ISSN:1660-8151    

DOI:10.1159/000183269

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

8 male patients undergoing maintenance hemodialysis were studied to determine the effect of administering supplements of pyridoxine hydrochloride, 50 mg/day for 3–5 weeks, on tests of immune function. In the 3 patients who initially had abnormal nitroblue tetrazolium reduction tests, the values returned to normal with therapy (p < 0.05). The generation of chemotactic factors from plasma was defective in all evaluated patients and improved after pyridoxine therapy in 4 of 5 patients (p < 0.01). The lymphocyte subpopulations changed with a rise in the populations of null cells after supplementation with pyridoxine. In addition, lymphocyte transformation in response to mitogens improved in the 3 patients who initially showed low values in these assays. The improvements occurred with pyridoxine therapy even though some patients who responded had no evidence for vitamin B6 deficiency before therapy, as indicated by a normal erythrocyte glumatic-pyruvic transaminase index. We conclude that several parameters of immune function are improved with pyridoxine supplementation. Studies are necessary to establish the minimum daily intake of pyridoxine which will maintain improved values of these tests of immune function in hemodialysis patient

ISSN:1660-8151    

DOI:10.1159/000183270

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Reports of parathyroid suppression during cimetidine therapy suggest that prolonged therapy with H2 antagonists may, by inducing relative hypoparathyroidism, compromise skeletal homeostasis and that under appropriate circumstances, these drugs may serve as a new modality in treating hyperparathyroidism. Using three different region-specific immunoassays, we have been unable to show an effect of cimetidine (1,800 mg/day) on parathyroid hormone concentration, or on urinary cyclic adenosine monophosphate and renal threshold phosphate concentration in 4 normal subjects. Ranitidine given for 8 weeks to 4 haemodialysed patients likewise failed to decrease parathyroid hormone concentration. H2 antagonists appear not to alter parathyroid status in either normal subjects or in uraemics and therefore are unlikely to influence skeletal metabolism in either instance.

ISSN:1660-8151    

DOI:10.1159/000183271

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Calcium metabolism was studied in hemodialyzed patients with diabetes mellitus nephropathy (HD/ DM) and in hemodialyzed nondiabetic patients with chronic glomerulonephritis (HD/non-DM). Incidence of bone changes visible in X-ray films, assessed by changes in the lamina dura and trabecular patterns of mandibulae, was less in HD/DM than in HD/non-DM patients. Serum c-terminal parathyroid hormone was significantly lower in HD/DM than that in HD/non-DM. Serum calcitonin was higher in HD/DM than that in HD/non-DM. The lower level of c-terminal parathyroid hormone would be a reason that bone changes were less in HD/DM than in HD/non-DM patients.

ISSN:1660-8151    

DOI:10.1159/000183272

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

25 patients undergoing regular haemodialysis for chronic renal failure underwent Holter ECG monitoring for a continuous 48-hour period covering dialysis and the intermediate period of everyday activity at home. A low dialysate potassium concentration (1.7 mEq/l) was used. Clinically significant arrhythmias ( > 100 ventricular extrasystoles/24 h) were found in only 1 patient and there were no complex ventricular arrhythmias. Benign atrial arrhythmias occurred in 22 patients (88%). Haemodialysis had no influence on type or frequency of arrhythmias.

ISSN:1660-8151    

DOI:10.1159/000183273

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The final report of a long-term nonrandomized controlled trial of phenytoin therapy in patients with IgA nephropathy is presented. The mean time period of follow-up was 17 months (range 6–48) in the treated group (41 patients) and 14 months (range 6–36) in the nontreated group (32 patients). Both groups were comparable in age, sex, onset of the nephropathy, blood pressure and renal function. The number of episodes per year of macroscopic hematuria decreased in both groups, but was significantly lower at each time period in the treated group than in the control one. The diminution of microhematuria only ocurred in the treated group. 1 patient in each group developed advanced renal failure. The mean serum IgA concentration diminished significantly in the treated group, as early as 6 months, but not in the nontreated group. There was a certain association between the presence of the HLA A2 and BW 35 antigens and the lowering of serum IgA. A normalization of the high serum levels of polymeric IgA occurred in the treated patients. A marked diminution of the Raji IgA immune complexes, well correlated with hematuria, was only observed in the treated group. However, despite the diminution of the serum IgA levels, the disappearance of the potential pathogenic IgA immune complexes and the hematuria in a number of treated patients, a progression in the percentage of global or focal glomerular sclerosis and/or vasculointerstitial lesions was seen in some of them. It is concluded that phenytoin decreases the clinical activity and corrects some of the immunological alterations of a certain number of patients with IgA nephropathy but has no valuable effects on the renal lesions. The overall results of this trial do not suggest the employment of this drug in patients with IgA nephropathy and normal renal function. Our data also suggest that a nonimmunological mechanism may be of importance in the progression of chronic renal damage in this dise

