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P Pils

Publications and source records attributed to P Pils.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Mixed infection after renal transplantation (author's transl)].

Severe mixed infection was observed in 9 out of 101 renal transplant recipients over a period of 6 years and was characterized by the simultaneous incidence of bacterial, fungal and viral infections. Severe septicaemia was clinically evident in all cases. The critical clinical situation called for a rapid assessment of the differential diagnosis and relevant bacterial, fungal and viral investigations. Antibacterial and antimycotic therapy must be instituted as soon as possible on account of the high mortality from mixed infection in renal transplant recipients. The reduction or discontinuation of immunosuppressive therapy during infection did not impair renal transplant function.

Bacterial Infections↗
PubMed1979

[Diagnostic relevance of thermography in renal transplantation (author's transl)].

During a followup period of 18 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a not invasive, quickly available and reproduceable method. Because of the high incidence of 85% exact diagnoses this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommendable for transplant patients, if postoperative haemodialysis is necessary. In these cases information can easily be obtained whether postoperative olig-anuria is caused by acute tubular necrosis or by primary insufficient vascularisation of the transplant.

Adolescent↗
PubMed1979

Reversible acute tubular necrosis following severe acute renal rejection.

The clinical observation of 6 out of 250 renal transplant patients showed that acute renal rejection may lead to reversible acute tubular necrosis (ATN) necessitating intermittent haemodialysis treatment. Despite missing early response to high-dose (methyl-) prednisolone therapy (during a mean period of 4.7 days) all 6 patients developed spontaneous diuresis 14.5 days on average after onset of rejection while on maintenance immunosuppressive therapy. From the clinical course the conclusion was drawn that in severe cases of renal rejection with arteriographic and histological findings consistent with acute tubular necrosis, prolonged therapy with high doses of (methyl-) prednisolone is not desirable, since after reversal of immunological rejection the onset of spontaneous diuresis will be determined mainly by the duration of the healing and recovery phase of acute tubular necrosis.

Acute Kidney Injury↗
PubMed1979

[Report on renal transplant patients. Ocular changes due to renal disease and immunosuppressive therapy (author's transl)].

51 patients with renal transplants were examined ophthalmologically 31,1 (1--77) months after the transplantation. 80,4 p. c. showed ocular complications: cataract formation in 43,1 p. c. of the patients examined and increased intraocular pressure values between 22 and 30 mm Hg in 3 patients are to be attributed to the systemic immunosuppressive therapy. Further ocular changes were recurrent subconjunctival haemorrhages due to increased vascular rigidity, calcium phosphate deposits in the conjunctiva due to persistant secondary hyperparathyroidism and fundus changes (pigmentary irregularities in the foveal regions, narrow arterial vessels). Although marked arterial hypertension was observed in 21 patients after the transplantation, no signs of hypertensive retinopathy could be found. Despite the high incidence of ocular complications after renal transplantation the risks of immunosuppressive therapy must be considered as tolerable: cataract formation and increased intraocular pressure do not impair the positive effect of renal transplantation on ocular functions. Regular ophthalmological control examinations of renal transplant patients are advisable.

Adolescent↗
PubMed1979

Use of thermography in kidney transplantation: two year follow up study in 75 cases.

During a period of 24 months 75 renal transplant recipients were examined by thermography according to Tricoire. Thermography is a non-invasive, quickly available and reproducible method. Because of the 92% incidence of exact diagnosis this investigation is a helpful additional test in kidney transplantation for evaluation of graft function as well as for diagnosis of pathological intrarenal or perirenal disorders. Thermography is especially recommended for patients if postoperative haemodialysis is necessary. In these cases information can easily be achieved whether postoperative oligo-anuria is caused by acute tubular necrosis or by primary vascular insufficiency of the transplant.

Abscess↗
PubMed1979

Cadaveric renal graft acceptance without azathioprine.

After azathioprine withdrawal serum creatinine concentrations at the end of an observation period of up to 26 months were not significantly different from the previous values in five out of seven patients with good transplant function. Patients with chronic rejection showed a constant rate of loss of transplant function, assessed by a straight line relationship between the logarithm of serum creatinine and time. After stopping azathioprine, however, there was no break in the slope of the curve in five out of six patients. Azathioprine withdrawal may be compatible with good long-term graft acceptance. Azathioprine seems to be of little value in the management of chronic renal rejection.

Azathioprine↗
PubMed1979

[Hemolysis after combined azathioprine and allopurinol therapy].

In a 37 year old renal transplant woman haemolytic anaemia was observed in the course of a combined azathioprine-allopurinol therapy. Azathioprine is converted to 6-mercaptopurine, which then catalyzed by xanthine oxidase is oxidized to 6-thiouric acid. When allopurinol and azathioprine are administered simultaneously, high 6-mercaptopurine concentrations in plasma may be expected because of inhibition of xanthine oxidase activity by allopurinol. We assume that elevated plasma 6-mercaptopurine concentration could possibly be responsible for haemolytic anaemia in this renal transplant patient.

Adult↗
PubMed1979

Recovery of kidney function following prolonged acute renal failure.

