摘要:

The effects of long-term low protein diet on albumin metabolism of uremic patients were evaluated. Studies were performed on 62 patients divided into two groups depending on the duration of the diet (35 subjects from 6 to 30 days, 27 subjects from 6 months to 5 years). All patients received a diet containing at least 20 g of high biological value proteins per day. Albumin catabolism and distribution were measured by the two-tracer technique, after simultaneous i.v. injection of 131I-human serum albumin and of free 125I-iodide. Albumin synthesis was directly determined in 10 patients by two tracers, 14C-carbonate and 131I-albumin, according to the xanthydrol technique for specific activities of urea and albumin guanido carbon in plasma. The main features of albumin metabolism observed in both groups studied were: normal intravascular albumin mass, marked reduction of extravascular and total albumin pools, with proportionally reduced catabolism. No significant turnover difference was found between the first group and the patients on diet from 0.5 to 5 years, thus suggesting that dietary treatment per se is not responsible for the albumin depletion observed in chronic uremia.

ISSN:1660-8151    

DOI:10.1159/000180524

出版商:S. Karger AG    

年代:1975

数据来源: Karger

摘要:

The cardiovascular responses to the Valsalva manoeuvre and sustained handgrip were measured in 26 patients with chronic renal failure treated with intermittent haemodialysis. Twelve (50%) had an abnormal Valsalva response and ten (45%) had an abnormal handgrip response. There was a reduction in the beat-to-beat variation of heart rate at rest in those patients who had abnormal Valsalva manoeuvres, independent of age or the resting heart rate. It is concluded that autonomic nerve fibres may be damaged in patients with chronic renal failure on intermittent haemodialysis in the absence of symptoms of autonomic neuropathy. These studies suggest three simple ways of testing autonomic function in haemodialysis patients which could routinely be performed to detect patients at risk of developing an abnormal reaction to volume depletion during haemodialysis.

ISSN:1660-8151    

DOI:10.1159/000180525

出版商:S. Karger AG    

年代:1975

数据来源: Karger

摘要:

Since 1969 four leg fistulae and 14 arm fistulae using the saphenous vein have been constructed in chronic haemodialysis patients. The operative procedures are described and the results show that these fistulae are an excellent alternative when the construction of Cimino-Brescia fistulae becomes impossible. Of the 14 arm fistulae, nine are still patent and in use, three have thrombosed and two patients have died of unrelated causes with the fistulae intact.

ISSN:1660-8151    

DOI:10.1159/000180526

出版商:S. Karger AG    

年代:1975

数据来源: Karger

摘要:

To determine the effect of changing concentrations of uremic metabolites on factors affecting oxygen transport, without the effects of extracorporeal blood pumping, we studied five patients before, during and after peritoneal dialysis. Significant decreases in serum urea, creatinine and phosphate and increase in serum bicarbonate were not associated with changes in P50, a reflection of hemoglobin-oxygen affinity. High erythrocyte 2,3-DPG concentrations decreased only slightly. Arterial pO2 increased slightly as negative fluid balance was achieved. The slight changes in oxygen transport parameters with dialysis suggest an interplay of compensatory factors and do not warrant modifying dialysis to limit the correction of acidosis or hyperphosphatemia. Effects on hemoglobin and pO2 resulting from fluid loss can be the dominant influence of peritoneal dialysis on tissue oxygenation.

ISSN:1660-8151    

DOI:10.1159/000180527

出版商:S. Karger AG    

年代:1975

数据来源: Karger

摘要:

Chronic pyelonephritis, especially that caused by the most common invader E. coli, corresponding satisfactorily to the pathophysiology of the human disease is difficult to reproduce. We have developed a pattern of infection with which we succeeded reliably in producing a chronic E. coli pyelonephritis. This was achieved by inserting a plastic catheter into the renal pelvis. A suspension of E. coli was injected via the catheter into the renal pelvis of 32 rabbits. This pattern of infection takes a chronic progressive course and, in all cases, results in typical macroscopic and histological changes in the kidney. The bacterial excretion in the urine remains unchanged over a period of months. With the experimental procedure described, the pathogenesis and pathophysiology of chronic E. coli pyelonephritis can be clearly studied. Drugs currently used on patients can be tested for their effectiveness in long-term application.

ISSN:1660-8151    

DOI:10.1159/000180528

出版商:S. Karger AG    

年代:1975

数据来源: Karger

摘要:

29 cadaveric renal transplant recipients were assessed clinically for evidence of occlusive arterial disease prior to undergoing blood viscosity studies. Nineteen patients had manifest arterial disease (myocardial infarction, cerebral thrombosis, angina, intermittent claudication, absent peripheral pulses), while ten were free from vascular complications. Patients with arterial disease showed significant elevations of plasma viscosity (p < 0.005), aggregation of red cells measured both at 37 and 20°C (p < 0.05), fibrinogen (p < 0.005), serum triglyceride (p < 0.01), serum cholesterol (p < 0.01), erythrocyte sedimentation rate (p < 0.02), and a significant reduction in the albumin/fibrinogen ratio (p < 0.005) when compared with those free of disease. Two patients with no apparent vascular disease when investigated were found to have distinctly abnormal blood viscosity factors, and one subsequently developed retinal arterial thrombosis while the other suffered serious damage of the graft within 3 months of viscosity study. When all patients were considered together, significant correlations were found between viscosity of artificial thrombi or aggregation of red cells and fibrinogen level (both p < 0.05), and serum triglyceride level (both p < 0.05); and between rigidity of red cells and the parathyroid hormone level (p < 0.01)

ISSN:1660-8151    

DOI:10.1159/000180529

出版商:S. Karger AG    

年代:1975

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180530

出版商:S. Karger AG    

年代:1975

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180531

出版商:S. Karger AG    

年代:1975

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180532

出版商:S. Karger AG    

年代:1975

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180523

出版商:S. Karger AG    

年代:1975

数据来源: Karger