ISSN:1660-8151    

DOI:10.1159/000183538

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Genetic factors are clearly involved in the pathogenesis of essential hypertension in man. In at least three rat models of genetic hypertension it is possible to transplant the hypertension with the kidney. To see whether or not the same is true for humans, we carried out a 2-year retrospective study of 50 selected recipients of a cadaver kidney. We correlated the following factors by multivariate statistical analyses: presence or absence of hypertension in the family of donor and recipients; donor’s and recipient’s age; mean blood pressure (MBP) and antihypertensive therapy (AHT) score during dialysis; months of dialysis and body surface before transplantation; body weight, plasma creatinine, prednisone dosage and cumulative rejections with MBP and AHT score at various time intervals after transplantation. The results obtained showed that, considering the recipients coming from normotensive families, the AHT score after transplantation was significantly greater (p < 0.05 1st and p < 0.0l 2nd year) in the patients receiving a kidney removed from donors with hypertensive families than in the patients receiving a kidney removed from donors with normotensive families. This difference was not present when the recipients coming from hypertensive parents were considered. AHT score after transplantation is also correlated with AHT score on dialysis (p < 0.01 1st and 2nd year), body weight (p < 0.02 1st and p < 0.01 2nd year), cumulative rejections (p < 0.025 1st and 2nd year) and inverse MBP after dialysis (p < 0.025 2nd ye

ISSN:1660-8151    

DOI:10.1159/000183539

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The acute effects of both acetate and bicarbonate hemodialysis on erythrocyte transmembrane sodium fluxes were investigated in 15 patients with chronic uremia. We observed a significant (p < 0.0l) stimulation of the Na+, K+ pump in both procedures, with a significant correlation to the amount of fluid removed during hemodialysis (r = 0.56, p < 0.03). Outward Na+ cotransport fluxes significantly rose (p < 0.05) after acetate hemodialysis and decreased (p < 0.05) after bicarbonate hemodialysis. Minor and not significant pre- and posthemodialysis bidirectional changes were observed as regards the intraerythrocyte Na+ and K+ concentration, passive Na+ and K+ permeability, and Na+, Li+ countertransport. Hemodialysis may acutely affect the erythrocyte sodium pump and cotransport fluxes, possibly through the modulation of hormonal factors triggered by the extracellular volume changes.

ISSN:1660-8151    

DOI:10.1159/000183540

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Increased plasma and red blood cell concentrations of riboflavin have been reported in uremia. The possible role of altered intestinal absorption of riboflavin in the genesis of this abnormality is not known. For this reason we examined the intestinal absorption of riboflavin in rats made uremic by subtotal nephrectomy and sham-operated (control) rats in vivo using the recycling perfusion technique and in vitro using the everted-sac technique. Paradoxically, the results showed a significant impairment of intestinal absorption of riboflavin in vivo in uremic rats compared to the control group. However, no significant difference was observed in riboflavin transport in vitro. We conclude that the intestinal absorption of riboflavin is decreased in experimental uremia and cannot account for the reported increase in its plasma and red blood cell concentrations.

ISSN:1660-8151    

DOI:10.1159/000183541

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Heart studies were carried out in 7 patients with end-stage renal disease (ESRD) who underwent parathyroidectomy for secondary hyperparathyroidism. The studies, which included echocardiography and equilibrium radionuclide angiography (ERNA), were performed prior to parathyroidectomy and 2 weeks, 3 months, and 6 months following it, on a nondialytic day. Heart rate decreased from 89.3 ± 1.3 to 81.4 ± 1.5min-1(p < 0.001) following parathyroidectomy and returned to the initial level at 3- and 6-month examination. Cardiac output decreased from 3170 ± 68 to 2943 ± 57ml/min(p < 0.01) following parathyroidectomy and returned to basal level on 3-and 6-month determinations. End-diastolic dimension (EDD), end-systolic dimension (ESD), septal and posterior wall thickness and shortening fraction (SF) as measured by echocardiography were normal prior to parathyroidectomy and remained unchanged following it. Left ventricular ejection fraction (LVEF), end-diastolic and end-systolic volumes measured by ERNA did not change following parathyroidectomy. This study suggests that hyperparathyroidism has little effect on cardiac performance and, except for a short-lived decrease in heart rate and cardiac output, parathyroidectomy does not affect cardiac performance when performed in patients with preoperatively normal cardiac out

