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Biomedical subjects

D Michalk

Publications and source records attributed to D Michalk.

49 records · Page 3Linked to original sources
PubMed1981

Plasma inorganic sulfate in children with chronic renal failure.

Plasma sulfate concentration (SO4) was determined in 38 non-dialyzed children with chronic kidney disease and compared to inulin clearance and to other parameters of renal function. SO4 was measured by atomic absorption spectrophotometry. Plasma SO4 was inversely correlated with GFR and effective renal plasma flow. Positive correlations were found between plasma SO4, BUN, serum creatinine and serum phosphate levels. The highest levels of plasma SO4 were observed in 15 children undergoing regular dialysis. It is suggested that sulfate retention might be involved in the pathogenesis of uremic acidosis and bone disease.

Acidosis↗
PubMed1981

Possible role of inorganic sulphate in the pathogenesis of hyperparathyroidism in chronic renal failure.

In order to investigate the role of hypersulphataemia in the development of hyperparathyroidism the blood levels of inorganic sulphate (SO4(2-)) and phosphate (HPO4(2-)) were compared with total and ionised calcium (Ca) and parathyroid hormone (PTH) in 20 patients with chronic renal failure (CRF). There was a positive correlation between plasma SO4(2-) and serum creatinine. Ionised Ca was inversely correlated with HPO4(2-), SO4(2-) and PTH, respectively. The best correlation was found between ionised Ca and the ion product of HPO4(2-) and SO4(2-). It is suggested that hypersulphataemia might be involved in the pathogenesis of secondary hyperparathyroidism and osteodystrophy in CRF by complex formation with Ca, thereby aggravating the effect of HPO4(2-) on ionised Ca and the resulting PTH stimulation.

Adolescent↗
PubMed1980

Determination of inorganic plasma sulfate by indirect atomic absorption spectrophotometry.

An indirect method for the determination of inorganic sulfate in small plasma volumes is presented. After removal of protein and phosphate by uranylacetate, sulfate is precipitated by barium chloride. Excess barium in the supernatant is measured by atomic absorption spectrophotometry. The sulfate content of the sample corresponds to the difference of the added and the measured barium. The mean concentration of inorganic plasma sulfate of healthy children, determined by this method, was 0.241 +/- 0.059 mmol/l.

Adolescent↗
PubMed1980

Idiopathic mesangial IgA-glomerulonephritis in childhood Description of 19 pediatric cases and review of the literature.

Nineteen out of 83 children with asymptomatic haematuria were classified as having IgA glomerulonephritis, characterized by diffuse mesangial deposition of IgA in the absence of systematic disease. Different histological patterns were observed: i.e., minor glomerular lesions (5 cases), focal and segmental proliferative glomerulonephritis (8 cases) and diffuse proliferative glomerulonephritis (6 cases). Recurrent gross haematuria is the clinical hallmark of the disease. Proteinuria was present in 14 children and exceeded 1 g/m2/day in 3 patients. Clinico-pathological correlations showed a close relation between the degree of proteinuria and the histological lesions. Serum IgA levels were elevated in 3 children. Glomerular filtration rate remained above 80 ml/min/1.73 m2 in a 1 to 9 year follow-up.

Adolescent↗
PubMed1980

[Haemofiltration in children. First experiences (author's transl)].

Haemofiltration was used in 12 children with terminal chronic renal failure. This method is an alternative for short-term treatment of renal failure by haemodialysis and can be combined with the single-needle-technique. It was also used in a 2 years old girl with acute renal failure. The main advantages of haemofiltration versus haemodialysis are a more rapid removal of fluid in the presence of stable blood pressure readings and a good tolerance by the patient. The primary indication for haemofiltration is hypervolaemia. The high water and salt losses during the procedure have to be exactly calculated and substituted. According to our current experience the volume needed for substitution of filtrate by fluid to be infused i.v. has to be in the range of 50% of body weight.

Acute Kidney Injury↗
PubMed1979

[Kidney transplantation in children].

