Histamine-stimulated gastric secretion in rats with chronic renal insufficiency

Chronic uremia was induced by long-term maintenance of rats which had undergone sub-total nephrectomy, with sham-operated rats serving as controls. Chronic gastric cannulas and chronic vascular catheters (vena cava) were installed and the rats were stimulated with intravenous infusion of histamine. In uremic rats, the volume of gastric juice, output of HC1 and H+ concentration were significantly higher than in the controls during the 6-hour secretion experiments.     

Cognitive disorders in patients with chronic renal insufficiency

Papillomaviruses are pathogens which induce cutaneous and mucosal lesions in man and in many animal species. The characterization of these viruses was rather low, because viral infection cannot be fully reproduced in cell culture. The development of molecular biology techniques in the 1970s permitted to establish the remarkable plurality of the viruses, the tissue specificity and pecular pathogenicity linked to the type. Studies of the genome organization, the gene expression regulation and the protein characterization gave many informations leading to understand the mechanisms of viral-related carcinogenesis, especially the role of HPV16, the major risk factor for the development of squamous cervical carcinoma.     

Chronic renal insufficiency: 1) adaptation of nephron function in chronic renal insufficiency and 2) progression of chronic renal insufficiency

In chronic renal insufficiency resulting from destruction of the vast majority of nephrons, the surviving nephrons adapt their functions to the conditions of vigorous haemodynamic and osmolar overloads. They acquire an appropriate behaviour to preserve the principal renal functions and to achieve the balance of inner space. In the long period of time, similarly as in healthy people. Glomerulotubular balance as well as tubuloglomerular balance distinguish the remaining nephron function, while autoregulation of perfusion pressure along the glomerulus rapidly vanishes. All three regulation mechanisms are characteristic of the nephron function under physiologic conditions. Intense work of the remaining nephrons in chronic renal failure is under the high level controls of the group of hormones, among them are rennin-angiotensin system, arginine-vasopressin and atrial natriuretic peptide playing very important and particular roles. Comparison of different published studies emerge the idea that chronically increased arginine-vasopressin levels in chronic renal failure could block the autoregulation of blood flow and hydraulic pressure in glomeruli, which together with other mediator actions give high and fluctuating tense within remaining glomeruli, during every single cardiac cycle. It is probably the main event in the further course of kidney disease progression resulting in definite damage of the overloaded nephrons. Angiotensin II is one of reliably recognised mediators of unfavourable outcome in the process of nephron adaptation in chronic renal failure. Knowing the pathophysiologic processes in the remaining functionally adapted nephrons in chronic renal insufficiency determines a more adequate therapeutic approach in these patients.     

Pericarditis in chronic compensated renal insufficiency

In 80 patients with renal insufficiency we found 15 cases of pericarditis, demonstrated by the diagnostic means of echocardiography. The incidence of pericarditis increased with the rise in serum-creatinin and the severity of hypalbuminemia. These findings confirm the assumption that toxic capillary damage combined with lowered oncotic pressure might be a cause of pericardial effusion. Echocardiography as a reliable and non-invasive diagnostic method should be applied routinely in patients with chronic renal insufficiency--regarding potential therapeutic consequences--especially in patients with a concomitant incidence of hypalbuminemia and pleural effusion.     

Disorders of the calcium-sensing receptor

From 1990 to 1995, 12 patients with cavo-atrial renal cell carcinoma underwent resection of the tumor. Circulatory arrest was employed in 11/12 cases. The neoplasm extended to the inferior vena cava in two patients and to the intrahepatic veins or right atrium in five cases. Two severely cardiac compromised patients died perioperatively. Of five patients who showed preoperative suspicion of isolated metastases, 3 patients died postoperatively because of relapsing disease after a mean period of 10.8 months. Five patients are alive and doing well after a mean follow-up of 14.8 months. In our experience myocardial dysfunction determined poor immediate survival. Mid-term survival was influenced by preoperative metastases and lymph-node involvement, but not by intracaval extension. Circulatory arrest appears to be a relatively safe technique to remove renal carcinoma with cavo-atrial extension and should be indicated whenever there are no metastases.     

