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Biomedical subjects

B Redaelli

Publications and source records attributed to B Redaelli.

At least 37 records · Page 2Linked to original sources
PubMed1989

A randomized trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy.

We conducted a controlled trial to investigate the long-term effects of treatment with methylprednisolone and chlorambucil in patients with idiopathic membranous nephropathy. We have previously reported that after a mean of 31 months, treated patients did better. We now report the results of a longer follow-up. Eighty-one patients with proteinuria (greater than or equal to 3.5 g per day) and biopsy-proved membranous nephropathy were randomly assigned to receive either supportive therapy alone or a six-month course of corticosteroids alternated with chlorambucil (0.2 mg per kilogram of body weight per day) every other month. Methylprednisolone was first given intravenously in three pulses (1 g per day) and was then given orally (0.4 mg per kilogram per day) for 27 days. The patients were followed for 2 to 11 years (median, 5). Two patients in the control group and one in the treatment group died. At the last follow-up visit, 9 of 39 patients assigned to the control group (23 percent) and 28 of 42 patients assigned to the treatment group (67 percent) did not have the nephrotic syndrome. At five years there were more remissions of the nephrotic syndrome in treated patients than in controls (22 of 30 vs. 10 of 25; P = 0.026). Compared with base-line values, the mean reciprocal of the plasma creatinine level declined significantly in the control group (33 percent; P = 0.0002) but not in the treatment group (6 percent; P not significant). Plasma creatinine increased by 50 percent or more in 19 controls (49 percent) and in 4 treated patients (10 percent). We conclude that a six-month course of methylprednisolone and chlorambucil can bring about sustained remission of the nephrotic syndrome and help to preserve renal function in patients with idiopathic membranous nephropathy.

Administration, Oral↗
PubMed1983

Potassium removal as a factor limiting the correction of acidosis during dialysis.

The diffusional fluxes of urea, potassium and bicarbonate across the dialysis membrane (external balance) were determined in seven patients during haemodialysis using potassium free dialysate and dialysate containing 2.0mEq/L of potassium. The results show an inverse correlation between extraction of potassium and intake of bicarbonate in both external and internal balances. This is probably due to the increase in cell membrane electrical potential resulting from a fall in blood potassium and emphasises the importance of electrical driving forces in diffusional fluxes across cellular membranes.

Bicarbonates↗
PubMed1983

[Potassium removal: a factor limiting the correction of acidosis during dialysis].

The diffusional fluxes of urea, potassium and bicarbonate across the dialytic membrane (external balance), and across the cellular membrane (internal balance), were determined in 7 patients in haemodialysis using potassium free dialysate and dialysate containing 2.0 mEq/1 of potassium. The results obtained show an inverse correlation between extraction of potassium and intake of bicarbonate in both external and internal balance. This is probably due to the increase in membrane electrical potential resulting from a fall in blood potassium and emphasizes the importance of electrical driving forces in diffusional fluxes across cellular membranes.

Acidosis↗
PubMed1979

Multicentre comparative trial of tienilic acid and hydrochlorothiazide in hypertensive patients.

To compare the clinical and metabolic effects of a new diuretic uricosuric agent, tienilic acid, with those of hydrochlorothiazide, a multicentre double-blind trial was performed in 56 hypertensive patients. Twenty-eight patients were randomly assigned to take tienilic acid and 28 to take hydrochlorothiazide. The diuretic and anti-hypertensive actions of the two compounds were similar. No significant differences were observed between tienilic acid and hydrochlorothiazide in their effects on urinary and serum electrolytes, hepatic and renal function tests, and fasting lipids. The patients who received tienilic acid showed a significant fall in serum uric acid, mediated by the uricosuric effect. The availability of an agent combining diuretic, antihypertensive and hypouricemic effects offers promise in the treatment of arterial hypertension.

Adolescent↗
PubMed1979

Hemodialysis with "adequate" sodium concentration in dialysate.

This investigation was undertaken to define the "adequate" sodium concentration in the dialytic fluid allowing to maintain a stable plasma effective osmolality during dialysis. Isonatric dialysate is shown to miss this aim by inducing a predictable postdialytic hypernatremia. To avoid this effect a new approach was made. 17 clinically stabilized patients, previously dialyzed over a period of at least 2 years with a dialysate sodium concentration of 133 mEq/l, underwent dialysis with the "adequate" sodium concentration in the dialysate for over 3 years. During dialysis cramps, headache, hypotension, hypertensive crises and postdialytic weakness were reduced in frequency and nearly disappeared. No deterioration in blood pressure control occurred and improvement in some general parameters (hematocrit, glucose and insulin metabolism, well-being) was reported after prolonged treatment.

Adult↗
PubMed1978

Ultrafiltration and high sodium concentration dialysis: pathophysiological correlation.

Five stabilised uraemic patients underwent two different procedures using the Gambro Ultradiffuser: ultrafiltration alone for one hour (mean body weight loss 2.97 +/- 0.24 kg) and ultrafiltration with simultaneous dialysis for one hour (mean body weight loss 2.92 +/- 0.22 kg) using a given dialysate sodium concentration which reproduced the changes in osmolality which occur during ultrafiltration alone. This mean sodium concentration was 154.75 +/- 2.02 mEq/L. The results did not show significant differences for the two procedures as regards tolerance to dehydration. These results underline the key role of osmolar stability in making dehydration tolerable.

Blood Pressure↗
PubMed1976

Acute renal failure after rifampicin: a case report and survey of the literature.

A new case of acute renal failure after rifampicin is presented, together with a review of the 36 similar cases published up to date in the literature. Evidence is provided that irregularities in drug intake, either as true intermittent treatment or as discontinuation of continuous therapy, play an important role in the pathogenesis of such reactions. Renal failure appeared after a rather long uneventful interval from the beginning of rifampicin therapy, ranging from 1 month to more than 1 year. Its clinical course was favourable in all but one case; the histological picture was mainly of tubulo-interstitial type. The controversial immunological data reported in the literature are reviewed; an increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of our patient: the implications of this finding are discussed, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampicin.

Acute Kidney Injury↗