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Biomedical subjects

C Mion

Publications and source records attributed to C Mion.

At least 91 records · Page 5Linked to original sources
PubMed1988

Dose-dependent salidiuretic efficacy of torasemide in comparison to furosemide and placebo in advanced renal failure.

In a controlled randomized double-blind clinical trial the salidiuretic efficacy of 20 and 100 mg torasemide (1-isopropyl-3-([4-(3-methyl-phenylamino)pyridine]-3-sulfonyl)urea) and 60 mg furosemide, respectively, was compared including a control group with placebo after a single i.v. administration in 46 patients with advanced chronic renal failure (creatinine clearance less than or equal to 30 ml/min). 20 mg torasemide exerted a significant natriuretic activity within the first 6 h, whereas 100 mg torasemide induced a significant 24-h extra-excretion if compared to placebo. The sodium excretion induced by 100 mg torasemide was superior to the one by 60 mg furosemide. The duration of action of torasemide was longer than that of furosemide. The tolerance was good in all groups.

Adult↗
PubMed1988

Allergy in long-term hemodialysis. II. Allergic and atopic patterns of a population of patients undergoing long-term hemodialysis.

Maintenance hemodialysis is widely used throughout the world, and anaphylactic reactions appear to be increasing in number and severity. However, the exact incidence of sensitization and the role of atopy in these reactions are not yet fully understood. All of the 111 patients routinely dialyzed in a center were tested. All patients had a complete investigation of atopy, RAST to chemicals released during the procedure of dialysis (ethylene oxide (Eto), formaldehyde, phthalic anhydride, and toluene diisocyanate), skin tests with the effluent, and the titration of blood eosinophils. The incidence of atopy was found to be lower (13.5%) than in the normal population of the area. Skin tests with either histamine or allergens are significantly (p less than 0.001) smaller than those of nondialyzed subjects, and this method does not appear to be ideal in this population of patients. Eto sensitivity ranked first (5.5%), followed by phthalic anhydride sensitivity (3.6%); 5/6 patients who had a sensitivity to Eto and/or phthalic anhydride presented symptoms during dialysis, but they never were life threatening. Formaldehyde RAST was only found in one patient who had a life-threatening reaction. Finally, three patients presenting pruritus had positive skin prick tests with the effluent of the dialyzer. All patients having a first use syndrome and 80/81 symptom-free patients did not have serum-specific IgE against the released chemicals, 5/17 patients who had a pruritus during dialysis had either positive RAST to released chemicals or skin tests to the effluent, 5/8 patients who suffered from anaphylaxis had positive RAST to released chemicals, but only those who had a positive RAST presented a severe reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Acute adaptative changes to unilateral nephrectomy in humans.

Renal function was monitored in 20, living-related kidney donors before and after uninephrectomy. Urinary protein excretion and retinoid metabolism respectively were studied in 10 and 6 of these donors. The functional adaptation was characterized by an increase in glomerular filtration rate and tubular function, which began in the first two days after uninephrectomy. Changes in tubular function were also demonstrated by significant increases in the urinary excretion of beta 2 microglobulin (beta 2M), retinol binding protein (RBP), kappa and lambda light chains of immunoglobulins. In addition, a protein identical to or homologous to cellular retinoic acid binding protein (CRABP), appeared in the urine after nephrectomy. We did not find CRABP in serum samples either before or after nephrectomy, suggesting that urinary CRABP was synthesized by the remaining kidney. Increases in serum levels of Vitamin A and RBP were also observed in the post-nephrectomy period. These modifications in retinol metabolism suggest that these substances could have a role as renotropic growth factors in compensatory hypertrophy.

Adult↗
PubMed1987

Haemodialysis-associated amyloidosis: beta 2-microglobulin alone or associated with globin chains?

1. The protein constituents of amyloid fibrils were characterized in amyloid deposits extracted from surgical material obtained from a 66-year-old patient undergoing maintenance haemodialysis and operated for a carpal tunnel syndrome. 2. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis disclosed the presence of bands at 12 and 14 kDa. Two-dimensional electrophoresis and Western blotting confirmed that the proteins were beta 2-microglobulin (beta 2M) and globin chains. 3. When the effluent of high-performance gel filtration chromatography corresponding to molecular masses of 10-15 kDa was subjected to Edman degradation, only one amino acid residue was found at each step. The 18 residues determined corresponded to the N-terminal sequence of beta 2M. 4. Although globin chains were clearly present in the amyloid material, they were not accessible for sequence determination. The identification of the other protein constituents present in the amyloid material, along with beta 2M, should provide a better understanding of haemodialysis-associated amyloidosis, the mechanisms of formation of which have not yet been completely determined.

