ISSN:1660-8151    

DOI:10.1159/000183665

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The effects were studied of a vegetarian low-protein, low-phosphorus diet supplemented with essential amino acids and ketoanalogues and those of maintenance hemodialysis (MHD) and free diet on the serum triglycerides (STG) of 85 patients with chronic renal failure. Following dietary therapy STG decreased significantly in the 61 male patients (from 185.7 ± 89.8 to 153.5 ± 68.7 mg/dl; p < 0.001), whereas in the females the decrease was not significant (from 189.1 ± 83.9 to 167.0 ± 62.2 mg/dl; NS). When patients changed to MHD therapy and free diet STG increased again. We can conclude that the correction of hypogonadism of chronic male uremics largely accounts for the improvement of hypertriglyceridemia, though other factors are likely to contrib

ISSN:1660-8151    

DOI:10.1159/000183666

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Plasma antithrombin III (AT III), α1-antitrypsin (α1-AT) and α1-macroglobulin (α1-M) concentrations were measured in 17 cases of the nephrotic syndrome (NS) in adults. The mean plasma level of AT III was normal. The AT III concentration was correlated with albuminaemia (r=+0.718, p < 0.005), cholesterolaemia (r= – 0.651, p < 0.005) as well as with urinary protein (r = – 0.531, p < 0.05). The α1-AT concentration was decreased (p < 0.01) and correlated with serum albumin level (r = + 0.643, p < 0.01). The α1-M concentration significantly increased (p < 0.001). A negative correlation of the α1-M level with serum albumin concentration (r= -0.561, p < 0.025) and a positive correlation with the cholesterol concentration (r= +0.819, p < 0.001) was found. AT III and α1-M were inversely correlated (r= –0.706, p < 0.005). It is considered that in NS in adults, the increase of α1-M is not compensatory for AT III, and there is no objection to the use of heparin in thrombosis prophylaxis with the exception of a few cases with very low

ISSN:1660-8151    

DOI:10.1159/000183667

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

We encountered 11 patients with aluminum-associated bone disease (AABD), and treated them with deferoxamine (DFO). In 3 patients, a second bone biopsy was done during DFO treatment. Clinical features of AABD were compared with surgically proven secondary hyperparathyroidism (2°HPT) with osteitis fibrosa on X-ray. Patients with AABD had disabling bone pain. This disease showed radiological signs ranging from normal, localized bone atrophy, to multiple fractures. It was characterized by increased soft tissue activity and localized abnormal uptake of 99mTc-MDP, detected by skeletal scintigrams. Patients with AABD had low levels of parathyroid hormone and alkaline phosphatase, but high aluminum (Al) levels compared to those with 2°ΗPT. Serum Al increased after DFO administration, and the patients improved both clinically and histologically. 1-α-Hydroxyvitamin D3 (1-α-OH D3) was not effective for AABD. We concluded that the administration of antacids containing Al should be minimized in dialysis pati

ISSN:1660-8151    

DOI:10.1159/000183668

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Postmortem iliac crest biopsies were performed on 16 uremic patients. 3 had been treated conservatively while 13 had been entered into a maintenance dialysis program. The dialysate was treated by reverse osmosis for more than 10 years, and the aluminium concentration was consistently below the detection limit of 0.15 mol/l.14 patients had been treated with aluminium hydroxide. Bone histomorphometry, aluminium labelling intensity, osteoid surface aluminium labelling extent (Al/OBI) and bone aluminium concentration were measured. 14 patients had significant bone aluminium deposition, including 2 who were not on dialysis of whom 1 had not received aluminium hydroxide. Bone aluminium concentration and labelling intensity were correlated to total aluminium hydroxide consumption (p < 0.001, p < 0.05) and present dose (p < 0.01, p < 0.01), while Al/OBI was not. The two patients with the highest aluminium concentrations had symptomatic osteomalacia, but 4 patients with significantly raised concentrations and mineralisation front labelling had secondary hyperparathyroidism. It is concluded that (1) bone aluminium deposition occurs despite the use of aluminium-free dialysate and is associated with total and present aluminium hydroxide consumption; (2) heavy aluminium deposition is associated with severe and symptomatic osteomalacia, but can also be observed in the presence of predominant hyperparathyroidism; (3) aluminium deposition can occur in the absence of treatment with dialysis or aluminium hydroxide; (4) bone aluminium concentration and labelling intensity are a better measure of bone deposition than Al/OBI.

ISSN:1660-8151    

DOI:10.1159/000183669

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In treating patients with end-stage renal disease, the dialyzer may be used on multiple occasions rather than once. Long-term effects of this practice are unknown. We report 259 and 1,059 successive patients from facilities practicing reuse in Cincinnati and Detroit, followed, respectively, for 535 and 2,209 patient years. The morbidity was relatively low, expressed by the number of hospital admissions (1.63 and 2.19/year) and by days in hospital (14.24 and 22.71/year), respectively. In Cincinnati the unadjusted case fatality rate was 70% of that in the Ohio Valley Renal Disease Network, in Detroit it was 96% of that in the Michigan Renal Network. There were no adverse long-term effects of multiple use of dialyzers.

