摘要:

We studied the upregulation of the intracellular glycoprotein Mac-1 (CD1 lb/CD 18, CR3) on monocytes and granulocytes during 36 bicarbonate hemodialyses in 12 patients who were randomly treated with Cuprophan (Cu), Hemophan (He) or Polysulfone (PS; low-flux) membranes. The degree of mobilization of this adhesion protein was related to changes in granulocyte and monocyte count, generation of C3a and production of interleukin-1(3 in plasma. Mac-1 expression on granulocytes was significantly higher after 5 and 15 min of Cu hemodialysis as compared to He or PS dialyses (p < 0.001) and correlated to changes in granulocyte count at 15 min (r= 0.62 and r = 0.76, p < 0.001). No differences in early Mac-1 mobilization on circulating monocytes was observed despite a decrease in cell count. Mac-1 expression on monocytes and granulocytes in the venous blood line at 180 min of treatment was significantly higher during Cu dialysis as compared to He and PS dialyses (p < 0.02 and p < 0.001, respectively). Early generation of C3a was higher in patients on Cu dialysis than in He or PS dialysis (p < 0.001) and correlated both to granulocytopenia (r =0.45, p < 0.01) and to the subsequent increase in Mac-1 expression on granulocytes (r=0.63, p < 0.001). An early increase in Mac-1 expression on monocytes was accompanied by an increase in plasma interleukin-1β later during dialysis (p < 0.05). Studies of Mac-1 expression during hemodialysis increased the sensitivity of biocompatibility measurements and correlated better than complement generation to changes in granulocyte count as it mediates adhesion to endothelial cells

ISSN:0250-8095    

DOI:10.1159/000168488

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We have investigated the influence of kidney function on soluble interleukin-2 receptor (S-IL-2R) serum levels. S-IL-2R is a glycoprotein with a molecular weight of 45 kDa. The serum concentration of S-IL-2R was positively correlated to serum creatinine (r =0.35) and complement factor D (r = 0.30), a low molecular weight protein, and the reciprocal value of S-IL-2R was negatively correlated to 51Cr-EDTA clearance (r= -0.35). When measuring S-IL-2R and factor D in a wide range of serum creatinine (140-1,380 (xmol/l), a high positive correlation was found between factor D and serum creatinine. S-IL-2R and serum creatinine had r = 0.92 and r = 0.79, p = 0.0001, respectively. The correlation coefficient between factor D and S-IL-2R was 0.86. S-IL-2R is used as a marker for an increased activity of the immune system and in a variety of lymphoproliferative disorders. However, it is important to keep in mind that a reduced kidney function may contribute to the increased S-IL-2R levels seen in different immune diseases. Therefore, renal function should be taken into account in the interpretation of elevated plasma concentrations of S-IL-2R.

ISSN:0250-8095    

DOI:10.1159/000168489

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Six hundred and sixty-seven hypertensive patients were analyzed by captopril-enhanced scintigraphy. If time to reach maximal activity (Tmax) was ≧ 5 min using 99mTc-diethylenetriaminepentaacetic acid (DTPA) or ≧ 3 min with 123I-oiodohippurate (OIH) and 99mTc-mercaptoacetyltriglycine (MAG3) and washout time ≧ 15 min, a control study with nifedipine was performed. If the difference between Tmax under captopril and nifedipine premedication was ≧ 5 min with 99mTc-DTPA or ≧ 3 min with 123I-OIH and 99mTc-MAG3, the renogram was defined highly suggestive of renovascular hypertension. In the evaluation of bilateral abnormalities an additional parameter was considered, i.e. the presence of functional asymmetry of the emuntories susceptible of partial reversal in the control study under nifedipine. Based on these criteria, 58 out of 667 (8.7%) scintigrams were found to be abnormal. Thirty-five of these 58 patients and 32 of the remaining 609 scintigraphically negative cases underwent additional arteriographic examination. A renal vascular stenosis ≧ 50% was found in 33 out of 35 (94.2%) patients with positive scintigraphy and in 3 out of 32 patients with negative scintigraphy. By examining results of the 67 patients undergoing arteriography, the sensitivity of captopril-enhanced scintigraphy was estimated to be 91.6 %, with a specificity of 9 3.5 %, an accuracy of 92.5 %, and predictive values of a positive or negative result of 94.2 and 90.6%, respectively. By restricting analysis to bilateral stenosis, sensitivity was found to be 76.9%. Postexamination of 16 patients undergoing revascularization by surgery or percutaenous transluminal renal angioplasty reflected the expected results with a substantial shortening in Tmax and T75 in the respo

