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Biomedical subjects

M G Bianchetti

Publications and source records attributed to M G Bianchetti.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Management of children and adolescents with kidney transplantation].

Successful renal transplantation is widely accepted as the treatment of choice for end-stage renal failure in infants, children and adolescents. The major issues currently requiring consideration when contemplating renal transplantation in the mentioned patients are: primary renal disease, psychosocial status, life-related versus cadaver donor allograft, optimal immunosuppressive regimen including cyclosporine, and maximization of growth and pubertal development. In transplanted adolescents, noncompliance is now a major problem, ranking only second to rejection as a cause of graft loss.

Adolescent↗
PubMed1995

Renal tubular function in children and adolescents with Gitelman's syndrome, the hypocalciuric variant of Bartter's syndrome.

Renal tubular function was studied in 14 patients with Gitelman's syndrome and 14 control subjects. Apart from the biochemical hallmarks of Gitelman's syndrome, namely alkalaemia, hyperbicarbonataemia, hypokalaemia, hypomagnesaemia (with increased magnesium over creatinine ratio), increased urinary chloride over creatinine ratio, and low urinary calcium over creatinine, the patients were found to have hyperproteinaemia, hypochloraemia, high total plasma calcium concentration, reduced plasma ionized calcium concentration, and high urinary sodium excretion. A statistically significant negative linear relationship between plasma magnesium concentration and magnesium excretion corrected for glomerular filtration was observed in patients. The fractional calcium clearance and the urinary excretion of calcium corrected for glomerular filtration was significantly decreased in patients. In patients the urinary osmolality after overnight water deprivation ranged from 526 to 1067 mmol/kg. Glucosuria and aminoaciduria were similar in patients and controls. The results of the study demonstrate the renal origin of hypomagnesaemia and hypocalciuria in Gitelman's syndrome. The failure to demonstrate hyperaminoaciduria, hyperglucosuria, hyperphosphaturia, hyperuricosuria, and severely impaired urinary concentrating ability provide evidence for a defect residing in the distal convoluted tubule.

Adolescent↗
PubMed1994

[Levamisole in children with frequently recurring idiopathic nephrotic syndrome].

10 children (8 boys and 2 girls) with frequently relapsing idiopathic nephrotic syndrome were treated with levamisole (5 mg/kg weekly). In 6 children with steroid dependent nephrotic syndrome a marked reduction in steroids by 62% to 75% was possible. Severe, transient neutropenia was observed in one patient. Levamisole failed to influence the disease course positively in 3 patients with relapses associated with intercurrent illness. It is concluded that levamisole may favourably influence steroid dependence in children with frequently relapsing idiopathic nephrotic syndrome.

Child, Preschool↗
PubMed1994

Hypermagnesiuria in children with newly diagnosed insulin-dependent diabetes mellitus.

In newly diagnosed insulin-dependent diabetes mellitus, the mechanisms underlying the concomitant occurrence of magnesium deficiency and normal blood magnesium concentration are unknown. The renal handling of magnesium was, therefore, studied in 37 children with newly diagnosed insulin-dependent diabetes mellitus and in 13 controls. Circulating magnesium levels were similar in patients and controls (0.86 vs. 0.84 mmol/l). However, the urinary excretion of magnesium was significantly higher in patients (90.6 vs. 32.2 mumol/l GFR). In the patients a significant positive correlation was found between excretion of magnesium and glycosuria or blood hydrogen ion activity. It is concluded that osmotic diuresis and acidosis increase magnesium excretion in newly diagnosed diabetes mellitus.

Child↗
PubMed1993

[Hemolytic-uremic syndrome in children: a 19-year retrospective study].

