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  • 1
    ISSN: 1420-9071
    Keywords: Acute ischemic renal failure ; angiotensin converting enzyme inhibition ; enalapril ; tubulo-glomerular feedback/proximal tubular pressure ; renal histology ; medullary capillary congestion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary The influence of the renin-angiotensin system on renal hemodynamics, tubular pressure and tubulo-glomerular feedback was investigated with the angiotensin converting enzyme inhibitor MK 421 (enalapril), in uninephrectomized rats with and without ischemia-induced acute renal failure. In animals with normal renal function proximal tubular pressure and tubulo-glomerular feedback response were lowered by enalapril long-term treatment, whereas glomerular filtration rate and renal blood flow were not influenced by the drug. After 45 and 70 minutes ischemia there was no difference between treated and untreated animals in the severely impaired glomerular filtration rate. Renal blood flow remained unaffected by the treatment. The histological damage due to ischemia (tubular casts, tubular necrosis and medullary capillary congestion) was not influenced by enalapril. As tubulo-glomerular feedback had been significantly inhibited during renin-angiotensin inhibition, its importance in mediating acute renal failure remains doubtful; other factors such as tubular obstruction and medullary congestion may be crucial.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2277
    Keywords: Cyclosporin A, alkaline phosphatase ; Alkaline phosphatase, CyA ; Kidney transplantation, CyA ; Osteodystrophy, kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1981 cyclosporin A (CyA) became available and replaced azathioprine (Aza) as the immunosuppressive agent in kidney transplantation at the University Hospitals in Basel, Switzerland. Patients on CyA and prednisone (CyA/p) therapy frequently demonstrated an isolated rise in bone-derived serum alkaline phosphatase (aP) concentration, but patients on Aza and prednisone (Aza/p) therapy did not. On the basis of long-term aP concentration and using noninvasive means, the present retrospective study was designed to investigate biochemical markers and radiographic signs of bone disease after successful kidney transplantation in patients on Cya/p treatment. Similar investigations were performed in patients on Aza/p and the results were compared. Follow-up examinations included clinical examination, radiography of the hand, and biochemical analysis of serum and urine. In 139 renal transplant patients on CyA/p, aP increased transiently after successful grafting (at transplantation 84±43 U/l; on day 90, 112±82 U/l). In 50 patients aP levels were higher at the time of transplantation (120±80 U/l) and aP peaked after 8±6 months, at a mean concentration of 242±103 U/l. In these patients aP concentrations exceeded the normal range for 16±10 months. None of the patients on CyA/p showed symptoms of bone disease when aP was increased. Radiological surveys revealed more pronouced osteodystrophy in patients at the time of transplantation, which increased aP to above the normal range after transplantation. Despite this rise in aP, over the long term bone lesions improved radiographically while bone mass remained stable. In constrast, patients treated with Aza/p demonstrated a significant decrease in aP level after transplantation from 75±33 U/l to 54±29 U/l on day 90. In addition, radiographic bone changes persisted and bone mass decreased significantly. After a 2-year follow-up, serum parathyroid hormone, 1,25-(OH)2-vitamin D3, calcium, and phosphorus concentrations, urinary excretion of hydroxyproline, and tubular reabsorption of phosphate did not differ between patients on CyA/p and controls on Aza/p. We conclude that after successful kidney transplantation and initiation of CyA/p therapy, a transient increase in bone-derived aP frequently occurred. These patients more often demonstrated radiographic signs of pre-existing osteodystrophy. However, over the long term, these changes improved.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-198X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-198X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Clinical and experimental medicine 143 (1967), S. 358-361 
    ISSN: 1591-9528
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The results of chronic intermittent peritoneal dialysis in 13 patients being prepared for transplantation with cadaver donor kidney are discussed. By contrast with other reported results, intermittent peritoneal dialysis 2 to 3 times weekly for 8 to 12 hours enabled hospitalised oliguric or anephric patients to be maintained in a satisfactory condition for as long as required, viz. a few weeks to a few months. Although the dialysis cannula was left within the peritoneal cavity peritonitis developed in only one case, and was controlled without difficulty. No major complications were encountered.
    Notes: Zusammenfassung An Hand von 12 Patienten wird über die Resultate der chronischen intermittierenden Peritonealdialyse bei in situ belassenem Dialysekatheter als Vorbereitung für die Transplantation von Leichennieren berichtet. Im Gegensatz zu Berichten anderer Autoren hat sich die Peritonealdialyse für die überbrückung des Endstadiums des chronischen Nierenversagens bzw. des renopriven Zustandes bewährt. Die Patienten konnten unter Spitalverhältnissen in ordentlichem Allgemeinzustand gehalten werden. Schwere Komplikationen in direktem Zusammenhang mit der Dialyse wurden nicht beobachtet. Nur ein Patient entwickelte eine leichte Peritonitis.
    Type of Medium: Electronic Resource
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