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Biomedical subjects

A Sturani

Publications and source records attributed to A Sturani.

At least 19 recordsLinked to original sources
PubMed1992

Aggregation of erythrocyte sodium/lithium countertransport activity in families of patients with immunoglobulin A nephropathy.

1. We evaluated the inheritance of erythrocyte Na+/Li+ countertransport activity in IgA nephropathy by assessing this parameter in 19 patients with biopsy-proven IgA nephropathy and in their 53 relatives (32 parents and 21 siblings). The possible use of erythrocyte Na+/Li+ countertransport activity as a marker of poor prognosis was also evaluated. 2. A significant correlation was found between 'familial' and proband Na+/Li+ countertransport activity, but not between that of spouses. 3. Mean blood pressure, although within the normal range, and Na+/Li+ countertransport activity were significantly higher in patients with proteinuria than in those without proteinuria. 4. Parents of proteinuric patients had a higher Na+/Li+ countertransport activity than parents of non-proteinuric patients. 5. In IgA nephropathy the inheritance of erythrocyte Na+/Li+ countertransport activity was preserved. Therefore genetic factors could play a role in the non-immunological progression of IgA nephropathy.

Adolescent↗
PubMed1990

Antiproteinuric effect of angiotensin-converting-enzyme inhibitors in patients with primary glomerular disease and normal renal function.

The antiproteinuric efficacy of angiotensin-converting-enzyme inhibitors (ACEI) has been extensively investigated in patients with several types of nephropathy, but there are few data on the use of ACEI in patients with primary glomerular disease without renal function impairment. We evaluate the effect of long-term therapy with captopril on arterial pressure and proteinuria in 13 patients with primary glomerular disease, selected on the following criteria: persistent proteinuria greater than 600 mg/day, serum creatinine less than or equal to 1.5 mg/dl, no dietary restriction or antihypertensive or immunosuppressive therapy for at least 9 months prior to enrolment. Ten of 13 patients were normotensive. The treatment with captopril induced an early and persistent decrease in proteinuria (41%), and a significant increase in serum albumin. We did not find a significant correlation between changes in MAP and changes in protein loss or between variations in serum creatinine and in proteinuria. Our results demonstrate that captopril is effective in reducing proteinuria in patients with primary glomerular disease with normal renal function. Since the antiproteinuric effect is not associated to a concomitant decrease in arterial pressure, we presume that it might be due to a specific intrarenal action of captopril.

Adolescent↗
PubMed1988

Glomerular dysfunction in diabetic nephropathy.

In the early stages of insulin-dependent diabetes mellitus (IDDM) in humans and in animals the renal plasma flow (RPF) and the glomerular filtration rate (GFR) have often been found higher than normal. Moreover, in a subset of IDDM patients, early abnormalities in protein excretion, termed 'subclinical proteinuria' or 'microalbuminuria' have been found. This finding is thought to be a predictor of clinically overt diabetic nephropathy. Hence, it has been proposed that high glomerular hydraulic pressure and/or plasma flow rate may be responsible for causing both proteinuria and the progression of diabetic nephropathy. However, other abnormalities such as the impaired synthesis of prostaglandins, an abnormal production of cationic polyamino-acids found in IDDM, may cause both proteinuria and nephropathy. So the role of increased glomerular pressure in initiating diabetic nephropathy is being debated. To verify whether increased GFR and proteinuria are causally linked, we have randomly allocated 12 IDDM patients (age range 25-58, mean 35 years; six males, six females) with increased GFR (131-165 ml/min, mean 145 ml/min), microalbuminuria above the normal range (range 35-130 micrograms/min, mean 80 micrograms/min) and moderate hypertension (mean blood pressure above 110 mmHg) to take a low protein diet with their standard antihypertensive therapy or their usual diet together with captopril administration (25-50 mg/day) for 4 weeks each. After low protein diet we found a significant decrease in GFR (P less than 0.05) and also in albuminuria (P less than 0.01). After captopril administration we found a small, statistically insignificant decrease in GFR with a moderate increase in filtration fraction and a significant decrease in albuminuria (P = 0.05). No correlation was found between the GFR and albuminuria variations during the low protein diet or during captopril administration. In conclusion, both the low protein diet and the captopril administration significantly decrease protein excretion. However, our data suggest that the proteinuria decrease does not correlate with the decrease in GFR, so other mechanisms besides hyperfiltration seem to be involved in the proteinuria of IDDM patients.

Adult↗
PubMed1985

Evidence of parasympathetic activity of the angiotensin converting enzyme inhibitor, captopril, in normotensive man.

Captopril (50 mg orally) produced a significant fall in systolic and diastolic blood pressure in six normotensive sodium replete subjects, without a rise in heart rate. On captopril, there was no change in the expected normal increase in heart rate on standing. Supine plasma noradrenaline was not reduced by captopril and normal postural increases were maintained. Atropine (0.04 mg/kg i.v.) reduced the difference in blood pressure change between captopril and placebo. Facial immersion in water produced a bradycardia. This change was abolished by atropine and attenuated both by captopril and edrophonium (10 mg i.v.), a cholinesterase inhibitor. Lying down after 6 min standing produced an immediate transient tachycardia, which was abolished by atropine and attenuated by captopril. Blood pressure and heart rate rose after a cold pressor test on both captopril and placebo. The tachycardia during the Valsalva manoeuvre was inhibited by edrophonium and to a lesser extent by captopril. The effects of captopril and edrophonium were additive. Parasympathetic activity of captopril may contribute to its haemodynamic profile.

Adult↗
PubMed1985

Effect of bromocriptine treatment on prolactin, noradrenaline and blood pressure in hypertensive haemodialysis patients.

Bromocriptine (2.5 mg/day orally) produced a significant fall in supine mean arterial pressure in nine hypertensive haemodialysis patients with high serum prolactin levels, without causing significant changes in heart rate. On bromocriptine, there was a significant decrease in the mean value of both serum prolactin and plasma noradrenaline, without significant changes in the mean value of plasma renin activity. A significant relationship was found between the changes in supine plasma noradrenaline and the changes in supine mean arterial pressure induced by bromocriptine. The increase in mean arterial pressure in response to the tilt test was greater on bromocriptine than on placebo although the changes in plasma noradrenaline were reduced by bromocriptine. Similar results were observed during the cold pressor test. These findings suggest that the arterial pressure-lowering effect of bromocriptine is related to the reduction in sympathetic out-flow. The parallel decrease in serum prolactin raises the question of the possible involvement of dopaminergic mechanisms in the development of hypertension in our patients. Moreover, bromocriptine seems to enhance the vascular response to endogenous noradrenaline.

Adult↗
PubMed1985

Failure of naloxone in reversal hemodialysis-induced hypotension.

In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial pressure sank below 90 mm Hg. In our patients, naloxone had no effect on the resting arterial pressure or on dialysis-induced hypotension.

Blood Pressure↗
PubMed1985

Parasympathetic activity assessed by diving reflex and by airway response to methacholine in bronchial asthma and rhinitis.

It has been suggested that airway hyperreactivity in asthma is associated with increased parasympathetic tone. We have accordingly assessed parasympathetic responsiveness in five groups of subjects (17 normal controls, 8 patients with extrinsic rhinitis, 6 with intrinsic rhinitis, 10 extrinsic asthmatic patients, 7 intrinsic asthmatic patients) by examining their responses to both diving reflex and methacholine inhalation challenge. The mean fall in heart rate during the diving test was significantly greater in asthmatic subjects than in normal controls and in patients with rhinitis. The diving-induced bradycardia was significantly greater in intrinsic than in extrinsic asthmatic subjects. There was a good correlation between the drop in heart rate during diving test and the provocation dose of methacholine producing a 45% decrease in specific airway conductance both in patients with rhinitis and in asthmatic patients. There was a less good correlation between diving response and clinical severity score in the same asthmatic patients. These results indicate that intrinsic asthma is associated with a marked degree of cholinergic hyperreactivity. The diving test seems to provide an accurate method for the analysis of the parasympathetic system in asthma.

Adult↗
PubMed1985

Plasma noradrenaline and blood pressure in uremia.

To evaluate a possible correlation between sympathetic activity and blood pressure in uremia, catecholamines and blood pressure were determined in 81 uremic patients. In 34 of these 81 patients, thyroid hormones were also measured. In 16 patients on maintenance dialysis, a longitudinal study was performed to compare long-term blood pressure and catecholamine variations. No correlation was found between mean blood pressure and noradrenaline in the 81 patients as a whole, but when male and female patients were evaluated separately, a significant correlation was found in the former group. In the 34 patients, a correlation between mean blood pressure and noradrenaline was found only when hypothyroid patients were excluded. Variations in mean blood pressure induced by chronic dialysis were related to noradrenaline changes in the 16 patients studied. In conclusion, sympathetic activity seems to be correlated to blood pressure in uremic patients.

Adolescent↗
PubMed1985

Effect of eosinophilia on the heterogeneity of the anticoagulant response to heparin in haemodialysis patients.

The anticoagulant response to heparin was determined, during haemodialysis, in a group of seven patients with eosinophilia and in a control group. The heparin half-life was similar in the two groups, but the heparin effect index was lower in patients with eosinophilia. The dose-response curve showed a reduced sensitivity to heparin in patients with eosinophilia. In patients with eosinophilia a significant reduction in eosinophil count was observed during cuprophan dialysis, but not during polyacrylonitrile dialysis. The hyposensitivity to heparin might be related to eosinophil degranulation, during cuprophan dialysis, with release of a major basic protein that neutralises heparin.

Adult↗