Acute renal insufficiency in renal transplants treated with interferon-alpha for chronic hepatitis C

Small-angle x-ray scattering (SAXS) can provide information on mean size, predominant orientation and typical shape of mineral crystals in bone. In this paper, recent developments of this technique for application in bone research are reviewed. Then the structure of the collagen/mineral composite in bone, as determined by SAXS, is compared for a number of species. The thickness of the mineral crystals was found to increase with age up to a value around 3 to 4 nanometers in adult animals, depending on the species. The SAXS results also suggest the existence of needle-shaped mineral crystals in mouse or rat bone and more plate-shaped crystals in other tissues like adult human bone or mineralized turkey leg tendon.     

Treatment of urinary infections in chronic renal insufficiency

The author describes some differences in the course of treatment of urinary pathway infections in prolonged reduced renal function. He emphasizes changes from the aspect of the clinical course of urinary infections and changes in the pharmacokinetics and pharmacodynamics of antibiotics and principles for selection of therapy are outlined.     

Plasma serine protease inhibitors in dialyzed patients with chronic renal insufficiency

In the plasma of fourty dialyzed patients with chronic renal insufficiency in comparison to controls a mild decrease of AT III activity, low activity of PAI-1 and alfa-2 AP with normal activity alfa-2 M. and alfa-1 PI were observed. Hemodialysis with the presence of heparin except of mild shortness of ELT did not influenced the activities of the inhibitors in the plasma of the patients. The decrease of PAI-1 and alfa-2 AP activity with increased FDP concentration in the dialyzed patients can suggests the occurrence of secondary fibrinolysis activation with consumption of these inhibitors.     

Patients with chronic renal insufficiency in hemodialysis: nurses educational activities

The aim of this study is to contribute to the knowledge of the nurse's educative activity with chronic renal patients undergoing an hemodialytic treatment, providing an improvement in the patient's quality of life and using a model called "awareness education". The subjects of this study were eight chronic renal patients--four female patients and four male patients whose age varied from 17 to 63 years old. The methodological approach was the research-action and data collection about significant situations was carried out through participant observation. Data interpretation was related to the referential proposed by PAULO FREIRE, i.e. the analysis of the generating themes. Data were selected and encoded in six generating topics: Chronic Renal Failure (IRC), Causes of IRC, Hemodialytic Treatment, Chronic Renal Patient's Limitations and Possibilities when undergoing an Hemodialytic Treatment, Renal Transplantation and Family Support. The Discussion Groups were developed according to the Pedagogical Method by PAULO FREIRE. After that stage, satisfactory changes in the chronic renal patients' quality of life who participated in the teaching-learning process have been observed. This has enabled us to conclude that there has been a development of the na?ve consciousness for the criticism about their situation, owing to some changes in their reality.     

Progression of chronic renal insufficiency in chronic rejection: the role of chronic transplantation glomerulopathy

The authors studied variations in the pulsatility index of the uterine arteries in postmenopausal women who had received hormone replacement treatment (HRT) for at least one year and compared them to those in a control group not receiving HRT. The results showed a significant variation in this index with the tendency to assume lower values compared to the control group, thus resulting in increased uterine vascularization, almost resembling that observed during the child-bearing period. This drop in the pulsatility index should probably be considered the anatomo-functional in patients not receiving HRT.     

Treatment of anemia in patients with chronic renal insufficiency with recombinant human erythropoietin

The discovery of recombinant human erythropoietin has enabled treatment of anaemia in patients whose anaemia was primarily caused by the lack of erythropoietin. This agent was most widely used in the treatment of anaemia in chronic renal failure patients. Non-regulated hypertension is considered to be the only absolute contraindication for recombinant human erythropoietin application, but thrombocytosis, predisposition to thromboses of arterio-venous fistulae, and convulsions are regarded as relative contraindications. Recombinant human erythropoietin may be administered intravenously, but the subcutaneous route is considered more rational. The treatment is initiated by low doses with gradual dose increase, what enables gradual anaemia correction and prevents the appearance of adverse effects. Haemoglobin level of around 100 g/l is considered the target haemoglobin level. The majority of patients respond well to treatment by human recombinant erythropoietin and the absence of anaemia improvement may be the result of iron deficiency, occult haemorrhages, chronic infection, inadequate dialysis, secondary hyperparathyroidism, aluminium intoxication. Anaemia improvement during the treatment with recombinant erythropoietin leads to the improvement of function of most organs and the quality of life in general as well as avoidance of blood transfusions and their adverse effects. The most frequent adverse effect of recombinant erythropoietin is the development of iron deficiency or hypertension aggravation.