ISSN:1660-8151    

DOI:10.1159/000186638

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In order to study bone metabolism after renal transplantation we measured serum levels of parathyroid hormone (PTH) and osteocalcin (OC), a specific biochemical parameter of bone formation, in 30 patients with functioning kidney grafts and 30 sex- and age matched control subjects. Serum levels of OC and PTH were markedly elevated in the kidney transplantation patients when compared with the control subjects (p < 0.0001). Elevated levels of OC and PTH were present even in patients with very well functioning transplants. In the kidney transplantation patients, a significant positive correlation between serum OC and serum PTH levels could be found. Our data give evidence of persistent hyperparathyroidism and increased bone turnover in patients after renal transplantation.

ISSN:1660-8151    

DOI:10.1159/000186639

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In order to evaluate the impact of ciclosporin in patients with adult onset polycystic kidney disease (ADPKD) following renal transplantation, we performed a single-center study of all (n = 65) patients with this disorder since 1978,43 of whom received CSA (PC-CSA) with the remaining 22 treated with azathioprine (PC-AZA). An additional group of 45 age- and time-matched group of non-polycystic CSA-treated patients (nonPC-CSA) were used as a separate control group. Patient and graft survivals at 1 and 5 years were similar in PC-CSA when compared to nonPC-CSA. The commonest causes of death in both groups were cardiovascular related. The incidence of posttransplant hypertension and acute rejection were also similar. Urinary tract infections (UTIs) were, however, more frequent among PC-CSA (11 and 33% pre- and posttransplant respectively) when compared to the nonPC-CSA (2 and 17% pre- and posttransplant respectively). The PC-CSA cohort showed improved 1-year patient and graft survivals when compared to PC-AZA (94 and 70% vs. 72 and 34%) with less rejection episodes (42 vs. 88%) during the first year posttransplant but a higher mean serum creatinine at the end of the first year (2.0 vs. 1.6 mg/dl, 176.6 vs. 141.3 μmol/l). Posttransplant hypertension (67 vs. 70%) and UTIs (33 vs. 33%) were, however, similar in both groups. In summary, renal transplantation in ADPKD in the CSA era is associated with equal patient and graft survivals when compared with nonpolycystic patients of comparable age, but superior results when compared with the earlier azathioprine era

ISSN:1660-8151    

DOI:10.1159/000186640

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

This study investigates the pharmacokinetics of a low molecular weight heparin (Fraxiparine®) after a single bolus intravenous injection of 100 antifactor Xa IC U · kg-1 in 3 groups of patients affected by chronic renal insufficiency of various severity: group A (n = 7) was composed of hemodialyzed patients; group B (n = 7) had a creatinine clearance ranging from 10 to 20 ml · min-1 and group C (n = 5) from 30 to 50 ml · min-1. There was no significant difference between the pharmacokinetic parameters determined in the 3 groups of patients and no correlation between these parameters and the creatinine clearance. However, when compared to the values established in a group of 12 healthy volunteers, the half-life of disappearance of the antifactor Xa activity was significantly prolonged. Therefore it is advised to monitor antifactor Xa activity in patients affected by chronic renal insufficiency of any severity to avoid a possible accumulation phenome

ISSN:1660-8151    

DOI:10.1159/000186641

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In order to examine T lymphocyte function in childhood IgA nephropathy, 13 patients and 10 age-matched control subjects were studied. T lymphocyte function was examined in terms of in vitro immunoglobulin synthesis by peripheral blood mononuclear cells (PBMC) and CD4-depleted (suppressor-rich) and CD8-depleted (helper-rich) PBMC in both unstimulated and pokeweed mitogen (PWM) and Staphylococcus aureus Cowan I (SAC) stimulated cultures. T lymphocyte subpopulations were examined by two-color immunofl·uorescence analysis using Fluorescein-Activated Cell Sorter (FACS). Children with IgA nephropathy showed (1) a significant increase in IgA synthesis by PBMC with or without mitogen stimulation, (2) a significant increase in IgG and IgA synthesis by CD4-depleted (suppressor-rich) PBMC, (3) a significant increase in IgG and IgA synthesis by CD8-depleted (helper-rich) PBMC, and (4) a significant decrease in suppressor-inducer T cells (Leu3a+Leu8+). These results suggest that a decrease in suppressor-inducer T cells, impaired suppressor T cell function and hyperactivity of helper T cell function are responsible for the increase in IgA production in children with IgA nephropathy

