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Biomedical subjects

P Zech

Publications and source records attributed to P Zech.

At least 91 records · Page 5Linked to original sources
PubMed1981

Cystine crystalluria and urinary saturation in cystine and non-cystine stone formers.

It has been suggested recently that the first step in the formation of calcium oxalate stones appears to be crystallisation. This step is said to depend on the state of saturation of the urine. This hypothesis was checked in cystine stone formers. Cystine crystalluria was found in 83% of 24 urine samples from cystine stone formers (CSF) but in one of the 400 control samples and appears to be a good guide in the diagnosis of cystine lithiasis. Urinary cystine saturation was constantly higher in CSF than in non-cystine stone formers (NCSF) who exhibited undersaturated urine with respect to cystine. There was almost no overlap between these 2 groups. Crystals were never found in undersaturated urine and were always present when the saturation was above 1. There appears to be a good correlation between the level of urinary saturation and the presence of crystalluria and there is no need for any additional factor such as a defective inhibitor. The study underlines the limits of a therapeutic regimen of a high fluid intake and alkalinisation of the urine.

Crystallization↗
PubMed1981

Treatment of idiopathic acute crescentic glomerulonephritis by immunodepression and plasma-exchanges. A prospective randomised study.

A prospective randomised trial was carried out in 14 patients with severe 'idiopathic' acute crescentic glomerulonephritis. The mean percentage of crescents was 78 per cent and 11 patients were anuric at presentation. Eight patients received pulses of methylprednisolone, immunosuppressive drugs and anticoagulants and six the same therapeutic regimen plus plasma exchanges for one to two months. Mean follow-up was 22 months. Recovery was statistically better in the PE+ group (p less than 0.02), but for discontinuation of dialysis, the difference is significant only at two months (p less than 0.02), perhaps because of the small number of patients. For this reason and because all pathological subgroups cannot be analysed separately, this study is continuing.

Acute Disease↗
PubMed1980

[Effects of labetalol, a new alpha- and beta-adrenoreceptor blocking drug, on arterial pressure, renal function and renin activity (author's transl)].

Labetalol, a blocker of alpha- and beta-adrenoreceptors, was tried on 45 patients with severe (29 cases) or mild to moderate (16 cases) hypertension. After an initial period of dosage adjustment and a 2 months treatment in effective doses, there was a significant fall in supine blood pressure from mean values of 207/132 to 170/106 mmHg. In 23 patients hypertension was controlled by labetalol alone in doses of 400 and 1800 mg per day. True failures were rare (16%). Digestive disorders and postural hypotension were the most frequently encountered side-effects; they obliged to discontinue treatment in 4 cases, but were compatible with it in 11 cases. In 22 patients the fall in BP was accompanied by a significant (p less than 0,001) decrease in plasma renin activity from 123 to 44 ng/l/min supine and from 144 to 83 ng/l/min standing. Studies of the renal function showed no changes during oral therapy. Following intravenous injection of 50 mg labetalol to 20 subjects, inulin and PAH clearances remained unaltered, and there was a significant, though transient (1 hour), decrease in chloride, sodium and phosphorus excretion. Effective in lowering blood pressure be used and well tolerated by the kidneys, labetalol can safely be used for the treatment of severe hypertension with organic renal involvement.

Adolescent↗
PubMed1980

Uric acid, monosodium urate and ammonium urate urinary relative saturations in normo-uricuric calcium oxalate stone formers.

Monosodium urate (NaU), ammonium urate (NH4U) and uric acid (UA) urinary relative saturations were studied in 15 normo-uricuric calcium oxalate (CaOx) recurrent stone formers whose CaOx relative saturation was identical to age- and sex-matched controls. NaU and NH4U relative saturations were constantly below 1 and not higher in stone formers than in controls, suggesting that heterogeneous nucleation is an unlikely mechanism of CaOx stone formation in vivo. Such values of NaU relative saturation would also tend to rule out any change in the CaOx formation product or urinary inhibitory activity. However, at a given urinary flow rate, NaU relative saturation was suggestively higher in stone formers than in controls. Some disturbance in the equilibrium between NaU and urinary inhibitors might then exist even in normo-uricuric CaOx stone formers.

