Conversion from conventional in-centre thrice-weekly haemodialysis to short daily home haemodialysis ameliorates uremia-associated clinical parameters.

Background: Under physiological conditions, kidneys work continuously, 168 h/week. In contrast, patients with end-stage renal disease are usually dialysed only 12 h/week. Even if considered adequate by current Kt/V-based dose estimates, this unphysiological dose is associated with an unacceptable annual mortality rate of 10-20%.

Prospective evaluation of an in-centre conversion from conventional haemodialysis to an intensified nocturnal strategy.

Introduction: Under physiological conditions kidneys work continuously, 168 h/week. In contrast, patients with end-stage renal disease are usually dialyzed only 12-15 h/ week. This unphysiological dialysis dose, even if considered adequate by current Kt/V-based dose estimates, is just capable to maintain the alterations of multiple metabolic parameters at a level that permits an unacceptable annual mortality rate of 10-20%, mainly due to cardiovascular events, protein energy wasting and infections.

Lack of clinical evidence for a specific HIV-associated glomerulopathy in 203 patients with HIV infection.

Several authors described a high incidence of proteinuria with frequent progression to nephrotic syndrome and/or renal failure in patients with HIV infection. Though renal histological changes were rather non-specific, the existence of a specific, HIV-associated glomerulopathy was postulated. We repeatedly investigated proteinuria and serum creatinine in 203 HIV-infected patients.

Is the rise in plasma beta-2-microglobulin seen during hemodialysis meaningful?

Beta 2-Microglobulin (beta 2M) plasma levels and levels of a second low-molecular-weight protein (myoglobin) were studied during a 2- to 4-hour sham dialysis period (no dialysate flow, no weight loss) and during a 4- to 5-hour hemodialysis (HD) with a Cuprophan capillary dialyzer. While no rise of the beta 2M or myoglobin levels occurred during sham dialysis, a rise of 22.1 +/- (SD) 8.

High-flux synthetic versus cellulosic membranes for beta 2-microglobulin removal during hemodialysis, hemodiafiltration and hemofiltration.

Efficient removal of beta 2 microglobulin (beta 2-M) in end-stage renal failure patients is a continuing preoccupation, as the incidence and severity of dialysis-associated amyloidosis are increasing. To evaluate comparative beta 2-M removal we studied six stable end-stage renal failure patients during high-flux 3-h haemodialysis, haemodia-filtration, and haemofiltration, using acrylonitrile, cellulose triacetate, polyamide and polysulphone capillary devices. The reduction of plasma beta 2-M, total removal in ultrafiltrate/dialysate, and beta 2-M sieving coefficients were measured by RIA.

Is renal involvement a prognostic parameter in patients with infective endocarditis?

Renal involvement (RI)--defined as proteinuria greater than 150 mg per 24 h with haematuria or impaired glomerular filtration rate--was studied in 80 patients with infective endocarditis (IE). Proteinuria was measured quantitatively and further differentiated by the SDS-polyacrylamide-gel electrophoresis. RI was found in 40 patients (50%) with proteinuria from 150 to 8000 mg per 24 h.

Uptake of polyvinyl alcohol by macrophages in the glomerular mesangium of rats. Histologic and functional studies.

Rats received daily subcutaneous injections of the synthetic polysaccharide polyvinyl alcohol (PVA) for 1-28 days. The amount of PVA localized in the glomerular mesangium increased progressively during this time. By 28 days, all glomeruli showed extensive intracellular mesangial sequestrations of PVA, causing marked widening of mesangial areas, while the peripheral capillary loops were unaltered.

[Pheochromocytoma in pregnancy--pathophysiology and therapy (author's transl)].

In this paper pathophysiology of pheochromocytoma and its modern diagnostic and therapeutic management are discussed with special regard to the combination of pheochromocytoma and pregnancy. The preoperative treatment with phenoxybenzamine is evaluated. As for the anesthetic management barbiturates and neurolept anesthesia are recommended.

Renal sodium conservation during starvation in the rat.

The phenomenon of natriuresis during the early phase of total starvation has been described in man and rabbit. We have examined the pattern of electrolyte excretion initiated by starvation for 4 days in the male Wistar rat. Within 24 hr sodium excretion is significantly diminished when compared to prestarvation values (control 2.

[The clinical significance of hyperuricemia for the prognosis of pregnancy toxemia].

This study demonstrates that uric acid serum levels are of importance in the prognosis of pregnancy complicated by hypertension. In early pregnancy the uric acid level probably is the most sensitive parameter to select the risk-prone pregnancies with EPH-gestosis to conduct the further course of pregnancy under medical care. Pregnant hypertensives with high uric acid levels develop more often retardation of the fetus, the incidence of eclampsia increases.

Renal tubule ion transport and collecting duct function in the elasmobranch little skate, Raja erinacea.

Renal micropuncture and microdissection techniques with ultramicro fluid analysis have been applied to evaluate single nephron function in the skate, Raja erinacea. We have divided the skate nephron into three proximal tubular segments (PTS I-III), three distal coilings (DC I-III), and a countercurrent loop system located between the proximal segments and the distal coilings. The collecting duct is the principal site of urinary dilution.

Role of sodium and water in hypertensive patients on maintenance hemodialysis.

In 46 patients of the chronic hemodialysis program blood pressure regulation was studied according to variations of sodium and fluid balance. A strong relationship was observed between blood pressure and the amount of exchangeable sodium. In the hypertensive patients exchangeable sodium was increased depite fulfilled clinical signs of sufficient dehydration.

Effect of angiotensin on the filtration of protein in the rat kidney: a micropuncture study.

We have analyzed the protein content of proximal tubular fluid (PTF) by ultramicro disc electrophoresis and measured total protein excretion rates both in control conditions and during angiotensin infusion to the rat. Under control conditions PTF albumin concentration was 1.49 +/- 1.

Effect of angiotensin on glomerular filtration of albumin.

Angiotensin-induced proteinuria was examined at the glomerular-tubular level in rats. Ultra-micro-disc electrophoresis was employed to determine albumin concentration of rat proximal tubular fluid samples under control conditions and during the infusion of 0.15 mug/min X 100 g body weight angiotensin II using micropuncture techniques.

Amino acid reabsorption in the rat nephron. Free flow micropuncture study.

The concentration of nine endogenous free L-alpha-amino acids (ALA, LEU, ILE, PHE, TYR, LYS, GLU, PRO, GLY) and of taurine were determined simultaneously along the nephron of the rat kidney using free-flow micropuncture techniques without altering plasma amino acid concentration or kidney function. The amount of each amino acid was determined after dansylation (14C-labelled dansyl-chloride) in the micropuncture sample followed by thinlayer chromatography. The main site of reabsorption is the proximal tubule.

Glomerular protein filtration in normal and nephritic rats. A micropuncture study.

The acute heterologous phase of anti-basement membrane glomerulonephritis in rats was studied morphologically and functionally at the single nephron level. In samples drawn from Bowman's space or from the very early segment of the proximal tubule the protein content was measured by ultra micro-disc-electrophoresis. Morphologically, in rats which were treated with anti-glomerular basement-membrane serum (AGBM) no significant changes could be seen in light microscopy whereas in immunohistology the typical, linear, subendothelial fluorescent staining for IgG could be seen.