ISSN:1660-8151    

DOI:10.1159/000188011

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000188012

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Proteinuria in 13 patients with IgA nephritis with nephrotic syndrome (IgANS) was analysed by isoelectric focusing (IEF) and compared with 12 patients with minimal change nephrotic syndrome (MCNS) (n = 8) or focal global sclerosis nephrotic syndrome (FGS) (n = 4) to determine the pattern of proteinuria on IEF and to assess the value of IEF and protein selectivity index (SI) as predictors of response to therapy with predisolone or cyclophosphamide. Steroid/cyclophosphamide responsive patients with IgANS had SC:UA (cationic serum albumin with anionic urine albumin) or SA:UC (anionic serum albumin with cationic urine albumin) IEF patterns and steroid/cyclophosphamide unresponsive patients with IgANS had an SC:UC (cationic serum albumin with cationic urine albumin) IEF pattern. The majority of patients with MCNS or FGS who had an SA:UC IEF pattern were steroid responsive. SI was a better predictor of steroid/cyclophosphamide responsiveness in patients with IgANS (r = 0.78, p < 0.002 compared to IEF, r = 0.64, p < 0.02).

ISSN:1660-8151    

DOI:10.1159/000188013

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Serum levels of oxalate are elevated in uremic patients on dialysis. The effect of living related donor kidney transplants on serum and urine oxalate levels was studied in 8 patients. Serum and urine oxalate levels were measured prior to transplant, on the day of transplant and daily for 5 days postoperatively, and the results compared to those in 11 normal subjects. All transplanted kidneys functioned immediately. Serum oxalate fell from 55 ± 9 μmol/l (484 ± 79 μg/dl) before transplant to 21 ± 3 μmol/l (185 ± 26 μg/dl) the day after transplant, and to 9 ± 2 μmol/l (79 ± 18 μg/dl) 72 h after transplant. Serum oxalate in normal subjects was 9 ± 2 μmol/l (79 ± 18 μg/dl). During the initial 24 h after transplant urine oxalate averaged 1,244 ± 150 μmol/l (109.5 ± 13.2 mg), but fell to levels not statistically different from normal by 72 h after transplant. Rapid clearance of oxalate after transplant leads to transient hyperoxaluria until normal levels of serum o

ISSN:1660-8151    

DOI:10.1159/000188014

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To investigate the effect of rapid correction of chronic metabolic acidosis on circulating intact parathyroid hormone (I-PTH) activity by free calcium clamp in chronic renal failure, 18 patients were enrolled in this study. Metabolic acidosis was corrected by continuous bicarbonate infusion while plasma ionized calcium was clamped at the preinfusion level throughout the entire procedure. The plasma pH, bicarbonate, total CO2, sodium, serum total calcium and 1,25(OH)2 vitamin D3 levels increased significantly while serum concentrations of I-PTH, alkaline phosphatase and albumin showed significant decreases after bicarbonate infusion. The plasma ionized calcium, potassium, serum magnesium and inorganic phosphorus levels showed no significant difference before and after bicarbonate infusion. These results demonstrate that rapid correction of metabolic acidosis attenuates circulating PTH activity in chronic renal failure and may underline the importance of maintaining normal acid-base homeostasis particularly in the presence of secondary hyperparathyroidism.

ISSN:1660-8151    

DOI:10.1159/000188015

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In the past 4 years we have carried out 650 percutaneous renal biopsies (PRB), 54 on transplanted and 596 on native kidneys. PRB was performed with a 14-gauge one-piece disposable needle that was introduced free-handedly into the lumbar wall without any form of fixed guidance or support. Ultrasound was used to locate the kidney pole and to follow the progression of the needle tip in the renal parenchyma. The time needed for the whole procedure was about 5 min. The tissue specimen was adequate for histological evaluation in 98.8% of the cases. The prevalence of post-biospy complications (haematuria, pain, anaemia) was 2.5%. Haematuria was not a common complication (1.6%) in our series, whereas clinically silent perirenal haematoma was common. Mild perirenal bleeding (volume < 5 ml) was found in 40 of a series of 150 patients (26.6%) who underwent ultrasound scan 24 h after the PRB. Haematoma exceeding 100 ml was revealed with US in only 0.6% of the patients. We conclude that free-hand ultrasound-guided PRB makes this technique easier, highly successful, time-saving and almost free of severe side effects.

