ISSN:1660-8151    

DOI:10.1159/000181188

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Sweat collected from the forearm of chronic renal failure and control patients, after iontophoretic stimulation with pilocarpine, was analyzed for Na, K, Cl, Ca, Mg, phosphate and urea. Concentrations of Ca, Mg and phosphate in sweat from chronic renal failure patients were significantly elevated (p < 0.05) as compared to controls, while the concentrations of Na, K, and Cl were normal. The mean sweat rates and apparent skin conductivities were lower in uremics, but not significantly different from controls (0.05 < p < 0.10). Tentatively it is concluded that the increase of Ca, Mg and phosphate in uremic sweat is due to an increase in the secretion of these electrolytes in the secretory portion of the sweat gland, while the reabsorptive duct is normal.

ISSN:1660-8151    

DOI:10.1159/000181189

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Membranes from Gambro Lundia Nova dialyzers were investigated for presence of bacteria after hemodialysis with centrally and peripherally mixed dialysate. Centrally mixed dialysate was found contaminated with Pseudomonas aeruginosa, and bacterial cultures as well as electron scanning micrographs showed the presence of these bacteria on the dialysate side as well as on the blood side of membranes from dialyzers perfused with this dialysate during hemodialysis. No bacteria were found on membranes used with peripherally mixed dialysate, in which very few bacteria were found. Despite this the frequency of febrile episodes in patients submitted to hemodialysis with the two different dialysate mixing systems showed no significant difference in our material.

ISSN:1660-8151    

DOI:10.1159/000181190

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Since vasodilators can restore toward normal the decreased peritoneal clearances associated with vascular disease, the influence of aminophylline on peritoneal solute transport was studied in unanesthetized rabbits. Mean control creatinine clearance was 0.56 ml/kg/min and urea clearance 0.80 ml/kg/min. Neither intraperitoneal nor intravenous aminophylline increased peritoneal clearances, nor did the ratio creatinine clearance/urea clearance change from the control value, 0.70. Bidirectional flux of theophylline occurred at clearances of 0.70 ml/ kg/min efflux and 0.64 ml/min influx. The removal rate of theophylline was 0.05% min, allowing therapeutic removal of excess aminophylline and warranting supplemental therapy during dialysis if therapeutic theophylline concentrations are required. As the intraperitoneal aminophylline was well tolerated, this route can be considered for therapeutic administration.

ISSN:1660-8151    

DOI:10.1159/000181191

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Paraffin-embedded kidney biopsies sent to our laboratory in 1967 were re-embedded in Epon and studied with electron and light microscopy (1-μm thick sections). Of 28 biopsies with enough material 18 were cases with clinical suspicion and symptoms of glomerular disease. In electron microscopy all of these were shown to be of glomerular origin by demonstrating either dark deposits in or at the basement membrane, or amyloid fibrils, or areas with retraction of the foot processes of the epithelial cells. Original light microscopy in 1967 had given proof of glomerular origin in 9 of these 18 cases. Light microscopy of plastic sections of these originally paraffin-embedded biopsies was also helpful in diagnosis and showed deposits in 9 out of 14 cases with ultrastructural deposits. The study shows that considerable benefits can be gained through re-embedding biopsies in plastic, especially in cases with minor alterations

ISSN:1660-8151    

DOI:10.1159/000181192

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Addition of many oxidizable substrates to medium often enhances p-aminohippurate (PAH) transport by incubating renal tissue. Since the oxidation of various substrates by rat kidney tissue may change medium pH and this pH change has not been considered by many in conclusions, we followed the effects of medium pH on the magnitude and kinetics of in vitro PAH transport. Two previous studies employing rat kidney slices reported different optimal medium pH for PAH accumulation, i.e. pH 6.5 and pH 8.0. By repeating these studies over a wide range of medium pH, we confirmed the presence of enhanced steady state accumulation relative to pH 7.4 at two separate pH ranges, one at pH 6.7–6.9 (+15%), and the other at pH 7.7–7.9 ( + 22%). PAH influx, as measured by early tissue accumulation, was not different at pH 7.4 and 7.8; while at pH 6.8, it actually decreased. It was only later in the incubation that accumulation was greater at pH 6.8 and 7.8. Probably due to the small stimulation in steady state accumulation at either pH, we could not discern, by the methodology currently available, if this was secondary to augmented influx, decreased efflux, or a combination of both in the latter part of incubation. We conclude that the contribution secondary to medium pH changes must be considered when evaluating the effects of various substrates on PAH accumulation by kidney sli

