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Biomedical subjects

J P Van Hooff

Publications and source records attributed to J P Van Hooff.

12 recordsLinked to original sources
PubMed1999

Body composition in renal transplant patients: bioimpedance analysis compared to isotope dilution, dual energy X-ray absorptiometry, and anthropometry.

Whether multifrequency bioelectrical impedance analysis (MF-BIA), a relatively new method for measuring body composition, is also applicable for accurate body composition measurements in renal transplant (RTx) patients is not known. Therefore, the use of MF-BIA is validated in 77 RTx patients with a stable renal function at least 2 yr posttransplantation. MF-BIA is compared to isotope dilution techniques for measurement of body water compartments, and to dual energy x-ray absorptiometry (DEXA) and anthropometry for measurement of fat and fat free mass. Finally, DEXA and anthropometry are compared to each other. Method agreement is assessed by intraclass correlation coefficients (ICC) and plotted by Bland and Altman analysis. MF-BIA significantly underestimates total body water (TBW, 0.7+/-2.1 L) and overestimates the extracellular water (ECW, 3.3+/-1.8 L) compared to isotope dilution; the ICC between both techniques is 0.943 for TBW and 0.846 for ECW. The percentage body fat (BF) measured by MF-BIA is significantly higher than both BF measured by DEXA (3.4+/-4.7%) or by anthropometry (5.5+/-5.2%). The ICC between MF-BIA and DEXA is 0.887 and between MF-BIA and anthropometry 0.856. BF measured by DEXA is significantly higher than BF measured by anthropometry (2.1+/-4.4%); their ICC is 0.913. In conclusion, MF-BIA seems to be suitable for measurement of TBW in RTx patients; however, method agreement between isotope dilution and MF-BIA for the measurement of ECW is not satisfactory. In the assessment of fat and fat free mass, the reliability of MF-BIA appears to be questionable. Method agreement between DEXA and anthropometry seems to be slightly better.

Absorptiometry, Photon↗
PubMed1991

Renal handling of urate and the incidence of gouty arthritis during cyclosporine and diuretic use.

The incidence of gouty arthritis and the role of renal urate handling and diuretic use were studied in 85 cadaveric kidney graft recipients with a graft functioning for at least two years. The incidence of gout was 24% in patients using cyclosporine (CsA, n = 55); no patient using azathioprine (Aza, n = 23) had gout. In patients using CsA, the fractional urate clearance decreased between 1 and 3 months after transplantation, thereafter remaining stable at a significantly lower level than in patients using Aza, pointing toward a specific effect of CsA on tubular urate handling. This impaired fractional urate clearance was not reversible up to 18 months in 7 patients after conversion from CsA to Aza, suggesting irreversible tubular damage. Multiregression analysis showed that the impaired fractional urate clearance and the use of furosemide were significant contributors to the occurrence of gout in patients using CsA.

Arthritis, Gouty↗
PubMed1985

Hepatic sinusoidal dilatation with portal hypertension during azathioprine treatment after kidney transplantation.

An unusual hepatic disease developed in 3 patients with a well-functioning kidney graft 16-24 months after transplantation. Vague abdominal pain, increased bleeding tendency and edema were initial complaints, and hepato- or splenomegaly and ascites were found as well. Liver function tests were not or only mildly disturbed; hemolysis and pancytopenia were always present. Colloid uptake was absent at liver scintigraphy and the hepatic venous wedge pressure was increased. Esophageal varices were demonstrated. Liver biopsy showed extensive midzonal and pericentral sinusoidal dilatation. After discontinuation of azathioprine the symptoms and the extent of sinusoidal dilatation disappeared gradually, but after 1-3 years fibrosis or micronodular cirrhosis had developed and splenomegaly with hypersplenism remained. These observations strongly suggest an association between chronic use of azathioprine and the development of venous congestion of the liver with sinusoidal dilatation, eventually resulting in chronic liver disease.

Adult↗