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  • 1
    ISSN: 1432-2277
    Keywords: Conversion from steroids to azathioprine, in kidney transplantation ; Azathioprine conversion after steroids, in kidney transplantation ; Acute rejection after conversion, in kidney transplantation ; Cyclosporin and conversion, in kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In renal graft recipients primarily treated with cyclosporin and low-dose methylprednisolone, withdrawal of the long-term steroid medication increases the likelihood of developing rejection episodes. In order to determine the predictive value of clinical parameters and routine prewithdrawal graft biopsies for the risk of rejection, the authors studied 141 kidney recipients from whom steroids were with-drawn 7–9 months after transplantation in a clinically stable situation. Both the quality of the HLA-match and the results of prospective graft biopsies were found to correlate significantly to the occurrence of acute rejection. In order to investigate the influence of additional azathioprine medication on the incidence of acute rejections in recipients not receiving steroids, immunosuppression was continued with cyclosporin monotherapy in 88 patients and with cyclosporin plus azathioprine in 53 patients. The risk of developing rejection episodes was significantly reduced from 48% after 1 year on monotherapy to 28% after the addition of azathioprine medication.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 6 (1993), S. 290-292 
    ISSN: 1432-2277
    Keywords: Steroid withdrawal, kidney transplantation ; Kidney transplantation, steroid withdrawal ; Conversion, steroid to azathioprine, kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The long-term graft function after withdrawal of steroids from maintenance immunosuppression was analyzed in 98 kidney recipients (59 on cyclosporin monotherapy, 39 on cycloporin plus azathioprine) who had not developed an early rejection episode when prednisolone was discontinued. Seven years after steroid withdrawal the probability of an increase in serum creatinine (〉20% of baseline levels) was 51%. The increase in creatinine was associated with sclerosing arteriopathy as a marker of chronic rejection in 29 of 43 graft biopsies. The addition of azathioprine had no, effect on the stability of long-term graft function and did not influence the 7-year graft survival rate in this highly selected group of patients.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 237-247 
    ISSN: 1432-1440
    Keywords: Child ; Renal osteodystrophy ; Vitamin D ; Kind ; renale Osteodystrophie ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine Therapiestudie mit Vitamin D3 in pharmakologischen Dosen bei 27 Kindern in der progredienten Niereninsuffizienz bzw. unter intermittierender Dauerdialysebehandlung über 24 Monate zeigte, daß weder die Vitamin-D3-Behandlung unterstützt durch orale Calciumsupplementation alleine noch in Kombination mit Dialysebehandlung eine renale Osteodystrophie heilen oder verhindern kann. Es gelang zwar in 34,0% der Fälle mit progredienter Niereninsuffizienz und 50% der Fälle unter Hämodialysebehandlung den sekundären Hyperparathyreoidismus für einige Zeit zu suppremieren, eine Suppression auf Dauer konnte allerdings nicht erreicht werden. Das Ausmaß der Mineralisationsstörung und der Wachstumsverzögerung blieb unverändert, die Osteoblastenzahl erlitt mit Suppression des sekundären Hyperparathyreoidismus eine Reduktion, die eine Verminderung des Knochenanbaues und der Knochenmasse unter Dauertherapie mit Vitamin-D3 in pharmakologischen Dosen befürchten läßt. Hypercalcämien und extraossäre Verkalkungen wurden nicht beobachtet.
