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Biomedical subjects

K Olgaard

Publications and source records attributed to K Olgaard.

At least 55 records · Page 3Linked to original sources
PubMed1985

Aldosterone response to modulation of potassium in patients on dialysis or with essential hypertension.

This investigation demonstrates in patients with essential hypertension an abnormal response of the adrenal glands to modulation of potassium metabolism by infusion of insulin-glucose. Similar results have been reported in anephric patients, while the inverse response of non-nephrectomised patients on dialysis corresponded to that of normal subjects. It is suggested that the abnormal response of patients with essential hypertension may be of importance to the understanding of the pathogenesis of this important disease.

Adult↗
PubMed1985

Clinical results and cyclosporine effect on prednisolone metabolism of cadaver kidney transplanted patients.

In the first randomised study of cyclosporine in Denmark 43 cadaveric kidney recipients were treated either with cyclosporine (Cys) and prednisone or azathioprine (Aza) and prednisone. The degradation of prednisolone was examined in 18 of these patients. The 12 month graft survival of the Cys group was not significantly greater than that of the Aza group (68% and 60%, respectively), but fewer rejection episodes occurred in the Cys group (p less than 0.05). The degradation of prednisolone was significantly decreased in the Cys group compared to the Aza group. Accordingly, plasma half-lives of prednisolone were increased in the Cys group compared with the Aza group. As a decreased degradation of prednisolone during Cys treatment may lead to increased steroid activity, we recommend that a reduction of the prednisone dosage during Cys treatment is safe.

Adult↗
PubMed1983

Altered adenosine 3',5'-monophosphate release in response to parathyroid hormone by isolated perfused bone from glucocorticoid-treated dogs.

The interaction between glucocorticoids (GC) and PTH has been suggested to play a role in the pathogenesis of GC-induced osteopenia. The present studies were designed to examine the effect of acute (5-h) or chronic (4-week) GC administration in vivo on 1) cAMP release by the isolated perfused dog tibia before (basal) and after the addition of synthetic bovine PTH-(1-34) [syn bPTH-(1-34)] (stimulated) to the perfusate in vitro, in the presence or absence of the phosphodiesterase inhibitor 3-isobutyl-1-methyl-xanthine (IBMX; 1 mM), and 2) the percent arteriovenous difference of immunoreactive PTH across bone. Acute administration of 6 mg/kg methylprednisolone (MP) did not affect the basal release of cAMP from bone (6.9 +/- 1.6 pmol/min in control vs. 6.1 +/- 1.2 pmol/min in MP-treated animals); however, syn bPTH-(1-34) stimulated release of cAMP was higher in the MP-treated animals (45 +/- 8.1 pmol/min) than in controls (26.8 +/- 3.0 pmol/min). When IBMX was added to the perfusate, basal cAMP release was not different in control and MP-treated bone (17.2 +/- 2.1 pmol/min in control vs. 19.1 +/- 1.9 pmol/min in MP-treated bone), and syn bPTH-(1-34)-stimulated release of cAMP was equivalent in both groups. In contrast, chronic prednisone therapy lead to a decrease in both basal and PTH-stimulated release of cAMP from bone (3.1 +/- 0.4 and 6.9 +/- 1.6 pmol/min for basal, and 13.1 +/- 1.7 and 26.8 +/- 3.0 pmol/min for stimulated values, respectively). However, the percent changes from the basal levels were not different in the two groups. These results were correlated with histological studies of rib biopsies obtained from these animals, which showed evidence of osteopenia and decreased bone turnover. Neither acute nor chronic GC administration had any effect on arterio-venous differences for PTH across the bone. Thus, these studies demonstrate that 1) acute administration of MP enhances the response of bone to PTH, an effect that is not apparent in the presence of the phosphodiesterase inhibitor IBMX; and 2) chronic prednisone therapy decreased basal and PTH-stimulated cAMP release, an effect that correlated with histological evidence of decreased bone turnover.

1-Methyl-3-isobutylxanthine↗
PubMed1982

Abnormal skeletal response to parathyroid hormone in dogs with chronic uremia.

