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Biomedical subjects

D N Kerr

Publications and source records attributed to D N Kerr.

At least 91 records · Page 5Linked to original sources
PubMed1982

A note on association of Bf and glomerulonephritis.

In a study of 86 histologically defined glomerulonephritis patients, a striking association between the BfF allele and glomerulonephritis has been found. There is also an enhanced genetic predisposition to glomerulonephritis in individuals with rare Bf alleles. The role of the chromosome 6 loci in the pathogenesis of the disease is emphasized.

Alleles↗
PubMed1982

Serum immunoglobulins in minimal change nephrotic syndrome--a possible defect in T-cell function.

Serum immunoglobulin concentrations were determined in eighteen patients with minimal change nephrotic syndrome. Serum IgG and IgA were significantly decreased; whereas IgM was significantly increased in majority of the cases. Eight of the eighteen patients were treated with steroids. All the eight patients showed a significant increase in serum IgG and a decrease in IgM in response to steroid therapy. The increased serum IgM and decreased IgG before treatment and their restoration to normal levels after steroid therapy may suggest a possible defect in T-cell function.

Adolescent↗
PubMed1982

The natural history of chronic pyelonephritis in the adult.

One hundred and thirty patients with primary chronic pyelonephritis diagnosed radiologically or by nephrectomy, 84 with unilateral and 46 with bilateral disease, have been followed for six to 240 months. The clinical and radiological features of the disease at presentation, together with its influence on pregnancy, have been analysed. Serial observations of bacteriuria, blood pressure and renal function have been made during follow up and the intravenous urogram (IVU) has been repeated after five years in most patients. Although the disease probably starts in early childhood it often presents to the nephrologist in young adults, mainly women, as symptomatic urinary tract infection, hypertension, renal insufficiency or a combination of these features. Though associated with increased morbidity in pregnancy it does not usually interfere with fertility and in this series it did not cause increased fetal loss. Repeated urinary tract infections and hypertension are common events. Proteinuria is usually minimal and when present is associated with hypertension. The disease in most patients with unilateral disease runs a benign course; a poorer prognosis is associated with bilateral disease, hypertension and proteinuria. Since we found no association between frequent urinary infections and declining renal function we suggest that only symptomatic urinary infection should be treated in adults with chronic pyelonephritis.

Adolescent↗
PubMed1981

Heparin effect on ionised calcium concentration.

The effect of heparin on plasma ionised calcium was studied by adding it in increasing amounts to whole blood from 10 normal subjects. There was no significant change in ionised calcium from the addition of 1 U/ml but a significant fall of 0.02 mmol/l when 2 U/ml were added and a progressive further fall with increasing concentrations. Heparin from three different manufacturers produced similar results. The effect of heparinisation in vivo was studied during regular haemodialysis on 10 patients with chronic renal failure. Following intravenous injection of 10 000 U of heparin there was a consistent and significant fall averaging 0.03 mmol/l.

Calcium↗
PubMed1981

Residual formaldehyde in dialyzers: quantity, location, and the effect of different methods of rinsing.

When formalin-sterilized dialyzers were rinsed by our standard technique (similar to that used in many other dialysis centres) undesirable concentrations of formaldehyde were found in the dialyzers at the start of dialysis. When the technique was modified by passing part of the saline through the blood compartment immediately before connection and discarding the saline left in the dialyzer at the time of connection, the concentration of formaldehyde infused into the patient fell below 2 micrograms/ml. However, the dialyzers still contained up to 13 mg of formaldehyde which leached slowly from the dialyzer during simulated dialysis. Some residual formaldehyde was found in several components of the dialyzer but the great majority was contained in the cellulose membrane.

Disinfectants↗
PubMed1981

Formation of anti-N-like antibodies in dialysis patients: effect of different methods of dialyzer rinsing to remove formaldehyde.

Use of formalin to sterilize dialyzers is known to be responsible for the formation of anti-N-like antibody in long-term hemodialysis patients. Patients dialyzed as in-patients using formalin were found to be completely free of anti-N-like antibody, while among those on home dialysis, there was a high prevalence (31%) and incidence. The hospital patients were found to be receiving concentrations of formaldehyde less than 1 microgram/ml while those on home dialysis received 3-13 micrograms/ml. This is offered as an explanation for the absence of anti-N-antibody in patients using formalin-sterilized dialyzers.

