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Biomedical subjects

E Quellhorst

Publications and source records attributed to E Quellhorst.

At least 55 records · Page 3Linked to original sources
PubMed1978

Clinical and technical aspects of hemofiltration.

The removal of uremic substances in hemofiltration, in contrast to hemodialysis, is achieved by means of a convective transport across membranes of high porosity. Since 1974, more than 30 patients with chronic renal insufficiency have been treated with regular hemofiltration three times weekly for four to five hours each. After completing a pilot study, a controlled study to compare hemodialysis and hemofiltration was initiated during January, 1978. A normalization of blood pressure in patients with severe hypertension, and remarkable stability of the circulatory system, even after dehydration in patients who had hypotension in spite of fluid overload, could be demonstrated. Hemofiltration is preferred, especially in older patients with cardiovascular or cerebrovascular problems, because of its lower frequency of hypotensive episodes compared to dialysis. An important aim--the miniaturization of the artificial kidney--has not yet been achieved, however, because of the necessity for an extensive monitoring system for the exact proportioning of the sterile substitution fluid. First results in the application of a fluid regeneration system consising of a charcoal cartridge and a bioelectric cell, for degradation of urea, are presented.

Blood Pressure↗
PubMed1978

[Elimination rate of meproscillarin following repeated application in patients with reduced renal function (author's transl)].

It was to be investigated whether the elimination rate of 14-hydroxy-3beta-[(4-O-methyl-alpha-L-rhamnopyranosyl)oxy]-14beta-bufa-4,20,22-trienolide (meproscillarin, Clift) is influenced by the renal function after discontinuance of long-term application. A group of 9 patients with renal insufficiency of varying extent associated with heart failure received 0.75 mg of meproscillarin per day over a period of 14 days. The plasma levels of the glycoside were measured by means of the 86rubidium erythrocyte assay up to 60 h after the last dose. After discontinuance of the glycoside the mean plasma half-life was 45.8 (S.-X = 6 h), a value corresponding to the results obtained in healthy test persons (49.3 h). Thus it could be demonstrated that the rapid elimination rate (and thereby the rate of inactivation) of meproscillarin is not influenced by renal function even after discontinuance of long-term application.

Adult↗
PubMed1977

Peritoneal dialysis in small laboratory animals.

Healthy rats and guinea-pigs were treated with a simple method of continuous peritoneal dialysis for 12, 24 and 48 h. Increasing with time, both animal species developed severe hypoproteinemia and hemoconcentration due to protein loss into the dialyzate fluid. These changes were associated with a high mortality rate, when Sterofundin was used for dialysis. Therefore, protein loss should be substituted and the type of dialyzate must be considered in experimental long-term dialysis using these small laboratory animals.

Animals↗
PubMed1977

[Treatment of glomerulonephritis with heparin (author's transl)].

32 patients with different histologically proven forms of glomerulonephritis were treated with heparin for an average of 31 days. A dosage of heparin was chosen, which allowed an increase in thrombin time to 20-40 seconds. Histological findings alone do not allow any prediction concerning the therapeutic success of heparin treatment in glomerulonephritis. According to our results and comparable information given in the literature, the following therapeutic scheme can be recommended: Best results are seen in patients with a slow decrease of GFR (i.e. less than 30 ml/min) during the year preceding the beginning of the treatment. In rapid progredient glomerulonephritis, however, as in patients without any changes of GFR during this time, predictions as to the course of illness cannot be made. A high level of fibrin split products in serum may be expected to be the most valuable sign of therapeutic effect, as could be documented in 7 out of 8 successfully treated patients. Hypertension and proteinuria were not influenced by the treatment. Because of severe side effects the heparin treatment of glomerulonephritis should not be initiated in patients with severe hypertension.

Blood Coagulation Tests↗
PubMed1977

[Dialysis treatment of advanced diabetic nephropathy (author's transl)].

Dialysis treatment of patients with diabetic nephropathy turns out to be difficult because of numerous late complications which arise in addition to the renal disease and which often influence the direction of the course of the disease. But this experience does not in the least justify the exclusion generally of patients with diabetic nephropathy from dialysis the-rapy. Hemodialysis and peritoneal dialysis are equally suitable for the treatment of renal insufficiency; patients with accumulated hemorrhagic complications (e. g. vitreous hemorrhages) should be treated by peritoneal dialysis for preference, and those with a predominant hypertension by hemodialysis. Early preparation for dialysis treatment is of great importance.

Blood Glucose↗
PubMed1977

Effect of dialysate calcium concentration on plasma parathyroid hormone during hemodialysis.

The effect of changes in the dialysate calcium concentration on calcium fractions and parathyroid hormone species in plasma during hemodialysis has been examined. C-terminal immunoreactive parathyroid hormone was suppressed when plasma calcium increased by greater than 25% whereas N-terminal fragments demonstrated an increase. The significance of this is discussed in light of present knowledge of parathyroid hormone metabolism.

Adult↗
PubMed1977

Hemofiltration: treatment of renal failure by ultrafiltration and substitution.

Hemofiltration, in contrast to hemodialysis or peritoneal dialysis, eliminates toxic substances accumulated in uremia by a process that is independent of molecular weight. By means of a special device, the ultrafiltrate of blood is replaced, up to the desired amount, by a modified Ringer's lactate solution. The application of this new method results in better control of severe hypertension, and controls calcium phosphate and lipid metabolism in a more physiologic manner than dialysis does, without additional drug therapy being necessary. Smaller amounts of fluid and a simplification of devices improve hygienic conditions and patient mobility.

Blood Pressure↗
PubMed1977

Changes in peripheral nerve function with long-term hemofiltration treatment.

The changes in the peripheral nerve function of three patients with chronic renal failure who were treated over a period of 1-1/2 to 2 years by hemofiltration have been analyzed in the form of a longitudinal study by quantitative measurements of vibratory perception threshold and nerve conduction velocity. Changes in vibratory perception threshold were measured in six patients both before and after treatment. Despite increased values of creatinine and BUN, an improvement in the peripheral nerve function of all patients undergoing hemofiltration could be observed, although vibratory perception and nerve conduction velocity did not return to normal. All of the vibratory perception threshold measurements made directly after hemofiltration showed an improved vibratory perception in comparison to the original values. A comparison of the measurement methods showed a good correlation and clearly indicated the advantage of vibratory perception threshold measurements as a means for the routine diagnosis of nephrogenic polyneuropathy.

Adolescent↗
PubMed1977

Alterations of clotting factors and platelets during hemofiltration.

The influence of hemofiltration on the number of platelets and on coagulation factors was investigated in patients with chronic renal insufficiency. These investigations were done on 12 patients during 22 treatments with hemofiltration. Blood samples were taken before hemofiltration, 10, 30 and 120 minutes after the beginning of the treatment and at the end of hemofiltration. In comparison to the original values we found a loss of platelets, a small decrease in the concentration of fibrinogen and a small increase in the fibrin monomer complex, plasminogen, antithrombin III, alpha1-antitrypsin and in alpha2-macroglobulin. The thrombin time, the partial thromboplastin time and Quick's test showed that the blood of these patients contained sufficient hepatin. Use of fibrin plates (Astrup) showed no signs of fibrinolytic activity. Compared to the results, which were obtained some years ago during hemodialysis, we found a smaller extent of alterations of blood coagulation factors and number of platelets.

Antithrombins↗