摘要:

The number of abnormal glomeruli present in a renal biopsy can be viewed as a binomial distribution. Recognition of this fact permits a quantitative assessment of the effect of biopsy sample size in renal biopsy interpretation. If the percent of glomerular involvement in a biopsy is used to determine the severity of a focal glomerular lesion, a small biopsy sample size will lead to considerable misclassification of disease severity. In addition, a small biopsy sample size will make the exclusion of focal disease difficult.

ISSN:0250-8095    

DOI:10.1159/000167563

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Suprofen, a nonsteroidal anti-inflammatory drug, has been associated with the onset of acute flank pain, hematuria, and transient renal dysfunction after the ingestion of one or two doses, particularly in young males. Potential mechanisms of this nephropathy were evaluated in normal males following ingestion of suprofen (200 mg) on two occasions: the first with ad libitum fluid intake and the second during forced water diuresis. On the first study occasion, creatinine clearance, the fractional excretions of uric acid (FEUA) and sodium (FENa), the urinary concentration of undissociated uric acid, and the urinary excretions of prostaglandins and glomerular and tubular proteins were assessed. On the second occasion, inulin and PAH clearances and FEUA and FENa were determined. Within 90 min after suprofen administration, the FEUA increased from 8.8 ± 2.6 to 35.5 ± 9.6% (p < 0.05). Urine became supersaturated for uric acid during ad libitum fluid intake. Glomerular filtration rate, renal plasma flow, and FENa decreased significantly, while prostaglandin and protein excretions did not change. The findings are consistent with acute uric acid nephropathy as a mechanism of suprofen-induced renal dysfunctio

ISSN:0250-8095    

DOI:10.1159/000167564

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

The relations between renal hemodynamics (Inutest, CPAH) and sodium segmental handling (sodium distal delivery, distal reabsorption, and fractional excretion) were studied in 9 healthy adults infused with an isotonic amino acid solution and in 6 subjects infused with 0.9% saline for 3 h at 0.2 ml/min/kg. During all tests maximal water diuresis was induced and maintained to effect analysis of sodium segmental transport. Both types of infusion produced a similar expansion of extracellular volume (weight increase, hematocrit fall, suppressed plasma renin activity and plasma aldosterone). The amino acid infusion increased the glomerular filtration rate (GFR) and renal blood flow without modifying the filtration fraction. With saline no hemodynamic modifications were observed. The expansion with saline depressed proximal and distal sodium reabsorption whereas during amino acid infusion sodium distal delivery was unaltered and the significantly increased sodium fractional excretion was sustained only by depressed distal reabsorption. Therefore, in parallel with the GFR increase, closely dependent on renal vasodilatation, the well-known stimulation of sodium cotransport by amino acids is able to antagonize the effects of expansion on the proximal sodium reabsorption. An explanation of glomerular hyperfiltration based on a primary metabolic stimulation of the proximal tubular function is suggested.

ISSN:0250-8095    

DOI:10.1159/000167565

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Characteristic deposition of C3 has been reported in type I membranoproliferative glomerulonephritis (MPGN). Immunofluorescence microscopy shows diffuse granular deposition of C3 along the majority of capillary loops with lobular pattern. To determine the specificity of this immunofluorescence finding which might aid in distinction between type 1 MPGN, particularly focal MPGN, and the other glomerulopathies, 530 renal biopsies from 437 children were studied retrospectively. Nineteen patients showed diffuse granular deposits of C3 along the capillary walls with lobular distribution. Three patients had lupus nephritis. Nine patients showed the light microscopic changes of diffuse type I MPGN with the characteristic double-walled capillaries. Six patients showed the changes of focal MPGN, and 1 had diffuse mesangial proliferation but without double contours, and they were regarded as examples of a mild or early form of MPGN. A similar deposition of C3 was not seen in the 418 patients with other conditions. We concluded that diffuse granular deposits of C3 along the capillary walls with a lobular distribution appear to be confined to type I MPGN and lupus nephritis and are seen in all patients with diffuse and focal type I MPGN.

