ISSN:1660-8151    

DOI:10.1159/000180896

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

112 cases of MPGN, whose diagnosis was made on light microscopy, were reviewed. Histological examination showed 66 cases of ‘classical’ MPGN, 33 of MPGN with a lobular pattern and 13 of MPGN with epithelial crescents. In 11 patients dense intramembranous deposits were observed. On immunofluorescence (95 cases) 62 patients showed deposits of C3 together with immunoglobulins, 20 had a predominant deposition of C3 and in 13 C3 alone was present. At the moment of biopsy 57 patients had nephrotic syndrome, 43 hypertension, 43 impaired renal function and 65 hypocomplementaemia. In 23 cases, one or more episodes of macroscopic haematuria occurred. The actuarial survival was 70% after 10 years and 50% after 20 years from onset. At last observation 25 patients were dead or on haemodialysis, 22 had impaired renal function, 62 had normal renal function and 2 were in complete remission. The histological variety with epithelial crescents had a significantly worse outcome. The presence of dense deposits or of any specific immunofluorescence pattern had no prognostic significance. Nephrotic syndrome, renal function impairment and hypertension indicated a poor prognosis : however, macroscopic haematuria or hypocomplementaemia did not influence the outc

ISSN:1660-8151    

DOI:10.1159/000180897

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Rats were injected with various amounts of bovine albumin (0.5,1.0 and 1.75 g/24 h), inducing thereby proteinuria ranging from 100 to 400 mg/24 h. The glomerular oxygen uptake, dry weight and glucose-6-phosphate dehydrogenase (G-6-PDH) activity were measured on the 4th day of proteinuria and in a group of control animals. Oxygen uptake increased of +60%, expressed per glomerulus and of +25% when expressed per milligram dry weight and this increase was not different between the 3 groups of rats. Glomerular dry weight increased significantly in the 3 series. There was an highly significant relationship between glomerular dry weight and oxygen uptake, combining the 3 series together. G-6-PDH increased as expected from previous experiments and this increase was more marked for the more marked proteinuria. The relationship between G-6-PDH and QO2 was of borderline statistical significance (p = 0.05). The glomerular hypertrophy, oxidative hyperactivity and increase in G-6-PDH activity are probably related to transcellular transport of protein.

ISSN:1660-8151    

DOI:10.1159/000180898

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Twelve diabetics with terminal renal failure were maintained on chronic peritoneal dialysis (PD) for 2–28 months (average 10 months). 7/12 survived more than 1 year. Blood glucose levels were well controlled by the use of supplemental, intradialysis, intraperitoneal insulin. The incidence of dialysis-related complications, including peritonitis was not significantly higher than in controls. Neurophysiological studies revealed a high incidence of neuropathy initially with progression in most patients. Radiological studies revealed initial vascular calcifications in 7 out of 12 patients with progression in 4. Retinopathy did not progress significantly. PD is a suitable alternative to hemodialysis in the management of end-stage diabetic nephropath

ISSN:1660-8151    

DOI:10.1159/000180899

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Peritoneal dialysis in acute and chronic renal failure has been greatly facilitated by the advent of Tenckhoff indwelling peritoneal catheters and by strict control of peritoneal infections. A number of reports on long-term treatment have been published. A simple device has been developed and tested for regular peritoneal dialysis in the hospital and in the home, in order to accelerate the time required. Employing a ‘single needle apparatus’, a rotary pump and a thermostatic heating unit, it is possible to carry out a very efficacious peritoneal dialysis, similar to the ‘continuous peritoneal dialysis’. The purpose of this paper is to discuss its use and its advantages in comparison with classic pro

