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91.
M. Hoogerwerf 《Journal of Renal Care》2002,28(Z2):54-55
The patient with acute renal failure is a very ill patient suffering from high urea levels causing poor appetite, nausea and vomiting. These patients are usually treated with a low sodium, low protein and, if the potassium in the blood is high, with a low potassium diet (1). This paper discusses whether or not this is the correct treatment. The symptoms of high urea levels in the blood together with increased needs for energy and protein makes it very hard to prevent the patient becoming malnourished. Often energy‐enriched drinks are necessary to achieve recommendations and it is prudent to let the patient eat and drink what they desire. By calculating the energy and protein needs and comparing these with the intake and the state of illness and by following the patient's body weight over time we can obtain information about the state of nourishment. When we alter the food that's offered we achieve better intake and reduce the risk of malnourishment. 相似文献
92.
Philippe Brun Heykel Kchouk Brigitte Mouchet Véronique Baudouin Alain Raynaud Chantal Loirat Annabelle Azancot-Benisty 《Pediatric nephrology (Berlin, Germany)》1997,11(1):27-30
To evaluate the reliability of Doppler ultrasonography (US) in identifying children with renal artery stenosis (RAS) among
those with hypertension, we compared Doppler US results in 22 hypertensive children (mean age 8.9±4.3 years), with (13 cases)
and without RAS at angiography, and in 33 normotensive children (mean age 8.8±4.7 years). We observed 2 false-negatives and
2 false-positives with Doppler US. Of the 2 false-negative diagnoses, 1 had RAS on an accessory renal artery located behind
a normal upper polar artery and the other was observed in a patient with bilateral multiple stenosis of the very distal segments
of renal arteries. The 2 false-positive diagnoses were due to sinuous left renal artery and to technical reasons, respectively.
In another patient, Doppler US showed a tight RAS, while arteriography was normal. RAS was subsequently confirmed by a second
arteriography. Peak systolic velocity values of Doppler US were significantly higher in patients with proven angiographic
RAS (3.44±0.66 m/s) than in hypertensive patients with normal renal arteries at angiography (0.99±0.35 m/s, P <0.0001) and normotensive healthy children (1.04±0.23 m/s, P <0.0001). With the use of multiple views, and the experience acquired with practice, false-negatives or false-positives due
to the geometry of the renal artery can be avoided. Nevertheless, very distal stenosis can be missed by Doppler US.
Received October 30, 1995; received in revised form April 16, 1996; accepted May 14, 1996 相似文献
93.
病理性损伤因素对肾小管上皮细胞表型转化的影响 总被引:4,自引:0,他引:4
目的 :观察低血清、高糖、高蛋白刺激下肾小管上皮细胞向间叶性细胞的表型转化 ,探讨损伤的肾小管上皮细胞在肾小管间质纤维化中的作用。方法 :以体外培养的人近端肾小管上皮细胞为对象 ,分别用含低血清(0 .2mol·L-1小牛血清 )、高葡萄糖 (4.5 g·L-1)、高白蛋白 (15 g·L-1)的培养液培养 7d ,透射电镜检测细胞形态变化 ;免疫组化和Westernblot检测细胞表型改变 ,包括CK、Vimentin、α SMA、Ⅰ和Ⅲ型胶原 ,原位杂交检测Ⅰ型胶原mRNA表达 ,同时检测细胞TGFβ1蛋白表达。 结果 :低血清、高糖、高蛋白直接刺激下 ,肾小管上皮细胞出现明显形态学改变 ,包括细胞变为长梭形 ;透射电镜下细胞内线粒体明显减少 ,粗面内质网明显增加 ,并出现actin样微丝。免疫组化染色和Westernblot显示CK表达明显减弱 ,Vimentin、Ⅰ、Ⅲ型胶原、α SMA和TGFβ1表达增强。原位杂交显示Ⅰ型胶原mRNA表达增强。结论 :低血清、高糖、高蛋白可直接引起人近端肾小管上皮细胞TGFβ1表达增加 ,并发生向间叶性细胞的表型转化 相似文献
94.
为研究败血症时细菌溶解的程度对内毒素血症的影响,本文对肾移植术后怀疑为革兰氏阴性杆菌败血症患者的血中内毒素和细菌进行了定量检查。13名患者中有4人血中细菌定量>50cfu/ml,其血中内毒素水平由开始检查到最高峰时相差2~35倍,有一名患者在使用抗生素治疗过程中突然发生休克,最后由于呼吸、循环衰竭而死亡,其血中内毒素明显升高。本文结果表明:对于感染发病率很高的肾移植患者,如何控制和处理抗生素治疗后的高内毒素血症是一个值得研究的问题。血中内毒素和细菌的定量检查可以为及时采取针对性措施,防治内毒素血症提供依据。 相似文献
95.
We present a patient with vertebrobasilar insufficiency, with vertigo and horizontal nystagmus, induced by turning the head to the right. Angiography demonstrated transient occlusion of the left vertebral artery at the atlantoaxial joint during rotation of the head. The pathogenesis and angiographic findings are discussed. 相似文献
96.
益母草防治初发期急性肾小管坏死的实验研究 总被引:13,自引:3,他引:10
SD成年雄性大鼠,禁止16小时,肌注甘油引起急性肾小管坏死(ATN),于其初发期给予不同药液,观察到益母草组3、24及48小时Bcr升高值,24及48小时BUN升高值均明显低于自来水组和单纯禁水组,而与校正对照异搏停组近似,肾组织损伤程度亦明显减轻。结果表明,益母草对初发期急性肾小管坏死(IATN)有一定的防治作用。 相似文献
97.
Azathioprine, a well-known immunosuppressive agent, is used extensively in renal transplantation. There have been several case reports of pure red cell aplasia induced by this drug following a successful kidney transplant. Previous management of azathioprine-induced red cell aplasia included reduction of azathioprine dose, or treatment with cyclophosphamide. We propose the substitution of cyclosporine for azathioprine, in this clinical setting. Not only does cyclosporine allow recovery of bone marrow function, but it maintains a level of immunosuppression which stabilizes renal function in the post-transplant patient. 相似文献
98.
When regional intraarterial infusion is applied in the treatment of malignant tumors it is essential to reach the tumor via all its major feeder vessels. In this study VX-2 carcinoma was implanted into the lower pole of the left kidney in 24 rabbits to investigate whether the renal capsular artery takes part in tumor feeding. The rabbits were divided into four groups that were followed for 8, 10, 12 or 14 days after tumor implantation. At that time the renal artery was ligated close to the kidney and subsequently silicone rubber or barium sulfate/gelatin suspension was injected into the capsular artery. The tissue was cleared, and the tumor carefully removed and examined microscopically for traces of silicone rubber. When barium sulfate had been injected, the kidney was examined radiographically in order to detect possible presence of contrast medium in the tumor. This study revealed no vascular supply to the implanted VX-2 carcinoma from the capsular artery when the tumor was confined intracapsularly, i.e., up to 12 days after tumor implantation in untreated rabbits.This investigation was performed at the Oncological Research Laboratory, Department of Diagnostic Radiology, University of Bergen, Bergen, Norway 相似文献
99.
对60例临床诊断为椎—基底动脉供血不足的老年人进行脑干听觉诱发电位(BAEP)检查,51例异常者(异常率为85%)均在发作期检查,9例颈性眩晕病人于缓解期检查(BAEP)正常。BAEP异常提示老年人可能由于长期椎—基底动脉供血不足造成脑干内有影响听觉通路的微小梗塞灶。证明BAEP检查叫老年性椎—基底动脉供血不足的诊断很有价值。 相似文献
100.