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Biomedical subjects

J Erben

Publications and source records attributed to J Erben.

At least 19 recordsLinked to original sources
PubMed1992

[Determination of lactoferrin in the diagnosis of pancreatopathy in patients with chronic kidney failure].

The authors investigated in patients with renal disease the lactoferrin content in duodenal aspirate. The aspirate was obtained after previous stimulation of the pancreas with pancreozymin. Lactoferrin estimation is described in the literature as a sensitive examination of changes of exocrine pancreatic secretion. The authors provided evidence that by assessing lactoferrin it is possible to detect initial changes of reduced exocrine pancreatic capacity already in subjects who are on the waiting list of chronic intermittent haemodialyzation programmes (CHIDP); maximum increase of the lactoferrin content in the duodenal aspirate corresponds with the severity of chronic renal failure. Transplantation of the kidneys leads to normalization of the amount of lactoferrin secreted by the pancreas which is evidence of normalization of pancreatic secretion. In patients with chronic renal failure lactoferrin is a sensitive marker of developing uraemic pancreatopathy.

Humans↗
PubMed1992

[Hemorrhage into the digestive tract as a cause of death in patients after kidney transplantation].

The authors investigated the prevalence, cause and possible prevention of haemorrhage into the gastrointestinal tract in 218 patients after transplantation of the kidney (TK). 1. Haemorrhage into the gastrointestinal tract after TK occurred in 32 patients incl. 53.1% who died. In the total mortality after TK haemorrhage into the gastrointestinal tract account for 15.7%. 2. The danger of haemorrhage into the gastrointestinal tract is increased in particular: in the early postoperative period (within one month after transplantation of the kidney), during acute rejection with declining function of the graft, in infectious complications, after graftectomy, in preexisting peptic ulcers. 3. The most frequent cause of haemorrhage were duodenal ulcers. The authors elaborated a system of preventive provisions which involve: a) medicamentous prophylaxis by administration of H2 blockers and antacids not only at the time of transplantation of the kidney and during the early postoperative period but also when there is an increased risk, b) detailed gastroenterological examination before transplantation of the kidney, c) in case of relapsing peptic ulceration in the case-history or haemorrhage into the gastrointestinal tract, subject patients on the waiting list for transplantation of the kidneys during the dialyzation period to proximal gastric vagotomy, or so-called highly selective vagotomy.

Gastrointestinal Hemorrhage↗
PubMed1991

[The critical value of residual kidney function in patients with chronic kidney failure from the viewpoint of the concentration of urea and potassium in the plasma].

Residual kidney function was examined in 10 patients with chronic renal insufficiency under balance conditions and in 30 outpatients on the basis of urea clearance (Curea) and potassium clearance (CK). Protein intake was 35-40 g/day (0.5 g/kg/day) and potassium intake was 30-40 mmol/day. Under these conditions the critical values of residual kidney function were as follows: 1) plasma urea concentration (Purea) did not exceed 30 mmol/l if Curea did not drop below 3.8 ml/min; 2) plasma potassium concentration (PK) did not exceed 5 mmol/l if CK did not decrease below 4.1 ml/min. Clinical examination of Curea and CK provides additional information to the examination of creatinine clearance (Ccr) or its plasma concentration (Pcr). Our results suggest that the critical value of residual kidney function cannot be defined only on the basis of examination of Ccr or Pcr. Examination of Curea and CK can help in the interpretation of very high Purea and hyperkalemia in patients with chronic renal insufficiency.

Ambulatory Care↗
PubMed1990

[Visual function in patients with neuroretinopathy on regular dialysis treatment].

Eight patients included in a regular dialyzation programme who developed neuroretinopathy were subjected to improved dialyzation treatment. It involved variation of sodium and variation of ultrafiltration. After regression of acute symptoms on the fundus in all patients a vision of 6/6 was achieved. Patients with neuroretinopathy have a markedly reduced contrast sensitivity. The latter increases considerably after absorption of the oedema, although it does not attain values recorded in healthy subjects.

