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Biomedical subjects

O Toupance

Publications and source records attributed to O Toupance.

47 records · Page 3Linked to original sources
PubMed1985

[Continuous arteriovenous hemofiltration in acute renal failure. Value of regulating the rate of ultrafiltration].

Continuous arteriovenous hemofiltration (CAVH) requires constant supervision and frequent readjustment of the rate of infusion of the substitution fluid because of variable filtration rate. In order to lighten the management of patients treated with CAVH, an ultrafiltration-pump assisted CAVH was used in 16 patients with oliguric renal failure and cardiovascular instability treated in the intensive care unit. A plate hemofilter (Biospal) was used which is equipped with the high hydraulic permeability AN 69 S membrane. The driving pump was set in order to modulate the ultrafiltration rate from 400 to 1000 ml/h. Ultrafiltration-pump assisted CAVH was given for 8.1 +/- 5.3 days and the filtration volume was 16.3 +/- 3.1 l/day. The mean life span of the hemofilter was 36.4 +/- 27.3 hours. No adverse reaction toward the artificial membrane was detected. Adequate control of fluid balance and electrolyte and acid-base homeostasis were obtained allowing parenteral nutrition. However, in two instances additional hemodialysis was required to adequately control urea generation. Ultrafiltration-pump assisted CAVH proved to be a simple and effective method of fluid removal and urea subtraction by convective transport. Maintenance of stable fluid balance and parenteral nutrition without osmotic disequilibrium was allowed. The pump driven hemofiltration allows optimal use of the filter.

Acute Kidney Injury↗
PubMed1984

[Hemorrhagic fever with renal syndrome due to Hantaan virus or a serologically related virus].

Seven cases of acute renal failure consecutive to haemorrhagic fever with renal syndrome (HFRS) due to the Hantaan virus or to a serologically related virus are reported. These cases were observed in north-eastern France between March, 1983 and January, 1984. All patients were of rural origin and had been in contact with field mice. The predominant initial clinical symptoms were signs of infection and diffuse muscle pain, without evidence of haemorrhage. However, massive proteinuria was noted, and acute anuric renal failure unaccompanied by oedema or arterial hypertension developed. Renal biopsy performed in 2 patients showed tubular and interstitial nephritis but no glomerular or vascular lesions. Two patients only required haemodialysis. All patients recovered within 2 to 8 weeks without sequelae. Antibodies directed against the Hantaan virus were detected by indirect immunofluorescence tests, and seroconversion could be demonstrated in 2 patients seen at a sufficiently early stage. The risk of epidemics suggested by this small outbreak of HFRS can only be evaluated after an exhaustive epidemiological study.

Acute Kidney Injury↗
PubMed1984

[Acute renal failure caused by clometacin hypersensitivity].

Renal involvement is not frequently observed during therapy with clometacine and its mechanism not fully understood. We report on a case of acute renal failure occurring four times in conjunction with acute hepatitis before the causative effect of clometacine was demonstrated. Drug hypersensitivity was documented by anatomical findings consisting in renal interstitial infiltration by mononuclear cells and eosinophils and by hypereosinophilia, increase in plasma IgE and a positive basophil degranulation test.

Acute Kidney Injury↗
PubMed1984

[Role of sodium in the control of compartmental distribution of water during hemodialysis. I. Measurement of water transfer].

Symptomatic hypotension and other symptoms of the so-called dialytic desiquilibrium syndrome have been related to alterations of body fluid osmolality and distribution. Fluid removal from the intracellular compartment can be achieved by manipulating the sodium dialysate (NaD). The extracellular fluid volume ( EFCV ) was measured with inulin and/or 35SO = 4. Total body water changes were calculated in terms of fluid substraction induced by dialysis. They were monitored in 12 patients on hemodialysis with a highly permeable membrane and a careful monitoring of ultrafiltration. NaD was maintained constant throughout the session and was comprised between 140 and 170 mmol/l. Below 150 mmol/l NaD, ECFV was reduced more than the weight loss, indicating concomitant intracellular water loading. Conversely, over 150 mmol/l NaD weight loss resulted from extracellular and cellular water. We conclude: 1) transcellular water shift during dialysis is dependent of sodium dialysate; 2) net cellular water-shift was obtained for NaD higher than 150 mmol/l; 3) at least two compartments for water distribution should be taken into account for sodium modeling.

Body Water↗
PubMed1982

Long-term results of dialysis therapy with a highly permeable membrane.

