ISSN:1660-8151    

DOI:10.1159/000185800

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

It is well known that macrophages are the principle cells responsible for removal of senescent erythrocytes from circulation and are the major storage cell for body iron. Monitoring stored iron in patients with anemia secondary to renal failure and chronic hemodialysis is an important parameter used for gauging supplementing these patients with iron. We have proven that blood monocyte ferritin unlike serum ferritin reflects adequately bone marrow iron stores and thus replaces an undesirable procedure in such patients namely bone marrow punctures.

ISSN:1660-8151    

DOI:10.1159/000185801

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The therapeutic benefits and risks of short-term corticosteroid were investigated in 8 patients with membranous nephropathy and hepatitis B surface antigenaemia. Seven patients presented with nephrotic syndrome, and the remaining patient had significant proteinuria. Their liver function tests were normal on repeated examination. Their sera demonstrated the persistent presence of hepatitis B virus surface antigen and high titres of antibody to hepatitis B virus core antigen. Hepatitis B virus e antigens were present in the sera of 4 patients at initial presentation. Their clinical responses were compared with 7 similar patients previously treated with diuretic therapy alone and acting as historic controls. Short-term corticosteroid (6 months) with stepwise reduction resulted in an early regression of the nephrotic syndrome in 3 patients. Five patients had persistent but reduced proteinuria. Transient liver impairment was observed in 3 patients. Corticosteroid therapy induced transient viral replication with increased serum concentration of hepatitis B virus e antigen and hepatitis B virus DNA. Two of the 7 patients receiving diuretics developed spontaneous remission though apparently later than those receiving corticosteroid. Yet complications such as liver dysfunction and hypertension were not observed in the patients treated with diuretics. Our findings suggest that corticosteroid therapy could be harmful in membranous nephropathy related to hepatitis B surface antigenaemia, as activation of viral replication could occur with corticosteroid therapy.

ISSN:1660-8151    

DOI:10.1159/000185802

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The incidence and pathogenetic role of hepatitis B surface antigen (HBsAg) were evaluated in patients with IgA nephropathy. Among 130 consecutive patients with IgA nephropathy, HBs antigenemia was detected in 4 patients (3.1%). Serum antibody to hepatitis B core antigen was positive in these 4 patients indicating that they were persistent carriers of hepatitis B virus. Serum hepatitis B e antigen (HBeAg) was detected in 1 patient, and antibody to HBeAg was positive in the other 3 patients. The incidence of HBs antigenemia was not significantly higher than the 2.0% of the general population. An immunofluorescent study in the renal tissues from the 4 IgA-nephritic patients with HBs antigenemia did not demonstrate HBsAg or HBeAg in the glomeruli. These findings suggest that HBsAg appears to play no role in the pathogenesis of IgA nephropathy.

ISSN:1660-8151    

DOI:10.1159/000185803

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Tissue fluid and plasma oncotic pressure levels were measured in an unselected group of 13 patients presenting with congestive heart failure. Patients had a mean serum albumin of 3.6 g&slash;dl ± (SD) 0.35; serum oncotic pressure was 22.23 ± 1.8 mm Hg; tissue fluid (lower leg) oncotic pressure was 0.985 ± 0.34 mm Hg. The oncotic pressure gradient between plasma and tissue fluid was 21.25 Hg ± 1.7. This is about 10 mm Hg greater than △π in normal man. The high value in congestive heart failure is a mechanism to protect against the formation of edema. The possible mechanisms responsible for the formation of edema in congestive heart failure are dis

ISSN:1660-8151    

DOI:10.1159/000185804

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

During hemodialysis there is a complex interaction between the patient and the extracorporeal circuit that activates the complement system, among others. To better understand the influence of the dialyzer geometry and the dialysate composition, we compared hollow fiber versus parallel plate dialyzers and acetate versus bicarbonate dialysates and their role in the production of C3a, C4a and C5a. There was no significant difference in the plasmatic levels of these anaphylotoxins and their des-Arg derivates, as measured by RIA, in either dialyzer. The same was true when the dialysate in question had a different composition. We thus concluded that neither the geometric configuration of the dialyzer nor the composition of the dialysate influence their biocompatibihty as regards the activation of the complement system, and that the differences that have been described shall have to be explained in another manner or assessed by methods other than those used in this study.

