ISSN:0886-022X    

DOI:10.3109/08860229109022147

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Approximately 6 million people in the United States are known to be diabetic, with an estimated 4 million individuals having undiagnosed diabetes mellitus. The metabolic derangements of both insulin-dependent diabetes mellitus (IDDM) and noninsulin-dependent diabetes mellitus (NIDDM) result in widespread end-organ damage, including progressive kidney failure. Since its initial description in 1936, the incidence of diabetic nephropathy has progressively increased, and it is now the most common cause of newly diagnosed end-stage renal disease (ESRD) requiring renal replacement therapy in the United States. While basic research efforts into pathogenesis continue, there is significant interest in clinical interventions that may slow the progression of diabetic renal disease. In addition, the options available for renal replacement therapy have increased and improved substantially in recent years.

ISSN:0886-022X    

DOI:10.3109/08860229109022148

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The post insult administration of vascular decongestants has resulted in attenuation of experimental acute renal failure (ARF) following the introduction of various nephrotoxins including drugs, heavy metals, and endotoxin. In the present, study, the dose-dependent effects of a novel methylxanthine, HWA-138, were studied in the glycerol-induced murine model of ARF. Renal function, assessed by serial inulin clearances at 24 and 48 h after glycerol injection, urinary electrolyte excretion rates, and renal morphology, was compared between controls and those given glycerol and single i.v. doses of0.1, 0.5, 1.0, 5.0, and 10.0mg/kg of HWA-138, or physiologic saline. Whereas significant renal dysfunction was found in all animal groups given glycerol, the mean inulin clearance values of animals given HWA-138 1 mg/kg closely approximated values found in control rats. There were no changes in renal electrolyte excretion rates in animals given HWA-138 compared with relative natriuresis found in untreated glycerol ARF rat. Although a modest decrease in medullary congestion was associated with rats given 1 mg/kg of HWA-138, there was no obvious structural improvement found with HWA-138. The present data provide further evidence of the potential of methylxanthines in the glycerol-ARF murine model.

ISSN:0886-022X    

DOI:10.3109/08860229109022149

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The present study investigated the renal function in male Sprague—Dawley rats receiving continuous NaHCO3(0.077 M) infusion. The renal effects of aldosterone administration in this preparation were also examined. Continuous NaHCO3infusion significantly (p<0.01) depressed plasma aldosterone concentration to 2.36±1.22 nmol (n = 8) when compared to saline infused rats (4.36±0.72 nmol, n = 7). The low plasma aldosterone levels in HCO3-infused rats was associated with renal loss of large amounts of K+and hypokalaemia. Aldosterone administration (42 pmol/min) for 2 h significantly (p<0.01) reduced the Na+excretion rate in bicarbonate infused rats from a mean peak of 9.82±1.16 to 5.16±1.20μmol/min (n = 8). Aldosterone administration did not alter renal excretion in saline-infused rats. It is concluded that NaHCO3loading depressed endogenous aldosterone secretion, and that this lowered endogenous plasma aldosterone level allows the mineralocortoid effect of exogenous aldosterone to be observed.

ISSN:0886-022X    

DOI:10.3109/08860229109022150

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Intermediary metabolism has been studied in a viable suspension of renal proximal tubules isolated from dogs before and after 48 h of a 60 min period of renal ischemia by clamping the renal artery. The study consisted in measurements of tubular uptake/production of glucose, lactate, glutamine, glutamate,α-ketoglutarate, alanine, ammonium, and oxygen, using as substrates either glutamine 1 or 5 mM (+ glutamate 0.1 or 0.5 mM) or lactate 1 or 5 mM (+ pyruvate 0.1 or 0.5 mM). The combination of glutamine + lactate was also studied. Data revealed that the gluconeogenic ability of the postischemic tubules was maintained, with the exception of glutamine 5 mM as substrate (8.5±2.1 vs 15.4±2.1 n`mol/min/g in control tubules). The production of NH4was also decreased only with this substrate (from 214±15 to 165±9 n`mol/min/g). Lactate extraction was decreased in the postischemic tubules, but the difference was only significant when lactate + glutamine 1 mM was used as substrate (72±12 vs 44±6 n`mol/g/min). Postischemic tubules showed a greater oxygen consumption when either glutamine or lactate 1 mM were used, but lower ouabain-inhibitable O2consumption when these substrates were used at 5 mM. These data revealed a modification of the metabolic profile of proximal tubules during the recovery of transient renal ischemia.

