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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 1115-1125 
    ISSN: 1432-1440
    Keywords: Long-term management ; Inherited renal tubular disorders ; Fanconi syndrome ; Pharmacotherapy ; Langzeitbetreuung ; Tubulopathien ; Fanconi-Syndrom ; Pharmakotherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Hereditäre Tubulopathien mit isolierten tubulären Funktionsstörungen erfordern oft keine oder nur eine einfache, aber wirksame ärztliche Behandlung. Bei einigen angeborenen Stoffwechselerkrankungen mit komplexen tubulären Störungen gibt es eine spezifische Form der Behandlung, wie z.B. die galaktosefreie Diät bei der Galaktosämie oder die Entleerung der Kupferspeicher bei der Wilson'schen Erkrankung. Bei Patienten mit idiopathischem Fanconi-Syndrom, Zystinose, oculo-cerebro-renalem Syndrom oder Glykogenose Fanconi-Bickel hat die symptomatische Substitutionsbehandlung mit Flüssigkeit, Elektrolyten und Wasser die Lebenserwartung in den letzten 20 Jahren deutlich erhöht. Die Substitutionsbehandlung scheint jedoch keinen Einfluß auf die Entwicklung einer chronischen Niereninsuffizienz zu haben. Die Langzeitbetreuung von Patienten mit angeborenen Tubulopathien sollte sowohl die Behandlung der Tubulopathie, der chronischen Niereninsuffizienz und der mitbetroffenen Organe als auch die genetische Beratung und Hilfestellungen bei der sozialen Eingliederung beinhalten.
    Notes: Summary In inherited renal tubular disorders with isolated defects of tubular transport medical treatment is usually either not indicated or is simple and effective. In some inherited metabolic disorders with complex defects of renal tubular transport a specific therapy is known. For example, in galactosemia and hereditary fructose intolerance crude products may be restricted or in cases of Wilson's disease copper stores may be reduced. In idiopathic Fanconi syndrome, cystinosis, oculocerebrorenal syndrome and glycogenosis Fanconi-Bickel, a symptomatic replacement treatment based on supplementation of water, electrolytes and vitamin D has improved the non-uremic survival of these patients considerably within the last 20 years. For long-term management of inherited renal tubular disorders, treatment of tubular dysfunction, chronic renal failure, and involved extrarenal organs must be supported by genetic counseling and assistance for social integration.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 54 (1976), S. 405-413 
    ISSN: 1432-1440
    Keywords: Uremia ; slipped epiphysis ; renal osteodystrophy ; vitamin D ; parathyreoidectomy ; growth ; Urämie ; Epiphysenlösung ; renale Osteodystrophie ; Vitamin D ; Parathyreoidektomie ; Wachstum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die urämische Epiphyseolyse unterscheidet sich grundlegend von der juvenilen Epiphyseolyse. Anhand eigener Erfahrungen bei der Behandlung von 8 Kindern mit urämischer Epiphysenlösung wurden Indikation und Durchführung der konservativen sowie der chirurgischen aktiven Behandlung besprochen. Eine Stabilisierung der abgerutschten Epiphysen wurde ohne chirurgische Maßnahmen und meist ohne Parathyreoidektomie allein durch Vitamin D3-Therapie innerhalb weniger Wochen erreicht. Die Initialdosis betrug 10 000–30 000 E Vitamin D3/die, die kurative Gesamtdosis 1,8–5,6 Mill. E Vitamin D3. Längerdauernde Immobilisation durch Bettruhe war unnötig. Auf den Wert der Urin-Calciumausscheidung zur Früherkennung der Vitamin D-Intoxikation auch bei fortgeschrittener Niereninsuffizienz wurde hingewiesen. Stärkste metaphysäre Verbiegungen an distalem Femur und distaler Tibia machten bei einem Patienten eine operative Korrektur notwendig, um die Gehfähigkeit des Kindes sicherzustellen. — Als allgemeine Behandlungs-richtlinie ist anzustreben, zunächst die metabolische Skeleterkrankung durch Vitamin D-Therapie mit oder ohne Parathyreoidektomie zu beseitigen. Erst anschließend sollen notwendige Osteotomien zur Beseitigung metaphysärer Deformierungen oder einer Coxa vara epiphysarea durchgeführt werden.
