ABSTRACT
1. In 70 patients with untreated essential hypertension, blood pressure variability was correlated to plasma catecholamines and to the response of blood pressure and peripheral flow to cold pressure and handgrip tests. 2. Supine blood pressure was recorded every 5 min, during 3 h. Variability was defined as the standard deviation of the mean of the readings in that period. 3. Blood pressure variability is positively and significantly correlated to the level of pressure and to age. 4. No significant correlation could be found with plasma catecholamines and sympathetic function tests. 5. It is concluded that blood pressure variability is related to the level of pressure but not to activity of the sympathetic nerves.
Subject(s)
Blood Pressure , Hypertension/physiopathology , Sympathetic Nervous System/physiopathology , Epinephrine/blood , Humans , Muscles/blood supply , Norepinephrine/blood , Regional Blood Flow , Skin/blood supplyABSTRACT
Serum protein binding of phenylbutazone has been measured in the rat, guinea pig, cat, rabbit and dog, and the influence on it of renal failure induced by uranyl nitrate injection has been studied. In all speciies a clearcut decrease in binding was observed after the occurrence of renal failure; the time course of the fall in binding correlated well with development of renal failure. In further experiments, serum protein binding of two acidic drugs (phenylbutazone, warfarin), two basic drugs (papaverine, quinidine) and one neutral drug (digitoxin) was studied in rabbits with experimental renal failure, and the results compared with those obtained in patients with acute renal failure. In the rabbits, a decrease in the binding of phenylbutazone, warfarin, papaverine and quinidine was found, whereas protein binding of digitoxin was unchanged. In man, there was a definite fall in protein binding of phenylbutazone and digitoxin, a small decrease for warfarin and papaverine, and a slight increase for quinidine.
Subject(s)
Acute Kidney Injury/physiopathology , Blood Proteins/metabolism , Pharmaceutical Preparations/blood , Acute Kidney Injury/blood , Acute Kidney Injury/chemically induced , Animals , Cats , Digitoxin/blood , Dogs , Female , Guinea Pigs , Humans , Male , Papaverine/blood , Phenylbutazone/blood , Protein Binding , Quinidine/blood , Rabbits , Rats , Species Specificity , Time Factors , Uranyl Nitrate/pharmacology , Urea/blood , Warfarin/bloodABSTRACT
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.
Subject(s)
Cadaver , Graft Rejection/drug therapy , Kidney Transplantation , Methylprednisolone/therapeutic use , Tissue Donors , Acute Disease , Humans , Methylprednisolone/administration & dosage , Methylprednisolone/adverse effects , Transplantation, Homologous/mortalityABSTRACT
Five patients with Salmonella typhimurium infection after a renal cadaveric graft are described. Salmonella were isolated from the urine of four patients, from the stool of one patient, from the blood of two patients, from the hip joint of one patient and from the cerebrospinal fluid of one patient. Infections were difficult to eradicate and necessitated prolonged antibiotic treatment. Renal function only deteriorated after the infection in some patients; salmonellosis could have triggered the rejection of the graft. Impaired cell-mediated immunity due to immunosuppressive drugs may be considered to be a predisposing factor for this kind of infection. Higher humoral antibody titers against Salmonella were found in the patients most clinically ill.
Subject(s)
Kidney Transplantation , Salmonella Infections/epidemiology , Salmonella typhimurium , Adolescent , Adult , Antibodies, Bacterial/analysis , Bacteriuria/diagnosis , Cadaver , Female , Graft Rejection , Humans , Immunity, Cellular , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Salmonella Infections/diagnosis , Salmonella Infections/immunology , Salmonella typhimurium/immunology , Salmonella typhimurium/isolation & purification , Transplantation, HomologousABSTRACT
Diazoxide was given orally to nine hypertensive patients with renal failure and its effect on blood pressure and on glucose metabolism was studied. There was no long-term antihypertensive effect. During treatment insulin release and glucose assimilation after an intravenous glucose load were frankly impaired, but this impairment was reversible after stopping the treatment. Two major complications (diabetic ketoacidosis and pancreatitis) were observed. In view of these observations, the authors are of the opinion that oral diazoxide is contraindicated in the treatment of hypertension in patients with renal failure.
