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Biomedical subjects

E Balzar

Publications and source records attributed to E Balzar.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Haemodialysis in children (author's transl)].

Thirty four children, aged 2 to 15 years, were treated by haemodialysis between 1967 and 1978. Eleven children suffered from acute renal failure. Twenty three children with end-stage chronic renal disease were treated over periods ranging from 1 week to 19 months. All children were dialysed in a renal unit for adult patients awaiting renal transplantation. Our results refer especially to the technical equipment for paediatric dialysis and to the problems of blood access. The medical problems of chronic uraemia and chronic intermittent haemodialysis in children are discussed. From our experience we conclude that a sufficient degree of rehabilitation can be reached only in a paediatric dialysis unit.

Acute Kidney Injury↗
PubMed1978

Urinary excretion of glomerular basement membrane antigens in Alport's syndrome. A new diagnostic approach.

Alport's syndrome is defined by the combination of hereditary nephropathy and neurosensory deafness, and is diagnosed from the family history combined with renal electron microscopy. Immunoelectrophoresis of the urine of 8 of 12 children suspected of Alport's syndrome showed a precipitation line moving into the beta-zone, applying an antiglomerular basement membrane antibody derived from an immunised rabbit. All patients who showed the typical pattern of Alport's syndrome on renal electron microscopy were among the 8 cases whose urine gave this immunoelectrophoresis pattern. Additionally, 5 of the mothers of the 8 children excreted the same antigen in their urine. The urine of 30 healthy children and of 10 patients with the idiopathic nephrotic syndrome did not show the presence of this antigen. This characteristic sign of Alport's syndrome may therefore be useful for its detection.

Adolescent↗
PubMed1978

Acquired antithrombin III deficiency in patients with glomerular proteinuria.

Antithrombin III (AT II/III) was determined immunologically and by means of a heparin cofactor assay in plasma samples and 24-hour urine of 15 patients with various degrees of proteinuria, being predominantly of glomerular origin. In urine the AT II/III concentrations were significantly correlated to the concentrations of albumin, plasminogen and IgG. One third of the patients had AT II/III plasma levels below the normal range. The plasma levels showed a significant inverse correlation to the AT II/III and albumin clearance rates. Similarily, the plasminogen concentrations in plasma were decreased in two thirds of the patients, being inversely correlated to the renal plasminogen clearance values. It is proposed that AT II/III deficiency in the nephrotic syndrome is an important pathogenetic factor in venous thrombosis.

Adolescent↗
PubMed1977

[Hemodialysis in children (author's transl)].

Long term hemodialysis and kidney transplantation has proved to be a very efficient method in the treatment of renal failure in childhood. Accordingly, the number of children treated by dialysis and transplantation in Europe is still increasing. At this time more than 1250 have been treated. As a result of recent studies, one to two children under the age of 15 years per one million population per one year reach the terminal stage of renal insufficiency. We performed our own informative study in 1975 to estimate the needs for dialysis facilities in Austria. Our results are in line with those of other projects. In view of the special childhood problems (growth, puberty, psychological problems, schooling etc.) there is a need for specialized pediatric centers which should include the facilities for nephrologic out- and in-patient treatment, a dialysis team consisting of a pediatrician, pediatric nurses, teacher, child psychologist, dietician and social worker. These enormous investments in apparature, personnel and organization are justified by the good results of survival and the reasonably normal life these children can lead.

Acute Kidney Injury↗
PubMed1977

[Tubular involvement in glomerular diseases of the kidney (author's transl)].

An attempt is made in this study to provide an answer to the question whether glomerular diseases are accompanied by tubular disorders. The urinary lysozyme activity was determined by means of a turbidimetric assay method in 10 healthy children as controls, 10 patients with glomerulonephritis, 8 patients with Alport's syndrome (hereditary glomerulonephritis with deafness) and 12 children with idiopathic nephrotic syndrome. In most of the cases a significant increase in urinary lysozyme excretion, indicative of tubular damage, was found and this finding correlates well with the tubular morphology of the patients.

Child↗
PubMed1977

[Alpha-2-macroglobulin in children with glomerular diseases (author's transl)].

The serum and urine levels of alpha-2-macroglobulin (alpha2-MG) was determined in 33 children with glomerular diseases and in 26 healthy control children. Healthy children showed a minimum level of 275 mg% and maximum level of 337 mg%, with a mean concentration of 301 mg% and a standard deviation of 13 mg%. No alpha2-MG was detected in the urine. Steroid-treated patients with idiopathic nephrotic syndrome displayed elevated inhibitor levels of up to 490 mg%. This might be a direct result of steroid therapy or a consequence of reactively-increased protein synthesis in response to the renal protein loss. In all these patients the urine was found to be alpha2-MG-negative, irrespective of the presence or absence of proteinuria. In the miscellaneous group of glomerulopathies without the nephrotic syndrome, serum levels of alpha2-MG were shown to be normal. The urinary concentrations of alpha2-MG were related to the activity of the disease. alpha2-MG determination in serum and urine seems to be a tool for differential diagnosis and prognosis in some cases of glomerular disease.