    Notes: Summary Epiphyseal slipping in uraemia differs strikingly from juvenile epiphyseal slipping with respect to pathology and therapy. Based on our own experience with the treatment of 8 uraemic children with epiphyseal slipping, an effort was made to establish the respective indications for conservative and surgical treatment. Mechanical stabilization of slipped epiphyses was achieved within a few weeks without any surgery and usually without parathyreoidectomy by vitamin D3 alone. The initial dose was 10,000 to 30,000 I.U./day, the total curative dose 1.8 to 5.6 millions I.U. Prolonged immobilization was unnecessary. Rising urinary calcium excretion was a valuable indicator of vitamin D intoxication even in advanced renal failure. In one case, pronounced metaphyseal deformations (distal femur, distal tibia) required surgical correction before the ability to walk normally was restored. — The following therapeutical approach is recommended: metabolic bone disease must be cured by vitamin D therapy with or without parathyreoidectomy. Osteotomy to correct metaphyseal deformities or coxa vara epiphysaria never should be performed before metabolic bone disease is healed.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 52 (1974), S. 143-144 
    ISSN: 1432-1440
    Keywords: α-ketoglutarate ; kidney ; metabolism ; renal failure ; α-Ketoglutarat ; Nierenstoffwechsel ; Niereninsuffizienz
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Nach einer einmaligen intravenösen Injektion von α-Ketoglutarat während 15 min fällt bei Patienten mit chronischer Niereninsuffizienz der venöse Blutspiegel von α-Ketoglutarat wesentlich langsamer ab als bei Nierengesunden. Die Single Injection-Clearance von α-Ketoglutarat beträgt bei chronischer Niereninsuffizienz vor und unter Dialysebehandlung etwa 1/4 derjenigen von Nierengesunden. Dieser Unterschied ist wahrscheinlich Folge eines stark verminderten renalen α-Ketoglutaratverbrauchs bei chronischer Niereninsuffizienz.
    Notes: Summary In chronic renal failure the decrease of the peripheral blood concentration of α-oxoglutarate after intravenous injection of this substrate is delayed compared to that in normal subjects. The values of the single injection clearance of α-oxoglutarate in patients with chronic renal failure before and under intermittent dialysis are about a fourth of those observed in controls. This difference probably is due to an impaired renal metabolism of α-oxoglutarate in uraemia.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Hemodialysis ; Kidney transplantation ; Psychic reactions ; Psychosocial rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 6 Kinder und Adoleszenten unter intermittierender Hämodialyse und ein transplantiertes Kind wurden im Abstand von 8–20 Monaten zweimal psychologisch-psychiatrisch untersucht. Ihre Stimmung, Reaktivität, Körperschema, Reaktionsbildung sowie Anpassung an die eingreifenden Behandlungsmethoden werden dargestellt. Der Adaptationsprozeß wird günstig beeinflußt durch eine komplikationsarme Behandlung, Vertrauen zum behandelnden Team und eine realistische, angstarme Einstellung der Eltern gegenüber der Krankheit und Behandlung ihres Kindes. Die Rehabilitation im psychosozialen Bereich hängt weitgehend von der Ausprägung dieser Faktoren ab.
    Notes: Abstract Six children and adolescents on intermittent dialysis and one child transplant recipient were subjected to both psychiatric and psychological examinations twice over 8 to 20 months. Mood, reactivity, body image, reaction formation and adjustment to the radical method of treatment are presented. The process of adaptation seems to be positively influenced by a treatment with few complications and also by confidence in the therapeutic team and a realistic attitude with a minimum of anxiety on the part of the parents towards the illness and treatment of their child. Rehabilitation in the psychosocial sphere depends largely on the successful achievement of these goals.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 150 (1991), S. 808-812 
    ISSN: 1432-1076
    Keywords: Chronic renal failure ; Dialysis ; Transplantation ; Lung volumes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lung volumes were measured in 45 children with chronic renal failure and compared to 10 healthy controls. Six patients were receiving conservative treatment (CT), 11 were undergoing regular haemodialysis (HD), 8 were on continuous ambulatory peritoneal dialysis (CAPD) and 20 were post transplantation (TP). We measured vital capacity (VC) and forced expiratory volume in 1 s (FEV-1) with a bell spirometer. In addition residual volume (RV) was determined in CAPD patients. VC and FEV-1 values below the lower limit of predicted normal values from healthy children with the same body height were found in 38% and 52% of all patients respectively (P〈0.05). Median values of VC and FEV-1 were lowest in CT and highest in TP patients. Median FEV-1 was significantly reduced to 79% of predicted values in CT and to 82% in HD patients (P〈0.05). No correlation was found between FEV-1 and haemoglobin levels or the concomitant use of beta-blocking agents. During a HD session mean FEV-1 increased significantly. In CAPD patients the routine filling of the abdomen was followed by an 11% decrease of RV (non significant) while the other parameters remained stable. It is concluded that lung volumes are frequently reduced in chronic renal failure but remain essentially stable during the dialysis procedures.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 120 (1975), S. 111-120 
    ISSN: 1432-1076
    Keywords: Infantile nephrotic syndrome ; Mesangial sclerosis ; Immunohistology ; Pathogenesis of nephrotic syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei einem Säugling, der im Alter von 10 Monaten an einem steroid-resistenten nephrotischen Syndrom erkrankte, wurde bei der Nierenbiopsie eine diffuse mesangiale Sklerose der Glomeruli festgestellt. Nach dem Tod an interstitieller Pneumonie 3 Monate nach Krankheitsbeginn wurde der Nierenbefund bestätigt. Der Prozeß betraf sämtliche Glomeruli, war aber segmental verschieden stark ausgeprägt. Immunhistologisch wurden granuläre Ablagerungen von IgM und Komplement (C3) im Mesangium und subendothelial an der Basalmembran beobachtet. Die Befunde sprechen dafür, daß bei der Pathogenese der diffusen mesangialen Sklerose möglicherweise die Bildung und glomeruläre Ablagerung von Immunkomplexen eine Rolle spielen.
