[Urinary lithiasis in children. Etiology, diagnosis and medical treatment].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A Chachati.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Upper gastrointestinal tract pathology observed at autopsy in 94 patients with end-stage renal disease (GFR less than 10 ml/min) was analysed retrospectively. To better evaluate the effect of haemodialysis on this pathology, the chronic renal failure patients were subdivided into three groups: 19 patients who had died before haemodialysis treatment could be undertaken (group I), 21 patients who had died during the first month (group II), and 54 patients who had died after at least one month of haemodialysis treatment (group III). The results revealed that the number of patients with upper gastrointestinal tract pathology was significantly higher in groups I and II (58% and 57% respectively) as compared to group III (31%) and controls (35%). No difference could be demonstrated between group III and controls. The most prevalent lesions observed were gastritis, followed by gastric and peptic ulcers. The incidence of this pathology appeared to decline as the duration of dialysis therapy increased. Mortality caused by upper gastrointestinal tract pathology remained high during the first two years of treatment in group III, despite a smaller incidence of upper tract lesions. This was explained by a relatively higher proportion of haemorrhage.
The precise measurement of glomerular filtration rate (GFR) and renal plasma flow (ERPF) usually requires continuous intravenous administration of adequate substances, with multiple blood and urine analysis, and does not allow measurement of separate renal function. Schlegel et al. and Gates described isotopic methods for the measurement of global and unilateral GFR and ERPF based on the determination by scintillation camera of the fraction of the injected dose ([99mTc]DTPA-[131I]hippuran) present in the kidneys 1-3 min after its administration. These methods require counting of the injected dose and correction for attenuation, but no blood or urine sampling. We have validated these techniques by simultaneous infusion of inulin and PAH in patients with various levels of global renal function (anuric to normal). To better define unilateral renal function we have also studied nine kidneys in patients either nephrectomized or with a nephrostomy enabling unilateral function measurement. A good correlation between inulin or PAH clearances and fractional uptake of [99mTc]DTPA or [131I]hippuran by the kidney was observed. Very good reproducibility of both isotopic techniques was shown. We conclude that determination of the fractional uptake of [99mTc]DTPA and [131I]hippuran between 1 and 3 min allows good and reproducible prediction of global and especially of unilateral kidney function with great rapidity and simplicity, rendering this technique suitable for clinical practice.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Considerable discrepancies exist in the literature concerning Na excretion by the rat kidney in experimental antiglomerular basement membrane (GBM) glomerulonephritis (GN). Previous studies in our laboratories demonstrated a disturbance in Na excretion with an impaired absolute (UNa X V) and fractional (FENa) excretion of Na after saline loading. However, most of the other authors in the literature failed to observe similar findings. The present study was undertaken to elucidate some of these controversies: We showed that a difference in Na excretion between anesthetized GN and normal rats might not be detected after a volume expansion if the latter is small or slow (FENa in GN 2 +/- 0.1%, in normals 2 +/- 0.2%; not significant). Only a rapid and important volume expansion is sufficient to unmask such a difference between the two groups (FENa 3 +/- 0.3 and 6 +/- 1%, respectively, p less than 0.001), and detect an impaired Na excretion in GN animals. The same amount of NaCl was nevertheless administered during slow and rapid volume expansion. Similarly, in GN conscious rats only after a saline load or repeated water loads did we observe a significantly smaller UNa X V compared to normals while no difference was present between the two groups after a single water load. In the literature, all the authors, that failed to demonstrate a disturbance in Na excretion in anti-GBM GN, administered slow and small isotonic saline loads to their rats. The hypothesis we formulate to explain these controversies is that the nonobserved disturbance in sodium excretion in most of these studies is probably secondary to insufficient natriuretic stimuli.
In the light of accumulating evidence implicating the diluting segment as the site of final regulation of sodium excretion by the nephron, we produced in this experiment distal blockade in anti-glomerular basement membrane (GBM) glomerulonephritic (GN) rats by the administration of furosemide and polythiazide. This allowed to dissociate the sodium reabsorption that occurs in the proximal tubule from the one that occurs more distally and permitted an appreciation of the rôle played by the diluting segment in the sodium retention of anti GBM GN. In a previous experiment we showed that GN conscious or anaesthetized rats presented an increase in Na tubular reabsorption and failed to raise their fractional and absolute excretion of sodium as normal one did after rapid volume expansion. In this study distal blockade corrected almost completely the difference in sodium excretion that existed between GN and normal groups before the administration of diuretics, pointing to the important rôle played by the diluting segment in the sodium retention of experimental GN.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Sixteen adults patients with insulin-dependent diabetes mellitus and 16 healthy controls, matched for sex and age, were asked to collect their urine during the night and during the day at rest, at weekly intervals on four occasions. Subjects with heart failure, kidney disease, hypertension, abnormal urinalysis (Albustix positive) or poorly controlled diabetes prior to entry in the study, were excluded. A high variability in the albumin excretion rates (AER) was observed in both diabetic and control groups but the variance was significantly greater in diabetics. Moreover the variance in AER was higher in daytime as compared to overnight urine collections in both groups. Overnight urine collections are more precise than daytime urine collections for the determination of AER.
Explore the source record for details and available documents.
Schlegel and Gates described an isotopic method for the measurement of global and separated glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) based on the determination by scintillation camera of the fraction of the injected dose (99mTc-DTPA-[131I]hippuran) present in the kidneys 1-3 min after its administration. This method requires counting of the injected dose and attenuation correction, but no blood or urine sampling. We validated this technique by the simultaneous infusion of inulin and polycyclic aromatic hydrocarbon (PAH) in patients with various levels of renal function (anuric to normal). To better define individual renal function we studied 9 kidneys in patients either nephrectomized or with a nephrostomy enabling separated function measurement. A good correlation between inulin, PAH clearance, and isotopic GFR-ERPF measurement for both global and separate renal function was observed.