Remission of essential hypertension after renal transplantation.

Six patients in whom "essential hypertension" led to nephrosclerosis and kidney failure received kidney transplants from normotensive donors. After an average follow-up of 4.5 years, all were normotensive and had evidence of reversal of hypertensive damage to the heart and retinal vessels.

Chloride-depletion alkalosis with a normal extracellular fluid volume.

Current concepts hold that volume expansion is essential to the correction of chloride-depletion alkalosis (CDA) with chloride repletion in a permissive role. In this scheme, intranephronal fluid reabsorption would be redistributed with increased delivery to the distal nephron where the provided chloride is readily reabsorbed and the limited capacity for bicarbonate reabsorption would promote bicarbonate excretion and correction of CDA. In a model of CDA produced by peritoneal dialysis against 0.

Effect of volume expansion and plasma chloride on function of the loop segment.

To determine the effect of acute volume expansion and changes in plasma chloride on fluid and chloride uptake in superficial loop segments of rats, this segment was microperfused in vivo at 22 nl/min with a fluid containing Na 145, Cl and 36Cl 130, and HCO3 15 meq/liter during hydropenia and after acute volume expansion with 0.15 M NaCl, 0.15 M NaHCO3, or an isotonic bicarbonate Ringer (Cl 106 meq/liter) solution.

Crescentic light-chain glomerulopathy. Report of a case.

Light-chain glomerulopathy occurred in a middle-aged woman with adult-onset diabetes mellitus and IgG-kappa light-chain multiple myeloma. Unusual features of the glomerulopathy included the presence of numerous epithelial crescents and rapid progression to chronic renal failure. The aggressiveness of her disease may be related to her underlying diabetes mellitus and associated abnormalities in glomerular clearance of macromolecules, including immunoglobulin light chains.

Plasmid-controlled resistance to copper in Escherichia coli.

The copper resistance of a strain of Escherichia coli isolated from the effluent of a piggery where pigs were fed a diet supplemented with copper sulfate was controlled by a conjugative 78-megadalton plasmid designated pRJ1004. Plasmid pRJ1004 exhibited surface exclusion and incompatibility with standard plasmids belonging to incompatibility groups I1 and K. Sensitive strains of E.

Effect of chloride on renin and blood pressure responses to sodium chloride.

Both the inhibition of renin release by sodium chloride and salt-sensitive hypertension have been attributed to sodium. We evaluated the contribution of chloride to these responses to sodium chloride. In the Sprague-Dawley rat, acute and chronic administration of sodium salts other than sodium chloride failed to suppress plasma renin activity, whereas renin was inhibited by both sodium chloride and by selective chloride (without sodium) loading.

Effects of NaCl on renin and aldosterone responses to potassium depletion.

We have previously suggested that renin secretion is inversely related to the magnitude of absorptive chloride transport in the thick ascending limb of the loop of Henle. Potassium depletion inhibits chloride transport at this site in the nephron. Consequently, we studied the effects of varying sodium and chloride intakes on the renin and aldosterone responses to potassium depletion.

Successful renal transplantation in hyperoxaluria. A report of two cases.

Two patients with documented primary hyperoxaluria have received renal allografts with successful function for 10 years and 25 months. The patient in case 1 required a ureterolithotomy 6 years post-transplantation to remove a renal calculus of calcium oxalate. This case illustrates that despite recurrence of oxalate stones in the allograft, satisfactory renal function can be maintained by careful follow-up and appropriate interventions.

Effect of pretransplant stored donor-specific blood transfusions on early renal allograft survival in one-haplotype living related transplants.

The effect of pretransplant stored donor-specific blood transfusions (DSBTs) on early renal allograft survival in 37 consecutive one-haplotype living related donor (LRD) transplants (group B) was compared with a similar consecutive series of 38 one-haplotype LRD recipients (group A) who did not receive DSBTs. All transplant recipients in both groups were treated with identical immunosuppressive protocols using azathioprine and prednisone. Forty patients received pretransplant DSBTs and three of these patients (8%) developed cytotoxic antibodies to their prospective donors.

Influence of aortic constriction on proximal chloride reabsorption during volume expansion.

Extracellular fluid volume expansion is associated with a decrease in the transepithelial chloride gradient in the proximal convoluted tubule. We have previously shown that this effect occurs in the presence of hypo- or hyperchloremia and is not dependent on a change in filtered chloride or bicarbonate load. To determine the influence of filtered fluid load on this effect of volume expansion, micropuncture studies were carried out during acute extracellular fluid volume expansion in rats with (group AC) and without (group CON) a reduction in renal perfusion pressure.

Effect of alternate-day prednisone on plasma lipids in renal transplant recipients.

While numerous groups have reported high prevalences of plasma lipid abnormalities in their renal transplant recipients, we have been unable to confirm this finding. We have suggested that the routine use of alternate-day steroids (ADS) in our patients may be responsible. To test that hypothesis, a prospective controlled trial of equal total dose ADS versus daily steroids (DS) was conducted.

Iron-suppressible production of hydroxamate by Escherichia coli isolates.

A total of 476 strains of Escherichia coli isolated from humans, pigs, cattle, poultry, potable water, or effluent were examined for iron-suppressible ability to produce hydroxamate. Isolates able to produce such material (Hyd+ isolates) are presumed to be able to carry out hydroxamate-dependent transport of iron. The percentages of Hyd+ isolates found among E.

Hereditary thrombotic thrombocytopenic purpura: microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency occurring in consecutive generations.

Microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency occurred in a mother an daughter when each was in her third decade. The mother had prominent neurological findings, fever, and expired from renal insufficiency. Her daughter's only major symptom was renal insufficiency.

Quantitative urinary protein excretion in chronic renal failure.

The diagnostic value of the measurement of quantitative proteinuria in patients with a creatinine clearance of less than 10 ml/min was determined in patients seen in a single center over a 5-year period. All 126 patients in whom a definitive renal diagnosis was possible were included. Patients with glomerular disease excreted 6.

Professionalism, accountability and peer review.

Passage in April 1979 of the new hospital standard on quality assurance by the Joint Commission on Accreditation of Hospitals (JCAH) has given impetus to the development of an expanded literature on the organizational/behavioral aspects of quality assurance. In response to this need for new literature, several conferences on quality assurance were held resulting in the preparation for publication of the four papers included in this special issue of . This paper presents the general orientation which guided selection of the papers.

Effect of hypochloremia on loop segment chloride and solute reabsorption in the rat during volume expansion.

Hypochloremia has been associated by inference from clearance studies with disturbances in free water reabsorption and renal renin release by a macula densa mechanism. To examine directly these relationships, we studied chloride, fluid, and solute transport in the loop segment (LS) of rat superficial nephrons by micropuncture techniques following acute volume expansion with 0.15 m sodium chloride (CVE) or sodium bicarbonate (BVE).

Comparison of daily and alternate-day prednisone during chronic maintenance therapy: a controlled crossover study.

To determine if dose spacing of low dose chronic suppressive corticosteroid therapy would result in different effects on circulating T lymphocytes and hypothalamic-pituitary-adrenal (HPA) axis suppression, a crossover trial of two maintenance steroid regimens was performed. Twenty stable renal allograft recipients were treated for 6 mo with daily prednisone (DS) and then the same patients were abruptly converted to alternate-day prednisone (ADS) for another 6 mo. Total prednisone dosage was identical during the 6-mo study periods and only dose spacing differed.