Adult↗
PubMed1990

Residual kidney function and plasma urea concentration in patients with chronic renal failure.

The relationships between the plasma levels of urea (P(urea)), renal clearance of urea (C(urea)) and creatinine (Ccr) at an intake of 0.5 g protein/kg body weight/day were followed in 10 patients with chronic renal failure (CRF) under balance conditions. Under these conditions, P(urea) attained a value of 30 mmol/l when C(urea) had decreased below 3.8 ml/min. By contrast, no correlation could be demonstrated between P(urea) and Ccr under these conditions. The same relationships were followed in another group of 30 outpatients with CRF. Even in patients not followed under balance conditions, C(urea) determination makes it possible to establish whether the high increase in P(urea) is due to the decrease in residual renal function below the critical level or whether extrarenal factors are involved. Likewise, no significant correlation between P(urea) and Ccr could be demonstrated under these conditions. The findings suggest that C(urea) measurement in CRF patients helps to assess residual renal function in terms of P(urea) regulation and provides information that cannot be obtained by Ccr measurement.

Blood Urea Nitrogen↗
PubMed1990

Occurrence of neuroretinopathy in dialyzed patients.

In the last 11 years, the neuroretinopathy is reported to occur in 26 dialyzed patients, what represents 5.3% of all patients treated. During the last 4 years, the occurrence rate showed the decrease to 1.6%. The mentioned disease occurs most frequently by the first two years of treatment with dialysis. The averaged survival rate after the onset of neuroretinopathy is ranged as 19.4 mos. in 16 died patients. The disease occurred in 13 patients under the condition of normal diastolic pressure. Metabolic disorder characterized with high levels of serum nitrogenic substances may be further factor inducing the onset of neuroretinopathy backgrounded by cerebral oedema. Since neuroretinopathy consequentially worsens both the subjective (visual acuity, sensitivity to the contrast) and objective (electric activity) sight functions, the appropriate attempt is to be made in achieving rapidly retrogression of pathologic retinal changes by modification of dialysis process.

Adult↗
PubMed1990

[The critical level of renal function in patients with chronic renal failure from the aspect of maintaining normal levels of potassium in the blood].

In 29 subjects with chronic renal failure (Pkr = 826 +/- 69 mumol/, Ckr 0.128 +/- +0.039 ml/s) treated by conservative therapy the urinary excretion and residual renal potassium clearance (CK) was investigated. In 17% of these patients the plasma potassium level (PK) was higher than 5 mmol/l. The PK levels were not significantly related to the value of the residual diuresis, to the daily urinary potassium excretion nor the value of residual creatinine clearance. A significant relationship was found between values PK and CK. The critical CK value where PK rises above 5 mmol/l (under conditions of reduced protein intake 0.5 g/kd/day and a potassium intake not exceeding 40 mmol/l/24 hours) suggests the participation of extrarenal factors (excessive K intake or it's increased shift from cells to extracellular fluid).

Adult↗
PubMed1989

The plasma concentration and renal elimination of phenols in patients with chronic renal insufficiency.

The plasma concentration and renal elimination of phenols was studied in 32 individuals with various renal insufficiency (CRI) and in 30 healthy subjects. In patients with chronic renal insufficiency the increase in P phenols values correlated directly with Per and P urea. Daily urinary excretion of phenols in patients with CRI is only mildly decreased compared with that in healthy controls. Renal clearance (C phenols), 8.52 (+/- 2.69) ml/min on an average, decreases significantly in patients with CRI. While fraction excretion of phenols (FE phenols) was 9.53 (+/- 4.14) % on an average in healthy persons, patients with CRI displayed a significant increase. A significant linear correlation in the values of FE phenols and FEH2O and those of FE phenols and FE urea was documented. Our findings support the assumption that phenols are excreted by the kidney by a mechanism similar to that of urea excretion. Filtration of phenols in the glomeruli is followed, in healthy volunteers, by their significant reabsorption which is a flow-dependent process. In the residual nephrons of patients with CRI, the tubular reabsorption of phenols is decreased, a mechanism largely compensating the effect of decreased filtration of phenols on their total urinary excretion.