ISSN:1660-8151    

DOI:10.1159/000181193

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

The protein binding of 14C-hippurate has been measured by conventional ultrafiltration techniques in the plasma of normal subjects and in uremic subjects pre- and postdialysis. In addition, the clearance of 14C-hippurate was determined in vitro in both isotonic saline and plasma to assess binding limitations on hippurate removal during dialysis. Binding levels of hippurate in normal subjects of 68 ± 1.8% (n = 5) were significantly higher than either postdialysis (48.3 ± 15.4%; n = 7) or predialysis (36.6 ± 11.7%; n = 7) levels in the same uremic subjects. Actual levels of plasma hippurate were, however, considerably greater in uremics (24.7 ± 11.2 mg/dl; n = 7) than in normal subjects (≈0.5 mg%).The difference in hippurate binding between pre- and postdialysis samples in uremics was significantly different from zero (p < 0.01, t = 5.36), indicating depletion of competitive site-binding species during dialysis. The saline clearance of hippuric acid (99.1 ± 0.5 ml/min; n = 6) under standard conditions in a capillary dialyzer (CDAK-4) was consistent with the expected clearance of a solute of its molecular weight. Hippurate clearance in citrated plasma, where binding was determined as 50 ± 3%, was 65 ± 0.7 ml/min (n = 6), in good agreement with a theoretically predicted clearance of 60 ml/min for this level of binding. High serum levels of hippurate and its derivatives, may depress effective function of various organs. In addition to the normal dietary intake of hippurate and its precursors, patients on dialysis receive a further burden of hippurate precursor in the form of benzyl alcohol, the common preservative in heparin solutions. The large body burdens of hippurate in dialysis patients, coupled with its impaired removal on dialysis due to binding, point to the necessity for a thorough investigation of the potential toxicity of this

ISSN:1660-8151    

DOI:10.1159/000181194

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Serial changes in plasma of renin concentration (PRC), renin-substrate concentration (PSC) and renin activity (PRA) were followed in rats during glycerol-induced acute renal failure. There was an early but transient increase in PRC and a more delayed and prolonged rise in PSC. PRA began to rise a few hours after glycerol administration at the expense of increases in renin, but by 24 h the high activity was maintained largely by increases in renin-substrate. No correlations between PSC, PRC, or PRA changes and severity of renal failure could be demonstrated. These results suggest that these changes are not causally related to the development of kidney failure.

ISSN:1660-8151    

DOI:10.1159/000181196

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Acute and chronic studies were performed on 6 bealthy human volunteers. Four subjects took a Single oral dose of tienilic acid 1,000 mg. A week later, the same subjects took pyrazinamide (PZA) orally 3 g 90 min prior to the ingestion of the same dose of tienilic acid. Following tienilic acid alone, a marked uricosuric effect lasting at least 8 h was noted, the ratio of urate clearance over endogenous Creatinine clearance (Cur/Ccr) reaching 0.55. At the same time, plasma urate feil from 6.8 to 2.7 mg%. After PZA, the uricosuric response to tienilic acid was only slightly depressed during the first 4 h. However, the blunting effect became more important during the next 20 h. During the chronic studies tienilic acid (250–500 mg/day) was administered during 7 days to 6 subjects maintained on a constant diet. In these studies Cur/Ccr rose from 0.11 to 0.25 while plasma urate decreased from 6.0 to 3.0 mg%. Hydrochlorothiazide administered in equivalent dosage (50–100 mg/day) induced a fall in Cur/Ccr from 0.09 to 0.05. This was accompanied by a significant rise in plasma urate from 6.3 to 7.8 mg%. Cumulative increase in urinary sodium excretion after 7 days was slightly higher with hydrochlorothiazide than with tienilic acid. Total body loss averaged 1.9 kg with tienilic acid and 2.2 kg with hydrochlorothiazide. However, in contrast to hydrochlorothiazide, the cumulative increase in potas-sium excretion was much greater with tienilic acid and serum potassium feil from 4.0 to 3.4 mEq/1. At the same time net urinary hydrogen ion excretion rose markedly and was accompanied by the development of moderate metabolic alkalosis serum bicarbonate rising from 26.5 to 34.2 mEq/1. Tienilic acid had a definite hypocalciuric effect. However, the latter was less important than that induced with hydrochlorothiazide. Tienilic acid, a new diuretic, appears to be a potent uricosuric agent in normal man when administered on an acute or a chronic basis. In spite of a moderate natriuretic effect, it exerts a marked action on both potassium and net acid excretion with resulting hypokalemia and metabolic alkalo

ISSN:1660-8151    

DOI:10.1159/000184854

出版商:S. Karger AG    

年代:1978

数据来源: Karger