ISSN:0250-8095    

DOI:10.1159/000167105

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Low-dose heparin has achieved wide use for the prevention of deep vein thrombosis. Full-dose heparin (20,000 U/day or more) has a well-documented suppressive effect on adrenal aldosterone production. To determine whether this effect may also occur with low-dose heparin, 5 healthy male volunteers were given heparin, 5,000 U subcutaneously every 12 h for 10 days, and their renin-aldosterone axis was studied. Plasma aldosterone fell from a mean of 17.2 ng/dl at baseline to 6.6 on day 5 and 4.3 on day 10. The 24-hour urinary aldosterone fell from 11.5 μg/day at baseline to 5.3 and 6.8 on days 4–5 and 9–10, respectively. After stimulation with furosemide (60 mg orally) and 4 h ambulation, plasma aldosterone remained suppressed on heparin: 22.4 ng/sl at baseline, 7.0 on day 5 and 6.2 ng/dl on day 10. Plasma renin activity, serum and urinary electrolytes, and body weight were unchanged during the study. Hence, low-dose heparin can inhibit aldosterone production. Patients receiving this treatment should be observed (during and after therapy) for impaired electrolyte homeost

ISSN:0250-8095    

DOI:10.1159/000167106

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Oral protein loads are known to induce an increase in glomerular filtration rate (GFR) in man and animals. The mechanism underlying this phenomenon is currently unknown. In order to study the possible role of growth hormone (GH) or other hypothalamo-hypophyseal (HH) factors in the response of GFR to a protein meal, we studied 4 chronically GH- or HH-defîcient adults and age-matched controls, free of renal disease, before and after ingestion of a large protein meal (red cooked meat). GFR, measured by inulin clearance and corrected for body surface area, was 18.5% lower during basal conditions (89.1 ± 6.0 ml/min) in the GH- or HH-deficient population when compared to controls (109.7 ± 9.1 ml/min), but this difference did not achieve statistical significance for this small patient population (p > 0.1, < 0.2). For a 3-hour postprandial period, mean GFR increased by 25.3% in the control population (136.8 ± 10.7 ml/min; p 0.2). However, 1 female control was found to increase GH levels 10 times preprandial levels. These studies suggest that HH factors other than GH are mediators of the augmentation of GFR following a large protein load in human ad

ISSN:0250-8095    

DOI:10.1159/000167107

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Plasma arginine vasopressin (PAVP) was studied in patients before and after hemodialysis. The levels of PAVP were higher before and reverted to normal range after dialysis (5.7 vs. 2.7 pg/ml). Sequential chemical dialysis showed that vasopressin was removed during the chemical dialysis phase. Data obtained during a simulation experiment were also consistent with the view that vasopressin was removed during the chemical dialysis phase.

ISSN:0250-8095    

DOI:10.1159/000167108

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Sixteen patients with an established diagnosis of renovascular hypertension were entered in an open study of enalapril (MK421), an oral angiotensin-converting enzyme (ACE) inhibitor, for treatment of their hypertension. Initial blood pressure was 178.9 ± 6.3/106.2 ± 3.1 mm Hg during conventional therapy on a median of 3 different antihypertensive agents. All antihypertensive therapy was ceased and the patients admitted to hospital. Following introduction of enalapril, blood pressure fell to 161.5 ± 6.9/90.6 ± 4.1 mm Hg at 24 h (p < 0.01 systolic and diastolic). Blood pressure control (diastolic blood pressure, phase V, < 95 mm Hg) was achieved with monotherapy in 7 patients and in a further 5 patients with addition of a diuretic. Renal function was compromised in 4 patients, requiring cessation of enalapril in 2 instances. Enalapril is an oral ACE inhibitor useful in the treatment of renovascular hypertension. Close monitoring of renal function is necessary during the introduction of enalapril therapy in patients with renovascular hypertens

ISSN:0250-8095    

DOI:10.1159/000167109

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A study of double immunofluorescence-staining of immunoglobulins and sialic acids in the glomeruli from patients with IgA nephropathy is described. Renal biopsy specimens from patients with IgA nephropathy were stained with rhodamine-labeled antihuman IgA, IgG or IgM antisera and then stained with FITC-labeled Limulus polyphemus (LPA), Tricum vulgaris (WGA) or antihuman C3 antisera. Marked positive stainings of IgA and C3 and positive binding of LPA or WGA were observed in the glomerular mesangial areas from patients with IgA nephropathy. LPA or WGA were not bound with glomerular capillary walls from patients with moderate and advanced stages of IgA nephropathy, although depositions of IgA and C3 were markedly observed in such walls. There was a significant inverse correlation between the deposition of IgA and the binding of LPA or WGA in glomerular capillary walls obtained from these patients with IgA nephropathy. The levels of proteinuria from patients with moderate and advanced stages of IgA nephropathy were significantly higher than those with minimal and slight stages of such disease. It is suggested that the decrease of sialic acids in glomerular capillary walls might be due to a deposition of IgA in some patients with IgA nephropathy. It is concluded that high levels of proteinuria might be due to the decrease of sialic acids in glomerular capillary walls from patients with moderate and advanced stages of IgA nephropathy.

