ISSN:1660-8151    

DOI:10.1159/000183217

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

This study measured plasma β2-microglobulin (β2-m) in patients with mesangial IgA nephritis. Plasma β2-m was measured in 51 patients with IgA mesangial nephritis and in 50 normal controls using a Phadebas β2-m RIA kit available from Pharmacia Diagnostics (Uppsala, Sweden). The mean plasma β2-m in IgA nephritic patients (1.92 ± 0.67 mg/l) was significantly different from that of healthy controls (1.33 ± 0.41 mg/l; p < 0.001). The mean plasma β2-m in non-IgA nephritic patients (1.83 ± 0.73 mg/l) was also significantly different (p < 0.001). Patients with IgA nephritis with glomerular sclerosis (n = 33) had significantly higher levels of β2-m (2.02 ± 0.70 mg/l) than IgA nephritic patients without glomerular sclerosis (n = 18, 1.72 ± 0.65 mg/l; p < 0.025). In the group with IgA nephritis and glomerulosclerosis, raised β2-m levels were correlated with the severity of proteinuria (r = 0.41) (p < 0.02) as well as the intensity of IgA staining on immunofluorescence (r = 0.34; p < 0.05). Elevated β2-m levels in IgA nephritis may serve as a useful prog

ISSN:1660-8151    

DOI:10.1159/000183218

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

15 episodes of symptomatic urinary tract infection are described in 11 patients on maintenance hemodialysis. The diagnosis was confirmed by clean-catch or simple voided urine samples where possible, urethral catheterization and bladder washout being used only in anuric patients. Treatment with oral antibiotics proved successful in 13 episodes but 2 patients with polycystic kidneys were admitted to hospital for intravenous therapy. Urinary tract infections are common in dialysis patients including those who are anuric, and patients with polycystic kidneys have an increased risk of serious complications.

ISSN:1660-8151    

DOI:10.1159/000183219

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

When triglycosyl glycopeptide (nephritogenoside) was contaminated with glucosyl, galactosyl, mannosyl, and heteropolysaccharide glycopeptide, a mixed lesion of proliferative glomerulonephritis (PGN) with immunofluorescent mesangial pattern and membranous glomerulonephritis (MG) with immunofluorescent granular pattern resulted. It was concluded that PGN was caused by the presence of nephritogenoside and MG by the presence of the heteropolysaccharide glycopeptide in the crude nephritogenic glycopeptide mixtures derived from various solubilization steps used to treat the kidney extracts. Trichloroacetic acid treatment of crude nephritogenic glycopeptide mixtures precipitated the heteropolysaccharide glycopeptide of the MG-inducing factor, thus permitting the separation of nephritogenoside from the heteropolysaccharide glycopeptide by a rather simple technique. Both the heteropolysaccharide glycopeptide and Heymann’s antigen (so-called tubular antigen) have a common antigenic substance, but we cannot conclude, at the present state, that both substances are chemically the same. The degree of contamination of pure nephritogenoside by this substance that is antigenically the same as Heymann’s antigen (in pure nephritogenoside) can be chemically and accurately determined, based on the evidence that pure nephritogenoside is a glycopeptide having only three glucose residues as the sugar moiety, that is, by estimating the amount of contaminated monosaccharide components such as galactose, mannose, and N-acetylglucosam

ISSN:1660-8151    

DOI:10.1159/000183220

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In normal subjects a relation was found between the log plasma aldosterone concentration (PAC) and the ratio of renal potassium excretion (Uĸ) and sodium delivery to the sodium-potassium exchange site (UNa+ĸ). This relationship was independent of plasma renin activity (PRA). On these grounds, the Uĸ/UNa+ĸ ratio disturbance was considered to be a function of the PAC, and this relation was considered to reflect an altered sensitivity of the distal tubule to aldosterone. In several pathological conditions involving the kidney, the relation between the PAC and Uĸ/UNa+ĸ remained normal while the glomerular filtration rate was within normal limits. Under these conditions, however, the serum potassium concentration had some influence on this relation, in that a low potassium concentration was accompanied by an elevated (though still normal) PAC relative to the Uĸ/UNa+ĸ ratio. The relation was completely abolished when the effect of endogenous aldosterone was impaired by chronic spironolactone administration in patients with essential hypertension. Analysis to these relations in chronic renal disease made it possible to classify them according to the pathophysiological disturbance in question. We conclude that determination of the Uĸ/UNa+ĸ ratio and its relation to the PAC, PRA, and serum potassium level is very useful for the analysis of disorders of potassium m

