ISSN:1660-8151    

DOI:10.1159/000183035

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The foremost goal in organ transplantation is to achieve normal graft function without rejection. 31 (8.7%) of 357 cadaveric kidney transplants had no evidence of rejection for the first 3 months. Among these, 2 patients died with a functioning graft and four grafts failed during the 1- to 7-year follow-up period. Actuarial graft survival rates of these patients were 96.8 and 79.0% at 2 and 5 years, respectively, as compared with 64.6 and 51.2%, respectively, for the controls (p < 0.01). Multiple preoperative blood transfusions and the adjunctive immunosuppressive therapy with retroplacental gamma globulin appeared to be playing a role for the induction of the ‘no-rejection’ state. However, continuous immunosuppressive therapy is necessary to maintain graft funct

ISSN:1660-8151    

DOI:10.1159/000183036

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Urinary excretion of oxalate, calcium and urate has been investigated in 88 patients affected by idiopathic calcium oxalate stone disease and in 20 normal subjects. Of these ions, only oxalate was found significantly higher in stone formers. Defining hyperoxaluria as urinary oxalate excretion greater than 2 SD above normal, 50% of stone-forming people were found to be hyperoxaluric. When stone formers were classified in normo- and hyperoxaluric, the prevalence of hypercalciuria, hyperuricuria, family history of stone disease and recurrencies in stone formation was the same in both groups. It is concluded that hyperoxaluria is a frequent finding in idiopathic calcium oxalate renal stone disease.

ISSN:1660-8151    

DOI:10.1159/000183037

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The pathogenesis of anemia in patients with end-stage renal disease was studied by assessing the effect of uremic serum on the proliferation and maturation of erythroid progenitor cells, BFU-E and CFU-E, into colonies in vitro. Nucleated peripheral blood cells from 10 anemic patients produced normal or increased numbers of BFU-E colonies in response to added erythropoietin when cultured in control serum, but declined a mean of 63% when autologous uremic serum was substituted. Uremic sera from 90 patients cultured with normal human marrow produced a mean decrease in BFU-E colony growth of 72%, and of CFU-E colony growth of 82%, compared to control serum. Neither hemodialysis nor peritoneal dialysis was effective in removing the inhibitor. We conclude that patients with uremia have adequate circulating erythroid progenitors that respond to erythropoietin normally when removed from the uremic environment, and that uremic serum is toxic and inhibitory to erythropoiesis. This may be an important mechanism in the anemia of chronic renal failure.

ISSN:1660-8151    

DOI:10.1159/000183038

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Serum cholesterol, triglycerides and their fractions in high density (HDL), low density (LDL) and very low density (VLDL) lipoproteins were measured sequentially in fasting patients on continuous ambulatory peritoneal dialysis (CAPD) who entered a prospective study. Of the 30 who entered, all have been followed to 3 months, 24 to 6 months and decreasing numbers to 18 months. Serum total cholesterol, VLDL cholesterol, total triglycerides and VLDL triglycerides all rose significantly during the first 6 months and VLDL cholesterol has remained elevated to 18 months. Changes in other fractions have been insignificant or inconsistent. 1 patient has developed angina. No associations were found between use of high dextrose fluid, weight gain and hyperlipidemia, probably because of consistent practice between patients. Our results confirm the adverse effect of CAPD on serum lipids and the need for dietary modification but are broadly similar to the changes that have been observed during regular hemodialysis.

ISSN:1660-8151    

DOI:10.1159/000183039

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

This is the first report of primary glomerular disease with both mesangial IgA and subepithelial IgG deposits in the glomeruli at the same time. This nephropathy, discovered in 3 patients, is either a new disease entity or an overlapping of IgA nephropathy and membranous nephropathy. Follow-up studies may clarify the pathogenesis of IgA nephropathy and/or membranous nephropathy. In 1 patient the clinical findings resembled those of IgA nephropathy, and in the other 2 they were those of membranous nephropathy. Light microscopy showed generalized diffuse increases in mesangial cells and matrix, and there was slight capillary wall thickening. In the glomeruli, immunofluorescence microscopy demonstrated both granular deposits of IgA in the mesangium and granular deposits of IgG along the capillary loops. On electron microscopy, electron-dense deposits were identified not only in the mesangium but also on the epithelial side of the glomerular basement membrane. These findings were confirmed by the immunoperoxidase technique in electron-microscopic studies of these antibody classes. These glomeruli contained both the dense reaction products of IgA deposits in the paramesangium and mesangial matrix and the dense reaction products of IgG deposits on the epithelial side of the basement membrane.

ISSN:1660-8151    

DOI:10.1159/000183040

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The different modes of progression of renal diseases were studied in 73 patients by plotting the reciprocals (1/SCr) and logarithms (logSCr) of their serum creatinine values against time. The regression was linear in the reciprocal plot for 42 patients (57.5%) and in the logarithmic plot for 12 patients (16.4%). The type of renal disease did not predict the mode of progression. The deviations from the linear regression lines were probably most often due to changes in the level of blood pressure and to intensification of treatment for hypertension. The reciprocal plot turned out to be useful for predicting the date when end-stage renal failure was reached. An accuracy of 4 months was reached in 81.5% using the reciprocal plot but only in 25.9% using the logarithmic plot.

ISSN:1660-8151    

DOI:10.1159/000183041

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The effect of the change from supine to upright position on GFR (measured by creatinine clearance) was studied in nonazotemic patients with biopsy-proven primary glomerulonephritis. Compared to healthy subjects, the fall in GFR following the postural change was significantly larger in patients with mesangial proliferation (MP) and with both MP and thickening of glomerular capillary wall (GCW), while similar in those with thickening of GCW alone, suggesting that MP, but not thickening of GCW, augments posturally induced fall in GFR. The augmented fall in GFR in patients with MP was accompanied by larger fall in GFR per unit increase in plasma renin activity than in healthy subjects, and was eliminated by angiotensin-converting enzyme inhibition. We conclude that MP augments posturally induced fall in GFR through affecting glomerular reactivity to angiotensin II.

ISSN:1660-8151    

DOI:10.1159/000183042

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The role of the kallikrein system in the natriuresis of SIADH was studied in 3 patients. Following free water intake, serum Na decreased. Urinary Na excretion, urinary aldosterone excretion and urinary kallikrein-like activity (UĸaV) increased. Significant relationships were observed between UĸaV and urinary aldosterone excretion during the study. Further, there were significant relationships between serum Na and UĸaV, and between uric acid clearance and UĸaV. In 1 patient, who was observed for a longer period, a significant relationship was observed between Na clearance and UĸaV. We conclude that UĸaV is increased during hyponatremia in SIADH by volume expansion. This increase in UKaV may play a role in the natriuresis in

ISSN:1660-8151    

DOI:10.1159/000183043

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In chronic renal failure both Hb A1 and Hb Aιc levels have been reported to be elevated. In order to investigate the causes of such increase we measured Hb A1 (cation-exchange chromatography), blood urea nitrogen, arterial blood pH and plasma bicarbonate in 40 patients with chronic renal failure receiving conservative treatment, 45 uremic patients on intermittent hemodialysis and 60 subjects with normal renal function. In patients with chronic renal failure Hb A1 highly correlates with arterial blood pH and plasma bicarbonate, thus emphasizing the major role played by uremic acidosis in the increased Hb Ai fraction in chronic renal failure

ISSN:1660-8151    

DOI:10.1159/000183044

出版商:S. Karger AG    

年代:1983

数据来源: Karger