ISSN:1660-8151    

DOI:10.1159/000183085

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We studied the long-term outcome of a group of children with the nephrotic syndrome who showed the histological lesion of focal segmental glomerular sclerosis (FSGS) during the course of their illness. Of 25 such children studied, a complete follow-up ranging from 3 to 19 years was available in 24. Two distinct groups could be identified. Patients in the first group were characterized by steroid resistance (SR) from the onset, whereas those in the second group were initially steroid sensitive (SS), and had the histological lesion of minimal change which, over time, evolved into FSGS. SR patients had a mean age of 7.7 ± 3.7 years compared to SS patients who were 3.5 ± 2.5 years old (p < 0.01). There were more females (11 of 14) in the SR group than in the SS group (3 of 10; p < 0.02). The incidence of hematuria was higher in the SR patients (9 of 14) than SS patients (2 of 10; p < 0.05). SR patients also exhibited a greater degree of growth retardation at the end of the follow-up period (9 of 13 compared to 1 of 8 SS patients; p < 0.02). SR patients reached end-stage renal failure earlier (2.3 ± 1.3 years) than SS patients (10 ± 5.8 years; p < 0.01) after the initial biopsy. Of the 13 kidneys transplanted into 9 SR patients, recurrence of FSGS was noted in two allografts. Of the 4 kidneys transplanted into 2 SS patients, recurrence was seen in 1. The overall recurrence rate of FSGS in allografts was 17.6%. Our study suggests that the two varieties of FSGS occurring in nephrotic patients may be distinct nosologic entities rather than a single disease with varied manifestati

ISSN:1660-8151    

DOI:10.1159/000183086

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The present study investigates 14 patients on intermittent haemodialysis. Pre-dialysis blood and muscle samples were taken for determining plasma free- and acetylcarnitine levels. The tissue fragments were used for light and electron microscopy studies. Our results support the findings of other investigators that patients on haemodialysis generally display decreased free- and acetylcarnitine levels both in plasma and skeletal muscle when compared with control values. Muscle carnitine deficiency was apparently more severe in the longer-term haemodialysis patients. Moreover, a significant correlation (p < 0.05) between plasma and muscle free-carnitine values was found. Morphologically no pathological alterations were observed in the muscle fibres in 13 of the patients. Light and electron microscopic studies of the muscle fibre of the 14th patient showed a typical nemaline myopathy with rod bodies in the cytoplasm. The muscle free-carnitine concentration in this patient was among the lowest of the group.

ISSN:1660-8151    

DOI:10.1159/000183087

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Serum lipids, apoprotein and lecithin-cholesterol acyltransferase activities were studied in 27 renal transplant recipients with stable and normal renal function (serum creatinine 0.16 mM/1 or less) sustained for more than 1 year following grafting. Hypertriglyceridemia, which was characteristic of hyperlipidemia in 18 hemodialyzed patients with chronic renal failure, was no longer manifest in transplant recipients. On the other hand, de novo hypercholesterolemia was observed posttransplant with mean serum levels of 5.82 ± 1.34 versus 5.01 ± 0.88 mM/1 in 575 normal controls. As to the high-density lipoprotein metabolism, the cholesterol content (1.72 ± 0.56 mM/1) was significantly higher in transplant patients than in hemodialyzed patients (0.82 ± 0.31 mM/1). In contrast, no variation in apoprotein A-I levels was found between both groups of patients, which produced an elevated high-density lipoprotein cholesterol: apoprotein A-I ratio. Thus, derangement in the serum lipid profile, although qualitatively different, continued to be present following transplantation, and its relevance to the cardiovascular morbidity in these patients remains to be evalua

ISSN:1660-8151    

DOI:10.1159/000183088

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Plasma choline levels were measured in patients who received a kidney transplant, in donors who underwent nephrectomy and in nonrenal surgical patients. Choline was measured using a choline kinase assay. Choline levels in patients receiving a kidney fell from 29.8 ± 1.86 µM before transplantation to 15.7 ± 2.32 1 day later; this normal level was maintained for at least 7 months and in a single case for 2 years. Kidney donors and nonrenal surgery patients showed a significant decrease in plasma choline on the day following surgery but choline levels returned to normal by 3 days after surgery. Thus a transplanted functional kidney reduced the high plasma choline levels, associated with uremia, to normal and maintained these normal levels throughout the period of observati

ISSN:1660-8151    

DOI:10.1159/000183089

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The reasons why the peritonitis rate in patients on CAPD with the traditional connection system remains unacceptably high are investigated and identified. In order to overcome such a highly limiting complication, a complete revision of the connection philosophy is suggested, substituting the exasperate prevention of the contamination with a simpler and more effective sterilization of the connection site after the connection has been made. Practical examples of chemical and thermal sterilization are illustrated.

