ISSN:1660-8151    

DOI:10.1159/000185665

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Patients on chronic hemodialysis with hyperlipidemia were found to respond either with decreased levels (responders) or with a further increase of the plasma triglyceride levels (nonresponders) to a carnitine substitution therapy. The aim of the present study was to find possible predictors to distinguish between responders and nonresponders prior to the initiation of therapy. Since it is suggested that erythrocytes are involved in carnitine transport to tissues, it was of interest to determine plasma and erythrocyte carnitine concentrations in the hemodialyzed patients before and during carnitine substitution therapy and to compare the results with those of healthy controls. Before therapy, comparatively lower plasma levels of both free and total carnitine, but higher portions of short-chain acylcarnitine on total carnitine were found in all patients. In erythrocytes, the nonresponders showed significantly higher total carnitine levels, compared to responders and controls. After the start of carnitine substitution, the increase of total plasma carnitine during the substitution period corresponded with the carnitine dose administered in responders, in nonresponders the highest carnitine values were found in the second week when the lower carnitine dose was administered. The changes of the plasma short-chain acylcarnitine levels with time were very similar to those of plasma triglycerides. All patients showed a time-delayed accumulation of carnitine in erythrocytes and, interestingly, markedly higher concentrations in the second week when the lower carnitine dose was administered. The results of the present study demonstrate that the erythrocyte carnitine content is a reliable predictor to distinguish between responders and nonresponders prior to the start of a carnitine substitution therapy.

ISSN:1660-8151    

DOI:10.1159/000185666

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Among 98 patients with IgA nephritis who had protein selectivity studies performed, 54% had nonselective proteinuria and the remaining 46% had selective proteinuria. Patients with nonselective proteinuria had a higher incidence of glomerulosclerosis. At the end of a 4-year follow-up period, patients with nonselective proteinuria had lower creatinine clearance, higher incidence of hypertension and chronic renal failure when compared to patients with selective proteinuria. Six out of eleven patients (55%) in the study who had the nephrotic syndrome had selective proteinuria. Among these 6 patients, 1 had spontaneous remission and 5 responded to steroid or cyclophosphamide therapy. The remaining 5 patients with nonselective proteinuria did not respond to therapy. In the patients who had selectivity studies repeated, the data showed that the selectivity index (SI) can fluctuate depending on the clinical course of the patients. SI can therefore be used to monitor the progress of patients on long-term follow-up. Protein selectivity appears to be a useful prognostic index in IgA nephritis. For patients with the nephrotic syndrome it may serve as a guide to therapy.

ISSN:1660-8151    

DOI:10.1159/000185667

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The effect of ciclosporin on the cellular immunoregulation was examined in 19 patients with IgA nephropathy. The patients were randomly divided into two groups: 9 patients receiving oral ciclosporin (5 mg/kg/ day) for 12 weeks and 10 patients receiving placebo and acting as controls. T lymphocyte subpopulations were determined using OKT monoclonal antibodies. The functional capability of lymphocytes was assessed by in vitro immunoglobulin synthesis of cultured peripheral mononuclear cells, thymidine uptake by cultured lymphocytes, and t lymphocyte activation with expression of interleukin-2 receptors. A fall of in vitro IgA production by cultured lymphocytes (p < 0.05), a reduction of thymidine uptake by Staphylococcus aureus Cowan-stimulated cultured lymphocytes (p < 0.05), and a reduction of activated lymphocytes expressing interleukin-2 receptor (p < 0.05) were observed in patients after 12 weeks of ciclosporin therapy. The percentages of OKT4 and OKT8 lymphocytes and OKT4/8 ratios were not altered with therapy. A simultaneous reduction of proteinuria and a transient impairment of renal function were observed. Similar changes in cellular immune parameters and clinical response were not observed in the controls. Our study suggests ciclosporin could modulate the cellular immunity in IgA nephropathy.

