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Biomedical subjects

O Schück

Publications and source records attributed to O Schück.

At least 19 recordsLinked to original sources
PubMed1995

[A nutritionally defined liquid diet for hemodialyzed patients].

BACKGROUND: For patients having regular haemodialysis there are no suitable complete preparations for general use in case intensive treatment is needed. Nutrilac renal is a new preparation of a nutritionally defined liquid diet corresponding as to its composition to the needs of haemodialyzed patients. The purpose of the present work was to assess whether this preparation when administered as a supplement will have a favourable effect on the nutritional parameters of haemodialyzed patients. METHODS AND RESULTS: Nutrilac renal was administered to haemodialyzed patients for a period of three weeks as a supplement meeting 20% of the energy requirements. The protein intake rose from 0.87 to 0.95 g/kg body weight (p < 0.05), the energy intake from 109 to 126 kJ/kg body weight (p < 0.05). As to nutritional parameters, the serum albumin values improved (from 25.0 to 29.4 g/l, p < 0.05) and Whitehead's quotient from 1.8 to 1.5, p < 0.05). The favourable effect on the amino acid spectrum was manifested by a significant rise of essential amino acids and those with branched side chains (p < 0.01). The preparation did not lead to a rise of potassium, ura and vitamin A levels. CONCLUSIONS: The newly developed preparation Nutrilac renal exerts a favourable effect on nutritional parameters. Changes in the aminogram characterized by an increase of essential amino acids, in particular threonine, valine, leucine and isoleucine indicate the high biological value of the protein component of the preparation for patients with chronic renal failure.

Amino Acids↗
PubMed1995

[Kinetics of phosphorus in individuals on regular dialysis therapy].

In eight subjects with hyperphosphataemia included in regular dialyzation treatment repeatedly phosphorus kinetics (iP) were assessed based on changes in serum concentrations and the amount of iP removed from the organism during every dialysis (D). The serum concentration of iP before dialysis (HD) was on average 3.06 (+/- 0.81) mmol/l and D was on average 55.6 (+/- 10.0) mmol. The value of D calculated per body weight (D/BW) was on average 0.76 (+/- 0.15) mmol/kg. As the differences of predialysis serum concentrations of iP after consecutive HD sessions did not exceed the range of error of analytical assessment of iP, the D values were considered identical with the iP value retained during the interdialysis interval (R). Between values of D/BW and R/BW resp. and the difference of iP serum concentrations at the beginning and end of the interdialyzation interval a significant direct correlation was found (r = 0.715, p < 0.001). From an analysis of this correlation ensues that if the predialysis serum concentration is not to exceed the upper range of the normal value (1.7 mmol/l), the retention of iP in the interdialysis interval must not significantly exceed the value of 0.57 mmol/kg. At the end of the interdialysis interval iP was distributed in the organism in such a way that the extracellular space contained on average 0.38 (+/- 10) from the total retained amount and the remaining portion penetrated into deeper body compartments.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Individualized supplemented low-protein diet in patients with chronic kidney failure].

The possibility of developing protein-energy malnutrition poses a serious risk associated with long-term administration of a restrictive low-protein diet. We conducted a randomized prospective study designed to evaluate 36 patients with chronic renal failure in initial malnutrition (BMI 22%, albumin 35 milligrams, WQ 2.02). In 20 of these patients (Group I), low-protein diet was supplemented with ketoanalogs of essential amino acids along with a low-phosphate drink from casein-free protein. The diet of another 16 patients (Group II) was supplemented with a mixture of essential and non-essential amino acids of egg white. Three-month follow-up revealed a statistically significant improvement in selected metabolic parameters (Surea, albumin, WQ, valine HDL-CH cholesterol, SP and SCa), particularly in Group I (p < 0.01). In group II, the improvement was either not marked (p < 0.05) or no improvement was seen. Results of the study indicate that patients found to suffer from initial malnutrition require early dietary supplementation including ketoanalogs of essential amino acids and a special protein providing an adequate amount of energy.

Adult↗
PubMed1992

[Evaluation of glomerular filtration in patients after renal transplantation and treatment with cyclosporin A].

