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Biomedical subjects

A Blumberg

Publications and source records attributed to A Blumberg.

At least 91 records · Page 5Linked to original sources
PubMed1977

[Effect of aluminium-hydroxide-containing antacids on the intestinal absorption of iron in patients on long-term dialysis].

In 6 patients on maintenance hemodialysis the influence of an aluminium hydroxyde containing antacid (administered to prevent hyperphosphatemia) on the intestinal absorption of iron was measured with 59Fe and with a whole body counter. Iron absorption was 3.4% of the dose administered (geometric mean) while the patients were on antacids. After omission of the medication it rose slightly on 4.1%, the difference being not statistically significant (p greater than 0.5). It is concluded that aluminium hydroxyde containing antacids do not impair intestinal iron absorption in patients on maintenance hemodialysis.

Adult↗
PubMed1977

Monitoring of pulmonary fluid volume and stroke volume by impedance cardiography in patients on hemodialysis.

Changes of intrathoracic fludi volume during maintenance therapy with hemodialysis were studied in ten patients with the aid of impedance cardiography. It was found that there was a statistically significant correlation between the decrease in body weight and the increase in basic thoracic impedance in the individual patients, but the values differed considerably from one patient to another. Therefore, comparison of sequential measurements is feasible only in one and the same patient. Out of 16 patients with overhydration undergoing dialysis, the stroke volume could not be determined by impedance cardiographic studies in eight, owing to the abnormal morphology of the dZ/dt curve. Moreover, because the basic thoracic impedance was not constant during treatment, the calculated changes in stroke volume did not appear to be reliable. This has to be taken into account when repeated measurements are made under clinical conditions. In some of the patients, the dZ/dt curve displayed interesting anomalies, probably resulting from hemodynamic alterations. The diagnostic meaning of these features is not yet known.

Adult↗
PubMed1976

Serial measurements of total blood volume in patients on maintenance hemodialysis.

In 10 patients on maintenance dialysis red cell and plasma volumes (PV) were measured before and after dialysis and several times during the next 3 days in order to establish the usual pattern of intravascular variation associated with this treatment and to determine whether there was a correlation with dialysis induced untoward effects. PV decreased from 23.7 +/- 1.5 before to 20.7 +/- 1.5 ml/cm body height immediately after dialysis. Unexpectedly it was even significantly lower 16 h after (20.1 +/- 1.4 ml/cm). Nevertheless, undesired dialysis symptoms had disappeared by that time indicating that they had not been caused by a reduction in PV or that the patients had adapted to it. Changes in PV correlated better with changes in hematocrit (r = 0.89) than with changes in body weight (r = 0.60). Therefore careful determination of the large vessel hematocrit offers a reliable estimation of blood volume variations over short periods.

Blood Volume↗
PubMed1976

Hypertension in terminal renal failure.

Inverse interrelations between plasma renin activity and exchangeable sodium or blood volume were found in both normotensive (N = 23) and hypertensive (N =29) hemodialysis patients (r= 0.47; P less than 0.005); however, mean plasma renin for any given sodium/volume state was at least two-fold higher in hypertensive than in normotensive hemodialysis patients or normal subjects (N =31). In the hemodialysis patients, blood pressure correlated weakly but significantly with the products of circulating renin and exchangeable sodium (r=0.37; P less than 0.005) or blood volume (r = 0.29; P less than 0.05). Multiple regression analysis including duration of previous hypertension as the second independent variable increased these correlation coefficients to 0.44 and 0.42, respectively. This suggests that hypertension in endstage kidney disease is often associated with resetting of the body sodium/fluid=renin feedback mechanism. Inappropriately increased plasma renine activity relative to the body sodium/volume state as well as high blood pressure-induced vascular changes may play important complementary roles, but it appears evident that additional mechanisms are also operative in maintaining end-stage renal hypertension.

Adult↗
PubMed1976

Mechanism of post dialysis hyperventilation in patients with chronic renal insufficiency.

Several hypotheses have been put forward to explain postdialysis hypocapnia. Three were tested in this study: impairment of tissue oxygenation by dialysis (D)-induced alkalosis (Bohr effect), the D disequilibrium syndrome, and the loss of carbon dioxide (CO2) in D fluid. In 17 patients pre-DPCO2 was significantly correlated with plasma bicarbonate concentration (HCO3) and no disproportionate reduction of PCO2 was discernible. In 10 patients using a bath acetate concentration of 38 mEq/1 PCO2 was unchanged after D (35.4 versus 35.9 mm Hg before D), and was low relative to HCO3 whic increased from 21.2 to 28.0 mEq/1. After a dialysis using an acetate concentration of 25 mEq/1 HCO3 remained constant (20.4 versus 21.1 mEq/1 pre-D), whereas PCO2 fell from 35.3 to 30.8 mm Hg (P less than 0.001). Consequently PCO2 was again low relative to HCO3. Removal of CO2 by D fluid was excluded as a cause for low blood PCO2: addition of gaseous CO2 to the bath had no influence on arterial blood gases. Since post-D hypocapnia was not prevented when HCO3 was kept constant, it was concluded that post-D alkalosis cannot be the main reason for post-D hyperventilation, and that other factors related to the process of D are responsible.

Acetates↗
PubMed1975

[Proceedings: Correlations between blood pressure, body sodium/blood volume state and plasma renin in patients with terminal kidney insufficiency].

Plasma renin activity was found to correlate inversely with exchangeable sodium or blood volume in both normotensive and hypertensive hemodialysis patients. However, in the hypertensive patients mean circulating renin for any given sodium/volume state was markedly higher than in normotensive patients or normal subjects. Blood pressure correlated more closely with the products of circulating renin and exchangeable sodium (r = 0.55; p less than 0.001) or blood volume (r = 0.43; p less than 0.001) than with the individual components (r less than or equal to 0.39); multiple regression analysis including duration of previous hypertension as a second independent variable further improved these correlations (r = 0.66 and r = 0.63 respectively). This suggests that the sodium/volume state, circulating renin and vascular changes resulting from previous hypertension may be important complementary determinants of blood pressure in hemodialysis patients.

Blood Pressure↗
PubMed1975

[Hemolytic-uremic syndrome in a young woman following the use of ovulation inhibitors].

After prolonged intake of oral contraceptives a 28-year-old woman developed a hemolytic uremic syndrome with microangiopathic hemolytic anemia, renal failure, malignant hypertension and blindness due to papillary congestion. Renal biopsy revealed widespread arteriolar alterations with massive intimal thickening, narrowing of the lumina and fibrinoid necrosis. During treatment with anticoagulation, antihypertensives and hemodialysis the hemolysis disappeared and vision improved, but the renal failure persisted. The possible relation between oral contraceptives and hemolytic uremic syndrome is mentioned and the literature is reviewed.

Adult↗