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Biomedical subjects

R Schmicker

Publications and source records attributed to R Schmicker.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Complications in the treatment of chronic glomerulonephritis].

In a retrospective study involving 97 patients with histologically confirmed glomerulonephritis the complications which led to the breaking off or changing of an immunosuppressive therapy [Prednison monotherapy (n = 39), Prednison cyclophospohamide therapy (n = 13), Prednison azathioprin therapy (n = 49), Indometazin therapy (n = 25)] were examined. Of 97 patients treated repeatedly over long periods, 22 suffered complications which caused the therapy to be broken off or changed. Because of the risk involved, immunosuppressive therapy of glomerulonephritis should only be practised by institutions specializing in nephrology.

Azathioprine↗
PubMed1983

Influence of keto acids on serum parathyroid hormone levels in patients with chronic renal failure.

The metabolic effects of short-term and long-term treatment by keto acids were examined in 46 patients with chronic renal failure. Long-term as well as short-term administration to chronic uremics resulted in a significant reduction of serum PTH and inorganic phosphate levels while serum concentrations of serum calcium, 25-OH-D and calcitonin were not influenced. The results presented in this paper allow the conclusion that keto acid treatment of patients with chronic renal failure may be helpful in the control of abnormal calcium-phosphate metabolism and secondary hyperparathyroidism.

Adult↗
PubMed1983

Morphologic and functional tubular changes in chronic glomerulonephritis.

In 135 patients with different glomerular diseases but normal glomerular filtration rates (CCr and In = 103 +/- 2ml/min) correlations between morphological tubular lesions (tic) and changes in tubular function were investigated. Between the extent of tubular lesions and the impairment of specific tubular functions (formula; see text) exists a highly significant correlation. The combined diminution in Uosmmax and UNH4 + V reflects in 72 per cent the appearance of a severe tubular lesion and should be used for its clinical recognition.

Biopsy↗
PubMed1980

[Conservative therapeutic possibilities in chronic renal failure].

The three main points of the conservative therapy of the chronic renal insufficiency are the treatment of the basic disease, the dietary therapy and the symptomatic medicamentous measures. The possibilities of treatment of the basic disease, however, are restricted in advanced renal insufficiency, but they may reduce the progression of the nephropathy. Decisive for the success of the conservative therapy are the dietary measures, in which case the restriction of the quantity of proteins with consideration of the biological value, the caloric intake of at last 35 Cal/kg body weight/day and the equalized fluid balance must be particularly emphasized. The different possibilities of the protein restriction and possibilities of control of the protein metabolism are explained. Depending on the degree of the chronic renal insufficiency and the present clinical symptomatology symptomatic medicamentous measures are used. Following in indications for the beginning of the therapy of dialysis it is referred to the importance of the system of renal dispensaries for the optimum performance of the conservative therapy.

Acidosis, Renal Tubular↗
PubMed1980

Conservative treatment with ketoacid and amino acid supplemented low-protein diets in chronic renal failure.

Twenty-six patients with advanced renal failure (glomerular filtration rate less than 6 ml/min) were treated with a mixed quality low protein diet and ketoacid analogues. An improvement in nitrogen balance, serum transferrin and phosphate, and base excess was observed after 2 weeks of treatment. In a longer term study, the result of 20 patients treated with ketoacids for up to 14 months were compared to a group 40 patients who received a low-protein diet with essential amino acids. Patients responded similarly to the two diets; however, the group receiving ketoacids had a significantly lower glomerular filtration rate. There was improvement in calcium and phosphate metabolism with ketoacid treatment. The patients were able to tolerate treatment with both the ketoacids and vitamin D.

Adult↗
PubMed1979

[Serum complement and protein metabolism in chronic dialysis patients].

1. When a so-called free diet is granted there is the danger of a protein deficit, which can be proved in a significant decrease of the serum transferrin and of the complement factor E3c, in patients in the chronic haemodialysis programme. 2. Within the group undergoing dialysis a correlation analysis did not result in a statistically ascertained connection between the complement factor C3c and the total haemolytic activity and the transferrin, respectively. 3. On the basis of a diet analysis a connection between the protein supply and the serum transferrin level could be established, which was not to be proved for the complement factor C3c and the total haemolytic activity, respectively. 4. Low transferrin values in the serum seem to be followed by a deterioration of the anaemia situation of the patient undergoing haemodialysis. 5. Compared with the total haemolytic activity and the complement factor C3c the determination of the serum transferrin allows an essentially exacter information about the protein metabolism of the patient undergoing a chronic haemodialysis.

Blood Proteins↗
PubMed1979

Serum complement and protein metabolism in chronic dialysis patients.

1. Patients receiving regular hemodialysis treatment who are permitted to select their own diets are in danger of a protein deficiency manifested by a significant reduction in serum transferrin and in complement C3c. 2. Correlation analysis within the dialysis group revealed no secure connexion between the complement C3c and total hemolytic activity respectively, and transferrin levels. 3. Analysis of diets showed that protein intake and the serum transferrin level correlate. No such correlation was found for the complement C3c or total hemolytic activity. 4. Low transferrin levels in the serum appear to result in more severe anemia among dialysis patients. 5. Knowledge of the serum transferrin level permits much more exact assessment of the protein metabolism in regular hemodialysis patients than knowledge of the total hemolytic activity or the level of the complement C3c.

Blood Proteins↗
PubMed1978

[Conservative therapy of chronic kidney failure].

