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Biomedical subjects

E Savdie

Publications and source records attributed to E Savdie.

33 records · Page 2Linked to original sources

Impaired plasma triglyceride clearance as a feature of both uremic and posttransplant triglyceridemia.

After accurate plasma volume calculation, endogenous plasma very-low-density-lipoprotein (VLDL)-triglyceride turnover rates were measured in 20 undialyzed patients with chronic renal failure (CRF) and in 16 renal transplant recipients with stable graft function. When kinetic criteria were based on a group of healthy subjects (Vmax = 36.7 mumoles/hr/kg), it was clear that, on the whole, CRF patients had a reduced capacity for VLDL-triglyceride removal (Vmax = 14.0 mumoles/hr/kg), as did graft recipients (Vmax = 19.5 mumoles/hr/kg). In transplant recipients with impaired graft function, however, extremes of both under removal and over production of VLDL-triglycerides were observed. In CRF, defective clearance was accompanied by a reduction in postheparin lipoprotein and hepatic lipase activities, although there was no statistical relationship. Enzyme activities were not reduced, however, after transplantation, and the metabolic factors responsible for defective clearance were not clearly identified.

Adolescent↗

High-density lipoprotein in chronic renal failure and after renal transplantation.

Serum high-density-lipoprotein (HDL) cholesterol and apoprotein (apo) A concentrations were significantly reduced at the time of renal transplantation in 26 patients with chronic renal failure. In a prospective evaluation the behaviour of HDL concentrations after grafting was found to depend on renal function. Graft function was sustained in 19 patients, in whom HDL-cholesterol and apo A concentrations increased to lie within normal limits by six months after the operation. Successful transplantation also restored to normal the lipid and protein content of HDL as expressed by the ratio of HDL cholesterol to apo A. When transplant function was not sustained (seven patients), however, no changes in HDL were observed up to the time of the graft loss. Such changes in HDL with successful kidney grafting augur well in a population with many risk factors for coronary heart disease.

Adult↗

High density and low density lipoproteins in chronic renal failure before and after renal transplantation.

The hyperlipoproteinaemia accompanying chronic renal failure and renal transplantation has been re-examined in terms of the apoprotein (apo A and apo B) moieties of the high density (HDL) and low density (LDL) lipoproteins. Hypertriglyceridaemia is prevalent in chronic uraemia and is not corrected by haemodialysis or renal transplantation. Hypercholesterolaemia is characteristic only of renal allograft recipients. Apo A levels are reduced in undialyzed uraemic and remain low during haemodialysis, as well as in patients with renal allografts of less than six months duration. In renal transplant recipients of greater than one year duration, apo A levels are normalized. The normalization of apo A level is related to the stability of graft function, as determined by sequential analysis of 15 renal transplant recipients. Apo B levels are normal transplant recipients. Apo B levels are normal in uraemic and dialyzed patients, but are elevated in long term transplant recipients. Unlike apo A levels, this alteration does not appear to reflect the restoration of kidney function.

Apolipoproteins↗

Circulating thyroid hormone levels and adequacy of dialysis.

In vitro thyroid function tests were performed in three groups of patients with chronic renal failure who were receiving, on average, 15, 18 and 27 hours of maintenance hemodialysis per week. Total thyroxine levels were low and total triiodothyronine levels low to normal in those receiving the least dialysis (15 hours), and were significantly higher in those receiving longer dialysis. Free thyroxine levels, as measured by the effective thyroxine ratio, were normal and similar in all three groups, as were serum thyrotrophin levels. All patients were clinically euthyroid. As total hormone levels showed a significant inverse relationship to both urea and creatinine, this study suggests that there is a dialyzable metabolite retained in uremia which competes with thyroid hormones for protein-binding sites.

Adult↗

Lung abscess due to Corynebacterium equi in a renal transplant recipient.

A case of Corynebacterium equi infection in a renal transplant recipient is reported. This not uncommon pathogen of farm animals caused a lung abscess in a graft recipient who had received continuous immunosuppression with azathioprine and prednisone for seven years. Antibiotic therapy yielded radiological improvement, although the patient died from other causes. C. equi joins a growing list of rare opportunistic organisms which may cause disease in subjects who have received transplants.

Corynebacterium Infections↗

Iron therapy in maintenance haemodialysis.

1. Marrow-iron stores were absent or reduced in twenty-three of thirty-nine patients studied within 52 months of starting maintenance haemodialysis. 2. Oral iron was given to twelve patients (group I) with absent or reduced, and to eleven patients (group II) with normal or increased marrow-iron stores. 3. A significant increase in mean haemoglobin concentration and marrow iron was observed in group I. No significant change in mean haemoglobin concentration or marrow iron occurred in group II. Mean haemoglogin concentration after treatment was significantly higher in group I than in group II. 4. The four patients who had normal or increased marrow iron and who received no oral iron all suffered a fall in haemoglobin concentration, and three of them showed a reduction in marrow iron. 5. These findings indicate that continuous oral iron therapy should be given to all patients on maintenance dialysis to correct or prevent iron deficiency.

Anemia, Hypochromic↗

Recovery of pure red-cell aplasia secondary to antierythropoietin antibodies after cessation of recombinant human erythropoietin.

We describe a patient with end-stage renal failure (ESRF) who developed anti-erythropoietin (anti-EPO) antibodies and pure red-cell aplasia (PRCA) after using Eprex (Janssen-Cilag, Sydney). Anti-EPO antibodies were detected with an immunoprecipitation technique and were shown to inhibit erythropoiesis in vitro. Antibody levels waned upon ceasing Eprex. The patient required transfusions for 21 months then recovered after immunosuppression.

Autoantibodies↗

Total parathyroidectomy and renal function in patients with chronic renal failure.

5 patients with nonterminal renal failure who underwent total parathyroidectomy at Sydney Hospital over a 4-year period showed significant postoperative deterioration in renal function. In 4 of these patients, this deterioration occurred at a time when they were receiving supplements of calcium and 1,25-dihydroxyvitamin D3 but when close monitoring failed to show any evidence of hypercalcemia. In 1 patient the deterioration in renal function was clearly associated with hypercalcemia. We suggest that parathyroidectomy in nondialyzed patients be reserved for those with severe symptomatic hyperparathyroidism and that wherever possible the need for large doses of calcium and vitamin D be avoided.

Adult↗