ISSN:1660-8151    

DOI:10.1159/000184884

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000184885

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and humoral factors were simultaneously examined before and after a 50-gram oral protein load in 12 healthy controls and 12 nephrotic patients. The protein load led to rises in GFR with unchanged filtration fraction in both groups although the rate of increase in GFR was greater in the former. The levels of blood urea nitrogen, serum osmotic pressure, plasma glucagon and serum insulin, but not plasma angiotensin II, were significantly elevated following the protein load. The increase in GFR after the protein load appears to be mainly caused by increased ERPF and afferent arteriolar vasodilation.

ISSN:1660-8151    

DOI:10.1159/000184886

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

To determine the prevalence of left ventricular hypertrophy (LVH; left ventricular wall thickness > 1–2 cm in diastole) among end-stage renal disease (ESRD) patients and the most important risk factors that independently relate to LVH, 189 non-diabetic ESRD patients without dilated cardiomyopathy in two centres had echocardiography and full clinical review. 104 of 189 (55%) patients had LVH consisting of 52 of 83 (65%) patients on haemodialysis, 18 of 20 (90%) peritoneal dialysis patients and 34 of 86 (40%) transplanted patients. Using multiple logistic regression, the most important factors which independently related to LVH, in all patients studied, were dialysis as current ESRD treatment (p 1.4 cm), a high serum alkaline phosphatase level was the best predictor of LVH (p < 0.001), followed by high diastolic blood pressure (p = 0.004) and age (p = 0.02). In dialysis patients, the most important variables were age (p = 0.009) and high serum alkaline phosphatase (p = 0.03). In the transplant group, patients with LVH were taking significantly more antihypertensive medications than those without LVH (p = 0.002). This variable was the only predictor of LVH in the transplant group. It is concluded that the most important factors associated with LVH in ESRD are age, hypertension, hyperparathyroidism and some factors associated with dialysis treatment, which are not functioning vascular access, anaemia or high serum creatinine. Hyperparathyroidism may be particularly important in the pathogenesis of severe LV

ISSN:1660-8151    

DOI:10.1159/000184887

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Experiments were conducted which revealed the renal transport mechanism(s) of oxypurines by employing uricosuric agents and pyrazinamide. All specimens being drawn from healthy, normal subjects, the data showed that probenecid increased fractional uric acid, fractional hypoxanthine and fractional xanthine clearance, 3.97-, 1.52- and 2.31-fold, respectively, while benzbromarone increased fractional uric acid clearance 2.11-fold, decreased fractional xanthine clearance 0.48-fold and had no effect on fractional hypoxanthine clearance. In addition, pyrazinamide decreased both fractional uric acid clearance 0.35-fold and fractional xanthine clearance 0.44-fold but increased fractional hypoxanthine clearance 1.49-fold. These results suggest the possibility of differing renal transport mechanisms among the purine bases, uric acid, hypoxanthine and xanthine.

ISSN:1660-8151    

DOI:10.1159/000184888

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Scleroderma renal crisis (SRC) is defined as sudden development of accelerated hypertension, hyperreninemia, and acute renal failure in a patient with progressive systemic sclerosis (PSS). Although the diagnosis of PSS is generally straightforward because of dermal fibrosis, we report 2 patients who had PSS with SRC without the characteristic fibrotic skin changes of scleroderma. PSS should be considered in the differential diagnosis of unexplained acute renal failure and accelerated hypertension even though the cutaneous fibrotic manifestations of the disease may be absent.

ISSN:1660-8151    

DOI:10.1159/000184889

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A number of recent studies of long-term kidney donors have reviewed glomerular function and blood pressure. Little attention has been paid to the potentially damaging effects of compensatory hyperfiltration on renal tubular cells after donor nephrectomy. The urinary excretion of high-molecular-weight enzymes is a sensitive indicator of renal tubular cell damage. This study compares the urinary excretion of four enzymes (alanine aminopeptidase, alkaline phosphatase, N-acetyl-β-D-glucosaminidase, and lactate dehydrogenase) in a group of 77 subjects who had undergone unilateral nephrectomy up to 21 years previously with 52 healthy non-nephrectomized controls. The urinary excretion for all four enzymes by the remaining kidney after contralateral nephrectomy in the kidney donors was significantly greater than the enzyme excretion per single kidney in the control group (p < 0.001). No correlation was found between the degree of enzymuria and either glomerular filtration rate or time since nephrectomy. The elevated activity of urinary enzymes in kidney donors may be related to increased metabolism by the renal tubular cells after contralateral nephrectomy. This study suggests that long-term compensatory hyperfiltration does not damage tubular cells, at least over this time scale

ISSN:1660-8151    

DOI:10.1159/000184890

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Very recently it was reported that the amyloid associated with chronic hemodialysis contains, as a major component, a new form of amyloid fibril protein which is homologous to β2-microglobulin. As β2-microglobulin has a molecular weight of 11,600 daltons, investigations were carried out to see whether or not this protein would be handled differently by hemodialysis and hemofiltration, because the latter method especially is capable of eliminating solutes with such a high molecular weight. The results clearly indicate that hemofiltration removes substantial amounts of β2-microglobulin (about 190 mg per treatment, which represents 80% of daily production). It remains to be clarified whether or not hemofiltration is therefore superior to hemodialysis with regard to amyloid deposit formati

ISSN:1660-8151    

DOI:10.1159/000184891

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In rhabdomyolysis-related acute renal failure evidence of patchy renal vasoconstriction during the recovery phase was obtained by abdominal CT scan, which showed a wedge-shaped high-density area in the kidney.

ISSN:1660-8151    

DOI:10.1159/000184892

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Exposure to paraquat was followed 1 week later by mild respiratory distress in a previously healthy farmer who developed a mixed nephrotic/nephritic syndrome 3 months later. Percutaneous renal biopsy showed endo-extra-capillary proliferative glomerulonephritis associated with a linear pattern of IgG deposits along the glomerular capillary wall. This is the first case report of an association between exposure to a low dose of paraquat (as suggested by the mildness of the respiratory symptoms) and development of glomerulonephritis, possibly related to the occurrence of anti-glomerular basement membrane antibodies. The possibility is suggested that immune-mediated mechanisms of glomerular damage may be triggered by exposure to low-dose paraquat.

ISSN:1660-8151    

DOI:10.1159/000184893

出版商:S. Karger AG    

年代:1988

数据来源: Karger