According to some findings (Ross et al. 1987) the creatinine plasma concentration (Pcr) is an inaccurate indicator of glomerular filtration (GFR) in patients with a transplanted kidney, treated with cyclosporin A (CyA), who are in a stabilized state of renal function. In the submitted work the authors investigated whether the inaccuracy of the assessed GFR based on Pcr or creatinine clearance (Ccr) is greater than in patients with various chronic renal diseases who at the time of examination did not take any drugs. The investigation was made in 30 patients with a transplanted kidney treated with CyA as well as azathioprine and prednisone. The authors examined also 51 patients with various chronic renal diseases, mostly chronic glomerulonephritis or tubulo-interstitial nephritis. The GFR value was assessed on the basis of polyfructosan clearance (CPF). In subjects with a transplanted kidney a significant linear relationship was found between Ccr and CPF (r = 0.829, p < 0.001). A similar relationship was found in patients with chronic renal disease (r = 0.935, p < 0.001). The regression lines characterize this relationship in both groups and do not differ significantly. Between values of Pcr and CPF a significant relationship of a hyperbolic character was found in both groups (r = 0.693, p < 0.001 and r = 0.741, p < 0.001 resp.). The hyperbolic relations found in the examined groups did not differ significantly. The findings confirm that a normal or only slightly elevated Pcr value can be associated with a markedly reduced GFR, in some instances to as much as one third of the normal values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Relation between creatinine clearance and glomerular filtration in various stages of chronic renal disease].

The relationship between creatinine clearance (Ccr) and inulin (C(in)) was investigated in 20 healthy subjects (group A) and 54 subjects with chronic renal disease (C(in): 10-80 ml/min/1.73 m2) treated conservatively (group B) and in 10 subjects with regular dialyzation treatment and a preserved residual diuresis (more than 1000 ml/24 h) (group C). In subjects from group B the Ccr/C(in) values were significantly higher than in healthy subjects (p < 0.01). In subjects of group C the values of Ccr/C(in) before dialysis did not differ significantly from values recorded in healthy subjects. Twelve hours after dialysis a marked increase of C(in)/Ccr occurred (p < 0.001). The findings are consistent with the idea that the increase of tubular creatinine secretion in patients with chronic renal disease is associated with a rise of its plasma concentration. In terminal stages in chronic renal failure there is, however, again a drop of tubular creatinine secretion which is reversible and rises after dialysis. These changes in tubular creatinine secretion could be explained by the fact that in chronic renal failure substances cumulate in the organism which inhibit tubular creatinine secretion. Due to haemodialysis the concentration of these inhibitors of creatinine secretion declines and after dialysis this process increases again temporarily. The findings suggest that the residual Ccr value assessed before dialysis is closer to the real value of glomerular filtration than values assessed during dialysis.

Adult↗
PubMed1992

Cyclosporine A treatment and evaluation of glomerular filtration rate in patients with a transplanted kidney.

According to some findings [Ross et al. 1987], the plasma concentration of creatinine (Pcr) is an inaccurate reflection of the glomerular filtration rate (GFR) in renal graft recipients with stabilized renal function, treated with cyclosporine A (CyA). In this study, we sought to determine whether the inaccuracy of GFR assessment on the basis of Pcr or creatinine clearance (Ccr) in these individuals is greater than in patients suffering from various chronic renal diseases untreated by any drugs during the examination. The study was performed in 30 renal graft recipients, treated with CyA in combination with azathioprine and prednisone. Further, 51 patients suffering from a chronic renal disease, mostly chronic glomerulonephritis or tubulointerstitial nephritis, were investigated. GFR was evaluated on the basis of polyfructosan clearance (CPF). A significant linear relation between Ccr and CPF (r = 0.829, p less than 0.001) was demonstrated in individuals with a transplanted kidney graft treated with CyA. A relationship of the same character was observed in the group of patients suffering from chronic renal diseases (r = 0.935, p less than 0.001). There is no statistically significant difference between the regression lines characterizing these relationships in both groups. A significant correlation of hyperbolic character between Pcr and CPF was found in both groups investigated (r = 0.693, p less than 0.001, and r = 0.741, p less than 0.001, respectively). The hyperbolic relationship noted in the studied groups did not differ significantly. These findings confirm a normal, or a mildly raised Pcr can be associated with a marked decrease in GFR, in some cases to a value as low as a third of the normal one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The critical value of residual kidney function in patients with chronic kidney failure from the viewpoint of the concentration of urea and potassium in the plasma].

Residual kidney function was examined in 10 patients with chronic renal insufficiency under balance conditions and in 30 outpatients on the basis of urea clearance (Curea) and potassium clearance (CK). Protein intake was 35-40 g/day (0.5 g/kg/day) and potassium intake was 30-40 mmol/day. Under these conditions the critical values of residual kidney function were as follows: 1) plasma urea concentration (Purea) did not exceed 30 mmol/l if Curea did not drop below 3.8 ml/min; 2) plasma potassium concentration (PK) did not exceed 5 mmol/l if CK did not decrease below 4.1 ml/min. Clinical examination of Curea and CK provides additional information to the examination of creatinine clearance (Ccr) or its plasma concentration (Pcr). Our results suggest that the critical value of residual kidney function cannot be defined only on the basis of examination of Ccr or Pcr. Examination of Curea and CK can help in the interpretation of very high Purea and hyperkalemia in patients with chronic renal insufficiency.

