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1.
Kalman S Buyan N Yürekli M Ozkaya O Bakkaloğlu S Söylemezoğlu O 《Pediatric nephrology (Berlin, Germany)》2005,20(8):1111-1115
Adrenomedullin (AM) is a strong vasodilator peptide with proven antimitogenic and antiproliferative effects in renal mesangial cells, as well as diuretic and natriuretic actions. Its gene expression is stimulated by endotoxins (lipopolysacharides) and cytokines. Consequently, its plasma and urinary levels are known to deviate from normal levels in many renal diseases. The purpose of this study is to determine plasma and urinary AM levels in children with renal parenchymal scar (RPS) and vesicoureteral reflux (VUR). The study was carried out on 74 children with recurrent urinary tract infections, arranged in groups: 25 patients with RPS with VUR (group I), 16 patients with RPS without VUR (group II), 12 patients with VUR without RPS (group III) and 21 healthy children as the control group. Plasma and urinary AM concentrations were both determined by high performance liquid chromotography (HPLC). Plasma AM was measured as picomoles per milliliter (pM/ml) and urinary AM as pM/mg urinary creatinine. In addition, serum creatinine, creatinine clearance and fractional sodium excretion (FENa) were measured. All cases with RPS and VUR had normal blood pressure levels. The plasma AM levels were higher, although not significantly, in the control group (56.2±14.0 pM/ml) than in group I (50.6±4.2 pM/ml), group II (49.6±3.7 pM/ml) and group III (50.6±3.6 pM/ml) ( P =0.162). The urinary AM levels were higher in the control group (80.1±33.9 pM/mg) than in the three study groups (52±7.6 pM/mg, 58.6±7.5 pM/mg and 44.2±6.4 pM/mg; P =0.003, P =0.002 and P =0.002, respectively). There were no differences among the 4 groups (group I, group II, group III and the control group) in terms of FENa and creatinine clearance ( P >0.05 and P >0.05, respectively). The finding that diminished urinary AM levels in patients with RPS and VUR implies that AM can be a prognostic factor in the long-term follow-up of cases with these diseases. 相似文献
2.
Islek I Balat A Cekmen M Yürekli M Muslu A Sahinöz S Sivasli E 《Pediatric nephrology (Berlin, Germany)》2003,18(11):1132-1137
Nitric oxide (NO) is synthesized from endothelium and has an important role in the control of vascular tonus. Adrenomedullin (AM) is a potent vasodilator, and cytoprotective peptide is produced not only in adrenal medulla, but also in the vascular smooth muscle and endothelial cells. To investigate the endothelial synthesis of AM and NO, and endothelial injury in Henoch-Schönlein purpura (HSP), we measured their levels in 16 children with HSP, who were evaluated during the acute and remission phases, and compared with 12 healthy controls. Plasma AM levels (pmol/ml) were significantly higher in acute phase children (46.87±11.49) than in those in remission (35.59±12.39, p<0.01) and controls (30.70±9.12, p<0.001). Similarly, plasma total nitrite levels (mol/l) were higher in acute phase patients (47.50±12.30) than in those in remission (35.94±10.08, p<0.005) and controls (34.56±11.51, p<0.05). Urinary excretion of AM (pmol/mg creatinine) was higher in acute phase patients (53.85±23.22) than in remission patients (29.97±9.33, p<0.01) and controls (37.43±15.78, p<0.05). Patients had increased urinary nitrite excretion (mol/mg creatinine) in acute phase (2.39±1.18) compared to those in remission (1.53±0.90, p<0.05) and controls (1.05±0.61, p<0.005). There was no significant difference between remission phase and controls in AM and nitrite levels (p>0.05). This study concluded that AM and NO may have a role in the immunoinflammatory process of HSP, especially in the active stage, although whether this perpetuates, or protects against, further vascular injury is not clear. Further studies are needed to clearly establish the roles of AM and NO in the pathogenesis of HSP. 相似文献
3.
Cytokines and adhesion molecules in renal vasculitis and lupus nephritis 总被引:20,自引:1,他引:19
Tesar V; Masek Z; Rychlik I; Merta M; Bartunkova J; Stejskalova A; Zabka J; Janatkova I; Fucikova T; Dostal C; Becvar R 《Nephrology, dialysis, transplantation》1998,13(7):1662-1667
Background: Plasma levels of some pro-inflammatory
cytokines and soluble adhesion molecules have been suggested to be useful
parameters to assess the activity of antineutrophil cytoplasmic antibody
(ANCA)-positive vasculitis and lupus nephritis. We hypothesized that the
renal activity of these diseases is better reflected by the urinary
excretion and fractional excretion of these molecules.
