摘要:

In this report, we describe the development of renal function impairment in a 33-year-old patient with mesangial IgA nephropathy and a history of recent gout. Increased body lead burden was identified with a positive EDTA mobilization test. The patient was treated with 1 g of edetate disodium calcium weekly for 2 months until normalization of urinary lead excretion. Improvement of renal function and proteinuria were noted. It was even more interesting to find that both immunofluorescence and electron microscopy studies of the second biopsy specimen revealed the loss of previous mesangial immune deposits. Our case demonstrated that lead may be a nonspecifically damaging factor related to the deterioration of renal function in patients with preexisting renal disease. Moreover, the disappearance of mesangial immune deposits after chelation therapy has not been previously documented. The pathogenetic basis of this observation is unknown, and its causal relationship with lead requires further elucidation.

ISSN:0250-8095    

DOI:10.1159/000168498

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We report a patient with nondiabetic end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) associated with chronic hypovolemia. Despite the administration of nilvadipine, the patient showed accelerated hypertension and concomitantly orthostatic hypotension. Plasma renin activity was markedly high, and blockade of angiotensin II action by captopril or an angiotension II antagonist decreased the supine blood pressure. This indicated that the enhanced activity of the renin-angiotensin system was the principal cause of the supine hypertension. The plasma concentration of norepinephrine was also very high. After correction of hypovolemia by blood transfusion, the enhancement of the renin-angiotensin system and high plasma norepinephrine level were reduced, and symptomatic orthostatic hypotension disappeared. The accelerated hypertension was easily controlled by the administration of low-dose captopril and nilvadipine. These findings suggest that chronic hypovolemia related to the intractable supine hypertension as well as orthostatic hypotension. Hypovolemia-induced enhancement of the renin-angiotensin system and sympathetic nerve activity may cause vasoconstrictive hypertension in patients on CAPD.

ISSN:0250-8095    

DOI:10.1159/000168499

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A 14-year-old boy presented with fever, anemia, hepatosplenomegaly, generalized lymphadenopathy and nephrotic syndrome. Lymph node biopsy showed angiofollicular lymph node hyperplasia (generalized Castleman’s disease) of the plasma cell type. Kidney biopsy showed membranoproliferative glomerulonephritis type 1. Complete remission was achieved with corticosteroid treatment and repeat kidney biopsy 22 months later showed complete resolution of the renal pathology. The association between membranoproliferative glomerulonephritis and multicentric angiofollicular lymph node hyperplasia, plasma cell type, has not previously been reporte

ISSN:0250-8095    

DOI:10.1159/000168500

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We present an 18-year-old patient who has been on renal replacement therapy since the age of 11. He had growth retardation and delayed puberty, with a bone age of 13.6 years. Treatment with human recombinant growth hormone (rhGH) resulted in a clearcut increase in height and lean body mass. We emphasize that rhGH treatment could be tried even at a postpediatric age, provided bone radiology suggests that further growth is possible.

ISSN:0250-8095    

DOI:10.1159/000168501

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168502

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168503

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168504

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168505

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168506

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168487

出版商:S. Karger AG    

年代:1992

数据来源: Karger