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Biomedical subjects

F Mignon

Publications and source records attributed to F Mignon.

At least 127 records · Page 7Linked to original sources
PubMed1989

[Recovery of renal function after treatment with continuous ambulatory peritoneal dialysis].

The methods of dialysis were rarely studied as factors of recovery of renal function, in patients receiving long term dialysis. The authors report their experience about 400 end-stage renal disease patients treated between 1983 and 1988. The frequency of renal function recovery was 3.9%, irrespective of the dialysis modality. The two main favorable factors were the type of the primary renal disease and the associated potentially reversible factors at the onset of the dialysis. As the hemodialysis group and the peritoneal dialysis group differed regarding these factors, no definite answer could be given. No conclusion will be drawn up without a prospective randomized trial.

Acute Kidney Injury↗
PubMed1988

Atrial natriuretic peptide and adaptation of sodium urinary excretion in patients with chronic renal failure.

1. In order to examine the potential role of endogenous atrial natriuretic peptide (ANP) in modulating the increased sodium excretion per nephron in chronic renal failure, we studied healthy subjects with normal renal function (group I) and patients with moderate (group II) or severe chronic renal failure (group III) before, during and after administration of an intravenous sodium load. All subjects had been on a controlled diet containing 120 mmol of sodium per day for 5 days before the study. 2. Under basal conditions, plasma ANP and fractional excretion of sodium (FENa) were highest in group III. Both parameters increased in response to the sodium load in the three groups studied (P less than 0.001). Changes with time differed from group to group (P less than 0.05), the more marked response for both parameters being observed in group III. After adjustment with respect to plasma ANP (analysis of covariance), FENa was no longer modified in response to the sodium load, whereas adjustment of FENa with respect to mean blood pressure was without consequence on the significance of its change with time. This demonstrates that plasma ANP, but not mean blood pressure, represents the main factor producing variation in FENa during and after the sodium load. 3. These results suggest an important role for plasma ANP in promoting adaptation of short-term sodium excretion in response to an acute sodium load in patients with chronic renal failure who ingest a normal sodium intake.

Adaptation, Physiological↗
PubMed1988

Gallium67 scintigraphy in the diagnosis of glomerulonephritis.

To assess the role of gallium-67 (67Ga) scintigraphy in the diagnosis of glomerular diseases, we performed the following technique in 39 patients with glomerulonephritis (GN) who underwent simultaneous Ga scan and histologic examination. 72 hours after IV injection of Ga citrate (2 mCi), isotopic kidney activity (normally undetectable) was compared to the activity of the liver and quantified as follows: less than (1+), equal to (2+) or greater than (3+) that of the liver. Renal biopsy was performed at the same time to evaluate the type of the GN and to quantify interstitial cellular infiltration. Proteinuria, serum albumin and creatinine were measured. There was a significant correlation between the level of 67Ga kidney activity and the degree of proteinuria and hypoalbuminemia. On the contrary, no correlation was found between isotopic activity and the degree of renal failure or the degree of interstitial cellular infiltration. Increased kidney 67Ga activity did not appear characteristic of a specific histologic type of GN. Increased glomerular permeability may alter renal uptake of Ga; therefore 67Ga scanning does not appear to contribute significantly to the diagnosis and the follow-up of either primary or secondary GN.

Biopsy↗
PubMed1987

Multiple myeloma and severe renal failure: a clinicopathologic study of outcome and prognosis in 34 patients.

Renal failure (RF) occurring in the course of multiple myeloma is often judged irreversible and generally considered an ominous complication. The aim of the present study was to re-evaluate the outcome, triggering conditions and prognostic factors of severe RF in a series of 34 patients, 33 to 90 years old. RF was totally reversible in 7 patients and partially reversible in 9 although 6 of them had to be temporarily dialyzed. However, the improvement in renal function was often very slow as indicated by an average recovery time of 115 days. The high rate of RF reversibility was associated with markedly lengthened survival. Review of triggering events confirmed the leading role of dehydration and hypercalcemia, but further suggested that intake of nonsteroidal anti-inflammatory drugs and renal infection might play a part in the development of RF. Systematic statistical analysis of potential prognostic factors showed that the outcome was significantly more severe in females, but age, myeloma characteristics including tumor mass, calcemia, and triggering events had no predictive value. The most reliable prognostic indicators were provided by analysis of kidney biopsy performed in 30 patients. Complete recovery from RF was observed only in the absence of global tubular atrophy and interstitial damage. In contrast, cast-induced tubular obstruction detected by the presence of Tamm-Horsfall protein in urinary space of glomeruli did not seem to influence the outcome of RF. Finally, we analyzed the prognostic value of immunochemical properties of light chains (LC). Lambda LC were unexpectedly detected in 2 of 3 patients, as compared to a ratio of 1 to 3 in the population of normal and monoclonal Ig, but LC type did not correlate with the course of RF. Isoelectric points of LC measured in 32 patients were dispersed from 5.2 to 8.9 and bore only weak prognostic significance. These results underline the value of kidney biopsy and justify aggressive treatment including dialysis and chemotherapy.