Methods: Plasma levels and urinary excretion of tumour
necrosis factor-&agr; (TNF-&agr;), interleukin (IL)-6, IL-8, and
the soluble cell adhesion molecules sICAM-1 and sVCAM-1 were measured by
enzyme-linked immunosorbent assay (ELISA) in 15 patients with ANCA-positive
renal vasculitis (eight active, ANCA-A; six in remission, ANCA-R), six
patients with active lupus nephritis (LN), 15 patients with IgA nephropathy
(IgAN) and nine healthy subjects. Fractional excretion of selected
cytokines and adhesion molecules was also calculated.
Results: Patients with ANCA-A had increased urinary
excretion and fractional excretion of TNF-&agr; (9.27±3.19%
vs 0.58±0.02%, P<0.01), IL-6
(120.79±65.83% vs 1.89±0.34%,
P<0.01) and increased fractional excretion of IL-8
(23.34±6.38% vs 2.56±1.07%,
P<0.01) and sVCAM-1 (0.81±0.33% vs
0.03±0.02%, P<0.01) compared with controls. Urinary
excretion of TNF-&agr; and IL-6 and fractional excretion of
TNF-&agr;, IL-6 and IL-8 were higher in ANCA-A than in ANCA-R. Patients
with LN had increased plasma TNF-&agr; (20.52±2.01 pg/ml
vs 12.33±0.23 pg/ml, P<0.05) and
sVCAM-1 (1537.88±276.36 ng/ml vs
692.26±44.42 ng/ml, P<0.05) and increased urinary
excretion of TNF-&agr; (2.81±0.51 &mgr;g/mol creat
vs 0.98±0.05 &mgr;g/mol creat,
P<0.01), IL-8 (35.78±14.03 &mgr;g/mol creat
vs 12.46±5.19 &mgr;g/mol creat,
P<0.05) and sVCAM-1 (48.98±20.20 &mgr;g/mol creat
vs 2.92±1.35 &mgr;g/mol creat,
P<0.01) compared with controls. Patients with IgAN had, in
comparison with controls only increased plasma TNF-&agr;
(18.10±0.57 pg/ml vs 12.33±0.23
pg/ml, P<0.05). Conclusions: Urinary excretion
and fractional excretion, but not plasma levels of selected proinflammatory
cytokines (TNF-&agr;, IL-6 and IL-8) were increased in patients with
active ANCA-positive renal vasculitis, but not in ANCA positive vasculitis
in remission. These parameters may be useful to monitor the activity of
this disease. 相似文献
4.
Meglic A Cavić M Hren-Vencelj H Trsinar B Ravnik M Kenda R 《Pediatric nephrology (Berlin, Germany)》2000,15(1-2):132-133
Urogenital infection with Chlamydia trachomatis in adults and adolescents is a common sexually transmitted disease. The purpose of this study was to investigate whether isolated
microhematuria in children and adolescents is associated with Chlamydia trachomatis infection of the urinary tract. The study group included 37 children and adolescents with isolated nonglomerular microhematuria.
Urethral smears for the isolation of Chlamydia trachomatis in cell culture were taken at the time of cystourethroscopy from all patients. Polymerase chain reaction (PCR) for the detection
of chlamydial DNA in urine was carried out in 25 of 37 (68%) patients and direct immunofluorescence (DIF) of urine in 16 of
37 (43%) patients. The control group included 33 children and adolescents without hematuria; PCR and DIF of urine were carried
out in all controls. Chlamydia trachomatis infection of the urinary tract was confirmed in 8 of 37 (22%) patients in the study group, and in none in the control group
(0 of 33, P<0.001). Further studies of larger groups of patients should be conducted, before recommending testing for Chlamydia trachomatis infection of the urinary tract in children and adolescents with unexplained microhematuria.
Received: 26 January 2000 / Revised: 26 April 2000 / Accepted: 2 May 2000 相似文献
5.
