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Biomedical subjects

A Drukker

Publications and source records attributed to A Drukker.

At least 73 records · Page 4Linked to original sources
PubMed1986

Combined cyclophosphamide and corticosteroid-induced remission in severe glomerulopathy associated with systemic vasculitis.

Three patients with systemic vasculitis and severe renal disease as major manifestations are reported. In 2 cases, rapidly progressive glomerulonephritis presented as oliguric renal failure. In the third case, the clinical picture was severe nephrotic syndrome with decreased renal function. Combined cyclophosphamide and corticosteroid treatment resulted in dramatic improvement of renal function and remission of nephrotic syndrome. In 2 cases, histological improvement was documented by repeated kidney biopsy. The optimal duration of cyclophosphamide therapy has to be determined.

Adult↗
PubMed1986

Hyperlipidemia after renal transplantation in children on alternate day corticosteroid therapy.

We studied the serum lipid profiles of 29 children, 3.9-17.9 years of age who were 0.6-7.6 years after renal transplantation (Tx). Twenty normoglycemic and non-proteinuric children had a well functioning allograft and 5 children had reduced renal function. Both groups were at least 7 months on alternate day corticosteroid (ADCS) therapy. Four additional patients had good renal function but were only 2.3 +/- 0.5 months on an ADCS regimen. Fifteen normal children served as controls. The levels of serum triglycerides (STG) and total cholesterol (CHOL) were elevated and high-density lipoprotein CHOL (HDL-CHOL) were low in all patients compared to control subjects (p less than 0.01). Their cardiovascular risk factor (CHOL/HDL-CHOL) was increased. The lipid abnormalities were most prominent in Tx patients with reduced graft function. These data show that treatment with ADCS does not prevent post-Tx hyperlipidemia. More insight is needed into the mechanisms responsible for the hyperlipidemia after Tx in order to reduce possible future morbidity (and mortality) from premature cardiovascular disease in this group of young, high-risk patients.

Adolescent↗
PubMed1986

Natriuretic response to i.v. saline loading after acute poststreptococcal glomerulonephritis.

The outcome of acute poststreptococcal glomerulonephritis (APSGN) is still controversial. Whereas many studies show a good prognosis, particularly in children, late morphologic and functional renal abnormalities have been described. To verify this latter finding, we evaluated the sodium handling of the kidney several years after APSGN. Eleven subjects (9 children and adolescents and 2 adults) were studied 2 to 3 years after APSGN. At the time of the study all patients were well, without pathologic urinary findings and with normal blood pressures. Five healthy subjects (3 adults and 2 children) served as controls. Following two control periods of 30 min, an i.v. saline load (2.5% NaCl, 1 l/1.73 m2 body surface area) was administered over 45 min. Sodium excretion was measured during the control and salt-loading periods, and during four additional 30-min collection periods. No exaggerated natriuresis was found. We therefore conclude that epidemic APSGN in Israel carries not only an excellent clinical but also a good renal functional prognosis.

Adolescent↗
PubMed1985

Acute renal failure in a burn patient: the advantages of continuous peritoneal dialysis.

An 8-year-old girl sustained 65-70 per cent body surface area burns when her clothes caught fire. Two weeks later, she developed acute renal failure (ARF) and needed dialysis therapy. The extensive, infected burn area prevented the establishment of a safe vascular access for haemodialysis. Continuous peritoneal dialysis proved to be a valid alternative form of treatment and even had advantages over haemodialysis. Large amounts of fluids, calories and electrolytes could be administered via the peritoneal route. This facilitated the treatment of the catabolic state of the uraemic burn patient and served to correct the electrolyte losses via the skin. Peritoneal dialysis is a valuable adjunct to the treatment of acute renal failure in burn patients who need renal replacement therapy.

Acute Kidney Injury↗
PubMed1984

Dialysis-induced hypoxemia. Continuous monitoring of blood oxygen and carbon dioxide tension in children.

We report our experience with continuous, transcutaneous monitoring of capillary oxygen and carbon dioxide tension (PtcO2, PTlcCO2 ) during the entire length of hemodialysis treatment in 8 pediatric patients. The relative changes in PtcO2 and PtcCO2 observed with this method were in accordance with those reported in the literature, obtained with frequent arterial blood sampling. There was a temporary fall of PtcO2, averaging 26.2% after 2h of dialysis, with a concomitant rise of PtcCO2 of 9.9%. The noninvasive, transcutaneous measurement of PtcO2 and PtcCO2 is a reliable and valuable adjunct for the monitoring of the dialysis patient who is prone to develop hypoxemia. It is particularly useful in the very young.