ISSN:0886-022X    

DOI:10.3109/08860229109022151

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Since the introduction of interferonα-2b (IFNα-2b) into clinical oncology there have been several reports dealing with acute renal failure during therapy with this new type of anticancer drug. We investigated 58 patients (pts) with myeloproliferative syndromes (56 pts with chronic myelogenous leukemia, 2 pts with essential thrombocythemia) who were treated with 4×106IU IFNα-2b each day subcutaneously. In order to assess the nephrotoxic potential we used the following noninvasive methods: 1. Analysis of the excretion of 4 urinary enzymes (LDH, LAP, GGT, NAG), 2. Determination of the excretion of protein, albumin,α-1-microglobulin immunoglobulin G (Ig G), 3. serum creatinine. The investigations were done every 2 weeks and took 70 weeks. We found an increase in the excretion of all 4 enzymes which remained stable during the whole observation period, protein excretion was pathological in about 20% of all pts and reached values of up to 9.07 g/Lα-1-microglobulin was excreted in pathological amounts in about 20% of all pts during the whole observation period, albumin was found in pathological quantities in about 15% of all pts and Ig G was pathologically increased in the urine in about 10% of the pts. Serum creatinine rose in 5–10% of the pts up to 1.5 mg/dL. In conclusion, IFNα-2b is capable of inducing combined glomerular and tubular damage. Therefore, avoiding additional nephrotoxic insults is desirable.

ISSN:0886-022X    

DOI:10.3109/08860229109022152

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The administration of a single-injection of Adriamycin (ADR) to rats results in marked proteinuria and glomerular morphological changes that are similar to minimal change disease in humans. We have hypothesized that Adriamycin, by itself or through the release of some mediators from resident glomerular cells, could provoke a damage to epithelial glomerular cells. Sprague-Dawley rats received a single injection of Adriamycin, 7.5 mg/kg bw, allocated randomly in several groups and treated throughout 2 weeks of follow-up. All control nontreated animals developed important nephrotic syndrome and degenerative lesions of epithelial glomerular cells. Isolated glomeruli from animals injected with adriamycin 14 days before synthesized tromboxane (TxB2) and platelet activating factor (PAF) in amounts above the rates of control glomeruli. Animals treated with three structurally different PAF receptor antagonists did not present proteinuria or only to a very low extent (p<0.0005). In these rats no alterations in epithelial cells were noted. Furthermore, no significant changes in the TxB2 production were noted in rats treated with BN 52021, a PAF receptor antagonist. Leukotrienes also seem to participate since treatment with a 5-lipoxygenase inhibitor partially corrected proteinuria. Moreover, glomeruli from animals with nephrosis and treated with this compound presented only a discrete reduction in the PAF synthesis. On the whole, these data suggest a key role for PAF in the pathogenesis of adriamycin nephropathy. Other lipid meditors, released in cascade simultaneously or thereafter, could perpetuate the renal damage.

ISSN:0886-022X    

DOI:10.3109/08860229109022153

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

From November 3, 1975, to May 31, 1989, 711 (548 living-related and 163 cadavers) kidney transplantations were performed in our centers. In the final 2 years, 15 ABO-incompatible living related kidney transplantations were performed. In 4 cases, the recipient's blood groups was O and the donor's A1. In 3 cases the blood group of the recipient was A1and the donor's AB, two patients were B with the donors A1and the other 2 were O with donors B. The other 3 recipients group was B and the donors' were AB. The donors' and recipients' HLA-AB typing showed one haplotype matching in 12 and two haplotypes matching in 3 patients. The donors were mothers in 7 cases, sibling in 5, and father in 3 cases. At least 3 weeks before the renal transplantation, donor-specific skin grafts and subsequently splenectomy were performed on 9 recipients, but on 6 recipients without splenectomy. Following the skin graft, cross-match was done starting from the 15th day and then continued every week. The immunosuppression, which consisted of triple drugs (0.5 mg/kg prednisolone, 2 mg/kg cyclosporin-A and 2 mg/kg azathioprine) was followed by skin graft. Renal transplantation was performed according to cross-match and skin graft results, and all recipients prior to surgery received at least two sessions of plasmapheresis. Regular dose of immunosuppression that included triple drugs were used after the kidney transplantation and then Orthoclone OKT-3 and plasmapheresis were applied during the rejection episodes without bolus therapy. All patients were followed for 5 to 24 months (ave. 14,13 months). All grafts except one showed immediate function; one hyperacute rejection was encountered and the grafts were lost. Four patients displayed acute rejection on the 3rd to 7th days of the posttransplantation period. The conclusions were: (a) Effective and special immunosuppressive methods are necessary for renal transplantation in ABO-incompatible patients. (b) Donor specific skin grafts can be used as a simple guide factor in ABO-incompatible kidney transplantation.

ISSN:0886-022X    

DOI:10.3109/08860229109022154

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

We have used machine hemofiltration (MHF) with lactate-buffered hemofiltraton replacement solution in the management of four patients with severe hepatorenal failure. Hyperlactatemia developed in all four patients. However, consecutive treatments were associated with increasing blood lactate values postfiltration in the two patients who died and with a fall in the lactates in the two patients who survived. The survivors had lower postfiltration blood lactates 3.2±0.2 mmol/L (mean±SEM) compared to the nonsurvivors, 5.3±0.5 mmol/L (p<0.01). This suggests that the measurement of blood lactate following a lactate challenge may be of prognostic significance in patients with severe hepatorenal failure.

ISSN:0886-022X    

DOI:10.3109/08860229109022155

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0886-022X    

DOI:10.3109/08860229109022156

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor