ISSN:0250-8095    

DOI:10.1159/000168625

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

α-Tocopherol is transferred from serum to erythrocytes by high-density lipoproteins (HDL). We have studied total serum, HDL and erythrocyte tocopherol concentration in uremic patients on hemodialysis (HD; n = 18) and continuous ambulatory peritoneal dialysis (CAPD; n = 14), and the relationship between HDL and erythrocyte tocopherol content. Serum and erythrocyte tocopherol were determined by high-performance liquid chromatography. Serum tocopherol levels were higher in CAPD patients (p < 0.05) than in control (n = 30) and HD groups. Erythrocyte tocopherol was lower in HD patients than in the controls but there were no differences between CAPD patients and the control group. Bioavailable tocopherol was found to be normal in both HD and CAPD patients. HDL-tocopherol was lower in both HD and CAPD groups, but probably enough to reach a normal level of tocopherol in erythrocytes, as has been demonstrated in CAPD patients. So, although a defect in the transfer of tocopherol to red blood cells is possible, some other causes could influence it too, as a greater antioxidant consumption in HD patients

ISSN:0250-8095    

DOI:10.1159/000168626

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Serum levels of soluble interleukin-2 receptors (IL2R) and of β2-microglobulin (β2M) were studied with the immunoenzymatic technique in 38 patients with primary glomerulonephritis (GN), in 10 patients with essential hypertension (EH) and in 30 healthy subjects. IL2R correlated with β2M (p < 0.05). IL2R and p2M were higher in patients with GN (p < 0.003, p < 0.001, respectively) and in patients with EH (p < 0.003, p < 0.01, respectively) than in healthy subjects. IL2R and β2M correlated with serum creatinine, but not with proteinuria. Our data would suggest the existence of lymphocyte activation in patients with GN. Only speculations can be advanced with regard to the observed increase in these parameters in EH patie

ISSN:0250-8095    

DOI:10.1159/000168627

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The short- and long-term effect of felodipine on renal perfusion and tubular function was investigated using a new renal tubular imaging agent, 99mTc-mercaptoacetyl triglycine (99mTc-MAG3). Twelve patients with essential hypertension (mean age = 49 + 8 years) were studied. Renal scintigraphies with 180 MBq 99mTc-MAG3 were performed at baseline, at the 2nd hour following oral administration of 5 mg felodipine and 4 weeks later on 5-10 mg daily felodipine therapy. The time-activity curves of each kidney were obtained following background subtraction. The 99mTc-MAG3 clearance value was measured for each kidney. In addition, perfusion index (PI), reno index, time to maximum, half-maximum and two thirds of maximum activity values of each kidney were calculated. Systolic and diastolic blood pressures were significantly lowered with long-term administration of felodipine (from 159 ± 12/105 ± 5 to 141 ± 11/87 ± 7 mm Hg, p = 0.01 and p = 0.002, respectively). Heart rate did not change significantly. Initially, a decrease in PI indicating an increase in renal blood flow (from 246 ± 96 to 194 ± 54, p= 0.01) was observed, whereas no change was noted during the chronic administration (to 230 ± 69, p = NS). Total clearance of 99mTc-MAG3 was decreased nonsignificantly following the initial dose of felodipine (from 361 ± 93 to 351 ± 91 ml/ min, p = NS). During long-term therapy, felodipine did not alter the perfusion and tubular function of the kidneys. Our results indicated that felodipine causes a significant increase in renal blood flow initially, even with a nonsignificant change in systemic blood pressure.

ISSN:0250-8095    

DOI:10.1159/000168628

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A total of 75 jaundiced infants with gestational ages ranging from 37 to 42 weeks were studied during the first 10 days of age to evaluate renal function by measuring endogenous creatinine clearance (Ccr), fractional excretion of N-acetyl-β-D 20 mg/dl). Renal function defects are transient and reversible and can be prevented by lowering serum bilirubin levels to near-normal levels

ISSN:0250-8095    

DOI:10.1159/000168629

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The prognosis of severe hypernatremia in the adult is dismal, and new approaches are needed to improve this situation. Here we describe 3 cases of patients with severe hypernatremia (sodium levels of 178, 172, 182 mEq/1) associated with cardiopulmonary or hepatorenal complications that were treated successfully with acute hypotonic hemodialysis (dialysate sodium 110 mEq/1). We provide information of our investigational protocol since the past literature has dealt mostly with peritoneal dialysis. Our preliminary experience has yielded adequate results without significant side effects, but additional studies are needed to refine this technique that might be life-saving in selective situations.