ISSN:0250-8095    

DOI:10.1159/000167112

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

We describe 19 pregnancies in 18 women with chronic renal disease and plasma creatinine ≥1.6 mg/dl before pregnancy. There were 2 spontaneous abortions (11th and 21st week), 2 therapeutic abortions (18th and 19th week), 1 stillbirth (30th week), 1 neonatal death (31st week) and 13 live births, 7 of them were preterm. Nine cesarean sections were done. Serial determinations of plasma creatinine during pregnancy showed a trend to decrease during the first half and to increase during the second half of pregnancy. The effect of pregnancy on the progression of renal failure was evaluated in 14 patients by comparing the linear regression lines of reciprocal plasma creatinine versus time before and after pregnancy. In 5 patients the rate of progression worsened after pregnancy. Our data indicate that women with chronic renal failure may have a successful pregnancy, but one third of them will have an accelerated rate of progression of the diseas

ISSN:0250-8095    

DOI:10.1159/000167114

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Twelve HBsAg-negative patients with histologically documented cirrhosis of the liver of either alcoholic (8 of 12) or cryptogenic (4 of 12) origin underwent renal biopsy to investigate proteinuria, hematuria and/or renal failure. Immunofluorescence was positive for IgA in 2 patients with mesangiocapillary glomerulonephritis (MCGN) and could not be performed in 2 additional patients with the same diagnosis. However, in the remaining 8 patients, immunofluorescence was negative for IgA and frequently positive for C3, IgG, IgM and/or fíbrinogen. These 8 patients without IgA were classified as follows: MCGN with subendothelial electron-dense deposits (2 cases), IgM-IgG cryoglobulinemia with diffuse endocapillary glomerulonephritis (1 case), membranous nephropathy (1 case), diffuse endocapillary proliferative glomerulonephritis (1 case), vasculitis with focal segmental necrotizing glomerulitis and crescentic glomerulonephritis (2 cases). These results show that cirrhosis of the liver can be associated with a wide variety of glomerular disorders. Contrary to previous belief, IgA is absent in two thirds of patients with cirrhosis and glomerulopathy. Therefore, the pathogenetic importance of IgA in the development of glomerular disease in such patients is doubtful

ISSN:0250-8095    

DOI:10.1159/000167116

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Serum free and esterified carnitine levels as well as lipids were investigated in patients undergoing regular hemodialysis (HD) treatment before and during 12 weeks of treatment with L-carnitine (1 g i.v.) at the end of each HD. The results were compared with those obtained in patients on continuous ambulatory peritoneal dialysis (CAPD; n = 15) or intermittent peritoneal dialysis (IPD; n = 3) and healthy controls (CO; n = 20). In HD patients (n = 23) total carnitine (TC) was 49.9 ± 3.9 (CO: 46.0 ± 2.5; NS), free carnitine (FC) was 31.6 ± 2.8 (CO: 37.4 ± 1.3; p < 0.05), short-chain acylcarnitine (SCC) was 17.0 ± 1.8 (CO: 7.2 ± 0.9; p < 0.0001) and long-chain acylcarnitine (LCC) was 1.2 ± 0.2 μmol/l (CO: 0.6 ± 0.1; p < 0.05). FC was in the normal range in CAPD (35.6 ± 3.2) and IPD (44.5 ± 8.0 μmol/l) patients, whereas SCC (30.1 ± 3.5) and LCC (2.9 ± 0.2) levels were maximal elevated in IPD patients (11.8 ± 0.8 and 1.5 ± 0.2 on CAPD). Therefore, TC was higher in IPD than in CAPD patients (77.5 ± 5.0 vs. 49.0 ± 3.5 μmol/l). 12 weeks after L-carnitine supplementation in HD patients, TC was 313.9 ± 22.6, FC was 207.7 ± 12.4, SCC was 99.6 ± 12.1 and LCC was 7.1 ± 0.6 μmol/l. TC and FC were significantly lower in females compared with males. Total cholesterol and ketone bodies were normal, HDL cholesterol was significantly decreased before and after L-carnitine supplementation. On the other hand, a paradoxical rise in serum triglycerides was observed. Our data indicate abnormalities of free and esterified carnitine in HD, CAPD and IPD patients. The markedly elevated serum levels for TC, FC, SCC and LCC following L-carnitine therapy suggest limited carnitine utilization in

ISSN:0250-8095    

DOI:10.1159/000167119

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000167121

出版商:S. Karger AG    

年代:1986

数据来源: Karger