Showing papers in "Nephron in 1976"
TL;DR: A formula has been developed to predict Creatinine clearance from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr (mg/100ml) (15% less i).
Abstract: A formula has been developed to predict creatinine clearance (Ccr) from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr(mg/100ml) (15% less i
14,211 citations
TL;DR: There was a significant decrease in urine osmolality reached after 12 h dehydration with advancing age, which could not be correlated with the age-related decline in creatinine clearance and a significant age- related diminution in the ability to conserve solute.
Abstract: Alterations in urine concentrating ability with age were examined in 98 active community-dwelling volunteers (aged 20–79 years) who were free from evidence of diseases known to adversely affect renal
291 citations
TL;DR: Indomethacin induced a temporary sodium and water retention and a decrease in glomerular filtration rate and it also lowered PRA, which may be explained by indometHacin-induced inhibition of prostaglandin synthesis.
Abstract: 125Iothalamate and 131I-hippuran clearances, sodium excretion and plasma renin activity (PRA) before and during indomethacin administration in an oral dose of 3 x 50 mg/day were studied in volunteers with a normal or reduced kidney function, as well on non-sodium-restricted as on sodium-restricted diet. Indomethacin induced a temporary sodium and water retention and a decrease in glomerular filtration rate. It also lowered PRA. The latter phenomenon did not depend on sodium retention and was present within 2 h after an oral dose of 50 mg. The results may be explained by indomethacin-induced inhibition of prostaglandin synthesis.
254 citations
TL;DR: Furosemide did not significantly modify in cured patients the mean oliguric period, the number of dialyses and the mean period of renal insufficiency.
Abstract: A randomized study was conducted on 66 patients with acute established oliguric renal failure. Intravenous doses of furosemide ranging from 1.5 to 6.0 mg/kg were given every 4 h to 33 of the patients; the remaining 33 patients served as controls. A persisting diuretic response was observed in 5 treated patients and in 2 controls. Hemodialyses were required in most of them. Furosemide did not significantly modify in cured patients the mean oliguric period, the number of dialyses and the mean period of renal insufficiency.
152 citations
TL;DR: Observations demonstrate the not infrequent occurrence of severe oliguric renal failure following radio-contrast study in patients with preexisting renal disease.
Abstract: Over a 2-year period, acute renal failure following radio-contrast studies was observed in 25 patients after intravenous urography in 13, angiography in 10, oral cholecystography in 1, and cholangiogr
104 citations
TL;DR: The resulting conclusion, that cellular and humoral immune responses are suppressed in renal insufficiency, is further supported by experimental evidence.
Abstract: Pneumonia [4,9] and septicemia are still the principle causes of the high mortality in acute renal failure. Moreover, according to the EDTA report, 19% of chronic intermittent dialysis patients die from infection [17]. The resulting conclusion, that cellular and humoral immune responses are suppressed in renal insufficiency, is further supported by experimental evidence.
100 citations
TL;DR: Renal biopsy and clinical data from 60 patients with crescent formation were correlated and outcome was significantly related to percentage crescentic involvement and oliguria and renal function.
Abstract: Renal biopsy and clinical data from 60 patients with extracapillary proliferation (crescent formation) in > 50% of glomeruli were correlated. Nephropathy was related to infection (15 cases) malignancy
97 citations
TL;DR: Red blood cells from 7 out of 13 patients with chronic uremia were found to have increased intracellular concentrations of sodium associated with a reversible inhibition of ouabain-sensitive Na efflux when incubated in control plasma, and enzyme kinetics revealed a significant increase in KmATP values for this enzyme in uremic RBCs.
Abstract: Red blood cells from 7 out of 13 patients with chronic uremia were found to have increased intracellular concentrations of sodium associated with a reversible inhibition of ouabain-sensitive Na efflux when incubated in control plasma. Although mean Na-K-ATPase activity of RBC hemoly sates was only moderately decreased (21.8 ± 1.5 vs. 26.5 ± 1.8 nmol Pi/mg protein/h), enzyme kinetics revealed a significant increase in Kmatp values for this enzyme in uremic RBCs (1.01 ± 0.1 vs. 0.58 ± 0.03; p
72 citations
TL;DR: Careful aseptic technique seems to be the only necessary factor in prevention of peritonitis and bowel perforation among patients treated with chronic peritoneal dialysis for periods up to 38 months.