Antiproteinuric effect of angiotensin-converting enzyme inhibition and C5b-9 urinary excretion in membranous glomerulonephritis 总被引:1,自引:0,他引:1
Praga M; Artal E; Hernandez E; Segura; Moreno M; Morales J; Rodicio J 《Nephrology, dialysis, transplantation》1997,12(12):2576-2579
Background: Angiotensin-converting enzyme (ACE)
inhibitors have an antiproteinuric effect in membranous glomerulonephritis
(MGN). However, no studies hae investigated whether this antiproteinuric
effect is influenced by urinary C5b-9 excretion, a marker of immunological
activity in this disease. Methods: Eleven patients
with biopsy-proven MGN were treated with captopril for 8 weeks. The
evolution of several clinical and biochemical parameters, including 24-h
urinary protein excretion was evaluated every 4 weeks. Urinary C5b-9
excretion was measured at the onset and at the end of captopril treatment.
Results: Patients with MGN had significantly higher
C5b-9 excretions than a group of 14 healthy controls (89±23 vs
3.7±1.4 ng/mg UCr; P<0.001). A significant correlation
was found between urinary C5b-9 and the magnitude of proteinuria, both at
the onset and at the end of treatment. After 8 weeks of captopril
treatment, proteinuria had decreased from 8±1.8 to
5.2±1.3 g/day (P<0.05). Four weeks after captopril
discontinuation, proteinuria rose to 7.3±1.7 g/day
(P<0.05). A marked variability in the antiproteinuric response was
observed, ranging from 0 to 85% with respect to baseline values. No
correlation between decrease in proteinuria and baseline urinary C5b-9
levels was observed. Several patients with elevated urinary C5b-9 levels
had captopril-induced decrease in proteinuria.
Conclusions: ACE inhibition induces an antiproteinuric
effect in patients with MGN. The urinary C5b-9 excretion does not predict
the magnitude of this response. 相似文献
6.
Bone alkaline phosphatase in children with chronic renal failure 总被引:2,自引:1,他引:1
Behnke B; Kemper M; Kruse H; Muller-Wiefel D 《Nephrology, dialysis, transplantation》1998,13(3):662-667
Background: With the introduction of a new
immunoradiometric assay based on two monoclonal antibodies
(Tandem®-Ostase, Hybritech) the determination of bone alkaline
phosphatase (BAP) to evaluate bone metabolism in chronic renal failure has
become easier and more valid. Subjects and methods:
Using this test we investigated BAP in a total of 90 paediatric patients,
42 (9.2±5.5 years) with chronic renal failure on conservative
treatment, 22 (9.5±5.4 years) under chronic dialysis, and 26
(16.2±5.9 years) after renal transplantation, compared to 203
controls (10.1±5.7 years). Results: The
physiological age dependency found in controls including two peaks during
infancy and puberty was distinctly disturbed in chronic renal failure.
However, in patients BAP significantly correlated with height velocity
rather reflecting the last 6 (r=0.56 P<0.001) than the last 12
months. Although BAP correlated well with total alkaline phosphatase (TAP;
r=0.95 P<0.001), a significant correlation with the serum level of
the intact parathyroid hormone could only be detected for BAP (r=0.45
P<0.001) but not for TAP (R=0.19 N.S.) Furthermore, BAP positively
correlated with trabecular (n=40; r=0.40 P<0.05) and inversely with
cortical bone density (n=19; r=-0.58 P<0.01) but no relationship was
found with conventional X-ray. Conclusion: BAP
determined by the new radioimmunoassay seems to represent an additional
diagnostic tool to assess growth and bone turnover in paediatric patients
with chronic renal failure that is complementary to the information
provided by X-ray and total alkaline phosphatase. Key
words: bone alkaline phosphatase; children; chronic renal
failure
相似文献
7.
Kjell Tullus Omar Fituri Lars G. Burman Bengt Wretlind Annelie Brauner 《Pediatric nephrology (Berlin, Germany)》1994,8(3):280-284
Interleukin-6 (IL-6) and interleukin-8 (IL-8) are important mediators of the inflammatory response in serious bacterial infections. We studied the levels of these two cytokines (standardised for urinary creatinine) in the urine of infants and children during and 6 weeks after acute pyelonephritis and in non-renal febrile controls and healthy children without apparent infection. IL-6 was detected in the urine of 52% of children with pyelonephritis compared with 15% of other children (P<0.001). The median urinary IL-6 level in acute pyelonephritis was 4 pg/mol compared with undetectable levels in the control group (P<0.001). IL-8 was detected in 98% of children with pyelonephritis and 42% of other children (P<0.001). The median concentration of IL-8 was 188 pg/mol in pyelonephritis; it was undetectable in controls (P<0.001). IL-8 levels were higher in children less than 1 year of age (P<0.001). 相似文献
8.
