ISSN:1660-8151    

DOI:10.1159/000184003

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000184004

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Persistent activation of the complement system after escape from control by the regulatory proteins results in an excessive release of split products with inflammatory properties. Serum levels of the regulatory proteins of the complement system (Cl-INH, H, I and AT III) were assayed by the radial immunodiffusion technique in 521 serum samples from 124 patients with idiopathic chronic glomerulonephritis divided into two groups: (1) 81 cases with normal renal function (NRF), and (2) 43 cases with deteriorated renal function (DRF). Significant high mean levels of Cl-INH, H, I and AT III were found in patients with NRF, when they were compared with DRF patient groups. Positive correlations between the regulatory proteins and the corresponding complement components were found in patients with NRF, whereas they were reduced considerably in patients with DRF. Serial measurement of the control proteins showed a decay of the levels of Cl-INH, H and I in patients with progressive impairment of renal function. The presence of high levels of regulatory proteins suggest that a control mechanism may occur in patients with NRF; measurement of these proteins could, therefore, be of prognostic value, as the presence of high levels are indicative of a block of the complement system.

ISSN:1660-8151    

DOI:10.1159/000184005

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Isolation of an endogenous ligand solute from uremic serum was performed by high-performance liquid chromatography. This ligand solute inhibited the binding of diphenylhydantoin and tryptophan to plasma protein, and was considered to be one of the endogenous drug-binding inhibitors present in uremic serum. The gas chromatographic-mass spectrometric analysis revealed that this inhibitor is 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid, which is known to be a constituent of urine.

ISSN:1660-8151    

DOI:10.1159/000184006

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Computerized tomography (CT) has the advantage of allowing the isolation of trabecular bone of the axial skeleton, which is the more sensitive to metabolic changes. By means of single-energy X-ray CT we have devised a method for assessing trabecular bone mass (TBM) at L-4 vertebral body, which has an acceptable reproductibility (CV = 2.76%). Normal values where obtained after studying 29 normal individuals from both sexes and different ages. In order to know if the method is accurate, TBM was assessed in 17 patients (6 with creatinine clearance < 6 ml/min and 11 on chronic hemodialysis), and in all of them the results were compared with the histomorphometry of the iliac crest bone biopsy. TBM assessed by CT correlated with trabecular bone volume (TBV; mineralized bone + osteoid) (r = 0.82; p < 0.001) and this correlation was not improved after adding the volume of marrow fibrosis to TBV. TBM assessed by CT also correlated with mineralized bone volume but at a lower level of significance (r = 0.72 ;p = 0.001), and no correlation was found with relative osteoid volume alone. These findings suggest that final CT value is an integral of mineralized bone and osteoid but with a higher influence of mineralized bone. Osteomalacia and osteitis fibrosa were seen in situations of normal, decreased, or increased TBM assessed by CT, although the 2 patients with severe osteosclerosis suffered osteomalacia. We conclude that the assessment of TBM by CT at the axial skeleton of uremic patients has an acceptable reproducibility and accuracy. Its potential role in the management of renal osteodystrophy by noninvasive means must be stablished with repetitive studies in the same subjects, as is suggested by preliminary reports.

ISSN:1660-8151    

DOI:10.1159/000184007

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

15N-glycine administered orally to 3 patients with chronic renal failure and 15N-ammonium chloride given by intravenous infusion to 5 patients were used as tracers in studying the total body nitrogen metabolism during the course of dietary therapy. Patients on a diet providing 1.2 g protein per kilogram body weight per day had significantly lowered total nitrogen flux (Q) and rates of total body protein synthesis (S) and catabolism (C) as compared with the normal controls. A reduction in daily protein intake to 0.6 g/kg/day resulted in marked increases in all these parameters, so that the values actually approached that of the normal controls. While in the normal subjects low-protein intake did not affect the total body protein turnover significantly, it tended to decrease Q and to raise S, C, and S/Q. The results of the present study suggest that the adaptive response to restriction in protein intake is a more efficient utilization of nitrogen entering the metabolic pool for anabolic purposes, and less nitrogen excreted as urea. This response becomes manifest and essential to patients with chronic renal failure and forms the basis for low-protein diet therapy.

ISSN:1660-8151    

DOI:10.1159/000184008

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The ‘uremic toxin’, guanidino propionic acid (GPA), which was detected in uremic serum in correlation with BUN level, modified the mitogenic response of normal lymphocytes to phytohemagglutinin (PHA). Mild modifications can be detected in the concentrations which are found in uremic patients. Other guanidino compounds which have been detected in uremic sera, such as guanidino succinic acid (GSA), guanidino butyric acid (GBA) and guanidino acetic acid (GAA), show similar inhibitory pathways. It is suggested that guanidino compounds contribute to the immunological disturbances in uremia. The complexity of their action on lymphocyte mitogenic response is probably the cause of the conflicting results which have been reported in the literat

ISSN:1660-8151    

DOI:10.1159/000184009

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Methylguanidine (MG), a toxin reported in uremia, is thought to be a product of creatinine oxidation. This study is designed to demonstrate the role of active oxygen in the oxidation of creatinine under conditions compatible with those found in uremia. MG synthesis is moderately stimulated by the superoxide radical derived from 3 mM hypoxanthine and 0.015 units/ml xanthine oxidase and inhibited by the addition of superoxide dismutase. This is increased markedly by the addition of 0.05% hydrogen peroxide and augmented to about 56,000 times the control rate in the presence of hydroxyl radicals derived from the reaction of 10 mM FeSO4 and 0.05% hydrogen peroxide. In addition, MG synthesis is inhibited by the addition of sorbitol, lactulose or ethanol, the scavengers of hydroxyl radicals. These results indicate that creatinine can be oxidized to MG by various species of active oxygen and that one of the mechanisms of MG synthesis is such oxidation. MG, therefore, may be a useful indicator of peroxidation in vivo.

ISSN:1660-8151    

DOI:10.1159/000184010

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Two observers, unaware of each other’s findings and of the diagnosis, examined red cells in the urine of 109 patients by phase-contrast microscopy. All specimens were examined uncentrifuged by inverted microscopy, and 48 of the 109 were also examined under a light microscope after centrifugation. We were unable to confirm with either method the close correlation between red-cell morphology and diagnosis reported in previous studies, and our 2 observers differed in their interpretation on 38% of occasions. Proteinuria associated with the presence of casts in uncentrifuged urine examined by inverted microscopy was a better indication than red-cell morphology of renal parenchymal diseas

ISSN:1660-8151    

DOI:10.1159/000184011

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The interrelationships between tubulointerstitial immune deposits (TID), interstitial inflammation, glomerular changes, renal function, and prognosis were assessed in the renal biopsies from 93 patients with lupus nephritis. The prevalence of TID was 33% by immunofluorescence and 23% by electron microscopy. Although predominantly detected along and within tubular basement membranes, extraglomerular immune deposits were also present in the wall of renal interstitial capillaries and small arteries as well as in Bowman’s capsule. The prevalence of TID correlated with the activity of glomerular lesions and, to a lesser extent, with the severity of proliferative lupus nephritis (WHO classes II-IV).TID were much less common in the membranous form (WHO class V). The severity of interstitial inflammation correlated with the degree of renal insufficiency and was an accurate prognostic indicator of progressive deterioration of renal function. However, there was no correlation between prevalence of TID and prevalence and severity of interstitial inflammation, suggesting that the latter is not necessarily secondary to the presence of immune complexes and that other pathogenetic mechanisms may be involve

ISSN:1660-8151    

DOI:10.1159/000184012

出版商:S. Karger AG    

年代:1986

数据来源: Karger