A five-year study of short-term dialysis using highly permeable polyacrylonitrile membrane AN 69 was started in March 1973 to compare the effects of AN 69 and Cuprophan membrane (CM). The time of dialysis was calculated for each patient on the basis of vitamin B12 clearance of the dialyzer and the residual glomerular filtration rate. For the study, 101 patients (38,555 dialysis sessions) who had been dialyzed for more than six months were selected. They were divided into three groups: Group I (n = 31) patients treated with AN 69 only; Group II (n = 31) patients treated with CM; Group III (n = 39) patients treated first with the CM and then with AN 69. Patients treated with AN 69 had higher levels of plasma urea but no particular metabolic disturbances were observed. The dialysis sessions were significantly better tolerated with AN 69 than with CM, however, the main advantage of using AN 69 is the shortening of dialysis time. The duration of dialysis was 9.5 +/- 0.2 hours per week with AN 69 and 16.4 +/- 0.2 hours per week with CM. Shortening of dialysis time permits better social rehabilitation of the patients. The shorter dialysis was not associated with any recognizable side effects that could be demonstrated by routine clinical and biological analysis.

Acrylic Resins↗
PubMed1982

Increased renal excretion of 3 hydroxyproline in patients with active glomerular nephropathies and with polycystic renal disease.

The renal excretion of 3 hydroxyproline (3 HYP) and 4 hydroxyproline (4 HYP) was investigated in control subjects and in patients with various renal diseases. In normal adult subjects urinary 3 HYP was 12.5 +/- 3.5 (SD) mumoles/24 hr, 4 HYP was 226 +/- 62 mumoles/24 hr and the percentage ratio 3 HYP/4 HYP 5.4 +/- 0.5. This ratio was reduced during growth because of a relative excess of 4 HYP. In patients with acute glomerular disease (n = 12) 3 HYP was increased to 17.1 +/- 5.8 mumoles/24 hr (P less than 0.01), and the ratio 3 HYP/4 HYP was 7.3 +/- 0.7% (P less than 0.01). Such an increase in 3 HYP was not observed in patients with chronic glomerulonephritis (n = 24) where 3 HYP was 9.6 +/- 5.0 mumoles/24 hr and 3 HYP/4 HYP 5.7 +/- 1.6% or with diabetic glomerulopathy (n = 6). In patients with chronic interstitial nephritis (n = 8) the 3 HYP/4 HYP ratio was decreased except in patients with polycystic renal disease (PKD) where it was increased (P less than 0.001). The daily urinary content of 3 HYP and 4 HYP was slightly altered by renal insufficiency. Urinary 3 HYP did not change significantly in patients with GN with the nephrotic syndrome whatever the histological lesion. These results indicate that urinary 3 HYP: 1) is increased when glomerulonephritis is clinically acute or subacute; 2) is increased in PKD whatever the level of renal insufficiency.

Acute Kidney Injury↗
PubMed1980

Urinary 3-hydroxyproline in renal disease.

The renal excretion of 3-hydroxyproline (3-HYP), an isomer of 4-hydroxyproline (4-HYP) found 6-10 times more in basement membrane collagen than in interstitial collagen, was investigated in control subjects and in 58 adult patients with various kidney diseases. With the exception of polykystic renal disease, all the nephropathies were investigated by renal biopsy. In normal adult subjects urinary 3-HYP was 12.5 +/- 3.5 (SD) mumol/24 h, 4-HYP 226 +/- 62 mumol/24 h and the percentage ratio 3-HYP/4-HYP 5.5 +/- 0.5. This ratio was twice as little during growth because of a relative excess of 4-HYP. In patients with acute glomerular disease (acute and subacute glomerulonephritis, lupus nephritis...) (n = 13) 3-HYP was 17.1 +/- 5.8 mumol/24 h (p less than 0.01 when compared with the normal) and 4-HYP 234 +/- 77 mumol/24 h. The ratio between the two values was 7.3 +/- 0.7 (p less than 0.001). Such an increase in 3-HYP was not observed in patients with chronic glomerulonephritis (n = 24) where 3-HYP was 9.6 +/- 5.7 mumol/24 h and 3-HYP/4-HYP 6.0 +/- 1.6, neither in patients with diabetic glomerulonephritis (n = 6). In chronic interstitial nephritis (n = 8) the 3-HYP/4-HYP ratio was decreased with the exception of polykystic renal diseases (PKD), where it was increased (p less than 0.001). The daily urinary contents of 3-HYP and 4-HYP were slightly altered by renal insufficiency. In glomerulonephritis with nephrotic syndrome whatever the histological lesions, urinary 3-HYP did not change significantly. These preliminary results indicate that urinary 3-HYP (1) is increased when glomerulonephritis is clinically acute or subacute; (2) is increased in PKD suggesting a possible inborn error of collagen metabolism.

Adolescent↗