Effects of a nitric oxide synthesis inhibitor on renal sodium handling and diluting capacity in humans 总被引:1,自引:0,他引:1
Background: Inhibition of nitric oxide (NO) synthesis
has antinatriuretic and antidiuretic effects. Limited information is
available on the role of NO in tubular sodium transport in the human
kidney. Methods: We studied nine healthy,
sodium-replete males with clearance techniques during maximal diuresis.
NG-monomethyl-L-arginine
(L-NMMA, 3 mg/kg priming dose plus 3 mg/kg/h) was
infused for 3 h, to achieve steady-state inhibition of NO synthesis. Data
were compared with a time control study. Results: The
effects of L-NMMA were quickly established and
persisted through the entire infusion period. Mean arterial pressure
increased slightly from 85±3 to 91±3 mmHg
(P<0.05). Renal plasma flow decreased substantially, and glomerular
filtration rate slightly. Large decreases in absolute sodium excretion,
from 79&;plusmn;10 to 34±5 &mgr;mol/min (P<0.01),
and fractional sodium excretion, from 0.5±0.0 to
0.3±0.0% (P<0.01), were associated with significant
reduction in fractional lithium excretion (P<0.05) and maximum urine
flow (P<0.01). Minimal urine sodium concentration decreased from
5.8±0.04 to 3.9±0.4 mmol/l (P<0.01) whereas
minimal urine osmolality increased (P<0.05). Plasma renin activity,
aldosterone and atrial natriuretic peptide levels did not change, whereas
urinary excretions of guanosine 3'5'-cyclic monophosphate and of nitrite
plus nitrate decreased slightly. Conclusions:
Inhibition of endogenous NO synthesis in humans to an extent that raises
blood pressure only mildly causes antinatriuresis, that can be attributed
to increases in sodium reabsorption both at proximal and distal nephron
sites. In addition, renal diluting capacity decreases. The effects in the
diluting segment have not been reported before, and may be due to medullar
vasoconstriction, similar to that described for angiotensin II. 相似文献
9.
Farahnak K. Assadi 《Pediatric nephrology (Berlin, Germany)》1990,4(1):48-51
Renal function was evaluated in six patients with fetal alcohol syndrome (FAS) and eight control subjects before and after fluid restriction and acute acid loading. Baseline serum electrolytes, creatinine clearance, fractional sodium excretion, tubular reabsorption of phosphate, urine and blood pH and osmolalities, plasma renin activity, and plasma aldosterone level were normal in all subjects, but fractional potassium excretion (FEK) was lower in FAS patients than in control subjects (P<0.001). Despita equivalent plasma osmolalities (295±3 vs 293±2 mosmol/kg,P=0.2), the maximum urinary osmolality after 12 h of water deprivation in patients with FAS was significantly lower compared with controls (560±107 vs 965±77 mosmol/kg;P<0.001) and increased to only 578±101 mosmol/kg after vasopressin administration. After ammonium chloride loading, minimum urine pH was significantly higher in patients than in controls (5.7±0.17 vs 4.81±0.19;P<0.001). Net acid excretion and FEK were also lower in patients than in controls (102±11 vs 139.6±11.3 Eq/min per 1.73 m2 and 23.5±1.3 vs 29±1.6%, respectively;P<0.001). The data indicate a subclinical renal tubular defect in urine concentration and acidification in patients with FAS. 相似文献
10.