Adolescent↗
PubMed1984

Renal candidiasis in infancy--a case with fungus ball obstruction.

A sixteen day old infant developed candiduria after surgery on a single functioning, hydronephrotic kidney with ureteropelvic junction stenosis. Masses of candida albicans caused obstruction of the ureter with acute anuria. Endoscopic relief of the obstruction together with aggressive antifungal therapy led to irradication of the fungal infection. This case history emphasizes the fact that candida infection in early childhood should be evaluated carefully. Unfortunately no guidelines are yet available for the indications and the preferred mode of treatment, and length of therapy of infantile renal candidiasis.

Amphotericin B↗
PubMed1983

Intrarenal distribution of renin in the developing rabbit.

The purpose of this study was to evaluate the intrarenal distribution of renin in individual glomeruli during development in the rabbit. Superficial cortical and juxtamedullary glomeruli were obtained from animals at 1, 2, and 4 wk of age and from adults to determine renin concentration. In addition, kidney weight, total renal renin content, plasma renin concentration, and plasma angiotensin I concentration were also measured during this time period. Superficial cortical glomerular renin concentration at 1 wk of age averaged 7.7 +/- 1.6 (S.E.M.) pg/h whereas juxtamedullary glomerular renin concentration was 4.5 +/- 1.8 pg/h. There was no difference in concentration between the superficial and deep glomeruli at this age. At 2 wk of age, however, superficial glomerular content had increased significantly to 143.8 +/- 2.94 pg/h whereas the juxtamedullary concentration remained unchanged (7.9 +/- 1.6 pg/h). The concentration in the superficial nephrons continued to increase with age. At 4 wk, superficial renin content was 224.6 +/- 27.2 whereas the deep nephrons did not change (16.0 +/- 7.5 pg/h). Adult animals demonstrated a further increase to 842.7 +/- 15.1 pg/h in the superficial nephrons whereas the deep nephrons continued to remain low (15.9 +/- 4.7 pg/h). The results of this study demonstrate that after the first week of life there was significantly more renin activity in glomeruli in the outer cortex than in the juxtamedullary cortex. Total renal renin concentration increased with age and showed a significant positive correlation with the concomitant increase in kidney weight. But renal renin content increased more than kidney weight between 1-2 wk of age.

Age Factors↗
PubMed1983

Candida peritonitis-inefficacy of amphotericin-B and 5-fluorocytosine treatment.

A 3 1/2 year old child with chronic renal failure twice developed severe candida peritonitis in the course of treatment with continuous ambulatory peritoneal dialysis. Medical treatment was unsuccessful but removal of the catheter led to immediate cure. This case documents a long held clinical impression that the best, if not the only way of treatment of candida peritonitis is removal of the indwelling catheter. Thus, potentially hazardous, painful and costly medical treatment can and should be avoided.

Amphotericin B↗
PubMed1982

Impaired intestinal fat absorption in chronic renal failure.

We performed oral fat loading tests in 10 patients with chronic renal failure (CRF) on hemodialysis (5 children and 5 adults). Fat absorption was measured by hourly determination of serum triglycerides (TG), cholesterol (CHOL), and lipoproteins (LP) after oral administration of a 'milkshake' containing 50 g of fat of dairy origin. 10 age-matched healthy volunteers with normal fasting serum TG levels and 10 subjects with fasting hypertriglyceridemia served as controls. Mean fasting serum TG levels in CRF patients were elevated compared to normal controls (177.6 +/- 14.6 mg/dl, 2.0 +/- 17 mmol/l vs. 91.0 +/- 10.5 mg/dl, 1.03 +/- 12 mmol/l). 6 patients (4 adults, 2 children) had type IV LP patterns and 2 patients (both children) showed type IIb hyperlipidemia. In only 2 patients, 1 child and 1 adult were TG, CHOL and LP electrophoresis all normal. The oral fat loading test in all CRF patients showed delayed appearance of TG and chylomicrons (CHYL) in the bloodstream i.c. impaired or slow absorption of fat from the gut. In contrast to normal and hypertriglyceridemic controls, TG and CHYL levels in CRF did not decrease by 5 h after the oral fat load. This study demonstrates impaired intestinal fat absorption in children and adults with CRF.

Adolescent↗