The release of cyclic AMP from bone in response to stimulation with PTH 1-34 was examined in 20 dogs with long-term chronic renal failure (CRF) produced by unilateral nephrectomy and contralateral partial renal artery ligation. After 9 to 15 months of uremia, the tibiae were removed and perfused in vitro. Seven dogs with CRF served as controls, 7 dogs with CRF were treated with 24,25(OH)2D3 - 2.5 micrograms per day, and 6 CRF dogs underwent thyroparathyroidectomy (TPTX) 42 h before they were sacrificed. The release of cyclic AMP from bone in response to PTH 1-34 in the CRF dogs was severely reduced compared to the response observed in 7 dogs with normal renal function (net accumulation of cyclic AMP release 86 +/- 8.5 versus 426 +/- 59.0 pmol/30 min). Long-term treatment of uremic dogs with 24,25(OH)2D3 had no effect on the release of cyclic AMP by bone. However, the release of cyclic AMP was restored to normal levels in the CRF dogs that underwent thyroparathyroidectomy. All CRF dogs had secondary hyperparathyroidism and the fact that TPTX returned the cyclic AMP response to normal values suggests that desensitization to PTH of the adenylate cyclase system of bone exists in chronic uremia.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Two cases of 17 alpha-hydroxylase deficiency--one combined with complete gonadal agenesis.

Two cases of 17 alpha-hydroxylase deficiency are described. Both patients had primary amenorrhoea, total lack of female secondary sexual characteristics, slight hypertension and hypokalaemia. One patient was of male genotype (male pseudohermaphrodite), and in addition this patient had complete gonadal agenesis. The other patient was of female genotype. In both patients the level of plasma corticosterone was markedly increased, whereas the concentration of plasma cortisol was very low and plasma aldosterone low within the normal range. Furthermore, the plasma ACTH level was significantly increased and the plasma renin activity around the lower normal limit. The urinary excretion of corticosterone metabolites was markedly increased, whereas the excretion of both cortisol metabolites and tetrahydroaldosterone was decreased. The patients had no symptoms of glucocorticoid deficiency. Treatment with dexamethasone 0.5 mg daily completely suppressed the abnormal corticosterone production and normalized both blood pressure and serum potassium. In addition, the patient of male genotype has received sequential therapy with oestrogen and gestagen for 3 years, but so far no development of the secondary sexual characteristics has occurred.

17-Ketosteroids↗
PubMed1979

Influence of age on the endocrine-metabolic response to surgery.

The pathogenesis of the increased operative risk in elderly patients is unknown. From a theoretical point of view, a change in endocrine-metabolic response might be involved. In the present study, a battery of hormonal and metabolic variables were measured in eight young and eight elderly healthy males undergoing elective inguinal hernial repair under general anesthesia. Blood was drawn before induction of anesthesia, at skin incision, and one, two, and six hours after skin incision. The findings were: 1) Plasma cortisol increase was significantly higher in elderly than in young controls. 2) Plasma renin level was lower in old age, but renin-aldosterone and electrolyte response patterns were alike in the two groups. 3) Thyroid parameters, in terms of serum T4, serum T3, serum rT3, and T3-resin uptake, responded normally to surgery and showed no age-related differences. 4) The hyperglycemic response was not significantly influenced by age indicating unchanged glycoregulatory mechanisms also verified by determinations of plasma catecholamines, cAMP, and insulin. 5) Blood lymphocyte count was constantly lower in elderly than in young and decreased with time, but the age-related difference was not significant. 6) Blood polymorphonuclear leukocytes showed an increase of the same magnitude in both age groups, although at a significantly slower rate in the elderly. It is concluded that age affects some aspects of the initial endocrine-metabolic response to surgery.

Adult↗
PubMed1979

Epidural analgesia inhibits the renin and aldosterone response to surgery.

