ISSN:1660-8151    

DOI:10.1159/000183708

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Renal silicon handling was investigated in 23 healthy adults using electrothermal atomic absorption techniques. The mean urinary silicon excretion was 33.1 ± 3.85 mg/day; the mean renal silicon clearance was 88.6 ± 7.94 ml/min; the mean fractional excretion of silicon was 86.35 ± 8.1%, and the mean urine silicon concentration was 0.265 µg/ml. Using multiple correlation analysis, the urinary silicon was found to be highly significantly correlated with the urine magnesium concentration (p < 0.001) and also with urinary sodium and urinary osmolality (p < 0.01). 24-hour urinary silicon excretion was highly significantly correlated with fractional excretion of silicon (p < 0.001), sodium (p < 0.001), phosphorus (p < 0.001), magnesium (p < 0.001), and osmolar load. In split urine studies in 7 subjects urinary silicon was correlated highly significantly with urinary magnesium in all 7 and with urinary osmolality, urine calcium, and urine creatine concentration in 6 of 7. There was a highly significant correlation between renal silicon clearance and fractional excretion of silicon (p < 0.0005), with magnesium excretion (p < 0.01), and with sodium excretion. It is suggested that ion pairing of orthosilicate and magnesium may explain some of these urinary findi

ISSN:1660-8151    

DOI:10.1159/000183709

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A clinical study was performed in 2 groups of patients with solitary kidneys, followed for 11–146 months. Group 1 had 9 patients (7 males and 2 females, aged between 23 and 68 years) with unilateral renal agenesis. Group 2 had 13 patients (9 females and 4 males, aged between 27 and 70 years) who underwent unilateral nephrectomy for the following reasons: hydronephrosis secondary to ureteropelvic junction stenosis, 7 patients; renal trauma, 4 patients; benign neoplasia, 2 patients. During the follow up, urinary protein excretion of more than 300 mg/day was observed in 9 patients, 3 in group 1 and 6 in group 2. Eleven patients, 8 in group 1 and 3 in group 2, were hypertensive (diastolic blood pressure higher than 95 mm Hg). Hyperuricemia was observed in 14 patients, 10 in group 1 and 4 in group 2. Seven patients, 4 in group 1 and 3 in group 2, had a significant deterioration of renal function. Neither proteinuria nor renal failuure were observed before at least 10 years had elapsed since the anatomic condition of solitary kidney had been established. A surgical renal biopsy was performed in 1 patient with unilateral renal agenesis and showed focal glomerular sclerosis. This study adds support to the view that the reduction of 50% of the renal tissue may be a risky situation in humans as well as in animal

ISSN:1660-8151    

DOI:10.1159/000183710

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A technique of delayed-type hypersensitivity (DTH) skin reaction to a contact sensitizing agent, oxazolone, was used to assess the effects of uremia on cell-mediated immunity in chronically uremic mice and, for comparison, sham-operated and normal controls. The first objective was to establish that DTH responses are reduced in animals with renal failure. To do this, mice were made uremic by a combination of electrocoagulation of the entire surface of one kidney and subsequent contralateral nephrectomy; studies included biochemical and hematological evaluation using blood urea nitrogen level and hemoglobin concentration as routine indices to assess the degree and consequence of uremia, respectively. The second objective was to apply the technique to observe and compare changes during uremic states of varying severity and duration. A modest, although significant, decrease in both the induction and maintenance of DTH responses was observed in the mice with severe renal failure only (BUN above l00mg/dl). This immunosuppressive effect was manifest early and persisted unchanged throughout the entire observation period (3–9 weeks). This study presents new evidence that severe uremia readily produces in the mouse sustained, albeit mild, changes in cell-mediated immunity. Furthermore the ability to elicit DTH skin reaction in the chronically uremic mouse offers a versatile system for studying changes in cell-mediated immunity occurring during uremia with a broad range of potential applicabilit

ISSN:1660-8151    

DOI:10.1159/000183711

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Amyloid bone lesions were found in 2 chronic hemodialysis patients presenting with pathologic hip fractures. These amyloid deposits were noted as lytic defects on plain skeletal radiographs. No evidence for disseminated amyloidosis was discovered on physical examination, skin biopsy, or bone marrow biopsy. Myeloma, other plasma cell dyscrasia, and preceding chronic inflammatory states were not found in either patient. The amyloid deposits had staining characteristics suggestive of secondary amyloid based on the potassium permanganate reaction. Isolated amyloid bone deposits should be included in the differential diagnosis of lytic bone lesions or pathologic fractures in chronic dialysis patients.

