A new test for IgA containing immune complexes or aggregated IgA: its application to Berger and Schönlein-Henoch nephritis.
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Antigen-Antibody Complex↗
Biomedical subjects
A Aprato
Publications and source records attributed to A Aprato.
[Use of corticotherapy in the treatment of idiopathic glomerulonephritis].
Corticosteroids have multiform effects on traffic and functional capabilities of inflammatory or immunologically reactive cells, on various soluble factors, vascular and tissue responses. There is a different sensitivity of various populations and subpopulations of cells to the corticosteroid modulation. These mechanisms are still under discussion, but the final effects appear to support the use of corticosteroids in a number of idiopathic glomerulonephritis (GN). In the minimal change GN the 10 years after onset survival was not significantly increased by introducing corticosteroids, but the prompt disappearance of proteinuria (80% of adults by 8 weeks in our own series) supported their use. The problem of corticosteroid treatment in the focal sclerosing GN is complicated by the probable coexistence of two histologically undistinguishable forms (one of the these nonsteroid sensitive). In our own series the corticosteroid response, although transient, was present in 44% of 16 patients. We obtained a high number of total remissions (57%) and partial remissions (14%), in membranous GN, where the conflicting data of the literature suggest differences in the criteria of selection and admission of patients to corticosteroid treatment, calling attention to further controlled trials. In rapidly progressive GN the combined use of corticosteroids, immuno suppressants and heparin has elicited a stabilization or improvement of renal function in 40% of the treated patients. By the same treatment we observed a total remission in 19% and a partial remission in 62% of severely nephrotic patients with histological appearance of membranoproliferative GN characterized by massive subendothelial deposits of the early complement fractions (C1, C4). Although it is impossible to draw firm conclusions both on pathogenesis of idiopathic GN or on the biochemical, cellular and tissue effects of corticosteroid, these drugs appear sometimes effective in clinical practice.
Adrenal Cortex Hormones↗
[Semeiotic significance of the clinical use of methods of determining serum immunocomplexes in human glomerulonephritis].
The application of tests for the determination of serum immune complexes in nephrology has supplied fresh pathogenetic and symptomatological information. An account is given of results obtained in primary and secondary glomerulonephritis using four methods; the solid-phase Clq test, the polyethylene glycol precipitation test, the immunofluorescence on polymorphonucleates tests, and the solid-phase conglutinins test (with anti-IgA antibodies). The results take on a symptomatological meaning in many classes of human glomerulonephritis, both in the differentiation of primary forms and those secondary to systemic diseases, and in prognosis. A critical review is made of the data obtained in a personal series in the light of a long-term follow-up. The limits and specificity of each test are also discussed.
Antigen-Antibody Complex↗
[Acute renal failure and multiple trauma].
Only recently the relationship between trauma and acute renal failure has been described on a rational basis. Shock is commonly a major pathogenetic factor in tubulo-interstitial damage often associated with other causes, such as toxic agents, toxins, immunologic and coagulation mechanisms. The Authors consider the various patterns of acute renal failure such as the "functional, tubulo-interstitial, cortical necrosis" and analyze the different etiopathogenesis. Finally they report the mortality rate of acute renal failure in S. Giovanni Hospital of Turin from 1969 to 1979.
Acute Kidney Injury↗
[Hemofiltration: present and future].
Four thousand hemofiltrations have been performed in 22 patients with low tolerance to conventional hemodialysis (20 cases), and severe arterial hypertension (2 cases). In comparison with hemodialysis, hemofiltration had a low incidence of intradialytic collapses, vomit and cramps, and allowed a better state of well-being during interdialytic periods. In hypertensive patients hemofiltration has accomplished a better control of arterial pressure and pharmacotherapy has been reduced. In this study, we report the data concerning metabolism, electrolytes, acid-base balance during our experience utilizing bicarbonate in the replacement fluid. Our experience further supports the impression that hemofiltration may have some advantages in patients with low tolerance to conventional dialysis and/or severe dislipemia and hypertension. The possibility to reduce dialysis duration to 3 hrs, stimulates further application of this new treatment in a wider number of patients on RDT.
Acute Kidney Injury↗
Renal amyloidosis and treatment with dimethylsulphoxide (DMSO).
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Amyloidosis↗
[Regular dialytic treatment in the Piedmont region. Results and prospects].
The Piedmont planning for the prevention and treatment of chronic uremia started in 1976, with the purpose to extending full treatment of the whole region, through the development of home and self care dialysis and intensive use of hospital short dialysis. Hospital dialysis would be reserved either for new treatments or complicated or uncooperative patients. Thank to an intensive exploitation of the existing hospital centers, a 68.7% increment in the number of treated patients was achieved and costs were kept down to a limited acceptable range. With the development of home and self care dialysis, 27% of the patients were located in out-of-hospital centers, and 17% at home. The Piedmont planning concerned itself with the patients' data collected by the Regional Registry under the following items: a) characteristics of dialysis population; b) the present modes of treatment; c) the number of patients apt to varying treatments and renal transplantation; d) the epidemiology of uremia causing nephropathies. At the present time results are only preliminary. Nevertheless, the first observations showed a long and difficult work with good possibilities of success for computerized facilities in the field of dialysis, particularly in respect to regional areas which in the reformed Health Service are now considered to be operating as autonomous.
Adolescent↗