    Notes: Summary Growth arrest and renal osteodystrophy is a major problem in renal insufficiency of children. The present report describes our experiences in managing renal osteodystrophy by using vitamin D3 for 24 months. Values in plasma of Ca, Mg, alkaline phosphatase, iPTH, 25-OH-D were determined regularly. Skeletal X-rays and analysis of iliac crest bone biopsies were obtained in each child. In treatment with vitamin D3 no hypercalcemia was seen despite high serum levels of 25-OH-D. Plasma-Ca, alkaline phosphatase, and iPTH normalized nearly. Radiographic abnormalities improved. Bone biopsies showed improvement in signs of secondary hyperparathyroidism and ostitis fibrosa, whereas osteomalacia remained unchanged. Osteoblast population showed a small reduction. No real increment in body growth was seen.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 290 (1975), S. 29-33 
    ISSN: 1432-1912
    Keywords: Solanum Malacoxylon ; Line Test ; Vitamin D ; Rickets
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The plant Solanum malacoxylon (S.M.) is known to cause severe soft tissue calcifications in cattle and sheep and has recently become of special, interest since it exerts biological actions which resemble those of vitamin D. In order to investigate whether S.M. is capable to improve the rachitic bone changes in vitamin d and phosphate deficient rats, a watery extract of 50, 100 and 200 mg S.M. was fed daily to these animals over a period of 10 days. The width of epiphyseal plates was compared after that time with those of rats treated with 0, 0.225, 0.45 and 0.9 IU of vitamin D3 daily. There was a dose related curative effect of S.M. on the epiphyseal lesions very similar to that of vitamin D3. The hypercalcemic and hyperphosphatemic effect of S.M. was identical to that of vitamin D3. The 25-hydroxy-vitamin D serum levels remained almost undetectable, in the S.M. treated rats as well as in the vitamin D3 treated animals.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 297 (1977), S. 75-80 
    ISSN: 1432-1912
    Keywords: Vitamin D resistancy ; 5,6-trans-25-hydroxycholecalciferol ; Renal osteodystrophy ; Hypoparathyroidism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relative vitamin D resistance in patients with chronic renal failure and in those with hypoparathyroidism is due to an impairment of 1-hydroxylation of cholecalciferol. 5,6-trans-25OHCC, which has a similar steric configuration as 1,25(OH)2CC was examined at a daily dose of 18,000 IU for 14 days in both diseases. Intestinal 47calcium absorption as well as serum calcium level could be normalized in most patients with hypoparathyroidism. The improvement was less in patients with chronic renal failure, suggesting an additional depressing influence of uremia on calcium metabolism.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1440
    Keywords: Cyclosporin ; Drug monitoring ; Immunoassay ; High-performance liquid chromatography ; Renal transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cyclosporin blood trough levels were measured with four different immunoassays and high-performance liquid chromatography in 12 patients receiving low-dose steroids and CsA after kidney transplantation. These patients represent a selection with an uncomplicated posttransplant course and received no drugs with a known influence on CsA pharmacokinetics. The use of specific antibodies against the parent drug yielded levels comparable to those detected by HPLC. CsA levels measured with nonspecific antibodies exceeded those measured with specific ones by a factor of two to three. All immunoassay-detected CsA levels correlated significantly with the HPLC-determined CsA levels. In addition, blood levels of the CsA metabolites 1, 17, 18, and 21 were determined by HPLC. In one additional patient, who was under tuberculostatic treatment and had a transitory deterioration of liver function, levels of nonspecificantibody-determined CsA rose, as confirmed by rising levels of metabolite 17, while those of the parent drug fell. We conclude that routine drug monitoring should include at least one immunoassay with a specific antibody detecting the unchanged CsA, and a supplementary immunoassay with a nonspecific antibody detecting a composition of cross-reacting metabolites plus the unchanged substance. If available, HPLC should be used to confirm levels of CsA and its metabolites in patients with suspected alteration of their CsA metabolism.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 56 (1978), S. 1007-1012 
    ISSN: 1432-1440
    Keywords: Hyperparathyroidism ; Immunoreactive parathyroid hormone ; Selectively catheterized thyroid veins ; Hyperparathyreoidismus ; Immunreaktives Parathormon ; Selektiv sondierte Schilddrüsenvenen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 16 Patienten mit primärem oder sekundärem Hyperparathyreoidismus wurden selektiv Blutproben aus den Hals- und Schilddrüsenvenen gewonnen. Das immunreaktive Parathormon wurde mit zwei aminoterminal-(Anti-N)- und drei caboxylterminal-(Anti-C)-spezifischen Antiseren gemessen. Zwei Anti-C Seren und ein Anti-N-Serum erwiesen sich als geeignet zur Lokalisation der Nebenschilddrüsentumoren. Zusätzlich wurden die Parathormonfragmente durch Gelfiltration aufgetrennt, die Immunreaktivität in den Eluaten wurde mit Anti-N-und Anti-C-Seren bestimmt. Die Ergebnisse ließen erkennen, daß die Eignung der Antiseren zur Lokalisationsuntersuchung durch ihre Affinität für intaktes Hormon bestimmt wird, unabhängig von ihrer Anti-N-oder Anti-C-Eigenschaft.
