ISSN:1660-8151    

DOI:10.1159/000183018

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Cell-mediated immunity (CMI) was evaluated in 8 patients with focal glomerular sclerosis (FGS), 50 patients suffering from chronic mesangial proliferative glomerulonephritis without renal insufficiency and 24 healthy controls. The following parameters were measured: delayed skin reactivity to purified protein derivative, circulating lymphocytes, lymphocyte cell-surface markers (neuraminidase-treated sheep erythrocyte and erythrocyte-antibody-complement rosettes) and functional markers (mitogenic responses to concanavalin A and phytohemagglutinin). The FGS patients with nephrotic syndrome (NS) had a significant depression in CMI, characterized by decreased responses of the lymphocytes to both concanavalin A and phytohemagglutinin, impaired delayed hypersensitivity to purified protein derivative and a decreased proportion of T lymphocytes as compared with normal subjects. In contrast, the levels of all CMI parameters studied in FGS patients in remission and in patients with chronic glomerulonephritis with or without NS did not differ from normal subjects. Thus, the majority of FGS patients with NS demonstrated an impaired response in a CMI assay system. The possible significance of these phenomena in the pathophysiology of FGS is discussed.

ISSN:1660-8151    

DOI:10.1159/000183019

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The pattern of circulating calcitonin (CT) has been studied in relation to other humoral factors (PTH, calcium, phosphate and magnesium) in patients with chronic renal failure on either conservative or dialysis treatment. The latter group was studied before and after dialysis. In both groups, in basal conditions there was a significant increase in the circulating levels of CT, PTH, phosphate and magnesium and a significant decrease in calcemia compared to control group values. Positive correlations were found between increased CT and PTH and between CT and phosphate in uremic patients on conservative medical treatment, but not in those on hemodialysis. In the hemodialyzed group, the postdialysis increase in calcemia was significantly correlated to an increase in calcitoninemia. These data would indicate that even in severe uremia parafollicular cells are still able to increase CT secretion in response to physiological stimuli.

ISSN:1660-8151    

DOI:10.1159/000183020

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Hand bone calcium content [Ca] has been measured by local neutron analysis in hemodialyzed patients free of signs of osteomalacia before and 6–12 months after treatment with vitamin D metabolites, and it has been compared to some iliac bone histomorphometric parameters. With 1,25-(OH)2D3 alone, [Ca] increases significantly at the 6th month of treatment (p < 0.001) but not from the 6th to the 12th month. With 1α-(OH)D3 + 25-(OH)D3 the same phenomenon is observed at the 6th and 12th months of treatment. Before treatment, [Ca] was correlated negatively with the osteoid surfaces (OS) (r = – 0.62, p = 0.01) and the number of osteoclasts per square millimeter (Ocl/mm2)(r = -0.79, p < 0.001). At the 6th month of treatment, [Ca] was still correlated negatively with OS (r = – 0.42, p = 0.05) and with Ocl/mm2 (r = -0.60, p < 0.005). At the 12th month, the two negative correlations decreased but remained significant (r = -0.42, p = 0.05; r = -0.45, p = 0.05). These data suggest that (1) hand bone calcium analysis by neutron activation permits to follow up the peripheral bone mineral content in hemodialyzed patients and (2) the [Ca] increase only observed during the first months of treatment with vitamin D metabolites probably result from an attenuation of secondary hyperparathyr

ISSN:1660-8151    

DOI:10.1159/000183021

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

7 patients with chronic renal insufficiency (4 of whom were on maintenance hemodialysis) and 6 healthy controls received single 15-mg oral doses of oxazepam for 7 consecutive days. Multiple venous blood samples drawn during the 72 h after the final dose were analyzed for concentrations of oxazepam and its glucuronide metabolite, and the extent of oxazepam protein binding. In hemodialysis patients, the final dose was taken just prior to dialysis; arterial (inflow) and venous (outflow) plasma was analyzed as well as dialysate. Mean steady-state plasma concentrations (Css) of total (free and bound) oxazepam in nondialysis renal failure patients (133 ng/ml) were lower, and clearance of total oxazepam (2.5 ml/min/kg) higher, than the corresponding values in controls (330 ng/ml and 1.2 ml/min/kg, respectively). However, these differences were attributable to the greatly increased oxazepam free fraction in renal insufficiency patients (12.0 vs. 4.5% unbound). After correction for individual values of free fraction, Css and clearance of pharmacologically active, unbound oxazepam were essentially identical between groups (14.6 vs. 14.4 ng/ml; 27 vs. 28 ml/min/kg). Compared to controls, Css of the inactive glucuronide metabolite of oxazepam among renal failure patients was greatly increased (2,377 vs. 372 ng/ml) and clearance greatly reduced (0.16 vs. 0.89 ml/min/kg) since excretion of the glucuronide depends on glomerular filtration. Dialyzability of oxazepam and oxazepam glucuronide was minimal. Arterial and venous plasma concentrations were essentially identical, and dialysate concentrations were a small fraction of those in plasma. Thus renal insufficiency does not alter the clearance or Css of pharmacologically active, unbound oxazepam.

