Treatment of immune nephropathies with high doses of immunoglobulins.

UNLABELLED: The present study presents the results from the application of high doses of gamma-globulin in the treatment of immune (idiopathic and satellite) glomerulopathies. MATERIALS AND METHODS: Twenty patients were treated. Of these 12 were with primary chronic glomerulonephritis, 7--with lupus nephritis and 1--with renal amyloidosis. All diagnoses were verified through a renal puncture biopsy. The following therapeutic scheme was used--85 mg/kg/body weight of gamma-globulin was applied intravenously three times a day every other day till reaching a total course dose of 250 mg/kg/body weight. All patients presented with nephrotic syndrome following conventional treatment with corticosteroids, anticoagulants and anti-aggregants. The blood cell count, the serum creatinine, creatinine clearance, 24 h diuresis and level of proteinuria were monitored. RESULTS AND DISCUSSION: 14 of the patients showed a complete clinical and laboratory remission. Four of them got an incomplete remission with a proteinuria of 2 g/24 h. No positive effect from the treatment was observed in 2 of the patients. All patients with lupus nephritis were influenced positively to a certain extent by the treatment applied. No serious side effects leading to therapy interruption were observed. CONCLUSIONS: 1. The treatment with high doses of immunoglobulin is a good alternative to the pulse immunosuppressive treatment of patients with idiopathic and lupus nephritides, manifested with a nephrotic syndrome and unaffected by a previous conventional immunosuppressive and anticoagulant therapy. 2. The results from the treatment with high doses of immunoglobulin are more pronounced in patients with lupus nephritides, which in turn raises the possibility for an earlier reduction of corticosteroid therapy and avoidance of its side effects. 3. Immunoglobulin therapy is an alternative in the management of nephrotic symptoms in cases with chronic renal failure where an immunosuppressive treatment is irrelevant.

Cyclic adenosine monophosphate (cAMP) levels in predialysis patients with chronic renal failure.

We studied the changes in the urinary cAMP level in fifty-five predialysis patients (30 men and 25 women) with chronic renal failure (CRF). The excretion of cAMP in 20 patients with first-degree CRF (serum creatinine levels below 356.6 mmol/I) and 15 patients with second or third degree CRF (serum creatinine below 800 mmol/I) was compared with that of 20 age-matched controls using the original I-125 RIA (radioimmunoassay) kit of Incstar Corporation, USA. The urinary cAMP was within normal limits in first-degree CRF patients (mean +/- Sx = 2,617 +/- 268.2 nmol/l) whose serum calcium level was slightly decreased. When calculated per 100 ml of glomerular filtration rate, their urinary cAMP level was significantly elevated--101.17 +/- 0.39--as compared with that of the controls--2.5 +/- 0.2. The urinary cAMP excretion was significantly higher in second and third degree CRF patients--mean 3,755 +/- 435.2 nmol/l, p < 0.05. This increase correlated with hypocalcemia whereas the serum alkaline phosphatase levels remained normal. 20% of the patients with second or third degree CRF had normal urinary cAMP excretion. In our opinion, urinary cAMP levels can reliably be employed as a sensitive and specific indicator of the onset of mild secondary hyperparathyroidism in predialysis patients with CRF.

[The characteristics of the spontaneous realization of sexual intercourse in economically employed women]. / Osobenosti v neposredstvenata realizatsiia na polovoto snoshenie pri ikonomicheski angazhirani zheni.

The basic parameters, connected with spontaneous realization of sexual intercourse in 411 women workers and employees, chosen at random, are studied. Various regularities are established: the lubrication is connected with difficulties in women with inflammatory changes in the internal sexual organs. The feeling of sexual excitation during sexual intercourse is stronger in women with larger number of sexual partners since the beginning of their sexual life. Disturbances in the occurrence of orgasm are more frequent in employees. Dyspareunia is connected mainly with organic changes in genitals, but it is determining factor for the success of sexual life. The frequency of the experienced pleasure is influenced by various social and biological factors comparatively slightly.