ISSN:1660-8151    

DOI:10.1159/000182461

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Ureteral stenosis is unusual in Wegener’s granulomatosis. We describe a case in which surgical intervention enabled the diagnosis to be made and appropriate treatment to be give

ISSN:1660-8151    

DOI:10.1159/000182462

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Leukocyte adherence inhibition (LAI) test was examined in 35 patients with renal disease and 14 normal controls, using collagenase-treated glomerular basement membrane, glycosidase-treated glomerular basement membrane and renal tubular epithelium as antigens. Although the control group showed strikingly similar mean LAI indices for all antigens tested, the whole group of patients with renal disease showed a wide scatter of values. Two categories of patients had significantly increased LAI indices (p < 0.01) when their mean values were compared with those of normal controls: (1) rapidly progressive glomerulonephritis (RPGN) and (2) lupus nephritis (SLE). In the serial studies of the RPGN and SLE cases, there were no significant changes in the pattern of LAI and they continued to give positive and very comparable results when re-examined at intervals of 1–6 months. Out of the 30 patients who were able to be evaluated with the three antigens, 15 cases exhibited positive LAI response to two or more antigens simultaneously. These in vitro findings suggest that there is an abnormal cellular response to certain antigen or widespread LAI reactivity to a variety of renal antigens in certain forms of human glomerulonephriti

ISSN:1660-8151    

DOI:10.1159/000182463

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

18 adults with nonnephrotic proteinuria showed a milder form of idiopathic membranous nephropathy on renal biopsy. These patients were allocated to two groups, 2 years’ steroid treatment or nontreatment. 8 of 9 treated patients showed complete disappearance of proteinuria in an average time of 2.4 months after starting the treatment, but in 9 patients of the nontreatment group proteinuria continued for at least 1 year. All five repeated biopsy specimens obtained after subsidence of proteinuria in the treatment group revealed a distinctive regression of glomerular basement membrane alterations. Though the study was not a controlled one, these results suggest that steroid therapy in idiopathic membranous nephropathy is beneficial, particularly in patients with lesser degrees of basement membrane lesion

ISSN:1660-8151    

DOI:10.1159/000182464

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

It is the aim of this paper to review in tabulated form the supplementary dose of drugs required after hemodialysis and to discuss the basic pharmacokinetics of these drugs in the presence of reduced renal function. This review is intended to point out practical aspects of clinical nephrology. It refers to data available from the literature. The descriptions of pharmacokinetics focus on the amount of drug in the body. The fraction of this amount removed by dialysis is replaced by the supplementary dose to maintain effective drug action. The rebound phenomenon affecting plasma drug levels after dialysis renders the calculation of the supplementary dose difficult. Linear extrapolation from plasma drug concentrations measured 6–12 h or more after dialysis may offer a solution to this proble

ISSN:1660-8151    

DOI:10.1159/000182465

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Heart rate variation is dependent upon an intact vagus nerve. Inherent beat-to-beat variability is expressed statistically as the mean square successive difference. Sinus arrhythmia is expressed as the standard deviation of the RR intervals. 19 normal volunteers and 19 nondiabetic hemodialysis patients were assessed for cardiac vagal innervation by monitoring heart rate variation on resting electrocardiograms. Comparison of the dialysis subjects with the normal individuals revealed significantly less heart rate variation in dialysis patients (p < 0.001) consistent with abnormal cardiac vagal innervation. Measurement of resting heart rate variation allows assessment of the integrity of cardiac vagal innervation in normal individuals and nondiabetic patients with end-stage renal disease treated with intermittent hemodialysis.