Acidosis, Renal Tubular↗
PubMed1976

[Alpha-1-antitrypsin in children with glomerular diseases (author's transl)].

Alpha-1-antitrypsin was determined in children with glomerular diseases by means of a quantitative radial immunodiffusion method. The concentration of this inhibiting protein has been found to be very low during relapses. An attempt has been made to correlate this finding with the clinical picture and the presumed underlying pathological mechanism. The loss of this inhibitor due to proteinuria is one of the explanations, in concurrence with the findings of other authors. The second explanation lies in the consumption of the inhibitor protein as a consequence of the reaction with liberated proteolytic enzymes.

Adolescent↗
PubMed1976

[The presence of cold agglutinins in hemolytic uremic syndrome (author's transl)].

A boy, 2 years old, developed a HUS after a pneumonitis. He was treated with Heparin, salicylates and recurrent peritoneal dialysis and recovered slowly. The course of the disease was complicated by myocarditis, gastric hemorrhage and severe neurologic disturbances. 7 days after unset of hemolysis a cold agglutinin titer of 1:256 was detected. This fact arises the question whether infection with Mycoplasma pneumoniae and the presence of cold agglutinins in serum could be involved in the development of HUS. The possibility of a viral etiology for this disease is discussed.

Agglutinins↗
PubMed1976

[Alport's-syndrome: diagnosis, light- and electronmicroscopic findings (author's transl)].

Alport's syndrome is a hereditary nephropathy with grave prognostic consequences. The occurrence of this disease is probably more frequent than was assumed until now - many cases are not immediately recognized as such. It is possible to make a clinical diagnosis from detailed family histories and through careful examinations of family members including audiometric tests. In the early stages of the disease children merely have recurrent macro- or microhematuria. Renal functional tests are normal and there is general well-being of the patient. Whereas the biopsy specimens examined by light microscopy show non-specific alterations, those examined under the electronmicroscope already show specific defects of the basement membrane. Our studies lead us to believe that these morphologic findings correspond with changes of the basement membrane, detectable by immunochemical investigations. 6 of 12 patients have been biopsied in recent time and the above cited typical changes of the basement membrane could be demonstrated. Therefore these investigations are recommended in Alport's syndrome.

Adolescent↗
PubMed1975

[Validity of simple X-ray-techniques in misdiagnosed anorectal malformations (author's transl)].

One particular form of an anorectal malformation--the anterior perineal anus--is frequently overlooked in the neonate period because defecation is easy at this age. However, with the change of diet, this malformation as a rule leads to chronic constipation. The lateral view at the beginning of an irrigoscopy usually shows a characteristic picture of a horizontal caudal limitation of the rectum, a dorsal pouch, a beakshaped fistula and an elevation of the anorectal transition. These findings contribute essentially to the clinical diagnosis and permit early operation.

Abnormalities, Multiple↗
PubMed1975

[Megacystis].

Explore the source record for details and available documents.

Child, Preschool↗
PubMedDate not supplied

[Formula creatinine clearance as a substitute for 24-hour creatine clearance in children with kidney transplantation].

Despite many theoretical advantages, formula-creatininclearance (Schwartz et al, Journal of Pediatrics 1976) has not found broad clinical acceptance in everyday pediatric patient care. In this study we report our results of long term observations (11.7 +/- 6.8 (1.7-24.8) months) of measured and computed creatininclearance in 27 children after renal transplantation (15 boys, 12 girls, mean age 14.5 +/- 4.2 (5.5-20) years) at the Kinderdialyse of the Universitäts-Kinderklinik of Vienna. We found a wide scattered correlation between the measured and computed creatininclearance values with a 90% confidence interval between -30% to +60% of the 24 hour creatininclearance. Formula creatininclearance (SD 17.8%) was markedly better reproducable than the 24 hour creatininclearancethe (SD 37.8%), the intraindividuell collecting error (36.1%) was almost twice the interindividuell "coefficient" error (20.27%). We therefore conclude that the 24 hour creatininclearance is by far not as accurate as the complexity of the procedure pretends and support broad clinical acceptance for the formula creatininclearance.

Adolescent↗
PubMedDate not supplied

Effect of growth hormone treatment on glucose tolerance in a patient with cystinosis after kidney transplantation.

A 16 year-old boy with nephropathic cystinosis and kidney transplantation was successfully treated with rhGH because of growth retardation. After 15 months of rhGH therapy he developed impaired glucose tolerance. Various causes like cystinosis itself, the immunosuppressive therapy with cyclosporine A and cortisone, but rhGH too might have been the responsible factors for that. Treatment with rhGH was initiated again after 4 months of interruption of therapy because no relation between impaired glucose tolerance and GH could be established.

