ISSN:1660-8151    

DOI:10.1159/000183198

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000183199

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000183200

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Recent studies have shown that the mass transfer coefficients (MTC) for low- and middle-molecular-weight substances are maintained at medium terms in patients under continuous ambulatory peritoneal dialysis (CAPD) therapy. We have studied the MTC for parathormone (MW 5,500–6,000) in 29 patients under CAPD. 11 patients were assessed once, 9 patients were assessed twice, and 9 were assessed three times, with 6-month intervals between assessments; in 15 cases nitroprusside (4.5 mg/l) was added to the dialysate, and in 2 cases the assessment was carried out during an episode of peritonitis. A bicompartmental model with exponential ultrafiltration was used, and the generation rates were calculated by mass balance. The MTC was calculated by minimization of the quadratic error, following the procedure of Runge and Kutta. The mean MTC values were 21.2 ± 5.9 for urea, 10.26 ± 5.9 for creatinine 2.8 ± 1.8 for inulin and 1.0 ± 0.8 for parathormone (PTH), with significant correlation between the MTC values for PTH and inulin (r = 0.5, p < 0.01). There is a direct correlation between MTCpth and peritoneal PTH clearance, and an inverse one between MTCpth and serum PTH, with r = 0.8 and 0.51, respectively. No correlation was found between the MTC for inulin or PTH and the duration of the CAPD therapy, nor with the number of episodes of peritonitis. No significant medium-term variations were detected in the MTC values for PTH and inulin. Both peritonitis and the intraperitoneal administration of nitroprusside induce significant increases in the M

ISSN:1660-8151    

DOI:10.1159/000183201

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The magnesium status of 22 hemodialysis patients was studied by analyses of serum, skeletal muscle and peripheral blood lymphocyte levels of magnesium. Despite elevated serum magnesium, normal magnesium levels were noted in skeletal muscle and lymphocytes. 12 patients were exposed to a low dialysate magnesium concentration, resulting in normalization of serum magnesium but no changes in muscle or lymphocyte magnesium, which might indicate slow exchange between these intracellular stores and the extracellular fluid. Normalization of serum magnesium was followed by a slight rise in circulating parathyroid hormone levels without noticeable changes in serum calcium or phosphate levels. Since signs of an absolute magnesium excess were not detected, a combination of low dialysate magnesium and the use of an oral magnesium compound as a phosphate binder might be a way to decrease aluminium exposition in hemodialysis patients.

ISSN:1660-8151    

DOI:10.1159/000183202

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In the early phase of hemodialysis progressive decreases in some enzyme activities in the leukocyte homogenate, neutrophil granule fraction and postgranular supernatant were found with concomitant rise in plasma β-glucuronidase activity, which is indicative of the release of neutrophil granule factors into the extracellular environment. Intravenous infusion of human neutrophil granule products to rabbits induced profound transient neutropenia. The results suggest that the release of neutrophil granule factors in the early period of hemodialysis may be a possible cause of hemodialysis neutropenia

ISSN:1660-8151    

DOI:10.1159/000183203

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A shortened life of erythrocytes in uremia has been suggested as one of the causes of anemia in this condition. Since partially desialylated erythrocytes are promptly removed from the circulation, we examined whether sera from renal failure patients would exhibit increased neuraminidase activity which could be held responsible for this phenomenon. Sera of 22 patients with end stage renal failure were examined for neuraminidase activity by assessing their effect on desialylation upon incubation at 37°C for 2 and 1 h, respectively, of erythrocytes of healthy donors matched for blood group and of fetuin as substrate. As deduced from the residual content of sialic acid of erythrocytes and of the amount of sialic acid released from fetuin, the results showed a statistically higher neuraminidase-like activity of patients’ sera as compared to sera of healthy individuals. It is suggested that increase in neuraminidase activity could be one of the factors involved in the mechanism of generation of anemia in uremia by acting on erythrocytes, rendering them more prone to sequestration by the liver and sple

ISSN:1660-8151    

DOI:10.1159/000183204

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Into 24 oliguric patients with acute renal failure (ARF) for whom mannitol and high-dose frusemide had failed to promote a diuresis, dopamine (3 μg/kg/min) plus frusemide (10–15 mg/kg/h) were infused for 6–24 h. In 19 of the 24 patients this treatment produced significant increases in diuresis (from 11 ± 7 to 85 ± 51 ml/h; p < 0.001) and natriuresis (from 45 ± 13 to 88 ± 22 mEq/l; p < 0.001), without any significant modification of blood pressure, pulse rate or central venous pressure. 10 of the 24 patients required dialysis: 5 because therapy failed to promote diuresis and the other 5 because of their hypercatabolic state in spite of polyuria. 5 patients died of causes unrelated to ARF. Since all patients who responded were treated within 24 h after the onset of oliguria, it appears to be crucial to administer dopamine and frusemide early, before more severe anatomical and functional damage

ISSN:1660-8151    

DOI:10.1159/000183205

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The mechanism of sodium retention in the nephrotic syndrome remains controversial, though the classic pathophysiological explanation is stimulation of the renin-angiotensin-aldosterone system. Recent evidence has shown that many patients with the nephrotic sydrome have a normal or low plasma renin activity suggesting that there might be an intrarenal cause for their sodium retention. We gave captopril, an oral angiotensin-converting enzyme inhibitor, during 10 separate episodes of sodium retention in nephrotic syndrome. There was evidence of stimulation of the renin system in 7 of these episodes. Despite a marked fall in plasma aldosterone, all patients continued to retain sodium and water and gain weight. This demonstrates that the sodium retention of nephrotic syndrome is not due to stimulation of the renin-angiotensin-aldosterone system, but must be due to some other mechanism, which is probably intrarenal.

ISSN:1660-8151    

DOI:10.1159/000183206

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Lipids of the blood serum were studied in 29 patients with untreated nephrotic syndrome (NS) and in 28 patients treated with corticosteroids or nonsteroid drugs. None of the patients had evidence of renal failure, either acute or chronic. The patients with untreated NS showed massive proteinuria, marked hypoproteinemia, considerable hypertriglyceridemia and hypercholesterolemia. Serum high-density lipoprotein cholesterol (HDL cholesterol) concentrations were lower in these patients than in the control group, including 35 normal subjects, and correlated with the total serum protein (r = 0.46, p < 0.05) and serum albumin (r = 0.46, p < 0.05). An inverse correlation was observed between HDL cholesterol and serum triglyceride levels (r = -0.58, p < 0.01). In the treated patients the laboratory indices of NS were less pronounced. HDL cholesterol levels were within normal limits in 14 patients with NS treated mostly with nonsteroid drugs, while in the patients receiving the corticosteroids (14 subjects) they were significantly higher than in the control group.

ISSN:1660-8151    

DOI:10.1159/000183207

出版商:S. Karger AG    

年代:1984

数据来源: Karger