[Treatment of chronic kidney failure by the keto-analogs of essential amino acids: 4 years' experience].

From June 1981 to June 1985, 22 patients with advanced chronic renal failure were treated with a preparation of ketoanalogues of essential amino acids (Ketosteril, 1 tablet/5 kg/day) combined with a protein supply of 0.4 g/kg/day. At the beginning of treatment, their mean plasma creatinine was 762 +/- 135 mumol/l and their creatinine clearance, 8.

Post-surgical deterioration of renal function in primary hyperoxaluria.

Primary hyperoxaluria leading to calcium oxalate urinary stones and renal deposits occurs rarely in adults. We report three cases in whom end-stage renal failure was precipitated by urological surgery. In contrast, in one case renal stones were destroyed by extracorporeal shock-wave lithotripsy and renal function was not significantly altered.

Azathioprine withdrawal in renal transplant recipients. A long-term follow-up.

Azathioprine (AZTP) must sometimes be discontinued in cadaveric kidney recipients. Long-term survival of patients after AZTP withdrawal is questionable, and many groups consider that maintenance treatment with AZTP is preferable to its discontinuation despite potential severe side effects. In our group AZTP had to be discontinued in 39 recipients of first renal allografts (30 cadaver kidney recipients, 9 living-related recipients) because of severe liver disease or cancer.

Hepatitis B vaccine: randomized trial of immunogenicity in hemodialysis patients.

In order to determine whether reinforced vaccinations improve the immune response among uremic patients, three vaccination schedules with hepatitis B surface antigen vaccine (Institut Pasteur Production) were compared. A total of 215 hemodialysis patients treated in HBV free units were randomly allocated to Group I (3 injections of 1 ml), Group II (3 injections of 2 ml) and Group III (4 injections of 1 ml). Immune response was evaluated in 204 patients.

Nonsteroid antiinflammatory agents as a substitute treatment for steroids in ATGAM-treated cadaver kidney recipients.

A nonsteroid antiinflammatory agent (Ibuprofen) was used in a controlled randomized study to determine its ability to replace steroids in the prophylaxis of cadaveric kidney rejection. Thirty-three cadaver kidney recipients were randomly assigned either to a control group (16 patients) receiving azathioprine, high doses of prednisolone, and antithymocyte globulin (ATGAM) for three months, or to an experimental group (17 patients) receiving azathioprine and ATGAM according to the same protocol, ibuprofen instead of steroids. The frequency of rejection was higher in the experimental group (2.

Relationship between liver histopathological changes and HBsAg in 111 patients treated by long-term hemodialysis.

We studied liver biopsies performed between January 1972 and June 1980 in 111 patients receiving regular dialysis treatment. Biopsies were performed either because of suspected liver disease (61 patients) or routinely during abdominal surgery or kidney transplantation (50 patients). Repeat biopsies were done in 14 cases.

Detection of human papillomavirus type 5 DNA in skin cancers of an immunosuppressed renal allograft recipient.

A renal allograft recipient with an epidermodysplasia-verruciformis-like syndrome was found to have human papillomavirus type 5 (HPV-5) in his benign warty lesions and HPV-5 DNA in two of his skin cancers. This finding points to a role for HPV-5 in skin oncogenesis in renal allograft recipients.

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in french haemodialysis units: II, Haemodialysis patients.

A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in 138 haemodialysis patients in a placebo-controlled randomised double-blind trial. In an interim analysis, hepatitis B infections were observed in 21% of the vaccine group and 45% of the placebo group (p less than 0.02).

Antithymocyte globulin in cadaver kidney transplantation: a randomized trial based on T-cell monitoring.

The influence of horse antihuman thymocyte globulin (ATG) on renal allograft survival was assayed between March 1977 and August 1978. Fifty consecutive patients were randomly assigned to the treatment or the control group. Patients in both groups received azathioprine and prednisolone.

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in French haemodialysis units: I, Medical staff.

A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in staff members from forty-eight French haemodialysis units where the risk of hepatitis B was high. Of 318 subjects who completed the protocol, 164 received three monthly injections of vaccine and 154 received corresponding injections of placebo. Hepatitis B infection was observed in 3.

Hereditary nephritis associated with May-Hegglin anomaly.

Hereditary nephritis associated with hematologic abnormalities seems to be an exceptional occurrence. We have observed a family which nephritis was combined with May-Hegglin anomaly. A girl and her father suffered from proteinuria; a paternal uncle received kidney graft; a paternal grand aunt died on periodic hemodialysis.

Hepatitis B in haemodialysis: vaccination against HBS antigen.

Institut Pasteur Production vaccine, prepared from plasma of chronic carriers of HBsAg (ad + ay sub-types) negative for HBeAg, inactivated by formaldehyde, containing 5 microgram HBsAg per 1ml dose, with Al (OH)3 as adjuvant, was tested in a multicentric efficacy trial. After informed consent and exclusion of subjects positive for HBsAg, anti-HBc or anti-HBs, 367 permanent staff members and 138 chronic haemodialysis patients from 64 centres were enrolled in the trial. They received randomly, double-blind, 3 subcutaneous doses of either vaccine (V) or placebo (P) at one-month intervals and were followed monthly for one year.

An unusual wart-like skin lesion found in a renal allograft recipient.

Immunosuppressed renal allograft recipients have an increased tendency to acquire warts. While studying such patients, we found a virus-induced, wart-like lesion that had an unusual histologic picture. Light microscopic studies showed bizarre keratinocytes with cytoplasmic, juxtanuclear, giant, crescentic bodies and round, nuclear inclusions, By electron microscopy, the giant cytoplasmic bodies were found to be composed of tonofilaments, and the nuclear inclusions were found to be composed of papillomavirus-like particles in a filamentous matrix.

[Secondary hyperparathyroidism: subtotal parathyroidectomy versus total parathyroidectomy with parathyroid autotransplantation (author's transl)].

Between 1967 and 1978, among more than 1 000 patients under haemodialysis, 66 who had severe secondary hyperparathyroidism, underwent parathyroidectomy (PTx). Subtotal PTx's were performed in 57 patients and total PTx's immediately followed by autotransplantation of parathyroid gland fragments in 9 patients. The patients operated upon by these two methods since 1976 were compared.