Aluminium that has accumulated in the body is thought to have a generalised cytotoxic effect. A prospective study of aluminium accumulation in bone-that is, subclinical aluminium toxicity--was carried out in 94 recipients of kidney allografts, who were followed up for three years. Subclinical aluminium toxicity was found in 66 patients. A significantly smaller proportion of patients with aluminium accumulation experienced a rejection episode: 30 (58%) nu 12 (86%) who received grafts from cadavers and 4 (29%) nu 10 (71%) who received grafts from living donors. On multivariate analysis only the source of the kidney and aluminium accumulation were found to influence the rejection rate. These findings suggest that aluminium accumulation has an immunosuppressive effect.

Adult↗

PubMed1988

Renal replacement therapy in elderly patients.

The results of renal replacement therapy (RRT) in elderly patients in Norway were evaluated. During the 5-year period between 1981 and 1985, 368 patients at least 60 years of age (mean, 66.7 years) at the start of RRT were included and followed until 15 February 1987. Transplantation was planned for 249 patients; of these 127 were not grafted. The actuarial survival in this group was 64%, 44%, and 7% at 6, 12, and 48 months, respectively. Survival in 122 grafted patients was 93%, 87%, and 62%, respectively, and the corresponding graft survival was 70%, 67%, and 48%. The remaining 119 patients were allocated to long-term dialysis, with a survival of 63%, 48%, and 13%, respectively. Our results describe the outcome of a treatment program available to the entire elderly population accepted for RRT. In two-thirds of the patients transplantation was planned, and one-third of all patients were actually grafted, with good patient and graft survival. The results suggest that transplantation is the treatment of choice for most elderly patients.

Aged↗

PubMed1988

Natural cytotoxicity in adult acute leukemia.

Natural cytotoxic activity was studied in 32 adult patients with acute non-lymphoid leukemia (ANLL) and 27 adult patients with acute lymphoblastic leukemia (ALL). Thirteen patients with active ANLL had a significantly reduced natural cytotoxicity in peripheral blood compared with that of healthy controls, 5.0 +/- 3.4 versus 27.1 +/- 11.5 (p less than 0.0005). Patients with ANLL in remission had a normal natural cytotoxicity (p greater than 0.05). Patients with active ANLL had a significantly reduced number of Leu-7-positive cells (p less than 0.001), while patients in remission had normal proportions of these cells (p greater than 0.05). Peripheral blood from patients with ALL showed reduced natural killer (NK) cell activity, both in active disease and in remission (p less than 0.0005). The percentage of Leu-11b (CD 16)-positive cells was increased in patients in remission from ALL (p less than 0.05). Bone marrow cells from patients with ALL in remission had a reduced natural cytotoxicity, 2.8 +/- 4.0 versus 16.3 +/- 9.0 in bone marrow controls (p = 0.01). In contrast, patients with ANLL in remission showed a normal bone marrow cytotoxicity (p greater than 0.05) while patients with active ANLL had a reduced NK cell activity (p less than 0.03). The low NK activity observed in leukemic patients may be of importance for the pathogenesis of the diseases. Acute non-lymphoid leukemia (ANLL) is a malignant disease of the multipotential hemapoietic stem cell. The stem cell is capable of differentiating into various cell lineages, i.e. erythroid, granulocytic, monocytic and megacariocytic cell lineages.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1988