ISSN:0250-8095    

DOI:10.1159/000168490

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the conventional and high-flux membranes were cellulose acetate, the dialy-sate was bicarbonate, and dialysate sodium was held constant. The high-flux membrane had an ultrafiltration rate of 15 ml/h/mm Hg transmembrane pressure, a B12 clearance of 88 ml/min and a β2-microglobulin clearance of 11.4 ml/min. The values for the conventional membrane were 3.5-5.0, 34-45 and negligible. Each treatment period was 4 months. Twenty-two patients completed both phases of the cross-over. The KT/V value was higher during high-flux than conventional treatment; 1.42 versus 1.27(p 0.01) and none were clinically significant. Symptoms between dialyses were less severe during high-flux than conventional treatment for 18/20 items. No single item had a statistically significant improvement but 3 had clinically important improvement. Among the 23 neuropsychological variables, none demonstrated statistically significant changes

ISSN:0250-8095    

DOI:10.1159/000168491

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In the evaluation of renal osteodystrophy bone biopsy is often performed. However, a reliable noninvasive test could be very useful, and recently the estimation of osseous tracer uptake as an index of bone formation has been introduced – the bone bisphosphonate clearance (BBC). The aim of the present investigation therefore was to compare BBC with parameters of bone histology, serum levels of osteocalcin, alkaline phosphatase, and parathyroid hormone in patients (n = 8) undergoing continuous ambulatory peritoneal dialysis (CAPD). No significant correlations were found between BBC values and the bone histomorphometrical variables measured. A positive correlation was seen between serum osteocalcin and resorption and active resorption surface (p < 0.05), as well as tetracycline-labelled surface, bone formation rate, surfaces, volume and tissue referents, respectively (p < 0.01). Furthermore, levels of alkaline phosphatase showed significant correlations to mineral appositional rate, tetracycline-labelled surface and bone formation rate, volume referent (p < 0.05). Values of parathyroid hormone were significantly correlated to resorption surface (p < 0.02), active resorption surface, mineral appositional rate and mineralization lag time (p < 0.05). In conclusion, BBC was of no use in patients treated with CAPD as a noninvasive test for evaluation of bone histomorphometry. However, osteocalcin correlated best with resorption and bone dynamics indices. Levels of alkaline phosphatase and parathyroid hormone were of a more limited valu

ISSN:0250-8095    

DOI:10.1159/000168492

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Renal tubular acidification function was studied in 12 patients treated with cyclosporine (Cy) for idiopathic uveitis (IU) and in 5 patients with IU not treated with Cy. After intravenous bicarbonate loading fractional bicarbonate excretion was similar in both groups indicating normal proximal tubular acidification function. Plasma renin activity, plasma aldosterone and transtubular potassium gradient were similar in both groups. Distal hydrogen ion secretion evaluated by the ability to increase urine-blood (U-B) pCC2 in a highly alkaline urine was impaired in Cy-treated patients (31.8 ± 3.2 mm Hg) as compared to controls (47.9 ± 0.5 mm Hg) (p < 0.005). We conclude that Cy therapy is associated with a distal acidification defect with a low U-B pCO2 gradient during sodium bicarbonate loading. Because none of our Cy-treated patients spontaneously developed overt metabolic acidosis one could classify them as having an incomplete form of distal tubular acidosi

ISSN:0250-8095    

DOI:10.1159/000168493

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Septic shock is frequently associated with acute renal failure. Management of these patients becomes complicated if either the renal or systemic hemodynamic derangement cannot be corrected. Although previously large doses of furosemide and naloxone infusion have been used separately in managing these patients, the combination of both agents has not been employed. We therefore report our limited experience with this combined treatment in 5 patients with septic shock, of which 4 had acute renal failure.

ISSN:0250-8095    

DOI:10.1159/000168494

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

The present paper presents a morphometric study of the evolution of the glomerulus in Adriamycin-induced focal and segmental glomerulosclerosis in the rat over 32 weeks. The morphometric parameters studied generally varied significantly when the groups treated with Adriamycin were compared with controls. Glomerular area and perimeter showed an irregular pattern and finally ended up with values similar to those of the control group. Glomerular capillary tuft area and perimeter were always significantly greater in Adriamycin-treated groups than in controls. The mesangial area of treated animals increased over the study period in comparison with that of controls. While the total number of cells in the glomerular capillary tuft had an irregular pattern, the proportion of cells in relation to glomerular capillary tuft area was significantly lower in treated animals than in controls.

ISSN:0250-8095    

DOI:10.1159/000168495

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168496

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Vascular access failure in hemodialysis patients remains a significant problem. The use of thrombolytic agents and balloon angioplasty instead of or in conjunction with surgical revision, has been helpful in increasing the life span of vascular access in these patients. The application of newer endovascular therapies, such as vascular stents, may further improve the salvage rate of hemodialysis access sites. These stents may be particularly valuable in treating stenoses in large central veins. We present 2 cases in which a balloon-expandable Palmaz® stent was used to treat a central venous stenosis causing signs of vascular access failure

ISSN:0250-8095    

DOI:10.1159/000168497

出版商:S. Karger AG    

年代:1992

数据来源: Karger