ISSN:1660-8151    

DOI:10.1159/000183670

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Renal biopsy specimens from 39 patients with rheumatoid arthritis and clinical signs of renal disease disclosed a mild mesangial glomerulopathy in more than 1 in 4 cases. Almost all patients had deposits of immunoglobulin and complement in the mesangial lesions. This type of glomerulopathy was the most common cause of hematuria and was also frequently encountered in proteinuric patients. Clinically it was not possible to distinguish between mesangial and membranous nephropathy.

ISSN:1660-8151    

DOI:10.1159/000183671

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The serum concentrations of calcium, phosphorus, parathyroid hormone, vitamin D3 metabolites and their transport protein (DBP) were measured in 18 patients with the nephrotic syndrome (mean daily proteinuria 8.8 g). The glomerular filtration rate was normal in 13 patients while the remaining 5 had a mild degree of renal failure. The serum concentrations of total protein, albumin and DBP were significantly decreased in patients with the nephrotic syndrome. The serum calcium concentration was decreased but the calculated ionized calcium concentration remained normal. The serum concentrations of 25-hydroxycholecalciferol (5.3 ± 3.1 μg/l) and 1,25-dihydroxycholecalciferol [1,25-(OH)2D3 (20 ± 12 ng/l)] were significantly lower in patients with the nephrotic syndrome and normal glomerular filtration rates than in normal controls (14.4 ± 4 μg/l and 42 ± 13 ng/l, respectively). The free 1,25-(OH)2D3 index was also significantly below normal (0.9 ± 0.4 vs. 1.8 ± 0.4). Total and free 1,25-(OH)2D3 were still further reduced in patients with mild renal failure. The nephrotic syndrome thus results in mild vitamin D depletion with decreased free 1,25-(OH)2D3 concentrations but generally without secondary hyperparathy

ISSN:1660-8151    

DOI:10.1159/000183672

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The protein selectivity index was measured in 68 patients (53 males, 15 females) with proteinuria due to IgA nephropathy to determine whether it bore any relationship to other clinical and pathological features of known prognostic significance. The mean age of the patients was 25 ± 8 years with a follow-up period of 42 + 35 months. Forty-six presented with asymptomatic haematuria and proteinuria, 17 with macroscopic haematuria and 5 with the nephrotic syndrome. Twenty-three (34%) patients had selective proteinuria and 45 (66%) had non-selective proteinuria. Patients with non-selective proteinuria had more glomerulosclerosis (29% ± 20 vs. 16% ± 20, p < 0.02), higher serum creatinine (1.47 mg/dl ± 0.70 vs. 1.17 mg/dl ± 0.33, p < 0.02), lower creatinine clearance (79 ml/min ± 28 vs. 95 ml/min ± 25, p < 0.02), and higher incidence of hypertension (χ2 = 3.84, p < 0.05) when compared to those with selective proteinuria. The protein selectivity was measured at the end of the study. Of the 5 patients with the nephrotic syndrome, 1 had poorly selective proteinuria and failed to remit and 4 had highly selective proteinuria who either remitted spontaneously (1 patient) or with treatment (3 patients). The results suggest that patients with IgA nephropathy and poorly selective proteinuria are more likely to have other features indicating a poor prognosis such as glomerulosclerosis, renal impairment and hyper

ISSN:1660-8151    

DOI:10.1159/000183673

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The sequential changes of cell morphology and the ratio distribution of the different types of cells which exist in tubular cysts induced by methylprednisolone acetate have been studied by light, transmission and scanning electron microscopy. We have also studied the blood levels of sodium and potassium by flame photometry. In both control and cystic ducts, at the level of the outer cortex, the first intercalated cells (IC) were not observed until the 4th postnatal day. Some intermediate cell configurations were observed during the 3rd postnatal day, suggesting that some primitive principal cells (PC) are transformed into IC. Development of IC seems to be independent of both the effects of corticoids and the blood levels of potassium. The ratio distribution and the types of IC observed throughout the period studied was similar in both normal and cystic ducts. The type of IC characterized by the presence of a huge apical process, which has gone previously undescribed with either TEM or SEM, was observed in both control and cystic ducts. We propose to name these cells as cells with surface pattern type V. During the period of regression of the tubular cysts dead and migrating cells were observed closely associated with cilia of the PC. Both types of cells do not seem to represent, based in their localization and frequency, abnormall cell types of the cyst wall. Our results support the hypothesis that renal cysts are giant collecting ducts which conserve both the morphology and the function of the epithelium.

ISSN:1660-8151    

DOI:10.1159/000183674

出版商:S. Karger AG    

年代:1986

数据来源: Karger