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Biomedical subjects

C Chantler

Publications and source records attributed to C Chantler.

At least 181 records · Page 10Linked to original sources
PubMed1976

Value of renal biopsy in acute intrinsic renal failure.

Eighty-four patients presented with acute renal failure and features suggesting a diagnosis of intrinsic renal disease other than "acute reversible renal failure." Renal biopsy proved valuable in establishing the diagnosis, in indicating the reversibility of the lesion, and in helping to decide on treatment.

Acute Kidney Injury↗
PubMed1976

Dialysis and renal transplantation of children in Europe, 1974.

About a third of all children with end-stage renal failure in Europe were accepted for treatment by regular dialysis or transplantation during 1974. The number of specialised paediatric dialysis centres increased. The number of renal transplants also increased, but fewer living donor grafts and retransplants were performed in 1974. The best survival was again observed on home dialysis. Patient survival after a cadaver graft improved. Children more than ten years old appeared to have a better survival on dialysis and a somewhat better graft function than younger patients. Rehabilitation was similar on home dialysis and after transplantation, but full school activity in ordinary school was reported in only 40% of all children on hospital dialysis. Children on haemodialysis tended to dialyse more frequently in 1974, than before, but for fewer hours per week. Hepatitis was still a problem and only a small reduction in the incidence was noted during 1974. Children on dialysis required more blood transfusions than adults. Body growth on haemodialysis was retarded to a similar degree on boys and in girls; 70% of the haemodialysed and 63% of the transplanted children had a growth velocity below the third percentile. Growth rate was noted to fall after the first year on dialysis.

Adolescent↗
PubMed1976

Estimation of glomerular filtration rate from plasma creatinine concentration in children.

The relation between the true plasma creatinine concentration (Pc) and the glomerular filtration rate corrected for body surface area (GFR/SA) was investigated in 108 individuals, and the following formula was derived: GFR/SA (ml/min per 1-73m2SA) = 0-43 Ht (cm)/Pc (mg/100 ml). This formula was tested in a second group of 83 children, and its accuracy and precision was compared to the 24-hour creatinine clearance. It was found to be superior to the creatinine clearance overall, and was as good, even if all results involving suspect 24-hour-urine collections were eliminated from analysis. The formula in SI usage is: GFR/SA (ml/min per 1-73 m2SA) = 38 Ht (cm)1Pc (mumol/l).

Adolescent↗
PubMed1976

Analysis of 100 children with severe and persistent hypertension.

In 100 children with persistent hypertension seen over the past 5 1/2 years the commonest causes of hypertension were chronic glomerulonephritis, reflux nephropathy, coarctation of the aorta, and obstructive uropathy, accounting for some 70% of cases. 17 children have died, but in the remainder hypertension has been controlled by surgery, chronic haemodialysis, or by the use of pharmacological agents. Methyldopa was the commonest drug used, and the children appeared relatively resistant to the side effects of this and of other drugs, even when large doses were used. The improvment is the prognosis of severe hypertension in childhood indicated in this survey is largely due to the availability of chronic haemodialysis and transplantation for end-stage renal disease, but the advances in diagnositc methods and surgical techniques and the introduction of new drugs have also contributed.

Adolescent↗
PubMed1976

Mesangiocapillary glomerulonephritis with dense "deposits" in the basement membranes of the kidney.

Amongst 125 patients with mesangiocapillary glomerulonephritis (MCGN), 19 showed continuous intramembranous dense "deposits" (IDD). Most were children or young adults. Two patients had partial lipodystrophy. Eleven had a consistently low plasma concentration of C3; only three, however, had an initial low plasma concentration of C4, which rose and then remained normal in two. Tests for the C3 nephritic factor were positive in thirteen patients, and plasma C1q was normal in 8 out of 11 cases investigated. Ten out of twelve (seven of them with low plasma C3) showed C3 deposition by immunofluorescence in the glomerular tuft. This was also demonstrated in some instances in Bowman's capsule and tubular basement membranes. Stains for IgG, IgA, C4 and C1q were negative in all, whereas stains for IgM and fibrin were weakly positive in the glomeruli of three and eight cases repectively. Eight patients went into terminal renal failure over an average of thirty-three months and required hemodialysis or transplantation. MCGN with IDD is an uncommon pattern of renal response to injury, which involves activation of the alternate pathway of the complement system and has a poor short term prognosis. The association with partial lipodystrophy and C3-splitting activity suggests a primary complement abnormality.