Ten years' experience of renal transplantation in 40 children (aged 5--18 years) is reviewed. Including 3 second transplantations 40 cadaver grafts and 3 living donor grafts were transplanted. Mean graft survival was found to be 19 months, the longest being 8 years. At the time of last examination 24 children were alive wtith a functioning graft (mean serum creatinine level 1.5 mg/dl). After graft failure 9 children were again on intermittent hemodialysis. 7 children had died mainly because of infections or cardiovascular complications. Cumulative survival rate of patients and cadaver grafts after 2 years was 84 and 53% respectively. Growth velocity was variable but improved in the majority of patients compared to the previous dialysis period. Full social rehabilitation could be achieved in every case. Main complications were acute rejections (irreversible in 7 of 67), chronic rejections (irreversible in 6 of 10), side effects of immunosuppressive drugs (infections; hematologic, metabolic, and bone disorders), hypertension (60%), recurrence of primary renal disease (in 5 of 9 patients with focal segmental glomerulosclerosis) and surgical complications (28%). Therapeutic guide-lines are given emphasizing the role of specialized children's centres and the cooperation between pediatric nephrologists, immunologists, urologists and psychologists including the time before, during and after transplantation.

Adolescent↗
PubMed1978

Erythrocyte organic phosphates in the anemia of renal failure in childhood.

Erythrocyte 2,3-diphosphoglycerate (2,3-DPG ) and adenosinetriphosphate (ATP) levels were determined in 43 children with chronic renal failure on conservative treatment (CT), and 12 children on regular hemodialysis (HD) immediately before and after a HD session. The results were compared to non-anemic and anemic controls. In spite of anemia, erythrocyte 2,3-DPG in renal failure was similar to non-anemic controls at normal blood pH, but rose during dialysis as a result of alkalosis. In contrast, ATP levels were high already at a normal blood pH. 2,3-DPG correlated with packed cell volume (PCV) in children with renal failure but at lower concentrations compared to controls. Both organic phosphates in the erythrocytes showed a significant correlation with blood pH. The poor increase of 2,3-DPG, in combination with elevated ATP levels, suggests uremia-induced inhibition of 2,3-DPG synthesis.

Adenosine Triphosphate↗
PubMed1978

[Haematuria in children. I. Differential diagnosis of haematuria in childhood (author's transl)].

Haematuria in children is either of glomerular or nonglomerular origin. In the latter case intravenous urography should always be performed. A renal biopsy is indicated if unexplained haematuria persists for at least one year or if an unfavorable prognosis is indicated by the appearance of hypertension, significant proteinuria or persistently low levels of serum complement (C3). The importance of screening the families of haematuric patients is emphasized. More than half of our cases with persistent or intermittent haematuria undergoing renal biopsy showed no or only minimal glomerular changes. In other children with a similar clinical picture more severe histological lesions were detected. In any case the kidney tissue obtained by biopsy should be examined by immunofluorescence and by electron microscopy. One of the most frequent causes for persistent or intermittent haematuria during childhood is Berger's disease (IgA/IgG nephropathy).

Adolescent↗
PubMedDate not supplied

[Diagnosis of bilateral renal vein thrombosis in infancy by pulsed Doppler sonography of the renal vessels].

In a premature infant bilateral renal venous thrombosis and associated thrombosis of the inferior vena cava were diagnosed at the age of 6 weeks, using a 2-dimensional ultrasound sector scanner with integrated pulsed doppler ultrasound of the renal vessels. In contrast to 30 healthy children, who showed continuous forward flow in the renal arteries throughout systole and diastole, diastolic flow was decreased or even retrograde in renal venous thrombosis (RVT) according to the severity of thrombosis. Doppler recordings in renal veins normally showed continuous retrograde flow patterns, whereas in RVT venous flow was decreased or absent. Pulsed doppler ultrasound is a useful and noninvasive method for recording renal flow patterns, especially in renovascular disease.

Humans↗
PubMedDate not supplied

[Plasma separation as an effective treatment of glomerulonephritis in lupus erythematosus].

Positive anti-DNA-antibodies and lowered C3 and C4 levels were found in serum of a 13 year old girl presenting with edema, microscopic hematuria and proteinuria. Renal biopsy revealed diffuse endo- and extracapillary glomerulonephritis with mesangial deposits of IgA, IgG, IgM, C1q, C3 and fibrinogen. In spite of treatment with prednisone (60 mg/m2/d) severe nephrotic syndrome (proteinuria greater than 20/d) developed with excessive hypertension and deterioration of renal function (GFR: 20 ml/min./1,73m2 BSA). Plasma exchange therapy (3 sessions) led to recovery of renal function, blood pressure and complement activity and to a reduction of anti-DNA-antibodies and protein excretion.

Adolescent↗