Adult↗
PubMed1979

Serum and ultradiafiltrate middle molecules in hemodialysed patients.

The gel filtration technique was used for the fractionation of middle molecular substances (MMS) in plasma from conservatively treated patients, from dialysed patients with renal failure and in the ultradiafiltrate from dialysed ones. The following observations were made: 1. MMS accumulate in the plasma of conservatively treated patients in chronic renal failure. 2. The accumulation of MMS in dialysed patients is even higher. 3. The elimination of the most important MMS in the ultradiafiltrate is excellent. 4. It is concluded that hemofiltration and ultradiafiltration are indicated also for the removal of MMS, namely in the case of clinical complications which cause a further accumulation of MMS.

Humans↗
PubMed1979

Long-term experience with the technique of subclavian and femoral vein cannulation in hemodialysis.

Large vein cannulation for hemodialysis was used in 1164 patients undergoing dialysis treatment and in an acute dialysis program. Subclavian vein cannulation was utilized in 2494 dialyses, and femoral vein cannulation was used in 2368 dialyses. No significant differences with regard to clinical complications were encountered in either type of cannulation. The mortality rate due to subclavian vein cannulation was 0.12%, while that due to femoral vein cannulation was 0.04%. The main risk of subclavian vein cannulation was arterial bleeding, due to trauma to an artery, and pneumothorax, more likely occurring in asthenic patients or in patients with emphysema. Single-needle hemodialysis using subclavian or femoral vein cannulation gave the same results as the arteriovenous Cimino fistula. Intermittent or combined use of both types of large vein cannulation is advantageous in long-term regular dialysis patients that are waiting for a new fistula.

Catheterization↗
PubMed1979

[Tuberculosis in patients deceased of renal insufficiency in a long-term hemodialysis program].

Eight cases of tuberculosis were seen in a series of patients dying of renal insufficiency after having been subjected to a long-term haemodialysis. In 5 cases Mycobacterium tuberculosis was successfully cultivated (4 were typed as human, 1 as bovine). In 5 cases the disease affected mainly the lymph nodes, not the lungs. In 3 of these a prevalence of abscessing specific granulomas with the presence of leucocytes was noted on microscopical examination. The findings have been regarded as possibly related to an impairment of cellular (lymphocytic) immunity, presumably caused by chronic uraemia or long-term haemodialysis.

Adult↗
PubMed1979

Serum levels of IgM, IgD, IgA and IgG before and during rejection of renal allotransplants.

In recipients of renal allotransplants the relationship of IgM, IgA and IgG serum levels to 26 rejections was investigated, as well as the relationship of IgD and 22 rejection. For IgM and IgG a significant decline was found in the whole group (p less than 0.05) and in the sub-group of rejections after a period longer than one month following transplantation (p less than 0.05 in IgM and p less than 0.02 in IgD). As compared with values before rejection, a decline of IgM occurred in 11 rejections which amounted to more than 20% and a decline of IgD in 10 rejections by more than 50%. Changes of the serum levels of IgA and IgG were not statistically significant (p greater than 0.05). In recipients of renal allotransplants serum immunoglobulin (Ig) levels of the main classes were investigated for two reasons: (1) as part of a check-up of the condition of the graft and screening of rejection and (2) to detect possible deficiencies of humoral immunity with increased liability to infections. As regards monitoring of the risk of the rejection crisis, hitherto assembled experience did not provide an unequivocal answer in which class of Ig the greatest change may be expected, whether a rise or fall, and it is not even clear whether investigations of serum Ig levels will be a positive contribution. There is only agreement on the point that IgA levels are not related to rejection; according to some authors this applies also to IgM and IgG (8, 11). Other authors (1, 15, 17) appreciate in conjunction with rejections the importance of high IgM and IgG levels, while other workers observed a significant decline of IgM (13, 16, 19). IgD levels were investigated in our previous work on the relationship of renal functions and serum Ig levels in recipients of renal allotransplants (7); we found no reports on the relationship between IgD and rejection.

Adolescent↗