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Biomedical subjects

A Baumelou

Publications and source records attributed to A Baumelou.

At least 73 records · Page 4Linked to original sources
PubMed1988

Acute renal failure induced by foscarnet: 4 cases.

Foscarnet (FC) is a new antiviral agent which has been recently proposed for the treatment of severe cytomegalovirus (CMV) infections in immunocompromised patients. When used intravenously (i.v.), main adverse effects of FC are a fall in hemoglobin, and an increase in liver enzymes and serum calcium. Although increased serum creatinine have been noted in several patients, deterioration of renal function is often accounted for by the concomitant use of other nephrotoxic drugs, the severity of underlying disease or the presence of graft rejection. Consequently FC is often considered as a non or poorly nephrotoxic drug. We report 4 cases of acute renal failure (ARF) which can be exclusively attributed to FC. FC was used for CMV chorioretinitis in 3 AIDS patients and in one non-immunocompromised patient. ARF was diagnosed between the 6th and 15th day of treatment, with oligoanuria in two patients (one of whom required two hemodialysis periods). ARF was most likely secondary to acute toxic tubulopathy. Three patients did not receive any other nephrotoxic drug. The fourth patient received concomitantly sulfadiazine but renal function returned to baseline value after FC completion although sulfadiazine was continued. In conclusion, our 4 observations suggest that FC may be responsible for acute tubulopathy. We suggest that in these patients renal function should be carefully monitored and dehydration promptly corrected to limit the risk of nephrotoxicity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Functional renal effects of cyclosporin. Physiopathological mechanisms].

Animals and humans undergoing a treatment with cyclosporin (CsA) show a reversible increase in renal vascular resistance and decrease in glomerular filtration rate. The causes of these abnormalities have not yet been established. In animals potential mechanisms for CsA induced renal functional impairment are an increase in urinary thromboxane A2 excretion, plasma renin activity and renal sympathetic nervous system activity and an enhancement of vasopressin stimulated Ca++ mobilisation and cell contraction in vascular smooth muscle cells. In human, the problem is far less clear. CsA induces an inhibition in PRA and urinary prostaglandins excretion. Furthermore CsA does not modify urinary and plasma levels of catecholamines. Whatever the mechanism underlying the vasoconstriction induced by CsA, the inhibition of PGI2 synthesis and angiotensin II formation may participate in the decrease in renal blood flow and glomerular filtration rate which is observed in patients receiving CsA.

Animals↗
PubMed1988

[Clinical aspects of continuous ambulatory peritoneal dialysis in diabetics].

The treatment of end stage renal diabetic nephropathy remains a challenge. A large experience allows us to clearly outline the advantages and the drawbacks of continuous ambulatory peritoneal dialysis (CAPD). 81 patients, mean age 51.3 years, were treated over the past nine years by CAPD-CCPD. Extrarenal complications, mainly vascular lesions, account for qualifying these patients as a high risk population. The technique was modified in order to inject insulin intraperitoneally, four times per day, to control blood glucose level. Peripheral vascular disease was prospectively studied in 19 patients. Actuarial survival was 92% at one year, 50% at four years mainly influenced by age: 85% survival at two years in 35 patients aged less than 50 years and 62% at two years in 46 patients aged more than 50 years. The main causes of death were of cardiovascular origin: arteritis, myocardial infarction, stroke. The main causes for transfer to an alternative method of treatment were technical complications. Peritonitis rate was one episode ever 14 months. Satisfactory control of blood pressure, blood glucose levels, main biological parameters, visual status were the clear advantages of the method. Peripheral vascular disease is not influenced by the technique. CAPD can be the technique of first choice in young diabetics awaiting a kidney transplant and the reference technique for home dialysis.

Adult↗
PubMed1988

Effects of nifedipine on cisplatinum-induced nephrotoxicity in rats.

The effects of calcium channel blockade with nifedipine (N) on cis-diammine dichloroplatinum II (CDDP)-induced nephrotoxicity were tested in male Sprague-Dawley rats. Renal function was evaluated before and five days after CDDP administration (5 mg/kg). The rats were treated with various doses of N (0.1; 0.3; 0.6 mg/kg/day) 2 days before CDDP administration and throughout the study. The severity of CDDP-induced acute renal failure was markedly modified in N-treated animals according to the daily dosage of N. At 0.3 and 0.6 mg/kg BW/day, N enhanced CDDP nephrotoxicity. Serum creatinine was 637 +/- 45 and 611 +/- 71 mumoles/liter, respectively, 5 days after CDDP administration (vs. 313 +/- 24 mumoles in animals treated with CDDP alone; p less than 0.05). In these animals the plasma potassium level was significantly elevated at day 7 when compared with CDDP-treated and control rats. In contrast, at the dose of 0.1 mg/kg BW/day N attenuated CDDP nephrotoxicity with a serum creatinine of 214 +/- 35 mumoles at the end of the study. The pathologic changes were also more severe in the groups receiving 0.3 and 0.6 mg/kg of nifedipine. We postulate that at the higher doses (0.3 and 0.6 mg/kg) the systemic hemodynamic effects of nifedipine may override the potentially beneficial intrarenal effect which may account for the favorable results recorded with a dosage of 0.1 mg/kg.