ISSN:1660-8151    

DOI:10.1159/000183221

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

5 patients with chronic renal failure on maintenance hemodialysis and 5 healthy matched controls received single 20-mg intravenous doses of clorazepate dipotassium. Clearance of pharmacologically active unbound desmethyldiazepam was reduced in renal failure patients as opposed to controls, and free fraction in serum was greater. Since desmethyldiazepam distribution was reduced in renal patients, elimination half-life was actually shorter than in controls (36 vs. 57 h). In 10 dialysis patients receiving chronic diazepam treatment (5–15 mg/day), steady-state concentrations of diazepam (56 ng/ml) and desmethyldiazepam (77 ng/ml) were significantly lower than in age- and weight-matched controls receiving similar doses (189 and 216 ng/ml, respectively). However after correction for the higher free fractions of both compounds in renal patients as opposed to controls, steady-state concentrations of unbound drug were found to be similar between groups. Interpretation of kinetic variables and steady-state serum concentrations of extensively protein-bound drugs requires consideration of alterations in protein binding that may occur in disease state

ISSN:1660-8151    

DOI:10.1159/000183222

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We report our experience with continuous, transcutaneous monitoring of capillary oxygen and carbon dioxide tension (PtcO2PTlcCO2) during the entire length of hemodialysis treatment in 8 pediatric patients. The relative changes in PtcCh and PtcCO2 observed with this method were in accordance with those reported in the literature, obtained with frequent arterial blood sampling. There was a temporary fall of PtcCO2, averaging 26.2% after 2 h of dialysis, with a concomitant rise of PtcCO2 of 9.9%. The noninvasive, transcutaneous measurement of PtcCO2 and PtcCO2 is a reliable and valuable adjunct for the monitoring of the dialysis patient who is prone to develop hypoxemia. It is particularly useful in the very young.

ISSN:1660-8151    

DOI:10.1159/000183223

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Iron dextran, an electron-dense tracer, was given intravenously (100 mg of iron/100 g of body weight) to 8 normal rabbits to study its movement from the plasma to the peritoneal cavity during peritoneal dialysis. The dialysate infused at 75 ml/kg contained 1.5 g/dl of glucose in 4 animals and 4.25 g/dl in the remainder. Peritoneal dialysis was discontinued and the peritoneum was fixed in vivo at various times (20–120 min) after the injection of the iron dextran. Large amounts of tracer were detected in the effluent after draining the peritoneal cavity. Electron microscopic examination of the mesentery showed particles of iron dextran in the endothethial cells of small vessels (capillaries and venules) the interstitium and the mesothelial cells adjacent to vessels irrespective of the dialysate concentration or duration of dialysis. Tracer was not clearly demonstrated in the interendothelial or intermesothelial spaces. In the mesothelial cells, the particles were found exclusively in (small, elongated or large) vesicles, while in the endothelial cells they were both in vesicles and free in the cytoplasm. Our findings suggest that during the 20- to 120-min period after intravenous administration, the intracellular transport of iron dextran, depends on either moving vesicles or the presence of pre-existing tunnels in the mesothelial cells of rabbit mesenter

ISSN:1660-8151    

DOI:10.1159/000183224

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

To quantify the effects of gentamicin, kanamycin and netilmicin on renal protein reabsorption and accumulation, these drugs were administered to rats intraperitoneally (30 mg/kg/day) for 7, 14 or 21 days. Scanning electron microscopy of the glomerular endothelia, urinary measurements of sodium, potassium, endogenous lysozyme, N-acetyl-β-D-glucosaminidase (NAG) as well as clearance and accumulation experiments after i.v. administration of egg-white lysozyme and measurements of inulin clearance (GFR) were done in each treatment group. Gentamicin administration decreased diameter, density and shape of endothelial fenestrae. Kanamycin and netilmicin appeared to have no effect at the dose used. All three aminoglycosides decreased GFR and increased urinary excretion of sodium and potassium. While gentamicin and kanamycin decreased the percentage reabsorption and accumulation of lysozyme after i.v. administration of egg-white lysozyme netilmicin had no effect. Daily excretion of total protein, endogenous lysozyme and NAG increased only after treatment with kanamycin and gentamicin. Thus, aminoglycosides may act as nephrotoxicants at glomerular and/or tubular level inducing impairment of renal reabsorption and accumulation of proteins

ISSN:1660-8151    

DOI:10.1159/000183225

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The common occurrence of a wasting syndrome in patients with end-stage renal disease (ESRD) on haemodialysis indicates the need for nutritional management. Pancreatic hypofunction has been documented in these patients, and is suggested as a contributory factor to the wasting of ESRD. The patient presented illustrates the presence of pancreatic disease, and details his management. The advantages of pancreatic supplementation in improving nutritional status in ESRD are considered.

ISSN:1660-8151    

DOI:10.1159/000183226

出版商:S. Karger AG    

年代:1984

数据来源: Karger