ISSN:1660-8151    

DOI:10.1159/000182466

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We have designed a method for the assessment of trabecular bone mass (TBM) in a central portion of L4 by means of CT scanning. A total of 29 normal individuals of different ages from both sexes, and 19 hemodialysis patients were studied. 3 selected patients were also studied 1 year later. A good in vivo reproducibility was demonstrated in a dog after repositioning. A positive inverse correlation was observed in the control group between age and TBM supporting the reliability of this method. As reported by others in the postmortem bone mineral analysis of L4, a majority of patients (78.9%) showed a normal or high TBM. From a total of 5 patients with increased TBM only 2 showed radiological osteosclerosis, and 4 of them presented advanced subperiostal resorption suggesting a pathogenetic role of excessive circulating PTH in the genesis of osteosclerosis. A total of 4 had decreased TBM and only 2 of them showed radiological demineralization. 2 patients with decreased TBM, 1 of them under anticonvulsant therapy, experienced a considerable increase in the TBM after 1 year of 25OHD3 therapy. We conclude that this method can be an important help in the early detection and management of renal osteodystrophy.

ISSN:1660-8151    

DOI:10.1159/000182468

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Intracellular calcium plays an important role in the regulation of platelet function. It has also been demonstrated that platelet functions are impaired in uremia. A rise in intracellular calcium has been shown in several tissues and has been held responsible for the impaired function of several organs seen in uremia. This study was undertaken to evaluate whether the calcium (Ca) content of thrombocytes is elevated in uremia and, if so, whether treatment with an active vitamin D metabolite might correct this abnormality. In 10 patients on chronic hemodialysis, platelet Ca content was determined by a technique utilizing consecutive freezing and thawing of platelet-rich plasma. The platelet Ca content of uremic patients was found to be markedly higher (20.86 ± 0.9 ng/200,000 platelets, p < 0.001) than that of a group of 20 normals (12.8 ± 1.2 ng/200,000 platelets). 1 month after treatment with 1α(OH) vitamin D at a dosage of 0.5–2.5 µg/day, the platelet Ca content of the dialysis patients decreased to 14.99 ± 2.14 ng/200,000 platelets (p < 0.05). The data show that in dialysis patients the platelet Ca content is markedly elevated in comparison with that of normals, and that treatment with 1α(OH) vitamin D may significantly reverse this abnormality. It is suggested that elevated Ca content may play a role in the pathogenesis of uremic platelet dysfunction, and that 1α(OH) vitamin D administration may be of benefit in correcting this

ISSN:1660-8151    

DOI:10.1159/000182471

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

10 hypertriglyceridaemic haemodialysis patients were given dl-carnitine, 600 mg daily, for 8 weeks and then 1.2 g daily for 12 weeks. Serum total cholesterol, total triglyceride, high-density lipoprotein cholesterol and plasma free fatty acid (FFA), glucose, and immunoreactive insulin concentrations were measured at regular intervals during the treatment. Intravenous fat tolerance tests were performed in 9 patients. Plasma FFA concentrations fell and the post-heparin fractional clearance rate of Intralipid increased significantly after dl-carnitine administration. While overall no clear-cut effect of dl-carnitine on serum lipids was found, two patterns of response to dl-carnitine could be distinguished: the ‘paradoxic’ response with a rise in serum triglyceride concentrations and the dual response to two different dosages of dl-carnit

ISSN:1660-8151    

DOI:10.1159/000182473

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A 20-year-old girl with rheumatoid arthritis who had been treated with D-penicillamine for 7 months presented with fulminating Goodpasture’s syndrome and a focal necrotising glomerulonephritis. A 35-year-old man who had been taking a low dose of phenytoin for epilepsy presented with nephrotic syndrome and a mesangiocapillary glomerulonephritis. CH50, C3 and C4 were low and a high level of immune complexes was detected. Both patients had severe lesions which were unlikely to recover on immunosuppression alone so were treated with intensive plasma exchange. 2 patients are described with serious drug-induced renal disease who recovered with intensive plasma exchange and immunosuppressio

ISSN:1660-8151    

DOI:10.1159/000182475

出版商:S. Karger AG    

年代:1982

数据来源: Karger