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Biomedical subjects

M Lao

Publications and source records attributed to M Lao.

At least 19 recordsLinked to original sources

[Level of erythropoietin and parathormone in blood plasma during acute rejection of kidney transplant].

The acute rejection of kidney transplant is accompanied by kidney ischaemia which in turn is a triggering factor for erythropoietin (EPO) synthesis. It was shown, on the other hand, that during the rejection an increase in blood serum parathormone (PTH) concentration takes place. The present study was aimed at answering the question what is the effect of acute rejection of kidney transplant on blood serum concentrations of EPO i PTH. Seventeen patients with kidney transplant participated in the study. In all the patients the investigations were carried out four times: 1--few days before rejection, 2--after ascertaining that kidney transplant is being rejected, 3--immediately after rejection, and 4--few days after completing the anti-rejection therapy. High doses of methylprednisolone were used as anti-rejection therapy. Control group consisted of 16 healthy persons. Acute rejection of kidney transplant was accompanied by a significant increase in blood serum concentrations of EPO and PTH. After methylprednisolone therapy, normalization of EPO and decrease in PTH concentration were observed in kidney transplant patients. Significant positive correlations were found between EPO and PTH concentrations in blood serum. It was concluded that acute rejection of kidney transplant is characterized by a significant increase in blood serum concentrations of EPO and PTH. Despite the existence of a significant positive correlation between blood serum concentrations of EPO and PTH in patients with kidney transplant, any pathogenic relation between the observed disturbances of secretion of the two hormones seems to be of little probability.

Acute Disease

Immune monitoring after renal transplantation. I. HLA-D expression on T cells from renal allograft recipients.

The expression of class II antigens (HLA-DR, DP and DQ) on resting and PHA-activated T cells from renal allograft recipients was studied. A tendency for increase in DR+/DQ+ T cells was noted in azathioprine and cyclosporine-treated recipients undergoing rejection. Low inducible HLA-D expression (especially DP) was associated with CMV infection. Cyclosporine (but not azathioprine) lowered the rate of synthesis of HLA-D by T cells activated in vitro.

Biomarkers

[Serum erythropoietin level during acute rejection of transplanted kidney].

Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. This fact justified our present studies which aimed to assess the influence of acute rejection (AR) on plasma EPO level in KTP. A total of 17 KTP were examined some days before AR (I), at the onset of AR (II), immediately (III) and some days after (IV) discontinued therapy of AR episodes by methylprednisolone. The control group consisted of 16 healthy subjects. KTP 2-3 weeks after renal transplantation showed relative EPO deficiency both during efficient excretory function and rejection episodes. At acute graft rejection episodes a marked increase of plasma EPO level was found. Results presented in this study suggest absence of the physiological relationship between EPO secretion and erythropoiesis 2-3 weeks after transplantation.

Acute Disease

[Plasma erythropoietin levels of kidney transplant patients in the early period after transplantation].

Plasma erythropoietin (EPO) levels were assessed in 51 uraemic patients immediately after kidney transplantations and in 16 healthy subjects. Before transplantation EPO levels were significantly higher than in normals. In patients with acute renal failure of the transplanted kidney, a significant increase of plasma EPO level was noticed. Such an increase of plasma EPO was absent in patients with a normally functioning kidney transplant. In these last patients normalization of plasma EPO was found during the first month after transplantation. No significant correlation was found between plasma EPO level and the haematocrit value in kidney transplant patients. From results obtained in this study it seems, that factors other than EPO are also involved in the pathogenesis of anaemia in patients at the early phase after kidney transplantation.

Acute Kidney Injury

[Plasma erythropoietin levels in patients with stabilized function of the transplanted kidney].

Plasma erythropoietin level was assessed in 96 kidney transplant patients with stabilized function of the graft 3 months up to 5 years after transplantation and in 16 healthy subjects. In kidney transplant patients on CyA or azathioprine respectively, plasma erythropoietin levels were significantly higher during the first three months after transplantation than in normals. Normalization of erythropoietin levels were observed 6 to 12 month after kidney transplantation. As compared with patients on CyA, in azathioprine treated patients plasma erythropoietin levels were significantly higher 12 to 60 months after transplantation. These elevated erythropoietin levels in azathioprine treated patients seem to be due also to factors other than higher prednisone dosage.