Forty-two children (22 girls and 20 boys, ranging in age between 2 months and 13 years, median age 17 months) were admitted with acute hemolytic-uremic syndrome to the University Children's Hospital, Berne from 1973 to 1991. Seventeen patients developed hypertension and 30 renal failure. Three out of the 19 cases necessitating acute dialysis progressed to end stage renal failure. Four out of the 7 patients with signs of severe central nervous system involvement died. The initial clinical course was consistently more favourable in 35 patients with diarrheal prodrome. Increased protein excretion in association with high blood pressure was observed in 4 patients with initial favourable course who were examined one year after disease onset. This study indicates the generally favourable immediate prognosis of childhood hemolytic uremic syndrome and the possible persistence of high blood pressure and pathological proteinuria on follow-up.

Child↗
PubMed1993

High proximal excretion of sodium during activation of beta 2-adrenoreceptors in humans.

The effects of acute beta 2-type adrenoreceptor activation with intravenous albuterol on plasma and urinary sodium, potassium, calcium, magnesium, phosphate and lithium were investigated in 9 volunteers during acute hydration. When compared with the control infusion with inactive vehicle, beta 2-type adrenoreceptor activation decreased plasma and urinary potassium and phosphate and increased the excretion of calcium and magnesium. In addition, activation of the beta 2 adrenoreceptors did not influence creatinine clearance and plasma level and the net fractional excretion of sodium but increased the fractional clearance of exogenous lithium which measures the fraction of filtered sodium delivered by the proximal tubule. The results indicate that activation of beta 2-type adrenoreceptors decreases the proximal reabsorption of sodium.

Adult↗
PubMed1992

[Glomerulonephritis with transient C3 hypoclompimentemia and endotheliomesangial glomerulonephritis in childhood. A long-term experience].

62 children (20 girls and 42 boys, ranging in age between 3 and 15 years), presenting with acute hypocomplementemic glomerulonephritis or morphologically confirmed endotheliomesangial glomerulonephritis, were admitted to the University Children's Hospital, Berne from 1970 to 1991. The annual incidence of cases of acute hypocomplementemic glomerulonephritis was stable during the study period. The site of the antecedent infection was the throat in 26 patients, upper respiratory tract in 15, the skin in 9, and unknown in 10. The latent period ranged from 0.5 to 3.5 weeks. 41 patients developed hypertension and 17 renal failure. Hypertensive complications were observed in 6 patients and remitted completely in 5 cases. A nephrotic syndrome (edema, proteinuria of 40 mg/[m2.h], albuminemia < 25 g/l) was observed in 11 patients. Microscopic hematuria persisted in many patients for one year or more. Proteinuria remitted in all but one patient, who was found to have Alport syndrome. This study shows the stable frequency of hypocomplementemic glomerulonephritis since 1970, its good prognosis, and the importance of the measurement of C3-complementemia in children presenting with acute glomerulonephritis.

Adolescent↗
PubMed1992

[Assessment of the nephrotoxicity of amikacin in patients with cystic fibrosis].

Cystic fibrosis patients are at risk for nephrotoxic effects of aminoglycosides. Fifteen cystic fibrosis patients were admitted to hospital with 18 acute exacerbations of pulmonary symptoms associated with the isolation of Pseudomonas aeruginosa from sputum. They were treated intravenously with amikacin and ceftazidime for 14 days. Urinary excretion of N-acetyl-beta-D-glucosaminidase and alpha 1-microglobulin, two markers of tubular damage, and of albumin, a marker of glomerular permeability, was studied before and during treatment. Urinary activity of N-acetyl-beta-D-glucosaminidase and excretion of alpha 1-microglobulin was normal before amikacin treatment in approximately two thirds of patients and pathologically increased at the end of the study in 95%. Urinary albumin excretion was always normal before amikacin treatment and failed to increase consistently during treatment. The pattern of urinary protein excretion observed in the study before and during treatment with amikacin indicates a selective tubular toxicity.

Acetylglucosaminidase↗
PubMed1992

Cough and converting enzyme inhibitors.

Persisting cough developed in three children treated with converting enzyme inhibitors. The symptoms disappeared within 3-7 days after withdrawing medication. These observations in children complement previous reports in adults and indicate that cough may be induced by treatment with these agents.

Adolescent↗
PubMed1992

Use of calcium excretion values to distinguish two forms of primary renal tubular hypokalemic alkalosis: Bartter and Gitelman syndromes.