Rajman I; Harper L; McPake D; Kendall M; Wheeler D 《Nephrology, dialysis, transplantation》1998,13(9):2281-2287
Background: Small low-density lipoprotein (LDL)
particle size, a newly recognized risk factor for cardiovascular disease in
the general population, is frequently associated with
hypertriglyceridaemia, the predominant plasma lipid abnormality present in
uraemia. Methods: Plasma lipids and LDL subfraction
profiles were examined in 33 non-dialysed patients with chronic renal
failure (predial), 40 patients on continuous ambulatory peritoneal dialysis
(CAPD), 42 haemodialysis patients (HD), 47 renal transplant recipients
(RTR), and 44 controls. LDL subfractions separated by gel electrophoresis
were scored by densitometric analysis (higher scores indicate profiles
comprising smaller particles). Results: All groups
with renal failure had significantly elevated (mean±SD) LDL
scores (predial 1.36±0.6, CAPD 1.71±0.9, HD
1.68±0.9, RTR 1.92±0.8 vs
control 0.87±0.4, all P<0.001), this being the only lipid
abnormality detected in the predialysis patients. In CAPD and HD patients,
LDL scores were associated with serum triglyceride (r=0.81, P<0.0001
and r=0.70, P<0.01 respectively), cholesterol (r=0.55,
P<0.001 and r=0.49, P<0.01) and HDL-cholesterol (r=-0.43,
P<0.01 and r=-0.51, P<0.01), whilst no such relationship was
seen in the predialysis and RTR groups, suggesting that other factors were
important. Conclusions: The presence of small LDL
particles appears to be an early and unexplained feature of the uraemic
dyslipidaemia. This abnormality persists after renal transplantation and
may represent an important atherogenic risk factor. Key
words: LD subfractions; renal failure; transplants
相似文献
11.
Hansson S Svedhem A Wennerström M Jodal U 《Pediatric nephrology (Berlin, Germany)》2007,22(9):1321-1325
There are few reports on urinary tract infections caused by Haemophilus influenzae or Haemophilus parainfluenzae in children. The true incidence is not known, since bacteria of Haemophilus species do not grow in standard urine culture media. With the objective of investigating the occurrence and character of
urinary tract infections (UTIs) caused by Haemophilus bacteria in children, we searched the files of our UTI clinic. Over a 24-year period 36 children with Haemophilus spp. bacteriuria were identified out of a total of more than 5,000 UTI episodes. There was a significant gender difference
in that Haemophilus influenzae dominated in girls and Haemophilus parainfluenzae in boys. With one exception, all children had important urinary tract abnormalities, such as malformation, gross reflux or
bladder dysfunction. Permanent renal damage was seen in 25. We conclude that growth of Haemophilus bacteria in urine is associated with serious urinary tract abnormalities. The inability of bacteria of the Haemophilus species to grow in standard media commonly used for culture of uropathogens suggests that the true frequency of these strains
as a cause of urinary tract infections is underestimated. 相似文献
12.
Voros P; Farkas G; Lengyel Z; Degi R; Rosivall L; Kammerer L 《Nephrology, dialysis, transplantation》1998,13(11):2899-2904
Aim of the study: The prevention of diabetic
nephropathy is as yet an unresolved issue. The aim of our study was to
assess the effects of transplantation of long-term cultured and
cryopreserved fetal pancreas islets on metabolic control and the
development of diabetic nephropathy. Methods: Serum
C-peptide, glucose, HbA1c, insulin requirements, urinary albumin excretion
rate, and blood pressure of 10 insulin-dependent diabetic patients after
transplantation were compared with a group of 27 insulin-dependent diabetic
controls on insulin therapy only during a 10-year follow-up.
Results: In the first year after transplantation mean
insulin requirement decreased from 53.6±2.2 to
35.8±1.2 units. C-peptide levels appeared (0.55±0.08
ng/ml) and remained detectable throughout the follow-up.. Blood glucose and
HbA1c were significantly (P<0.05) lower than in the controls. Mean
albumin excretion rates of the transplant and the control groups during the
follow up were 18.8±8.5 and 11.7±2.0,
16.6±6.6 and 14.0±2.3, 15.0±5.0 and
15.1±2.7, 15.3±7.5 and 20.4±4.2,
19.8±6.2 and 36.7±11.1, 11.7±3.6 and
51.3±14.6, 14.1±4.2 and 71.4±23.1,
22.7±8.6 and 92.0±28.1, 18.0±5.9 and
107.6±35.6, 21.7±11.0 and 101.5±29.2
&mgr;g/min respectively. From the 6th year the difference between the
two groups was significant (P<0.001). In the transplant group
initial mean systolic and diastolic blood pressure values were
132.0±3.3 and 81.5±1.5 mmHg, in the controls
130.4±3.4 and 79.6±1.6 mmHg respectively. Significant
changes (P<0.05) of blood pressure during the follow-up or
differences between the two groups were not observed.
Conclusions: We conclude that fetal islet
transplantation is effective in achieving good long-term diabetes control
and in the prevention of diabetic nephropathy. Key
words: albuminuria; diabetic nephropathy; diabetes mellitus;
diabetes control; fetal pancreas islet transplantation
相似文献
13.
