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At least 1,333 records · Page 74Linked to original sources
PubMed1976

Evaluation of percutaneous kidney biopsy in advanced renal failure.

As more information is gained on the long-term survival in chronic dialysis and transplant patients, it is unacceptable to be satisfied with a clinical impression of the etiology of the end stage renal failure in each case. It becomes important to know the histological diagnosis in patients who present with terminal renal failure. In the past there was little to offer such individuals in terms of therapeutics, and their prognosis was uniformly poor. Thus, biopsy for other than academic reasons was difficult to justify. This is no longer true and presented here is a series of 28 such patients in whom percutaneous renal biopsy was performed. The complications and diagnostic yield are reported. It is further demonstrated that the added knowledge of histological diagnosis can be of benefit to the individual patient.

Adolescent↗
PubMed1976

Studies on erythropoiesis in patients with renal failure and after kidney transplantation.

Ferrokinetic studies were made in 16 patients before and after kidney transplantation. The Fe clearance decreased in 9 of 11 patients, the plasma iron turnover showed no variation in six patients, while it increased in three and decreased in one, the production of hemoglobin increased significantly after transplantation. The nonnephrectomized patients showed more erythropoiesis after transplantation, manifested by higher hemoglobin level, shorter Fe clearance, and lower serum iron. Uremic patients, including the anephric, had significant responses in erythropoiesis both to stimulation by phlebotomy and to inhibition by blood transfusion. After transplantation, however, the response to phlebotomy was greater and the blockade by blood transfusion smaller, than during uremia.

Adolescent↗
PubMed1978

Nephrotic syndrome and focal glomerular sclerosis in aging man.

Focal glomerular sclerosis (FGS) with the nephrotic syndrome is a disecades. Less than 2% of reported patients are older than 60 years of age, and to our knowledge no patients over 70 years of age have been described. The present report documents with renal biopsies the occurrence of FGS and the nephrotic syndrome in 4 patients with an average age of 70 years, 3 being septuagenarians. We suggest that FGS in these patients may represent a disease of senescence, and that FGS in younger patients may result from accelerated glomerulotubular senescence.

Adult↗
PubMed1979

Glucose-enriched dialysate and tolerance to maintenance hemodialysis.

10 patients entered a controlled 4-week study to evaluate the effect of a glucose-enriched dialysate (400 mg/100 ml) on hemodialysis tolerance. Headache during and after dialysis and post-dialysis fatigue decreased in a statistically significant manner. The average glycemia was only moderately increased with an adequate insulin response. Blood cholesterol and triglycerides did not vary signifcantly during this short study period.

Adult↗
PubMed1984

Generation of superoxide anions during phagocytosis by monocytes of uremic patients.

The phagocytic activity of monocytes from 15 uremic patients was estimated by the superoxide anion test. There was a significant decrease in the ability of monocytes from these patients to produce superoxide anions in comparison with monocytes obtained from healthy subjects. Addition of urea to monocytes from healthy subjects caused a marked reduction in their ability to produce superoxide anions, while addition of creatinine did not cause any effect. Monocytes from patients with renal failure of glomerular origin were found to produce less superoxide anions than those from patients with other types of renal diseases.

Creatinine↗
PubMed1987

Hypertension and the kidney.

The purpose of this study was to confirm, using longitudinal observations in a normal population, that the rate of decline in renal function (creatinine clearance) is inversely correlated with blood pressure. The negative regression coefficients plotting individual rates of decline over time (Bcr) against mean blood pressures (MBP) were highly significant (p less than 0.001) for all subjects and subjects in category 3 (normals). Although the Bcr also decreases significantly with age and MBP increases with age suggesting this might be an age effect, a multiple regression analysis shows that both MBP and age as independent variables exert statistically significant effects on Bcr, the dependent variable.

Adult↗
PubMed1989

Urinary excretion rate of guanidinoacetic acid as a new marker in hypertensive renal damage.

