ISSN:1660-8151    

DOI:10.1159/000183155

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A high incidence (40%) of cardiac arrhythmias was found in patients while on dialysis. This incidence was significantly higher than on nondialysis days. A comparison study of patients with significant cardiac arrhythmia and patients with cardiac arrhythmia was made. There was no difference in the echocardiogram, total body potassium, plasma renin activity, aldosterone, catecholamines, serum sodium, potassium and calcium between the two groups. Significant alkalinization occurred in all patients at the end of dialysis. Blood levels of total PTH and C peptide were higher in the arrhythmic patients versus the nonarrhythmic patients. No explanation was found as to why patients developed arrhythmias or what differentiated the two groups.

ISSN:1660-8151    

DOI:10.1159/000183156

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The increasingly frequent use of continuous ambulatory peritoneal dialysis (CAPD) as substitutive therapy in terminal renal failure has induced the investigation of the advantages and disadvantages of this therapeutic modality. The effects of CAPD on pulmonary function are one of the aspects currently under study. Based on previous data suggesting the existence of extrapulmonary ventilatory restriction in uremic patients under CAPD, we have studied in these patients the respiratory muscle function as expressed in the maximal inspiratory pressure (MIP) and assessed the impact of the infusion of 2 liters of dialysis fluid into the peritoneal cavity on both MIP and the pulmonary volumes. Uremic patients evidenced significantly lower MIP values as compared with healthy controls. The filling of the peritoneal cavity induced, both in the supine and in the sitting position, a restrictive effect and an increase in the inspiratory capacity. We conclude that uremic patients under CAPD evidence a respiratory muscle dysfunction of as yet unclear cause. Our findings further suggest that the infusion of 2 liters of dialysis fluid into the peritoneal cavity induces not only a restrictive effect, but also an increase in the strength of the respiratory muscles, the latter effect being probably due to increased diaphragmatic contractility.

ISSN:1660-8151    

DOI:10.1159/000183157

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The antibacterial activity of fresh and heat-inactivated normal serum was compared with that of sera from patients with renal failure: 16 on diet, 9 on regular hemodialysis (HD) and 9 on continuous ambulatory peritoneal dialysis (CAPD). The antibacterial activity was determined on Proteus rettgeri (Sanelli) by a turbidimetric method. The inhibitory activity of fresh serum was only slightly descreased in nondialyzed uremic patients, whereas it was significantly impaired in CAPD and HD patients. Heat-inactivated normal serum (56°C, 30 min) lost its antibacterial activity. Only CAPD patients’ sera behaved as the normal ones. In fact, a consistent residual antibacterial activity was found in heat-inactivated sera of nondialyzed and hemodialyzed patients. The results are in keeping with the view that uremic patients have reduced host-defence reactions. Dialysis treatment appears to further depress the antibacterial capacity of uremic patient’s sera. The residual antibacterial activity of heat-inactivated sera is due to substances, not present in normal controls, which act with a mechanism independent of the complement system. CAPD seems more effective than hemodialysis in removing these substa

ISSN:1660-8151    

DOI:10.1159/000183158

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Circulating concentrations of 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D and 25-hydroxyvitamin D were measured in 21 anephric subjects. 13 subjects had no therapy with vitamin D, dihydrotachysterol or lα-hydroxyvitamin D3. In 7 subjects of this group 1,25-dihydroxyvitamin D was undetectable ( < 5 pmol/l). In the other 6 patients concentrations ranged from 10 to 43 pmol/l (reference value 111 ± 33 pmol/l). All subjects taking high doses of vitamin D showed detectable 1,25-dihydroxyvitamin D concentrations in the same range. Dihydrotachysterol therapy caused spuriously high ‘1,25-dihydroxyvitamin D’ values, probably by interference of a metabolite of dihydrotachysterol in our assay. In subjects on vitamin D or dihydrotachysterol therapy 25-hydroxyvitamin D concentrations were significantly elevated (314 ± 146 nmol/l and 98 ± 19 nmol/l, respectively; reference value 52 ± 22 nmol/l). Concentrations of 24,25-dihydroxyvitamin D were only measured in subjects without vitamin D2 intake. In general very low but detectable concentrations were found. One subject on a high dose of vitamin D3 showed a 24,25-dihydroxyvitamin D3 concentration of 10.2 nmol/l (reference value 4.4 ± 2.9 nmol/l). Our results therefore confirm earlier reports on extrarenal synthesis of 24,25-dihydroxyvitamin D and suggest that there may be extrarenal production of 1,25-dihydroxyvitamin

