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Biomedical subjects

E Heidbreder

Publications and source records attributed to E Heidbreder.

At least 55 records · Page 3Linked to original sources
PubMed1987

Severe hypertensive retinopathy. Increased incidence in renoparenchymal hypertension.

In 205 patients with histologically evaluated glomerulonephritis, 69 patients with essential hypertension and 12 patients with renovascular hypertension, the retina was examined and evaluated by fundus photography. Changes of the retina were classified according to the recommendations of WHO: mild to severe changes of retinal arteries were termed as mild hypertensive retinopathy, and exaggerated changes, including exudates, hemorrhages and optic disc changes, as severe hypertensive retinopathy. In spite of the short duration of renal disease and the young age of the patients in many cases, retinal changes in patients with renal hypertension were significantly more severe: especially in focal segmental sclerosis and membranoproliferative glomerulonephritis was severe hypertensive retinopathy observed. Mild hypertensive retinopathy was more prevalent in essential hypertension. When renal disease progresses the retinal findings tended to deteriorate as well. Since the 24-hour blood pressure profile was comparable in most of the groups studied, it was supposed that the vulnerability of the retina and probably other vascular beds (e.g. kidneys) was increased. We conclude that the retina of these patients should be examined even in the case of relatively mild hypertension (greater than 180/100 mm Hg) and early antihypertensive treatment is an important requirement.

Adult↗
PubMed1986

[Fundus hypertonicus malignus. Increased incidence in renal parenchymal diseases].

Using photography of the fundus oculi the eyeground of 186 patients with histologically different forms of nephritis, 68 patients with essential hypertension and 10 patients with renovascular hypertension was investigated and evaluated. The fundal lesions were classified according to the grades recommended by WHO. Although in many individual cases the duration of the disease was short and the patients were young, the eyeground changes in renal hypertension were notably severe. Taking as basis comparable pressure rises, marked signs of fundus hypertonicus malignus were particularly frequent in primary and secondary hypertension with focal segmental sclerosis and membranoproliferative glomerulonephritis, whereas in essential hypertension non-malignant fundus hypertonicus predominated. The eyeground findings deteriorated further with impairment of renal function. Owing to the high incidence of severe fundal lesions in renal hypertension the eyeground of these patients should be examined and the hypertension treated accordingly even when the rise in blood pressure is relatively mild (less than 180/100 mm Hg).

Adult↗
PubMed1986

Diminished parathyroid gland responsiveness to hypocalcemia in diabetic patients with uremia.

The parathyroid gland responsiveness to hypocalcemia induced by short-term calcium-free hemodialysis in patients with insulin-dependent diabetes mellitus was investigated in comparison with 10 nondiabetic uremic patients and compared with test results from the autonomic nervous system. Diabetic patients had lower C-terminal parathyroid hormone (cPTH) levels before hemodialysis than uremic control patients and showed a significantly smaller increase in cPTH during hypocalcemia. The neurological tests revealed severe disturbances of the autonomic functions in the diabetic group. In conclusion, the disturbances observed in the parathyroid secretory pattern are probably caused by gland dysfunction; it is hypothesized that the defective autonomic nervous system has an additional effect on the development of this hormonal dysfunction.

Adult↗
PubMed1986

Norepinephrine-induced acute renal failure: beneficial effects of atrial natriuretic factor.

The effect of the atrial natriuretic factor (ANF) on early norepinephrine-induced acute renal failure (ARF) was investigated. In anaesthetized female Sprague-Dawley rats, weighing 247 +/- 36 g, ARF of the left kidneys was induced by 40-min intrarenal arterial infusion of norepinephrine (NE; 0.75 micrograms/kg body weight). In each case the right kidney served as a control organ. Inulin clearance was used as an estimate of glomerular filtration rate (GFR). Urine volume (V), GFR and fractional excretion rates of sodium, potassium and chloride were studies in both kidneys. Immediately after NE-induced ARF one group received ANF (alpha-hANaP) and the other groups 5% glucose or isotonic saline; all infusions were administered intrarenally. In the experimental kidney NE-infusion induced anuria. ANF infusion was able to induce complete reversal of the NE effect, and GFR and diuresis improved markedly in the experimental kidney. In addition, a tremendous rise in fractional excretion rates of sodium and potassium after administration of ANF was observed. In the control kidney an additional increase of GFR and diuresis was seen. Following 5% glucose or isotonic sodium chloride infusion, no profound effects were obtained in both kidneys. The results of the present study demonstrate that ANF provides beneficial effects on the functional damage of NE-induced ARF. We conclude that the NE-antagonistic effect of ANF and the consecutive amelioration of GFR may play an important role in the recovery of impaired renal function.