ISSN:1660-8151    

DOI:10.1159/000183542

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

In the present study, hog pancreatic kallikrein (HPK, 2,000 KU/kg body weight) was intramuscularly injected into male rabbits and several plasma hormones [kinin, prostaglandin E (PGE), 6-keto-prostaglandin F1α (6-keto-PGF1α), thromboxane B2 (TXB2), plasma renin activity (PRA), aldosterone, and ACTH] were measured before and after the HPK administration, in order to clarify the role of glandular kallikrein in the blood. The plasma kinin concentrations were significantly (p < 0.001) increased from 1 ± 1 (mean ± SE), the baseline level, to 230 ± 22,288 ± 36 and 130 ± 9 pg/ml at 30, 60, and 120 min, respectively, after HPK administration. The plasma levels of PGE were slightly increased after HPK administration, but the change was not significant compared to the mean baseline level. The plasma levels of 6-keto-PGF1α were significantly increased from 229 ± 38, the baseline level, to 594 ± 131 (p < 0.05) at 30 min after the administration of HPK and tended to increase (378 ± 67) at 60 min after the HPK administration, but fell to 278 ± 37 pg/ml at 120 min after the administration of HPK. On the other hand, the changes in plasma TXB2, aldosterone, ACTH, and PRA before and after HPK administration were not significant. The present results showed that exogenous intramuscular administration of HPK increased the plasma levels of kinin and prostacyclin, but caused no elevation in the plasma levels of other hormones including PRA. It is concluded, therefore, that in this acute experiment, there was a close relationship between the kallikrein-kinin system and pro

ISSN:1660-8151    

DOI:10.1159/000183543

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The urinary excretion of α1-microglobulin (α1M), β2-microglobulin (β2M), retinol-binding protein (RBP) and N-acetyl-β-D-glucosaminidase (NAG) as markers of proximal tubular dysfunction was measured in various forms of urinary tract infections (UTI) and in fever due to non-renal infections. The urinary concentration of these proteins was significantly increased in acute pyelonephritis compared with acute cystitis and asymptomatic bacteriuria. Tubular proteinuria and enzymuria could also be demonstrated in subjects with fever of non-renal origin and corresponded to the findings in pyelonephritis. It is suggested that fever per se is the most likely cause of the tubular proteinuria seen in acute pyelonephritis. In localizing an acute UTI characterization of the urinary protein profile seems to have no advantage over a carefully measured body temperature. The urinary excretion of α1M, β2M and RBP were highly correlated, while urinary NAG activity was less correlated to these low-molecular weight proteins. Fibrin degradation product D (FDP-D) was detected in the urines in 60% of the patients with acute pyelonephritis and in one third of those with acute cystitis. The estimation of FDP in urine therefore seems to be of little value in the level diagnosis

ISSN:1660-8151    

DOI:10.1159/000183544

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The elimination of CO2 across the dialyzer has been reported as the cause of the pulmonary hypoventilation during hemodialysis. There are some evidences that the venous line blood composition could influence the central venous blood and this one the pulmonary ventilation. Our purpose was to analyze (1) the influence of the changes in composition of the venous line blood on the central venous blood and (2) the possible role of the central venous blood composition on the pulmonary ventilation of 10 chronic renal failure patients during hemodialysis performed twice in the same patients in two different conditions: acetate dialysate without (condition I) and with (condition II) constant addition of 100% CO2 bubbling into the dialysis bath. During condition I the venous line blood pH was kept in a normal range, and the PCO2 was low, whereas during condition II the pH was very low and the PCO2 extremely high. The patients during condition I decreased their pulmonary ventilation and lost CO2 across the dialyzer as the central venous blood pH and HCO-3 increased, and PCO2 did not change. The same patients during condition II increased their pulmonary ventilation and absorbed CO2 across the dialyser as the central venous blood pH decreased and PCO2 increased. Thus, the venous line blood has influence on the central venous blood composition, and this plays a role on the control of pulmonary ventilation of these patients.

ISSN:1660-8151    

DOI:10.1159/000183545

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Disturbances of peripheral and autonomic nervous system function were evaluated in 37 normal subjects, in 52 patients with non diabetic chronic renal insufficiency (25 predialysis patients, 27 dialysis patients), and in 21 patients with diabetic chronic renal failure (10 predialysis patients, 11 dialysis patients). In nondiabetic patients, the predialysis group showed abnormal test results indicating parasympathetic lesions, in dialysis patients these derangements were nearly normalized. In predialysis diabetic patients, the autonomic alterations were much more extensive, corresponding to alterations of electroneurographical findings; in addition to parasympathetic lesions, sympathetic disturbances were seen. In contrast to the nondiabetic groups, in dialysis patients a deterioration of autonomic lesions was observed. In conclusion, these data indicate that deranged autonomic functions are common in uremia; they improve in dialysis patients with nondiabetic renal failure in contrast to diabetic patients; in this group the autonomic functions worsen in dialysis patients as a function of duration of diabetes and hemodialysis.

ISSN:1660-8151    

DOI:10.1159/000183546

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The effects of high sodium 144 mmol/l (mEq/l) dialysate were studied in normotensive, hypertensive and anephric chronic hemodialysis patients. Comparisons of blood pressures, weights and side effects associated with the hemodialysis procedure were made between two 6-month periods using dialysate sodium concentration of 133 mmol/l (mEq/l), followed by a high dialysate sodium of 144 mmol/l (mEq/l), each patient acting as his own control. No difference was found in the frequency of cramps or ‘disequilibrium’ side effects (nausea, vomiting, headache, restlessness). High sodium dialysate is beneficial for normotensive and anephric patients in reducing dialysis-induced hypotension and was not associated with any deleterious effects on long-term blood pressure control. In hypertensive patients, the benefit is less clear, and hypertension may incre

ISSN:1660-8151    

DOI:10.1159/000183547

出版商:S. Karger AG    

年代:1985

数据来源: Karger