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Biomedical subjects

H K Stummvoll

Publications and source records attributed to H K Stummvoll.

At least 55 records · Page 3Linked to original sources
PubMed1982

[High-density-lipoprotein and renal insufficiency (author's transl)].

Disturbances in lipid metabolism and accelerated atherosclerosis are well-known phenomena of chronic renal insufficiency. The disturbance in lipid metabolism has been repeatedly described as secondary type IV hyperlipoproteinemia according to the classification of Fredrickson. The classification of Fredrickson, however, does not take into account the role of the alpha-lipoproteins (the HDL lipoproteins and HDL cholesterol). Hence, HDL cholesterol was determined and correlated to other routine parameters of lipid metabolism in 66 patients with different degrees of renal insufficiency. Furthermore, an intravenous fat tolerance test was performed in 14 patients with terminal renal insufficiency. Beside the well-known hypertriglyceridemia with cholesterol values near the upper limits of normal, a significant reduction in HDL cholesterol was found, showing a significant inverse correlation to plasma creatinine values. Patients with advanced or terminal renal insufficiency additionally showed a significant inverse correlation between HDL cholesterol and plasma triglycerides. The disappearance rate of intravenously administered fat emulsion (which corresponds to the clearance rate of chylomicrons and VLDL) was diminished in azotaemic patients, showing a significant inverse correlation between HDL cholesterol and disappearance rate in the intravenous FTT. Beside hypertriglyceridemia, the diminished HDL cholesterol values represent an additional risk factor for the genesis of accelerated atherosclerosis. The diminished k value demonstrates a diminished activity of lipoprotein lipase as cause of hypertriglyceridemia, whereby the positive correlation between the k value and HDL cholesterol and the inverse correlation between HDL cholesterol and triglycerides suggest a causal relationship between the decreased activity of lipoprotein lipase and diminished HDL cholesterol levels.

Arteriosclerosis↗
PubMed1981

[Hyperparathyroidism in chronic renal insufficiency new clinical and surgical aspects (author's transl)].

The therapy of secondary hyperparathyroidism in chronic renal disease has been improved by the availability of active 1-alpha-hydroxylated vitamin D derivatives. However, in cases with progressive secondary hyperparathyroidism which have not been brought under control conservatively, surgical intervention is still required. Total parathyroidectomy with autologous transplantation of parathyroid tissue in the forearm has recently been recommended as the optimum surgical approach to secondary hyperparathyroidism. Recent literature is reviewed and personal clinical experience is reported in this paper, followed by a presentation and discussion of the pathophysiology of hyperparathyroidism in chronic renal failure, various means of conservative treatment, indications for parathyroidectomy, surgical aspects and technique of cryopreservation, as well as a standardized therapeutic regimen for pre- and postoperative treatment with calcium and 1-alpha-hydroxylated vitamin D analogues.

Calcium↗
PubMed1981

Aluminum removal by hemodialysis.

Aluminum kinetics were studied in 24 patients on chronic hemodialysis. All patients had elevated predialytic serum concentrations of aluminum (mean, 3.44 mumoles/liter), which correlated significantly with the ingestion of aluminum hydroxide (P less than 0.01). Simultaneous measurements of aluminum in plasma and ultrafiltrate revealed an ultrafiltrability of about 20% of total plasma aluminum, thus suggesting that 80% of aluminum is protein bound. When a dialysate with a very low aluminum content (varying from 0.1 to 0.3 mumoles/liter) was used, mean values across the dialyzer were 3.20 and 2.67 mumoles/liter, respectively, showing a significant decrease of plasma aluminum during dialyzer passage (P less than 0.0001). It could be shown that dialysance of aluminum depends on the concentration gradient between the free diffusible plasma aluminum and the dialysate aluminum concentration. After 6 hours of dialysis, plasma aluminum concentrations were significantly lower than were predialysis values (P less than 0.0001). We conclude that a negative aluminum balance during hemodialysis can be assumed as long as the aluminum concentration of free diffusible plasma aluminum lies above the aluminum concentration of the dialysate.

Adolescent↗
PubMed1981

Renal phosphate wasting after successful kidney transplantation: 1-alpha vitamin D therapy in patients with normal parathyroid gland activity.

1 alpha-hydroxycholecalciferol was tried as a therapy for renal phosphate wasting in kidney allograft recipients with normal parathyroid gland activity. During a 3-week period of treatment we observed a significant rise in renal phosphate threshold concentrations and plasma phosphate levels paralleled by a significant decrease in serum immunoreactive parathyroid hormone levels and a significant increase in intestinal calcium absorption. It is suggested that 1 alpha-hydroxycholecalciferol acts on renal phosphate handling in a dual fashion: one is by suppression of parathyroid hormone and the other by restoration of 1,25-dihydroxycholecalciferol levels to an appropriate level.

Antigens↗
PubMed1981

[Determination of immune complexes in renal diseases (author's transl)].

The concentration of circulating immune complexes were determined by Clq solid phase assay in 30 patients with systemic lupus erythematosus (n = 15), glomerulonephritis (n = 5), and after kidney transplantation (n = 10). Elevated immune complex concentrations were found in glomerulonephritis and systemic lupus erythematosus correlating with disease activity. In the posttransplant period the level of immune complexes was increased after antilymphocyte globulin therapy. The function of the transplanted kidney or rejection crises showed no effect on immune complex formation. The presence of circulating immune complexes indicates a high activity of disease in cases of glomerulonephritis and systemic lupus erythematosus.

Antigen-Antibody Complex↗
PubMed1981

Platelet microaggregates and release of endogenous prostacyclin during the initial phase of haemodialysis.

In six patients arterial blood samples were withdrawn during haemodialysis (HD) for the measurement of platelet microaggregates, platelet and leucocyte counts, pO2 and 6-oxo-PGF1 alpha (the stable metabolite of prostacyclin). During the initial phase of HD the plasma concentrations of 6-oxo-PGF1 alpha increased, indicating an increased release of endogenous prostacyclin. Coincidentally to this phenomenon, hypoxaemia, reduction in platelet and leucocyte counts, and an increase in number of platelet microaggregates could be observed. Since prostacyclin is able to resolve platelet aggregates, we interpret the increased prostacyclin release to be in part a self protection mechanism against embolisation of microaggregates released from the dialyser into lung and peripheral vascular systems.

6-Ketoprostaglandin F1 alpha↗
PubMed1981

Desferrioxamine-induced changes of aluminium kinetics during haemodialysis.

The effects of desferrioxamine administration of aluminium kinetics during haemodialysis were studied. Desferrioxamine leads to an increase of plasma aluminium levels in patients on chronic haemodialysis which could be attributed to mobilisation of tissue aluminium. Furthermore the ultrafiltrable function of plasma aluminium was greatly enhanced thus increasing the effective concentration gradient of aluminium between plasma and dialysate. Desferrioxamine therefore leads to increased aluminium removal during haemodialysis and should be considered in the therapy of aluminium toxicity syndromes.

Aluminum↗
PubMed1980

[Haemodialysis in children (author's transl)].

Thirty four children, aged 2 to 15 years, were treated by haemodialysis between 1967 and 1978. Eleven children suffered from acute renal failure. Twenty three children with end-stage chronic renal disease were treated over periods ranging from 1 week to 19 months. All children were dialysed in a renal unit for adult patients awaiting renal transplantation. Our results refer especially to the technical equipment for paediatric dialysis and to the problems of blood access. The medical problems of chronic uraemia and chronic intermittent haemodialysis in children are discussed. From our experience we conclude that a sufficient degree of rehabilitation can be reached only in a paediatric dialysis unit.

Acute Kidney Injury↗