Biomedical subjects

D von Herrath

Publications and source records attributed to D von Herrath.

At least 73 records · Page 4Linked to original sources

PubMed1979

[Treatment of renal osteopathy with 5,6-trans-25-hydroxycholecalciferol (author's transl)].

The influence of 5,6-trans-25-hydroxycholecalciferol on renal osteopathy was investigated in a total of 132 patients in 26 dialysis centres. Various doses were used, the average being 4000-6000 IU/day. In 32 patients a daily dose of 6000-9000 IU was used. The average individual duration of treatment was 276 days with a maximum of 910 days. Histologically there was an improvement in the renal osteopathy in 55.9% of evaluable cases (n = 34) and in 25.3% there was no deterioration. Radiographically these results were found in 21% and in 70.5% of evaluable cases (n = 105). Serum calcium increased in 46.6% of cases (n = 131), remained the same in 32.8% and decreased in 20.6%. The changes in alkaline phosphatase were similar : it dropped in 42.1% of patients, remained the same in 28.1% and rose in 29.8%. Immunoreactive parathormone which was invariably raised at the beginning of treatment (n = 36), fell in 25.0%, remained the same in 44.4% and rose further in 30.6%. The clinical symptoms of renal osteopathy which had been present in 57 patients improved in 51.0%, remained the same in 46.0% and deteriorated in 3.0%. Signs of intolerance and side effects were rare. Severe hypercalcaemia did not occur.

Adolescent↗

PubMed1978

Chronic hemofiltration. A critical evaluation of a new method for the treatment of blood.

The experiences which have been compiled in more than 2400 hemofiltrations confirm that this method represents an alternative way of treating uremic patients. The main advantages of chronic hemofiltration are the comfort of the patient and the ease in handling excess overhydration without extending treatment time, which is less than 3 X 3 hours/week if adequate hemofilters are used. With regard to the improvement of such typical uremic complications as severe hypertension, hypertriglyceridemia or neuropathy, hemofiltration does not seem to be superior to hemodialysis. However, since most hemofiltration patients do not require phosphate binders and, additionally, remarkable amounts of parathyroid hormone are removed during one hemofiltration, it appears possible that hemofiltration might be an important therapeutic alternative for those renal patients who suffer from severe hyperphosphatemia and secondary hyperparathyroidism.

Adult↗

PubMed1977

[Investigations on the pharmacokinetics of pentoxifylline in chronic renal failure (authors transl)].

The pharmacokinetical behaviour of 14C-labelled pentoxifylline was investigated in normal volunteers and in patients with different stages of impaired renal function. It was shown that in patients, having a creatinine-clearance of less than 10,0 ml/min., occurs an accumulation of pentoxifylline. This finding leads to the conclusion that in patients with advanced renal failure the daily dose of pentoxifylline should be adjusted to the diminished renal elimination.

Administration, Oral↗

PubMed1977

Clinical aspects of hemofiltration.

We report on clinical experiences obtained in 7 uremic patients treated since January 1976 3 times weekly by chronic hemofiltration. The observations which we collected in more than 300 treatments suggest that hemofiltration might be superior to conventional hemodialysis. The main advantages of this treatment are characterized by its better control of hypertension, hyperhydration, and possibly of uremic bone disease. Furthermore, the applied acrylonitrile membrane allows the removal of substances with a molecular weight up to 60,000, similar to the glomerular basement membrane. Additionally, we report on methodological problems, on the compatibility of hemofiltration, and finally on its efficiency for removal of different uremic solutes.

Adult↗

PubMed1977

The hemofiltration system: variations of the negative pressure.

The physical conditions of the hemofiltration process are briefly discussed to describe the applied system that is characterized by a negative pressure pump which is directly attached behing the filter. A schema is presented that shows the characteristics of a fully automatic hemofiltration apparatus that is presently in development.

Humans↗

PubMed1977

Parathyroid hormone-, 25-OH-vitamin D-, and digoxin levels in patients treated by chronic hemofiltration.

Immunoreactive parathyroid hormone (iPTH) was measured in the serum and filtrate before, during and after hemofiltration. iPTH regularly declines during hemofiltration; one patient, investigated for a longer period, showed a normalization of iPTH serum level with this treatment. The iPTH values found in the hemofiltrate were remarkably high, a finding that could be explained by non-specific effects, by the occurrence of hormone fragments or by an increased secretion rate. At any rate, the results suggest a filtration of parathyroid hormone and/or hormone fragments. On the other hand, it was impossible to detect any 25-OH-vitamin D in the hemofiltrate. Finally, digoxin could be found in the filtrate, but only in very low concentrations.

Digoxin↗

PubMed1976

[Idiopathic hypophosphataemic osteomalacia (author's transl)].

In an adult with sporadic idiopathic osteomalacia an increased phosphate clearance, hypophosphataemia, normocalcaemia, normal serum-25-hydroxycalciferol and an only slightly increased immunoreactive parathormone were found. Intestinal 47Ca absorption was clearly decreased. Radiologically and histologically there was a clear-cut defect of skeletal mineralisation. Under treatment with daily doses of 1-1.25 mg of vitamin D3 the 25-hydroxycalciferol level increased markedly, the immunoreactive parathormone decreased slightly. Serum calcium and hypophosphataemia remained unchanged and intestinal 47Ca absorption was improved. Already 4 weeks after commencing treatment pain and defective gait of the patient disappeared. Radiologically skeletal changes were improved after 7 months. However, histologically no significant bone healing had occurred. The biochemical findings of this disease correspond to those of familial hypophosphataemic (vitamin-D-resistant) rickets. The therapeutic effects of pharmacological doses of vitamin D resemble those in pseudo-vitamin-D-deficient rickets. The pathogenesis of idiopathic osteomalacia of the adult remains unclear. Vitamin D metabolism is unchanged as far as the stage of 25-hydroxycholecalciferol. It is unknown if a disorder of the renal synthesis of 1,25-dihydroxycholecalciferol or a peripheral resistance to the effects of this metabolite exists. In addition a defect of the tubular phosphate reabsorption independent of parathormone and vitamin D is assumed.

Adult↗

PubMed1975

The metabolism and organ distribution of 5,6-trans-25-hydroxycholecalciferol, an analog of vitamin D-3 in vitamin D-deficient rats.

Investigations have been performed on the metabolism and organ distribution of 5,6-trans-25(OD)D-3, which represents an analog of vitamin D-3 being active in uremia. This analog is rapidly metabolized into at least two more metabolites. The main storage organ for this compound seems to be fat, whereas liver and intestinal mucosa showed at 24 hrs the highest concentration of polar metabolites. In contrast to 25(OH)D-3 5,6-trans-25(OH)D-3 is much less absorbed from the intestinal tract, which should be considered if this compound is applied for treatment of uremic bone diseases.

Adipose Tissue↗

PubMed1975