ISSN:1660-8151    

DOI:10.1159/000188458

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188459

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188460

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Complications associated with vascular accesses account for approximately 30% of hospital admissions for chronic hemodialysis patients. Long-term patency of access was evaluated in 76 patients, without diabetes mellitus, who had been on dialysis for at least 3 years and 41 patients, with diabetes mellitus, who had been on dialysis for over 2 years. Fistulas functioned longer than grafts (58 vs. 22 months, p < 0.01, in nondiabetics and 70 vs 22 months, p < 0.01, in patients with diabetes). Declotting or revision of restored graft function for short periods of time ( < 6-10 months) and subsequent declotting was ineffective. Infections were uncommon in grafts (1 per 13.5 years of dialysis) and in fistulas (1 in 200 years of dialysis).

ISSN:1660-8151    

DOI:10.1159/000188461

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Four patients with antineutrophil cytoplasm antibody (ANCA)-positive vasculitis were followed over a period from 27 to 54 months after successful kidney transplantation under immunosuppressive treatment with ciclosporine. ANCA titer prior to transplantation was markedly elevated and decreased in 1 of 4 patients under therapy with ciclosporine. Despite adequate ciclosporine blood trough levels, a relapse occurred in 2 patients 18 and 24 months after transplantation but therapy with cyclophosphamide induced remission and no patient lost his graft due to relapse of vasculitis. This observation demonstrates that kidney transplantation may be offered to ANCA-positive patients with end-stage renal disease due to vasculitis. However, patients under ciclosporine therapy are still at risk for the development of relapsing disease and cyclophosphamide has to be added to or substituted in part for standard immunosuppressive therapy in order to reverse clinical symptoms and prevent rapid deterioration of kidney function.

ISSN:1660-8151    

DOI:10.1159/000188462

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Nephrocalcinosis was described in preterm infants by several authors who tried to determine its association with hypercalciuria and furosemide therapy. We evaluated these potential mechanisms along with other lithogenic factors not previously studied in 10 premature babies. Hypercalciuria was an inconsistent finding like in other reports; elevated uric acid excretion and hyperoxaluria were observed in 5 and 6 cases, respectively. The aminocid excretion was normal in all infants. Our data suggest that in addition to hypercalciuria, other lithogenic factors may play a role in the pathophysiology of nephrocalcinosis of premature infants.

ISSN:1660-8151    

DOI:10.1159/000188463

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Idiopathic low-molecular-weight (LMW) proteinuria is a newly described renal disease in Japan and Italy. We report on 7 patients who manifested bilateral or unilateral nephrocalcinosis, as demonstrated by abdominal computed tomography scans. Renal histology revealed calcinosis of renal tubules in 2 patients. Computed tomography is a reliable method for the detection of nephrocalcinosis in this disorder. Hypercalciuria was also seen in 6 patients. A calcium-loading test performed in 2 patients suggested that hypercalciuria was of renal origin. Although the true pathogenesis is still not known, hypercalciuria and nephrocalcinosis appear to be a common complication in patients with idiopathic LMW proteinuria. These complications and clinical features suggest that idiopathic LMW proteinuria in Japan is likely to be identical to Dent’s disease in the United Kingdo

ISSN:1660-8151    

DOI:10.1159/000188464

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Isolated resting platelets are able to limit neutrophil activation and then can control the tissue-damaging potential of activated neutrophils. In the present study, platelet-neutrophil interactions have been evaluated in 10 uremic patients; the blood samples have been collected before the hemodialysis session. Twelve normal subjects served as controls. Platelets and neutrophils have been isolated and recombined in an autologous ex vivo system. Anion superoxide production and chemiluminescence (which is related to hypochlorous acid production) have been evaluated after stimulation with N-formyl-methionyl-leucyl-phenylalanine. Coincubation of platelets from normal subjects with autologous neutrophils led to a dose-dependent inhibition of both superoxide anion generation induced by N-formyl-methionyl-leucyl-phenylalanine and chemiluminescence. Instead, platelets from uremic patients have not affected superoxide anion production by autologous neutrophils. The chemiluminescence was reduced by coincubation with autologous platelets only at the highest platelet-neutrophil ratio (100:1). In conclusion, the modulation exerted by platelets towards neutrophil activation can be impaired in chronic uremia. Therefore, the tissue-damaging potential of circulating neutrophils, due to toxicity by superoxide anion and hypochlorous acid, may be increased.

ISSN:1660-8151    

DOI:10.1159/000188465

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Ingestion of potassium salts typically induces both a kaliuresis and an increase in the systemic plasma potassium concentration. In this study normal healthy adults undergoing water diuresis ingested potassium citrate or sodium citrate (0.5 mmol/kg body weight) or continued without ion ingestion (a time control group). Urine was collected over 20-min intervals and venous blood sampled at midinterval. Intake of potassium citrate led to a significant increase in potassium excretion that began during the first postingestion collection and peaked 60-80 min after intake with a maximal increase in potassium excretion above baseline of 1.60 μmol/min·kg-1 The kaliuresis occurred without changes in plasma potassium concentration, excretion of creatinine or calcium, or urine hypo-osmolality and was associated with a briefer, smaller, and less regular increase in sodium excretion and a pronounced but irregular increase in chloride excretion. Plasma aldosterone was insignificantly elevated above baseline, and the initial increase did not occur until 40-60 min after potassium intake. Intake of sodium citrate did not produce a kaliuresis. The cause of the kaliuresis does not appear to be an increased systemic plasma potassium concentration, an increased plasma level of aldosterone, intake of citrate, or an elevated excretion of sodium. The mechanism inducing the kaliuresis following oral potassium intake in the absence of changes in systemic plasma potassium may involve a reflex initiated at potassium sensors in gut, portal vein, or live

ISSN:1660-8151    

DOI:10.1159/000188466

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Improvement in erythropoiesis following renal transplantation (RT) was assessed in 74 consecutive patients by serial measurements of serum erythropoietin (EPO), hematocrit, absolute reticulocyte count (ARC) and serum creatinine during the first month after RT. The reticulocyte maturity index (RMI) which provides an objective measure of red-cell maturity was assessed in 31 patients by flow cytometry using thiazole orange. In group I (n = 39) with immediate graft function, EPO levels increased rapidly from day 2 and remained elevated at the plateau between two and three times the upper limit of normal during the first 2 months. In group II (n = 29) with delayed graft function, EPO levels increased gradually from day 10 when renal function improved significantly. No particular significant biphasic pattern of secretion was detected in group I or II. In both groups, hematocrit rose to over 35% approximately 3 months after RT. In a third group (n = 6) with immediate postoperative acute blood loss and severe anemia, a hematocrit fall was followed by a steep increase in EPO levels with a negative correlation between hematocrit and EPO levels during the first 4 days. During acute rejection, EPO diminished significantly by more than 50% either on the day of diagnosis or on the following days in 8 patients. RMI increased by 25% over the pretransplantation values by 7 days on average before the ARC rose. Thus the RMI seems to be an early sensitive predictor of erythropoiesis after RT. EPO response after RT depends on graft function, and the early transient increase in EPO observed in patients with acute blood loss may explain the apparent biphasic response previously reported.

ISSN:1660-8151    

DOI:10.1159/000188467

出版商:S. Karger AG    

年代:1995

数据来源: Karger