ISSN:1660-8151    

DOI:10.1159/000183235

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Bone histology and its relationship with calcium metabolism was evaluated in adult patients with nephrotic syndrome: 29 had normal renal function (GFR 103 ± 4 ml/min/1.73 m2) (group 1) and 20 had renal insufficiency (GFR 31 ± 4 ml/min/1.73 m2) (group 2). In group 1 serum PTH, 1.25-HCC and 24.25-HCC levels were normal, while 25-HCC values were reduced. Bone histology was normal in 76% of the patients, while 17% had isolated osteomalacia and 7% an associated bone resorption. Group 2 showed a higher incidence of bone resorption when compared with a matched group of patients with renal failure and no proteinuria (40% vs. 13%) and a comparable frequency of isolated mineralization defect (25% vs. 34%). PTH levels were definitely increased and serum total calcium and all the vitamin D metabolites were reduced. A significant correlation between the apparent duration of the disease and the severity of osteodystrophy was found only in group 2. In conclusion, no constant derangement of calcium metabolism and bone histology is evident in patients with nephrotic syndrome and normal renal function, while patients with persistent proteinuria are at high risk of osteodystrophy even in the early phases of renal failur

ISSN:1660-8151    

DOI:10.1159/000183236

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Increased morning plasma free cortisol levels have been reported previously in chronic renal failure (CRF) patients. To see whether binding abnormalities of plasma proteins contributed to the increase in morning free cortisol, binding characteristics of corticosteroid-binding globulin (CBG) were studied in pooled plasma from CRF patients and normal subjects. Using an isocolloidosmolar equilibrium dialysis method the unbound, albumin-bound, and CBG-bound fractions of plasma cortisol were measured within the physiologic range of plasma cortisol levels. Cortisol binding to CBG was equal in uremic and nonuremic plasma as determined by the affinity constants and the binding capacities of CBG for cortisol. In addition, the distribution of cortisol binding was identical in uremic and in nonuremic plasma samples at equal total cortisol concentrations. By confirming that cortisol binding properties of CBG are unaltered in CRF patients, these data support the assertion that elevated morning free cortisol levels in CRF patients are probably due to increases of plasma total cortisol.

ISSN:1660-8151    

DOI:10.1159/000183237

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In order to investigate the influence of diabetes mellitus on immune complex-mediated nephritis, we produced Heymann nephritis in streptozotocin-induced diabetic rats (DM-HN group) in which the clinical course for 24 weeks and histological changes were examined. Nondiabetic rats with Heymann nephritis (HN group) and diabetic rats (DM group) were also examined as controls. The degree of proteinuria, hypoproteinemia, hyperlipidemia and anemia were more pronounced and the mortality rate was higher in the DM-HN group than in the HN group or in the DM group. Histologically, larger and more subepithelial or intramembranous electron-dense deposits as well as a more markedly thickened glomerular basement membrane (GBM) were observed in the DM-HN group than in the HN group. In conclusion, the nephrotic manifestations and histological changes in the GBM in Heymann nephritis were augmented by the association with diabetes mellitus.

ISSN:1660-8151    

DOI:10.1159/000183238

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Although acute interstitial nephritis associated with the use of nonsteroidal anti-inflammatory drugs has long been recognized, only recently has its association with ‘minimal change’ nephrotic syndrome been reported. We report here a case of this pattern of nephrotic syndrome without concurrent interstitial nephritis associated with the use of tolmetin. The clinical picture, laboratory data, course, and relevant histopathologic findings of previous cases in the literature of nephrotic syndrome related to the use of the nonsteroidal anti-inflammatory drugs are reviewed and discus

