PubMed Health⌕ Search

Biomedical subjects

J S Tannenbaum

Publications and source records attributed to J S Tannenbaum.

6 recordsLinked to original sources

Tolerance of hemodialysis: a randomized prospective trial of high-flux versus conventional high-efficiency hemodialysis.

Hemodialysis is frequently complicated by hypotension and associated symptoms. It has been suggested that these symptoms may be related to the biochemical changes caused by cellulosic dialysis membranes. In this study, a prospective randomized crossover trial was conducted comparing the incidence of hypotension and acute symptoms during dialysis with large-surface-area (1.6 m2) cellulosic (cuprophane [CUP]) and noncellulosic (polyacrylonitrile [PAN], AN69) membranes. Dialyzers were used for a single use only. There was no difference in predialysis BUN, predialysis blood pressure, intradialytic weight gain, blood flow, dialysis efficiency (urea reduction), dialysis duration, hematocrit, or erythropoietin dose between the two study phases. When these clinical characteristics were matched, there was no difference in the number of episodes of hypotension (CUP, 19 +/- 3; PAN, 22 +/- 3; P = not significant [NS]). The incidence of symptomatic hypotension, as reflected by the number of episodes of hypotension requiring more than 100 mL of saline for correction, was also not different between study phases (CUP, 10 +/- 1; AN69, 11 +/- 2; P = NS). The incidence of intradialytic symptoms, including emesis, cramping, headache, angina, pruritus, and bronchospasm, was similar during the two study phases (CUP, 11 +/- 2; AN69, 10 +/- 1; P = NS). It was concluded that noncellulosic membranes do not offer any significant advantage over cellulosic membranes in reducing the acute complications of hemodialysis.

Acrylic Resins↗

Renal thromboxane synthesis in excised kidney distal to renovascular lesions.

Excision of a kidney with three distinct zones of perfusion was required in a patient with renovascular hypertension. One third of the kidney was normal, one third was ischemic from a stenotic artery, and one third was severely ischemic from a completely occluded artery. This provided a unique opportunity to study renal prostaglandin production in hypoperfused and control tissue by radioimmunoassays of incubated tissue slices. The thromboxane-prostacyclin synthesis ratio for the outer cortex increased from 2.2 in control tissue to 5.8 in moderately ischemic tissue and 11.3 in severely ischemic tissue; for the inner cortex, 2.1 to 6.3 and 8.8; and for the medulla, 0.4 to 1.2 and 3.0, respectively . Similar ratios were noted for thromboxane-prostaglandin E2. This correlates, for the first time in man, absolute and relative increases in renal thromboxane synthesis with renovascular hypertension.

Humans↗

Prostaglandin synthesis associated with renal allograft rejection in the dog.

Vasospasm and intrarenal thrombosis are characteristics of acute renal allograft rejection. A possible mediator of these phenomena is thromboxane A2. Single kidneys were exchanged between nonimmunosuppressed mongrel dogs. At intervals after transplantation, rejecting and normal kidneys were removed and slices of cortex and medulla were prepared for incubation. The in vitro release of thromboxane B2 (TxB2), prostaglandin E2 (PGE2), and 6-keto-prostaglandin F1a (6-keto-PGF1 alpha) into the incubation media was measured by radioimmunoassay. Within 72 hr of transplantation the cortex of rejecting kidneys synthesized 10 to 30 times as much PGE2 and TxB2 as normal controls. A similar increase was not observed for 6-keto-PGF1 alpha synthesis. In the medulla there was a selective reduction in 6-keto-PGF1 alpha production within five days of transplantation. In both cortex and medulla there was a significant increase in the ratio of TxB2 to 6-keto-PGF1 alpha production. Reversal of the normal TxB2:6-keto-PGF1 alpha ratio could induce the widespread intrarenal thrombosis and vasospasm that characterizes acute renal allograft rejection.

Animals↗