Adolescent↗
PubMed1976

IgA and glomerular disease.

Serum IgA levels are raised in a proportion of children with Henoch-Schönlein disease (H. S. P.), patients with Berger's mesangial IgA disease, and in patients with glomerular lesions in association with hepatic cirrhosis. These conditions are all characterized by mesangial staining with anti-IgA antisera on immunofluorescence. It has been suggested that elevated serum IgA levels are of value in the diagnosis of these diseases. We have measured serum IgA levels by radial immunodiffusion in a variety of primary and secondary glomerular diseases. High serum IgA levels were confined to patients with glomerular IgA deposition, but were not restricted to H. S. P. and Berger's disease, nor to patients with deposition of IgA only in a mesangial pattern. Elevated salivary IgA levels were found in 3/4 patients with high serum IgA levels but we found no evidence for involvement of the secretory system in glomerular mesangial IgA deposition.

Adolescent↗
PubMed1975

Local infusion of urokinase and heparin into renal arteries in impending renal cortical necrosis.

Two patients with presumed impending cortical necrosis, after haemolytic uraemic syndrome in one and after concealed accidental haemorrhage in the other, were treated by local infusion of urokinase and heparin into the renal artery. Both recovered and one regained normal renal function. Local infusion of anticoagulants or thrombolytic drugs into one renal artery offers the possibility of a controlled examination of the efficacy of this treatment in preventing cortical necrosis.

Adult↗
PubMed1975

Membranous nephropathy. Long-term follow-up and association with neoplasia.

Sixty-six patients of all ages whose renal biopsy appearances satisfied strict criteria for the histopathological diagnosis of membranous nephropathy were studied and followed for a mean of 5-4 years (range 1 to 20 years). From initial investigation seven patients were found to have associated neoplasia, and in two patients the condition followed treatment with a mercurial diuretic and gold. One patient was Australia antigen positive. Two patients developed renal vein thrombosis, but in both this appeared to follow not precede their nephrotic syndrome. In the remaining 56 patients there was no associated factor. During the follow-up period, approximately one-quarter of the patients (15) died, nine from renal failure; one-quarter (10) had a persistent nephrotic syndrome, another one-quarter (15) proteinuria of lesser degree. The final one-quarter (16) are now in complete remission. The prognosis of the 54 patients with an initial nephrotic syndrome was poorer than the 12 with lesser proteinuria and no oedema at onset; five of 11 children were in complete remission when last seen. All but one of the nine patients who developed terminal chronic renal failure 4 to 18 years from onset had an unremitting nephrotic syndrome, eight of the 10 currently alive with a persistent nephrotic syndrome have reduced renal function. Renal functional deterioration did not occur in the absence of proteinuria. There was only slight correspondence between the stage of biopsy appearance, glomerular filtration rate at time of biopsy, time of the biopsy from apparent onset, or status at last follow-up. Staging is therefore of limited prognostic value. Twenty-two patients were treated with corticosteroids for 2 to 36 months; we detected no short or long-term benefit when compared to patients not so treated.

Adolescent↗
PubMed1974

Long-term stability of remission in nephrotic syndrome after treatment with cyclophosphamide.

Fifty-eight children with minimal-change nephrotic lesions who relapsed repeatedly and showed toxic side effects from corticosteroids were treated with cyclophosphamide for an average of 12 weeks. The initial dose was 5 mg/kg/day. Four to seven years (mean 5.8 years) later 20 remained in remission, 34 were still relapsing, and 4 had died (two during relapses, one of measles after cyclophosphamide, and one of a brain-stem astrocytoma). The half time for the relapse-free period after treatment was 2.8 years. There was no relationship between the length of treatment with cyclophosphamide and the stability of remission within the limits studied.

Adolescent↗