Renin activity and aldosterone concentration in plasma and excretion of sodium and potassium in urine were measured during a period of 24 hours in 12 patients undergoing hysterectomy under general anaesthesia or epidural analgesia. Analgesia extended from T4 to S5 and was effective throughout the study. The normal stress-induced increase in plasma renin activity and aldosterone was inhibited by epidural analgesia. Urinary excretion of potassium was significantly lower in the epidural group, but sodium and water retention showed no difference between groups. It is concluded that neurogenic stimuli from the surgical area are important release mechanisms of the renin-aldosterone response to surgery. The results suggest that post-operative sodium retention is caused by factors other than the mineralocorticoid system.

Adult↗
PubMed1979

Fluid and electrolyte absorption and renin-angiotensin-aldosterone axis in patients with severe short-bowel syndrome.

In eight patients who had received long-term parenteral nutrition because of short-bowel syndrome the need for parenteral supply of fluid, sodium, and potassium was estimated by balance studies. Six patients had jejunostomies. In two, most of the colon was preserved. Jejunostomy patients had a huge stool mass (1710--5270 g, median 2530 g/day) with fixed concentrations of sodium (92 +/- 10 mmol/l) and potassium (15 +/- 4 mmol/l). In contrast, two patients with massive small-bowel resection but with more than half of the colon intact showed almost normal sodium absorption and considerably smaller stool mass (170--510 g/day). Despite apparently good health and normal plasma electrolytes, urea, and haematocrit, four of six jejunostomy patients were sodium-depleted with low plasma volume, low sodium excretion in the urine, and increased plasma renin activity and, in the three most severe cases, increased aldosterone. Even in case of sodium depletion the sodium loss from jejunostomy effluents remained high and presumably unaffected by salt-retaining hormones. The study confirms the importance of preservation of part of the colon for maintenance of fluid and electrolyte balance in patients with extensive bowel resection. Jejunostomy patients who are eating normally may need large parenteral saline supply. Assessment of water and electrolyte homeostasis in these patients requires determination of the urinary sodium excretion and is supported by measurements of plasma renin activity and plasma aldosterone concentration.

Adult↗
PubMed1979

Hormonal response to volume depletion in non-nephrectomised patients on regular haemodialysis.

The hormonal response to volume depletion by isolated ultrafiltration has been studied in seven non-nephrectomised haemodialysis patients. The mean reduction in blood volume was 14%, and pulmonary artery wedge pressure reduction averaged 77%. No increments in heart rate were observed in any of the patients. Cardiac output decreased while systemic vascular resistance increased. Mean arterial blood pressure remained stable in all but two patients. Significant increments in plasma vasopressin concentration were only found during hypotensive episodes, while in the whole group no significant increase was found. Both plasma renin activity, plasma aldosterone and plasma cortisol increased significantly during isolated ultrafiltration. The moderate increase in systemic vascular resistance indicates that the peripheral sympathetic nervous system - at least partly - was functioning. It was, however, not correlated with changes in any of the measured hormones. Furthermore the adrenal and cardiac response appeared to be absent.

Aldosterone↗
PubMed1979

Scintigraphic skeletal changes in non-dialyzed patients with advanced renal failure.

Technetium-99m-polyphosphate (Tc-PP) bone scintigraphy was performed in 51 patients with advanced renal failure in order to evaluate the applicability of this method in detection of metabolic bone changes in these patients. The creatinine clearance varied from 2 to 40 ml/min and none of the patients had previously been on dialysis treatment. The scintigrams were graded according to the focal and the generalized abnormal uptake of the tracer in the skeleton. 34 patients showed generalized scintigraphic changes and among these the changes in 18 patients were classified as severe. An inverse correlation was found between the kidney function and the generalized scintigraphic classification. Focal bone changes were found in 11 patients. In order to evaluate the influence of the lack of kidney function on the scintigraphic results, 3 patients with acute oliguric renal failure were examined. All had normal scintigrams. It is concluded that Tc-PP bone scintigraphy is a sensitive method in revealing renal osteodystrophy in non-dialyzed patients with advanced renal failure in agreement with previous reports on patients on chronic hemodialysis and after kidney transplantation.

Adolescent↗