ISSN:1660-8151    

DOI:10.1159/000183624

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Sera from patients with chronic renal failure (CRF) contain a factor(s) which enhances the oxidative metabolism of polymorphonuclear leukocytes (PMN) as assessed by chemiluminescence (CL), superoxide anion generation, and hexose monophosphate shunt activity. PMN oxidative metabolic activity was higher in CRF sera than in sera from hospitalized patients with normal renal function or in sera from normal healthy subjects. The enhancement occurred regardless of whether PMN were unstimulated or were stimulated by a nonspecific soluble membrane stimulant (phorbol myristate acetate), or by opsonized Candida albicans. The enhanced CL was significantly reduced in their sera after normal renal function was restored with successful renal transplantation. This CL-enhancing factor was also detected in dialysate fluids from CRF patients and in urine from normal healthy subjects. When serum, urine, dialysate fluids of these CRF patients were fractionated by Sephadex G-25 column chromatography, the specific fraction responsible for enhanced CL was found in the molecular weight range < 1,000 daltons, and is an ethanol extractable substance with natural fluorescence. Our findings suggest that the enhanced PMN stimulatory activity in CRF serum is specifically associated with renal dysfunction and can be useful, along with other conventional parameters, for monitoring the progression of CRF.

ISSN:1660-8151    

DOI:10.1159/000183625

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In order to examine the effect of different dialysates on hemodialysis-induced hypoxemia, 6 stable patients with chronic pulmonary disease (CPD) were compared with 8 control subjets using, alternately, acetate and bicarbonate in the dialysate. These patients were also studied during acetate dialysis and 2 liters/min of nasally administered oxygen. In the control group the presence of hypoxemia with acetate and its absence with bicarbonate suggests that the major mechanism responsible for hypoxemia is hypoventilation. In CPD patients the higher hypoxemia with acetate which bicarbonate analysis did not prevent suggests that a superimposed mechanism may be an important factor in hypoxia aggravation. In these patients hypoxemia can be prevented easily by increasing the inspired oxygen concentration.

ISSN:1660-8151    

DOI:10.1159/000183626

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Parlodel, 2.5 mg daily, was given during 1–3 months to 14 uremic hypogonadal patients (placebo controlled in 6). Except for a decrease in serum prolactin levels on Parlodel (p < 0.01), no significant changes in hormonal values (gonadotropins and testosterone) were observed either on Parlodel or on placebo. Parlodel treatment improved the potency of 10 patients, eliminated gynecomastia in 2 and normalized spermatogenesis in 6; the best results were obtained in patients on low-protein diet. On placebo, potency improved only in 1 patient; no improvement in spermatogenesis was registered. Thus, Parlodel can improve sexual function and spermatogenesis in hypogonadal uremic male

ISSN:1660-8151    

DOI:10.1159/000183627

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Two female patients with metastatic breast carcinoma had acute renal failure secondary to metastatic ureteral obstruction. Retrograde pyelography showed bilateral segmental constriction and dilatation of the ureters with hydronephrosis. Drainage procedures reversed the renal failure in both patients. A review of the literature indicates that ureteral involvement is frequent in patients with malignancies.

ISSN:1660-8151    

DOI:10.1159/000183628

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A standard acid loading test was used to assess the buffering capacity in 9 hemodialysis (HD) and 25 continuous ambulatory peritoneal dialysis (CAPD) patients. There was a significant increase in H+ concentration and a decrease in plasma bicarbonate levels after the acid loading in all patients; however, PaCO2 did not change significantly. CAPD patients tolerated the acid load better, at least in the first 2 h, than HD patients. The brief duration of experiments did not allow us to observe differences, if any, in the recovery rates between HD and CAPD patients. CAPD patients tolerated the acid load equally, whether studied with or without fresh dialysate in the peritoneal cavity. Their tolerance to the acid load did not change with an increasing duration of the CAPD therapy. Baseline values and acid tolerance curves were similar in CAPD patients on regular Dianeal (lactate 35 mEq/l) and Dianeal PD2 (lactate 40 mEq/l). It is concluded that the buffering capacity is marginally higher in CAPD than in HD patients, although the baseline acid-base parameters were essentially identical.