ISSN:1660-8151    

DOI:10.1159/000180900

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

An acidotic state has been shown to inhibit sodium (Na) transport both in vitro in toad and turtle bladders an in vivo in rat and dog proximal tubules. To determine if renal Na transport was altered in man by acidosis, we examined the effect of metabolic acidosis produced by ammonium chloride (NH4CI) ingestion on proximal and distal tubular Na reabsorption under conditions of maximal water diuresis in seven normal volunteers. During maximal water diuresis, urinary volume (V) can be used as an estimate of Na and H2O delivered out of proximal tubule, the clearances of free water and sodium (CH2O + CNa) as an estimate of distal Na delivery, and the clearance of free water (CH2O) as a measure of Na reabsorption in the diluting segment. The urinary volume, the distal Na delivery, and the clearance of free water were not significantly different in the control (HCO3 – 24.6 mEq/l, venous pH 7.34) and experimental (HCO3 – 15.9 mEq/l, venous pH 7.25) states. However, the proportion of Na load reabsorbed by the diluting segment CH2OCH2O±CNa×100 Can was higher in the acidotic state (p < 0.01). It is concluded that moderate metabolic acidosis does not affect proximal Na reabsorption in man. An increased fractional reabsorption of Na distally is seen in acidosis and may reflect a direct effect of metabolic acidosis on the diluting segment or be secondary to the greater chloride and lesser bicarbonate presented to the diluting segment during aci

ISSN:1660-8151    

DOI:10.1159/000180905

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

Negative sodium balance was produced in 10 human volunteers. Body weight, plasma sodium, osmolality, hematocrit, renin activity (PRA), and antidiuretic hormone (ADH) concentrations were determined before, during, and after sodium restriction. Body weight declined and PRA rose during the period of low sodium intake. Plasma sodium concentration and osmolality did not change. A statistically significant change in ADH was not observed. It is suggested that a decrease in ADH was prevented by a rising titer of renin and contraction of the extracellular space.

ISSN:1660-8151    

DOI:10.1159/000180901

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

A 62-year-old white male suffering from plasmacytosis with monoclonal gammopathy developed gastrointestinal bleeding, microscopic hematuria, proteinuria and progressive azotemia. A renal biopsy demonstrated capillary wall thickening, mesangial hyperplasia, crescent formation and subepithelial humps. Serum immunoglobulin analysis showed IgG of lambda type. Serum complement, ANA, ASO titer and cryoglobulin were normal. It is suggested that proliferative glomerulonephritis with subepithelial humps should be added to forms of renal pathology that can be seen in plasma cell dyscrasias.

ISSN:1660-8151    

DOI:10.1159/000180902

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

A 42-year-old male was hemodialyzed for 2 years with excellent control of calcium-phosphate metabolism. He received a cadaveric renal transplant but experienced a prolonged episode of acute tubular necrosis during which he could not tolerate phosphate-binding antacids. His calcium X phosphate product became markedly elevated for 20 days. Following a brief period of function, the homograft was removed on the 45th post-transplant day after severe rejection and subsequent infection. Chest X-ray was normal. Six days after graft nephrectomy, he became acutely dyspneic and markedly hypoxemic. Diffuse, fíocculent pulmonary infiltrates appeared on the chest film. The patient expired 1 day later. At postmortem examination, there was severe, diffuse pulmonary alveolar calcification demonstrated by chemical and histologic examination. Although unlikely, the prolonged post-transplant period characterized by elevated calcium X phosphate product may have played a pathogenetic role. Calciphylaxis may have occurred, with hyperparathyroidism as the sensitizing agent and any of several drugs acting as challenger

ISSN:1660-8151    

DOI:10.1159/000180903

出版商:S. Karger AG    

年代:1977

数据来源: Karger

摘要:

The authors present the first case of cardiac arrest, occurring at the time of vessel clamps removal, of a kidney transplantation cooled prior to grafting with Collins’ solution. Monitoring of cardiac (K) has demonstrated the role of Collins’ solution (K = 141 mEq/l) in the genesis of this incident. The mean ± SD increase of the K concentration in the right atrium within the seconds following the removal of the graft vessels clamps was 2.6 ± 1.5 mEq. Acute electrocardiographic abnormalities primarily represented by sudden apparition of hyperkalemic T waves and extrasystols occurs in more than 50% of the cases. The effects of progressive blood release in the graft and other preventive manipulations are studied and disc

ISSN:1660-8151    

DOI:10.1159/000180904

出版商:S. Karger AG    

年代:1977

数据来源: Karger