ISSN:1660-8151    

DOI:10.1159/000186642

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

IgA class anti-IgA antibody was sought by an immunoabsorbent technique in sera from patients with IgA nephropathy (IgA-N, n = 62), other forms of primary glomerulonephritis (PGN, n = 41), seropositive rheumatoid arthritis (RF-positive, n = 18) and normal controls (c, n = 50). IgA-N (31%) and RF-positive (56%) patients showed a significant increase in IgA anti-IgA antibody levels. The subclass of IgA anti-IgA antibody was predominantly IgAl in both IgA-N and RF-positive patients. Size analysis revealed the dimer/monomer ratio to be significantly increased in IgA-N patients compared with that of RF-positive patients (p = 0.03). These results indicate the possible existence of the dimeric form of IgA class anti-IgA antibody in the circulation of IgA-N patients.

ISSN:1660-8151    

DOI:10.1159/000186643

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

IgA specific for 7 food and 6 airborne antigens were sought in the serum of 30 adult patients with IgA mesangial nephropathy (IgA GN), 23 with membranous nephropathy (MGN), 20 with idiopathic nephrotic syndrome (INS), 11 with membranoproliferative GN (MPGN) and 22 healthy controls by means of an enzyme-linked immunoassay. The IgA subclass was determined using monoclonal antibodies. Increased levels of IgA specific for gliadin, bovine serum albumin (BSA), ovalbumin, lysozyme and α-lactalbumin were found in IgA GN, while increased levels of IgA to BSA, ovalbumin, lysozyme and α-lactalbumin were observed in MGN; IgA specific for α-lactalbumin were increased in INS, and MPGN patients had reduced levels of IgA to BSA and increased levels of IgA to β-lactoglobulin and α-lactalbumin. These specific IgA to food antigens were restricted to the IgAl subclass. Patients with IgA GN had significantly increased levels of IgA specific for Dermatophagoides pteronyssinus (DP) and Dactil while the MGN group showed increased levels of IgA specific for DP, feathers, Dactil and mold. INS patients had increased levels of IgA specific for DP, feathers, Dactil, mold and dog hairs, while MPGN patients had increased levels of IgA specific for feathers, Dactil, dog hairs and mold. All these specific IgA to airborne antigens were restricted to the IgA1 subclass. Patients with the four types of primary glomerulonephritis had decreased IgA specific for cat hairs which were of both the IgA1 and IgA2 subclasses. We conclude that anomalies of the IgA repertoire to environmental antigens are also encountered in primary glomerulonephritis other than Ig

ISSN:1660-8151    

DOI:10.1159/000186644

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Hemodialysis induces thrombocytopenia and activation of coagulation. The severity of this reaction depends on the kind of membrane. In this study, we present the results of determination of platelet count, and of different factors of coagulation in 10 stable dialysis patients. Measurements were performed at the start and after 15 and 45 min of dialysis. Samples were taken before and after the dialyzer. All 10 patients were treated consecutively and in a random order during 14 days with the following membranes: polyacrylonitrile (Filtral 12, Hospal), hemophan (GFS 120 Plus, Gambro, and Bio-Nephros HF Andante, Organon), polysulfone (F6, Fresenius), cuprammonium (AM50-BIO, Asahi) and cellulose acetate (Duo-Flux, Cordis-Dow). The cellulose acetate membrane induced a small but significant drop of mean platelet count [results are mean (SEM)]: from 245,000 (17,000) to 224,000 (16,000)/μl after 15 min. With the same membrane a dramatic increase after 15 min was noted of 6-keto-PGF1α from 56.3 (9) to 146.7 (35.7) pg/ml. The other membranes did not influence significantly prostanoid levels and platelet count. During dialysis no significant changes of fibrinopeptide A (FPA) and von Willebrand factor (VWF) were observed. Nevertheless, predialysis FPA and β-thromboglobulin (βTG) concentrations were lowest after 14 days of treatment with cellulose acetate and polyacrylonitrile membranes. It is concluded that the activation of coagulation depends on the membrane used. The activation may be dominated by one single system (e.g. prostanoids). The different predialysis concentration of some of the factors suggests interference of the dialysis membrane with the activation of coagulation during the interdialytic per

