ISSN:1660-8151    

DOI:10.1159/000184112

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000184113

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In order to gain insight into the role of IgG Fc receptors in essential mixed cryoglobulinaemia (EMC), we analyzed quantitatively the expression of such molecules on polymorphonuclear leukocytes (PMN) and assessed them, functionally, on PMN, tissue macrophages and circulating monocytes in 6 HLA-B8-, DR3-negative patients with EMC and glomerulonephritis. The Fc receptors expressed on PMN surface, as estimated by using AB 8.28 monoclonal antibody to PMN Fc receptor and 125I-labelled rabbit F(ab’)2 fragments to mouse IgG as detecting system, were found to be quantitatively normal in EMC patients, whereas PMN Fc- receptor-mediated phagocytosis was reduced. Moreover, the patients were found to have prolonged macrophage clearance of IgG-sensitized autologous erythrocytes and reduced kinetics of ingestion of IgG-coated material by circulating monocytes. This impairment of Fc receptor function may play a remarkable role in the tissue localization of immune material in this diseas

ISSN:1660-8151    

DOI:10.1159/000184114

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Repeated bouts of ventricular tachycardia were triggered by the inflow of dialysate during acute peritoneal dialysis performed in a 79-year-old woman. Subsequent continuous Holier monitoring of 21 patients, many elderly and with cardiac disease, undergoing chronic ambulatory peritoneal dialysis (CAPD) revealed atrial and/or ventricular premature beats in 19 out of them. However, there were no differences in the type and frequency of the extrasystoles between the recordings performed on a day of dialysis or on a day on which dialysis was deliberately withheld. No new arrhythmias were seen in the 2 patients who were previously free of arrhythmias, in whom CAPD was undertaken. It seems that CAPD does not provoke or aggravate arrhythmias, even in elderly or cardiac patients.

ISSN:1660-8151    

DOI:10.1159/000184115

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Total protein and 12 specific proteins were measured in dialysates from 8 patients on continuous ambulatory peritoneal dialysis during training. Mean daily loss of total protein was 10.5 g and this included 5.2 g albumin, 805 mg of the immunoglobulins G, A and M, 323 mg transferrin and 530 mg of the remaining 7 proteins measured. The plasma to dialysate ratio of protein concentrations correlated with the natural logarithm of molecular weight, suggesting that proteins in dialysate are an ultrafiltrate of plasma. A greater loss of proteins overnight was due to longer dwell time as the mean rate of loss was similar for all exchanges. Losses were similar with 1.36% and 3.86% dextrose fluids, suggesting that the initial effects of hypertonicity are diminished or reversed by dilution and absorption of dextrose. Daily outflow volumes for 4 patients correlated inversely with the quantities of several proteins removed, probably due to effects of osmolality. It is concluded that protein losses are related to plasma concentration, molecular weight and osmolality of the dialysis solution and to the physiology of the patient.

ISSN:1660-8151    

DOI:10.1159/000184116

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

A quantitative, noninvasive method of assessing autonomic control, based on the spectral analysis of beat-to-beat fluctuations in heart rate (HR), was applied to patients with chronic renal failure (RF). Since the power spectrum of HR fluctuations measures the dynamic nervous control of HR, it can be used to quantitate a normal control system as opposed to a disturbed or depressed system. Indeed, in RF patients, a strong reduction in the HR power spectrum was observed in all frequency ranges, both sympathetically and parasympathetically mediated. A similar depression in autonomic control was demonstrated in patients on hemodialysis or peritoneal dialysis. RF patients not yet undergoing dialysis show a lesser degree of depression. Spectral analysis of HR fluctuations in RF patients makes it possible to quantitate autonomic dysfunction and to reliably measure its development as a function of time, and requires only a 10-min standard electrocardiogram recording.

