ISSN:1660-8151    

DOI:10.1159/000182722

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

This paper compares renal scintigraphy (RS) with renal vein renin activity (RVRA), intravenous pyelography (IVP), and peripheral plasma renin activity (pPRA) in a population of hypertensive subjects with suspect renovascular hypertension (RVH), of whom 30 underwent surgery, in order to evaluate (a) screening ability of RS for RVH, and (b) surgical prognosis of RS for RVH. RS agreed with arteriographic findings of arterial stenosis in 91% of patients and proved more sensitive as a screening test than IVP and pPRA. The false-negative rate of RS was 9% and the false-positive rate was 10%. In the patients who underwent surgery RS was positive in 89% and RVRA in 85% of those who benefited from surgery. In this series false-negatives for RS occurred only in the presence of extensive collateral circulation, where RVRA also gave the same result. In patients who had been operated on, the sensitivity and specificity of RS, compared to RVRA, were very high. Our work supports the view that RS is a good screening test in RVH; moreover, it seems to be as accurate as RVRA as a surgical prognostic method for curable RVH.

ISSN:1660-8151    

DOI:10.1159/000182723

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The role of the renin-angiotensin system in polyuric patients was studied in 5 patients with pituitary diabetes insipidus, 1 patient with nephrogenic diabetes insipidus and 3 patients with psychogenic polydipsia by determining the plasma renin activity and infusing an angiotensin II analog, 1-Sar, 8-Ile angiotensin II. In all patients with diabetes insipidus, plasma renin activity was markedly increased and the blood pressure was reduced in 5 of 6 patients by the administration of the angiotensin II analog. In the other patient, the blood pressure remained unchanged. The plasma renin activity and response of blood pressure to the angiotensin II analog in a patient with nephrogenic diabetes insipidus were not significantly different from there of patients with pituitary diabetes insipidus. On the other hand, in all patients with psychogenic polydipsia, plasma renin activity was normal or low, and the blood pressure increased with the administration of the angiotensin II analog. These results suggest that evaluation of the renin-angiotensin system by determining plasma renin activity and infusing an angiotensin II analog is useful in differentiating between diabetes insipidus and psychogenic polydipsia.

ISSN:1660-8151    

DOI:10.1159/000182724

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We have studied purine metabolism in mononuclear and polymorphonuclear cells from uraemic patients using microradiochemical enzyme assays and high-pressure liquid chromatography. In mononuclear cell lysates the mean activties of adenosine deaminase (EC 3.5.4.4) and 5’-nucleotidase (EC 3.1.3.5) were significantly diminished. The activities of adenylate kinase (EC 2.7.4.3), purine nucleoside phosphorylase (EC 2.4.2.1), adenine phosphoribosyltransferase (EC 2.4.2.7), and hypoxanthine phosphoribosyltransferase (EC 2.4.2.8) were not significantly different in the two groups. The activities of adenosine deaminase and adenine phosphoribosyltransferase were reduced in the polymorphonuclear cell lysates. No clear differences emerged in the concentration of adenine nucleotides in the mononuclear cells. The significance of these changes, which are less marked than those in erythrocytes, is discussed with reference to the immunodeficiency associated with uraemi

ISSN:1660-8151    

DOI:10.1159/000182725

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Lecithin cholesterol acyltransferase (LCAT) and lysolecithin acyltransferase (LAT) activities in plasma were significantly lower in undialyzed than in dialyzed uremic patients and controls. Both LCAT and LAT activities were normal in the maintenance dialysis group. The free/total cholesterol ratio was significantly increased in the undialyzed patients only. This ratio and LCAT were inversely related in the dialyzed group, unrelated in the undialyzed patients, and positively correlated in controls. Unlike non-uremic populations with hypertriglyceridemia in which LCAT is increased, no correlation was found between plasma triglyceride and LCAT in the uremic population studied. Our results show that both LCAT and LAT activities are reduced in undialyzed chronic uremic patients but are not significantly different from control levels in patients treated with chronic hemodialysis. These results indicate that the changes in LCAT activity contrast with those described in lipoprotein composition and metabolism which do not appear to be affected by chronic dialysis therapy.