Abstract: Peritonitis and bowel perforation are the most serious complications of peritoneal dialysis. This paper reports our experience with these two complications among 87 patients who were admitted to our p
57 citations
56 citations
TL;DR: In patients with residual CCr above 15 ml/min, impairment in several parameters is hardly evident and even after several years of dialysis may still remain minimal, so effective and not the apparent dialysis rehabilitation is concerned.
Abstract: The results of a 1–7 years follow-up of multiple processed and recorded semiquantitative parameters in 148 cases of chronic uremia on regular dialysis treatment (RDT) are reported. Patients were group
TL;DR: An increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of the patient, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampsicin.
Abstract: A new case of acute renal failure after rifampicin is presented, together with a review of the 36 similar cases published up to date in the literature. Evidence is provided that irregularities in drug intake, either as true intermittent treatment or as discontinuation of continuous therapy, play an important role in the pathogenesis of such reactions. Renal failure appeared after a rather long uneventful interval from the beginning of rifampicin therapy, ranging from 1 month to more than 1 year. Its clinical course was favourable in all but one case; the histological picture was mainly of tubulo-interstitial type. The controversial immunological data reported in the literature are reviewed; an increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of our patient: the implications of this finding are discussed, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampicin.
TL;DR: It is suggested that intensive glucocorticoid treatment, even of short duration in the previously kidney-transplanted patients, may aggravate uremic osteodystrophy.
Abstract: 99Tcm-polyphosphate (Tc-PP) bone scintigraphy was performed in 30 consecutive uremic patients on regular hemodialysis and compared with a normal control group. 27 of the patients
TL;DR: The date of onset of 360 acute renal transplant rejection episodes from 1969 to 1973 have been compared with the prevalence of various common viral infections and infections due to Mycoplasma pnuemoniae to find a positive correlation.
Abstract: The date of onset of 360 acute renal transplant rejection episodes from 1969 to 1973 have been compared with the prevalence of various common viral infections and infections due to Mycoplasma
TL;DR: A dialysate calcium concentration of 7 mg/100 ml is optimal for hemodialysis, and several clinical trials indicate that it reduces the risk of progressive secondary hyperparathyroidism and normalization of plasma calcium and phosphate levels reduces therisk of metastatic calcification.
Abstract: A dialysate calcium concentration of 7 mg/100 ml is optimal for hemodialysis. Provided plasma phosphate concentrations are maintained within the normal range and provided that thrice weekly dialysis is employed, this concentration of calcium in the dialysate restores plasma-ionized calcium level to normal, provides sufficient calcium during dialysis to offset loss of calcium in the stool, and prevents loss of calcium from bone. Several clinical trials indicate that it reduces the risk of progressive secondary hyperparathyroidism. Normalization of plasma calcium and phosphate levels reduces (but does not eliminate) the risk of metastatic calcification.
TL;DR: Gradients of renin and renin substrate across the placenta are established, but the resulting renin activity is similar on both sides and the levels of generated angiotensin II are also nearly indentical with a good correlation between these last parameters.
Abstract: Plasma renin activity, renin substrate, angiotensin II, aldosterone and cortisol were measured concurrently and renin concentration calculated in plasma from mothers during labor and delivery, from co
TL;DR: In a group of 48 patients with a renal cadaveric allograft 38 acute rejection episodes were treated by increasing the daily prednisolone doses to 300 mg the first day, 200 mg the second day and 100 mg the third day, gradually tapering down over a matter of weeks, and rejection treatment was successful in 26 of 38 in the first group.
Abstract: In a group of 48 patients with a renal cadaveric allograft 38 acute rejection episodes were treated by increasing the daily prednisolone doses to 300 mg the first day, 200 mg the second day and 100 mg the third day, gradually tapering down over a matter of weeks In a second group of 48 patients 39 acute rejections were treated by 1 g of methylprednisolone intravenously on alternate days with a maximum of four injections Rejection treatment was successful in 26 of 38 in the first group (68%) and in 30 of 38 in the second group (76%) Complications such as gastrointestinal bleeding, aseptic necrosis and diabetes were more frequent in the first series
TL;DR: There was a close correlation between the degree of fusion and the amount of proteinuria in those biopsied before remission, and after remission the number of slit pores increased progressively towards normal over the next 4 weeks.
