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  • Digitale Medien  (3)
  • Atrial natriuretic peptide  (1)
  • Extracorporeal plasma treatment  (1)
  • GFR  (1)
  • 1
    ISSN: 1432-1440
    Schlagwort(e): Atrial natriuretic peptide ; Cyclic GMP ; Hemodialysis ; Hemofiltration ; Ultrafiltration ; Atriales natriuretisches Peptid ; zyklisches GMP ; Hämodialyse ; Hämofiltration ; Ultrafiltration
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Bei 7 chronisch niereninsuffizienten Patienten, die regelmäßig hämofiltriert (HF) wurden, erfolgten während der Behandlung periodische Bestimmungen von ANP and c-GMP. Um den Einfluß des Blutreinigungsverfahrens auf die Veränderungen der Plasmakonzentrationen dieser Hormone zu untersuchen, wurde bei den Patienten eine Hämodialyse (HD) mit identischer Ultrafiltration und Behandlungsdauer durchgeführt. Bei beiden Behandlungsverfahren wurde ein gleichartiger kontinuierlicher Abfall von ANP und c-GMP beobachtet. Nach Kopf-Tieflagerung wegen Hypotonie unter HD stiegen die ANP und c-GMP Werte akut an. Bei einem anderen Patienten wurde gleichfalls ein akuter Anstieg während der HD beim Auftreten einer Tachyarrhythmia absoluta beobachtet. Diese Befunde zeigen, daß die Freisetzung von ANP bei chronischer Niereninsuffizienz nicht verändert ist. Da eine enge Beziehung zwischen Intravasalvolumen und der Höhe des Plasma ANP besteht, kann die regelmäßige Bestimmung dieses Hormons zur Beurteilung des Hydratationszustandes terminal niereninsuffizienter Patienten herangezogen werden.
    Notizen: Summary ANP and c-GMP concentrations in 7 patients with chronic renal failure (CRF) undergoing regular hemofiltration (HF) were determined. After switching to hemodialysis (HD) under identical ultrafiltration and treatment time no significant difference of the ANP and c-GMP profiles was detected, suggesting that the type of treatment does not affect ANP and c-GMP plasma levels. In both procedures a continuous decrease of ANP and c-GMP was observed. Head down tilting to compensate hypotension during HD was immediately followed by an increase in ANP and c-GMP during ultrafiltration. An acute onset of tachyarrhythmia absoluta during HD was also accompanied by a rise in ANP plasma concentrations. This demonstrates that ANP secretion is not altered in patients with CRF. Since ANP plasma levels closely correlate with intravascular volume, periodic determination of this hormone in HD/HF patients may provide diagnostic information to detect volume overload.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-1440
    Schlagwort(e): Hypercholesterolemia ; Low-density lipoproteins ; Heparin precipitation ; Extracorporeal plasma treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The first clinical application of a new extracorporeal procedure (HELP) for the selective elimination of low-density lipoproteins by heparin precipitation at acid pH is described. Plasma, obtained by filtration of whole blood through a 0.2 µ filter, is continuously mixed with an equal volume of an acetate buffer (pH 4.85) containing heparin. After removal of the precipitated heparin complex by filtration, excess heparin is adsorbed to a specially developed filter and the clear plasma filtrate is subject to bicarbonate dialysis/ultrafiltration to restore physiologic pH and remove excess fluid. The calculated efficiency for the elimination of low-density lipoproteins from plasma by HELP is 100% and is therefore comparable to conventional plasmapheresis. The HELP system shows a high degree of specificity with over 80% of total protein being returned to the patient. Over 130 treatment procedures have now been performed. Patient compliance and acceptance have been excellent and no major complications have been observed.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1432-1440
    Schlagwort(e): Renal functional reserve ; GFR ; Type I diabetes ; ACE inhibition
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Renal functional reserve capacity was evaluated in 19 normotensive type I diabetics without microalbuminuria. All patients had normal basal renal function as assessed by 24-hour creatinine clearances higher than 120 ml/min. PAH, inulin, and creatinine clearances were carried out every hour before, during, and after infusion of an amino acid (AA) solution. The same experiment was repeated after ACE inhibition with captopril (25 mg). Two groups of patients were found: Group A (responders) showed a significant rise in GFR after AA infusion (inulin clearances from 117±8 to 138±10 ml/min) (p〈0.05), whereas in Group B (non-responders) no significant change in GFR was observed. Groups were comparable in age, duration of diabetes, metabolic control, and mean arterial blood pressure. Group B, however, had a significantly higher basal inulin clearance (167±17 ml/min) than Group A (117±8 ml/min). In Group A ACE inhibition completely blocked the AA-induced rise in GFR, while basal GFR in Group B was significantly reduced (167±17 to 148±8 ml/min) after captopril administration. In both groups renal plasma flow was enhanced by ACE inhibition. A rise in glucagon was observed in all patients during AA infusion. It is concluded that type I diabetics with normal basal renal function already have reduced (Group A) renal functional reserve capacity, which is completely abolished (Group B) when concomitant hyperfiltration occurs. ACE inhibition reduces hyperfiltration and is capable of blocking the AA-induced rise in GFR in these patients.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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