Clinical or biochemical findings were reevaluated in 34 pediatric patients with primary renal tubular hypokalemic metabolic alkalosis. The patients were subdivided into two groups. Bartter syndrome (primary renal tubular hypokalemic metabolic alkalosis with normocalciuria or hypercalciuria) was diagnosed in 18 patients with molar urinary calcium/creatinine ratios greater than 0.20, and Gitelman syndrome (primary renal tubular hypokalemic metabolic alkalosis with magnesium deficiency and hypocalciuria) was diagnosed in 16 patients with molar urinary calcium/creatinine ratios less than or equal to 0.20 and plasma magnesium levels less than 0.75 mmol/L. Some clinically important differences between the groups were observed. Patients with Bartter syndrome were often born after pregnancies complicated by polyhydramnios (8/18) or premature delivery (7/18) and had short stature (11/18) or polyuria, polydipsia, and a tendency to dehydration (16/18) during infancy (12/18) or before school age (18/18). Patients with Gitelman syndrome had tetanic episodes (12/16) or short stature (3/16) at school age (14/16). We conclude that the Bartter and Gitelman syndromes represent two distinct variants of primary renal tubular hypokalemic metabolic alkalosis and are easily distinguished on the basis of urinary calcium levels.

Alkalosis↗
PubMed1991

Acyclovir-induced renal failure: course and risk factors.

Of 19 children treated with high-dose intravenous acyclovir, 7, all of whom had encephalitis, also had a restricted fluid intake. Of these, 3 experienced non-oliguric renal insufficiency (plasma creatinine up to 176, 250 and 351 mumol/l, respectively) which resolved within 1 week of discontinuing acyclovir. Renal function was stable in the remaining 4 patients in this group and in the 12 children treated with acyclovir but without fluid restriction. We suggest the decreased renal function resulted from intratubular acyclovir crystalluria.

Acute Kidney Injury↗
PubMed1991

Epoetin alfa in anaemic children or adolescents on regular dialysis.

Eighteen patients aged 5-18 years on regular dialysis had a packed cell volume (PCV) less than 0.27. On treatment with epoetin alfa (EA) PCV increased by 0.05 or more in all patients. Iron supplementation was necessary in 13 patients with a ferritinaemia less than 300 micrograms/l before study. During treatment, plasma potassium increased significantly and more vigorous antihypertensive measures were required in 8 patients, 5 of them being already on antihypertensive drugs before EA. Iliofemoral thrombosis occurred in 1 patient 10 days after renal transplant. The data indicate that EA ameliorates the anaemia of chronic renal disease. The main concerns arising during treatment with EA are hyperkalaemia, arterial hypertension and possibly thrombosis.

Adolescent↗
PubMed1991

Persisting renotubular sequelae after cisplatin in children and adolescents.

UNLABELLED: Information on persisting renal sequelae after cisplatin in children and adolescents is limited. Twelve patients aged 4-20 years had been treated with cisplatin and were healthy 4-43 months after stopping chemotherapy. Plasma creatinine, calcium, albumin and hydrogen ion concentration, plasma and urinary sodium, chloride, phosphate and urate, and urinary magnesium and potassium were comparable in patients and controls. However, mean calciuria, magnesemia and potassemia were significantly reduced and bicarbonatemia increased in the patients. Calciuria, magnesemia, potassemia and bicarbonatemia were normal in 3 patients only, calciuria was below -2 SD control in 9 patients, renal magnesium deficiency was demonstrated in 5 patients (all with hypocalciuria as well), and 4 patients presented with hypokalemic metabolic alkalosis (all with magnesium deficiency and hypocalciuria). CONCLUSIONS: (1) Renotubular dysfunctions persist very often after cisplatin; (2) hypocalciuria is more frequent than hypomagnesemia; (3) the most severe tubulopathy after cisplatin includes hypocalciuria, renal magnesium deficiency and hypokalemic metabolic alkalosis.

Adolescent↗