ISSN:1660-8151    

DOI:10.1159/000182726

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

In a group of patients with a range of degree of advancement of renal failure, the red cell survival estimated as the half-life of radiochromium-labelled red blood cells (T½.51Cr) was correlated with several indices of renal failure. The T½. 51Cr was not improved by a dialysis programme which was otherwise adequate. Furthermore, the correlation of a T½. 51Cr to the biochemical indices of renal failure was lost which might suggest that some other factor or factors than those measured was the ultimate correlate with red cell survival. This work adds to the circumstantial evidence in favour of a guanidine or a similarly behaving molecule being the haemolyzing agent. The additional premise is extended that a methionine-rich diet will inhibit the haemolytic fact

ISSN:1660-8151    

DOI:10.1159/000182727

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The fall in white blood cells (WBC) and arterial oxygen pressure that occurs during hemodialysis was investigated as a function of different dialysis membranes and different sterilization methods. 8 chronic hemodialysis patients were studied and each was dialyzed with three different membranes: cellulosic hollow fiber, polyacrylonitrile flat sheet and polymethylmethacrylate hollow fiber. Each dialyzer was studied with a dry sterilization method and after formalin treatment. Arterialized blood gas, bicarbonate and WBC were drawn at various intervals throughout dialysis. The effect of the sterilization method was minimal. Cellulosic membranes were shown to cause significantly more neutropenia (p < 0.001) and hypoxemia (p < 0.0l) than the other two membranes. No significant differences was seen in pH, PCO2 and bicarbonate. The results indicate differences in biocompatibility between different membranes. Clinical implications are discussed.

ISSN:1660-8151    

DOI:10.1159/000182728

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We studied theophylline elimination in 8 patients with chronic renal failure to determine the effect of hemodialysis on the pharmacokinetics of theophylline. Each subject was studied twice, once on a nondialysis day and again during dialysis. Total body theophylline clearance on the nondialysis day was similar to that reported for patients with normal renal function (57–4 ± 27.2 ml/kg/h). Hemodialysis accelerated theophylline elimination and shortened serum theophylline half-life in all patients (nondialysis t½ = 7.3 h ± 2.3 vs. dialysis t½ = 2.7 ± 0.9 h, p < 0.01). Dialysis clearance averaged 59.7 ± 16.4 ml/kg/h with a fraction of drug removed of 0.4 liters in 4 h. Guidelines for theophylline management during hemodialysis are su

ISSN:1660-8151    

DOI:10.1159/000182729

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The impact of low plasma protein levels on the kinetics of prednisolone was investigated in patients with the nephrotic syndrome. Nephrotics exhibited higher unbound fractions of prednisolone, lower total plasma concentrations than normal volunteers, but normal unbound plasma concentrations and normal mean residence times. Thus altered prednisolone kinetics in patients with low plasma protein levels do not explain the higher frequency of prednisolone-related side-effects in these patients, compared to patients with normal plasma protein levels.

ISSN:1660-8151    

DOI:10.1159/000182800

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The prolonged bleeding times of 12 patients with chronic renal failure were significantly shortened at 1 and 2 h after an infusion of 0.4 µg/kg 1-deamino-8-D-arginine vasopressin (DDAVP). In 5 of these patients, the bleeding times 24 h after infusion had returned to approximate baseline values, suggesting that the effect of DDAVP is a temporary one. The levels of factor VIII coagulant activity, factor VIII related antigen activity, and factor VIII ristocetin cofactor activity were all normal or elevated prior to infusion, and a tendency to further elevation, although significant only for the factor VIII ristocetin cofactor activity, was observed after infusion of DDAVP. The latter observation suggests that the effect of DDAVP infusion on the bleeding time is unrelated to alteration of factor VIII activities

ISSN:1660-8151    

DOI:10.1159/000182801

出版商:S. Karger AG    

年代:1982

数据来源: Karger