    Notes: Abstract A 10-month-old infant developed a steroid resistant nephrotic syndrome. The renal biopsy revealed diffuse mesangial sclerosis of the glomerula. The child died from interstitial pneumonia 3 months after onset of the renal symptoms. Post mortem, the glomerular changes were diffuse but prominent in certain segments of the glomeruli. The immunohistological examination showed granular deposits of IgM and C3 in the mesangium and in the subendothelial region of the basement membrane. These findings are compatible with the hypo. thesis that diffuse mesangial sclerosis is caused by glomerular deposition of immune complexes.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 134 (1980), S. 13-22 
    ISSN: 1432-1076
    Keywords: IgA-Glomerulonephritis ; Haematuria ; Proteinuria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nineteen out of 83 children with asymptomatic haematuria were classified as having IgA glomerulonephritis, characterized by diffuse mesangial deposition of IgA in the absence of systematic disease. Different histological patterns were observed: i.e., minor glomerular lesions (5 cases), focal and segmental proliferative glomerulonephritis (8 cases) and diffuse proliferative glomerulonephritis (6 cases). Recurrent gross haematuria is the clinical hallmark of the disease. Proteinuria was present in 14 children and exceeded 1 g/m2/day in 3 patients. Clinico-pathological correlations showed a close relation between the degree of proteinuria and the histological lesions. Serum IgA levels were elevated in 3 children. Glomerular filtration rate remained above 80 ml/min/1.73 m2 in a 1 to 9 year follow-up.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 147 (1988), S. 233-238 
    ISSN: 1432-1076
    Keywords: Nephrotic syndrome ; Lipoproteins ; Apolipo-proteins ; Atherosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated lipoprotein profiles in 24 children with normal renal function at different stages of the idiopathic nephrotic syndrome (NS). Four groups of patients were studied: (I) steriod-resistant NS with persistent proteinuria; (II) untreated steroid-sensitive NS during a relapse; (III) steroid-sensitive NS in remission induced by steroid-treatment; (IV) steroid-sensitive NS in long-term remission with-out therapy. Triglycerides (TG), cholesterol (CHOL), and phospholipids (PLP) were measured in plasma as well as in the lipoprotein fractions of very low (VLDL), intermediate (IDL), low (LDL) and high density (HDL). Apoproteins (Apo) AI, AII, B and C-apoproteins were measured in patients of groups I and IV. Results were compared to those obtained in 24 healthy control subjects. All patients with active NS (groups I–III) had significantly elevated CHOL levels. TG and CHOL in the VLDL, IDL, LDL, and CHOL in HDL2, but not HDL3 were inversely correlated with the serum albumin level. Patients with active NS had increased concentrations of TG and CHOL in lipoprotein fractions of lower density. Total and fractionated HDL-CHOL was not significantly different from control levels in any group. Patients in group I had significantly reduced Apo AI levels, whereas an increase of Apo AI and Apo AII in HDL3 and of most C-apoproteins in both HDL fractions was observed in patients of group IV. While changes in HDL apoprotein composition during longterm remission are of yet unknown clinical significance, our data indicate an increased risk of atherosclerosis only in those paediatric patients with persistent steroid-resistant NS.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1076
    Keywords: Hyperoxaluria type I ; Liver transplantation ; Kidney transplantation ; Oxalate pool ; Paediatric patient
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 4.5-year-old boy received a combined liver and kidney transplant for correction of hyperoxaluria type 1. Both organs were from the same donor and functioned primarily. Three months after transplantation, urine oxalate excretion reached a maximum of 10500 μmol/24 h and remained above 2300 μmol/24 h for the next 2 months. Two months later, oxalate excretion decreased to about 565 μmol/24 h, indicating exhaustion of a large oxalate pool. Six months after transplantation plasma oxalate is near normal (4.9 μmol/l). With the exception of one episode of acute rejection of the renal transplant, both organs were tolerated well and continue to have a unimpaired function 9 months after transplantation. However, there is increased echogenity on renal ultrasound, indicating oxalate deposits in the grafted kidney. This case illustrates that successful combined transplantation of both liver and kidney can be performed in infants, resulting in cure of the metabolic defect. The prolonged or acute excretion of oxalate may lead to oxalate deposition in the grafted kidney without impaired graft function or early graft loss.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 138 (1982), S. 354-357 
    ISSN: 1432-1076
    Keywords: Adolescent cystinosis ; Renal function ; Renal morphology ; Renal transport of amino acids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Morphological and functional investigations of the kidney were performed in an adolescent with cystinosis. The late onset and the gradual development of moderate complex tubular dysfunction was documented. Whereas in patients with infantile cystinosis tubulo-intersitial lesions and tubular dysfunction are pronounced, this patient with adolescent cystinosis show a predominance of glomerular lesions and glomerular dysfunction.
    Type of Medium: Electronic Resource
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