Ambulatory Care↗
PubMed1991

[The effect of hemodialysis on potassium excretion by residual nephrons].

In 19 patients with chronic renal failure and still preserved residual diuresis the inulin clearance (Cin) and renal potassium excretion were assessed before and 12 hours after haemodialysis (HD), combined with conventional ultrafiltration. The mean value of Cin after HD declined significantly (p less than 0.001). As a result of HD a significant decline of the plasma potassium concentration occurred (p less than 0.005) and of the urinary excretion (p less than 0.01). The mean value of the fractional potassium excretion (FEK) did not change significantly as a result of HD. The reduced urinary K excretion after HD correlated significantly (p less than 0.05) with the decline of Cin. The findings suggest that the decline of the urinary potassium excretion after HD is above all due to a decline of the glomerular filtration rate. The tubular potassium secretion does not change significantly under these conditions. These findings support indirectly the idea that the increased tubular potassium secretion in residual nephrons in patients with chronic renal failure is not conditioned by retention of low-molecular dialysable substances.

Female↗
PubMed1991

Renal amino acid excretion and aging.

The urinary excretion and serum concentration of amino acids were studied in 62 healthy individuals aged 15 to 70 years. In elderly subjects (61-70 years), it was found that renal amino acid clearance per 100 ml GFR (fractional excretion, FE) rose significantly in the following amino acids: CYS, VAL, MET, ILE and LEU. Since the serum concentrations of these amino acids showed no significant changes, but the GFR was reduced, it can be concluded that the raised FE of these amino acids was due to a decrease in their effective tubular reabsorption. A significant correlation was found between FENa and FE of most amino acids including those mentioned above. The findings support the assumption that changes in tubular Na+ transport probably participate in the changes of tubular amino acid transport in elderly individuals.

Adolescent↗
PubMed1990

[Preclinical modeling of the possible effect of acute uremia on drug resorption in the gastrointestinal tract].

The authors investigated in experiments on rats the course of serum concentrations of sulfisoxazole (S) and acetylsulfisoxazole (AS) in normal rats and in rats after bilateral nephrectomy after intra gastric administration of S. Serum concentrations of S and AS during the first three hours following administration did not differ significantly or were very close. During the subsequent hours the serum concentrations of S and AS in uraemic animals were significantly higher than in controls. The value of the absorption constant in the uraemic animals was on average higher and the absorption half-life lower than in controls. The assembled results suggest that in acute uraemia in rats the intestinal reabsorption of S and its metabolism in the liver are not reduced. The findings support the idea that the model used could be useful in preclinical research of drugs used in the treatment of acute uraemia.

Acute Disease↗
PubMed1990

[Urea clearance and measurement of glomerular filtration in patients with chronic renal insufficiency].

In 31 patients with chronic renal insufficiency (CHRI) the authors investigated the relationship between insulin or polyfructosan S (CPFS) clearance, urea clearance (Curea) and creatinine clearance (Ccr). The mean clearance values of these substances were as follows: CPFS: 0.198 (+/- 0.091) ml/s, Curea: 0.183 (+/- 0.086) ml/s, Ccr: 0.315 (+/- 0.169) ml/s. Between the values of Curea and CPFS, similarly as between values of Ccr and CPFS, a significant linear relationship was revealed, however, the regression line indicating the relationship between Curea and CPFS was closer to the identity line than the relationship between Ccr and CPFS. The results suggest that in patients with CHRI (where CPFS less than 0.4 ml/s) Curea is close to the value of glomerular filtration.

Adult↗
PubMed1990

Residual kidney function and plasma urea concentration in patients with chronic renal failure.

The relationships between the plasma levels of urea (P(urea)), renal clearance of urea (C(urea)) and creatinine (Ccr) at an intake of 0.5 g protein/kg body weight/day were followed in 10 patients with chronic renal failure (CRF) under balance conditions. Under these conditions, P(urea) attained a value of 30 mmol/l when C(urea) had decreased below 3.8 ml/min. By contrast, no correlation could be demonstrated between P(urea) and Ccr under these conditions. The same relationships were followed in another group of 30 outpatients with CRF. Even in patients not followed under balance conditions, C(urea) determination makes it possible to establish whether the high increase in P(urea) is due to the decrease in residual renal function below the critical level or whether extrarenal factors are involved. Likewise, no significant correlation between P(urea) and Ccr could be demonstrated under these conditions. The findings suggest that C(urea) measurement in CRF patients helps to assess residual renal function in terms of P(urea) regulation and provides information that cannot be obtained by Ccr measurement.