ISSN:1660-8151    

DOI:10.1159/000185668

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

In an attempt to further study the possible contribution of circulating immune complexes (CIC) in the pathogenesis of the classic form of hemolytic uremic syndrome, 9 patients were studied during the acute phase of the diseases. Clq solid-phase ELISA and conglutinin solid-phase ELISA, were used to measure the levels of immune complexes. All 9 were positive in one or both assays. No correlation was found between the levels of CIC and the clinical severity of the disease. The constant finding of positive CIC in these patients might represent an epipheno-menon, point out the postinfectious nature of this disease but also suggest a possible pathogenic role.

ISSN:1660-8151    

DOI:10.1159/000185669

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Normal peripheral nerve conduction is a marker of adequate dialytic therapy in the ESRD population. Decreasing nerve function detected by periodic testing indicates insufficient dialysis. The standard test for the quantitative evaluation of nerve integrity is the nerve conduction test (NCT). A study of 34 dialysis patients proves that the measurement of current perception threshold (CPT) is equally effective to NCT in defining peripheral nerve function (r = 0.81; p < 0.001). The superiority of the CPT examination is discussed.

ISSN:1660-8151    

DOI:10.1159/000185670

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A low molecular weight (approx. 8,000 daltons) protein has been found to be the major aluminum-binding protein in plasma of patients with dialysis dementia. Following treatment with desferrioxamine, the concentration of the low molecular weight protein and its aluminum content rise in parallel. The results suggest that aluminum exposure in dialysis dementia may result in the de novo synthesis of an aluminum-binding protein and that desferrioxamine may release aluminum in conjunction with its binding protein from tissue stores.

ISSN:1660-8151    

DOI:10.1159/000185671

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Ultrafiltration experiments, using Amicon® membranes with molecular weight exclusions of 1,000, 10,000 and 30,000 daltons, have revealed that Desferal®, both in vitro and in vivo, markedly increases aluminum ultrafilterability in plasma from patients with dialysis dementia. Ultrafilterability was greater with the 10,000-dalton membrane (60%) as compared with the 1,000-dalton membrane (40%); the difference could be related to the presence of an 8,000-dalton aluminum-binding protein in the 10,000-dalton filtrate. These observations are pertinent to in vivo dialysis studies which have demonstrated enhanced aluminum clearance with high-permeability polyacrylonitrile dialysis membrane

ISSN:1660-8151    

DOI:10.1159/000185672

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Urinary calculi found in 4 patients on chronic hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) were identified as protein calculi by infrared spectroscopic analysis. Positive Congo red staining and immunological assessment revealed that the calculi were composed of amyloid protein derived from β2-microglobulin. A comparison of the patients who excreted calculi with 10 patients on chronic dialysis without urinary calculi showed no significant differences in the urinary and serum levels of β2-microglobulin. The mechanism of amyloid calculus formation may involve factors independent of the concentration of β2-microglobulin in urine or serum. Urinary calculi found in patients on chronic hemodialysis or CAPD were composed of amyloid protein derived from β2-microglobu

ISSN:1660-8151    

DOI:10.1159/000185673

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Renal hemodynamics and sodium excretion were determined before and during infusion of dopamine in doses ranging from 0.25 to 8 μg/kg/min in healthy volunteers (n = 15) and in patients with renal disease and moderately impaired renal function (n = 21, baseline glomerular filtration rate 34–85 ml/min). While in normal volunteers dopamine resulted in marked renal vasodilation (maximal fall in filtration fraction 24%), in patients with moderately impaired renal function, the renal vasodilatory response to dopamine was impaired (maximal fall in FF 13%) and was found to depend on baseline glomerular filtration rate. Infusion of dopamine in doses of 2 μg/kg/min and higher resulted in an increase in urinary sodium excretion, which was comparable for healthy volunteers and patients with renal disease. We conclude that dopamine results in a predominantly efferent glomerular vasodilation and, therefore, may be salutary in lowering intraglomerular hypertension. However, in patients with renal disease the renal hemodynamic response to dopamine infusion is impaired compared to healthy volunteers, while the natriuretic response is maintai

ISSN:1660-8151    

DOI:10.1159/000185674

出版商:S. Karger AG    

年代:1989

数据来源: Karger