ISSN:1660-8151    

DOI:10.1159/000183712

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The possible relationship between platelet dysfunction and secondary hyperparathyroidism (HPT) in chronic renal failure was examined in 23 uremic patients on conservative therapy (group I) and in 27 patients on maintenance hemodialysis (group II). Platelet function was assessed by measuring the degree of aggregation in response to various concentrations of adenosine diphosphate. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (x-ray films of the hand skeleton). This study showed impaired platelet aggregation in group I patients, compared to either group II patients or controls. There were no significant differences when group II patients were compared to controls. No significant correlations between platelet aggregation and the hematochemical changes associated with secondary HPT were found. No differences in platelet aggregation were found with regard to the activity (alkaline phosphatase) and the severity (x-ray findings) of secondary HPT. Effective treatment of secondary HPT with 1,25-dihydroxycholecalciferol in both group I and group II patients was not associated with consequent changes in platelet aggregation. It is concluded that secondary HPT is probably not a major factor in the pathogenesis of platelet dysfunction in chronic renal failure.

ISSN:1660-8151    

DOI:10.1159/000183713

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The number of peripheral blood mononuclear cells (PBMC) producing IgA, IgG and IgM spontaneously, after in vitro polyclonal stimulation with pokeweed mitogen (PWM) and in response to autologous mixed lymphocyte reaction (AMLR), were determined by a protein A hemolytic plaque assay in 23 patients with IgA nephropathy confirmed by renal biopsies and in 24 normal controls. The geometric mean of circulating IgA-producing cells in Berger’s disease (689 ± 1.73 cells/106 PBMC) was increased when compared with the normal controls (332× 1.52 cells/106 PBMC; p < 0.001). To a lesser degree, there was also an increase in the number of IgG-secreting cells (98 ± 3.97 cells/106 PBMC vs. 38 ± 2.90 cells/106 PBMC; p < 0.05). After PWM stimulation, although the number of IgA-producing cells was increased in patients with IgA nephropathy, no significant differences were observed between the 2 groups. In response to AMLR, the number of IgA-secreting cells was significantly higher in the cases with Berger’s disease (1,979 ± 1.76 cells/106 non-T cells vs. 783 ± 1.95 cells/106 non-T cells; p < 0.001). Although it did not reach statistical significance, the patient group had also an increase in the number of IgG-producing cells (884 ± 2.64 cells/106 non-T cells vs. 317 ± 5.05 cells/106 non-T cells). These data support the existence of some abnormalities in the mechanisms regulating the synthesis of IgA in Berger’s disease which might contribute to its

ISSN:1660-8151    

DOI:10.1159/000183714

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

To distinguish amphotericin B effects on peritoneal transport from those of the solvent, sodium desoxycholate, dialyses in intact rabbits with either substance added intraperitoneally were compared to controls. Powdered amphotericin B added to instilled dialysis fluid increased peritoneal ultrafiltration from 0.31 to 0.44 ml/kg/ min (p < 0.02), but did not affect mass transport (e.g. urea clearance changed from 0.86 to 1.04 ml/kg/min). In contrast, 10 mg of desoxycholate induced peritoneal irritation and raised clearances of urea (0.76–1.34 ml/kg/min), potassium, phosphate and dextrose, but did not affect ultrafiltration. Intraperitoneally, 1 mg/kg of desoxycholate changed clearances inconsistently, but lowered the ultrafiltration rate from 0.33 to 0.21 ml/kg/min. The dialysate-plasma dextrose gradient dissipated faster with 10 mg/kg of desoxycholate. Amphotericin B tended to raise ultrafiltration per osmotic gradient and mass transport of sodium. Selective increase in fluid flux results from amphotericin B, not its solven

ISSN:1660-8151    

DOI:10.1159/000183715

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Serum ferritin levels were measured in 57 patients on maintenance haemodialysis to determine if patients who possessed 1 or more of the histocompatibility antigens associated with idiopathic haemochromatosis (HLA A3, B7 or B14) were at increased risk of iron overload. There was no significant difference in the mean serum ferritin levels between those patients with HLA A3, B7 or B14 (357.9 + 522.6 ng/l; n = 19) and those without these antigens (393.7 + 556.2 ng/l; n = 38). Iron overload in haemodialysis patients is not a histocompatibility-linked disorder.

ISSN:1660-8151    

DOI:10.1159/000183716

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Renal biopsies were obtained from 164 patients with diabetes mellitus. Their histological changes were evaluated together with clinical findings and prognosis. In 36 patients, various types of glomerulonephritis were complicated: mesangial proliferative glomerulonephritis (17 patients), membranous glomerulonephritis (8), endocapillary proliferative glomerulonephritis (5), membranoproliferative glomerulonephritis (4) and minimal change nephrotic syndrome (2). Superimposed glomerulonephritis was suspected in diabetic patients with a short history of less than 5 years, persistent proteinuria, occasional hematuria and no retinopathy. They may, however, produce little effects on the long-term prognosis of diabetic patients except membranoproliferative glomerulonephritis.

ISSN:1660-8151    

DOI:10.1159/000183717

出版商:S. Karger AG    

年代:1986

数据来源: Karger