ISSN:1660-8151    

DOI:10.1159/000185612

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Phagocytosis, H2O2 production, and C3bi receptor (CR3) expression by polymorphonuclear leukocytes (PMN) obtained from patients before, during, and after a hemodialysis treatment were evaluated by flow microfluor-ometry. The results were compared to changes in plasma levels of C3adesArg and C5adesArg. Prior to hemodialysis C3adesArg and C5ades Arg levels, CR3 expression and phagocytosis were not different from normal controls. However, both basal and phagocytosis-induced H2O2 production were increased. C3adesArg and C5adesArg were increased after 15 min of dialysis; this was accompanied by transient but significant reductions in PMN count and phagocytosis and increased CR3 expression. No changes in basal or stimulated H2O2 production were observed. We conclude that PMN of hemodialysis patients are primed for an enhanced respiratory burst before dialysis is initiated. Dialysis-induced complement activation after the initiation of dialysis does not further stimulate H2O2 production or enhance the response to phagocytosis. However, complement activation may cause leukopenia and CR3 expression.

ISSN:1660-8151    

DOI:10.1159/000185613

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Substitution of calcium carbonate for aluminum hydroxide in patients on dialysis: effects on acidosis, parathyroid function, and calcemia. We studied the effects of substituting CaCO3 for aluminum-containing gels on metabolic acidosis and on the response of the parathyroid glands in 11 patients treated with chronic hemodialysis. The 8 men and 3 women were clinically stable, were known to be compliant, and had no clinical evidence of aluminum overload; they were not receiving vitamin D supplements; and they had been on dialysis for an average of 65.6 months (range: 13–188 months). After 3 weeks of CaCO3 administration plasma phosphate concentration remained well controlled, and plasma calcium concentration increased from 9.2 ± 0.2 (2.3 ± 0.1 mmol/l) to 10.1 ± 0.2 mg/dl (2.5 ± 0.1 mmol/l). Predialysis plasma bicarbonate concentration increased from 19.7 ± 0.6 to 21.9 ± 0.6 mmol/l. Plasma aluminum concentration decreased from 78.7 ± 12.5 to 48.5 ± 3.9 μg/l. Plasma PTH level increased from 2.0 ± 0.7 to 3.3 ± 0.8 ng/ml despite the concurrent increase in plasma calcium levels. All values returned to control levels following discontinuation of CaCO3 and resumption of aluminum gels. We conclude: (1) In addition to controlling hyperphosphatemia and increasing plasma calcium concentration, CaCO3 ameliorates metabolic acidosis. (2) Avoidance of oral aluminum intake is followed by prompt lowering of plasma aluminum levels. (3) PTH levels paradoxically increase despite the increment in plasma calcium concentration. The hypercalcemia seen with CaCO3 administration may be due, in part, to transient parathyroid hypersecretion that develops when aluminum administration is

ISSN:1660-8151    

DOI:10.1159/000185614

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Albumin electrical charge, conformation and hydrophobicity taken as indexes of renal selectivity were evaluated in 8 children affected by steroid-unresponsive nephrotic syndrome associated with glomerulosclerosis or mesangial hypercellularity. These characteristics related to urinary albumin have already been reported to vary markedly in steroid-responsive nephrotic syndrome of minimal-change nephropathy giving rise to new pathogenetic possibilities in this disease. In the steroid-unresponsive nephrotic children albumin was found to be more microheterogenous and cationic in urine than in serum and at the same time it was conformationally altered. Regarding these characteristics, the selectivity properties of the renal filter are similar in steroid-unresponsive nephrotic syndrome, suggesting a pathogenetic connection between these two renal disorders.