Acute Kidney Injury↗
PubMed1987

Massive plasma arginine vasopressin (AVP) removal during hemofiltration stimulates AVP secretion in humans.

Arginine vasopressin (AVP) was measured in the plasma and its ultrafiltrate in 11 patients with end-stage renal failure treated by hemofiltration. Nineteen liters of ultrafiltrate were produced in 170 min and continuously replaced by an isoosmotic substitution fluid to maintain constant body weight. Plasma and ultrafiltrate AVP concentrations were not significantly different and did not change with time. The AVP clearance rate due to hemofiltration was 114 +/- 2.6 (+/- SE) ml/min, which represented more than two thirds of the predicted MCR in these patients. Corrected plasma osmolality, body weight, mean blood pressure, hematocrit, and PRA did not change during the hemofiltration session. These results indicate that there is a compensatory increase in AVP production which maintains plasma AVP unchanged in response to the increased MCR resulting from hemofiltration. The responsible stimulus could be a direct effect of the decrease in plasma AVP on the AVP-secreting neurones. Alternatively, ultrafiltration itself, via the hemodynamic changes it produces or the loss of an unrecognized inhibitory substance, may be the stimulus to AVP secretion.

Adult↗
PubMed1987

Role of cardiac parasympathetic dysfunction in atrial natriuretic peptide response to volume changes in patients with chronic renal failure.

Plasma atrial natriuretic peptide (ANP) was measured by radioimmunoassay in 10 patients with end-stage renal failure during two successive 150-min periods of ultrafiltration and perfusion of an identical fluid volume (1,800-2,400 ml). The patients were divided into two groups of 'denervated' and 'intact' patients based on three different tests for cardiac parasympathetic dysfunction. Plasma ANP was higher in the denervated group than in the intact group throughout all the study, but decreased with the volume ultrafiltered and increased with the volume perfused in both groups. The sensitivity of ANP response to perfusion was greater in denervated than in intact patients. These results demonstrate the close relationship between plasma ANP and stepwise decremental or incremental changes in extracellular fluid volume. They also suggest that cardiac parasympathetic innervation plays a role in modulation of ANP secretion in humans.

Adult↗
PubMed1987

[Prosthesis without puncture, 3d generation of vascular access for hemodialysis: a study of Hemasite in 10 patients].

Hemasite is a new vascular access for hemodialysis. The device has a carbon coated T-shaped body with a resealable silicon septum that obviates the need for skin punctures. It is implanted with attached PTFE grafts. Since August 1984, 10 Hemasite have been placed in 10 patients. After one year, 63% of Hemasite are still permeable: this success rate is at least similar to usual synthetic grafts. There is no infectious complication. The rate of thrombosis is high, but Hemasite offers the interesting facility to perform local infusion of thrombolytic drugs and/or painless angioplasty through its removable septum in case of venous stenosis. Patients and staff acceptance has been excellent.

Adult↗
PubMed1986

Glomerular lesions in lymphomas and leukemias.

Renal lesions in lymphoid malignancies are rare, with most lesions observed in association with Hodgkin's disease. In two large series of patients with Hodgkin's disease, only 0.4 percent had minimal-change lesion whereas 0.1 percent had amyloidosis. The non-Hodgkin's lymphomas and leukemias comprise large and heterogeneous groups with equally diverse renal lesions. As in Hodgkin's disease, the most frequent lesion is minimal-change nephrotic syndrome. Also recognized are rare reports of renal disease associated with the atypical lymphoid proliferations of angioimmunoblastic lymphadenopathy, giant lymph node hyperplasia syndrome, and acquired immune deficiency syndrome. Broad generalizations regarding the pathogenesis of renal disease in these syndromes are difficult, partly due to the paucity and sporadic reporting of such cases. Mechanisms proposed to explain the renal pathologic findings include autologous nontumor antigens, tumor antigens, fetal antigen expression, immune complex deposition, viral antigens, and disordered T cell function.

