ISSN:1660-8151    

DOI:10.1159/000187913

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187914

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Since the urea kinetic model is used as an objective method for monitoring dialysis, it has been possible to shorten reasonably its duration. From the usual practice, we have observed that it is easier to reduce the dialysis time in women as compared to men. The purpose of this study is to find out the reason for such observation and to corroborate it. Fourty-two patients, 25 males and 17 females on 3-weekly dialysis (3 h/session) were studied. All patients were dialyzed under the same dialysis characteristics: 3-hour sessions, blood flow 350 ml/min, ultrafiltration 1.5 liters/h, 1.5-m2 cuprophane membrane and bicarbonate buffer. The dialysate was collected in a graduated tank. Urea concentration in plasma and in the dialysate was measured. Then, the urea distribution volume, dialyzer clearance, the KT/V index and protein catabolic rate were calculated. The KT/V value was higher in women with respect to men, 1,017 ± 0.10 versus 0.82 ± 0.14 (p < 0.001). The urea distribution volume value was significantly higher in men as compared to women, 60.04 ± 6.6 versus 51.48 ± 5.88% (p < 0.001). There were no significant differences in dialyzer clearance, protein catabolic rate or body weight. In conclusion, under identical dialysis conditions, it is easier to dialyze women than men, because women’s urea distribution volume is lower than

ISSN:1660-8151    

DOI:10.1159/000187915

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In order to evaluate the influence of sex on bone metabolism in patients on regular dialytic treatment, 82 patients (51 males and 31 females) were studied. All the women were amenorreic and none of them took estrogens. Women showed radiological features of hyperparathyroidism more frequently than men and, in addition, higher bone GLA protein and lower calcitonin serum levels. In both sexes a significant positive correlation was observed between PTH and BGP, but the slope was higher in females, even though not significant. These results suggest that the uremic females show an increased skeletal sensitivity to PTH, probably due to the lack of protective effect of estrogens.

ISSN:1660-8151    

DOI:10.1159/000187917

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In 6 pre-menopausal and 6 post-menopausal women we compared urine volume and excretion of creatinine and urea daily from day 2 of the 1st period of menstruation to day 1 of the 2nd, along with clearances of creatinine (CCr) and urea (C-urea). Clearances were based on 7 serum samples which were taken on day 2 of the 1st menstruation and on days 8,14,15,16, 21, and day 1 of the next menstruation, when 4 cycling hormones were also assayed. Mean group ages were 35 and 59 years for pre- and post-menopausal women. CCr cycled only in the pre-menopausal group, with a nadir around the time of ovulation. The mean CCr combining days 14 and 15 was lower than that for the average of the 5 other days by 22% (p < 0.003) in the pre-menopausal but not in the post-menopausal group (p = 0.99). Average CCr values fell from the peak mean of 129 ml/min on day 8 in the follicular phase to the mean nadir of 93 ml/min for days 14 and 15 and recovered to 117 ml/min by day 1 of the 2nd menstruation; the percent fall in CCr ranged from 9 to 39%. A mid-cycle nadir was also present for C-urea (p = 0.03), also found only in the pre-menopausal group. We conclude that, in pre-menopausal women, there is generally a fall in CCr and C-urea from a peak in the follicular phase to a nadir around ovulation.

ISSN:1660-8151    

DOI:10.1159/000187919

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Ten anemic hemodialysis patients were treated for 6-14 months with human recombinant erythropoietin (EPO). The mean hemoglobin level significantly increased by 42%. Pretreatment skeletal muscle heat production rate at rest, as determined by direct microcalorimetry, was lower than normal (p < 0.03), indicating decreased metabolic activity. ATP levels in muscle were inversely correlated (rs = -0.66, p < 0.05) with the heat production values. The latter significantly increased by about 40% and were almost normalized by the therapy, whereas a decline in the mean ATP level was seen, from 14.8 to 13.2 μmol g-1 of muscle (p = 0.06). We hypothesize that the lowered ATP concentration in muscle after treatment might have been due to an enhanced ATP consumption in parallel with improved muscle strength. Alternatively, since acidosis prior to treatment might have altered the equilibrium state of the creatine kinase reaction towards ATP production, it is possible that the improved oxygenation after EPO had increased pH in the muscle and catalyzed the transfer of phosphate from ATP to PCr. It is concluded that EPO treatment can almost normalize the decreased muscle metabolic rate in hemodialysis patients, and that the anemia per se seems to be an important cause of the deranged metabolism in striated muscle

