ISSN:1660-8151    

DOI:10.1159/000187555

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000187556

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

To evaluate the acute effect of human erythropoietin (r-HuEPO) on basal and stimulated prolactin (PRL) secretion, 18 normal subjects (12 females, 6 males) were studied. The PRL response to thyrothropin-releasing hormone (TRH; 200 μg intravenously, n = 7), metoclopramide (MCP, 20 mg intravenously, n = 5) and fenfluramine (FF, 60 mg os, n = 6) was tested in presence of saline or r-HuEPO (30 U/kg intravenously). The drug neither modified basal PRL levels nor affected the normal PRL release to TRH, MCP and FF. Our results indicate that, in normal subjects, the acute administration of therapeutic doses of r-HuEPO does not interfere with PRL secretion both after a direct pituitary stimulus and after stimuli involving dopaminergic and serotoninergic pathways

ISSN:1660-8151    

DOI:10.1159/000187557

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Recent studies suggest the existence of a relationship between the renin-angiotensin system and erythropoietin (EPO) secretion. It has been studied whether patients with various forms of arterial hypertension (essential, renal, renovascular, in the course of arteritis) differ with respect to EPO secretion and whether EPO serum levels are related to renin response induced by dietary sodium restriction to 10-20 mmol Na/24 h for 3 days and upright body position for 3 h. Patients with different forms of hypertension and normal renal excretory function and healthy subjects did not differ in hematocrit value, markers of iron metabolism, and EPO secretion except for patients with arteritis who had higher ferritin values. In these patients a positive correlation between EPO levels and hematocrit values suggests the existence of an altered regulation of EPO secretion. In essential hypertension a negative correlation found between changes in EPO and PRA levels in response to sodium restriction and upright body position may also reflect an altered regulation of both EPO and renin production.

ISSN:1660-8151    

DOI:10.1159/000187558

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A previous report suggests that treatment with recombinant human erythropoietin (rH-EPO) significantly improves many abnormalities in circulating amino acids (AA) in hemodialysis patients. We evaluated the effects of a 12-month treatment with rH-EPO (150-250 U/kg/week) on blood AA levels in 10 patients with chronic renal failure under regular dialytic treatment. During treatment, hemoglobin levels increased from 7.0 ± 0.3 to 10.1 ± 0.3 g/dl at 3 months remaining steady thereafter. Before the treatment, patients showed reduced levels of essential AA (EAA), mainly valine, leucine and threonine (p < 0.05-0.01); among non-EAA (NEAA), aspartate and serine were reduced, wheres glycine, alanine, proline, citrulline and cyst(e)ine were increased (p < 0.05-0.001). Val/Gly, Ser/Gly and Tyr/Phe ratios were low (p < 0.05-0.01). Total EAA and total NEAA (619 ± 21 and 1,382 ± 75 μmol/l, respectively, before the study) were unchanged (639 ± 22 and 1,410 ± 89 μmol/l, respectively) at 12 months. Abnormalities in AA levels observed before the treatment persisted throughout the study. Only serine increased at the end of the study (p < 0.05). In conclusion, contrary to what has been reported, treatment with rH-EPO is not associated with an amelioration of AA metabolism in hemodialysis p

ISSN:1660-8151    

DOI:10.1159/000187559

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

By using a radioimmunoassay specific for endothelin-1 (ET-1), we measured urinary excretion of ET-1-like immunoreactivity (LI) in 63 spot urine samples of 48 patients with primary vesicoureteral reflux (VUR). And also, urinary excretion of N-acetyl-β-D-glucosaminidase (NAG), β2-microglobulin (β2-MG), microalbumin (Alb) and creatinine (Cr) were measured. There was no significant correlation in any of the pairs ET-1 and NAG, ET-1 and β2-MG, and ET-1 and Alb. Comparing the grade of reflux according to the International Classification with urinary ET-1, urinary ET-l/Cr levels in patients with grade 2, 3 and 4 VUR were higher than normal, and the ratio of more than normal urinary ET-l/Cr increased in proportion to the grade of reflux, but it conversely decreased in grade 5. In conclusion, urinary ET-1 maybe an indicator of renal tubular injury in patients with primary VUR, and its meaning may be different from conventional urinary paramet