Aged↗
PubMed1987

Hemodiafiltration using dialysate as substitution fluid.

To reduce the cost of hemodiafiltration (HDF), a standard hemodialysis machine was modified to permit in-line production of substitution fluid from bicarbonate dialysate. The authors' present data showing that this procedure was made bacteriologically safe; was simple to use, and offered a cheap approach to perform high-flux HDF using a hemodifilter of relatively small membrane surface area.

Bicarbonates↗
PubMed1987

[Amyloid deposits in hemodialysis patients: immunochemical analysis].

We have analyzed 9 amyloid deposits isolated from 7 patients treated by long-term hemodialysis [6] and/or hemofiltration [1] for 8 to 19 years. Amyloid deposits were extracted from carpal tunnel synovitis [7] or femoral bone [2]. Proteins were analyzed by SDS-PAGE, two-dimensional electrophoresis and the identification was made by Western Blotting and specific antibody fixation. Several proteins were found: immunoglobulin light chains, beta 2 microglobulin (B2M), as well as globin chains, albumin and hemopexin. These findings suggest that amyloid deposits are not only made of B2M, but also with other protein species not cleared by dialysis membranes. Among these proteins, B2M and immunoglobulin light chains have well known amyloidogenic properties. We suggest that the role played by the remaining proteins on the pathogenesis of dialysis associated amyloidosis should also be considered.

Adult↗
PubMed1987

[What does circulating beta 2 microglobulin signify in uremic patients on maintenance dialysis?].

The authors report a 2 years prospective study on s beta 2M variations observed in a large uremic population (237 patients, 159 M, 78 F, age: 51.1 +/- 5.9 y.o.). The study consisted in two parts. A long term follow-up of s beta 2M in patients regularly treated with various dialysis modalities; hemodialysis (HD), hemofiltration (HF), hemodiafiltration (HDF), intermittent peritoneal dialysis (IPD) and continuous ambulatory peritoneal dialysis (CAPD). s beta 2M was found elevated in the overall population (41.4 +/- 10.2 mg/l) with a 12.5% variation over time observation in stable patients, not influenced by sex, causal nephropathy, and dialysis mode in anuric patients, beta 2M was inversely correlated with residual diuresis. Residual kidney function preserved longer and in a higher proportion of PD patients was the only significant fact explaining for the difference observed in s beta 2M levels between HD (46 +/- 5) and PD (33 +/- 3) patients. Intercurrent inflammatory and tumoral states increased significantly s beta 2M level in uremic patients. The short term study showed that highly permeable membranes (AN69, polysulphone) used either in HD, HF or HDF were able to decrease s beta 2M from 50 to 60%, and to remove 150 to 200 mg per session, while on the opposite HD/cuprophane increased s beta 2M from 10 to 15%. beta 2M dialysate/plasma equilibrium ratio for peritoneal membrane after a 6 hour dwelling time was 0.20, permitting a net removal of 45 +/- 4 mg/24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1986

Internal jugular vein cannulation with two silicone rubber catheters: a new and safe temporary vascular access for hemodialysis. Thirty months' experience.

Temporary and immediately usable vascular access is a vital need in treating uremic patients. Subclavian vein cannulation, although a major progress, has been associated with significant morbidity and mortality. Accordingly, for the last 2.5 years the authors have been developing an alternative technique consisting of internal jugular vein cannulation (IJVC) with two silicone rubber catheters with a long-term, proved biocompatibility. One hundred sixty-five pairs of cannulas were inserted in 153 patients. Mean duration of use was 57 days (1 day to 17 months). More than 3,000 high-performance hemodialysis sessions were performed. IJVC handling and care were easily managed by nurses. A low incidence of complications was observed: two thrombosis episodes, four skin infections with three septicemia, one air embolism, and one anaphylactoid reaction. No death was related to the technique itself. IJVC offers a new, safe, and reliable temporary vascular access immediately usable for all kinds of extracorporeal treatment.

Aged↗
PubMed1986

Internal jugular vein cannulation using 2 silastic catheters. A new, simple and safe long-term vascular access for extracorporeal treatment.

