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Biomedical subjects

W Cremer

Publications and source records attributed to W Cremer.

At least 19 recordsLinked to original sources
PubMed1984

[Reproducibility of acute captopril-induced renal insufficiency with enalapril].

In this case we are reporting on a patient suffering from malignant renovascular hypertension and chronic renal failure due to occlusion of both renal arteries. The acute renal insufficiency after Captopril and later on after Enalapril treatment was fully reversible. We believe that the acute reversible renal insufficiency was caused by the blockage of glomerular autoregulation depending on Angiotensin II.

Acute Kidney Injury↗
PubMed1978

Chronic hypokalemic nephropathy: a clinical study.

Description of 23 patients (21 women, 2 men) with an average age of 36.6 (19--68) years, who were hypokalemic during 6.5 years on the average (range 1/2--16 years). The cause of the potassium depletion was malnutrition (anorexia nervosa, vomiting) and/or abuse of laxatives and/or diuretics. With increasing duration of potassium depletion renal function deteriorated; in two cases terminal renal failure developed. Histology of the kidneys (9 cases) showed the picture of chronic abacterial interstitial nephritis. Urinalysis was negative or non-specific. The blood pressure levels were normal or low, hypertensive values being exceptional. Aside of hypokalemia a tendency to hyponatriemia, hypochloremia and metabolic alcalosis was observed, the latter turning into hypokalemic normochloremic acidosis with advancing renal insufficiency. Plasma renin activity and aldosterone concentration or excretion frequently were elevated, but no close correlation was found between these parameters or with the blood pressure. Bacterial infection of the urinary tract occured, if at all, in the late phase and seems to be complication rather than the cause of the kidney disease. The discussion of other possible pathogenetic factors leads to the conclusion that the term "chronic kaliopenic nephropathy" is justified. Some diagnostic and therapeutic consequences are mentioned.

Adult↗
PubMed1977

[Hypercalcaemic crises in patients with chronic renal failure caused by ion-exchange resins, antacidotics and other calcium-containing drugs (author's transl)].

Between 1972 and 1976 15 patients with chronic renal failure of different aetiology and varying severity were observed who developed 23 hypercalcaemic phases during treatment with calcium-containing drugs. 12 instances of hypercalcaemia occurred during conservative treated during conservative treatment (serum creatinine 177-1061 mumol/l, equivalent to 20-120 mg/l) and 11 during chronic haemodialysis (serum creatinine 707-1061 mumol/l, equivalent to 80-120 mg/l). In 15 cases hypercalcaemia was caused by a hexacalciumhexasodium-heptacitratehydrate complex (Acetolyt), in 6 cases by the combined use of this drug with calcium ion-exchange resins on a calciumpolystyrolsulfonate base, and in two cases by the use of calcium tablets and calciumpolystyrolsulfonate, respectively. The daily doses of these drugs were in the usual therapeutic range in most cases. Deterioration of renal function was observed in two cases and coma in a further two cases. In 5 cases gastric ulcers were demonstrated. Three patients died. In no patient was there evidence of florid hyperparathyroidism. Treatment with calcium-containing drugs in patients with renal failure should only be carried out under regular control of calcium concentrations.

Aged↗
PubMed1977

[Splenic infarcts in Goodpasture's syndrome: its significance for diagnosis, prognosis, and treatment (author's transl)].

Necrotising splenic arteritis with numerous extensive anaemic splenic infarcts was found in four cases of Goodpasture's syndrome with the necrotising variant of rapidly progressive glomerulonephritis. The disease was rapidly fatal. Early scanning of splenic infarcts for diagnostic, prognostic and therapeutic purposes of the fulminating form of Goodpasture's syndrome is recommended.

Adult↗
PubMed1977

[Haemodialysis of acute renal poisoning (author's transl)].

A 16-year-old laboratory technician ingested 30 g of sodium nitrite (NaNO2) in a suicidal attempt. Within a short time severe cyanosis and distressing dyspnoea developed. The conservative therapeutic approach with redox substances showed little success. However, haemodialysis resulted in rapid improvement of all signs. After three hours of dialysis the patient was symptom-free and could be discharged after two days without damage due to the intoxication. Additional experimental investigations showed NaNO2 to be easily dialysable. There is, however, no binding to active charcoal.

Adolescent↗
PubMed1977

[Permeability of dialysis membranes for hepatitis-B virus: on the prophylaxis of hepatitis in a haemodialysis centre (author's transl)].

Dialysis fluids of two hepatitis-Bs (HBs) antigen-positive dialysis patients were tested for hepatitis-B virus. Total dialysate volume of 5.5 litres each - as obtained on haemodialysis with the Redy-recirculation system - was concentrated by ultrafiltration and trap and rate-zonal ultracentrifugation, followed by fractionation, and purified. Electron-microscopic evidence of permeability of an intact dialysis membrane for hepatitis-B was obtained. Concentration of hepatitis-B virus was at least 10(3) to 10(4) particles per total volume. Because of the potential infectiousness of the dialysis apparatus by effective heat sterilisation after every dialysis is essential.

Adolescent↗
PubMed1977

Symptoms and course of chronic hypokalemic nephropathy in man.

The symptoms and clinical course of chronic hypokalemic nephropathy are described in 21 patients with longstanding potassium deficiency. In 14 patients (group A) the potassium depletion was caused by malnutrition and/or abuse of laxatives and/or diuretics. 7 patients (group B) suffered from primary (6 cases) or secondary (1 case) aldosteronism. The average duration of potassium depletion was 8.8 years in group A and 3.4 years in group B. Depending on the duration of potassium depletion, chronic renal disease develops which may end in terminal renal failure. Urinalysis is non-specific or negative. The clearance of creatinine slowly decreases. Metabolic alkalosis is a constant finding and in group A occurs with a tendency to hyponatremia and hypochloremia, with the development of metabolic acidosis only in advanced renal insufficiency. In contrast to patients of group B, patients of group A have normal or low blood pressures converting to hypertension, if at all only in the late phase. The cases of group A had secondary aldosteronism (and, correspondingly, a hyperplastic juxtaglomerular apparatus). Although urinary tract infection is a regular finding in advanced stages, the clinical, radiological and histological evidence suggests that bacterial pyelonephritis, if occurring at all, is rather a complication than the cause of the disease. In 5 patients 7 instances of acute renal failure of unknown origin were observed which was lethal in one case. Another patient died from terminal renal failure, a third from an intercurrent pneumonia. Renal histology obtained from 13 patients showed the picture of diffuse chronic abacterial interstitial nephritis.

Adult↗
PubMed1975

[Further investigations on cellular immunodeficiency in uraemic patients and the effect of haemodialysis (author's transl)].

The spontaneous rossette-formation of lymphocytes and the rate of the DNA-synthesis was determined in 33 uremic patients of the haemodialysis unit. 1. Spontaneous rosette-formation of uremic lymphocytes (39,5%,n=16) did not differ from normal lymphocytes (39,3%,n=39). 2. The absolute lymphocyte count was slightly but not significantly reduced in uremic patients compared to normal controls and the slight increase after dialysis was not significant. 3. The PHA-induced DNA-synthesis of lymphocytes of 23 uremic patients was significantly reduced compared to normal controls. 4. The reduced PHA-induced DNA-synthesis of lymphocytes of uremic patients was not different in patients dialysed two times (22 hours) per week and patients dialysed three times (30 hours) per week. 5. No correlation of the reduction of PHA-induced DNA-synthesis to the underlying renal-diseases could be found.

Adult↗