ISSN:1660-8151    

DOI:10.1159/000185805

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Over a 1-year period, 239 patients with community-acquired bacteraemia in positive blood culture were prospectively evaluated to establish the prevalence and outcome of acute renal failure (ARF). Fifty-eight patients (24%) were identified as having ARF defined by a doubling or more in serum creatinine. The overall mortality in this group was 53% compared with 22% for patients with bacteraemia but without ARF (p < 0.001). Within the ARF group there were two identifiable subgroups. Thirty patients had resolution of renal failure with treatment of the bacteraemia, and only 6 (20%) of these died. Of the remaining 28 where ARF persisted, 25 (89%) died (p < 0.000001). Nine patients were dialysed, and only 2 survived. The majority of the remaining 24 patients died of overwhelming bacteraemia before dialysis was indicated. ARF is a common finding in community-acquired bacteraemia, and this has a poor prognosis particularly in those without early resolution of renal failure.

ISSN:1660-8151    

DOI:10.1159/000185806

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

We measured membrane fluidity of polymorphonuclear leukocytes (PMN) from 14 uremic patients on hemodialysis by the excimer-forming lipid technique with pyrenedecanoic acid using flow cytometry. Membrane fluidity of PMN was significantly lower in the uremic patients during the predialysis period. During hemodialysis, progressive normalization in membrane fluidity was observed. Cross-incubation studies indicated that this observation is ascribed to factors in the patients’ serum and that they can be removed by hemodialysis. When sera of these patients were fractionated by Sephadex G-25 column chromatography, the specific fraction responsible for a decreased fluidity was found in the low-molecular-weight fraction. Uremic patients have an increased risk of infection, which may be partly due to altered membrane fluidity of their PM

ISSN:1660-8151    

DOI:10.1159/000185807

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Salivary components (proteins, albumin, IgA1, IgA2, IgG, IgM, β2-microglobulin, neopterin and peroxidase) were investigated in 3 adult types of primary glomerulonephritis (PGN): IgA mesangial glomerulonephritis (IgAGN; n = 14); idiopathic membranous glomerulonephritis (n = 8); idiopathic nephrotic syndrome (INS; n = 14), and a control group (n = 11). Salivary IgAl levels were significantly increased in all these PGN whereas salivary IgA2 levels were only higher than controls in INS. Albumin and proteins did not differ between PGN and controls, while the IgAl + IgA2/protein ratio was significantly increased in these 3 PGN. Salivary neopterin levels were enhanced in the 3 types of PGN, whereas β2-microglobulin levels were not. The other salivary components did not differ from controls. These results demonstrate the nonspecificity of the IgA increase at mucosal sites previously found in IgAGN and raise the hypothesis of an activation of mucosal immunity of PGN or of a disturbed isotypic network or lymphokine secretion in these disease

ISSN:1660-8151    

DOI:10.1159/000185808

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

A placebo-controlled study of Ramipril on total and intrarenal flow distribution was carried out in 7 patients with essential hypertension. Cortical nephron flow was measured using radiolabelled tubular secreted radiopharmaceuticals 123I orthoidohippurate or 99mTc mercaptoacetyl triglycine by the transit time distribution technique. Both systolic and diastolic blood pressure were reduced significantly by Ramipril without significant changes in an index of cardiac output or in effective renal plasma flow. Cortical nephron flow increased from 207 ± 7 to 257 ± 21 ml/min (mean ± SEM) p < 0.05 and the percentage of flow to cortical nephrons increased by 6% (p = 0.05). Ramipril corrects the reduced cortical nephron flow found in essential hypertensi

ISSN:1660-8151    

DOI:10.1159/000185809

出版商:S. Karger AG    

年代:1990

数据来源: Karger