The optimum performance of the conservative therapy of the chronic renal insufficiency demands a good cooperation between the patients, the dietician and the physician. The foundation of centres of the nephrological care for patients with renal insufficiency guarantees the possibility of a continuous control. In the conservative therapy the measures in question are symptomatic ones, excluding the medicamentous therapy of the basic disease in acute episodes. The dietetic measures are the basis of the conservative therapy. The diet moderately poor in protein should be given at creatinine values in the serum 4 mg/100ml and the diet strongly poor in protein from 8 mg/100 ml (prophylactically perhaps from 6 mg/100 ml). In the dietetic measures apart from the protein restriction the calorie intake (35 to 40 calories/kg body weight a day), the intake and output of fluids and the electrolyte metabolism as well as the vitamin intake should particularly be taken into consideration. Additional symptomatic medicamentous measures are necessary in order to improve the clinical symptomatology of the chronic renal insufficiency. By means of the conservative therapy the period to the necessary dialytic treatment can be delayed. Apart from this a lengthening of life and an improvement of the rehabilitation is possible in those patients, in whom an active therapy is not taken into consideration.

Dietary Proteins↗
PubMed1978

[Hemodialysis and metabolic disorders].

On the basis of investigations of the water and electrolyte balance, of the protein balance, the lipid metabolism and the hormone metabolism at the instance of aldosterone a concept of specific dialysis-conditioned pathophysiological disturbances is developed in patients undergoing a chronic programma of dialysis. The changes of metabolism induced by apparative therapy have a decisive influence on the pathophysiological mechanisms in the uraemic organism and condition a specific pathophysiology of the patient undergoing dialysis.

Aldosterone↗
PubMed1978

[Serum transferrin in chronic kidney failure with conservative treatment and hemodialysis].

1. Serum transferrin is a sensitive indicator for the establishment of a subclinical protein deficit. 2. When a diet moderately poor in protein was given (0.5-0.6 g/kg body weight/daily) was given the transferrin values (243 +/- 61 mg/100 ml) were significantly lower than in the control group (284 +/- 61 mg/100 ml), but they were altogether still in the lower normal region.

Diet Therapy↗
PubMed1978

[Clinical and histological studies on the course of glomerulonephritis].

It is reported on 37 patients in whom on the basis of the clinical suspicion of a glomerulonephritis a biopsy of the kidneys was carried out, and after treatment in these patients a rebiopsy was carried out 21 months later in order to examine clinical and histological changes during this period. Hereby could be established that the rebiopsy only six times evoked an apparant improvement, whereas the other cases showed clinical findings or deterioration and only in half the cases a correspondence between clinical and histological developmental tendencies was recognizable. As conclusion indications to rebiopsy are proposed.

Biopsy↗
PubMed1976

[Chemotherapy in pyelonephritis].

In the present paper the most important general directions of the chemotherapy of the acute as well as the chronic pyelonephritis are explained. In adult age actual acute pyelonephritides are rare. In most cases acute attacks of chronic pyelonephritides are in question. Also in the acute pyelonephritides for the initial therapy the application of highly effective chemotherapeutics is recommended which lead to high tissue and serum levels. The exclusive application of nitrofurantoin or an only symptomatic therapy is not indicated in acute pyelonephritis. Only a consequent therapy of the acute form of the course gives the possibility to reduce the number of chronic pyelonephritides. The most favourable conditions for the treatment of chronic pyelonephritis with the aim of stopping the chronic process or eventually even a cure are given by the long-term therapy. For the initial therapy according to the antibiogramme a tissue effective chemotherapeutic remedy is administered. This was followed by a long-term prophylaxis of about 6 months. Taking into consideration the therapeutic mechanisms of the preparations and the severity of the clinical picture always the least toxical antibacterial remedies should be administered. The most important chemotherapeutics for the therapy of pyelonephritis, their side-effects and the peculiarities of their use in renal insufficiency are discussed.

Acute Disease↗
PubMed1976

[Urolithiasis and its conservative treatment based on analysis of the calculi].

The exact analysis of urinary calculi is the condition for an aimed conservative therapy of urolithiasis. As standardized method of the analysis of urinary calculi the X-ray diffraction was introduced in the GDR. This investigation method allows a qualitative and quantitative analysis of the concrements. The possibilities of the conservative therapy of urolithiasis were explained. To this conservative treatment belong the treatment of a colic, the removal of a calculus, the litholysis and the prophylaxis of recidivations.

Colic↗
PubMed1976

[Comparative clinical and histological studies in the diagnosis of isolated proteinuria and hematuria].

In 311 patients with clinical suspicion to glomerulonephritis biopsies of the kidneys were performed. In these cases in 82% the histological or tentative diagnosis, respectively, of a glomerulonephritis could be made. As diseases preceding the glomerulonephritis relapsing tonsillitides are occupying the first place, whereas scarlet fever, otitides, furunculoses and sinusitides were observed more infrequently. Clinically cases of oligosymptomatic glomerulonephritis were more frequently observed than monosymptomatic ones. One fifth of the patients exhibited a restricted renal function or a proteinuria of 3 g/24 hours, in which case proliferatively sclerosing, diffusely proliferative and membranaceous forms occupied the first place.

Adolescent↗
PubMed1976

[Antibody binding bacteria in the urine in chronic pyelonephritis].

Using the direct immunofluorescence technique antibody-coated bacteria were demonstrated in urine samples from 49 of 57 patients with the clinical diagnosis of chronic pyelonephritis, but were not observed in urines from 11 patients with cystitis. A correlation rate was found between the presence of antibody-coated bacteria in the urine seidment and elevated serum antibody titers in the pyelonephritis group as determined by the indirect immunofluorescence technique. Patients with elevated serum antibody titers without antibody-coated bacteria in the urine, and vice versa, were also found. Patients with cystitis did not have elevated serum antibody titers against the homologous strain isolated from the urine. The clinical diagnosis of chronic pyelonephritis could be confirmed in 86.5% of patients taking into account the presence of antibody-coated bacteria and/or elevated serum antibody titers.

Adult↗