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J A Hasbargen

Publications and source records attributed to J A Hasbargen.

31 records · Page 2Linked to original sources
PubMed1990

Methods for measuring GFR with technetium-99m-DTPA: an analysis of several common methods.

Several commonly used scintigraphic methods of GFR measurement were evaluated. Forty-three adult patients with a wide range of ages and renal function were studied. The two-sample plasma method of Russell and the urinary method of Jackson were the most accurate methods overall. The one-sample plasma method of Russell, the volume of distribution method of Fawdry, and a terminal slope method were less reliable, especially at low (0-60 ml/min) GFRs. The renal uptake method of Gates correlated poorly to the standards at all GFR levels even when corrected for body surface area or blood volume. The Russell two point and Jackson urinary GFR's can be used as complementary techniques and are recommended as primary methods of scintigraphic GFR determination.

Adolescent↗
PubMed1987

Efficacy of intramuscular and intraperitoneal deferoxamine for aluminum chelation.

As intravenous administration of deferoxamine is difficult in home dialysis patients we set out to determine the efficacy of intramuscular (i.m.) and intraperitoneal (i.p.) deferoxamine for removal of aluminum. Patients with serum aluminum levels greater than 90 micrograms/liter were studied in a paired fashion with each patient serving as their own control. Serum and peritoneal fluid aluminum were determined using flameless atomic absorption. In hemodialysis patients 2 g of intravenous deferoxamine increased serum aluminum from 124.7 +/- 32.4 to 415 +/- 192.4 micrograms/liter. One g of deferoxamine given intravenously or intramuscularly resulted in 76.8 +/- 35.3% and 70.4 +/- 23.2%, respectively, of the 2 g i.v. response. The rate at which serum aluminum increased following i.v. deferoxamine infusion was biphasic, with an initial rapid phase lasting 139 minutes followed by a much slower phase. The volume of distribution of aluminum following deferoxamine administration was 12.6 +/- 1.61 and the half life (t1/2) for aluminum removal during hemodialysis was 9.0 +/- 2.0 hours. The increase in serum aluminum following deferoxamine was not due to chelation of erythrocyte aluminum as erythrocyte aluminum remained constant over 24 hours. In patients on continuous ambulatory peritoneal dialysis, 2 g intravenous deferoxamine resulted in the removal of 560 +/- 267 micrograms of aluminum over 24 hours while 2 g deferoxamine given intraperitoneally gave 91 +/- 13% of the intravenous response. Aluminum clearance over 48 hours was twice that for 24 hours for both i.v. and i.p. deferoxamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1987

'Idiopathic' hematuria. A prospective evaluation.

Evaluation of the patient with isolated hematuria is often problematic. Sixty-five patients with this entity were studied prospectively with renal biopsy; serum IgA levels, skin biopsy for IgA immunofluorescence, and HLA typing were also studied in most patients. Previously, all patients had had a non-contributory history and physical examination, normal results of structural evaluation, serologic and clotting studies, and proteinuria of less than 1000 mg/d (less than 1 g/d). Seventy-eight percent were found to have abnormal renal biopsy results and were divisible into two patient groups: those with IgA nephropathy (49%, 32/65) and those with multiple nonspecific abnormalities (29%, 19/65). Ancillary testing, demographic data, and clinical data, other than abnormal amounts of proteinuria, were not distinguishable between these groups and patients with normal renal biopsy results (22%, 14/65). Etiologic differentiation of the hematuria was possible only by renal biopsy. At present, renal biopsy in this group of patients makes no difference therapeutically or, probably, prognostically. It should not, therefore, be considered necessary for routine management of asymptomatic hematuria.

Adult↗
PubMed1985

Utility of skin biopsy in the diagnosis of IgA nephropathy.

Thirty-seven patients with the diagnosis of IgA nephropathy were evaluated with punch skin biopsies of non-sun exposed skin. Biopsies were performed regardless of clinical activity. Biopsies were positive for IgA immunofluorescence in two patients. In an effort to enhance positivity of biopsies, patients were pretreated with 0.1 mL of histamine and then repeat biopsies were performed on 14 patients with previously negative skin biopsies. All 14 patients had negative repeat skin biopsies for IgA immunofluorescence. A review of the literature revealed 76 positive skin biopsies in a total of 138 patients with IgA nephropathy. Positive skin biopsies were also reported in 169 of 510 patients with other renal diseases. We conclude that a 4 mm punch skin biopsy with or without histamine is an insensitive and non-specific test for diagnosing IgA nephropathy.

Biopsy↗
PubMed1984

Rheumatoid arthritis and membranous glomerulonephritis: a role for immune complex dissociative techniques.