Kawasaki Y Suzuki J Murai M Takahashi A Isome M Nozawa R Suzuki S Suzuki H 《Pediatric nephrology (Berlin, Germany)》2004,19(8):920-923
Six Japanese children with rapidly progressive Henoch-Schönlein purpura nephritis (HSPN) received multiple drug therapy combined with plasmapheresis (PP). After five courses of PP, multiple drug therapy, including methylprednisolone and urokinase pulse therapy, oral prednisolone, cyclophophamide, dipyridamole, and warfarin was given. At presentation, urine protein excretion and histological indices of the mean activity and chronicity were 245±101 mg/m2 per hour, 6.6±1.2, and 1.5±1.3, respectively. After 6 months of therapy, urinary protein excretion had decreased significantly (P<0.001). The activity index decreased significantly at the second renal biopsy performed at a mean interval of 4.3 months after the first (2.8±1.4, P<0.05), while the chronicity index did not change. At the most recent observation, all showed clinical improvement. Two patients had normal urine, three had proteinuria of <20 mg/m2 per hour, one had proteinuria of >20 mg/m2 per hour, and none had renal insufficiency. Although this case series is without controls, our treatment protocol may be of benefit to children with rapidly progressive HSPN. 相似文献
14.
J. Basic E. Golubovic P. Miljkovic G. Bjelakovic T. Cvetkovic V. Milosevic 《Renal failure》2013,35(6):639-643
Vesicoureteral reflux (VUR) is a common congenital anomaly of the urinary tract that may be inherited. Reflux of infected urine may cause scarring in susceptible kidneys with the potential to compromise renal function. The aim of the study was to evaluate the possible influence of different grades of VUR on glomerular damage using microalbuminuria as a parameter. Children with VUR detected by voiding cystourethrography (VCUG) were investigated. According to the grade of VUR, patients were separated into three groups. The first group included 12 children with VUR grade I–II. The second group consisted of 12 children with grade III of VUR. Patients with VUR grade IV–V (n = 11) were members of the third group. The control group consisted of 17 healthy children. Microalbuminuria was examined in samples of morning urine specimens using a microalbumin/creatinine reagent kit. Serum urea, creatinine levels and creatinine clearance (CCR) were measured as markers of renal function. The mean value of microalbumin excretion in the third group showed a statistically significant increase (p < 0.001) compared to all other groups. CCR in the third group was statistically significantly decreased (p < 0.05) in comparison to the group of healthy children. There were no statistically significant changes of microalbumin excretion and CCR in the first and second group compared to control values. We discussed the presence of microalbuminuria and decrease of CCR in children with high grade of VUR as a possible consequence of retrograde urine flow (intrarenal reflux), glomerulosclerosis, and consecutive hyperfiltration. 相似文献
15.
Contrasting renal effects of nicotine in smokers and non-smokers 总被引:6,自引:4,他引:2
Background: Cigarette smoking is associated with acute
increase in arterial pressure due to systemic vasoconstriction and
decreased skin and coronary blood flow. Virtually all cardiovascular
effects of cigarette smoking are due to nicotine. However, whether nicotine
also affects the renal circulation and function in humans is at present
unknown. Methods: In the current study the acute
effects of a 4-mg nicotine gum on arterial pressure, heart rate as well as
renal haemodynamics and function were assessed in non-smokers and chronic
smokers. Results: In non-smokers, mean arterial
pressure (+8±1 mm Hg, P<0.001) and heart rate
(+13±3 beats/min, P<0.001) increased whereas effective
renal plasma flow (ERPF) and glomerular filtration rate (GFR) decreased by
15±4% and 14±4% respectively; in addition, urinary
cyclic GMP decreased by 51±12% in response to nicotine
administration. In smokers, mean arterial pressure and heart rate increased
similarly; however, in contrast with non-smokers, ERPF and GFR remained
unchanged whereas urinary cyclic GMP rose by 87±43%. Changes in
ERPF induced by nicotine were positively correlated with changes in urinary
cyclic GMP. Conclusions: These findings indicate that
nicotine administration is associated with renal vasoconstriction in
healthy non-smokers, possibly through alteration of a cyclic-GMP-dependent
vasoactive mechanism. Tolerance to the renal effect of nicotine was
observed in chronic smokers, despite the maintenance of the systemic
response to nicotine. 相似文献
16.