ISSN:1660-8151    

DOI:10.1159/000184117

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The frequency of thrombocytopenia in patients with chronic renal failure (CRF) is controversial. This study was undertaken to investigate the platelet count in 55 patients with end-stage renal disease on maintenance hemodialysis and in 19 patients with CRF before hemodialysis had begun. In both groups platelet counts were similar and significantly reduced, 175,000 ± 6,500 and 181,000 ± 10,800 compared to 253,000 ± 3,700/mm3 in the control (p < 0.0001). 31% of hemodialysis patients had thrombocytopenia (platelet count < 150,000/mm3). The megakaryocyte number in their bone marrow aspirate was not reduced. Primary renal disease, androgen treatment or parathyroidectomy did not affect the platelet count. Thrombopoietic activity using 75Se-selenomethionine incorporation into platelets measured in 7 thrombocytopenic patients was found to be reduced, 6.77 ± 0.29 vs. 9.06 ± 0.27 (× 10_2%; p < 0.001). This study shows that the platelet count is reduced and mild thrombocytopenia is frequent in patients with CRF. A possible cause for the platelet count reduction is insufficient thrombopoietic act

ISSN:1660-8151    

DOI:10.1159/000184118

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

A cross-sectional study was performed in 19 patients on haemodialysis and in 11 on continuous ambulatory peritoneal dialysis (CAPD) in order to investigate the relationship between thyroid hormones and nutritional status. T4, T3 resin uptake, T3, rT3 and TSH were measured by radio-immunoassay and compared with controls. Nutritional status was assessed by measurements of blood proteins, albumin, γ-globulin, transferrin, arm muscle circumference and triceps skinfold thickness. In haemodialysis, T4, FTI, T3 and rT3 were significantly decreased. TSH was normal. In CAPD, thyroid hormones were normal. In both groups, proteins, albumin, γ-globulin and transferrín were normal. Triceps skinfold thickness was normal in males and females, whereas arm muscle area was dramatically reduced in males and normal in females. In haemodialysis, a negative correlation was found between T3 and proteins (p < 0.01), rT3 versus proteins (p < 0.01) and versus γ-globulin (p < 0.01). In CAPD, a positive correlation was found between T3 and triceps skinfold thickness (p < 0.05). We suggest that the overload of carbohydrate might normalize the thyroid hormones in patients on CAPD. The relationship between thyroid hormones and nutritional status in patients treated by dialysis suggests a putative protective effect of low T3 levels against protein breakd

ISSN:1660-8151    

DOI:10.1159/000184119

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The impaired immune reactivity of hemodialysis patients has been reported to interfere with adequate antibody responses to standard doses of hepatitis B vaccine. In 22 hemodialysis patients, however, a 92% conversion rate could be obtained by administering multiple doses of plasma-derived MSD-vaccine. As the cost of such an amplified vaccination schedule is still lower than the cost of one dialysis treatment, this active vaccination policy for highly susceptible patients appears financially justified.

ISSN:1660-8151    

DOI:10.1159/000184120

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Twenty-two patients with primary IgA nephropathy (Berger’s disease), 12 with normal and 10 with high blood pressure, were studied. The mean intra-arterial pressure was 88 ± 6 mm Hg in the normotensive group and 113 ± 10mm Hg in hypertensive patients; plasma renin activity was high in normotensives and normal in hypertensives. The glomerular filtration rate was 83 ± 23 and 73 ± 26 ml/m in 1.73m2 in normotensive and hypertensive patients, respectively (p = n.s.). Blood volume was high in IgA nephropathy patients: 82 ± 12 ml/kg body weight in normotensives and 96 ± 7 ml/kg body weight in hypertensives. Mean arterial pressure was significantly correlated with blood volume (r = 0.541, p < 0.0l), but not with plasma renin activity and glomerular filtration rate. The cardiac index was high in both groups: 4.20 ± 0.88 liters/min/m2 in normotensive and 3.95 ± 0.87 liters/min/m2 in hypertensive patients. The total peripheral resistance index was significantly lower than normal in normotensives (1,659 ± 387 dyn/s/ cm-5m2) and significantly higher (2,419 ± 562 dyn/s/cm-5m2) in hypertensives. The cardiac index did not correlate with blood volume and mean arterial pressure; a positive correlation was found between mean arterial pressure and peripheral vascular resistance (r = 0.630, p < 0.01). No correlation was observed between blood volume and plasma renin activity. Our study indicates that hypertension in IgA nephropathy is primarily volume dependent, and that this increase in blood volume is not related to the deterioration of renal function. The role of the renin-angiotensin system in the maintenance of the hypertension is not well-defined. Hemodynamically, hypertension is characterized by high cardiac output and high total peripheral

ISSN:1660-8151    

DOI:10.1159/000184121

出版商:S. Karger AG    

年代:1987

数据来源: Karger