摘要:

In uremic patients, hyperlipoproteinemia is common, but its role as a risk factor in atherogenesis remains controversial. The main abnormality appears to be diminished catabolism of lipoproteins in the face of unchanged or low hepatic synthesis. The relation of diminished catabolism to reduced postheparin lipolytic activity and selective deficiency of hepatic triglyceride lipase remains to be established. Hyperlipoproteinemia in uremic patients, most commonly of the type IV variety, responds to dietary methods (reduction of carbohydrate content, increase in P/S ratio) or pharmacological intervention. Guidelines for therapy remain controversial in view of the uncertainty about the pathogenic role of hyperlipoproteinemia in atherogenesis.

ISSN:1660-8151    

DOI:10.1159/000181745

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Serum lipids were studied in 98 nonnephrotic patients with chronic renal failure at pre-dialysis, dialysis and post-transplant stages. Hypertriglyceridemia was observed in pre-dialysis patients, although its degree was a modest one as compared to the preceding occidental reports. This difference may be ascribed to an ethnic peculiarity, since Japanese patients have a diet richer in carbohydrate than their Caucasian counterparts (% carbohydrate/total calories of 70 vs. 54–58). Hypertriglyceridemia persisted in the hemodialysis group, while no elevation was observed in serum cholesterol level. Elevated serum cholesterol levels were found in post-transplant patients. 8 pre-dialysis patients were fed carbohydrate-rich (64% of total calories) and carbohydrate-poor (47%) diets, each for 1 week successively, while maintaining an isocaloric level of 1,800 cal and a similar polyunsaturated to saturated fatty acid ratio (0.90 vs. 0.76). Significant reduction in serum triglycerides (TG) took place due to a decrease in dietary carbohydrate, while the plasma extrahepatic and hepatic post-heparinic lipolytic activities (PHLAs) showed constant decreased levels throughout the diet therapy. This may be suggestive of a deranged TG metabolism present in all pre-dialysis patients studied, primarily because all the pre-diet PHLAs were low even though the serum TG levels were not necessarily elevated and secondarily, a carbohydrate-rich diet could not induce such a reactive elevation in extrahepatic PHLA as would normally be observed. In conclusion, hypertriglyceridemia in patients with chronic renal failure may be caused by potentially defective TG-clearing ability that becomes manifest by conventional carbohydrate-rich die

ISSN:1660-8151    

DOI:10.1159/000181746

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Most of the 52 patients on maintenance dialysis investigated in this study suffered from arterial hypertension in spite of efforts to reduce ‘dry weight’. In this situation we found that the majority of patients were underweight and that total body water, extracellular volume and blood volume were close to normal when related to reference systems consisting of height and age. Hypertensive patients were not volume expanded as compared to normotensive patients and controls. Plasma renin activity and angiotensin II were elevated in a few patients, with a trend to higher levels in the more hypertensive patients. Various approaches attempting to correlate blood pressure and the respective volume-renin factors did not prove to be conclusive in explaining the maintenance of hypertension in chronic renal failure on the basis of the sodium-renin feedb

ISSN:1660-8151    

DOI:10.1159/000181747

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The concentrations of fibrin degradation products (FDP) in the urine were determined by the passive hemagglutination test in 115 patients with biopsy-proven chronic proliferative glomerulonephritis (GN), 93 patients with urinary tract infection (UTI) and 23 patients who received kidney transplants. The active GN values (12.3 µg/ml) are significantly higher than those for latent GN (0.3 µg/ml). Those for acute UTI (9.2 µg/ml) are significantly higher than for chronic UTI (1.3 µg/ml). In contrast to the reports published by others, the numerous ‘false-positive’ and ‘false-negative’ values make diagnosis of the activity questionable. Prognostic value can be expected in GN with the nephrotic syndrome (NS): patients with steroid-sensitive NS excrete no FDP and patients with steroid-resistant NS excrete larger quantities of FDP. We have confirmed that a rise in the urinary FDP level in transplantation is indicative of rejection. However, since 10 of 27 rejections were FDP-negative, the absence of FDP in the urine does not preclud

ISSN:1660-8151    

DOI:10.1159/000181748

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The serum levels of 25-hydroxycholecalciferol (25-OHD3) and 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] were measured simultaneously in nephrectomized patients on maintenance haemodialysis, in haemodialyzed patients with preserved kidneys who were receiving different vitamin D supplement, and in patients who had undergone renal transplantation. The results indicate that the production of 1,25-(OH)2D3 can be stimulated in patients with minimal residual renal excretory function by increasing the serum levels of 25-OHD3. Successful renal transplantation was followed by a rise in serum 1,25-(OH)2D3 concentrations.

ISSN:1660-8151    

DOI:10.1159/000181749

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The Spanish brush goat (Capra hiricus) was studied as an animal model for the anephric state. This rugged animal has a hardy appetite and offers ready blood access for dialysis and sampling. BUN, plasma creatinine and potassium could be brought to normal values by daily hemodialysis. Continual weight loss, severe anemia and some tendency for the development of hypertension were observed despite dialysis. Maintenance of a healthy rumen proved a continual challenge but was possible by hyperalimentation and vigorous dialysis immediately postnephrectomy.

ISSN:1660-8151    

DOI:10.1159/000181750

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

As part of an evaluation of the Spanish brush goat (Capra hiricus) as an anephric animal model, free amino acids were determined in plasma before and after 4-hour hemodialysis periods for 30–90 days following nephrectomy. The 72 liters of dialysate used in 4 h contained 15–17 mmol free amino acids in about the same proportions as in pre-dialysis plasma. Acid hydrolysis of deproteinized dialysate fluid released an additional 20 mmol amino acids, with much of the increase due to bound glycine. Despite the loss of some 5 mmol into dialysate, essential amino acids in plasma were unchanged during dialysis, indicating rapid replacement from some intracellular source (probably via breakdown of tissue protein). Some nonessential amino acids, particularly glycine and alanine, were considerably lowered by dialysis, suggesting that synthesis is required for maintenance of normal concentrations. Essential amino acids in predialysis plasma declined soon after nephrectomy and continued to fall during the ensuing 2–3 months, but most nonessential amino acids remained at about control levels. Both valine and tyrosine were decreased in the anephric animal, so the valine: glycine and tyrosine: phenylalanine ratios were lower than in controls. The general similarity between these data and those found for many uremic patients suggests that the anephric goat may provide a convenient model for study of negative nitrogen balance and other processes known to occur in u

ISSN:1660-8151    

DOI:10.1159/000181751

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Two siblings are described with hypertension, hyperreninism, hyperaldosteronism and hypokalemia. Propranolol therapy lowered blood pressure markedly, but failed to normalize serum potassium. Indomethacin orally decreased blood pressure and normalized all biochemical abnormalities. We suggest that in these patients there exists a renin-dependent hypertension in combination with a state of hyperprostaglandinism. It is likely from our studies in these 2 patients, that the state of hyperprostaglandinism is secondary to a hypertension with increased sympathetic tone.

ISSN:1660-8151    

DOI:10.1159/000181752

出版商:S. Karger AG    

年代:1980

数据来源: Karger