Abstract: The degree of fusion of glomerular epithelial cell foot processes was quantitated by determining the mean number of inter-process slip pores along 10 mum of basement membrane of peripheral capillary walls in 45 children with steroid-responsive nephrotic syndrome and minimal lesion glomerulopathy. Fusion was present in all biopsies performed when the child had proteinuria, but after remission the number of slit pores increased progressively towards normal over the next 4 weeks. There was a close correlation between the degree of fusion and the amount of proteinuria in those biopsied before remission.
TL;DR: It was found that its incidence was related to the duration of dialysis prior to transplantation and the degree of secondary hyperparathyroidism as indicated by the levels of serum parathyroid hormone at various times following renal transplantation was essentially similar.
Abstract: 76 kidney transplant recipients who were up to 4 years post transplant, were studied to assess the incidence of secondary hyperparathyroidism. All patients had good renal function with a mean serum creatinine of 1.4 mg/100 ml. Secondary hyperparathyroidism, as evidenced by increased serum parathyroid hormone levels, was present in 53 of the 76 patients (66%) and radiologic bone disease in 26 of the 76 patients (34%), while hypercalcemia (serum calcium greater than 11.0 mg/100 ml) occurred in only 6 patients (8.5%). The incidence of secondary hyperparathyroidism decreased slightly with time following transplantation, but the degree of secondary hyperparathyroidism as indicated by the levels of serum parathyroid hormone at various times following renal transplantation was essentially similar. The causes for the persistence of this condition are not totally known, but it was found that its incidence was related to the duration of dialysis prior to transplantation.
TL;DR: Initial evidence is offered that the percutaneous approach may be a safe and effective alternative to pericardial fenestration in most uremic patients with pericARDial effusion.
Abstract: Pericardial drainage via percutaneous catheter placement and local nonabsorbable steroid instillation was employed as definitive therapy for uremic patients who had intractable pericardial effusions. Twelve patients are reported. Prior daily dialysis, and in one case systemic steroids, were not curative. 11 of 12 cases suffered severe tamponade requiring pericardiocentesis. One patient had an organized pericardial effusion, making pericardiocentesis impossible. He required pericardiectomy with prolonged hospitalization (2 weeks) due to postoperative complications. There were no complications in the 11 patients where catheter drainage and local steroid instillation were employed. No patient had recurrence of his pericardial effusion (followed from 2 weeks to 32 months). Instillation of a relatively nonabsorbable steroid through an indwelling pericardial catheter provides immediate and lasting relief without either the inconvenience or postoperative complications and prolonged hospitalization associated with the surgical procedure of pericardial fenestration. This report offers initial evidence that the percutaneous approach may be a safe and effective alternative to pericardial fenestration in most uremic patients with pericardial effusion.
TL;DR: The growth potential of 27 boys with varying degrees of chronic renal insufficiency has been determined from their present height centile for both bone age and chronological age, finding that bone age continues to advance in the presence of severe osteodystrophy and growth arrest.
Abstract: The growth potential of 27 boys with varying degrees of chronic renal insufficiency has been determined from their present height centile for both bone age and chronological age. With increasing age their growth potential diminishes. The delay in bone age is greatest in those children whose disease dates from infancy, but does not correlate with their present state of renal function. Bone age continues to advance in the presence of severe osteodystrophy and growth arrest. Knowledge of the growth potential of children with chronic renal failure is of relevance in interpreting the height increments observed following renal transplantation. Serial determination of bone age is therefore an important aspect of their clinical management.
TL;DR: The data suggest that at comparable flow rates, RPD is relatively more efficient than IPD (p greater than 0.01).
Abstract: Sorbent regeneration of peritoneal dialysate and use of small volume of dialysate for intermittent peritoneal dialysis (IPD) has been shown to be feasible. The present study compares the solute cleara
TL;DR: Tertiary hyperparathyroidism would appear to be rare although hyperfunctioning parathyroid glands can be demonstrated long after kidney transplantation, even when renal function is close to normal.
