摘要:

Glomerular capillary walls of 65 cases of IgA nephritis were observed electron microscopically. At least one-third of the cases showed local abnormalities including thinning and splitting. Usually such lesions were seen to have been protected from the rupture of the glomerular basement membrane by the reparative response of endothelial and/or epithelial cells. Nevertheless, it could be assumed that the small extracapillary lesions frequently observed in IgA nephritis developed from such a locus minoris of the glomerular capillary wall.

ISSN:1660-8151    

DOI:10.1159/000182423

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Red blood cell deformability was measured in 74 cases of renal failure and diabetic nephropathy by means of a modified nuclepore membrane filter method. Low red blood cell deformability was observed in a certain proportion of the patients. In cases of renal failure only weak correlation was found between reduced red blood cell deformability and BUN as well as between reduced red blood cell deformability and creatinine level, while simultaneous changes in these variables were observed in several patients. The reduction in red blood cell deformability in cases of diabetic nephropathy slightly exceeded that in cases of renal failure and correlated with an increment in HbA1c content. The effects of uremic toxins were unclear in in vitro tests. The red blood cell deformability was impaired in nephrectomized rabbits.

ISSN:1660-8151    

DOI:10.1159/000182424

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Plasma retinol and retinol-binding protein (RBP) concentrations have been estimated in patients on maintenance haemodialysis over a 4-year period. For the first 2 years multivitamin supplements containing vitamin A were taken, and for the second 2 years no vitamin A supplements were given. Mean plasma retinol concentrations decreased significantly but only from 3.8 times normal to 3.1 times normal after vitamin A supplements stopped. There was no significant change in the high plasma RBP levels. Ultracentrifugation of plasma at a salt density of 1.21 showed that nearly all the retinol was associated with RBP in the high density protein fraction, as it is with normal subjects. Column chromatography confirmed that there was no increase in plasma retinyl esters in the renal failure patients, as is found in hypervitamincsis A due to drug overdosage. The high plasma retinol and RBP levels remained remarkably stable in individual patients throughout the 4-year study. The increase in plasma RBP was possibly related to residual urine output. The results are compatible with a feedback mechanism whereby the extent of the increase in plasma RBP as renal failure develops controls the consequent high plasma level of retinol.

ISSN:1660-8151    

DOI:10.1159/000182425

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The porphyrin status of 38 renal transplant patients was investigated using a sensitive thin-layer chromatographic assay. Abnormalities of porphyrin synthesis observed in patients on hemodialysis were generally reversed on receipt of a transplant with sustained good renal function. Urinary coproporphyrin levels and the creatinine clearance appeared directly related in both individual cases and generally, substantiating the theory that coproporphyrin is of renal origin. The pre- and postoperative porphyrin status of a unique patient with variegate porphyria who received a successful renal transplant implies that the excess urinary porphyrins and precursors excreted in the acute porphyrias are also of mainly renal, as opposed to hepatic origin. Furthermore, the posttransplant overproduction of porphyrins by a kidney from a normal donor suggests the existence of an endogenous porphyrogenic agent in the circulation of patients with acute porphyria.

ISSN:1660-8151    

DOI:10.1159/000182426

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency occurred in a mother and daughter when each was in her third decade. The mother had prominent neurological findings, fever, and expired from renal insufficiency. Her daughter’s only major symptom was renal insufficiency. The similarity of the mother’s illness to thrombotic thrombocytopenic purpura and of the daughter’s to adult hemolytic uremic syndrome suggests that these diseases are variants of a single clinical disorder, while their occurrence in direct descendents strengthens the postulate that in selected instances a genetic predisposition to these disorders may be impo

ISSN:1660-8151    

DOI:10.1159/000182427

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Dialytic therapy was performed in 2 patients with combined hepatic and renal failure by dialyzing ascitic fluid extracorporeally through an artificial kidney and returning it to the peritoneal cavity. Efficient removal of urea (12.2–25.7 g) and creatinine (0.5–1.2 g) was achieved during each of 4 treatments without the attendant hypotensive and hemorrhagic complications often encountered in these patients when hemodialysis is attempted. Blood urea nitrogen and serum creatinine fell gradually following treatments due to diffusion into the reservoir of dialyzed ascitic fluid. Extracorporeal ascites dialysis thus offers a safe and effective alternative to hemodialysis in patients with ascites and hepatorenal fail

ISSN:1660-8151    

DOI:10.1159/000182428

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We evaluated the effect of endogenous parathyroid hormone (PTH) on serum bicarbonate in 12 patients with postrenal transplant hyperparathyroidism. EDTA-induced hypocalcemia produced a significant rise in serum PTH (p < 0.001). Associated with the increase in PTH was a significant fall in plasma bicarbonate (p < 0.001) and increase in the chloride: phosphorus ratio (p < 0.001). Magnesium remained stable but serum potassium fell in response to EDTA. These observations suggest that endogenous PTH can significantly affect plasma bicarbonate in vivo and may contribute to post renal transplant renal tubular acidosis.

ISSN:1660-8151    

DOI:10.1159/000182429

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

We present 2 patients associated with hypouricemia. Serum uric acid levels were 1.6 and 1.3 mg/l00 ml, and the ratios of urate clearance to creatinine clearance were 34.1 and 39.4%, respectively, while glomerular filtration rates (GFR) were normal. In the pyrazinamide (PZA) suppression test these 2 patients showed a different response of urate excretion. In the first patient urate excretion showed only a slight decrease following PZA. The load of benzbromarone did not increase urate excretion significantly. This patient is considered to have a defect of urate reabsorption in the proximal tubule, resulting in renal uricosuria. The second patient, on the contrary, showed nearly complete suppression of urate excretion after PZA. Uricosuric response to benzbromarone was far less than in the normal subjects. The suppression rate of urate excretion following PZA in benzbromarone-induced uricosuria was similar to the value of the normals. These results suggest that the latter has a defect of postsecretory reabsorption of urate in the tubule.

ISSN:1660-8151    

DOI:10.1159/000182430

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

36 consecutive patients whose biopsies showed significant extracapillary proliferation in the face of rapidly declining renal function were reviewed between 1967 and 1979. About 30% of the patients belonged to the pediatric age group with a male: female ratio of 2.5:1. Oliguria/anuria, hematuria, and progressive renal insufficiency were present in all cases. There was evidence of 9 cases being poststreptococcal, 2 SLE, 1 Henoch-Schönlein purpura, 2 possibly viral and 1 staphylococcal. Histologically, 29 cases had more than 60% crescents, 5 between 50 and 60% and 2 cases a little less than 50%. 28 cases were fatal in less than 10 months. 2 were lost to follow-up. 6 survivors with reversal of renal functions had 3 common factors to note, namely an antecedent disease, less crescents both in number and size, accompanied by fewer interstitial changes and early treatment. Rebiopsy in 2 survivors showed regression of histologic severity

ISSN:1660-8151    

DOI:10.1159/000182431

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A case of hypomagnesaemia due to a urinary leak of magnesium probably due to distal tubular damage by cytotoxic drugs is described. Tetany occurred 2 days after hysterectomy for choriocarcinoma with a plasma calcium of 1.54 mmol/l and magnesium of 0.15 mmol/l. The tetany was abolished, plasma calcium restored to normal and hypomagnesaemia improved by magnesium therapy alone. Circulating parathyroid hormone levels were low suggesting that the hypocalcaemia resulted from hypoparathyroidism induced by the initial severe hypomagnesaemia.

ISSN:1660-8151    

DOI:10.1159/000182432

出版商:S. Karger AG    

年代:1982

数据来源: Karger