Adult

[Plasma erythropoietin levels in kidney transplant patients with impaired function of the renal graft].

In 81 patients with failing kidney transplant, plasma levels of erythropoietin, iron, ferritin and TIBC were assessed. Progression of failure of the excretory function of the kidney transplant was accompanied by decreasing Hb and Ht values but increasing plasma levels of erythropoietin. In all examined patients presence of iron deficiency could be excluded. Results obtained in this study suggest that relative erythropoietin deficiency is the major cause of anaemia in patient with a failing kidney transplant.

Acute Kidney Injury

[The effect of erythropoietin treatment on endocrine organ function in patients with terminal-stage kidney failure on hemodialysis].

Eleven hemodialyzed patients with uremia were examined for the effect of erythropoietin (EP) treatment carried out for 3 months on functions of different endocrine organs. EP treatment resulted in a decrease of the initial plasma levels of somatotropin, prolactin, follicle-stimulating and luteinizing hormones. EP treatment being over, there was a decrease in the plasma content of ACTH, cortisol and aldosterone. The treatment with EP was also associated with an insignificant rise of the plasma levels of parathyroid hormone and testosterone. EP treatment did not influence the plasma concentration of calcitonin and 25-OH-D. EP was found to exert no significant effect on the pituitary-thyroid reverse relationship. The 3-month treatment with EP eventuated in plasma renin activity inhibition as well as in an increase of the atrial level of natriuretic peptide in the plasma. EP treatment stimulated insulin secretion and reduced glucagon secretion. Finally, EP decreased the gastrin level and to a less degree the plasma level of pancreatic polypeptide.

Adult

IgA nephropathy: a long-term progressive study.

Thirty-three cases of idiopathic IgA nephropathy were followed up for an average of 90.8 +/- 8.4 months. Four therapeutic regimens were applied: symptomatic therapy, immunosuppressive drugs, dipyridamole with acetylsalicylic acid and immunomodulating treatment with thymosin. Parameters of kidney function obtained during control and treatment periods were compared in each patient separately. In all cases but one, frequent fluctuations of serum creatinine levels were observed. Cumulative kidney survival ratio for 5, 10 and 15 years amounted to 1.00, 0.90 and 0.82, respectively. There was no apparent response to thymosin, aspirin and dipyridamole therapy. Immunosuppressive drugs are recommended in cases with steadily progressive disease, when serum creatinine concentration surpasses 2.5 mg/dl.

Adolescent

Endocrine abnormalities in patients with endstage renal failure.

Data presented in this study suggest existence of hyperendorphinism in uraemic patients. This hyperendorphinism may be regarded both as a primary beneficial compensatory mechanism counteracting disturbances of the internal environment, while causing secondary harmful side effects, which contribute to the uraemic state. Erythropoietin treatment of uraemic, haemodialyzed patients is followed by marked endocrine alterations (suppression of plasma levels of STH, ACTH, prolactin, glucagon, aldosterone, cortisol and plasma renin activity, elevation of plasma insulin and atrial natriuretic levels, lack of influence on plasma PTH, CT and AVP). It remains to be clarified whether the erythropoietin induced endocrine alterations are due to correction of the existing anaemia or reflect a specific effect of this hormone.

Endocrine System Diseases

Long-term immunosuppressive therapy of idiopathic membranoproliferative glomerulonephritis.

Fifty cases of idiopathic membranoproliferative glomerulonephritis were followed up for an average of 10 +/- 0.9 (SE) years. Forty of them, who presented a nephrotic syndrome, were treated by immunosuppressive drugs (prednisone, azathioprine, chlorambucil, cyclophosphamide) for 79 +/- 9.7 (SE) months. Cumulative survival ratio for 5, 10 and 15 years after enrollment was 0.90, 0.82 and 0.77 and after appearance of first symptoms or signs of kidney disease as determined by anamnestic data 0.97, 0.91 and 0.90 accordingly. Triple-drug therapy (prednisone and azathioprine combined with chlorambucil or cyclophosphamide) was more effective in improving proteinuria than other immunosuppressive regimens. No serious side effects were encountered.

Adult