ISSN:1660-8151    

DOI:10.1159/000183121

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A double-blind, randomized trial was conducted to compare the efficacy and safety of two doses of methylprednisolone (MP) in reversing acute rejection episodes in renal allograft recipients. 18 subjects were randomized to receive either 250 mg (group 1) or 1,000 mg (group 2) MP daily for 4 days. The two groups were similar with regard to HLA matching, number of cadaveric grafts, number of second transplants, and transfusion history. 6 of 10 patients in group 1 and 4 of 8 in group 2 responded to treatment with MP, i. e., serum creatinine returned to baseline. 1-year follow-up has demonstrated a similar graft survival, 70% in group 1 and 50% in group 2. There were no significant differences in mortality, infectious complications, blood glucose, and blood pressure between the two groups. We conclude that (1) 250 mg MP is as effective as 1,000 mg in reversing acute rejection in renal allografts; (2) 1,000 mg MP does not result in a greater incidence of adverse effects, and (3) 250 mg MP does not adversely affect 1-year graft survival.

ISSN:1660-8151    

DOI:10.1159/000183122

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

20 patients with systemic lupus erythematosus undergoing renal biopsies had their tubular function assessed by maximal concentrating ability, maximal urinary acidification and fractional urinary excretion of β2-microglobulin. 80% of patients showed disturbances in one or more of the parameters tested with fractional β2-microglobulin excretion being most frequently abnormal. No correlation was found between the histological changes and functional disturbance

ISSN:1660-8151    

DOI:10.1159/000183123

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The effect of cimetidine on basal and histamine-induced PTH secretion was tested using single cell suspensions obtained from (a) primary parathyroid adenomas, and (b) secondary hyperplastic parathyroid tissue from patients undergoing chronic hemodialysis. The histamine-stimulated hormone secretion was dose-dependent. Cimetidine suppressed both basal and histamine-stimulated hormone secretion. Within the therapeutic range the suppressive effect was identical for adenoma and hyperplasia. Both adenomata and secondary hyperplastic glands showed a histamine H2-receptor-related response. The role of histamine in the pathogenesis of hyperparathyroidism is not quite clear so that the possible benefits of cimetidine for medical treatment of primary and secondary hyperparathyroidism will have to be proven by careful clinical trials.

ISSN:1660-8151    

DOI:10.1159/000183124

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

44 patients receiving regular hemodialysis therapy were investigated using M-mode echocardiography and systolic time intervals to examine the effects of parathyroid hormone (PTH) and vitamin D on left ventricular function. 12 patients were treated with 1 µg daily of 1α-hydroxycholecalciferol for 6 weeks, which produced a decrease in plasma PTH concentration from 1,883 ± 226 to 1,123 ± 289 ng/l. Fractional fibre shortening (FS) increased from 34.6 to 37.6% (p < 0.025) and mean velocity of fibre shortening (Vcf) increased from 1.21 to 1.32 circ/s (p < 0.01). A second group of 20 patients was studied before and after the plasma magnesium concentration was increased from 1.25 to 1.70 mmol/l, resulting in a fall in plasma PTH concentration from 546 to 418 ng/l (p < 0.001). This was associated with an increase in both FS from 32.4 to 34.3%, and Vcf from 1.19 to 1.21 circ/s. A third group of 6 patients with severe hyperparathyroidism underwent total parathyroidectomy, FS increased from 34.9 to 36.3% and Vcf increased from 1.22 to 1.38 circ/s. In conclusion, our results indicate that vitamin D and PTH do influence left ventricular function in uremic patients on chronic hemodialysis, and that a reduction in plasma PTH levels is beneficial to the uremic he

ISSN:1660-8151    

DOI:10.1159/000183125

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The clinical course of 123 pregnancies in 86 patients with biopsy-proven glomerular diseases have been studied. In 35 women the onset of nephropathy occurred during pregnancy. No complications were observed in more than half of the pregnancies. In the others, one third of the complications were obstetrical or fetal accidents, one third were renal manifestations (hypertension or deterioration of renal function) and one third were both causes. The lowest incidence of complications was observed in patients with membranous nephropathy and the highest in membranoproliferative glomerulonephritis patients. There were 6 spontaneous late abortion, 6 stillbirths and 5 neonatal deaths. 17 deliveries were preterm and 7 fetuses were small for gestational age. Hypertension appeared in 24 pregnancies, in 13 of which it was reversible and related to superimposed preeclampsia and in 11 it persisted after delivery (5 of these 11 pregnancies were in patients with IgA nephropathy). Renal function deteriorated in 10 cases during pregnancy. The deterioration was reversible in 6 and progressive in 4 (2 of whom had membranoproliferative glomerulonephritis). It is suggested that in most patients pregnancy does not change the natural history of glomerular disease.

ISSN:1660-8151    

DOI:10.1159/000183126

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

In 48 patients on maintenance haemodialysis (HD), serum ferritin (SF) levels were measured and compared with ‘haemochromatosis alleles’, (HA), HLA A3, B7 and B14. A positive correlation was found between high SF levels and the presence of HA. When patients who had received 10 or fewer blood transfusions were studied, it was observed that this correlation did not exist, but it was evident, however, in patients who had received more than 10 blood transfusions. After 14 months in which blood transfusions were restricted, no significant difference in SF was observed between HA carriers and the rest. Our findings suggest that repeated blood transfusions can cause high SF in HD patients, especially in those with HLA A3, B7 or B14 antigens. Among our patients, restriction of blood transfusions seems sufficient to decrease high SF lev

ISSN:1660-8151    

DOI:10.1159/000183127

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We measured peritoneal losses of the active vitamin D metabolites 1,25(OH)2D3 and 24,25(OH)2D3 in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The serum concentration of 24,25(OH)2D3 was considerably lower than in hemodialysis patients. The serum concentration of 1,25(OH)2D3 was undetectable and rose to levels similar to those in hemodialysis patients only after loading with much higher oral doses of 1-α-vitamin D3 than those received by hemodialysis patients. Losses of both metabolites in peritoneal fluid were considerable, averaging approximately 6–8% of the plasma pool per day. These losses lead to low serum levels of these active vitamin D metabolites in CAPD patients, which may be an important factor in exacerbating renal osteodystrophy. Our results indicate the need for increased replacement doses of vitamin D metabolites in CAPD patien

ISSN:1660-8151    

DOI:10.1159/000183128

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A 36-year-old man with Behçet’s disease developed nephrotic syndrome and chronic renal failure. The renal biopsy confirmed renal amyloidosis, and the potassium permanganate staining indicated that the amyloid was of the AA protein type. To our knowledge, this is the first report of Behçet’s disease with amyloidosis and chronic renal failure in maintenance hemodia

ISSN:1660-8151    

DOI:10.1159/000183129

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

By univariate analysis of patients with membranous nephropathy, terminal renal failure was associated with male sex, a large amount of proteinuria, low serum albumin concentration, low creatinine clearance rate, high serum creatinine concentration, and high systolic blood pressure, but was not associated with age or prednisone treatment. In a multivariate life table analysis that controlled for all these factors simultaneously, the risk of developing terminal renal failure was significantly independently associated only with sex, serum albumin concentration, and prednisone treatment, being higher in men, lower in those treated with prednisone, and inversely related to serum albumin. Except for the minimal electron-dense deposition, the electron microscopic findings had no predictive value.

ISSN:1660-8151    

DOI:10.1159/000183130

出版商:S. Karger AG    

年代:1984

数据来源: Karger