Antibodies, Anti-Idiotypic↗
PubMed1981

The relative roles of sodium and renin in the hypertension of renal disease. An assessment based on the response to frusemide and propranolol.

Twenty-seven patients with hypertension and varying degrees of renal failure were studied before and during the administration of frusemide. In 15 patients studies were repeated following the addition of propranolol. Mean exchangeable sodium was increased before the introduction of frusemide or propranolol in patients with azotemia, possibly due in part to the administration of other antihypertensive drugs, and was reduced to normal during frusemide treatment increasing slightly but significantly following the addition of propranolol. Blood pressure fell significantly with frusemide but there was no further significant fall with propranolol. The relationship of change in blood pressure to change in exchangeable sodium with frusemide did not reach significance. There was no relationship between changes in blood pressure and changes in plasma renin activity with frusemide, suggesting that the blood pressure response to frusemide is not limited by the rise in renin. The fall in blood pressure following the addition of propranolol was proportional to the dose of the drug but inversely proportional to the change in renin suggesting that renin levels are to some extent determined by the blood pressure response to propranolol rather than themselves determining that response. Serum creatinine was significantly increased during treatment with frusemide probably due to a combination of the effects of sodium depletion and the natural progression of the underlying renal disease rather than to nephrotoxicity. The further slight increase in serum creatinine following the addition of propranolol is in keeping with the reported effect of this drug on renal blood flow and glomerular filtration rate in patients without renal disease.

Adolescent↗
PubMed1981

Renal transplantation in patients on continuous ambulatory peritoneal dialysis.

Over a two year period 15 patients on CAPD and 65 patients predominantly treated by haemodialysis received first grafts. There was no difference in graft survival in these two groups. In the continuous ambulatory peritoneal dialysis (CAPD) patients there were no post operative episodes of peritonitis, apart from one patient who had peritonitis at the time of transplantation. No technical difficulties were encountered at the time of grafting. CAPD is not a contraindication to transplantation.

Adolescent↗
PubMed1981

"Eosinophilic" peritonitis in continuous ambulatory peritoneal dialysis (CAPD).

Three cases of "sterile" peritonitis in CAPD patients are discussed, where the predominant white cell type in the peritoneal dialysis fluid was the eosinophil. No bacterial or fungal organism was isolated on repeated culture of the dialysis fluid and all had a benign course. The eosinophilic response appears to occur very soon after starting CAPD, is relatively asymptomatic and does not require antibiotic therapy. It is suggested that the eosinophilia is related to allergy to some constituent of the peritoneal dialysis system.

Adult↗
PubMed1981

Pharmacokinetics of intravenous and intraperitoneal cefuroxime in patients undergoing peritoneal dialysis.

The pharmacokinetics of cefuroxime sodium, a parenteral beta-lactam antibiotic, were investigated in 9 patients during peritoneal dialysis. In 6 patients cefuroxime 500 mg was administered intravenously. Mean plasma levels of cefuroxime thereafter fell from 28.0 +/- 5.0 mg/l at 1 hr to 6.0 +/- 1.6 mg/l at 24 hr. Mean peak levels 4.6 +/- 1.9 mg/l in peritoneal effluent were found 7 hr after dosing and clearance of the drug by peritoneal dialysis averaged 4.7 ml/min. There was no evidence of net tubular secretion or of increased non-renal elimination. In 5 patients, the administration of cefuroxime, 100 mg/2 l dialyzate, in each cycle of dialysis maintained mean cefuroxime levels of 25.4 +/- 13 mg/l in the dialysis effluent. An average of 44% of the dose was not recovered in the effluent, and was presumably absorbed by the patient, and mean plasma levels of cefuroxime increased from 1.1 +/- 0.4 mg/l at 1 hr to 14.0 +/- 8.1 mg/l at 24 hr. If cefuroxime is used to treat peritoneal infections associated with peritoneal dialysis it should be given by both intraperitoneal and intravenous routes and followed up with parenteral therapy alone.

Adult↗