ISSN:1660-8151    

DOI:10.1159/000183159

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Some metabolic alterations of the pentose-phosphate shunt can increase susceptibility to red blood cell (RBC) lipid peroxidation in uraemic patients on maintenance haemodialysis. We investigated this phenomenon in 19 uraemic patients undergoing chronic haemodialysis by determining RBC malonyldialdehyde (MDA), a secondary product of lipid peroxidation and plasma and RBC tocopherols, which are powerful antioxidants. Evidence of RBC membrane lipid peroxidation was demonstrated by an increase of RBC MDA. RBC tocopherols were significantly decreased because of enhanced antioxidant activity. No significant variations of these parameters were found before and after dialysis.

ISSN:1660-8151    

DOI:10.1159/000183160

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Water immersion up to the neck (WI) results in a central hypervolemia; the increased atrial pressure, evoked by this maneuver, stimulates low pressure receptors (LPR) which exert tonic inhibition on sympathetic activity and suppresses both the renin (PRA)-aldosterone (PA) system and the ACTH-cortisol axis in normal man. In hemodialyzed patients (HP), in whom autonomic neuropathy has been frequently found, PRA and ACTH were not suppressed during WI while plasma cortisol and PA were reduced. Other modulators, like dopamine, are supposed to be involved in regulating cortisol and PA levels in HP.

ISSN:1660-8151    

DOI:10.1159/000183161

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

HLA-A, B, DR, and MT antigens were examined in 50 patients with idiopathic membranous nephropathy (IMN) by the standard microlymphocytotoxicity technique. The frequency of HLA-DR2 was significantly increased in the patients in comparison to the controls. Significant decreases in the frequencies were seen for HLA-DR4, DRw8 and DRw9 in the patients. The linkage disequilibrium between HLA-Bw52 and DR2 was noted in the controls, but it was significantly weaker in the patients. The frequency of MTl was significantly higher, and that of MT3 was significantly lower in the patients as compared with the controls. The findings suggest that an immunological disturbance under the influence of genetic factors may confer a susceptibility to IMN.

ISSN:1660-8151    

DOI:10.1159/000183162

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Immunoelectron microscopy was used in this study of IgA nephropathy to examine the relationship between immune deposits and electron-dense deposits seen by electron microscopy, and these findings were correlated with the severity of mesangial proliferation. Immunoelectron microscopic studies for antihuman γ-chain, α-chain, µ-chain, C3, and C3d were performed by the method of Nakane in 16 patients with IgA nephropathy. The patients with minimal glomerular involvement and focal prohferative glomerulonephritis showed electron-dense reaction products of IgA in the paramesangial area, while the patients with diffuse prohferative glomerulonephritis showed electron-dense reaction products of IgA throughout the enlarged mesangial matrix. Immunoelectron microscopy showed electron-dense reaction products of IgA at the same locations as the electron-dense deposits seen on electron microscopy. C3 deposits were identified in 15 out of the 16 patients, but were less dense than IgA deposits. Electron-dense reaction products of C3 contained both positive and negative sites in 7 patients. Extensive C3d deposits were found in all cases in association with IgA deposits. The locations of these deposits were the same as those of the IgA deposits. These findings suggest that C3 deposits dissociate from the immune deposits and that the locations of the immune deposits correlate well with the severity of mesangial proliferati

ISSN:1660-8151    

DOI:10.1159/000183163

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Two groups of rats, one with surgically induced chronic renal failure and a sham-operated group were used. 10 weeks after surgery the animals were individually mated for 15 days according to 4 different schemes: uremic couple, control couple, a couple with a uremic male, and a couple with a uremic female. A second mating was allowed 18 weeks after surgery. There the uremic rats and nonfertile controls were matched against fertile controls. The experimental group showed a higher percentage of nonfertile rats, their offspring had fewer newborns and the uremic mothers had litters that weighed less at birth. In uremic males low plasma testosterone levels were detected. The analysis of plasma luteinizing hormone in the female and the delayed fertilization of uremic mothers suggest the presence of irregularities in the estrous cycle of uremic females.

ISSN:1660-8151    

DOI:10.1159/000183164

出版商:S. Karger AG    

年代:1984

数据来源: Karger