ISSN:1660-8151    

DOI:10.1159/000183022

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Sprague-Dawley rats given gentamicin from 10 to 70 mg/kg/day for 9 days showed a linear decrease in glomerular filtration rate with increasing dose, paralleled by histologic changes of acute tubular necrosis and cast formation only at the higher doses. Nephrotoxicity was correlated with the peak, rather than trough, serum gentamicin levels in this study, suggesting that it is the mean level of gentamicin over time that determines renal injury. The polyuria caused by gentamicin resulted mainly from a tubular concentrating defect rather than enhanced sodium or osmolal excretion and may be explained by the finding of a predominance of casts in the medullary thin limbs of the loops of Henle. No effect of gentamicin on the activity of cortical or medullary sodium-potassium adenosine triphosphatase was found to account for the modest sodium wasting. Concurrent administration of sodium1 cephalothin decreased the renal toxicity of gentamicin at high doses, an effect not explained by the added sodium or nonreabsorbable anion.

ISSN:1660-8151    

DOI:10.1159/000183023

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

The ultrastructure of the mesentery was examined by electron microscope (EM) after in vivo fixation in 7 normal rabbits. In 1, the fixation was performed after intravenous injection of an electron-dense tracer (iron dextran) and intraperitoneal infusion of dialysate 4.25% for 1 h. We studied morphometric data of what is considered to be the active peritoneal dialysis membrane, i. e. capillary endothelial cells, interstitium and mesothelial cells. The mesothelial cells are flattened and overlapping with tight junctions between them. They lie on a continuous basement membrane and they contain numerous intracytoplasmic vesicles, separated or in clusters. The mesenteric microvessels were mainly true capillaries of continuous type and postcapillary venules. Capillary lymphatics and larger lymphatic channels (lacunae) seem to be more extensive than the blood capillaries and venules. The endothelial cells contain many vesicles. The interstitium consists of bundles of collagen, fibroblasts and occasional macrophages. The electron-dense tracer was found in the vesicles of the mesothelial cells suggesting that vesicular transport may play an important part in the transportation of at least molecules of a certain size.

ISSN:1660-8151    

DOI:10.1159/000183024

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

We present 1 patient with hypouricemia and hyperuricosuria. Serum uric acid level ranged between 1.5 and 1.9 mg/dl and uric acid fractional excretion between 20 and 28%. Apart from that the renal function was normal. The pyrazinamide suppression test gave a normal response showing nearly complete suppression of urate excretion. The uricosuric response to sulfinpyrazone was normal too. The renal tubular response to extracellular fluid volume contraction induced by furosemide indicated a normal tubular sensitivity to extracellular fluid volume variations. From these results we conclude that our patient has a specific tubulopathy characterized by uric acid hypersecretion.

ISSN:1660-8151    

DOI:10.1159/000183025

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

A 51-year-old man with diabetes mellitus and the nephrotic syndrome on renal biopsy was found to have diabetic glomerulosclerosis, amyloidosis and membranous glomerulopathy. The presence of three distinct glomerular diseases in the same patient is unique. Possible factors involved in their pathogenesis are discussed and the literature on concomitant glomerular diseases is reviewed.

ISSN:1660-8151    

DOI:10.1159/000183026

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Recurrent peritonitis remains a critical problem in patients treated with continuous ambulatory peritoneal dialysis. 3 case histories are presented documenting an association between catheter defects and peritonitis. Illustrative defects are shown. Improved awareness of the hazard and better catheter design may reduce the risks of peritonitis.

ISSN:1660-8151    

DOI:10.1159/000183027

出版商:S. Karger AG    

年代:1983

数据来源: Karger