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H Kopsa

Publications and source records attributed to H Kopsa.

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

[Secondary oxalosis in chronic renal insufficiency].

The concentration of oxalic acid was determined in the plasma of 15 patients with conservatively treated chronic renal insufficiency and 17 dialysis patients. A cumulation of oxalic acid was found in connection with uraemia. The extent to which plasma oxalic acid concentrations were raised depended on the degree of renal insufficiency and was directly related to the plasma creatinine values in all patients with or without dialysis. In the patients with chronic renal insufficiency the median plasma oxalic acid concentration was 74.4-18.5 (control group 27.0 +/- 7.4) mumol/l. In the dialysis patients the levels were even higher, at 137.5 +/- 56.0 mumol. By means of haemodialysis it was possible to lower the plasma oxalic levels by about the same amount as creatinine concentrations. The higher plasma oxalic acid concentrations seem to be an important pathogenetic factor in the formation of uraemic calcification in various organs. The therapeutic consequences are to increase the duration and frequency of dialysis and to remedy possible vitamin B6 deficiency.

Adult↗
PubMed1981

[Alpha-1-antitrypsin and fibrinogen levels in chronic renal failure and after kidney transplantation (author's transl)].

In ten non dialyzed patients with chronic renal failure, 18 patients on regular dialysis treatment and 70 renal transplant recipients alpha-1-antitrypsin and fibrinogen levels were investigated. Alpha-1-antitrypsin and fibrinogen concentrations were highest in dialyzed patients with values of 314 +/- 98 and 485 +/- 127 mg/dl respectively. In renal transplant recipients a significant positive correlation between alpha-1-antitrypsin and fibrinogen concentration was found (p less than 0.001). High alpha-1-antitrypsin and fibrinogen levels seem to be a possible consequence of reactive processes due to underlying disease or complications. Our results seem to indicate that both alpha 1-antitrypsin and fibrinogen can be classified as "acute phase protein".

Creatinine↗
PubMed1981

[Fungal infections -- always dangerous for immunosuppressed patients (author's transl)].

Four renal transplant recipients, treated with the immunosuppressive combination of azathioprine-prednisolone, developed organ or systemic mycoses caused by Candida albicans and, in one case, additionally by Trichophyton rubrum. Ketoconazole, a new wide-spectrum antimycotic drug, was successfully used in the treatment of the fungal infections in these patients. The oral route of administration, good tolerance and excellent results are good recommendations for this drug.

Adult↗
PubMed1981

[Portal hypertension and chronic renal insufficiency. Successful treatment with hemodialysis].

We present three cases with portal hypertension, ascites and concomitant chronic renal failure, successfully treated for 38, 26 and 5 months respectively with chronic hemodialysis. The causes of portal hypertension were alcoholic cirrhosis of the liver in 2 cases and cavernous transformation of portal vein with intrahepatic block, in one case. The complications of portal hypertension, the conservative and surgical treatment of oesophageal varices and ascites are discussed.

Adult↗
PubMed1981

Comparison of the effects of muzolimine and furosemide in patients with end-stage renal failure on chronic dialysis.

The pharmacodynamic effects of muzolimine and furosemide were compared in a single dose cross-over study in 8 patients on regular dialysis treatment, who had a residual diuresis of more than 300 ml/day. The study periods comprised two dialysis-free intervals of 3 days. On the second dialysis-free day either muzolimine 240 mg or furosemide 240 mg was administered orally. Urine was collected in 12-h periods on the pre-treatment, treatment and post-treatment days, and the excretion of sodium, potassium, urea and creatinine were measured. After administration of muzolimine 240 mg urine volume rose to twice that of the previous day, and sodium excretion increased approximately threefold. In contrast, the effect of furosemide 240 mg was not a pronounced; the diuresis was only 1.6 times that on the previous day and natriuresis was only 2.2 times as large. Excretion of potassium and creatinine was only slightly increased by either substance. The elimination of urea was increased by both substances to the same degree as the corresponding increase in diuresis.