Subclavian vein cannulation, although a major progress in temporary vascular access, was associated with a significant morbidity and mortality. A safer alternative technique would therefore be welcome. For the last 2 years, we developed a new approach consisting in internal jugular vein cannulation (IJVC) with 2 silicone rubber catheters with a long-term proved biocompatibility. 138 pairs of cannulae were inserted in 129 uremics patients. Mean duration of use was 54 days (1 day to 17 months). More than 3,000 high-performance HD sessions were performed. IJVC handling and care was easily managed by nurses. Low incidence of complications was observed: 2 thrombosis episodes, 3 skin infection with 2 septicemiae, 1 air embolism, 1 anaphylactoid reaction. No death was related to the technique itself. IJVC offers a new method of percutaneous central vein cannulation, providing a safe and reliable temporary vascular access immediately usable for all kinds of extracorporeal treatment.

Adult↗
PubMed1986

[Hypertension and stenosis of the graft artery: effects of conversion enzyme inhibition].

The use of angiotensin converting enzyme inhibitors may lead to reversible renal insufficiency in transplant patients with transplant renal artery stenosis (TRAS). We assessed acute effects of captopril (50 mg, p. os) in 7 cadaver kidney recipients (mean age: 35.6 +/- 4 yrs) with TRAS, 9 to 46 mo after transplantation. All patients were treated by prednisolone and azathioprine. After captopril administration, mean arterial pressure decreased from 127 +/- 6 to 119 +/- 7 mmHg, effective renal plasma flow from 152 +/- 19 to 118 +/- 19 ml/min/1.73 m2, glomerular filtration rate from 59 +/- 8 to 39 +/- 10 ml/min/1.73 m2 and filtration fraction from 0.39 +/- 0.02 to 0.32 +/- 0.07. Among the 7 patients, 2 developed immediate and transient anuria; 4 presented a net decrease of GFR, only one had stable GFR. This patient was chronically treated by captopril; as BP was not controlled, furosemide (40 mg p. os) was added. Serum creatinine increased from 180 to 250 mumol/l. Percutaneous angioplasty was done without decrease in BP; however, treatment by captopril and furosemide could be reinstitued without deterioration in renal function. We conclude that: acute renal failure in kidney graft recipients with TRAS is frequent, but not mandatory; sodium depletion induced by diuretics enhances the fall in GFR; acute effect of captopril must be assessed in patients with TRAS before the use of this product as long term antihypertensive treatment.

Acute Kidney Injury↗
PubMed1986

[Effect of inhibition of angiotensin converting enzyme on hypertension following kidney transplantation].

The activation of the renin angiotensin system is thought to be an important factor contributing to hypertension following kidney transplantation (TX). We studied 21 hypertensive renal transplant recipients, without evidence of acute graft rejection or transplant artery stenosis, 6 to 60 months post-TX. The acute responses of mean arterial pressure (MAP) and renal hemodynamics (ERPF: effective renal plasma flow, 131I-Hippuran clearance) and function (GFR: glomerular filtration rate, creatinine clearance; UNaV: urinary sodium excretion rate) to converting enzyme inhibition (CEI) by captopril were assessed. CEI induced a decrease in MAP (118 +/- 2 to 110 +/- 2 mmHg), renal resistance (RR: 0.27 +/- 0.02 to 0.21 +/- 0.01) and filtration fraction (FF: 0.31 +/- 0.02 to 0.23 +/- 0.01). ERPF (307 +/- 24 to 333 +/- 18 ml/min/1.73 m2) and GFR (88 +/- 5 to 78 +/- 5 ml/min/1.73 m2) were not significantly changed. UNaV increased by 53 +/- 24 mumol/min. Changes in MAP (r = -0.66), ERPF (r = 0.74) and FF (r = -0.88) were significantly correlated with the log of control plasma renin activity (PRA). In 10 patients with an increase of ERPF (range: + 30 to + 70%) and no change in GFR, the activated renin system could originate from the recipient's own kidneys. In the remaining 11 patients, CEI was associated with no increase in ERPF (change: + 2 to - 27%) and a fall in GFR, a response suggesting a possible intrarenal vascular damage. These results indicate that RAS participates in the regulation of systemic and renal vascular tone, with a possible predominant effect on efferent glomerular arteriole.

Adult↗