Animals↗
PubMed1979

[Hypertension due to unilateral parenchymatous nephropathy (author's transl)].

One hundred and eight patients suffering from hypertension due to a unilateral parenchymatous neophropathy were studied over a period of one to eight years after treatment was starded. The aetiologies were diverse: harmonious hypoplasia, segmental hypoplasia, pyelonephritis, reflux nephropathy, hydronephrosis and tuberculosis. Thirty nine patients were treated surgically, with 50% good results. In 82 cases medical treatment was continued for at least a year with a 52% success rate. Such success was recorded in 94% of cases in which beta-blockers were used (38 cases). Surgical success was not dependent upon the period for which hypertension had been present. The best results were seen in cases of hydronephrosis and pyelonephritis and the worst in tuberculosis. Thirteen patients underwent surgery event though there was no unilateral increase in plasma renin levels. Seven were improved or cured. Ten patients underwent surgery with a renin activity 50% greater than on the healthy side, 9 being improved or cured. Treatment with beta-blockers, alone or in association with diuretics, controlled blood pressure in 90% of cases, regardless of the renin activity. Plasma renin activity in the renal veins is of good prognostic value in terms of the effectiveness of nephrectomy against hypertension. In Call cases, beta-blockers were more effective than surgery.

Adrenergic beta-Antagonists↗
PubMed1979

[Reno-vascular hypertension: prognosis variations according to the method; surgery, or medical treatment. Retrospective study of 114 cases (author's transl)].

A retrospective study made of 114 cases of renovascular hypertension was undertaken to compare the effectiveness of different types of treatment. In this series, with a follow-up of 18 months to 9 years, a favourable result with regard to blood pressure was obtained in 45% of cases with surgery, in 63% of cases with medical treatment and in 88% of cases if treatment included beta-blockers. Medical treatment represents a valid alternative to surgery in hypertension of this type, regardless of the amount of renin secretion and whatever the criteria of ischaemia. The choice of surgery as a method of treatment thus depends above all upon the age of patient, the type of stenosis and the anatomical risk represented by the vascular malformation. Despite the very spectacular results of medical treatment, it remains essential to seek a renal cause for hypertension, since many renal conditions which require specific treatment present with hypertension alone.

Adrenergic beta-Antagonists↗
PubMed1979

Nephrotic syndrome in procainamide induced lupus nephritis.

We report a case of the nephrotic syndrome occurring in a patient with procainamide induced LE. It was associated with bilateral pleural effusions, pericarditis, fever, positive LE cell preparation and a high titer of antinuclear antibodies. No anti-DNA antibodies were found. Renal biopsy showed mesangial proliferation with few IgM and C3 deposits and interstitial infiltrates; electron microscopy revealed subendothelial deposits. Clinical improvement occured after steroid therapy and there was no recurrence 24 months after withdrawal of prednisone.

Aged↗
PubMed1978

[Deliberate self-overdose with propranolol. Changes in serum levels (author's transl)].

Suicidal attempt using beta-blockers are rare. Overdose by the ingestion of a large number of tablets rarely exceeds the high therapeutic doses suggested for the treatment of certain resistant cases of hypertension. The case described is that of a 65-year-old patient who took 800 mg of propanolol. Observation of plama levels showed that the half-life propanolol in the case of overdose is prolonged: 8.6 hours in this case, with a maximum plasma level of 1536 ng/ml. Plasma renin activity levels were low during the phase of intoxication and showed evidence of a rebound effect at its end. Treatment is above all that of the circulatory insufficiency produced: isopropylnoradrenaline or glucagon. Indications for extra-renal dialysis should take into account knowledge concerning the pharmacokinetics of these drugs and their prolonged physiological action.

