ISSN:0250-8095    

DOI:10.1159/000166574

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The acute blood pressure response to the angiotensin converting enzyme inhibitor, captopril, was used to measure participation of the renin-angiotensin system in treatment-resistant hypertension. By 2 h after a single 25-mg oral captopril dose in patients still receiving a diuretic-vasodilator-beta-blocker combination, systolic and diastolic blood pressures had fallen significantly; the decrease in diastolic pressure correlated with the control (immediately pre-captopril) plasma renin activity (r = 0.64, p < 0.001). Apart from its possible contribution to the underlying hypertension, this captopri-identified renin component may have reflected diuretic and vasodilator-induced renin stimulation that could not adequately be prevented by the renin-lowering properties of the beta-blocker. Captopril, and perhaps other specific antirenin drugs, therefore, may be valuable adjuncts to treatment in patients with hypertension refractory to conventional therapy.

ISSN:0250-8095    

DOI:10.1159/000166575

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Renal function and life expectancy can be improved by aggressive antihypertensive therapy in severe hypertension. However, most reports of severe hypertension and renal failure concern primary hypertensive states. 3 cases of primary renal disease, 1 glomerular, 1 obstructive and 1 of chronic pyelonephritis, are described here. In all 3 cases, severe hypertension and renal failure were present. Adequate reduction in blood pressure resulted in substantial improvement in renal function.

ISSN:0250-8095    

DOI:10.1159/000166576

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

This report reviews the features of 149 cases of renal allograft rupture, while adding a detailed description of 3 more cases to the English literature. From November, 1973 to November, 1979, 3 cases of renal allograft rupture occurred in 100 renal transplants performed at Research Medical Center, Kansas City, Mo., an incidence of 3.0%. Rupture developed between the 6th and 8th day after transplantation while patients required dialysis because of poor allograft function. All patients had surgical exploration and successful repair of laceration. Clinical and/or histological findings were consistent with acute rejection in all 3 cases. One graft functioned for 5 years with gradual loss of function. The other two grafts are functioning at the present time. Review of reported cases suggests that acute rejection is the most common cause of allograft rupture. Rupture of the renal allograft did not appear to increase the intensity of rejection, nor did it represent an irreversible rejection. Transplant nephrectomy can be avoided unless hemorrhage is uncontrollable from the site of laceration.

ISSN:0250-8095    

DOI:10.1159/000166577

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

2 patients with systemic lupus erythematosus and mild renal functional impairment were treated with ibuprofen, one of the phenylproprionic nonsteroidal anti-inflammatory drugs. Within days after the onset of therapy, both developed renal insufficiency manifested by elevated serum creatinine levels, increased proteinuria, and active urinary sediments; 1 patient was oliguric. Renal biopsies disclosed mesangial proliferative lupus glomerulonephritis and acute tubular necrosis, the latter more pronounced in the oliguric patient. Renal failure resolved following discontinuation of ibuprofen and supportive therapy. It is postulated that altered blood flow, mediated through the well-known prostaglandin synthetase inhibitory effects of ibuprofen, resulted in tubular necrosis. This undesirable complication of ibuprofen therapy may be enhanced in patients with underlying renal disease, and may be a factor governing the limitation of its usage.

ISSN:0250-8095    

DOI:10.1159/000166578

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Rapid proteolytic digestion of three subunits of phosphorylase kinase was shown in plasma ultrafiltrates from a patient who was admitted with multiple traumatic injuries, respiratory insufficiency, hemorrhagic shock and acute renal failure. The observed cleavage of phosphorylase kinase may be a consequence of protease-antiprotease imbalance. After an initial determination of 80 mg/dl the alpha2-macroglobulin values were too low to be detected. Addition of purified alpha2-macroglobulin to the ultrafiltrates resulted in complete inhibition of phosphorylase kinase digestion in vitro. Aprotinin did not inhibit proteolytic digestion. Daily dialysis did not ameliorate the observed protein catabolism of this patient. These findings may have clinical application in hypercatabolic states, if alpha2-macroglobulin becomes available in a form suitable for human use.Introduction

ISSN:0250-8095    

DOI:10.1159/000166579

出版商:S. Karger AG    

年代:1982

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166580

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A patient developed a right pleural effusion soon after starting a program of continuous ambulatory peritoneal dialysis. The etiology of the effusion was unclear. 99mTc-labelled macroaggregated albumin was administered intrapentoneally, followed by 2 liters of dialysate. Trans-diaphragmatic leakage was clearly demonstrated, and confirmed by high count rates of pleural fluid with negligible blood count. This method can safely be used to demonstrate trans-diaphragmatic fluid leakage in peritoneal dialysis patients.

ISSN:0250-8095    

DOI:10.1159/000166581

出版商:S. Karger AG    

年代:1982

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166582

出版商:S. Karger AG    

年代:1982

数据来源: Karger

ISSN:0250-8095    

DOI:10.1159/000166583

出版商:S. Karger AG    

年代:1982

数据来源: Karger