Although controversial, several reports have linked rheumatoid arthritis (RA) with membranous glomerulonephritis (MGN). In none of these studies was an infectious etiology such as hepatitis B virus (HBV) thoroughly pursued. We evaluated a patient with classic RA and MGN unassociated with nephrotoxic drugs. Although negative by routine serological methods, hepatitis B surface antigen was eventually demonstrated in the serum, using immune complex dissociative techniques, and in the renal glomeruli, using tissue immunofluorescence. A review of the literature provides no conclusive evidence for a causal relationship of RA to MGN. The renal pathogenic potential of HBV, however, is well documented. Future use of immune complex dissociative techniques and tissue immunofluorescence may be of value in clarifying otherwise unexplained MGN in the setting of RA.

Adult↗
PubMed1976

Reflex suppression of renin secretion during distention of cardiopulmonary receptors in dogs.

We studied the effect of brief periods of left atrial-pulmonary vein distention on the rate of renin secretion in sodium-restricted dogs anesthetized with chloralose and breathing spontaneously. Series 1 consisted of 32 trials in seven dogs with intact renal nerves and intact vagi. Renin secretion, calculated as the product of renal venous minus arterial renin activity (radioimmunoassay) times renal plasma flow (electromagnetic flowmeter), was depressed to 56% of control during atrial distention despite no change in arterial pressure, central venous pressure, or renal blood flow. Series 2 consisted of 58 trials in 12 dogs which had undergone unilateral renal denervation several days prior to the studies. Simultaneous, bilateral determinations indicated that renin secretion from the innervated kidney was depressed to 58% of control during atrial distention; secretion from the denervated kidney was unchanged. Series 3 consisted of 30 trials in six dogs with bilateral cervical vagotomy. Atrial distention evoked no changes in renin secretion. We conclude that left atrial distention reflexly reduces the rates of renin secretion via vagal afferent and renal sympathetic efferent pathways.

Animals↗
PubMedDate not supplied

A review of the effects of correction of acidosis on nutrition in dialysis patients.

Metabolic acidosis is a condition that is commonly encountered in both chronic renal failure (CRF) and in end-stage renal disease (ESRD). Known complications and surmised consequences associated with the acidosis of renal disease include bone lesions, depression of myocardial contractility, and growth retardation. Conversely the correction of acidosis in children with renal tubular acidosis improves growth velocity. This is also the case in children with CRF. The conclusion drawn from this study was that the correction of metabolic acidosis improved serum albumin concentrations in patients on hemodialysis and that this correction also induced a decrease in the nPCR.

Acidosis↗
PubMedDate not supplied

Peritonitis due to Rhizopus in a patient undergoing continuous ambulatory peritoneal dialysis.

A 61-year-old man who had end-stage renal disease secondary to diabetes mellitus and hypertension developed peritonitis due to infection with Rhizopus as a complication of receiving continuous ambulatory peritoneal dialysis (CAPD). At the onset of infection, the patient was neither acidemic nor hyperglycemic; in addition, deferoxamine had not been administered and Elastoplast dressings had not been applied. The infection occurred after the technique for disinfection of the catheter used for CAPD had been changed. The catheter was removed, and therapy with amphotericin B was initiated. Although the patient died of apparently unrelated causes, an autopsy revealed active fungal infection with multiple abscesses and superficial invasion of the ileal wall.

Abscess↗
PubMedDate not supplied

Ultrastructural immunolabeling: a unique diagnostic tool in monoclonal light chain-related renal diseases.

Ultrastructural labeling can play a key role in the evaluation of morphologic expressions of monoclonal light chain-related renal diseases in cases where light microscopy, electron microscopy, and immunofluorescence data, even when combined, are not definitive in conveying a diagnosis and, in other cases, in clarifying the findings by providing immunomorphologic correlation. The important role of ultrastructural labeling is highlighted by the fact that in some of these cases bone marrow aspirates and biopsy specimens obtained at the time of the evaluation of the renal specimens are often unable to establish unequivocally a diagnosis of plasma cell dyscrasia. This is in part because renal manifestations commonly precede overt diagnostic bone marrow alterations. Overt bone marrow findings and clinical manifestations may be preceded for as long as 16 years by the renal manifestations. Determination or confirmation of monoclonality and detection of early deposition of monotypical light chains before the finding of ultrastructural morphologic correlates (ie, subendothelial, punctate, granular, electron-dense material) represent unique attributes of this technique. The increased sensitivity of ultrastructural immunolabeling compared with other available diagnostic techniques and its exquisite immunomorphologic correlative capabilities result in a comprehensive evaluation. Sixteen monoclonal light chain-related renal disease cases with early, unusual, or equivocal immunomorphologic manifestations that may have not been characterized properly if ultrastructural labeling had not been performed are presented. The crucial role played by ultrastructural labeling in evaluating these cases and establishing an accurate diagnosis is illustrated and emphasized.

Adult↗