Acute Kidney Injury↗
PubMed1986

Human atrial natriuretic factor prevents against norepinephrine-induced acute renal failure in the rat.

The aim of the present study was to investigate the potential protective effect of atrial natriuretic factor (ANF) on the norepinephrine (NE)-induced acute renal failure (ARF). After determination of basal renal function, ANF at different doses induced a dose dependent increase of glomerular filtration rate (GFR), diuresis (V), sodium (UNaV) and potassium (UKV) excretion. Unilateral intrarenal norepinephrine infusion induced acute renal failure in an isotonic saline pretreated rat group. The experimental kidney in this group was anuric, and no measurable GFR and electrolyte excretion was observed. ANF pretreatment prevented the norepinephrine-induced ARF. In the experimental kidney, GFR, V, UNa V and UK V were subnormal or even elevated during NE-infusion as compared to the basal clearance period. During the 60 min control period after the norepinephrine infusion in the isotonic saline pretreated rat group, anuria persisted. In the ANF pretreated groups, normal or significantly increased levels of GFR, V, UNa V and UK V were obtained.

Acute Kidney Injury↗
PubMed1986

Toxic renal failure in the rat: beneficial effects of atrial natriuretic factor.

Acute renal failure was induced in rats by intramuscular injection of glycerol. Experiments consisted of three periods: a basal infusion period for all animals, an infusion period of atrial natriuretic factor (5 micrograms or 10 micrograms/250 g body weight) in experimental rats, control rats received isotonic glucose solution, and a post-period with isotonic saline infusion in all animals. According to the severity of acute renal failure three subgroups were formed: mild, moderate, and severe acute renal failure. In all experimental rats, atrial natriuretic factor was capable of ameliorating impaired renal function, leading to increased glomerular filtration rate, diuresis and natriuresis. The effects of atrial natriuretic factor were less pronounced in severe forms of acute renal failure.

Acute Kidney Injury↗
PubMed1985

Role of alcohol in clinical nephrology.

Different nephrological derangements are observed in severe alcoholics. Until now the direct toxicity of ethanol is only shown in the fetal alcohol syndrome with various malformations of the genitourinary tract. In the adult the kidney is often involved in the development, maintenance and counterregulation of complex electrolyte disturbances like phosphate and potassium hypoglycemia etc. The alcohol associated retention of urate, induced by hyperlactatemia and/or increased beta-hydroxybutyrate concentration is only rarely complicated by urate nephropathy. Alcohol intoxication (acute and chronic) predisposes to rhabdomyolysis with the risk of acute renal failure. There are some hints that chronic alcoholism with myopathy increases the vulnerability of the kidney for further toxic agents. In rats glycerol induced renal failure is enhanced by alcohol pretreatment. Finally, regular alcohol consumption raises the blood pressure, which per se is a risk factor for renal damage.

Acute Kidney Injury↗
PubMed1985

Effect of diuresis on urinary erythrocyte morphology in glomerulonephritis.

The differentiation between glomerular and non-glomerular haematuria by phase-contrast microscopy has proved to be a useful tool in the diagnosis of glomerulonephritis. In an attempt to evaluate the effect of marked diuresis on the altered red cell morphology in patients with biopsy proven glomerulonephritis, urinary sediments were examined following water or furosemide-induced diuresis. In both diuretic states urine flow increased, urine osmolality decreased and the percentage of glomerular erythrocytes was significantly reduced in the urinary sediment. These data demonstrate that the alteration in urinary red cells in glomerulonephritis is mainly caused by tubular forces. The diagnostic significance is reduced during increased diuresis and the evaluation of urinary red cell morphology should not be performed.

Adult↗
PubMed1985

Autonomic neuropathy in chronic renal insufficiency. Comparative analysis of diabetic and nondiabetic patients.

Disturbances of peripheral and autonomic nervous system function were evaluated in 37 normal subjects, in 52 patients with non diabetic chronic renal insufficiency (25 predialysis patients, 27 dialysis patients), and in 21 patients with diabetic chronic renal failure (10 predialysis patients, 11 dialysis patients). In nondiabetic patients, the predialysis group showed abnormal test results indicating parasympathetic lesions, in dialysis patients these derangements were nearly normalized. In predialysis diabetic patients, the autonomic alterations were much more extensive, corresponding to alterations of electroneurographical findings; in addition to parasympathetic lesions, sympathetic disturbances were seen. In contrast to the nondiabetic groups, in dialysis patients a deterioration of autonomic lesions was observed. In conclusion, these data indicate that deranged autonomic functions are common in uremia; they improve in dialysis patients with nondiabetic renal failure in contrast to diabetic patients; in this group the autonomic functions worsen in dialysis patients as a function of duration of diabetes and hemodialysis.

Adult↗