ISSN:1660-8151    

DOI:10.1159/000181753

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

5 patients, including 4 with partial lipodystrophy and 1 with dense deposit disease (type II mesangiocapillary glomerulonephritis; MCGN), had positive C3 nephritic factor assays by both a crossed-gel immunoelectrophoretic and a magnesium-dependent hemolytic assay. One or more early classic complement component was significantly decreased in the serum from each patient. The titer of the C3 nephritic factor did not correlate with the presence of dense intramembranous deposits or with the severity of the renal disease. One patient with partial lipodystrophy had ultrastructural evidence suggesting transformation from type I to type II MCGN. These findings do not support a strict separation of MCGN into subtypes according to current criteria.

ISSN:1660-8151    

DOI:10.1159/000181754

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The clinical and renal biopsy findings in 3 patients with recurrent focal and segmental glomerulosclerosis (FSG) are reported, as well as the results of a survey among 17 European centers totaling 27 kidney-transplanted children with FSG. From these 27 patients, 10 had recurrent FSG. The duration of the original disease was less than 3 years in 9 of them. In contrast, this rapid progression of the disease was observed in only 7 of 17 patients in the group without recurrences. Heavy proteinuria was noted within the 1st day, or week, in all but 2 patients where it was detected at 3 and 7 weeks. All developed the nephrotic syndrome. From the 10 kidneys (mostly from cadaver donors) which functioned for more than 1 month, 5 were lost 2–24 months after transplantation because of recurrence (3 patients) or infection (2 patients). It appears that the risk of recurrence can best be predicted by the duration of the original disease: 50% or more if the duration was short ( < 3 years), and only 10–20% when the duration was lon

ISSN:1660-8151    

DOI:10.1159/000181755

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

It has been suggested that minimal-change nephropathy (MCN) may be related to a disorder of cell-mediated immunity. Lymphocyte cell-surface markers (E and EAC rosettes) and functional markers (mitogenic response to PHA, Con A and PWM) were examined in 13 patients with MCN and nephrotic syndrome (NS) and in 13 patients with MCN in remission compared to 20 patients with membranous glomerulonephritis (MG) and NS, and 20 normal controls. None of the patients received medication at the time of the study. The response to various mitogens of MCN with NS was significantly reduced, while MCN in remission and MG had mean values of the mitogenic response not significantly different in respect to normal controls. Lymphocyte hyporeactivity in autologous plasma was associated, in approximately 50% of the patients with MCN and NS, to a normal lymphocyte response in homologous plasma and to the presence of an inhibitory effect of MCN plasma on normal lymphocytes. Also, the percentage of E rosettes was reduced, while the percentage of EAC rosettes was increased. The defect of T cells was not related to the degree of the NS. In 7 patients, studied at the onset of NS and afterwards in remission, the functional and numerical lymphocyte deficit disappeared during recovery. There is evidence that MCN is associated with a functional disorder of T cells which may be related to the presence of a humoral inhibiting factor.

ISSN:1660-8151    

DOI:10.1159/000181756

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The effects of constant intravenous infusion of propranolol, 1 mg/kg/h, on acute renal failure produced by 1 h occlusion of the left renal artery in the rat were investigated by clearance and micropuncture techniques. Propranolol infusion resulted in a significantly smaller rise in proximal intratubular pressure than that observed following renal ischemia in the saline-infused group. When compared with saline-infused animals, this effect was accompanied by a significant improvement in inulin clearance without commensurate increase in renal blood flow or stop flow pressure and suggests attenuation of intratubular obstruction by the drug. A complex metabolic effect may be involved.

ISSN:1660-8151    

DOI:10.1159/000181757

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

A retrospective review of 27 patients with nonvisualization on 131I-orthoiodohippurate (Hippuran®) renal scan during 1972–1977 was carried out. 5 patients had renal failure caused by urinary tract obstruction and of these, 4 were submitted to surgical relief. Varying levels of life-sustaining renal function were recovered in all 4 patients. 16 had chronic intrinsic renal disease, of whom 7 were admitted for reasons not directly related to renal failure. All of these required chronic dialysis within 3–6 months. The remaining 7 patients had acute renal failure (clinically, acute tubular necrosis) and none of them survived. It has been well established that the prognosis for recoverability of renal function is extremely poor in patients with nonvisualization on hippuran scan. It is important, therefore, to emphasize that nonvisualization on 131I-orthoiodohippurate renal scan in patients with urinary tract obstruction does not exclude the potential for recoverable renal function. Therefore, even in the absence of renal visualization, the need to definitively rule out urinary tract obstruction rem

ISSN:1660-8151    

DOI:10.1159/000181758

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Six episodes of septic arthritis involving 5 patients and eleven joints were documented in the last 7 years in a population receiving 450 patient-years of dialysis treatment. The same micro-organisms were often cultured simultaneously from the joint, blood and/or arteriovenous fistula, suggesting hematogenous spread. A tendency toward multiarticular involvement was also observed. Early diagnosis is mandatory to avoid severe joint damage. Since such patients have other potential causes of arthritis and periarticular pain not due to infection, it is important to culture the joint fluid promptly whenever the possibility of infection exists.

ISSN:1660-8151    

DOI:10.1159/000181759

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Previous studies of gastric secretory function and serum gastrin levels in patients with chronic renal failure (CRF) have yielded conflicting results. In a study of 30 patients on regular hemodialysis, serum gastrin levels were higher than normal (p < 0.05), and the gastric secretory response to pentagastrin was normal for the group as a whole. There were, however, 8 patients who were hypochlorhydric (4 achlorhydric) and 7 who were hyperchlorhydric. The patients with gastric hyposecretion were older, predominantly male and this group was associated with the highest gastrin levels as well as the highest incidence of gastrointestinal hemorrhage. Chronic gastritis is thus more common in CRF than generally believed and may be responsible for much of the morbidity from gastrointestinal complications during hemodialysis.

ISSN:1660-8151    

DOI:10.1159/000181760

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Renal tubular function was studied in 318 consecutive recurrent renal stone formers. Impaired acidification capacity was found in 19% of the patients, and tubular proteinuria in 13% of the patients. Most of the patients with defective acidification of the urine had the incomplete form of renal tubular acidosis (RTA), proximal and distal defects being equally common. The incidence of impaired acidification was much higher in the female (38%) than in the male (13%) stone formers. A further analysis of the clinical picture in patients with acidification defects revealed a more severe stone disease than among other stone formers. Characteristic findings were an early onset, multiple recurrences with an increased need for surgery. Stone analyses showed a high frequency of calcium phosphate stones. Investigations of renal tubular functions appear to be a valuable adjunct in the evaluation of recurrent renal stone disease.

ISSN:1660-8151    

DOI:10.1159/000181761

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Acute renal failure, following major surgery of the abdominal aorta, was managed in 3 patients using the subclavian vein for single-needle dialysis. Peritoneal dialysis could not be done, as the posterior peritoneum is violated. Blood access for hemodialysis also poses several problems. Percutaneous cannulization of the femoral vein is risky because of the possibility of accidental entry into the synthetic graft. The subclavian vein provides an alternate source of blood supply for single-needle dialysis in these high-risk postsurgical patients who have acute renal failure. Several advantages are described with this technique, including preservation of forearm vessels. Utmost care has to be taken during cannulization of the subclavian vein, as well as meticulous attention given, to prevent infection.

ISSN:1660-8151    

DOI:10.1159/000181762

出版商:S. Karger AG    

年代:1980

数据来源: Karger