This study was undertaken to evaluate the relation between the urinary excretion of guanidinoacetic acid (GAA) and other substances in hypertensive patients (6 with borderline hypertension and 29 with hypertension) and 12 normal controls. In 10 of the hypertensive patients, GAA was measured before and after 4 weeks of treatment with calcium entry blocker. In hypertensive patients the rate of GAA urinary excretion was 43.5 +/- 17-4 micrograms/min, which was much lower than in the controls (77.2 +/- 35.9 micrograms/min) (p less than 0.01). There was no significant difference among these groups in creatinine clearance (CCr), serum creatinine (Cr), beta 2-microglobulin (BMG) or in the urinary excretion of BMG, N-acetyl-D-glucosaminidase (NAG) or radiosensitive microalbumin (mAlb). The urinary excretion rate of GAA was positively correlated with CCr (r = 0.62; p less than 0.01), and negatively correlated with mean blood pressure (r = -0.49; p less than 0.01). Finally, the GAA excretion was significantly correlated with urinary NAG (r = 0.24; p less than 0.05) and serum BMG (r = -0.31; p less than 0.05), but not with urinary mAlb (r = 0.12; p less than 0.05). Ten hypertensive patients followed for 4 weeks attained their ultimate mean blood pressure reduction after treatment (from 119.3 +/- 8.0 to 101.7 +/- 13.5 mm Hg; p less than 0.001), but the GAA/Cr ratio in the urinary excretion was significantly elevated (from 0.054 +/- 0.016 to 0.070 +/- 0.02; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylglucosaminidase↗
PubMed1996

A study on regulating factors of plasma refilling during hemodialysis.

Hypotension is frequently encountered during hemodialysis (HD). One of the main factors of the HD-induced hypotension is acute reduction of circulating plasma volume by water removal, which is induced by the poor plasma refilling from the extravascular space into vessels. The determinants of plasma refilling, however, have not been clearly identified. Recently, we devised a mathematical model of water transport in HD patients, which can estimate the plasma-refilling coefficient (Kr) during HD. In the present study, we evaluated the factors determining plasma refilling by using this model. In 13 patients undergoing regular HD, the changes of Kr during HD were calculated from the model. Levels of ANP, cGMP, cAMP, endothelin, angiotensin II and vasopressin were measured before and after HD. Kr fell from 750.4 +/- 558.0 to 112.8 +/- 81.9 ml/mm Hg/h during HD. The rate of water removal during HD showed no significant correlation with the changes of Kr. Among the hormones and nucleotides measured here, plasma ANP level and cGMP were significantly correlated with Kr (r = 0.78, p < 001 and r = 0.62, p < 0.01, respectively). Our findings suggest that severe reduction in the level of serum ANP during HD, which is induced by water removal, plays some role in HD-induced hypotension through the attenuation of plasma refilling in HD patients.

Adult↗
PubMed1996

An index of plasma refilling in hemodialysis patients.

During hemodialysis therapy, a large amount of water is removed from the patient's blood in a short time; however, blood pressure remains stable in most patients. As water is removed, the circulating serum proteins become more concentrated, resulting in a marked increase in the driving force which pulls water from the extravascular space into the blood vessels, by a process called plasma refilling. However, since a method for studying plasma refilling has not previously been proposed, it is not known what determines the plasma refilling capacity of hemodialysis patients. To evaluate the plasma refilling capacity of patients, we propose here a method for calculating an index of plasma refilling capacity, which we have called the plasma-refilling coefficient (Kr). In 14 patients receiving maintenance hemodialysis therapy, total serum protein was measured before hemodialysis, and hematocrits were measured hourly during hemodialysis. From the changes in the hematocrits, we estimated the changes in the circulating plasma volume and in the intracapillary oncotic pressure at each time point. The water removal rate was also measured hourly. From these values, we calculated Kr. An averaged volume of 2,692 +/- 219 ml of water was removed from each patient resulting in a decrease in the estimated circulating blood volume, while the hematocrit and the estimated intracapillary oncotic pressure increased gradually. Kr calculated after 1 h of hemodialysis varied widely between patients, 140.3-1,744.2 ml/mm Hg/h, and decreased gradually as water removal continued. The average Kr of 14 patients was 698.9 +/- 15.2 ml/mm Hg/h at the beginning of water removal, and it decreased to 405.3 +/- 75.4, 203.9 +/- 39.5, 130.2 +/- 20.5 and 93.9 +/- 14.3 each hour thereafter. The index of plasma refilling proposed in this paper is useful for examining capillary water permeability and the degree of plasma refilling in hemodialysis patients.

Adult↗
PubMed1994

Aging of a class of arteries in various mammalian species in relation to the life span.

Age-related sclerosis of human renocortical arteries is associated with essential hypertension and limitation of the life span by cardiovascular mortality. Arteries in the kidneys of nonprimate species, examined here, showed near absence of arteriosclerosis when the average life span was less than 12 years and small amounts of sclerosis in longer-lived species. The fastest progression of arteriosclerosis was, paradoxically, in the longest-lived species, the human and the macaque. Results are incompatible with theories of aging that include arteriosclerosis within the framework of mechanisms that are proposed to explain the life spans of species.

Adolescent↗