Blood Urea Nitrogen↗
PubMed1990

Bile composition in patients with chronic renal insufficiency.

Very little is known about bile composition in the end stage of chronic renal sufficiency. Patients with this condition are either assigned to a dialysis-transplantation programme, or are treated temporarily with a low-protein diet. Our study was designed to determine bile composition both in a group of ten patients treated with a low-protein diet over a long period of time, and in 11 patients on regular haemodialysis. The patients on haemodialysis were found to have increased bile cholesterol and an increased saturation index in the bile, i.e. changes implying increased risk of cholecystolithiasis. These changes were further enhanced by the effect of a low-protein diet with subsequent increases in cholesterol values and the bile saturation index, as well as a decrease in primary and an increase in secondary bile acids in the bile, i.e. a change in the spectrum of bile acid characteristic for cholecystolithiasis.

Adult↗
PubMed1990

The effect of haemodialysis on tubular secretion of creatinine in residual nephrons.

In a group of 16 patients on regular haemodialysis treatment, inulin and creatinine clearance was examined before and 12 h after haemodialysis. Inulin clearance (CIn) decreased significantly (P less than 0.001) whereas creatinine clearance (CCr) did not change after haemodialysis. The CCr/CIn ratio increased significantly (P less than 0.05) as did calculated tubular secretion of creatinine (TCr) (P less than 0.01) and TCr/CIn 100 (P less than 0.001). The results suggest that uraemic sera contain dialysable substance(s) depressing tubular secretion of creatinine.

Creatinine↗
PubMed1990

Changes of lithium elimination in acute polyuric renal failure caused by cisplatin and mercuric chloride.

Changes in lithium elimination were studied under the condition of experimentally induced polyuric acute renal failure by cisplatin (6 mg/kg body wt) or HgCl2 (3 mg/kg body wt). The histologically proven lesions of tubuli were associated with the decrease of plasma clearance of lithium (C(Li)) and polyfructosan-S (CP(FS). The decrease of these clearance values was not proportional and the ratio C(Li)/CP(FS) (indicating renal fractional excretion of Li+) increased significantly (p less than 0.01). The increase of C(Li)/CP(FS) was related to the increase of renal fractional sodium excretion (FENa) (p less than 0.01). The results suggest that the impairment of tubular cells by cisplatin or HgCl2 caused the decrease of tubular reabsorption of Li+ and Na+. From the pharmacokinetic point of view, these experiments suggest that changes in tubular transport of drugs should be taken into account in their dosing adjustment in patients with acute polyuric tubular lesion.

Acute Kidney Injury↗
PubMed1990

[Metabolic characteristics of patients with chronic renal failure in long-term diet therapy and substitution with keto analogs of essential amino acids].

12 patients suffering from chronic renal failure did receive for 12 to 22 months a special protein-poor diet containing 20 g of high-class proteins and essential amino acids (4.8 g/d). During this period the serum levels of albumin, transferrin, immunoglobulins, hemoglobin and ferritin did remain unchanged, whereas the levels of C3 was reduced significantly. The glucose metabolism and the serum levels of cholesterol and triglycerids were constant. The results show no metabolic changes during long-term protein-poor diet containing minimal doses of essential amino acids.

Amino Acids, Essential↗
PubMed1990

The influence of benzbromarone and its combination with hydrochlorothiazide on renal excretion of uric acid and electrolytes.

The results of a study investigating the effect of single oral administration of B (benzbromarone), and a combination of B + H (hydrochlorothiazide), in 10 healthy volunteers suggest the following conclusions: 1) In agreement with literary data, B at a dose of 100 mg has a significant hypouricemic effect with a 39% decrease after 6 h, and a 53% decrease after 24 h. 2) B and B + H significantly enhance renal clearance and fractional excretion of uric acid but there was no demonstrable significant inverse relation between these parameters and the plasma level of uric acid. 3) B affects PUA (plasma concentration of uric acid) also by some extrarenal action which is not related to the pre-existing alteration of uric acid metabolism. 4) Simultaneous single administration of B + H does not reduce the effect of B on renal excretion and on the plasma level of uric acid. 5) A single dose of B causes a slight but significant decrease in fractional potassium excretion without any demonstrable effect on fractional excretion of sodium and that of all osmotically active substances.

Administration, Oral↗