Creatinine↗
PubMed1981

Increased danger of bone marrow damage in simultaneous azathioprine-allopurinol therapy.

Two renal transplant recipients with reversible bone marrow damage in the course of a simultaneous azathioprine-allopurinol therapy are discussed. Anemia, leukocytopenia and thrombocytopenia were found in both patients. Discontinuation of the azathioprine-allopurinol treatment was followed by increase of hematocrit, hemoglobin, erythrocytes, white blood cells and platelets. Interaction of azathioprine and allopurinol seems to be responsible for bone marrow damage in these patients. It can be concluded that the dose of azathioprine should be reduced when allopurinol is given concomitantly.

Adult↗
PubMed1980

[Pharmacokinetics of trimethoprim and sulfametrol in patients with end stage renal failure and hemodialysis treatment (author's transl)].

In 6 patients with regular dialysis treatment the pharmacokinetics of intravenously administered trimethoprim and sulfametrol were investigated not only during dialysis procedure but also during the dialysis-free interval. Half-life of the free plasma sulfametrol component is normal even in cases with absent renal function and can be markedly reduced by hemodialysis treatment. The N4-acetylated main metabolite of the sulfonamide is - similar to trimethoprim - hardly dialyzable. Half-life of the latter drug component is prolonged in patients with far advanced renal failure. Due to the excellent dialysanceof the free plasma sulfonamide component the elimination of total sulfametrol is normal during hemodialysis despite cumulation of the N4-acetylated metabolite. Because of the tendency of this metabolite to cumulation, in dialysis patients the compound preparation of trimethoprim and sulfametrol should be used only for trasient treatment of acute infections.

Adult↗
PubMed1980

[Alpha 1-antitrypsin level in serum of dialyzed and renal transplant patients (author's transl)].

alpha 1-Antitrypsin in serum was determined by radial immunodiffusion in 30 healthy persons, 18 dialyzed patients and 11 renal transplant recipients with an observation time up to 24 months after surgery. There was no significant difference in serum alpha 1-antitrypsin concentrations in dialyzed patients when compared to the controls (2570 +/- 570 and 2280 +/- 450 mg/l respectively). alpha 1-Antitrypsin concentration increased significantly from the first day after successful renal transplantation, then decreased again 10 days thereafter. Long term follow up controls 3, 6, 12, 18 and 24 months respectively after surgery--with a good renal transplant function--revealed values within the normal range. An acute rejection episode of the transplant was connected with a significant increase of alpha 1-antitrypsin concentration in the serum. Determination of alpha 1-antitrypsin level in serum can be useful in the diagnosis and prognosis of acute renal transplant rejection.

Female↗
PubMed1980

Persistent pituitary-thyroid dysfunction patients following renal transplantation.

Pituitary-thyroid function, which is known to be altered in patients with chronic renal insufficiency, has been evaluated after successful kidney transplantation in 36 patients and compared with that in 15 healthy subjects. Thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) was in the low range of normal in 24, and markedly decreased in 12 patients (< 0.0005). In the former group serum thyroxine was normal, whereas triiodothyronine was lowered; in the latter group thyroxine, although within the normal range, and triiodothyronine levels were reduced when compared with that of healthy controls. This differential TSH response to TRH was unrelated to kidney transplant function, duration of renal insufficiency or duration of the preceding hemodialysis, or to the dose and dosing schedule of prednisolone therapy. However, a slight negative correlation between the dose of prednisolone administered and TSh responsiveness to TRH as well as serum triiodothyronine was established (P < 0.05). Thus, corticoid treatment may in part be responsible for the alteration in TSH secretion and in the peripheral conversion of thyroxine to triiodothyronine. Other, as yet undefined factors, such as patients' variability in pituitary susceptibility to the polypragmatic therapy administered, have to be suspected as the major causes of the persistent pathological pituitary-thyroid function tests observed after renal transplantation.

Adolescent↗
PubMed1980

[Diagnostic relevance of contact thermography in renal transplantation (author's transl)].