ISSN:1660-8151    

DOI:10.1159/000188016

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

High erythropoietin (EPO) levels in cyst fluid and blood plasma in patients with autosomal dominant polycystic kidney disease (ADPKD) have been reported. In the present study we assessed EPO levels and the biochemical composition of cyst fluid obtained from 50 simple renal cysts. Basing on cyst fluid/plasma sodium ratio 38 cysts were classified as cysts of proximal origin, and 12 as cysts of undetermined origin. EPO concentrations in cyst fluid obtained from proximal cysts were significantly higher than in fluid from cysts of undetermined origin (472.9 ± 116.2 vs. 122.1 ± 33.3 mU/ml, p < 0.05). Patients with proximal cysts had significantly higher plasma EPO levels (31.8 ± 3.5 mU/ml) than healthy subjects (17.3 ± 1.96 mU/ml, p < 0.005). We conclude that: (1) simple renal cysts of distal origin seem to be rare; (2) the presence of high EPO level in cyst fluid suggests its proximal origin; (3) estimation of cyst fluid EPO levels seems to be of similar pathogenetic value as the assessment of the cyst fluid/plasma sodium ra

ISSN:1660-8151    

DOI:10.1159/000188017

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The present study aimed to assess the relationship between erythropoietin (EPO) secretion and hyperoxemia in uremic patients. In 19 patients with chronic renal failure (10 were hemodialyzed and 9 were not dialyzed) and in 13 healthy subjects plasma erythropoietin levels were assessed during 6 h of air breathing and a second time during 2 h of pure oxygen breathing and during 4 h after discontinued oxygen breathing. Under basal conditions, uremic patients showed higher plasma erythropoietin levels (39.85 ± 5.86 mU/ml in hemodialyzed and 29.05 ± 4.94 mU/ml in nondialyzed patients) as compared with healthy controls (21.04 ± 1.77 mU/ml). Pure oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with chronic renal failure and in the control group. However, this decline was significantly less marked and of longer duration in chronic renal failure patients than in healthy contro

ISSN:1660-8151    

DOI:10.1159/000188018

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Eighty patients with non-insulin-dependent diabetes mellitus being treated in a south Indian hospital were biopsied to confirm suspected nondiabetic renal disease (NDRD). The positive predictive value of the standard clinical indicators for NDRD in the presence or absence of diabetic retinopathy was 54 and 87%, respectively. These values are higher than those given by comparable studies in Western populations. This is probably due to a higher prevalence of NDRD in the population of south India, and especially of proliferative glomerulonephritis, which was found in 21.5% of the patients studied. Standard clinical predictors of NDRD in diabetics have a high predictive value in the tropics where there is a high prevalence of proliferative glomerulonephritis.

ISSN:1660-8151    

DOI:10.1159/000188019

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In a large Italian family with adult-onset Alport syndrome, molecular analysis of the COL4A5 gene, which encodes the α5(IV)-chain of glomerular basement membrane collagen, revealed a GGC→AGC change in exon 38, resulting in substitution of a serine for a glycine in position 1143 of the polypeptide chain, between interruptions 19 and 20 of the triple helical domain. The mutation leads to loss of a restriction site for the enzyme Msp I, and could thus be easily recognized in several female and male relatives. Among relatives of both sexes who carried the same mutation, the clinical phenotype of Alport syndrome was variable as for the onset of renal failure and the presence of associated ear and eye abnormaliti

ISSN:1660-8151    

DOI:10.1159/000188020

出版商:S. Karger AG    

年代:1994

数据来源: Karger