomerulonephritis with nephrotic syndrome and subsequently a crescentic, rapidly progressive glomerulonephritis with glomerular basement membrane antibodies (anti-GBM). An analysis of the serum samples obtained during the follow-up revealed no infections at the onset of renal failure. However, anti-GBM could be demonstrated in the serum samples obtained 2 months before the deterioration of the renal function. The anti-GBM did not react with alveolar BM and the patient had no signs of pulmonary hemorrhage. The etiology and the sequence of the pathological events of rapidly progressive glomerulonephritis is discussed in the light of these observations.

ISSN:1660-8151    

DOI:10.1159/000183294

出版商:S. Karger AG    

年代:1984

数据来源: Karger