ISSN:1660-8151    

DOI:10.1159/000188250

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188251

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in uninephrectomized subjects with a negative Albustix test, in relation to the time since nephrectomy, the UAE was determined by a double-antibody 125I radioimmunoassay in 3-hour urine collections before and after 150 g OPL under conditions of moderate physical activity in 18 subjects who underwent unilateral nephrectomy more than 10 years (346.5 ± 178.60 months) before evaluation and had a mean basal creatinine clearance (CCr) of 45.3 ± 14 ml/min (group 1), in 21 subjects who underwent unilateral nephrectomy less than 10 years (31.5+28 months) before evaluation and had a mean basal CCr of 76.0 ± 22 ml/min (group 2), and in 16 normal volunteers (controls) with a mean basal CCr of 103. 1 ± 12 ml/min. The UAE was higher in group 1 as compared with either group 2 or controls at both basal state (90.8 ± 65, 19.6+17, and 11.0+5 μg/min/100 CCr for groups 1 and 2 and controls, respectively; p < 0.001) and after OPL (92.0+65, 43.6 ± 24, and 12.0+5 μg/min/100 CCr for groups 1 and 2 and controls, respectively; p < 0.001). However, the increase in UAE following OPL was significant (p < 0.001) only in group 2 patients. In all patients, the basal UAE was negatively correlated with basal CCr(r=0.63; p < 0.001) and positively correlated with the time since nephrectomy (r=0.73; p < 0.001) and with both systolic (r=0.57; p < 0.001) and diastolic blood pressures (r=0.69; p < 0.001). CCr calculated using 3-hour urine collections increased more in controls (11.2+44.2%) than in patient groups 1 (1.6+0.89) and 2 (7.7+3.7%; p < 0.001). Basal CCr calculated using 24-hour urine collections the day before the test was negatively correlated with the time since nephrectomy in group 1 (r=-0.69; p < 0.001) and positively correlated with the time since nephrectomy in group 2 (r=0.89; p < 0.001). Multiple regression analysis revealed that the relationship between CCr and duration of uninephric state was independent of age or systolic and diastolic blood pressures in both patient groups. These results suggest that UAE increase significantly after an OPL in subjects who have been nephrectomized less than 10 years before the study and have basal Ccr values higher than 50% of normal. They also suggest that the risk of developing renal insufficiency increases with time in subjects with a solitary kidney for more than 10 years; this increase in risk seems to follow a progressive compensatory increase in glomerular filtration rate of the remnant kidney during the early years following unineph

ISSN:1660-8151    

DOI:10.1159/000188252

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A major difficulty in diagnostic urinary microscopy is the need to observe a freshly passed urine specimen. This study illustrates the use of glutaraldehyde (GA) and formaldehyde (FA) to preserve urinary sediment for diagnostic microscopy. GA and FA in whole urine cause a precipitate to form if there is a trace or more of proteinuria. This can be eliminated by centrifugation and fixation of urine sediment. Red blood cells (RBC) and casts are adequately preserved for diagnostic microscopy for at least 3 months. However, subtle changes in RBC morphology consisting of hexagonal distortion and wrinkling of cell margins are seen in some cells. White blood cells (WBC) are less reliably preserved. Diagnostic phase-contrast microscopy can be performed on urine sediment stored at room temperature for up to 3 months after fixation with GA or FA.

ISSN:1660-8151    

DOI:10.1159/000188253

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Disturbances in hemostatic and hemorheological parameters have been investigated in a group of 29 children with nephrotic syndrome: 23 children classified as steroid-sensitive and 6 as steroid-resistant. Studies were performed before prednisone treatment and 3 weeks later, after initiation of steroid therapy. Before treatment, the alterations in hemostatic system involved moderate thrombocytosis with spontaneous aggregation in 19 patients. High levels of fibrinogen, factor VIII, Willebrand factor, protein C, protein S and α2-macroglobulin (α2M) were observed. Factor XII and α1-antitrypsin (α1AT) were lower than normal. Antithrombin III (ATIII) level was normal in the majority of patients. A plasma and blood hyperviscosity syndrome was also observed as well as an increase in erythrocyte aggregation. During treatment, an improvement in the hemostatic parameters was observed in the patients who responded to prednisone. The expected increase in factor VIII (frequently described in the literature) was not observed, while there was a significant increase in protein C. In the steroid-resistant patients, the only significant changes observed were decreased fibrinogen and increased protein C. The hemorheological parameters showed a tendency towards normality regardless of whether or not the treatment provided remission of NS. The relationship between hemorheological and hemostatic factors changes are discus