    Notes: Summary Blood samples were obtained from 16 patients with primary or secondary hyperparathyroidism by selectively catheterising cervical and thyroid veins. Immunoreactive parathyroid hormone was measured with two aminoterminal (anti-N)- and three carboxyl-terminal (anti-C)-specific antisera. Two anti-C sera and one anti-N serum were useful in localising the parathyroid tumors. In addition, the parathyroid hormone fragments were separated by gelfiltration and the immunoreactivity in the effluent was estimated with anti-N and anti-C sera. The results suggest that the usefulness of antisera for parathyroid tissue localisation is determined by their affinity for the intact hormone, regardless of their anti-N or anti-C qualities.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 54 (1976), S. 625-632 
    ISSN: 1432-1440
    Keywords: Renal osteodystrophy ; Parathyroid hormone ; Vitamin D ; 25-Hydroxycalciferol ; Bone biopsy ; Renale Osteopathie ; Parathormon ; Vitamin D ; 25-Hydroxycalciferol ; Knochenbiopsie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 32 Patienten mit renaler Osteopathie wurden die Serumspiegel des immunoreaktiven Parathormons (iPTH) und des 25-Hydroxycalciferol (25(OH)D) bestimmt und mit den Ergebnissen der Knochenbiopsie und anderen klinischen Parametern korreliert. Das iPTH entsprach den Ergebnissen der Knochenhistologie, zeigte jedoch keine Beziehung zum Serumcalcium und der alkalischen Phosphatase, während eine statistisch signifikante Korrelation mit dem Serumphosphat bestand. Die 25(OH)D-Spiegel verhielten sich unabhängig vom histologischen Nachweis einer Osteomalazie oder vermehrter Knochenresorption, es fand sich eine Beziehung zwischen dem Vitamin-D-Metaboliten und dem Serumcalcium. Da die iPTH- und die 25(OH)D-Spiegel eine signifikante inverse Korrelation zeigten, wurde ein inhibitorischer Effekt des 25(OH)D auf die Nebenschilddrüsenfunktion bei Niereninsuffizienz diskutiert.
    Notes: Summary Immunoreactive parathyroid hormone (iPTH) and 25-hydroxycalciferol (25(OH)D) serum levels were determined in 32 patients with renal osteopathy, they were correlated with the results of bone biopsy and other clinical parameters. iPTH was closely related to bone histology, it did not correspond to serum calcium and alkaline phosphatase, but the correlation to serum phosphate was statistically significant. 25(OH)D levels were not related to the histological findings of osteomalacia or increased bone resorption, while a correlation between the vitamin D metabolite and serum calcium could be observed. Since iPTH and 25(OH)D levels exhibited a significant correlation, an inhibitory effect of 25(OH)D on parathyroid gland function in renal failure was discussed.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 8 (1975), S. 255-260 
    ISSN: 1432-1041
    Keywords: Vitamin D ; renal osteodystrophy ; 5,6-trans-25-hydroxycholecalciferol ; rickets ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Vitamin D analogues of high biological activity are probably useful in the treatment of renal osteodystrophy. The pharmacokinetics of the synthetic compound 5,6-trans-25-hydroxycholecalciferol have been studied in healthy subjects who were of normal vitamin D status. In comparison to natural 25-hydroxy-cholecalciferol, serum levels of the analogue were lower and its half-life in blood after oral or intravenous administration was considerably shorter. In normal subjects no increase of dihydroxylated metabolites in serum was observed within seven days of an intravenous dose.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 146 (1987), S. 292-293 
    ISSN: 1432-1076
    Keywords: Osteomalacia ; Neonatal rickets ; 25-hydroxy-vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During the last 4 years we observed four cases of neonatal rickets. The mothers of the infants suffered from osteomalacia for 1–3 years prior to its diagnosis shortly after the birth of their children. All four infants were born with craniotabes, and one infant had, in addition, a radial fracture. The diagnoses were confirmed by radiological and laboratory tests which revealed a rarefied bone structure, decreased serum 25-hydroxy-vitamin D and increased alkaline phosphatase levels in all patients. The disorder regressed under low-dose vitamin D3 therapy. As osteomalacia seems to be predominant in oriental women living in Berlin, it is necessary to consider vitamin D deficiency when clinical symptoms of this disease arise and to treat these women at least during pregnancy.
    Type of Medium: Electronic Resource
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