ISSN:1660-8151    

DOI:10.1159/000185615

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A 72-year-old woman presented with rapidly progressive renal failure and multiple myeloma. The patient died 6 months later of severe hepatic insufficiency. The light-microscopic, immunological and ultrastructural findings showed widespread kappa-light-chain deposits including the kidneys, liver, spleen, heart, lungs, tongue, ovary, pancreas and bone marrow associated with massive AL amyloid deposits in the same organs and in the thyroid gland. The concurrent presence of two different deposits is very unusual and the possible mechanisms for such an association are discussed.

ISSN:1660-8151    

DOI:10.1159/000185616

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A 77-year-old man presented with macroscopic haematuria and oligo-anuric renal failure. A renal biopsy showed moderate linear glomerular basement membrane (GBM) staining with λ light chains alone, but both circulating IgG and λ light chain activity were present. There was no evidence of a serum or urinary paraprotein and a bone marrow biopsy was normal. Serum λ light chains did not bind to renal GBM when examined by indirect immunofluorescence. This case suggests that light chains are capable of binding directly to epitopes in the GBM and may initiate injury although by a different mechanism from the IgG anti-GBM molecu

ISSN:1660-8151    

DOI:10.1159/000185617

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Superficial dermal vasodilatory capacity and indirect segmental systolic arterial pressure were measured in 10 patients with end-stage renal failure and 13 controls. Laser-Doppler flowmetry was used to measure skin blood flow on the dorsum of the feet prior to and during local skin heating to 40 °C. Basal skin blood flow was not significantly different between the two groups (mean 0.8 ± (SD) 0.3 vs. 0.7 ± 0.2 U). Peak stimulated flow at 40 °C was significantly greater in the controls than in the azotaemic patients (10.0 ± 3.5 vs. 3.5 ± 1.6 U, p < 0.01). Stiffening of the major limb arteries was detected in the majority of the azotaemic patients and may have contributed to the reduction in vasodilatory cap

ISSN:1660-8151    

DOI:10.1159/000185618

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

In this report, we present a series of 6 patients with Behçet’s disease (BD) associated with amyloidosis whose illnesses date back at least 4 years. In all the cases, nephrotic syndrome heralded the onset of amyloidosis, which was diagnosed by percutaneous kidney biopsies. After the diagnosis of amyloidosis, all subjects received colchicine, and steroids were discontinued. Three patients have benefited from treatment. It was suggested that amyloidosis may be an intrinsic feature of BD or that the suppurative lesions may play a role in the accumulation of amyloid in the tissues. The literature was reviewed and discuss

ISSN:1660-8151    

DOI:10.1159/000185619

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Bone mineral content (BMC) was measured at the lumbar spine region by means of dual photon absorptiometry over a 3-year period in 20 patients on regular hemodialysis (RHD). Baseline mean BMC at the start of the monitoring was significantly decreased to 82.64% of predicted value (p < 0.05). During a 3-year follow-up mean BMC rose significantly to 90.61% (p < 0.05). Six patients received vitamin D supplements. Analysis of the data showed that rise of BMC was similar whether vitamin D was given or not. Our data suggest that (1) RHD inhibits bone loss at the lumbar spine level that occurred mainly before active uremia treatment and (2) the increment of BMC observed in this study can be attributed to the different site of measurement, the inaccuracy of the measurements by interference with soft tissue calcifications and the dialysis conditions

ISSN:1660-8151    

DOI:10.1159/000185620

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Uric acid is implicated in calcium oxalate kidney stone formation. Conspicuously so far, two hypotheses have been proposed: direct induction of calcium oxalate precipitation by uric acid, and uric acid as anti-inhibitor by binding urinary glycosaminoglycans (GAGS). The aim of this work is to evaluate uric acid and the relationship with GAGS in a group of patients with calcium oxalate lithiasis, and in a control group for detecting possible differences between the two groups. It was found that the lower concentration of GAGS in stone formers could impede their inhibitory activity on the heterogeneous nucleation of uric acid in calcium stone formation.

ISSN:1660-8151    

DOI:10.1159/000185621

出版商:S. Karger AG    

年代:1989

数据来源: Karger