ISSN:0250-8095    

DOI:10.1159/000168581

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Between January 1990 and December 1991, serial real-time ultrasound examinations and analyses of urine were performed on a total of 50 infants with birth weights less than 1,500 g to assess the incidence of renal calcification. Five infants (10%) developed renal calcification at a mean age of 48.8 ± 14.1 days. These 5 infants with renal calcification had significantly shorter gestations (28.2 ± 0.8 vs. 30.1 ± 1.7 weeks, p < 0.0005) and lower birth weights (934 ± 45 vs. 1,311 ± 188 g, p < 0.0005) when compared with infants without renal calcification. None of the affected infants were treated with furosemide. Affected infants had a mean urine volume of 85.8 ± 11.3 ml/kg/24 h, mean urine calcium level of 5.07 ± 1.18 mg/kg/24 h, mean urine calcium to creatinine (mg/mg) ratio of 0.67 ± 0.09, and a mean urine N-acetyl-β-D-glu-cosaminidase (NAG) to creatinine (U/g) ratio of 259 ± 133. Urinalyses showed that affected infants had significantly higher urine pH values and hematuria. Alkaline phosphatase concentrations and initial parathyroid hormone levels were not different among the two groups. In summary, renal calcification occurred in 10% of very low birth weight infants and multiple risk factors seem to be contributory. The smaller, sicker and more immature infants appear to have increased risk for developing renal calcification. For earlier detection and treatment of renal calcification, follow-up screening by serial ultrasound examinations and assay of urinary excretion of calcium, creatinine and NAG are useful, and a meticulous search for the causes of renal calcification is

ISSN:0250-8095    

DOI:10.1159/000168582

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

We evaluated the course of severe aluminum-related bone disease (ARBD) after the first year of a successful renal transplantation (RTx) in 11 adult patients. Bone pain and muscle weakness, presented in all patients previously to RTx, subsided, and all were able to walk, even the ones who were confined to wheelchairs. Bone necrosis developed in 6 patients, but none required surgical repair. Serum alkaline phosphatase activity increased 2.5 times the upper normal level, up to the 5th month and then declined to normal levels up the 12th month (p < 0.05). The inverse profile was observed in both serum calcium and phosphorus levels. In bone biopsies, there was a significant decrease in all of the following histomorphometric static parameters: osteoid volume, thickness and surface and also in aluminum surface. Also, there was a significant increase in all the dynamic parameters of mineralization: mineral apposition rate, mineralization surface, bone formation rate and adjusted apposition rate. In conclusion, ARBD remarkably improves after 1 year of successful RTx.

ISSN:0250-8095    

DOI:10.1159/000168583

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The issue of secondary hyperparathyroidism in idiopathic hypercalciuria (IH) was addressed in 61 male idiopathic calcium stone formers (SF) who underwent metabolic evaluation on a free-choice diet as well as bone mineral density (BMD) measurements by dual-energy X-ray absorptiometry. They were divided into hypercalciurics (HCSF, n = 30, Uca 7.5 mmol/day) and normocalciurics (NCSF, n = 31, Uca X V < 7.5 mmol/day). At identical blood Ca2+ levels, parathyroid hormone (PTH) was lower in HCSF (25.3 ± 1.8 pg/ml) than in NCSF (31.4 ± 1.8 pg/ml, p = 0.017). Since neither fasting urinary hydroxyproline nor pyridinoline/deoxypirdinoline excretions nor BMD values were different between HCSF and NCSF, chronic bone dissolution as the cause of relative hypoparathyroidism in HCSF could be excluded. Despite lower PTH in the face of similar phosphate, Ca2+ and IGF-1 blood levels, however, serum 1,25-dihydroxyvitamin D3 (calcitriol) concentrations were slightly (though not significantly) higher in HCSF than in NCSF (52.8 ± 3.2 vs. 47.3 ± 2.9 pg/ml, p = NS), and calcitriol/PTH ratio was elevated in HCSF (2.52 ± 0.29) vs. NCSF (1.66 ± 0.15, p = 0.001). Creatinine clearance, significantly higher in HCSF than in NCSF (113 ± 4 vs. 92 ± 3 ml/min/ 1.73 m2, p = 0.0001), was positively correlated with excretion rates of urinary markers of both protein and NaCl intake. Since serum calcitriol levels were positively correlated with creatinine clearance (r = 0.350, slope = 0.288, p = 0.006), up-regulation of calcitriol synthesis with subsequent relative hypoparathyroidism in HCSF is – at least partly – explained by exaggerated protein and sodium

ISSN:0250-8095    

DOI:10.1159/000168584

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

314 patients, aged 65 years or older, were biopsied because of a history of renal disease. In 203 patients, glomerular disease was diagnosed with one fourth having systemic disease and the remaining primary glomerulonephritis. 90 patients had tubulointerstitial disease, and 21 patients showed prominent vascular pathology. In a comparison with patients of younger age groups, it appeared that amyloidosis, membranous nephropathy, vasculitis and diabetes had a significantly higher incidence in the elderly. Main glomerular syndromes such as nephrotic syndrome and rapidly progressive glomerulonephritis imply to be managed appropriately. Glomerulosclerosis was found in high frequency, either as an isolated feature or associated with other lesions. Glomerulosclerosis seemed to be ischemic in origin and seems to represent a distinct entity as a cause of pathology in the elderly.

