摘要:

Plasma antithrombin-III (AT-III) levels in 18 patients on maintenance haemodialysis were studied. AT-III was measured functionally and immunologically before and after dialysis. Simultaneous counts of platelets were made. Prior to dialysis the average AT-III levels and platelet counts were found to be within the lower part of the normal range. On paired analysis the dialysis was seen to induce small, but significant decreases in AT-III levels and platelet counts. A positive linear correlation was found between levels of functionally and immunologically determined AT-III. Replacement of the intravenous application of heparin with an administration of low-dose, subcutaneous heparin is suggested.

ISSN:1660-8151    

DOI:10.1159/000182085

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Chronic renal failure is associated with altered insulin sensitivity of unclear etiology. To investigate the effect of renal failure on insulin binding, we studied insulin binding in mature erythrocytes from 5 undialyzed and 12 chronically dialyzed patients with renal failure. The cell suspension of the isolated and purified human erythrocytes (3.52 × 109/ml) was incubated with 100 pg of 125I-insulin and a range of unlabeled insulin concentrations (pH 8.0, 15°C for 3.5 h). A maximum of 7.9 ± 1.6 and 14.1 ± 3.5 (mean ± SD) specific percent of 125I-insulin was bound by the undialyzed and dialyzed patients respectively, as compared to 10.1 ± 1.4 (mean ± SD) maximum specific percent of insulin bound by the normal subjects. Scatchard plots from the normal, undialyzed and dialyzed subjects were curvilinear, indicating negatively cooperative insulin receptor site-site interactions. From the DeMeyts1 analyses of the Scatchard plots, it was determined that the unoccupied receptor site affinity constant, Ke, for the normal subjects was 0.5 × 108 M-1 whereas that for the undialyzed and the dialyzed patients was 0.69 × 108 M-1. The normal subjects had 410 receptor sites per erythrocyte; however, the undialyzed patients had 215 sites per cell and the dialyzed patients had a receptor number similar to that of the normal subjects. The undialyzed patients had 48% fewer receptor sites than the dialyzed patients and the normal subjects. The undialyzed patients comparing with the normal subjects thus, showed a reduction in insulin binding and in the number of receptor sites with increased affinity. Chronic dialysis caused an increase of insulin binding and of receptor number when compared with the undialyzed patients. In the undialyzed patients with renal failure, the defect in receptor number may be associated with a defect in tissue response to insulin. This defect in insulin receptor number was removed with chronic dialysis. Thus, chronic dialysis may improve insulin sensitivity at the cellul

ISSN:1660-8151    

DOI:10.1159/000182086

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

(PRL) secretion was investigated in 12 undialyzed patients with chronic renal failure (CRF), 30 hemodialyzed patients (HD), 19 renal transplant (RT) recipients and 17 controls. Basal PRL levels in CRF and HD patients were higher than in controls and RT subjects. Plasma PRL values were higher in CRF than in HD patients. In the HD group, plasma PRL concentrations were significantly higher in men with reduced sexual potency than in those in which it was normal. After TRH stimulation in CRF and HD the PRL response was considerably less and the time of peak delayed with respect to the controls. In RT subjects PRL did not return towards baseline after 120 min. After bromocriptine, plasma PRL suppression in CFR and HD patients was lower than in controls and RT subjects. These findings suggest that some factor which accumulates in uremia, is only partially removed by hemodialysis, and might be responsible for the hyperprolactinemia and might also interfere with the binding of TRH and bromocriptine to their respective pituitary receptors. Although a pituitary defect seems to be prevalent, a concomitant hypothalamic disorder cannot be excluded. Hyperprolactinemia seems to play a role in the sexual disturbances showed by some HD men. Whatever the alterations responsible for the impaired PRL regulation in uremia are, they are reversed by successful renal transplant.

ISSN:1660-8151    

DOI:10.1159/000182087

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The long-term effects of vitamin D analogues and metabolites on renal function were assessed in 24 patients with and without chronic renal failure. Treatment for periods of 5–45 months did not adversely affect renal function in 10 of 11 patients with stable renal function, although transient hypercalcaemia did cause transient rises in plasma creatinine. Of 13 patients with progressive renal failure before treatment, vitamin D-like compounds or the vehicle used for their administration may have accelerated renal failure in 3 patients independently of changes in plasma calcium or phosphate. Particular difficulties in assessing the effects of vitamin D-like compounds in progressive renal disease are discusse

ISSN:1660-8151    

DOI:10.1159/000182088

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Red blood ceils (RBC) of uremic or control subjects have been exposed to an oxidative stress by ascorbate and cyanide. The spectrophotometric determination of the sulfhemoglobin production has been used as a reliable method for the measurement of the hexose monophosphate shunt. The sulfhemoglobin production by RBC was significantly higher in uremic than in control subjects. Uremic plasma increased this production in uremic as well as in control RBC while control plasma was ineffective under the same conditions. In vitro the guanidinopropionic acid had the same toxic effect on normal RBC. These results suggest that the abnormal sulfhemoglobin production by uremic RBC might be due to an increased plasma concentration of guanidinopropionic acid in uremia.

ISSN:1660-8151    

DOI:10.1159/000182089

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Femoral neuropathy occurred in 3 patients after renal transplantation. This appeared to be due to compression of the femoral nerve by medial and inferior blades of the self-retaining retractors used during renal transplantation surgery. The condition resulted in weakness of quadriceps muscles, loss of patellar reflex, and sensory deficit on the side of transplantation surgery. The rate of recovery from neurologic deficits appeared to depend on the level of transplant renal function.

ISSN:1660-8151    

DOI:10.1159/000182090

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

This case of congenital nephrotic syndrome is not easy to classify. Treatment with usually effective doses of cyclophosphamide and prednisolone was unsuccessful, whereas a treatment with gammaglobulin was concomitant with a decrease in the frequency of infections, improvement of the nephrotic syndrome, growth, psychomotor development and bone maturation. Electron microscopy shows basal membrane abnormalities not yet described.

ISSN:1660-8151    

DOI:10.1159/000182091

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

We dialyzed 6 patients who developed acute renal failure after severe head trauma. 2 patients died relatively quickly (within 2 weeks) without regaining renal function. 4 patients regained renal function, but 2 died in approximately 1 month. The other 2 survived long-term in a vegetative state for 2 and 3 years, respectively. The 2 patients who died earliest had associated severe abdominal trauma and were both hemodialyzed. 3 of the 4 patients who regained renal function were peritoneally dialyzed. The 2 longest survivors had less frontal lobe involvement. Trauma followed by acute renal failure has an extremely dismal prognosis, and the head-traumatized patient carries the worst prognosis of this group. Peritoneal dialysis, preferably the new msthod of slow continuous peritoneal dialysis, is probably the best method of treating these patients. The decision whether to treat at all should be made early in the course based on clinical neurological criteria, ignoring the renal failure as a predictor of outcome.

ISSN:1660-8151    

DOI:10.1159/000182092

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Transformation of diffuse proliferative glomerulonephritis to membranous nephropathy 10 years later, in a patient with systemic lupus erythematosus, is reported. The original biopsy showed diffuse proliferative glomerulonephritis with epithelial crescent formation, ‘wire loop’ thickening of the capillary walls and moderately severe interstitial inflammation. Electron microscopy showed large subendothelial electron-dense deposits. Following treatment with a combination of prednisone and azathioprine for 2 years the 24-hour urine protein decreased from 8.8 g to 300 mg. In September, 1979, she again developed facial and pedal edema. With the exception of proteinuria of 6.0 g/24 h, the renal function remained normal. Repeat renal biopsy showed membranous glomerulopathy. On electron microscopy, electron-dense deposits were predominantly in a subepithehal position. The significance of the original biopsy as a predictor of eventual outcome and of sequential biopsies to the clinical management of patients with systemic lupus erythematosus is discus

ISSN:1660-8151    

DOI:10.1159/000182093

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

A method of cleaning the hollow fiber artificial kidney (HFAK) is described. Performance of the HFAK through six uses was evaluated and found to be constant for the described method of cleaning. The importance of air removal after use is stressed. A corollary of the study was that simple arteriovenous potassium measurement was found to be a reliable index of dialyzer performance.

ISSN:1660-8151    

DOI:10.1159/000182094

出版商:S. Karger AG    

年代:1981

数据来源: Karger