Twenty-two patients with prolonged acute renal failure (ARF), successfully treated by haemodialysis, were analysed. The clinical course was oliguric in 16 and non-oliguric in 6 cases. Twenty-seven haemodialyses on average (15-54) during a mean duration of 66.9 (30-172) days were needed for recovery of kidney function. Overall, maximum improvement of renal function was achieved within 116.4 (51-259) days, in oligo-anuric cases within 80.1 (51-208) days, in non-oliguric cases within 160.3 (90-259) days. In the latter group pre-existing renal damage was probably the cause of the more extended duration of acute renal failure.

Acute Kidney Injury↗
PubMed1978

[Long-term ophthalmologic follow-up after kidney transplantation].

16 renal transplant recipients underwent ophthalmological examination 11.4, 19.4 and 61.3 months after renal transplantation. The most common side effects of immunosuppressive therapy were steroid-induced cataract formation, steroid glaucoma, and recurrent subconjunctival haemorrhages. Posterior sub-capsular cataracts may develop as early as 2 months after surgery, reach their highest incidence within 2 years and may be reversible under low dosage steroid therapy. 75.5% of 57 ophthalmologically examined patients showed ocular complications or changes, but visual function was not severely disturbed. Despite hypertension in 23 cases, no hypertensive retinopathy was observed. In the light of these findings we assume that kidney transplantation has a positive influence on ocular functions, and especially on fundus changes dating from the time of regular dialysis treatment.

Adolescent↗
PubMed1978

[Oxygen consumption and body weight development of chronic uremic rats (author's transl)].

Impaired weight gain, a common feature in experimental chronic uremia, led to compare oxygen consumtion values of chronic uremic rats and their controls. Oxygen consumption measurement may allow an approach to the evaluation of total energy requirement. Three groups of animals were considered: uremic rats (CU) of less weight (402.66 +/- 9.9 g) than their control group (NA) (498.3 +/- 26.13) and younger normal animals (NJ), showing a similar weight (376.0 +/- 8.8) to that of the uremics. Significant differences in oxygen consumption values/body weight were found between group NJ (0.927 +/- 0.042 ml O2/mn/100 g rat) and both groups CU and NA (0.788 +/- 0.036 and 0.788 +/- 0.028 respectively). Proportional decrease of energetically active body mass in chronic uremic animals may be the reason of the findings.

Animals↗
PubMed1978

[Spontaneous birth of a live healthy child during successful hemodialysis treatment of pregnancy pyelonephritis with acute oligo-anuria].

A 19-year-old nullipara developed uremia due to acute pyelonephritis in the 30th week of pregnancy, necessitating hemodialysis within one week of onset of clinical infective symptoms. Almost daily prophylactic hemodialyses (7 in all) were performed. BUN and serum creatinine levels were maintained below 75 mg/100 ml and 12 ml/100 ml respectively, and the patient's weight was kept constant until delivery in the 32nd week of pregnancy. A live healthy child of 1.7 kg was born with a length of 39 cm and a normal neurologic examination. After 10 hemodialyses, polyuria set in and the maternal BUN and serum creatinine levels were within normal ranges 3 weeks after delivery. The importance of close cooperation between gynecologist and internist is stressed.

Adult↗
PubMed1978

[Recurrence of intramembraneous glomerulonephritis in 2 consecutive kidney transplantations].

A case of dense intramembranous deposit disease, partial lipodystrophy, hypocomplementemia, and nephritic factor-like activity in the serum is presented. Recurrence of underlying renal disease was noted in two consecutive renal allografts. The first transplant was lost 7 months after implantation, chronic renal rejection being an additional cause of graft failure. A favourable clinical course, however, was observed after the second renal transplantation. 22 months after surgery, the patient was fully rehabilitated and transplant function only slightly reduced despite electron microscopic evidence of typical dense intramembranous deposit lesions. Low C3-serum complement and normal C4-serum complement levels were constant findings throughout observation time. The case supports the assumption that patients with dense intramembranous deposit disease should not be excluded from renal transplantation As shown in the literature, maintenance of satisfactory graft function is usually obtained for a long period of time despite recurrence of original disease.

Adult↗
PubMed1978

[Hepatitis b infection in renal transplant recipients (author's transl)].

During a period of 4 1/2 years the incidence and clinical course of endemic hepatitis B infection was studied in 43 renal transplant recipients with an observation time of 3 to 47 (average: 26.3) months after surgery. During the investigation period 27 out of 43 patients (62.8 per cent) had hepatitis B infection. In 8 patients HBs antigenaemia persisted after chronic dialysis treatment. After surgery HBs antigenaemia was detected for the first time in 7 patients. Recurrence of HBs antigenaemia was noted in one patient. In 7 further cases with HBs antigenaemia after transplantation regular controls of HBsAg and HBsAb were not available before transplantation. In 2 patients HBs antibodies were detectable at the time of transplantation; 2 further patients developed HBs antibodies postoperatively. Hepatitis B infection showed a mild and persistent clinical course. 6 out of 7 icteric patients simultaneously had other severe mycotic and viral infections. Therefore, the conclusion was drawn that in patients with coexisting multiple infections liver damage is not necessarily attributable to HBs antigenaemia.

Azathioprine↗