Abstract: Parathormone levels were determined in 17 patients with functioning renal transplants. In 8 patients recently transplanted, very high serum levels of parathormone were found without obvious relation to the glomerular filtration rate. Hypophosphatemia was also present in these cases. In 9 other patients studied 2-7 years after transplantation the mean level of parathormone was lower than in the previous group but levels above normal were noted in half of the patients, some of which had perfect renal function and normal serum phosphorus. The response to induced hypercalcemia was used as a sensitive test to reveal abnormal responses even in cases which initially had normal peripheral levels of parathormone. From these results, tertiary hyperparathyroidism would appear to be rare although hyperfunctioning parathyroid glands can be demonstrated long after kidney transplantation, even when renal function is close to normal.
TL;DR: Excretion of urinary GBM antigens was within normal limits, in patients with steroid-sensitive nephrotic syndrome with minimal changes in renal histology and in the parents (heterozygotes) of CNF patients.
Abstract: Urinary and serum glomerular basement membrane (GBM) antigens were detected by immunodiffusion in patients with nephrotic syndrome and in healthy subjects. The excretion of urinary GBM antigens was gr
TL;DR: It was found that middle-sized molecules obtained from dialysate of uremic patients caused suppression of PHA-induced lymphocyte transformation and seem to be biologically active substances.
Abstract: It was found that middle-sized molecules obtained from dialysate of uremic patients caused suppression of PHA-induced lymphocyte transformation. This was expressed by the lowering of labeled leucine incorporation and by the suppression of lymphocyte transformation as morphologically assessed. In view of the presented data middle-sized molecules seem to be biologically active substances.
TL;DR: The entire family participates in the success of the home dialysis patient and isolation and study of discrete quantifiable aspects of behavior within the family may allow identification of patients with a greater risk of failure, thus making it possible to help such patients succeed.
Abstract: The entire family participates in the success of the home dialysis patient. Isolation and study of discrete quantifiable aspects of behavior within the family may allow identification of patients with a greater risk of failure, thus making it possible to help such patients succeed. A single such factor, ‘intrafamily identity’, measured in each of 40 diverse families before one family member began a home dialysis program, was found to correlate with success in the program 1 year later. This finding also may contribute to an understanding of systematic patterns of behavior within all families, with special emphasis upon the ability of family members to cope with continuing stress.
TL;DR: Findings suggested that this tumor was a hamartoma originated from the juxtaglomerular apparatus, which was the fourth case in the world diagnosed preoperatively.
Abstract: A case of juxtaglomerular cell tumor, the fourth case in the world diagnosed preoperatively, was reported. Neither strict sodium restriction nor loading of upright position increased a grade of hyperreninemia observed at recumbant position on ordinary diet, but Pald elevated in response to them. Abnormal glucose tolerance was considered to be due to hypopotassemia. Selective renal arteriography revealed a small number of tumor vessels, a lucent area on the nephrogram and early appearance of the renal vein of the diseased side. Histologically, the tumor contained some canalicular structures among the polygonal nonepithelial tumor cells with rhomboid bodies. These findings suggested that this tumor was a hamartoma originated from the juxtaglomerular apparatus.
TL;DR: The diagnosis of Alport’s syndrome is generally not considered in the absence of a positive family history, but family studies indicate that transmission occurs by a rare autosomal dominant gene.
Abstract: The diagnosis of Alport's syndrome is generally not considered in the absence of a positive family history. Family studies indicate that transmission occures by a rare autosomal dominant gene. The deviation of transmission ratios from the classical Mendelian pattern is best explained by abnormal segregation. Based on observed pedigree data, calculations were made of the expected equilibrium population frequency of Alport's syndrome assuming mutation rates of zero, 10, and 50 per million gametes. Zero mutation rate should result in disappearance of the Alport gene. An equilibrium frequency corresponding to that actually observed in Rhode Island implies a mutation rate of 10 per million gametes. Furthermore, up to 18% of all newborns with the Alport genotype may represent new mutants. Thus, isolated cases of Alport's syndrome may occur in the absence of other affected family members.