PubMed Health⌕ Search

Biomedical subjects

H K Stummvoll

Publications and source records attributed to H K Stummvoll.

At least 73 records · Page 4Linked to original sources
PubMed1980

Enhanced 6-oxo-PGF1 alpha levels in plasma during hemodialysis.

The activation of platelets due to foreign surface interaction is a well known fact. Earlier, we found an increase of circulating platelet microaggregates (method of Wu and Hoak) during hemodialysis. Since this phenomenon might cause a PGI2-release by lung and/or vascular tissue, we studied the plasma 6-oxo-PGF 1 alpha-levels in 6 patients during hemodialysis. We found an initial increase of plasma 6-oxo-PGF 1 alpha. Coincidently, hypoxemia, fall in platelet and lekocyte count and a decrease in platelet count ratio were observed. An effect of heparin was excluded in a control group. The findings support the hypothesis that PGI2 acts as a defense mechanism against platelet deposition on vascular wall by a temporary increased synthesis which could be monitored by a temporarily enhanced plasma 6-oxo-PGF 1 alpha-level during the initial phase of hemodialysis.

6-Ketoprostaglandin F1 alpha↗
PubMed1980

Pathophysiology of dialysis related hypoxaemia.

In order to elucidate the pathogenesis of haemodialysis related hypoxaemia, lung function studies, measurements of intra-thoracic fluid changes, leucocytes and complement activity were made in 12 patients during a routine six hours dialysis using cellulose membranes. Coincidently with the fall in arterial oxygen tension, lung function was significantly impaired, paralleled by a decrease in transthoracic impedance, leucopenia and a decrease in plasma complement activity. It therefore is suggested that blood membrane interaction leads to complement-mediated pulmonary leucostasis evoking mild pulmonary oedema with impaired oxygen diffusion, resulting in hypoxaemia.

Carbon Dioxide↗
PubMed1980

Enhanced prostacyclin synthesis in acute human kidney transplant rejection.

In acute and chronic kidney transplant rejection renal cortical and medullary tissue samples were examined for their prostacyclin (PGI2) generation by bioassay and compared with normal tissue. In acute rejection PGI2 formation was significantly enhanced, particularly in the cortex. In chronic rejection the PGI2 formation was comparable with control tissue. Since PGI2 is a very potent platelet aggregation inhibitor and vasodilator, it is concluded that the increase in PGI2 generation in acute rejection might be a self protecting mechanism which is, however, overwhelmed in irreversible rejection.

6-Ketoprostaglandin F1 alpha↗
PubMed1980

Effect of 1 alpha hydroxylated vitamin D on steroid induced calcium malabsorption.

As persistent bone loss is a major problem of chronic steroid therapy the effects of 3 weeks therapy with 1 alpha hydroxycholecalciferol were studied in 10 kidney transplant recipients on chronic steroid therapy. Treatment resulted in a significant increase in intestinal calcium absorption, paralleled by a significant decrease of serum iPTH, whereas neither plasma calcium nor urinary calcium excretion rose significantly, suggesting a positive calcium balance throughout the study. It is therefore suggested that administration of active vitamin D metabolites is an effective protection against one of the pathogenic mechanisms of steroid induced osteopenia.

Calcium↗
PubMed1980

[Aluminum-balance during haemodialysis (author's transl)].

Aluminium kinetics in patients with endstage renal failure and chronic intermittent haemodialysis have been studied. All patients revealed elevated predialytic serum aluminum levels. Because of a significant correlation between daily intake of aluminiumhydroxyd and serum aluminium levels it is concluded that the intestinal aluminium absorption plays an etiological role in the development of hyperaluminaemia. Plasma aluminium levels at the end of a regular dialysis procedure are significant lower compared to predialytic values. Similarly a significant decrease of aluminium concentration was observed in the plasma after passage through the dialyzer. This is due to the fact that the aluminium content of the dialysate used in our unit (0.1-0.3 mumol/l) is lower than the ultrafiltrable fraction of the plasma aluminium measured in vivo. Therefore a negative aluminium-balance during haemodialysis has to be assumed in our patients. Extreme aluminium-accummulation seems to be avoided and we therefore never experienced aluminium intoxication and dialysis dementia in our center. To assess a negative aluminium balance during haemodialysis, because of high protein binding of aluminium, a dialysate with an extreme low aluminium content has to be recommended.