ISSN:0250-8095    

DOI:10.1159/000167566

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Severe hypertension developed in 4 patients who had sustained blunt renal trauma 2–32 years previously. A protracted period of normal blood pressure separated the renal injury from the onset of hypertension. Angiography disclosed lesions which had been underestimated by intravenous pyelography. These lesions consisted of traumatic dissection of branches of the renal artery, leading to renal infarct. In 3 cases, unilateral high renin secretion was demonstrated, and in 1 case this was confirmed by immunofluorescence with an anti-renin antiserum which showed abundant renin granules within the infarcted zone. In all patients, total or polar nephrectomy was followed by return of blood pressure to normal or near-normal levels. Blunt renal trauma is an underestimated cause of renovascular hypertensio

ISSN:0250-8095    

DOI:10.1159/000167567

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In 4 cases of human acute renal failure (ARF) with oligo-anuria, normuria and polyuria the following findings were made. (1) The diameter of endothelial cell fenestrae is on average larger than that of the control values, but not significantly. (2) In ARF the ratio of the endothelial cell fenestral area to the total endothelial area is not significantly lower than in control kidneys. (3) In ARF the average density of fenestrae per unit of area is not significantly lower than in control kidneys. (4) The structure of the podocytes does not differ from that of control kidneys.

ISSN:0250-8095    

DOI:10.1159/000167568

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

We have developed an extracorporeal system for investigating in vitro the biofilm-adherent bacterial microcolonies (BABM) that grow on Tenckhoff catheters (TC), to study peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A modified Robbins’ device, attached to sampling plugs with TC discs and connected to the dialysate via a peristaltic pump, is run for 24 h; scrapings from pairs of TC discs are processed for assessment of viable BABM, one of each pair for culture by routine microbiology techniques and the other for examination by scanning and transmission electron microscopy (EM). No colonization was noted with fresh dialysis solutions and spent dialysates from patients without clinical peritonits; but, when bacterial suspensions were added to aliquots of the same dialysates, BABM were noted on both culture and EM. In a study of 4 patients on CAPD treatment, who had clinically evident peritonitis, routine cultures of spent dialysate were positive in only 2, but BABM were found in cultures and EM preparations of disc scrapings in all 4 cases. We conclude from these preliminary findings that this extracorporeal system is reliable, and well suited for studying the role of BABM in CAPD-associated peritonitis in vitr

ISSN:0250-8095    

DOI:10.1159/000167569

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

We carried out a prospective 2-year study on the transmission of human immunodeficiency virus (HIV) infection in a chronic dialysis unit with a high prevalence (11 %) of the infection. Only 1 of 45 HIV-negative patients seroconverted, and this was related to the administration of contaminated blood. We conclude that current Centers for Disease Control criteria are sufficient to prevent transmission of HIV infection in dialysis units.

ISSN:0250-8095    

DOI:10.1159/000167570

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Plasma renin activity, plasma aldosterone levels and renal tubular capacity to excrete hydrogen ions were studied in 13 patients suffering from diabetes mellitus with a creatinine clearance of less than 40 ml/min. The results were compared with those obtained in a control group, in a group of nondiabetic subjects with chronic renal failure (CRF) and in a group of diabetic patients without CRF. Twelve of the thirteen diabetic patients with CRF had data characteristic of hyporeninemic hypoaldosteronism associated with type IV renal tubular acidosis. On comparing the results with those of the other two groups of patients, it was observed that the manifestations of the latter two groups considered separately were different from those of the problem group, although in the diabetic patients with normal glomerular filtration rate (GFR) hyporeninism but not hypoaldosteronism was present accompanied by a lower net acid excretion (p < 0.001) due to a lower excretion of NH4 (p < 0.05) and titratable acid (p < 0.001) when the patients were challenged with an NH4C1 overload. We believe that a conjunction of diabetes and renal failure is necessary for the diabetic patients with a decrease in GFR to show hyporeninemic hypoaldosteronism and type IV tubular acidosis.

ISSN:0250-8095    

DOI:10.1159/000167571

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167572

出版商:S. Karger AG    

年代:1988

数据来源: Karger