ABSTRACT
We studied 20 patients on long-term hemodialysis. Concentrations of neopterin and creatinine were quantified in serum and in exchange buffers before, during and after treatment sessions. Neopterin is a low molecular weight product released by human macrophages upon stimulation with interferon gamma. It permits the quantification of the level of cellular immune activation in vivo. Neopterin and neopterin/creatinine ratios were found to be significantly increased in all patients. When comparing 15 patients treated with acetate exchange fluid buffers versus 5 patients treated with hydrogencarbonate, neopterin levels did not differ. Statistical computations revealed that the length of time on dialysis contributed to the increase of neopterin concentrations. Higher grade of cellular immune activation was preferentially detectable in those patients who had been on dialysis for more than 1 year. The demonstrated state of enhanced immune activation in dialysis patients might also help to explain accelerated development of AIDS in dialysis patients when infected with HIV.
Subject(s)
Biopterins/analogs & derivatives , Renal Dialysis , Acetates , Acetic Acid , Bicarbonates , Biopterins/analysis , Biopterins/blood , Buffers , Creatine/analysis , Female , Hemodialysis Solutions/analysis , Humans , Interferon-gamma/blood , Male , Middle Aged , Neopterin , Sex Factors , Sodium , Sodium Bicarbonate , Time FactorsABSTRACT
In the framework of a multicentric retrospective study between selected clinics of the Republic Austria and the GDR anamnestic, clinical and paraclinical data were investigated in their valency for the early recognition of glomerulonephritis. Data of 583 patients were evaluated. Hereby it was shown that independent of the size of excretion and the reproducibility the findings "proteinuria" are of particular significance for the early recognition. The serological investigations usually performed within the diagnostic of glomerulonephritis proved as insignificant for the early recognition. Since the establishing of an exact diagnosis is up to now possible only with the help of invasive methods, a call on research is made to develop reliable, non-invasive diagnostic methods.
Subject(s)
Glomerulonephritis/diagnosis , Adult , Anti-Inflammatory Agents/adverse effects , Female , Glomerulonephritis/chemically induced , Glomerulonephritis/pathology , Humans , Kidney Failure, Chronic/diagnosis , Kidney Glomerulus/pathology , Male , Proteinuria/diagnosis , RiskABSTRACT
A 24-year-old man who had been a drug addict for years, was admitted to hospital having been unconscious for several hours after injecting an overdose of heroin. He was in acute renal failure with extensive swelling of soft tissues of the right upper leg and right buttock without external signs of injury. The swelling rapidly extended to both right limbs, trunk and external genitalia. The clinical suspicion of rhabdomyolysis was confirmed by a high level of serum myoglobin (1570 mg/ml), and in a gluteus maximus muscle biopsy. The acute renal failure caused by the rhabdomyolysis was reversible after a short period of haemodialysis and, after decompression fasciotomy of the affected muscles, there were no severe sequelae. In view of the good prognosis with early diagnosis an exact clinical examination (observation of soft tissue swelling and dark urine) is of great importance in case of heroin addiction and/or poisoning.
Subject(s)
Acute Kidney Injury/chemically induced , Heroin/poisoning , Myoglobinuria/chemically induced , Acute Kidney Injury/pathology , Adult , Edema/chemically induced , Edema/pathology , Heroin Dependence/complications , Heroin Dependence/pathology , Humans , Male , Myoglobin/blood , Myoglobinuria/pathologyABSTRACT
Computertomography of the kidney is, in combination with the conventional non-invasive methods, a highly exact diagnostic process. It is very important especially in cases of tumours, bleeding, retention of urine in the kidneys and unilaterally quiescent kidneys. The use of boluscomputertomography and series--computertomography not only increases the exactness of diagnosis but should also yield information on functional dynamics.
Subject(s)
Kidney Diseases/diagnostic imaging , Tomography, X-Ray Computed , Contrast Media , Humans , Kidney Neoplasms/diagnostic imaging , Renal CirculationABSTRACT
Kidney biopsy was performed on 20 patients under computertomographic control. In all cases sufficient kidney tissue could be removed. All patients were checked for subcapsular or perirenal bleeding immediately after punction and 24 and 48 hours later. In only 7 patients was no bleeding found. In the other patients bleeding varied between 2 and 64 ml immediately after punction and between 1 and 41 ml after 48 hours.
Subject(s)
Biopsy, Needle , Hemorrhage/diagnostic imaging , Kidney Diseases/diagnostic imaging , Tomography, X-Ray Computed , Biopsy, Needle/adverse effects , Female , Hemorrhage/etiology , Hemorrhage/prevention & control , Humans , Kidney Diseases/etiology , MaleABSTRACT
Glomerular filtration rate (GRF) as measured by inulin clearance and renal plasma flow (RPF) as measured by PAH clearance were determined in 9 mountaineers before and during suspension. The two step permanent infusion technique was employed for 3 periods of 8 min. GRF decreased from 123.0 +/- 14.9 ml/min to 25.3 +/- 3.9 ml/min and RPF from 791.0 +/- 101.0 ml/min to 129.0 +/- 20.4 ml/min within 24 min. These results are consistent with the occurrence of acute renal failure in mountain climbers after free suspension on the rope even after long periods.