ISSN:0250-8095    

DOI:10.1159/000168630

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Considerable controversy exists in regard to the state of arterial circulatory Nephrotic syndrome integrity in patients with the nephrotic syndrome. Increased sympathetic nervous system activity, along with activation of the renin-angiotensin-aldosterone system and the nonosmotic release of vasopressin, is seen in other states of arterial underfilling. Thus, in the present study, sympathetic nervous system activity was assessed by determining plasma norepinephrine secretion and clearance rates using a whole-body steady-state radionuclide tracer method in 6 edematous patients with the nephrotic syndrome of various parenchymal etiologies and 6 normal control subjects in the supine position. Patients were withdrawn from all medications 7 days prior to study. Mean creatinine clearances and serum creatinine concentrations were normal in both the nephrotic syndrome patients and controls (99 ± 13 vs. 112 ± 15 ml/min, p = NS, 1.1 ± 0.1 vs. 0.8 ± 0.0mg/dl, p = 0.03, respectively). However, the nephrotic syndrome patients exhibited significant hypoalbuminemia (2.0 ± 0.4 vs. 3.8 ± 0.1 g/dl, p < 0.01). The supine plasma norepinephrine level was elevated in the patients with the nephrotic syndrome as compared with controls (240 ± 58 vs. 119 ± 22 pg/ml, p = 0.07). More significantly, the secretion rate of norepinephrine was markedly increased in nephrotic patients (0.30 ± 0.07 vs. 0.13 ± 0.02 ug/m2/min, p < 0.05), whereas the clearance rate of norepinephrine was similar in the two groups (2.60 ± 0.29 vs. 2.26 ± 0.27 1/min, p = NS). Plasma renin activity and plasma aldosterone, arginine vasopressin and atrial natriuretic peptide concentrations were not different in nephrotic syndrome patients compared with controls. We conclude that the sympathetic nervous system is activated in patients with the nephrotic syndrome, as assessed by the increased whole-body norepinephrine secretion rate, prior to a significant fall in glomerular filtration rate or a marked activation of either the renin-angiotensin-aldosterone system or the nonosmotic release of vasopressin. These data support the presence of arterial underfilling in the nephrotic syndrome.

ISSN:0250-8095    

DOI:10.1159/000168631

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A 60-year-old Japanese male was admitted with nephrotic syndrome complaining of facial and pedal edema. Renal biopsy revealed mesangial and endocapillary proliferation with massive mesangial and subendothelial deposits. Deposits of IgA, IgG, IgM, C3 and fibrinogen were identified by immunofluorescence technique in both mesangial and subendothelial areas. Deposits of k and λ light chains were also recognized in similar patterns. Electron microscopy revealed crystalline structures of various appearance in these deposits. A large deposit consisted of various small triangular, quadrilateral and polygonal shapes of deposits with crystalline structures. These crystalline structures exhibited lattice or parallel lamellar lines with different periodic distances. Although a disease producing paraproteinemia was suspected, no immunoglobulin disorder or light chain abnormality could be detected on clinical and laboratory examinations. On the second biopsy, a faint reaction for cryoglobulin was recognized. However, the crystalline deposits observed in this case were absolutely different from the tubular structures seen in cryoglobulinemic nephropathy. This was a very rare and unclassified case

ISSN:0250-8095    

DOI:10.1159/000168632

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

We report a case of hypercalcemia in a patient with coexisting hyperparathyroidism and Wegener’s granulomatosis. Parathyroidectomy with removal of an adenoma resulted in a low parathyroid hormone level but high calcitriol levels and hypercalcemia persisted. In various granulomatous diseases, hypercalcemia has been shown to be the result of overproduction of 1,25-dihydroxy-vitamin D by disease-activated macrophages. Chloroquine has been demonstrated to effectively reduce the extrarenal synthesis of 1,25-dihydroxyvitamin D and serum calcium concentration in hypercalcemic patients with sarcoidosis. Hypothesizing that a similar mechanism would explain hypercalcemia in Wegener’s granulomatosis as well, a therapeutic trial of chloroquine was initiated. The patient responded to chloroquine 500 mg twice daily with significant decreases in serum 1,25-dihydroxyvitamin D and calcium levels. This report extends previous observations of hypercalcemia associated with other granulomatous diseases to Wegener’s granulomatosis and demonstrates an effective reduction of serum calcitriol and calcium levels in response to chloroquine th

ISSN:0250-8095    

DOI:10.1159/000168633

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Bacteremia is a rare complication of peritonitis in end-stage renal failure (ESRF) patients treated by peritoneal dialysis. Three of our ESRF patients on peritoneal dialysis developed bacteremia during a peritonitis episode (1/19 peritonitis episodes). In 2 cases, the responsible organism was Escherichia coli and peritonitis was most likely associated with infection of the biliary tract. The 3rd patient had a perforation of the colon and Klebsiella spp. was the infective organism. Only the last patient survived but had to be transferred to hemodialysis. Bacteremia during peritonitis is infrequent in peritoneal dialysis patients and it appears to be related to other intra-abdominal events.

ISSN:0250-8095    

DOI:10.1159/000168634

出版商:S. Karger AG    

年代:1993

数据来源: Karger