ISSN:1660-8151    

DOI:10.1159/000182936

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Intracellular potassium was studied in 11 patients with predialysis chronic renal failure by the use of skeletal muscle biopsies and whole-body counting. For various clinical reasons, therapy was unavoidable in the patient group. 62 healthy subjects in two groups served as controls. Potassium in skeletal muscle was determined by a neutron activation technique. Total body fat (TBF) and lean body mass (LBM) were determined anthropometrically. Total body water (TBW) was determined by isotope dilution and total body hydrogen (TBH) by an in vivo neutron activation technique. Soft fat free solids (SFFS) were calculated from TBF, TBW and TBH. Erythrocyte potassium (EK) and serum potassium (SK) were determined. Intracellular potassium was low in patients with renal failure compared to healthy controls when determined in muscle biopsies (p < 0.01), and by whole body counting, expressed in percent of the predicted value from anthropometricdata (TBK%; p < 0.001) or when expressed as TBK/LBM (p < 0.01) TBK/TBW (p < 0.01) or as TBK/SFFS (p < 0.001). The SK was increased (p < 0.01) although all individual values were within the normal range. No significant differences were found in EK, TBW or in erythrocyte water content between the patients and controls. An inhibitory effect on the sodium potassium ATPase by uremic metabolites and a decrease in cellular potassium capacity are discussed as explanations for the potassium decrease in predialysis renal failure.

ISSN:1660-8151    

DOI:10.1159/000182937

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

To assess the psychological effects of exercise training in hemodialysis patients 4 dialysis patients, matched by age, sex, and medical history with 4 controls, received psychological testing before and after a 6-month period of exercise training. The trained patients had a 28% improvement in graded exercise treadmill stress test duration and a 13% improvement in aerobic capacity. This was associated with a significant reduction in anxiety and depression (p < 0.06), but no measurable change in these moods occurred in the control groups. These results suggest that exercise training may improve psychological functioning in dialysis patients.

ISSN:1660-8151    

DOI:10.1159/000182938

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

This study was undertaken to evaluate the effect of increasing the dialysate sodium concentration on myocardial ischemia assessed by EKGs taken immediately before and after dialysis in 43 hemodialysis patients. An increase in the R wave (V5 + V6) by more than 5 mm was seen in 26 patients with standard sodium dialysate, while only 12 cases showed the same changes after a high sodium dialysis. These was a positive correlation between an increase in R wave amplitude and the weight loss/dry weight ratio of patients only after standard sodium dialysis (r = 0.74, p < 0.001). Relative high sodium dialysate is beneficial during dialysis and reduce the incidence of myocardial ischemia and unpleasant disequilibrium syndrome.

ISSN:1660-8151    

DOI:10.1159/000182939

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

An epidemiologic survey in a maintenance hemodialysis population of 300 patients was undertaken to relate the appearance of acute serositis (pericarditis, pleuritis or ascites) to HBsAg antigenemia. A significant number of incidents of serositis occurred in patients acutely or chronically infected with hepatitis B surface antigen (HBsAg) suggesting an etiologic role for the virus in the serositis of uremia. In 2 patients with both end-stage renal disease and chronic HBsAg antigenemia, immunofluorescent studies of serosal tissues showed fluorescent clusters interpreted to be HBs antigen-antibody complexes. It is concluded that an immunologic response to viremia may be one of the causes of serositis in uremia.

ISSN:1660-8151    

DOI:10.1159/000182940

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In a series of 6,521 consecutive autopsies of infants and children, renal cysts were found in 136 cases (2%). Of these, 71 were females and 65 males; 103 patients had died in their first month of life. The different types of cystic disease represented were as follows: renal cystic dysplasia 65, cortical cysts in syndromes of multiple malformations 42, polycystic disease 16, simple cortical cysts 7, renal cysts in hereditary syndromes 3, and renal medullary cystic disorders 3. Extrarenal malformations were encountered in 102 of the 136 cases with renal cysts. Gastrointestinal malformations and in particular esophageal atresia very often appeared to be associated with renal disease. Esophageal atresia was found in 29 (21 %) cases, 20 in cases with renal cystic dysplasia and 9 in cases with cortical cysts in syndromes of multiple malformations. The possibility of renal cystic disease should therefore be kept in mind in infants with congenital malformation(s), especially those with esophageal atresia.

