[Immunsuppression by vitamin B6-antagonists. Prolonged survival of inbred rats with renal transplants (author's transl)]. / Immunsuppression durch Vitamin B6-Antagonisten. Verlängerte Uberlebenszeit von Inzuchtratten mit Nierentransplantaten.

The combined effect of Vitamin B6 free diet and 4-Desoxipyridoxin (a potent Vitamin B6-Antagonist) on the rejection reaction of inbred rats after renal transplantation was investigated. More than 90% of the control animals without Vitamin B6-deficiency died between 7 and 13 days with uremia due to an acute transplant rejection, where as the Vitamin deficient and successfully transplanted animals (n=38) showed a significantly prolonged survival time. In 17/38 rats survival was longer than 35 days. Vitamin B6-deficiency, induced by Desoxipyridoxin and Vitamin B6-deficient diet offers the possibility of an effective and reversible immunosuppression in renal transplantation.

[Efficacy, tolerance, and pharmacokinetics of sisomicin in urinary tract infections (author's transl)]. / Zur Wirksamkeit, Verträglichkeit und Pharmakokinetik von Sisomicin bei Nieren- und Harnwegsinfektionen.

Since 1973 30 patients with urinary tract infections (UTI) or pyelonephritis have been treated with sisomicin, a new aminoglycoside, in a daily dose of 2 mg/kg for a period of seven to nine days. From a clinical point of view the result of treatment was good. Complete resolution was achieved in 17 patients, improvement in nine, and there was no effect in four patients. Thirty-five causative organisms (Escherichia coli = 23, Proteus sp. = 7, Klebsiella sp. = 3, Pseudomonas aeruginosa = 1, Citrobacter = 1) were isolated before treatment. Thirty of the organisms were eliminated during treatment, but seven reappeared during the follow-up period; five strains persisted. Side effects observed consisted of reversible increase of serum creatinine in four patients, excretion of granular casts in 14 patients, and a transient rise of alkaline phosphatase, SGOT and/or SGPT in five patients. No signs of ototoxicity or any other adverse reactions were found and local tolerance was good. In 20 patients blood samples for assay were obtained daily one hour after i. m. injection of 1.0 mg/kg. No evidence of drug accumulation in the serum was found: the mean serum concentrations one hour after injection remained between 3.4 and 3,9 microgram/ml during the entire treatment period. Sisomicin is a highly effective antibiotic for the treatment of UTI caused by gramnegative pathogens. On account of its potential toxicity however, it should be used, like other aminoglycosides, only in selected cases.

[Immunsuppression under vitamin B6 deficiency (author's transl)]. / Immunsuppression durch Vitamin-B6-Mangel. Eine experimentelle Studie mit Hauttransplantaten an Inzuchtmäusen

The influence of a Vitamin B6 free diet and the effect of Desoxipyridoxin (a potent Vitamin B6 Antagonist) on the immunesystem of mice was investigated in several experimental setups. Rejection times of skintransplants from inbred strains (129 J) on C57bl/6J mice served as a model for immunosuppression. Rejection times under alimentary Vitamin B6 deficiency did not exceed those under hypocaloric nutrition associated with comparable weight loss. Immunosuppression with the Vitamin B6 antagonist Desoxipyridoxin was much more pronounced. The effect was related to the duration of treatment. Desoxipyridoxin offers the possibility of effective immunsuppression, which is readily reversible.

Immune system to uremia.

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.

[Hemostaseopathies in chronic, azotemic renal insufficiency. Pathogenesis, diagnosis, treatment (author's transl)]. / Hämostaseopathien bei chronischer, azotämischer Niereninsuffizienz. Pathogenese--Diagnostik--Therapie

A brief survey on the current concepts of diagnosis and pathogenesis of platelet dysfunction in chronic renal insufficiency is given on the basis of clinical hemostaseological investigations. Phenolic compounds, guanidine succinate and fibrin decomposition products are prominent in the discussion of uremia toxins possibly involved in disorders of thrombocytic function. Clinically practicable methods of analysis are briefly presented and the still imperfect status of therapy is emphasized.

[Immune mechanisms in uremia]. / Immunmechanismen bei Urämie

There is both clinical and experimental evidence that cellular and humoral immunity are suppressed in patients with renal insufficiency: observations in organ transplantation and in vitro stimulation of lymphocytes from uraemic patients, investigations of acute and late hypersensitivity reactions, the immune response after active immunization as well as changes of immunoglobulins and lymphatic organs in uraemia are discussed in the paper. The underlying mechanisms are complex and not yet fully understood. Lymphopenia, atrophy of the thymus gland, toxic serum factors, induction of enhancing mechanisms by certain serum fractions and metabolic defects of lymphocytes--all were shown to be involved or at least considered to be. At present, however, it is impossible to define their rank of importance and the exact place they may occupy in the genesis of this type of "natural immunosuppression".

[Medical problems of longterm dialysis (author's transl)]. / Medizinische Probleme bei Langzeitdialyse

The number of patients who can be kept alive with the aid of chronic intermittent dialysis increases each year all over Europe. Since the percentage of patients who have dialysis at home is increasing, the general practitioner also contact with the medical complications of these patients. The most common of these problems: hepatitis, anemia, neurological disturbances, secondary hyperparathyroidism and cardiac and vascular changes with the usual therapeutic measures are discussed.

[Pancreatic secretion of patients with chronic renal insufficiency (author's transl)]. / Exokrine Pankreasfunktion bei chronischer Niereninsuffizienz

Pancreatic function tests were performed in 15 patients with advanced renal insufficiency. Pancreatic secretion was stimulated with CCK/PZ and secretin and 60 minutes later with bile given intraduodenally and CCK/PZ and secretin intravenously. The Wilcoxon-test showed that there were significantly higher lipase levels in serum and lower amylase amounts in duodenal juice compared to normal volunteers. No differences could be demonstratd for volume, maximal bicarbonate concentration, lipase and trypsin outputs. It could be shown by nonlinear discriminant analysis that pancreatic secretion might specifically be changed in patients with chronic renal failure. These patients can be definitely differentiated according to the secretion pattern from normal controls and patients with chronic pancreatitis, pancreatic carcinoma, chronic and acute duodenal ulcer.