ISSN:1660-8151    

DOI:10.1159/000183239

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Patients with end-stage kidney disease untergoing chronic maintenance dialysis (HD) are a high risk group for sudden death due to cardiovascular complications. It was the aim of the study to investigate the quantity and quality of arrhythmias during HD and between two consecutive HD (interval, I) with regard to the reproducibility of the expected results. 15 patients (8 males, 7 females) underwent continuous Holier monitoring (LT-ECG) under ambulatory conditions over 96 h including two HD (HD 1 + HD2) and two intervals (11 + 12). The LT-ECG recordings were analysed with the computer assisted ‘Multipass-Scanning’ system with regard to heart rate (HR), supraventricular premature beats (SPB), ventricular ectopics (PVC) and malignant ventricular arrhythmias. Results: The HR demonstratd a typical, well-known circadian pattern with remarkable increase of the HR during each HD. Except for rare, single SPB and/or PVC, no supraventricular or ventricular arrhythmias could be detected reproducibly. Single PVC occurred in patients with a lower potassium value. No malignant ventricular arrhythmias were found. In comparison to previously published studies, which demonstrated a high incidence of malignant ventricular arrhythmias, these conflicting results were due to differences in patients’ recruitment (unterlying disease, age, etc.), the performance of HD (duration, ion concentration of the dialysate etc.), serum potassium levels and drug medication (digitalis, quinidine). In summary, chronic HD per se did not enhance the risk of malignant arrhythmias in patients with end-stage kidney di

ISSN:1660-8151    

DOI:10.1159/000183240

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A retrospective study of 410 renal transplant recipients showed that 1.96% (8/410) of patients had developed severe non-typhoid salmonella infections. The clinical features seen were fever, leucopenia, pneumonia, diarrhoea, abscesses, pyelonephritis, venous thrombosis and pleural effusion. Neither uraemia nor repeated high doses of steroids seemed to be major precipitating events. All isolates were strains of Salmonella entiritidis. All 8 patients were cured and none became permanent carriers. Salmonella infections cause severe, life-threatening infections in renal transplant patients and require vigorous treatment often with a long-term low-dose regimen. Patients seemed to respond best to chloramphenicol, but ampicillin and co-trimoxazole were useful in some. Bilateral nephrectomy should be performed before the transplantation if the organism is grown from the urine.

ISSN:1660-8151    

DOI:10.1159/000183241

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A 73-year-old man was given a total of 1 mg of digoxin intravenously over 3 days, close to the time that he developed acute renal failure with oligo-anuria. He received no cardiac glycosides before or after this 3-day period. 2 days after the last dose, the serum digoxin concentration (SDC) was 2.9 ng/ml, yet a peak value of 4.2 ng/ml was reached only 11 days later. The SDC remained above 2 ng/ml for another week, until urine output began to increase appreciably. As renal function improved, the SDC gradually fell to become undetectable 32 days after the last dose. Values for apparent volume of distribution calculated from the total dose, and also determined after injection of tritiated digoxin, suggest that the rise in SDC in the absence of additional doses was due in large part to a decrease in the apparent volume of distribution. Dosage and parameters of toxicity should be carefully monitored in patients receiving digoxin who develop acute renal failure.

ISSN:1660-8151    

DOI:10.1159/000183242

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The investigation of a sample of 99 women on maintenance hemodialysis has shown the presence of sexual disturbances to a great extent: the rate of sexual intercourse and the ability to reach orgasm were significantly lower than in age-matched control women. 80% declared a reduction in their sexual desire and the frequency of intercourse was also lower as compared to the period prior to dialysis. Ageing decreased the sexual activity in both the ill and healthy population, but in uremic patients the sexual activity ended at an earlier age. The patients with hyperprolactinemia reported lower frequencies of intercourse and lower percentages of orgasm than normoprolactinemic ones. The incidence of sexual dysfunction and the role of hyperprolactinemia in this respect were similar to those which are found among male patients on hemodialysis.

ISSN:1660-8151    

DOI:10.1159/000183243

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We analyzed 953 articles published in three established nephrology journals to select those pertaining to treatment with hemodialysis. A total of 152 papers were selected on the criteria that the reported results might have been affected by variation in the dialysis prescription. Only a small proportion of the papers studied (11.8%) detailed the complete dialysis prescription including type of dialyzer, blood flow rate, and duration and frequency of dialysis. A surprising 29% of papers provided no details of the dialyzer employed. Other potentially important variables such as the type of blood tubing or method of water treatment used were rarely mentioned. Comparative studies of the course and outcome of hemodialysis regimens require specification of exactly how dialysis was performed. It is suggested that manuscripts provide this information as a condition of suitability for publication.

ISSN:1660-8151    

DOI:10.1159/000183244

出版商:S. Karger AG    

年代:1984

数据来源: Karger