Quantification of proteinuria in children using the urinary protein-osmolality ratio 总被引:1,自引:0,他引:1
Kim HS Cheon HW Choe JH Yoo KH Hong YS Lee JW Kim SK 《Pediatric nephrology (Berlin, Germany)》2001,16(1):73-76
A prospective study was conducted to determine the correlation of early morning urinary protein/osmolality ratio (mg/l/mosmol/kg)
with 24-h urinary protein excretion (mg/m2/day). Study patients consisted of 53 children (aged 1 month to 15 years). Early morning urine samples and 24-h urine samples
were collected and analyzed. In group 1 (children without proteinuria), early morning urinary protein/creatinine ratio (Uprot/Ucr,
mg/mg) was 0.061±0.011 and the protein/osmolality ratio (Uprot/Uosm, mg/l/mosmol/kg) was 0.073±0.014. Twenty-four hour urinary
protein excretion in group 1 had no significant correlation with Uprot/Ucr or Uprot/Uosm. In group II (children with proteinuria),
Uprot/Ucr was 5.78±1.10 and Uprot/Uosm was 4.42±1.34. Twenty- four hour urinary protein excretion in group 2 was 1483.6±303.7
mg/m2/day and its correlation with both Uprot/Uosm and Uprot/Ucr was highly significant (r= 0.87, P<0.001 and r=0.88, P<0.001, respectively). The accepted nephrotic level of proteinuria of 40 mg/m2/h coincides with a Uprot/Uosm ratio of 1.9. In conclusion, early morning urinary Uprot/Uosm is a simple and potentially useful
test for 24-h urinary protein excretion, and possibly could be used safely for the assessment of the degree of proteinuria
in children.
Received: 13 April 1999 / Revised: 23 February 2000 / Accepted: 15 August 2000 相似文献
17.
Movilli E; Zani R; Carli O; Sangalli L; Pola A; Camerini C; Cancarini G; Scolari F; Feller P; Maiorca R 《Nephrology, dialysis, transplantation》1998,13(7):1719-1722
Background: Metabolic acidosis in haemodialysis (HD)
patients increases whole body protein degradation while the correction of
acidosis reduces it. However, the effects of the correction of acidosis on
nutrition have not been clearly demonstrated. Study
design: In this study we have evaluated the effects of 3 months
of correction of metabolic acidosis by oral sodium bicarbonate
supplementation on protein catabolic rate (PCRn) and serum albumin
concentrations in 12 uraemic patients on maintenance HD for at least 6
months (median 49 months; range 6-243 months). Pre-dialysis serum
bicarbonate, arterial pH, serum albumin, total serum proteins, serum
creatinine, plasma sodium, haemoglobin, PCRn, Kt/V, and TACurea, were
evaluated before and after correction. Results: Serum
bicarbonate levels and arterial pH increased respectively from
19.3±0.6 mmol/l to 24.4±1.2 mmol/l (P<0.0001)
and 7.34±0.03 to 7.40±0.02 (P<0.0001). Serum
albumin increased from 34.9±2.1 g/l to 37.9±2.9 g/l
(P<0.01) while PCRn decreased from 1.11±0.17 g/kg/day to
1.03±0.17 g/kg/day (P<0.001). No changes in Kt/V, total
serum proteins, serum creatinine, plasma sodium, haemoglobin, body weight,
pre dialysis systolic and diastolic blood pressure, and intradialytic
weight loss were observed. Conclusions: Our data
demonstrate that correction of metabolic acidosis improves serum albumin
concentration in HD patients. The correction of acidosis induced a decrease
in PCRn values, as evaluated by kinetic criteria, suggesting that in the
presence of moderate to severe acidosis this parameter does not reflect the
real dietary protein intake of the patients probably as a result of
increased catabolism of endogenous proteins. The correction of metabolic
acidosis should be considered of paramount importance in HD patients. 相似文献
18.
Background: The increment in glomerular filtration
rate (GFR) after a protein load has been taken to reflect the renal reserve
capacity; however, this response is preserved in end-stage kidney disease.