ISSN:1660-8151    

DOI:10.1159/000182941

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Tubular obstruction is an important pathophysiologic mechanism in acute renal failure (ARF). The anatomic basis for this obstruction may be impaction of the pars recta of the proximal tubule with sloughed brush border debris. If so, then diuretics which act proximal to the site of obstruction (e.g. mannitol, M) should be more effective in expelling brush border debris from the tubules than diuretics with more distal sites of action (e.g. furosemide, F). This difference could make M superior to F as a protector of renal function following acute renal injury. To test this hypothesis 35 rats were subjected to M or F diuresis. After a 60-min control period, nephrotoxic (HgCl2) or ischemic (vascular cross-clamping) ARF was induced. Glomerular filtration rate (GFR; clearance iothalamate-125I) and the urinary excretion of brush border derived-renal tubular epithelial antigens (RTE; measured by RIA) were determined before and after the nephrotoxic and ischemic insults. During control periods of diuresis, M and F produced comparable urine flow rates, GFRs, and RTE excretion. However, following HgCl2 or renal ischemia, M-treated rats had 3 times (HgCl2) and 9 times (ischemia) greater RTE excretion rates than did their F-treated counterparts (p < 0.01–0.001). M-treated rats also retained one third more of their original GFRs than did the F-treated rats (p < 0.01). The beneficial effects of M did not require its administration prior to renal injury: a single M bolus immediately post-ischemia produced GFRs and RTE excretion rates comparable to those observed in rats which had received M prophylactically. Conclusion: M is superior to F in protecting against ischemic and HgCl2 induced ARF. The efficacy of M may be due, in part, to its proximal tubular site of action which facilitates flushing of the pars recta of brush border debris, thereby decreasing intratubular obstructio

ISSN:1660-8151    

DOI:10.1159/000182942

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The effects of chronic gentamicin administration on renal function was studied in dogs receiving 4 mg/kg i. m. of gentamicin b. i. d. for 28 days. Administration of gentamicin resulted in a bimodal change in renal function. A decrease in urine osmolality was first noted on day 6 and declined progressively throughout the study. This decrease in urinary concentrating ability was preceded by a steady rise in urinary prostaglandin E2 (PGE) excretion and followed by a rise in plasma renin activity (PRA). Prior to an increase in azotemia, urinary PGE decreased precipitously while PRA continued to rise throughout the remainder of the study. The precipitous decrease in GFR was accompanied by a significant increase in FENa to seven times control. These studies suggest a dual effect of chronic gentamicin administration on renal function: (1) an early effect manifested by stimulation of urinary prostaglandin production with a concomitant loss of urinary concentrating ability and mild prerenal azotemia, and (2) a late effect, preceded by a decrease in urinary prostaglandin excretion while PRA continues to increase, and manifested by increase fractional excretion of sodium and progressive azotemia.

ISSN:1660-8151    

DOI:10.1159/000182943

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Different doses of anionic and cationic albumin (CA) were administered intravenously to 29 normal unanesthetized female rats. Administration of 20 and 30 mg of CA produced an increase in urinary excretion of endogenous albumin. Urinary CA levels in the urine samples collected during the first 60 min after injection of 30 mg of CA were higher than anionic albumin levels. A marked increase in the number of endocytic vacuoles, large numbers of images suggesting fusion of vacuoles with lysosomes, extrusion of cell elements into the tubular lumen and tubule rupture were observed in the animals injected with CA. These results show that CA may produce changes in proteinuria and in renal structure.

ISSN:1660-8151    

DOI:10.1159/000182944

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Urine samples of 17 patients with nephropathy were tested with precipitating anti-thermostable-kidney antigen sera (anti-kidney BE antigen), which had been made kidney specific by absorption with diverse tissues. Kidney BE antigen was demonstrated in the concentrated urine of a patient (case I.T.) with membranous nephropathy, in whom membranous nephropathy appeared to be associated with exposure to chromium. Kidney BE antigen was, however, not demonstrated in the concentrated urine from the other 16 patients with nephropathy (chronic glomerulonephritis, 7; acute glomerulonephritis, 3; lupus nephritis, 3; membranous nephropathy, 2; diabetic nephropathy, 1). Kidney BE antigen was localized in the tubular cells but not in the glomeruli, by indirect immunofluorescent staining. Kidney BE antigen was not demonstrated in the glomeruli in case I.T., even after acid elution of the sections. The possible role of kidney BE antigen in the pathogenesis of membranous nephropathy is discussed.

ISSN:1660-8151    

DOI:10.1159/000182945

出版商:S. Karger AG    

年代:1983

数据来源: Karger