ISSN:1660-8151    

DOI:10.1159/000187921

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Urine and serum concentrations of interleukin (IL)-6 and IL-8 were determined in 43 women with acute pyelonephritis caused by Escherichia coli. Urine and serum samples were also collected 2 weeks after the infection and during a subsequent episode of cystitis (n = 8) or asymptomatic bacteriuria (n = 8). Concentrations of IL-6 and IL-8 were related to the expression of 5 virulence markers of E. coli and glomerular filtration rate (GFR) after pyelonephritis. Patients with acute pyelonephritis had elevated urine and serum IL-6 and IL-8 levels as compared to 37 healthy women (IL-6: p < 0.001 in both cases, and IL-8: p < 0.001 in both cases). Patients infected with E. coli producing hemolysin and/or cytotoxic necrotizing factor (CNF) had significantly higher IL-6 levels in serum during acute pyelonephritis as compared to patients infected with strains without the ability to produce these factors (p = 0.0025 and p = 0.0154, respectively). Patients who had high concentrations of IL-8 in urine during acute pyelonephritis had lower GFR at follow-up as compared to patients with lower levels of IL-8 in urine (r = -0.48, p = 0.0123). In conclusion, acute pyelonephritis is accompanied by elevated urinary and serum IL-6 and IL-8 levels. Bacteria producing hemolysin and CNF seem to induce higher concentrations of IL-6 in serum. The secretion of IL-8 from renal cells may participate in the initiation and maintenance of renal inflammation which in turn may influence renal function.

ISSN:1660-8151    

DOI:10.1159/000187923

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To assess the value of endothelin-1 (ET-1) as a parameter of renal functional overload and the process of hyperfiltration, urinary excretion of ET-1-like immunoreactivity (U-ET-1) and urinary excretion of other parameters [β2-micro-globulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), albumin (Alb) and 24-hour creatinine clearance (Ccr24)] were measured before, 1,2 and 7 days after unilateral nephrectomy in 15 patients with unilateral renal lesions (renal cell cancer, renal pelvic cancer, ureteral cancer and renal tuberculosis) and after unilateral adrenalectomy in 5 patients with adrenal lesions. In the nephrectomy group (NX), Ccr24 significantly decreased at 1 and 2 days after the operation, but the other 4 parameters significantly increased after the operation as compared to preoperative values. In the adrenalectomy group (ADX), neither Ccr24 nor ET-l/Cr showed any change after the operation, but the other 3 parameters (β2-MG/Cr, NAG/Cr and Alb/Cr) significantly increased. Comparing the NX and ADX groups, both ET-l/Cr and β2-MG/Cr in NX were significantly higher than in ADX after the operation. On the other hand, neither NAG/Cr nor Alb/Cr in NX differed from values in ADX. Comparing ET-l/Cr and other parameters, only β2-MG showed a positive significant correlation. These results suggest that U-ET-1 may be an indicator of functional overload of the k

ISSN:1660-8151    

DOI:10.1159/000187925

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Although thrombomodulin (TM) in circulating blood is regarded as an indicator of vascular endothelial disorders, blood TM levels are also known to be affected by renal dysfunction. We measured plasma TM levels in primary glomerular disease (PGD) and lupus glomerulonephritis (GN) with the EIA method, and assessed the extent to which renal dysfunction and endothelial disorders contribute to plasma TM levels in these diseases. The plasma TM/serum creatinine (TM/Cr) ratio was significantly higher in lupus GN patients than in PGD patients or normal controls. A significant positive correlation was found between plasma TM and serum Cr levels in both PGD and lupus GN patients, but the slope (A) of the regression line (TM = A • Cr + B) in lupus GN patients was significantly steeper than in PGD patients. We conclude that plasma TM levels are greatly influenced by renal dysfunction, but that not only renal dysfunction but endothelial disorders may be an important determinant of increased plasma TM levels in diseases such as lupus G

ISSN:1660-8151    

DOI:10.1159/000187926

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The production of tumor necrosis factor alpha (TNFα) activity by peripheral blood mononuclear cells (PBMC) was determined in uremic patients on chronic hemodialysis (HD; n = 27), continuous ambulatory peritoneal dialysis (CAPD; n = 19), and in patients with chronic renal failure who were not yet on dialysis (CRF-ND; n = 18). In the HD group blood was taken immediately prior to and immediately following an HD session utilizing a cellulose acetate dialyzer. Post-HD PBMC spontaneously (i.e. in serum free media) produced significantly more TNFα activity than the PB MC of all other patient groups as well as those of the normal controls (n = 41) (p < 0.003). Post-HD PBMC produced significantly more TNFα activity than pre-HD PBMC both spontaneously and in the presence of nonuremic sera (p < 0.003). PBMC prior to HD also produced significantly more TNFα activity than CAPD PBMC and normal PBMC in the presence of autologous heat inactivated sera (p < 0.03). Under some culture conditions (i.e. in the presence of nonuremic sera) normal PBMC produced significantly (p < 0.003) more TNFα activity than CAPD PBMC. Finally, a positive correlation was found between PBMC TNFα activity and age for HD patients (r = 0.7, p < 0.004) but not for CAPD or CRF-ND patients. These findings suggest that PBMC of HD but not CAPD or CRF-ND patients are chronically stimulated to produce TNFα activity. Differences in TNFα activity production by PBMC of HD and CAPD patients may determine, at least in part, the types of short- and long-term complications seen in these patient popu

ISSN:1660-8151    

DOI:10.1159/000187927

出版商:S. Karger AG    

年代:1994

数据来源: Karger