Acute Kidney Injury↗
PubMed1988

Transperitoneal movement and pharmacokinetics of cefotiam and cefsulodin in patients on continuous ambulatory peritoneal dialysis.

The kinetics of cefotiam and cefsulodin were studied in plasma and dialysate after intravenous and intraperitoneal administration of 1 g to patients undergoing continuous ambulatory peritoneal dialysis. Instillation of autologous hemoglobin as a marker permitted calculation of the cavity volume and, hence, the rate of transfer to and from the peritoneal cavity with time. The patients were divided into 4 groups. Groups 1 and 2 were intravenously given cefotiam (5 patients) and cefsulodin (4 patients), respectively. Groups 3 and 4 (5 patients each) were given cefsulodin intraperitoneally. Group 3 did not have peritonitis, while the patients in Group 4 were studied during peritonitis. Blood and dialysate samples were obtained at selected times during the 5-hour dwell and, for plasma, until 24 hours after drug administration. Pharmacokinetic analysis of the data showed that only 6.0 and 8.7% of the intravenous doses of cefotiam and cefsulodin, respectively, were recovered in the dialysate at the end of the dwell. The net amounts of cefsulodin lost from the dialysate after intraperitoneal administration were 81 and 84%, in Groups 3 and 4 respectively. The peritoneal transfer clearances (using a unidirectional clearance model), calculated after intravenous (17 +/- 10 ml/min, Group 2) and intraperitoneal (17 +/- 5 ml/min, Group 3) administrations were the same. Mass balance of cefsulodin in the body and in the dialysate after intraperitoneal administration indicated that a significant amount (40%, Group 3) of the dose is unaccounted for. One explanation for this imbalance is retention of the drug in the peritoneal lining. This hypothesis is supported by the retention being lower in the peritonitis patients (less than 20%, Group 4), for whom the linings are expected to be partially eroded.

Adult↗
PubMed1988

[Removal of prednisone and prednisolone during plasma exchange].

Prednisone and prednisolone extraction was determined during seven sessions of plasma exchange in four patients. Each patient received 0.5 mg/kg of prednisone administered orally 2 hours before plasma exchange. Concentrations of prednisone and prednisolone were determined in blood before, every half hour during and at the end of plasma exchange. Both drugs were also determined in removed plasma, mean volume of removed plasma being 0.96 plasmatic mass. The amount of combined prednisone and prednisolone removed by plasma exchange was 1.70% of the administered prednisone dose. This quantity appears minimal and supplemental dosing of prednisone or modification of administration time would seem to be unnecessary.

Chromatography, High Pressure Liquid↗
PubMed1987

[Hemolytic-uremic syndrome in adults].

Haemolytic uraemic syndrome is a rare condition easily diagnosed from biochemical data. Numerous forms consecutive to pregnancy, systemic diseases, carcinomas (notably mucin-secreting gastric adenocarcinoma), infections and medications have been described. The physiopathology of the syndrome, although more elaborate, is not entirely clear. The fundamental anatomical lesions (fibrin-platelet microthrombi) develop from vascular endothelial injuries. They persist and extend due to the non-functioning of physiological regulatory systems, in particular the coagulation-fibrinolysis system. In spite of frequently heavy and expensive treatments empirically applied, the course of the disease is generally unfavourable, with a mortality of about 50%.

Hemolytic-Uremic Syndrome↗
PubMed1987

[Quantification of proteinuria by measurement of the protein/creatinine ratio].

Accurate quantification of urinary protein excretion is difficult due to problems in 24-hour urine collection. We have evaluated the value of the protein/creatinine ratio in one single urine sample. There was an excellent correlation between this ratio and the protein content of a 24-hour urine collection [Pu (g/24 h) = 11.7 Pu (g/l) Cr (mmol/l); r = 0.96; P less than 0.001]. The best correlation was found with the sample collected after the first voided morning specimen. In our experience the ratio is more accurate for the quantification of urinary protein excretion than measurement of protein excretion in the same urine sample and also determination of protein excretion in 24-hour urine collected under the usual ambulatory conditions. We suggest that the protein/creatinine ratio should be used in ambulatory and hospitalized patients, especially for multicentric clinical trials in nephrology.

Ambulatory Care↗