ISSN:0250-8095    

DOI:10.1159/000167944

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

This is an unusual case of fatal hepatic necrosis caused by disseminated type 5 adenovirus in a renal transplant recipient. This adult patient may have been colonized at the time of transplantation with a kidney from a pediatric donor. The adenovirus became invasive when the host’s cellular immune system was suppressed by high doses of corticosteroids given to reverse acute allograft rejectio

ISSN:0250-8095    

DOI:10.1159/000167945

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A case of mannitol-induced renal failure is described and previously reported cases are reviewed. Possible mechanisms of the etiology are discussed.

ISSN:0250-8095    

DOI:10.1159/000167946

出版商:S. Karger AG    

年代:1989

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167947

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Serum cholesterol, triglyceride, apolipoprotein B (apo B) and the cholesterol and phospholipid content of apo-B-containing particles was determined in 41 male patients on dialysis for chronic renal failure, in 41 male patients with coronary artery disease selected on the basis of a total cholesterol level below 6.72 mmol/l and in 41 male control subjects of similar age. Apo B was assessed as total B protein determined using polyclonal antibodies and also by measuring the expression of epitopes recognized by three different monoclonal antibodies (BL3, BL5 and BL7). Triglyceride was increased (p < 0.01) and cholesterol was decreased (p < 0.01) in the dialysed patients with chronic renal failure. Total apo B was similar in the three tested groups while the expression of the BL7 epitope was increased in the group of dialysed patients with chronic renal failure (p < 0.001). The expression of BL3 and BL5 epitopes was increased in patients with coronary artery disease (BL3: p < 0.05; BL5: p < 0.02) but not in dialysed patients with chronic renal failure. These results suggest an abnormal composition and an immunological heterogeneity of apo-B-containing lipoprotein particles in patients with coronary artery stenosis and in dialysed patients with chronic renal failure.

ISSN:0250-8095    

DOI:10.1159/000167948

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A national sample of dialysis physicians was used to obtain data for a comparison of patient characteristics, comorbid conditions and treatment patterns associated with the five leading causes of end-stage renal disease (ESRD). The data are used to assess trends in physician care for ESRD patients and likely changes in program costs. The analysis shows that patients with glomerulonephritis are the youngest. Those with hypertensive nephropathy are the oldest, and include the highest proportion of blacks, while those with polycystic kidney disease include the lowest proportion of blacks. Patients with diabetic nephropathy have the most problems noted at the time of physician contact, the most emergent and severe problems, the highest number of diagnostic tests utilized, the most complex treatments required and the longest physician time spent per encounter. Patients with ‘other interstitial nephritis’ are significantly more likely to have infections, musculoskeletal disorders, chronic obstructive pulmonary disease and neoplasms noted as comorbid conditions. They also have the highest number of therapeutic procedures and the greatest percentage of referrals for consultations. Survey data highlight the evolving nature of Medicare’s ESRD program. With increasing numbers of elderly and diabetic patients, more physician time will be required for the overall care of the dialysis patient, and increasing costs associated with necessary diagnostic tests and referrals can be exp

ISSN:0250-8095    

DOI:10.1159/000167949

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The clinical course of mesangial glomerulopathy with IgM deposits (IgM-nephropathy) was studied in 54 patients. The initial manifestations of the disease were nephrotic syndrome in 18, proteinuria in 21, proteinuria together with hematuria in 4 and isolated hematuria in 11 patients. The nephrotic syndrome was steroid-responsive in 60% of cases and of these 80% were steroid-dependent. During a 5-year postbiopsy follow-up 3 patients went into terminal uremia and in 6 more patients a milder renal insufficiency was observed. Three patients were rebiopsied and in 2 of these the second biopsy specimen disclosed typical focal and segmental glomerulosclerosis. Hematuria was a favorable sign, as no patient with hematuria showed progressive impairment of renal function. The prevalence of hypertension in the whole material was 37%. At close of follow-up 35% of all patients were in clinical remission. It is suggested that IgM-nephropathy associated with abundant proteinuria or the nephrotic syndrome represents a distinct disorder from that associated with hematuria. While the nephrotic type often manifested itself with a morphologic change and a tendency to develop renal insufficiency, the hematuric type showed female predominance, a high tendency to spontaneous clinical remission and a favorable clinical course.

ISSN:0250-8095    

DOI:10.1159/000167950

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A 30-year-old male who presented with acute renal failure was found to have acquired immunodeficiency syndrome (AIDS). Although sonography and computerized tomography did not show urinary tract dilatation, obstructive renal failure was demonstrated by retrograde pyelography. Relief of obstruction(s) due to encasement of the renal pelves and ureters with histiocytic lymphoma led to immediate return of normal renal function. Although the etiology of renal failure in this patient is highly unusual, the high incidence of lymphoma in patients with AIDS should make tumor-related renal disease a consideration in all such patients with renal dysfunction.

ISSN:0250-8095    

DOI:10.1159/000167951

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The responsiveness of atrial natriuretic factor (ANF) to central volume expansion and its role as a determinant of the natriuretic and diuretic responses of cirrhotic patients was evaluated utilizing water immersion (WI). Following equilibration on a 10-mEq sodium diet, 9 seated cirrhotic patients were studied during 3 h of WI. Before WI, plasma ANF levels (10.9 ± 2.4 fmol/ml) were similar to those previously observed in normal sodium-replete subjects (7.7 ± 0.9 fmol/ml). Five of the 9 cirrhotic subjects manifested an exaggerated peak ANF response, whereas the remaining 4 manifested increases similar to those of normals. The concomitant natriuretic response varied widely, ranging from absent to markedly exaggerated responses. The peak urinary sodium excretion varied independently of peak plasma levels of ANF and peak change of ANF from the prestudy hour (r = 0.36, p > 0.20, and r = 0.46, p > 0.20, respectively). Thus, in contrast to normal subjects, in whom the immersion-induced natriuresis correlated closely with the changes in ANF, the natriuretic responses of cirrhotic patients were dissociated from the concomitant increases in ANF. These observations indicate that sodium retention in cirrhosis is not attributable to impaired ANF releas

ISSN:0250-8095    

DOI:10.1159/000167952

出版商:S. Karger AG    

年代:1989

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167953

出版商:S. Karger AG    

年代:1989

数据来源: Karger