Tubular secretion of creatinine is increased in relation to the GFR in
renal failure, but little is known about the tubular functional response to
stimulation despite the fact that tubulointerstitial lesions are always
pre-eminent in chronic renal damage. Therefore we decided to compare the
urinary creatinine excretion (UcrV) and tubular secretion of creatinine
(TScr) induced by a test meat meal in normal individuals and in individuals
with reduced nephron mass. Methods: We studied 12
normal subjects, seven healthy uninephrectomized (kidney donors) and eight
patients with chronic renal disease (serum creatinine ranging from 121.2 to
486 &mgr;mol/l). They had been on a standard diet for 5 days before the
studies. The test meal provided 80 g of animal protein. Three baseline and
four stimulated (post-meal) 30-min simultaneous inulin and creatinine
clearances were carried out. Results: We found that
normals increased more than twice the UCrV (post-meal=329.5±SEM
13.1 nmol/min/kg) and 3.4 times the TSCr (114,4±12.7
nmol/min/kg) after the test meal. In contrast, patients were unable to
raise their baseline values (P<0.001), despite a normal increment in
GFR. The data in kidney donors fell between normals and patients. Strong
correlation existed between the stimulated (but not the baseline) TScr
(P=0.003) and GFR and between UcrV post-meal/pre-meal ratio and GFR
(P<0.0001). Conclusion: The increment in TScr
resulting from a protein meal is related to the functioning nephron mass.
Evaluation of this increment could have potential clinical relevance. 相似文献
19.
Osteosarcoma is the most frequent primary high grade bone tumor, usually occurring in adolescents and children. The aim of the present study was to investigate parameters of bone turnover as urinary excretion of pyridinoline (Pyr), and deoxypyridinoline (D-Pyr), serum osteocalcin (OC), and total alkaline phosphatase (AP) in patients with osteosarcoma. Thirty-five patients aged 7–22 (median age 14) with primary high-grade osteosarcoma of the extremity entered the study. A control population of age- and sex-matched healthy individuals was studied. Urinary excretion of Pyr, D-Pyr was measured on fasting urine specimens, corrected for creatine excretion (Ucr), and expressed as pM/µM UCr. At the same time as urine collection, blood samples were taken for measurement of AP and OC. In patients with osteosarcoma the urinary excretion of D-Pyr (74.5 ± 41) was significantly higher (P = 0.005) than in controls (38.2 ± 22.5). The serum level of OC was significantly lower (P < 0.001) in patients with osteosarcoma than in controls. Moreover, significantly (P = 0.03) higher excretion of D-Pyr (85.3 ± 43) was found in patients who relapsed after surgical removal of the tumor and chemotherapeutic treatment compared with those (58.1 ± 22) who remained continuously free of disease. The present study showed significant abnormalities of urinary excretion of pyridinium crosslinks and serum OC level in patients with osteosarcoma. The relation between urinary excretion of D-Pyr and biological tumor aggressiveness observed in the present study requires further investigation. 相似文献
20.
Urinary calcium excretion in healthy Thai children 总被引:2,自引:0,他引:2
The objective of this study was to determine age-specific reference values for urinary calcium/creatinine ratios (UCa/Cr)
of children in southern Thailand. Non-fasting urine samples were collected from a random population of 488 healthy children
(282 males, 206 females) ranging in age from 17 days to 15 years. Samples were divided into six groups by age. Subjects whose
calcium levels exceeded the 95th percentile within each age group were classified as having hypercalciuria. Pyuria, hematuria,
proteinuria, urinary sodium, and potassium levels in children with normal UCa/Cr were compared with levels in children with
high UCa/Cr. The 95th percentiles for UCa/Cr (mg/mg) by age were: <6 months, 0.75; 6 months to <12 months, 0.64; 12 months
to <2 years, 0.40; 2 years to <5 years, 0.38; 5 years to <10 years, 0.29; and 10 years to <15 years, 0.26. Pyuria, hematuria,
and proteinuria were no more prevalent in the 22 children with hypercalciuria than in children with normal urinary calcium
levels. Urinary sodium/creatinine ratios (UNa/Cr) and urinary sodium/potassium ratios (UNa/K) were correlated with UCa/Cr
(r=0.41, P<0.0001 and r=0.24, P<0.0001, respectively). Urinary potassium/creatinine ratios (UK/Cr) were not (r=0.05, P>0.1)). Children with high UCa/Cr ratios also had higher UNa/Cr and UNa/K (5.6±7.1 vs. 2.6±1.5, P<0.001 and 5.4±2.3 vs. 2.5±0.23, P<0.05, respectively) The study established reference values for random, non-fasting UCa/Cr for healthy Thai children and indicated
that urinalysis is not a good indicator of hypercalciuria.
Received: 30 April 1999 / Revised: 19 August 1999 / Accepted: 19 August 1999 相似文献