ISSN:0250-8095    

DOI:10.1159/000166795

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Peritoneal eosinophil counts were investigated in 61 intermittent dialysis patients over the course of 1 year. The peritoneal eosinophil percentage fell from 18 ± 2% (mean ± SEM) in the first 2 months of dialysis to 3 ± 0.4% after 6 months of dialysis. Absolute eosinophils per cubic millimeter fell from 586 ± 126 to 61 ± 18 (p < 0.01 for both percentage and absolute values). There was a wide range in the mean eosinophil percentages per patient in the first 6 months of dialysis (0–84%) that narrowed to 0–9% after 6 months. The majority of the high initial eosinophil counts resolved after 2 months. Peripheral eosinophilia was seen in 8 of the 10 patients with the highest mean peritoneal eosinophil percentages during the first 2 months of dialysis. Patients who developed peritonitis had a significantly lower percentage of eosinophils in the first 1.5 months of dialysis than patients who did not develop peritonitis. At the time of diagnosis of peritonitis, the peritoneal eosinophil count was near zero. 4 cases of peritoneal eosinophilia which developed after antibiotic therapy are d

ISSN:0250-8095    

DOI:10.1159/000166796

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A decrease in arterial oxygen tension during hemodialysis has been attributed to a number of factors. In order to more completely define these factors, we studied respiratory gas exchange, arterial blood gases and pH, and dialyzer flux of CO2 during pure ultrafiltration, three types of acetate dialysis, and sorbent regenerated bicarbonate dialysis in which the dialysate concentration of bicarbonate varies. Changes due to position and extracorporeal circulation of a 300-ml volume of blood (sham dialysis) were studied for any effect contributing to the hypoxemia noted with circulation through the membrane and variation in dialysate. Alveolar oxygen tension (PAO2) is calculated by the equation PAO2 = PIO2-PaCO2 (FIO2 + 1-FIO2/RE). RE is the ratio of CO2 excretion by the lung (VCO2) to oxygen consumption (VO2). RE equals RQ (metabolic quotient) when no extrapulmonary CO2 losses occur. Normals in a lounge chair had no change in RE and PACO2. RE decreased to 0.75 during sham dialysis and PAO2 decreased. During pure ultrafiltration RE decreased due to a decrease in VO2 and VCO2 with proportionately greater decrease in VCO2. PAO2 decreased accordingly. Acetate dialysis produced an increase in oxygen consumption without a proportional increase in CO2 excretion and both RQ and RE decreased. When PAO2 decreased during any of these procedures, arterial oxygen tension (PaO2) decreased without a change in A-aO2 gradient. No changes in PaCO2 were noted. RQ did not change during bicarbonate dialysis. At high bicarbonate dialysate concentrations, however, PaCO2 increased and PAO2 decreased. The major reason for hypoxemia during acetate dialysis is a decrease in alveolar oxygen tension due to changes in metabolism and a decrease in pulmonary CO2 excretion when CO2 is lost from the dialyzer. The increasing pH may contribute to the metabolic change during acetate dialysis and the hypoventilation during bicarbonate dialysis. There is little evidence to support an effect of pulmonary capillary obstruction or changes in oxyhemoglobin association on the decrease in arterial oxygen tension observed.

ISSN:0250-8095    

DOI:10.1159/000166797

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

During peritoneal dialysis, progressive increments in the osmotic gradient increase ultrafiltration rate. Solute transport by convective flux is thereby raised but there is no preferential increase in potassium clearance. The data imply that ultrafiltrate derives from extracellular fluid alone. Mesothelial cells appear to resist solute and water flux in response to an immediately adjacent osmotic gradient.

ISSN:0250-8095    

DOI:10.1159/000166798

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Peritoneal sclerosis, a disorder similar to that previously identified in nonuremic patients, is being noted in peritoneal dialysis patients with increasing frequency. The etiology in dialysis patients remains unknown. An association with previous or ongoing peritoneal inflammation or irritation suggests that the incidence of peritoneal sclerosis could be reduced by rapidly controlling peritonitis and by eliminating the irritant properties of catheters, dialysate, and other materials used in performing peritoneal dialysis. If peritoneal sclerosis does supervene, weight loss, abdominal pain, and intestinal obstruction may occur and further peritoneal dialysis may become impossible because of abdominal pain or poor fluid and solute transfer.

ISSN:0250-8095    

DOI:10.1159/000166799

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The relative contributions of glomerular epithelial cells, macrophages, and other cell types to the formation of cellular crescents characteristic of human rapidly progressive glomerulonephritis remain controversial. To identify and quantitate the cell types present during different stages of glomerular crescent formation, immunoperoxidase labelling of cryostat sections from renal biopsies with cellular (n = 9) or sclerosed (n = 3) crescents was performed using monoclonal antibodies to cell-specific antigens of leucocytes, epithelial cells, and other glomerular cell types. Fresh cellular crescents consisted of macrophages (34.5 ± 7.0%; mean ± SEM) plus lesser proportions of polymorphs (12.8 ± 4.7%) and epithelial cells (10.4 ± 1.5%). Sclerosed crescents contained fewer macrophages (5.1 ± 1.0%), but similar proportions of polymorphs (11.1 ± 2.9%) and epithelial cells (11.5 ± 2.1%). Lymphocytes were not detected within crescents. Many of the remaining unlabelled cells morphologically resembled fibroblasts and expressed surface fibronectin, though fibroblast-specific cell markers were not available. These results show that macrophages and not epithelial cells constitute the major cell type within cellular crescents. Therapeutic manoeuvres directed against macrophages may, therefore, be of clinical value in the management of human crescentic rapidly progressive glomerulonep

ISSN:0250-8095    

DOI:10.1159/000166800

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166801

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166802

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

This report describes 2 siblings with IgA nephropathy. Patient No. 1 was a 3 8-year-old woman with hematuria and proteinuria of 19 years duration. Her blood ABO type was A and Rh positive. She was found to have HLA-A2, Aw24;Bw54, Bw48;Cw1, C-;DR1, DR4. Her renal specimen was diagnosed as the advanced stage of IgA nephropathy histologically. Patient No. 2 was a 41-year-old man who was a brother of patient No. 1. His blood ABO type was·and Rh positive. His serotype for the HLA was found to be HLA-Aw24, A-;Bw35, Bw54;Cw1, Cw3; DR4, DRw9. His renal histology showed the advanced stage of IgA nephropathy. It is suggested that an abnormal immune response linked to gene coding for HLA-DR4 antigen might to involved in the development of IgA nephropathy

ISSN:0250-8095    

DOI:10.1159/000166803

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A case of bromate-induced acute renal failure (ARF) in an infant associated with hemolysis, thrombocytopenia and deafness is presented. The initial clinical and laboratory features suggested the diagnosis of hemolytic uremic syndrome (HUS). The serum bromide level was in the nontoxic range (1.2 mg/dl). However, further investigation of the ingested material revealed the toxic agent to be bromate rather than bromide. The spectrum of bromate (BrO3-) toxicity is different from bromide (Bγ) and includes the induction of ARF and deafness. This combined with clinical evidence of behavioral regression and speech loss led to detection of deafness in this patient and confirmed the diagnosis of bromate toxicity

ISSN:0250-8095    

DOI:10.1159/000166804

出版商:S. Karger AG    

年代:1984

数据来源: Karger