[Markers of chronic renal failure and assessment of renal function].
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Biomedical subjects
Publications and source records attributed to A V Papaian.
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Diuretic and aciduretic reactions were compared in healthy children and children with various renal diseases using furosemide loading test. Diuresis, urinary pH, urinary excretion of titered acids and ammonium, and ammonium coefficient were evaluated in healthy controls, patients with chronic and acute renal insufficiency, convalescents after acute renal insufficiency and acute postinfection glomerulonephritis, patients with chronic pyelonephritis, interstitial nephritis, lipoid nephrosis, hematuric chronic glomerulonephritis, and patients with a solitary kidney. Diuresis, urinary pH, ammonium excretion, and ammonium coefficient are proposed as the main test parameters. Patients with the distal tubular acidosis syndrome formed a special group by the results of urinary pH measurements during the third hour of furosemide action. The test helps evaluate the severity of disease and predict its course.
Peculiarities of the excretion of ions (Na, K, Ca, Mg) and water were studied in healthy children and children with the nocturnal enuresis, aged 6-15 years. A greater diuresis in the enuretic children is due to an increased excretion of the osmotically active substances including Na and Mg; excretion of K and Ca does nor differ from the control. A new formula is proposed for the quantitative evaluation of the role of different substances in the osmolar clearance. A high correlation is found between the sodium and magnesium excretion and the osmotic free water reabsorption. A single intranasal administration of 1-deamino-8-D-arginine-vasopressin (DDAVP) to the children before their going to bed returned to the norm the sodium and magnesium excretion in the enuretic children. It is suggested that the defect peculiar to this particular pathology is associated with a decrease in the ion reabsorption in the thick ascending Henle loop. The normal level of the ion transport is restored after stimulation of V2-receptors by DDAVP. An explanation is suggested of the mechanism of the increase of diuresis with a simultaneous rise in the osmotically free water reabsorption in children with enuresis.
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A catamnestic study was made of 188 patients suffering from the nephrotic syndrome with minimum changes (NSMC) in order to examine the characteristic features of its course and outcome. The patients' age ranged from 3 to 26 years, with the disease standing being from 1 to 22 years. The authors explored the anamnestic and clinico-laboratory data together with the morphological findings (in 6.9% of cases). Estimated the results of the treatment. Described the NSMC outcome in 188 children.
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Investigations of early changes of renal microcirculation in generalized Sanarelli-Schwartzmann's reaction revealed markedly manifest alterations in endotheliocytes, podocytes, basal membrane of the glomeruli accompanied by disorders in the permeability of their capillaries and disseminated microthrombosis.
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