Adolescent↗
PubMedDate not supplied

[Spontaneous growth of children with chronic renal failure].

Several pathogenetic factors may contribute to the growth failure in patients with CRF. We have analysed retrospectively spontaneous growth in 30 patients with CRF and investigated the influence of various therapies (conservative therapy, hemodialysis and transplantation with different immunosuppressive therapy) on spontaneous growth. At diagnosis (age 8.5 +/- 0.8 years; mean +/- SEM) height was reduced in the whole group (-1.46 +/- 0.2 SDS; x +/- SEM). Height SDS decreased further during the observation period of two and three years in the hemodialysis group (-2.19 +/- 0.69) and in the group with conservative treatment (-2.58 +/- 0.93), respectively. After Tx (n = 26) patients received different types of immunosuppressive therapy: 18 patients received cyclosporin A and prednisone (4-6 mg/m2 BS) daily; 8 transplanted patients received azathioprine (2 mg/kg BW) additionally. After Tx height improved not significantly (-2.02 +/- 0.30 vs. -1.49 +/- 0.36 SDS and -2.52 +/- 0.64 vs. -2.05 +/- 0.24 SDS after three and two years, respectively) irrespective of the immunosuppressive therapeutic regime. In the whole patient group neither hemodialysis nor conservative treatment nor Tx caused a significant change in height SDS; the possible factors, that might be involved in growth failure, are discussed.

Azathioprine↗
PubMedDate not supplied

Treatment of peripubertal children after renal transplantation (RTX) with recombinant human growth hormone: auxological data and effects on insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) during 24 months.

OBJECTIVE: To evaluate growth and endocrine parameters in RTX children with GH treatment during 24 months. SUBJECTS: 18 children (13 boys), age 13.1 yr (8.0-16.6), bone age 10.1 yr (5.4-15.3). Patients were 2.8 yr (0.5-7.5) after RTX and had immunosuppressive therapy, prednisone 0.16 mg/kg/d (0.08-0.68). METHODS: GH (4 IU/m2/day s.c.) was given and patients were seen every 3 months for evaluation of height, height velocity, bone age, and hormone parameters. Serum IGF-I was determined by RIA, IGFBP-3 by RIA and Western ligand blotting (WLB). Renal function and adverse effects (GFR, glucose tolerance, rejection episodes) were monitored. RESULTS: Height (+1 SDS) and height velocity (+2.2 SDS) increased significantly during 24 months GH treatment, but delta BA/delta CA was 1.7 and 1.5 during the first and second treatment year, respectively, and all patients entered puberty during the treatment period. GFR decreased slightly during 2 yr (p = 0.048), two patients had chronic rejection and GH therapy was terminated in one patient because of glucose intolerance. The ratio IGF-I/IGFBP-3 rose during the first year (p = 0.002) indicating more bioavailable IGF-I. IGFBP-3 determined by WLB was decreased, but IGFBP-1, -2 and -4 were elevated as compared to a standard. CONCLUSIONS: GH treatment increased height and growth rate in children after RTX. This may be due to significant changes in IGF-I and IGFBP-3 relationship. However, bone maturation was also accelerated thus diminishing height potential. From month 12 to 24 a continuous decrease of IGF-I was observed. There was a slight but significant deterioration of graft function. Adverse events that led to termination of GH therapy were observed in 3 of 18 patients.

Adolescent↗
PubMedDate not supplied

Timing of peritoneal dialysis catheter removal after pediatric renal transplantation.

BACKGROUND: A peritoneal dialysis (PD) catheter is in place at the time of kidney transplantation in children receiving PD. Removal of the catheter eliminates the risk of catheter-related infections. However, the patient benefits from leaving the catheter in place if dialysis is necessary posttransplantation. There is currently no consensus on the proper timing of PD catheter removal after kidney transplantation in children. OBJECTIVE: To identify the risks and benefits of an in-dwelling PD catheter after renal transplantation in children. DESIGN: Retrospective single-center study of infectious complications and posttransplantation PD catheter use in 31 renal transplantations in 26 children. RESULTS: Peritoneal dialysis catheters were used postoperatively in 13 of the 31 transplantations. In 12 instances the catheter was needed during the first month after transplantation, and 2 of the patients involved did not have a catheter in place when needed. Six catheter-related infections occurred in 5 patients posttransplantation, with only 1 infection taking place within 1 month after transplantation. CONCLUSION: Our data suggest that the need for catheter use occurs predominantly during the first month, while infectious complications usually happen later. This strongly suggests that PD catheters should not be removed until approximately 1 month after kidney transplantation.

Adolescent↗