Amyloidosis↗
PubMed1986

Anti-C3b-receptor (CR1) antibodies in patients with systemic lupus erythematosus.

Using an enzyme-linked immunoadsorbent assay, IgG in the plasma and purified IgG from 2 patients with systemic lupus erythematosus (SLE) were found to strongly react with purified C3b receptor (CR1) insolubilized on microtiter plates. The amount of IgG that bound to CR1 in 201 plasma samples from 179 other patients with SLE did not significantly differ from that which bound in 72 control samples from normal individuals. Purified IgG from the patients with anti-CR1 reactivity did not inhibit CR1 function in vitro. The number of CR1 antigenic sites expressed on erythrocytes from both patients was much lower than that observed in a normal population and in the lowest range of the decreased numbers found in patients with SLE. The occurrence of anti-CR1 antibodies in patients with SLE could provide an acquired mechanism for decreased expression of CR1 through antigenic modulation of the receptor on precursor cells and/or alter the function of cells of the immune system bearing C3b receptors.

Animals↗
PubMed1986

[Renovascular hypertension with renal failure: value of renal revascularization].

The purpose of this work was to determine the effects of renal revascularization on blood pressure and renal function in 9 patients with arterial stenosis involving both kidneys (7) or a solitary kidney (2). There were five women and four men with a mean (SD) age for 64.5 +/- 7 years. The duration of hypertension ranged from 2 to 28 years (mean = 12 +/- 8). Blood pressure ranged from 210/100 to 260/150 mmHg, despite the use of three or more antihypertensive agents in 7 cases. The serum creatinine level, on presentation, ranged from 160 to 265 mumol/l (mean = 198 +/- 30 mumol/l). Intravenous pyelograms were not suggestive of renovascular disease in 4 of 7 cases. Digital angiography or arteriography demonstrated severe stenosis of the artery of the solitary kidney in 2 patients, severe bilateral atherosclerotic disease in 7 patients, three of them had complete occlusion of a main renal artery. During hospitalization, therapy with captopril (5 patients) or minoxidil (1 patient) lowered blood pressure in 3 cases, but induced a marked increase in serum creatinine level in 4 cases. In two patients, medically treated, severe and rapidly progressive impairment of renal function was observed. The seven remaining patients underwent surgical revascularization (two after unfructuous percutaneous transluminal angioplasty). One died 45 days later. Blood pressure control with diastolic blood pressure of 100 mmHg or less was achieved in the other six, although each patient continued to require antihypertensive medication (bitherapy: 2, monotherapy: 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Rapidly progressive ('crescentic') glomerulonephritis and monoclonal gammapathies.

In 3 patients rapidly progressive glomerulonephritis revealed plasma cell dyscrasia in 2 cases and Waldenstrom's macroglobulinemia in the 3rd. Renal biopsy showed proliferative glomerulonephritis with marked endo- and extracapillary (crescentic) proliferation. In case 1, corticosteroids and cyclophosphamide favorably influenced the course of the disease. The 2nd patient was not treated and went on to maintenance hemodialysis. In the 3rd case, plasma exchange and cytotoxic drugs allowed discontinuation of hemodialysis. Thirteen other cases of proliferative glomerulonephritis associated with monoclonal gammapathies have been described in the literature, including 3 with crescents. B-cell dyscrasia should be considered a possible etiology in a patient with crescentic glomerulonephritis. In such case we show that treatment of the hematologic disorder can be followed by a dramatic improvement of renal function.

Aged↗
PubMed1983

[Urinary lithiasis secondary to intestinal diseases].

Urinary stones are much more common in subjects with intestinal diseases than in the general population. The chemical composition of the stones depends on the type of intestinal disease. In diarrhoeas with loss of water and electrolytes (inflammatory colitis and, chiefly, ileostomy), the urine is acid and concentrated and the stones are composed of uric acid. Extensive lesions of the ileum or wide resections of the small bowel increase the intestinal absorption of oxalates and expose the patients to oxalate stones. Treatment, which must be preventive, is based upon a knowledge of the pathophysiology of urolithiasis.

Humans↗