102 renal transplant recipients were checked by contact thermography according to Tricoire for 2 1/2 years. Diagnostic value of this non invasive, quickly available and reproduceable method was investigated. The grafted kidney reveals on the thermographic screen its size, site, and vascularisation. The thermograhic pattern of a well functioning transplant shows warm areas in green, blue and violet colour. Onset of acute or chronic renal rejection leads to impaired heat conduction to the body surface either by oedema or by diminished blood flow. By photographic documentation in natural colour spotted or diffuse cold regions of brown, maroon and orange are seen. In the very early posttransplant period up to two months thermography is helpful in differential diagnosis for those recipients requiring initial haemodialysis treatment. Information is available between non functioning grafts with diminished renal blood supply and transplants with acute tubular necrosis. Impressive thermograms are found by rupture and subrupture of the kidney respectively. Superficial perirenal changes lead to topical temperature elevation as well. The high reliability of 92% correct diagnoses depends on exact application of the thermosensitive film and on determination of the basic individual skin temperature in reference to repeated examinations of the grafted area. Temperature measurement is influenced by subcutaneous abdominal fat distribution and muscle thickness as well as by deep position of the transplant or asymmetry of the lower abdominal region. In the wide field of diagnostic procedures necessary for transplant recipients with complications thermography by Tricoire is recommended.

Adolescent↗
PubMed1980

[Therapy in chronic renal insufficiency (author's transl)].

Therapy of chronic renal failure requires individual management in diet and vigorous treatment of disorders of fluid and electrolyte metabolism and renal acidosis. Concomitant diseases such as renal hypertension, arrhythmia, cardiac insufficiency, pulmonary complications, gastrointestinal disorders, renal anaemia, affection of central nervous system, disturbance in glucose, uric acid and lipid metabolism and infections, demand careful medication Selection of drugs and doses related to impaired renal functions, is indicated.

Acid-Base Equilibrium↗
PubMed1979

[Mixed infection after renal transplantation (author's transl)].

Severe mixed infection was observed in 9 out of 101 renal transplant recipients over a period of 6 years and was characterized by the simultaneous incidence of bacterial, fungal and viral infections. Severe septicaemia was clinically evident in all cases. The critical clinical situation called for a rapid assessment of the differential diagnosis and relevant bacterial, fungal and viral investigations. Antibacterial and antimycotic therapy must be instituted as soon as possible on account of the high mortality from mixed infection in renal transplant recipients. The reduction or discontinuation of immunosuppressive therapy during infection did not impair renal transplant function.

Bacterial Infections↗
PubMed1979

[Diagnostic relevance of thermography in renal transplantation (author's transl)].

During a followup period of 18 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a not invasive, quickly available and reproduceable method. Because of the high incidence of 85% exact diagnoses this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommendable for transplant patients, if postoperative haemodialysis is necessary. In these cases information can easily be obtained whether postoperative olig-anuria is caused by acute tubular necrosis or by primary insufficient vascularisation of the transplant.

Adolescent↗
PubMed1979

[Morbidity during regular dialysis treatment and after renal transplantation (author's transl)].

Renal transplantation was associated with a lesser degree of morbidity than chronic dialysis treatment in a group of 48 patients with end-stage renal failure. Morbidity was defined as total days of in-patient hospitalization divided by total days of risk. The morbidity during chronic intermittent dialysis, with a mean observation time of 296.1 (20 to 2255) days, was 11.8%, whereas after renal transplantation, with a mean observation time of 1004.0 (131 to 2400) days, only 7.6% of all days at risk were spent in hospital. Morbidity rises to 38.1% during chronic dialysis if all dialysis days on an out-patient basis are considered as hospitalization days. Morbidity was lowest (3.8%) in patients sent home for the first time with a functioning graft. Cardiac complications and fluid lung were the most common causes for morbidity during haemodialysis treatment; morbidity after renal transplantation was mainly due to renal rejection and infections under non-specific immunosuppression. Social and occupational rehabilitation was better after renal transplantation than during haemodialysis treatment. It can be concluded from these data that with regard to the quality of life renal transplantation is the preferable alternative in the management of end-stage renal failure.

Adolescent↗