ISSN:1660-8151    

DOI:10.1159/000183274

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The phagocytic activity of monocytes from 15 uremic patients was estimated by the superoxide anion test. There was a significant decrease in the ability of monocytes from these patients to produce superoxide anions in comparison with monocytes obtained from healthy subjects. Addition of urea to monocytes from healthy subjects caused a marked reduction in their ability to produce superoxide anions, while addition of creatinine did not cause any effect. Monocytes from patients with renal failure of glomerular origin were found to produce less superoxide anions than those from patients with other types of renal diseases.

ISSN:1660-8151    

DOI:10.1159/000183275

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In order to evaluate the toxicity of hypervitaminosis A in regular dialysis patients, the relationships between the plasma levels of vitamin A, retinol binding protein (RBP), prealbumin (PA), and biochemical parameters were studied in 47 patients. Plasma vitamin A levels were inversely correlated with hematocrit (r = – 0.5), which was also significantly correlated with RBP/vitamin A ratio (r = 0.61). Immunoreactive parathyroid hormone (i-PTH) and very low density lipoprotein (VLDL) were inversely related to RBP/vitamin A and RBP/PA ratios. These findings suggest that a raised plasma vitamin A level in regular dialysis patients contributes to anemia and hypervitaminosis A toxicit

ISSN:1660-8151    

DOI:10.1159/000183276

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Accurate differentiation of upper from lower urinary tract infection (UTI) has been reported based on the presence or absence of antibody-coated bacteria (ACB) in the urinary sediment. The specificity of ACB localization in adults has been reported to be high based on a strong correlation with localization results obtained with the bladder washout technique. The present study examines the efficacy of ACB testing with respect to accurate anatomic localization of UTI in 20 studies in 14 patients exhibiting bacteriuria as a result of chronic urethral catheterization. 17 studies (85%) demonstrated significant ACB. Localization of UTI was assessed in each study by the bladder washout technique. Following instillation of a washout solution, a normal decrease in colony counts was observed in only 3 studies (15%), a frequency significantly lower than the value of 90% previously reported in noncatheterized bacteriuric patients (p < 0.001). Each of these 3 patients was ACB-positive, yet anatomic localization indicated lower tract UTI. The observed characteristics of the 14 patients included the absence of upper tract signs and symptoms, and spontaneous clearing of ACB and bacteriuria following catheter removal. These findings suggest that in chronically catheterized patients, both (1) the observed abnormal resistance of bacteria to bladder washout and (2) the high frequency of positive ACB tests are indices of severe chronic tissue invasion and intense antibody production in the lower urinary tract in this condition and thus not of value in localizing infection to the upper tract. Neither ACB nor washout testing with current techniques can reliably localize UTI in chronically catheterized patients.

ISSN:1660-8151    

DOI:10.1159/000183277

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Serum oxalic acid (sOx) was determined with a new, specific enzymatic method in 73 uremic patients and the values were plotted against serum creatinine. 41 patients received a free mixed diet, and 32 similar patients were given a low-nitrogen diet supplemented with essential amino acids, ketoanalogues, and calcium carbonate (AD). A significant correlation was found between serum creatinine and sOx levels in patients following a free mixed diet, while no correlation appeared in patients on AD: The sOx concentrations were significantly lower and even normal in this group, and a significant reduction of sOx occurred in 10 patients with chronic renal failure, who changed from a free mixed diet to the AD. The lowering of sOx concentration in patients following AD is attributed both to low intake of its metabolic precursors and to the oral calcium carbonate supplementation.

ISSN:1660-8151    

DOI:10.1159/000183278

出版商:S. Karger AG    

年代:1984

数据来源: Karger