Patients' representations of their end-stage renal disease: relation with mortality.

Background: Self-regulation theory explains how patients' illness perceptions influence self-management behaviour (e.g. via adherence to treatment).

Immunosuppression should be stopped in patients with renal allograft failure.

Patients returning to haemodialysis or peritoneal dialysis after a failed kidney transplantation sometimes have a renal allograft left in situ for some urine production. Low-dose immunosuppressive medication is often continued in such patients. To evaluate the morbidity and mortality between patients in time periods with (group A) or without (group B) low-dose maintenance immunosuppression, the present study was initiated.

Renal haemodynamics and sodium excretory capacity during urapidil treatment in patients with essential hypertension.

Objective: Since renal sympathetic nerves are involved in the regulation of sodium excretion, we investigated whether treatment with urapidil, an alpha1-adrenoceptor blocking agent which also lowers sympathetic activity, alters sodium excretory capacity in patients with essential hypertension.

Design: A double-blind, randomized, parallel-group study.

Methods: Studies were carried out in 26 patients who were randomized to treatment with either placebo or urapidil for 8 weeks.

Pharmacokinetics of temocapril and temocaprilat after 14 once daily oral doses of temocapril in hypertensive patients with varying degrees of renal impairment.

Aims: The aim of this study was to determine the potential influence of renal impairment on the pharmacokinetics of temocapril and its pharmacologically active diacid metabolite, temocaprilat.

Methods: Non-compartmental pharmacokinetics were assessed in four groups of hypertensive patients (n=8 per group, four investigational centres) with normal (creatinine clearance determined via 24 h urine sampling, CL[CR], > or = 60 ml min-1) and impaired renal function (CL[CR] 40-59, 20-39, < 20 ml min-1) after 14 once daily oral doses of 10 mg temocapril hydrochloride.

Results: For temocapril, there were no statistically significant differences in median tmax or mean Cmax, AUC(SS), t1/2,Z, CL/F between the four groups.

Natriuretic effect of nitrendipine is preceded by transient systemic and renal hemodynamic effects.

This study investigated whether the acute natriuretic effect of nitrendipine is related to its initial renal hemodynamic effects. We investigated 16 patients (10 men and 6 women, mean age 52 +/- 2 years) with essential hypertension, whose treatment, if any, was stopped 3 weeks before the study. They were admitted to a metabolic ward for 9 days and kept on a constant sodium diet of 55 mmol/day.

Heterogeneous patterns of sodium excretion during sodium restriction in essential hypertensive patients.

Objective: To study the sodium excretory pattern by which sodium balance is reached.

Methods: Ninety untreated essential hypertensives with a median age of 47 (range: 18-70 years) were admitted to a metabolic ward for 7 days and put on a sodium diet of 55 mmol/day. During these 7 days urinary excretions of sodium, potassium and creatinine were determined daily along with mean arterial pressure (MAP) and weight.

'Captopril test', with blood pressure and peripheral renin as response variables in hypertensive patients with suspected renal artery stenosis.

In forty six hypertensive patients in whom a high level of clinical suspicion for renovascular hypertension was present on the basis of clinical clues, a captopril test was performed with either 25 mg of captopril or placebo on 2 separate days to determine prospectively the value of the captopril test. Blood pressure (BP) and peripheral renin were used as response variables. All patients had discontinued their anti-hypertensive medication and were not salt depleted.

The impact of ischemic lesions in the donor kidney, donor age, recipient age and HLA (A, B, C, DR, DQ) matching on clinical course after kidney grafting.

It is generally accepted that HLA matching improves graft survival. However, there is no consensus on whether this improvement is reflected on daily clinical course. Clinical course after renal transplantation depends on many factors, such as donor age, recipient age, ischemic score in the kidney, and HLA matching.

The relationship between cause of death of the kidney donor and the presence of ischemic lesions in the kidney.

Chronic ischemic lesions in the donor kidney amplify the nephrotoxic effects of cyclosporine A. With increasing age, the presence of chronic ischemic lesions in the kidney increases, and data concerning the fate of kidney grafts from older donors are conflicting. Kidney from donors with an intracerebral bleed do less well compared to kidneys from other donors.