ISSN:1660-8151    

DOI:10.1159/000183090

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In the treatment of end stage renal disease, continuous ambulatory peritoneal dialysis has undoubtedly contributed more towards the solution of its inherent problems than any other peritoneal dialysis technique. Despite the validity of the basic idea, there are still many drawbacks, one of which is the high cost of commercial dialysates. While the manual procedure was indeed simple, we have preferred to concentrate our interest on a modern technology, such as that used for hemodialysis not only making possible the inexpensive preparation of peritoneal dialysates, but also avoiding the hazards usually involved in the preparation, sterilization and storing of the filled bags. We have built a machine composed of 4 modular automatic units, which will prepare the dialysate at pH 7 with no trace of methylfurfurol and which will also monitor the peritoneal dialysis procedure permitting a vast variety of schedules. It will also provide for a special schedule for overnight dialysis or simply fill bags as they are needed.

ISSN:1660-8151    

DOI:10.1159/000183091

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Carbohydrate metabolism in salivary glands of acutely uremic rats was investigated. In the submandibular glands there was an increase of total carbohydrate and glycogen content 24 and 48 h following binephrectomy or ureter ligation. In contrast, lactate concentration was significantly lower. Similar alterations of carbohydrate metabolism could not be observed in sublingual or parotid glands of acutely uremic rats.

ISSN:1660-8151    

DOI:10.1159/000183092

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We describe two preparations for chronic peritoneal dialysis in the dog. In one group uremia was induced by nephrectomy and in the other by ureteral ligation. Peritoneal access was obtained using the Ash disc column catheter. Survival of the animals ranged from 27 to 83 days. Using a dialysis schedule similar in concept to continuous ambulatory peritoneal dialysis in man we found that dialysate-induced ultrafiltration, equilibration of solute between serum and dialysate, as well as protein losses into dialysate approximated values found in patients undergoing continuous ambulatory peritoneal dialysis. Careful attention to detail is required in order to maintain these animals. The advantages of these models are their technical simplicity and prolonged survival making intermediate range studies feasible. Disadvantages include anemia, seen in the anephric animals, technical problems with the disc column catheter, the need for maintenance of strict aseptic technique when performing dialysis exchanges, and difficulties maintaining adequate nutrition.

ISSN:1660-8151    

DOI:10.1159/000183093

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The measurement of urinary or nephrogenous cAMP is considered to be a reliable index of parathyroid function. This test usually involves timed urine collections which renders it logistically burdensome. We have therefore assessed the validity of using spot urine samples for this purpose. 2-hour urine collections were compared to spot samples for the estimation of urinary and nephrogeneous cAMP in 10 patients with hypercalcemic primary hyperparathyroidism and 22 control subjects. The results demonstrated: (1) a considerable overlap between the primary hyperparathyroid and control groups when the urinary and nephrogenous cAMP values were expressed as a function of creatinine excretion. (2) A satisfactory separation between the two groups when the 2-hour urine and spot sample levels of urinary cAMP – and even more so nephrogenous cAMP – were expressed as a function of glomerular filtrate (i.e. nmol cAMP/100 ml glomerular filtrate). (3) An excellent correlation (r = 0.91, p < 0.001, n = 32) between 2-hour urine collections and spot samples for both urinary and nephrogenous cAMP levels. The feasibility of using a spot sample for measuring urinary or nephrogenous cAMP without impairing its diagnostic efficacy considerably simplifies the logistics of the test. This is of particular importance for ambulatory patie

ISSN:1660-8151    

DOI:10.1159/000183094

出版商:S. Karger AG    

年代:1983

数据来源: Karger