ISSN:1660-8151    

DOI:10.1159/000182035

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Creatinine clearance has been repeatedly measured in three groups of chronic uremics. In the first control group (31 cases), following a conventional low-protein diet, creatinine clearance declined linearly with time. In the second group (12 cases), following a very low nitrogen diet supplemented with essential amino acids and ketoanalogues, creatinine clearance remained practically constant with only one exception in which it continued to decline. In the third group of uremics (13 cases) on repeated dialysis therapy, the deterioration of creatinine clearance was markedly accelerated. The possible explanations and the practical implications of these findings are discussed.

ISSN:1660-8151    

DOI:10.1159/000182036

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Few studies have explored how patient characteristics may influence clearances. We sought to determine if patient age, sex, size, renal disease, blood pressure, hematocrit, serum total proteins and albumin affected peritoneal clearances, drainage volumes or dialysate protein concentration. We found inulin clearances to be related to surface area and total serum proteins. Creatinine clearance was related to age, serum albumin and hematocrit. Sex, blood pressure or type of renal disease did not influence peritoneal clearances.

ISSN:1660-8151    

DOI:10.1159/000182037

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

7 hypertensive patients (H) and 8 normotensive volunteers (N) were loaded with NaCl (4.5 mEq Na+/kg body weight i. v.) during water diuresis (A) and antidiuresis (B). In 6 antidiuretic subjects (3H and 3N) urine volume (V) was progressively raised up to over 30 ml/min, by intravenous infusion (12 ml/min) of hypertonic (3%) saline (C). It is assumed that in (A) CH2O is an index of Na+ reabsorption in short Henle’s loops. In (B) and (C) TcH2O is proportional to Na+ reabsorption in long Henle’s loops. In (A) CcH2O was significantly lower in H. In (B) TcH2O was similar in H and N. In (C), TcH2O reached an earlier plateau in H than in N. These results demonstrate that exaggerated natriuresis depends on defective Na+ reabsorption in Henle’s loops, suggesting that the defect depends upon the transmission of hypertension to medullary circulation. The increase in hemodynamic pressure in vasa recta opposes Na+ reabsorption both in short and in long Henle’s loops. However, the effects on TcH2O of the decrease in Na+ reabsorption in long loops is blunted by the greater Na+ delivery, secondary to the increase in GFR, that follows the rise in filtration p

ISSN:1660-8151    

DOI:10.1159/000182045

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Renal osteodystrophy, in part due to secondary hyperparathyroidism, is one of the major unresolved problems affecting patients on chronic hemodialysis. In addition, evidence has shown that parathyroid hormone (PTH) is toxic to other organ systems besides bone. The results of a prospective study on the effect of propranolol in reducing PTH levels in chronic renal failure patients on hemodialysis are reported. Propranolol administration reduced PTH levels by over 50–75%. The levels of calcium, phosphorus, alkaline phosphatase and hematocrit were variable, but patients with severe derangements in these measurements also seemed to benefit from propranolol. It should now be determined by larger and longer studies whether these biochemical improvements can be translated into clinical benefit

ISSN:1660-8151    

DOI:10.1159/000182038

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The decreases in serum osmolality as well as the rate of ultrafiltration during hemodialysis and the influence of each upon the side effects of this treatment were studied in 13 chronic stable dialysis patients. Mannitol (9 mosm/kg water) was infused in two out of four dialyses, in a double blind fashion. A solution of 5% glucose in water was used as control. 1 week after the treatment, there was no residual mannitol in the patients’ serum (p < 0.0005). The decrease in osmolality during dialysis was lower when the patients received treatment with mannitol than with placebo: 14.7 versus 25.0 mosm/kg water (p < 0.001). The symptoms during dialysis were much less severe when the patients received mannitol (p 0.1). Decrease in serum osmolality during dialysis seems to be the most important factor in the genesis of dialysis symptoms in chronic stable dialysis patients and are counteracted by the infusion of an osmotically active substance such as mannitol, 1 g/kg/dialysis; this results in a slight increase in body weight between dialyses, and cannot be used routinely because of slow accumulatio

ISSN:1660-8151    

DOI:10.1159/000182039

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

A high frequency of metabolic acidosis in a group of 30 patients on regular dialysis treatment initiated a study of the effect (and possible side effects) of a higher concentration of acetate in the dialysate. The concentration of acetate in the dialysate was increased from 32.6 (‘low ac’) to 38.2 mmol/l (‘high ac’)· The ‘lowac’ dialysis treatment changes the metabolic acidoses (mean pH = 7.34; base excess, BEb = – 8.3 mmol/l) to chronic hypocapnia(pH = 7.40; BEb = – 5.4 mmol/l). ‘High ac’ normalized the acid base status (pH =7.44; BEb = -0.6 mmol/l). No side effects occurred. Since PaCO2 does not change much during hemodialysis it is convenient to look at the linearly related changes of the pH and the logarithmic standard bicarbonate concentration along iso-PCO2 lines in a log standard bicar

ISSN:1660-8151    

DOI:10.1159/000182040

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Glomeruli isolated from rat renal cortex were incubated with radioactive precursor to study basement membrane production in vitro. Following incubation, basement membranes were purified with a novel technique of osmotic lysis followed by selective solubilization with detergents that leaves the membranes architecturally intact and results in their quantitative isolation. Incorporation of [14C]-proline into basement membrane increased in a linear fashion during the 3 h of incubation studied, with a progressive increase in the specific activity of hydroxy-[14C]-proline in isolated glomerular basement membrane. With identical incubational conditions, glomeruli from streptozotocin diabetic rats incorporated significantly greater amounts of precursor into the extracellular matrix than did glomeruli from nondiabetic animals.

ISSN:1660-8151    

DOI:10.1159/000182041

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The mortality rate of 67 sequential cases of acute renal failure (ARF) accompanied byjaundice was compared with the mortality rate of 168 patients without jaundice. The mortality rate in the group of jaundiced patients was 57%, significantly greater (p < 0.05) than the 42% mortality in patients without jaundice. The mortality rate correlated with serum bilirubin levels; patients with serum bilirubin greater than 20 mg% had a mortality rate of 85%, whereas patients with levels lower than 10 mg% had a mortality rate of only 33%. Average blood pressures were significantly lower (p < 0.01) in patients with jaundice than in those without. The data indicate that: (1) ARF accompanied byjaundice carries a worse prognosis; (2) reduced blood pressure which accompanies this condition may be an aggravating factor, and (3) serum bilirubin levels may be used as a prognostic index.

ISSN:1660-8151    

DOI:10.1159/000182042

出版商:S. Karger AG    

年代:1981

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000182043

出版商:S. Karger AG    

年代:1981

数据来源: Karger