Aged↗
PubMed1978

Correlation between evolution and treatment of hypertension in unilateral renal disease and values of renin activity in renal venous blood.

93 patients with renal hypertension and renal vein PRA determination were studied during 1--5 years follow-up. They were separated in two groups of medical and surgical treatment. Medical treatment is able to normalize blood pressure even in cases with high asymmetric PRA. 9 of 16 patients could be cured or improved in the surgical group and 14 of 22 in the medical group. The best results were obtained if beta-blockers were included in the drug regimen: cured or improved were 7 of 33 patients in medical treatment without beta-blockers, 17 of 28 in surgical treatment, and 31 of 32 in medical treatment including beta-blockers with or without hydralazine and/or diuretics.

Adolescent↗
PubMed1977

Pharmacokinetics of atenolol in patients with renal impairment.

The pharmacokinetics of atenolol, a new cardioselective beta-adrenoceptor blocking agent, were determined following both acute and chronic dosing in 33 hypertensive patients with widely differing levels of renal impairment. In patients with normal renal function the atenolol half-life was calculated to be about six hours following single 100 mg oral doses. This value increased markedly in patients with renal insufficiency and the blood clearance of atenolol was found to have a significant correlation with the glomerular filtration rate. This demonstrated the importance of the kidneys in the elimination of the drug. After 8 weeks oral treatment with atenolol (100 mg twice daily) a significant decrease in blood pressure, heart rate and plasma renin activity was observed, but no correlation was established between the blood levels of atenolol and any of its pharmacodynamic effects. A positive correlation was found however between the anti-hypertensive action of atenolol and the pretreatment value of the plasma renin activity.

Atenolol↗
PubMed1977

[Idiopathic cyclic edema: disorders in water elimination accentuated by orthostasis].

Forty patients suffering from idiopathic oedema were studied. The disturbance in water excretion is characterised by a delay in excretion of a water load (20 ml/kg body weight), an inability to decrease urinary osmolarity below 137 mOsm/1 standing (normal: 60 mOsm +/- 25) and an inability to increase free water clearance: 2.36 +/- 2 ml/mn/1. 73 m2 (normal value: 6.8 ml/mn/1.73 m2) in the upright position. This problem of water excretion related to orthostasis defines and characterises the syndrome, the clinical picture of which is well known. The disturbance suggest a fault in the regulation of anti-diuretic hormone whilst the aldosteronism often described would seem to be inconstant and secondary to diuretic therapy too often prescribed without supervision.

Adult↗
PubMed1976

Acute renal effects of new beta-adrenergic receptor site blocking agents on renal function.

The effects of two new beta blockers on renal function have been studied. There were significant decreases in urine flow, urea clearance, sodium and chloride excretion rates after acute administration. Fractional excretion of sodium (FeNa) fell significantly but did not continue to fall during chronic administration. Blood pressure and plasma renin activity decreased significantly after two months' therapy. These findings suggest that beta blockers in patients with unstable cardiovascular function increase the need for concomitant diuretic therapy.

Acebutolol↗
PubMed1975

[Changes in renal function in the hours following an intravenous injection of acebutolol].

A study was carried out, of the changes of renal functional value and of urinary electrolytes excretion after rapid intravenous injection of acebutolol in twelve subjects with various glomerular filtration. Renal functional value was estimated by measuring inuline. P.A.H., urea and creatinin clearances during a control period of thirty minutes and during the four hours following administration of acebutolol. The variations in the excretion of electrolytes: chloride, sodium, potassium, calcium and phosphorus were measured during the same periods. The following results were obtained: in subjects with normal renal functional value, administration of acetubolol brings about: a variation which is under 20 p.cent of glomerular filtration and P.A.H. clearance; a 50 p.cent average decrease of natriuresis. in cases of renal insufficiency: clearances of inuline and P.A.H. are unchanged. There is a 20 p.cent average decrease of natriuresis. There is a decrease of urinary output (35-45 p.cent) and of urea clearance (20-50 p.cent).

Acebutolol↗