ISSN:0250-8095    

DOI:10.1159/000168585

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The aim of this study was to determine whether or not angiotensin-converting enzyme inhibitor, enalapril, could ameliorate the chronic tubulo-interstitial nephropathy (TIN) in uninephrectomized (UNx) rats. Chronic TIN(M) was induced by 2-bromoethylamine hydrobromide. Rats were assigned to five groups; control, UNx-control (UNxC), UNx treated with enalapril (UNxE), UNxMC and UNxME. Enalapril was given for 12 months as drinking water (50 mg/l). At 6 months, albuminuria in UNxE decreased significantly compared with UNxC, but without change in UNxM rats. By 12 months, although all rats in control, UNxC and UNxE remained alive, 1 and 4 rats died in UNxME and UNxMC, respectively. Albuminuria in UNxC was reduced significantly by enalapril but not in UNxM rats. Both urine volume and urine osmolality became equal to control by enalapril in UNx rats, but not in UNxM rats. Serum cholesterol levels were normalized by enalapril in UNx rats, but not in UNxM rats. Levels of serum creatinine and blood urea nitrogen were invariably higher in UNxM than in UNx rats, irrespective of enalapril. Glomerular sclerosis was statistically decreased by enalapril in both UNx and UNxM rats. Enalapril reduced the overall tubulo-interstitial lesions in UNx rats, but not in UNxM group. However, in UNxM rats tubular changes in medullary portion were significantly ameliorated by enalapril. These data suggest that enalapril has a beneficial effect on chronic TIN in this model.

ISSN:0250-8095    

DOI:10.1159/000168586

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Abnormalities in the function of the central nervous system exist in phosphate depletion (PD). It is possible that this is due to an adverse effect of PD on the metabolism of neurotransmitters, such as norepinephrine (NE), in brain synaptosomes. We examined the effects of PD, produced by restriction of dietary phosphate intake on NE metabolism of brain synaptosomes. Synaptosomes from PD rats had significantly reduced NE content, uptake and release, elevated Km, but normal Vmax of tyrosine hydroxylase, normal Km and Vmax of monoamine oxidase, elevated resting levels of cytosolic calcium ([Ca2+]i), higher A[Ca2+]i in response to KC1, higher A[Ca2+]i/basal [Ca2+]i ratio, lower ATP content and reduced activity of Na+-K+-ATPase as compared to synaptosomes from pair-weighed rats. Treatment of PD rats with verapamil corrected all the synaptosomal derangements except for the elevated Km of tyrosine hydroxylase and NE content. Verapamil did not affect the metabolism of PW rats. The data demonstrate that PD causes significant derangements in NE metabolism of brain synaptosomes. Observations in the present study and in others indicate that these derangements in NE metabolism are due to the PD-induced abnormalities in the homeostasis of synaptosomal [Ca2+]i, ATP and phospholipids and in the activities of Na+-K+-ATPase and Ca2+-ATPase.

ISSN:0250-8095    

DOI:10.1159/000168587

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Obese Zucker rats spontaneously develop lipoprotein abnormalities, proteinuria, mesangial expansion and glomerulosclerosis. Previous studies have implicated these lipoprotein abnormalities in the pathogenesis of the progressive renal injury which these rats develop. The present study was designed to examine the chronological development of very-low-density lipoprotein (VLDL) abnormalities and renal injury. Obese and lean Zucker rats were maintained on a standard rat diet and sacrificed at 6, 11, 17, 23, 28, and 34 weeks of age. Renal tissue was examined histologically, serum was assayed for lipoproteins, and 24-hour urinary protein excretion determined. Hypertriglyceridemia, elevated VLDL-cholesterol and VLDL-triglycerides were seen at as early as 6 weeks of age in obese rats at a time when other lipoprotein fractions were normal. By 23 weeks, proteinuria developed in obese animals and renal tissue showed increased mesangial matrix, hypercellularity and glomerulosclerosis with lipid deposition noted in the mesangium. All of these abnormalities worsened during the 34 weeks of study at a time when almost all of the total circulating cholesterol was carried by VLDL rather than low-density lipoprotein (LDL), the predominant carrier of circulating cholesterol. These data suggest that increased lipoproteins with atherogenic potential, specifically cholesterolrich VLDL and triglyceride-rich VLDL particles, correlated positively with the development of renal injury and glomerulosclerosis in obese Zucker rats. They further support a hypothesis that the increased appearance of atherogenic lipoproteins, particularly cholesterol-rich VLDL, may be associated with proteinuria and progressive glomerular injury.

ISSN:0250-8095    

DOI:10.1159/000168588

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000168589

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The purpose of this report is to present a case of rhabdomyolysis associated with hypocalcemia due to idiopathic hypoparathyroidism. Throughout hospitalization and 1 year of outpatient follow-up, this patient displayed an inverse relationship betwee serum creatine phosphokinase and lactic dehydrogenase levels, and serum calcium levels.

ISSN:0250-8095    

DOI:10.1159/000168590

出版商:S. Karger AG    

年代:1993

数据来源: Karger