ISSN:1660-8151    

DOI:10.1159/000186645

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The expression of MHC class II (HLA-DR) and complement receptor (CRl) surface molecules on CD 14 + monocytes were compared with the production of the monokine interleukin-1β (IL-1β) in patients with endstage renal disease undergoing maintenance haemodialysis (HD) with hollow fibre dialyzers containing cellulose (CE, n = 8) and polysulfone (PS, n = 7) membranes. Monocyte staining was performed in blood samples obtained at the beginning and after 3 h of HD. Analysis of surface marker expression was done by immunofluorescence staining and flow cytometry analysis. Specific fluorescence intensity for both CRl and class II (HLA-DR) antigens was increased in patients treated with CE membranes at the beginning of a dialysis treatment when compared to healthy control values. Interestingly, after 3 h on dialysis a further increase was noted for CRl complement receptor expression whereas the increased HLA-DR expression was no longer detectable. In contrast, specific fluorescence intensity for both antigens was not significantly different from controls, either before or after dialysis, in patients treated with PS. The capacity of peripheral blood mononuclear cells to produce IL-1β spontaneously in vitro in the two patient groups was found to parallel results on phenotypic expression of surface molecules. The present study demonstrates that functional signs of monocyte activation, as evidenced by an augmented IL-1β production, in some patients on long-term HD correlate with an increased expression of two functionally important monocyte surface marker molecu

ISSN:1660-8151    

DOI:10.1159/000186646

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

A total of 246 cases of 166 primary glomerulonephritis (GN) and 80 secondary GN were examined for the presence of intraglomerular monocytes using nonspecific esterase reaction of α-naphthyl butyrate methods. The high score of monocyte index (MI) as the numbers of monocytes per glomerulus was found in crescentic GN (n = 5, MI = 3.72 ± 1.98), endocapillary proliferative GN (n = 8, MI = 2.17 ± 2.13), lupus nephritis (n = 43, MI = 2.21 ± 3.35), and cryoglobulinemia-related GN (n = 1, MI = 11.5). The intermediate score of MI was observed in IgA nephropathy (IgA-N, n = 64, MI = 0.63 ± 0.42) and Henoch-Schönlein purpura nephritis (HSP-N, n = 11, MI = 1.09 ± 0.87). Out of IgA-N and HSP-N, the scores of MI in patients with more severe proliferation and/or with segmental lesions were higher than those without this histological finding. However, there was not a significant correlation between the glomerular monocytic infiltration and clinical findings in each group. In primary GN including minor glomerular abnormalities, focal glomerular sclerosis and membranous GN, and in secondary renal diseases except for SLE, HSP, and cryoglobulinemia, the score of intraglomerular monocytic infiltration was of little value. The participation of monocytes was predominant in extra- and intracapillary GN, lupus nephritis, and cryoglobulinemia- related GN, as previously reported. Moreover, in some types of proliferative GN, especially IgA-N and HSP-N, some parts of glomerular hypercellularity result from the participation of monocyte-macrophage series, although the main parts of cell proliferation are intrinsic mesangial

ISSN:1660-8151    

DOI:10.1159/000186647

出版商:S. Karger AG    

年代:1991

数据来源: Karger