[Urine concentrating ability test with the vasopressin analog DDAVP].
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Biomedical subjects
Publications and source records attributed to J Ewald.
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Thirty-two patients aged 60 or less with brain infarction were examined with regard to possible changes in lipoprotein pattern as compared with a reference group. Except for a lower concentration of total lipids, cholesterol and high-density lipoproteins in the female patients, no difference was demonstrated in the two groups. In all patients a significant reduction in total lipids, cholesterol, triglyceride and all lipoproteins was demonstrated after the acute cerebrovascular accident presumedly due to the stress situation.
Out of 27 patients with advanced diabetic nephropathy accepted for renal transplantation. 11 had cardiac symptoms and 10 others had advanced neuropathy. The former group had a poor outcome with 100% mortality within one year, seven patients dying before transplantation. Neuropathy also indicated a poor prognosis. Early transplantation, before the stage of terminal uraemia, was at no advantage in this material.
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The remaining kidney undergoes compensatory hypertrophy after donor nephrectomy. Studies have shown that immediate increases of renal plasma flow (RPF) and glomerular filtration rate (GFR) take place. No studies of tubular functions in kidney donors have previously been published. Nine elderly kidney donors with a mean age of 55 years (range 48-71 years) underwent the following studies before and 6 and 12 months after nephrectomy: GFR, RPF, maximal tubular secretion of para-aminohippurate (TmPAH), net acid excretion after 3 days of ammonium chloride loading and test of the urinary concentration ability. RPFP and GFR decreased postoperatively to a mean of 61 and 63.5 per cent respectively, with a rise of the filtration fraction (FF). TmPAH decreased considerably less, to 76 per cent 6 months postoperatively and 86 per cent 12 months postoperatively. The TmPAH/GFR ratio changed from 0.77 to 0.95 and 0.99 postoperatively. The excretion of acid was slightly reduced concerning the NH4+-excretion but the values for H+-excretion and urinary pH were unchanged. The remaining kidney after donor nephrectomy shows the well-known increases in RPF and GFR. Energy-dependent proximal tubular functions such as TmPAH increase even more, indicating an altered glomerulotubular balance. Distal tubular function such as acidification and urinary concentration ability are essentially unchanged.