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Biomedical subjects

L F Gimenez

Publications and source records attributed to L F Gimenez.

24 records · Page 2Linked to original sources
PubMed1987

Relation between renal calcium content and renal impairment in 246 human renal biopsies.

Tissue calcium content from 246 diagnostic human renal biopsies was measured to assess whether elevated tissue calcium concentration could be demonstrated to exist early during the course of human renal disease or was only a manifestation of advanced renal impairment. Renal calcium content correlated significantly with serum creatinine (r = +0.23, P less than 0.001, N = 246); serum phosphate P less than 0.001, N = 169) but not with serum calcium (r = -0.10, P greater than 0.1, N = 193). Fivefold greater calcium content was measured in biopsied patients with normal renal function than in normal postmortem renal tissue (35.7 +/- 5.2 vs. 7.6 +/- 0.7 mgCa/100 g wet renal tissue, P less than 0.001). Those biopsied patients with significant functional impairment (SCr greater than 1.5 mg/dl) had a higher mean level of serum phosphorus and serum [Ca] X [P] product than patients with normal renal function (5.19 +/- 0.22 vs. 3.92 +/- 0.11 mg P/dl and 44.8 +/- 1.8 vs. 35.7 +/- 1.2 mg2/dl2, respectively), and slightly higher renal calcium content (85.3 +/- 32.2 vs. 35.7 +/- 5.2 Ca/100 g wet renal tissue, P = 0.06), which correlated with histologic calcium deposition (r = +0.52, P less than 0.02, N = 20). These findings are consistent with the hypothesis that renal calcium deposition begins early in the course of a variety of renal diseases and hence may play a secondary pathogenetic role that accelerates progression to chronic renal failure. Severity of renal calcium deposition is equally closely related to hyperphosphatemia and to the level of renal impairment.

Adult↗
PubMed1986

De novo diabetic nephropathy with functional impairment in a renal allograft.

Recurrence of diabetic nephropathy in the allograft of diabetics with end-stage renal disease who undergo renal transplantation has been reported. We report a case of a patient who underwent cadaveric renal transplantation for end-stage renal disease secondary to chronic glomerulonephritis 13 years ago. He developed steroid-induced, insulin-dependent diabetes mellitus 9 months after transplantation and florid nephrotic syndrome with progressive functional impairment due to biopsy-proven diabetic nephropathy 11 years later. This is, to our knowledge, the first report of de novo diabetic nephropathy in a renal allograft of a patient who was not a diabetic at the time of transplantation. It is suggested that histopathologic changes of diabetes mellitus cannot only recur in a renal allograft, but also can develop de novo and lead to functional impairment and ultimately affect graft survival. In view of increasing patient and graft survival in transplanted diabetic and non-diabetic patients, it is reasonable to anticipate an increased incidence of this complication.

Biopsy↗
PubMed1986

Acute renal failure following percutaneous transhepatic cholangiography. A retrospective study.

We analyzed retrospectively the incidence of potential nephrotoxic effects of radiographic contrast material associated with percutaneous transhepatic cholangiography and percutaneous biliary drainage. Of 72 consecutive patients who underwent these procedures, three developed acute renal insufficiency (defined as a rise in the serum creatinine concentration of greater than 2 mg/dL [greater than 180 mumol/L]) following administration of contrast medium. In two patients, abdominal roentgenograms taken after the procedure showed persistently opaque kidneys, indicating that contrast material had gained access to the circulation. Percutaneous transhepatic cholangiography and percutaneous biliary drainage may be associated with nephrotoxic effects of radiographic contrast material, and patients with recognized risk factors may benefit from prophylactic hydration regimens as recommended for other procedures.

Acute Kidney Injury↗
PubMed1985

Mucormycosis in renal transplant patients--a report of two cases and review of the literature.

Mucormycosis is a rare complication of diabetic ketoacidosis and immunosuppressed states, such as those occurring after renal transplantation. We describe two cases of mucormycosis in renal allograft recipients and present a review of similar cases previously reported. An analysis of these data suggests that renal transplant patients with concomitant diabetes mellitus are most susceptible to developing this complication.

Brain↗
PubMedDate not supplied

Differential glucocorticoid responsiveness of dialysis patients' lymphocytes.

OBJECTIVES: To evaluate in vitro glucocorticoid responsiveness of phytohemagglutinin (PHA)-stimulated lymphocytes from peritoneal dialysis (PD) patients compared to hemodialysis (HD) patients. DESIGN: Cross-sectional study of prevalent PD and HD patients and concurrent control subjects. SETTING: Urban outpatient dialysis unit. PATIENTS: 20 HD, 14 PD, and 20 control subjects. MEASUREMENTS: Using standard lymphocyte culture techniques, the concentration of prednisolone (P) and methylprednisolone (MP) required to cause 50% inhibition (IC50) of the proliferative response to phytohemagglutinin (PHA) was determined from dose-response curves. RESULTS: There was considerable heterogeneity in the sensitivities of individual patients' PBMC to glucocorticoid inhibition, especially those of HD patients' cells to P. The mean +/- SD IC50 for MP was significantly (p < or = 0.001) lower than that for P in each cohort: PD 11 +/- 5 vs. 34 +/- 18 ng/mL; HD 22 +/- 14 vs. 89 +/- 43 ng/mL; control subjects 14 +/- 11 vs. 55 +/- 56 ng/mL. Interestingly, the IC50 for both P and MP was significantly higher in HD than in either PD or controls (ANOVA, P: F = 6.56, p = 0.003; MP: F = 3.77, p = 0.03), indicating decreased sensitivity of HD lymphocytes to both drugs. There were no significant differences in mean IC50 values for either P or MP between PD and controls. No correlations were found between IC50 for either P or MP and patient age, gender, duration of dialysis, serum creatinine, serum albumin, or parathyroid hormone level. CONCLUSIONS: In vitro glucocorticoid responsiveness of dialysis patients' lymphocytes appears to be influenced by dialysis modality, but the factor(s) involved remains to be determined. The greater sensitivity of PD lymphocytes to both P and MP might result in better immunosuppression and less severe rejection after renal transplantation. MP may be particularly advantageous following renal transplantation for any patient manifesting relative or absolute in vitro resistance to P.

Cross-Sectional Studies↗