ISSN:1660-8151    

DOI:10.1159/000183629

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In order to compare hemofiltration (HF) and hemodialysis (HD) in connection with the risk of aluminum overload and renal osteodystrophy, double bone biopsies after double tetracycline labeling and a desferrioxamine test were performed in 12 patients on HF and 15 patients on HD. The aluminum concentration was low ( < 0.6 μmol/l) both in the dialysate and the substitution fluid. The duration of treatment (about 2 years) and the cumulative doses of Al(OH)3 and CaCO3 were comparable in the two groups. None of the patients was taking 1α-OH-D. The aluminum balance during an HF run ranged from – 22 to + 1.8 μmol/l, the balance being positive only when the plasma aluminum was < 0.5 μmol/l. Basal plasma aluminum and its increase induced by desferrioxamine were comparable in the two groups. Bone aluminum content was also comparable, but was about 10 times higher than in 7 nonuremic controls. Bone aluminum content and plasma aluminum increase after desferrioxamine were correlated to the Al(OH)3 cumulative dose. None of the patients had florid osteomalacia with increased osteoid thickness, and only 1 in each group had traces of stainable aluminum. The mineralization front was decreased in 8 of 12 HF and in 9 of 14 HD patients, so that no difference was observed between the means of the two groups. The predominant histological bone picture of the patients was osteitis fibrosa which was present in 10 of 12 HF and in 13 of 15 HD patients. Mean osteoclast count and active resorption surface were comparable in the two groups, but was increased (5–10 times the mean of the controls). Conclusions: Aluminum overload exists to a comparable degree in HF and HD patients. It is dependent upon the cumulative dose of Al(OH)3, not upon the procedure per se. After 2 years of treatment, it is not severe enough to induce florid osteomalacia. At this stage, the main histological lesion is osteitis fibrosa induced by hyperparathyroidism. This latter has the same severty in HF a

ISSN:1660-8151    

DOI:10.1159/000183630

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Plasma B12, folate, B6 and thiamine, and red blood cell folate, thiamine and niacin levels were monitored for a period of 6 months in 15 clinically stable, chronic hemodialysis patients who were not supplemented with the water-soluble vitamins. Microbiological assays were used to determine the blood levels of the water-soluble vitamins. Over the period of 6 months, none of the patients had plasma or red cell vitamin levels below the normal range. No appreciable changes were observed in the plasma and red blood cell vitamin levels before and after dialysis in 5 patients. This study showed that chronic hemodialysis patients are able to maintain normal plasma and red cell levels of some water-soluble vitamins without daily supplementation.

ISSN:1660-8151    

DOI:10.1159/000183631

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Eighteen hemodialysis, 12 chronic ambulatory peritoneal dialysis (CAPD), and 20 renal transplant patients performed maximal treadmill exercise tests. Heart rates and blood pressures were determined every minute and maximal oxygen consumption was measured directly. Exercise capacity as measured by VO2 max is low in dialysis patients and similar to sedentary normal individuals in renal transplant patients. Maximal heart rates were significantly lower in hemodialysis patients than transplant recipients. The lower exercise tolerance in end-stage renal disease indicates that most patients regardless of the treatment mode could benefit from attempts through exercise training to increase physical working capacity.

ISSN:1660-8151    

DOI:10.1159/000183632

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Parathyroid hormone (PTH) is elevated in patients with chronic renal failure (CRF) and was suggested to be one of the factors responsible for the anemic syndrome of these patients because it raises the osmotic fragility of the red blood cells (RBC). In the present study, the youngest and oldest RBC were separated from circulating erythrocytes by high-speed centrifugation. The age distribution was described, and the effect of PTH on the different age groups was investigated. Median density (MD) and glutamic-oxaloacetic transaminase (GOT) activity were chosen as age markers. MD (1.0985 ± 0.00087) and GOT activity (12.49 ± 2.083 IU/g Hb) of the young uremic cells did not differ significantly from the values of young normal cells (1.0987 ± 0.00046 and 10.36 ± 1.174 IU/g Hb, respectively). The MD of the oldest cells, however, was lower (1.1048 ± 0.00054) and GOT was higher (6.60 ± 1.1019 IU/g Hb) in the uremic than in the control cells (1.1093 ± 0.00175 and 3.77 ± 0.233 IU/g Hb, respectively). These results indicate that the life span of RBC in uremics is shorter than normal and that an enrichment of circulating RBC by young cells occurs in uremic patients. The median osmotic fragility (MOF) of the young cells was lower in both uremic (0.376 ± 0.006) and control patients (0.378 ± 0.003) than the MOF of old cells (0.402 ± 0.005 and 0.392 ± 0.004, respectively). PTH elevated the MOF of the young cells of both uremics (Δ = 18.7 ± 0.34%) and controls (Δ =17.4 ± 0.74%) more than it affected the old cells (13.9 ± 0.60 and 13.2 ± 0.83%, respectively). These results indicate that PTH may shorten the survival of the RBC in uremia by elevating their osmotic fragility. PTH acts more strongly on the young cells which are enriched in uremia, and thus reduces the result of the compensatory renewal of cells which usually takes place i

ISSN:1660-8151    

DOI:10.1159/000183633

出版商:S. Karger AG    

年代:1986

数据来源: Karger