Adolescent↗
PubMed1980

[Interaction between blood platelets and capillary kidney in haemodialysis (author's transl)].

In haemodialysis an interaction between platelets and the dialysator membrane occurs, which is not prevented by heparin. This can be demonstrated by parietal depositions of platelets in the capillaries of the artificial kidney by scanning electron microscopy, as well as in a marked increase of reversible platelet microaggregates during the first phase of dialysis. Some patients are prone to develop thrombosis of the capillary kidneys in spite of a high-dose heparinization. In these cases the use of diclofenac, a cyclooxygenase inhibitor, prevents these adverse platelet reactions.

Adolescent↗
PubMed1979

[Calcium and phosphorus metabolism in patients on chronic intermittent haemodialysis with different calcium concentrations in the dialysate (author's transl)].

A study was carried out in 25 patients on chronic intermittent haemodialysis on the effect of increasing the dialysate calcium concentration from 1.5 to 1.75 mMol/l on calcium and phosphorus metabolism. In 16 patients the increase in the dialysate calcium resulted in a sufficiently large increase in the plasma Ca level to suppress the parathyroid glands. The calcium influx during dialysis in these patients was sufficient to abolish the effects of diminished calcium absorption from the intestine due to loss of endocrine renal function. The remaining 9 patients showed no suppression of parathyroid gland activity and could be separated into two different groups, one requiring calcium supplementation and the other group manifesting signs of autonomic hyperparathyroidism. The five patients showing a higher calcium requirement were started on active vitamin D metabolites. In the remaining 4 patients parathyroidectomy will probably be inevitable if progression of the clinical manifestations of hyperparathyroidism occurs. Close control of plasma phosphorus levels is mandatory to avoid an increase in the calcium phosphate product or the danger of hypophosphataemic osteomalacia.

Adolescent↗
PubMed1979

[Circulating platelet aggregates during haemodialysis].

In eight chronically haemodialysed patients a significant increase of circulating platelet aggregates (method of Wu and Hoak) was observed immediately after starting haemodialysis. The number of aggregates decreased at the end of haemodialysis reaching the starting values after 360 min. The platelet interaction with the dialysis membrane surface might cause this phenomenon. Anticoagulation with heparin alone was insufficient in preventing aggregate formation during haemodialysis.

Adolescent↗
PubMed1979

[Renal failure and carbon monoxide diffusing capacity of the lung (author's transl)].

Reduced carbon monoxide diffusing capacity of the lung (DLCO) is reported in patients with impaired renal function. Since DLCO also depends on the pulmonary capillary blood volume the role of renal anaemia was evaluated. Measurements were carried out in 43 azotaemic patients [serum creatinine (SKr) 1.5 to 14.0 mg/100 ml], without evidence of cardiovascular or pulmonary complications of uraemia, of SKr, haemoglobin concentration (Hb) and steady state DLCO. In the case of DLCO values allowance was made for body surface area and thoracic gas volume. The relation was studied of the corrected DLCO to SKr and to Hb. There was a higher statistical correlation between DLCO and Hb than between DLCO and SKr. After additional correction of DLCO for Hb, no correlation to SKr was found. It is concluded that the reduction in DLCO in uraemia is due largely to a low Hb and, hence, to renal anaemia rather than to uraemic damage of interstitial lung tissue.

Adolescent↗
PubMed1979

Reversible acute tubular necrosis following severe acute renal rejection.

The clinical observation of 6 out of 250 renal transplant patients showed that acute renal rejection may lead to reversible acute tubular necrosis (ATN) necessitating intermittent haemodialysis treatment. Despite missing early response to high-dose (methyl-) prednisolone therapy (during a mean period of 4.7 days) all 6 patients developed spontaneous diuresis 14.5 days on average after onset of rejection while on maintenance immunosuppressive therapy. From the clinical course the conclusion was drawn that in severe cases of renal rejection with arteriographic and histological findings consistent with acute tubular necrosis, prolonged therapy with high doses of (methyl-) prednisolone is not desirable, since after reversal of immunological rejection the onset of spontaneous diuresis will be determined mainly by the duration of the healing and recovery phase of acute tubular necrosis.

Acute Kidney Injury↗