ISSN:1660-8151    

DOI:10.1159/000188254

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The expression of the adhesion molecules LFA-1 (CD 1 la-CD 18), Mac-1 (CDlib-CD 18), and LAM-1 on predialysis and intradialysis neutrophils (PMN) was analyzed by flow cytometry in 10 chronic hemodialysis patients (CHD) and compared with age-matched normal controls. All patients were dialyzed either with a polyacrylonitrile, or a polysulfone membrane. To appreciate the influence of the interdialytic time, we compared the samples of Monday (3 days without dialysis), with those of Wednesday (2 days without dialysis). A patient group not treated with recombinant human erythropoietin (rHuEPO) was also included to analyze the influence of r-HuEPO. We found on the predialysis and intradialysis samples that the expression of CD11a as not different in the CHD patients and in the normal controls. Hemodialysis was associated with a rapid and significant reduction in LAM-1 on the 15- and 30-min samples (p < 0.05). This reduction was only transient, and returned to near predialysis levels after 120 min dialysis. The MAC-1 increased significantly after 30 min dialysis (p < 0.1), and remained at the end of the dialysis procedure still substantially above the predialysis levels (p < 0.01). On the other hand, we have found a significant (p < 0.005) up-regulating of the MAC-1, and a down-regulating of the LAM-1 in the predialysis samples. We noticed further a significantly lower expression (82 ± 9.6%) for LAM-1 in these predialysis samples (p < 0.005). These results demonstrate that ‘high MAC-1 low LAM-1’eutrophils were not only a dialysis-related phenomenon, but that they were already present before the hemodialysis session, nor was there any difference between the interdialytic times or compared with the r-HuEPO treat

ISSN:1660-8151    

DOI:10.1159/000188255

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

It is well known that Al absorption is markedly enhanced by citrate. The aim of the study was to document whether low-dose citrate ingestion (4 g/day) contained in a well-known effervescent calcium supplement was sufficient to increase Al absorption in 16 normal volunteers and 15 subjects with stable chronic renal failure under conditions of either Ca carbonate or Al hydroxide supplementation. Serum and urine Al levels were measured using flameless atomic absorption spectrophotometry as previously described. After Ca carbonate plus Ca citrate ingestion, there was no rise over baseline (Ca Carbonate alone) serum or urine Al levels in either group. Ca carbonate and Al hydroxide taken together produced a significant rise in serum and urine Al levels in both groups. Maintaing Al hydroxide but substituting Ca citrate for the carbonate (same dose of elemental Ca) produced a further significant increment in serum Al (0.47 ± 0.28-1.15 ± 0.8 μmol/l; p < 0.001) and in urine Al(1.37 ± 0.46-5.77 ± 5.21 μmol/l; p < 0.001) in the chronic renal failure group as well as in serum Al (0.42 ± 0.2-0.76 ± 0.48 μmol/l; p < 0.001) and urine Al (2.70 ± 1.24-8.24 ± 3.96 μmol/l; p < 0.001 in the normal volunteer group. Due to decreased urine excretion, the increment in serum Al in the CRF group was significantly greater than in the normal subjects (p < 0.02). Thus small quantities of citrate present in effervescing Ca supplements can significantly enhance intestinal Al absorption even in normal subjects. All citrate-containing preparations are totally contra-indicated in chronic renal failure patients ingesting Al-containing compounds. Patients themselves should be warned of

ISSN:1660-8151    

DOI:10.1159/000188256

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Low-molecular-weight heparins (LMWHs) are used to prevent clotting in hemodialysis extracorporeal blood circuits. In order to test the possibility of using reviparine (a LMWH of 3,900 D) in this indication, we studied the pharmacokinetics of the drug after a mean dose of 3,300 IU anti-Xa in 10 hemodialyzed patients. Reviparine was administered subcutaneously between two dialysis sessions and intravenously at the start of 20 dialysis sessions performed either with high (HP) or low-permeability (LP) membranes. We observed a moderate increase of the elimination half-life of reviparine (TV2: 5 ± 1.6 h between dialysis, 3.6 ± 1.3 during dialysis with an HP membrane and 4.7 ± 1.8 during dialysis with an LP membrane) versus 3.3 ± 1 in healthy volunteers. Dialysis procedures with an HP or an LP membrane do not importantly modify the pharmacokinetics of reviparin compared with data observed in healthy volunteers. During the sessions, we observed no clotting in the extracorporeal circuit, no hemorrhagic event and no prolongation of the fistula compression times. Further clinical studies are required to define the optimal dosage of reviparine to prevent coagulation in hemodialysis blood circu

ISSN:1660-8151    

DOI:10.1159/000188257

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Detection of glycosylated protein in renal and dermal tissues was performed in patients in the microalbuminuric stage of diabetic nephropathy using the nitro blue tetrazolium (NBT) reaction. The intensity of NBT staining in glomeruli and dermal vascular vessels was marked in the microalbuminuric stage as well as in the overtly proteinuric stage. The NBT staining in the renal and dermal vascular walls in both stages was significantly stronger than in the samples of control autopsy patients. It appeared that nonenzymatic glycosylation in various tissues, i.e. kidneys and dermal vascular vessels, had already progressed in the microalbuminuric stage in patients with diabetic nephropathy.

ISSN:1660-8151    

DOI:10.1159/000188258

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Urinary albumin and β2-microglobulin (B2M) were measured during the neonatal period. Urinary albumin decreased postnatally in term neonates, while it remained almost constant in preterm neonates. Urinary B2M showed a peak level on day 7 both in term and preterm neonates. There was some trend towards higher levels of albumin and B2M with decreasing gestation, showing that glomerular permeability increases and proximal tubular protein reabsorption decreases with increasing degrees of prematurity. In sick preterms who were depressed at birth and had respiratory failure, both parameters were elevated during the first 2 weeks, indicating the presence of glomerular and tubular damage in this period. The changes in B2M with gestation or clinical condition were more pronounced than those in albumin

ISSN:1660-8151    

DOI:10.1159/000188259

出版商:S. Karger AG    

年代:1994

数据来源: Karger