ISSN:1660-8151    

DOI:10.1159/000187560

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The influence of donor age on the outcome of kidney transplantation (TX) was evaluated in 169 patients who received a primary cadaver kidney transplant at our center between September 16,1984, and December 31,1990. All the patients received cyclosporin A as part of the immunosuppressive protocol. Patients were grouped according to donor age: low donor age (LDA; donor age range 12-25 years), medium donor age (MDA; range 26-50 years) and high donor age (HDA; range 51-66 years). There were no differences between groups in graft and patient survival, and multivariate analysis did not show any effect of donor age on those parameters. Proteinuria/day and number of rejection episodes did not differ between groups either. Immediate diuresis was more frequent in group LDA than in the other two groups (73.8, 54.7 and 57.1%, respectively; p < 0.05) and immediate diuresis resulted as a weak positive prognostic factor for graft outcome at multivariate analysis (p = 0.05). At both univariate and multivariate analyses, donor age resulted inversely correlated with creatinine clearance (CCr) at every period after TX but the 5th year, with r2 from 0.12 to 0.23 (p < 0.01). The LDA group had significantly better CCrthan the HDA group at every period after TX but for the 5th year (the MDA group behaved intermediately). Moreover, in the 65 patients with a follow-up of 4 years or more, not only did the LDA group have the best CCr (LDA vs. MDA and HDA: p < 0.02) but also CCr remained roughly stable with time in groups LDA and MDA while it declined progressively with time in group HDA. The influence of donor age on hypertension after TX was negligible when compared to that of dialytic age and recipient sex. Our data show that kidneys from donors 12-25 years old give the best functional results, while those from donors over 50 are associated with the lowest kidney function. Moreover, if the reduced frequency of immediate diuresis and the progressive decline of CCr with time are taken into account, kidneys from donors over 50 are also probably associated with reduced graft survival in the long term (after the 10th year). We suggest that kidneys from donors over 50 may be used, but they should be probably given to patients with a life expectation of no more than 10-15 years.

ISSN:1660-8151    

DOI:10.1159/000187561

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Using improved microscopy of urine sediment, the consistent finding of bacteria, usually gram-positive cocci at low counts, free or even in casts, in the sediment of carefully collected urines from patients with systemic illnesses has led to the need to reconsider their exclusion by the customary criteria for ‘significance’ of bacteria in urine. Since ‘significance’ is currently based upon mathematical assumptions limited to high counts ( > 105 105 cfu/ml. Published data on growth in human urine show that very few bacterial species can divide so fast in urine, and those are the ones currently considered ‘significant’. Except for some enterococci, streptococci cannot. (2) With a division time only marginally longer than the CDT, any bacterium would wash out unless continuously supplemented via the kidney or from the bladder wall. (3) With a continued supplement and the longer division time, the concentration would fall to a low plateau, and that plateau is diagnostic of a continued supplement. The cocci observed by microscopy are fastidious or dead. They grow poorly if at all in urine, and thus are not likely to ascend the urinary tract. Their appearance corresponds to the earlier studies of bacteriuria and to the known excretion of blood-borne bacteria in natural disease, whether or not there are anatomical changes in the kidney. It is suggested that the low-level coccal bacteriuria found is a marker for scant bacteremia in many systemic diseases for which a bacterial provocation ha

ISSN:1660-8151    

DOI:10.1159/000187562

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The role of aluminum accumulation in articular tissues of patients affected by dialysis-associated arthropathy (DAA) is questioned. The aim of this work is to identify the nature of these aluminum accumulations by the use of secondary ion mass spectrometry (SIMS). Al/Si ratios of about 1, measured by SIMS, strongly suggest for the first time the presence of aluminum silicates and possibly aluminum hydroxides in amyloid synovial tissue and articular cartilage of 1 patient with DAA and aluminum intoxication. This is thermodynamically consistent with the total dissolved Al and Si contents and pH measured in the synovial fluids. These results are similar to the abnormal Al distribution recently found by SIMS in the forebrain of chronic renal dialysis patients and to the amorphous aluminum silicates identified in the core of senile plaques in Alzheimer’s diseas

ISSN:1660-8151    

DOI:10.1159/000187563

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The relationship between glycosaminoglycans and β2-microglobulin, glycosaminoglycans and N-acetyl-β-D-glucosaminidase as well as the relationship between the chondroitin sulfate/heparan sulfate ratio and SDS electrophoresis in the urine of subjects from the endemic area of Balkan nephropathy was studied in order to establish a method for early detection of this disease. The results show an unquestionable increase in urinary excretion of total glycosaminoglycans in subjects with or suspected of having Balkan endemic nephropathy while the chondroitin sulfate/heparan sulfate ratio was not statistically different between the groups studied. Thus, the chondroitin sulfate/heparan sulfate ratio cannot be used as a cheap and quick semiquantitative method for the diagnosis of early tubular damage in Balkan endemic nephropathy. However, the determination of total glycosaminoglycans in the urine of subjects from endemic areas proved to be valuable additional information helping with the diagnosis of Balkan endemic nephropath

ISSN:1660-8151    

DOI:10.1159/000187564

出版商:S. Karger AG    

年代:1993

数据来源: Karger