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Biomedical subjects

F P Brunner

Publications and source records attributed to F P Brunner.

At least 109 records · Page 6Linked to original sources
PubMed1980

[Phenacetin abuse II. Chronic renal insufficiency in Basle autopsies].

The frequency of chronic terminal renal failure (CTRF) (serum creatinine greater than or equal to 4,5 mg/dl) in an unselected autopsy material was about 1.7% from 1968 to 1976. Based on this figure, the estimated yearly incidence is 160 to 200/10(6) inhabitants of the Basel area. In inhabitants of Basel, analgesic nephropathy (42.2%) was the most important cause of CTRF (excluding obstructive nephropathy). Pyelonephritis (without evidence of analgesic abuse) represented only 25.7%. All other nephropathies were less common: glomerulonephritis 14.6%, diabetic nodular glomerulosclerosis 11.6%, cystic kidney disease and vascular nephropathies (each 4.5%). By contrast, in patients treated by hemodialysis and renal transplantation glomerulonephritis (28.7%) is the most important cause of CTRF, followed by analgesic nephropathy (20%), pyelonephritis (15%) and cystic disease of the kidney (12.5%). The difference between the two groups can be explained by the lower mean age of patients treated by hemodialysis and transplantation. Incidence and disease course can be affected significantly only in analgesic nephropathy. It is therefore very important to prohibit legally the use of phenacetin or paracetamol containing analgesics without medical prescription. In addition, these drugs should be replaced by other analgesic compounds.

Adult↗
PubMed1980

Feedback activation in rat nephrons by sera from patients with acute renal failure.

Tubuloglomerular feedback (TGF) may be triggered by varying the distal electrolyte load. TGF may contribute to acute renal failure (ARF), but maximal TGF stimulation induces only relatively small alterations in single nephron GFR (SNGFR) and stop-flow pressure (SFP), whereas in ARF, GFR may cease, raising the possibility that substances eliciting greater TGF responses than do elelectrolytes occur in ARF. We have sought such substances in serum, urine, and peritoneal fluid from patients with ARF. Sera samples from 1 healthy subject, 4 ARF patients, and 2 other anuric patients were dialyzed against glucose to reduce electrolyte concentrations and perfused through Henle's loops in salt-deplete rats. With ARF sera, SFP fell from 35.6 +/- (SD) 3.5 to 20.9 +/- 3.4 mm Hg (P less than 0.005) and SNGFR from 28.5 +/- 8.7 to 12.6 +/- 7.3 nl/min (P less than 0.005). Furosemide (10(-4) M) did not abolish the response. Perfusion with other patients' sera had no effect on SFP. ARF urine or peritoneal fluid induced similar responses. Conclusion. In some ARF patients, substances present in serum activate TGF in the rat. These substances might contribute to development of certain forms of human ARF, particularly ARF associated with liver dysfunction (hepatorenal syndrome).

Acute Kidney Injury↗
PubMed1978

Mortality and morbidity of reusing dialysers. A report by the registration committee of the European Dialysis and Transplant Association.

The practice of reusing dialysers in renal units in the UK was surveyed by examining the patient questionnaires returned to the EDTA registration committee for 1976 and by a special questionnaire sent to all UK renal units. Altogether 65.6% of the 1785 patients treated with non-disposable dialysers and 49.6% of the 1109 treated with disposable dialysers reused their equipment. Reuse of dialysers caused some morbidity but no mortality. Most centres where disposable dialysers were used accepted that their reuse was necessary because of financial constraints and was ethically defensible.

Adolescent↗
PubMed1978

[Tumors of the efferent parts of the urinary tract and abuse of analgesics].

Since 1965, when Swedish authors first suggested that analgesic abuse could cause uroepithelial tumors associated with or without analgesic nephropathy, an increasing number of cases have been reported from many parts of the world. In a retrospective analysis of all patients admitted to the medical department of the University Hospital in Basel from 1966 to 1976, records of 20 patients with analgesic nephropathy and tumors of the urinary tract (excluding hypernephroma) were found (17 uroepithelial tumors, 2 sarcomas, 1 chorionepithelioma). Typical symptoms, outcome and actuarial survival of the patients with uroepithelial tumors are summarized. Phenacetin as the common ingredient in analgesic mixtures has been regarded as carcinogenic, since some of its metabolites are similar in chemical structure to well-known industrial carcinogens. In animal experiments malignant tumors have in fact been induced with 2-hydroxylated metabolites and areneoxydes of phenacetin and paracetamol, and there is even more convincing evidence of the carcinogenic properties of N-oxydized metabolites such as N-hydroxy-phenetidine and N-hydroxy-phenacetin. Dimethylnitrosamine formed from aminophenazone appears to be improbable as a cause of uroepithelial tumors associated with analgesic abuse, since aminophenazone has not been a common ingredient of analgesic mixtures in Australia, where the incidence of uroepithelial tumors appears to be as high as in Sweden, where abuse of aminophenazone-containing analgesics has been massive.

Acetaminophen↗
PubMed1978

Dialysis and renal transplantation of children in Europe, 1975.

The number of new paediatric patients accepted for treatment by regular dialysis and transplantation increased more slowly than in previous years. Survival in children above 10 years appeared to be better with all modes of therapy than in younger children. The only improvement in survival noted among the different treatments was in patient and graft survival of living donor transplants. A quarter of all children transferred to home dialysis were less than 10 years of age. Nephronophthisis and Henoch-Schönlein nephritis emerged as major primary renal diseases. In 1975 the proportion of retransplants in children rose and living donor grafts from fathers were more common than from mothers. Evening dialysis was practised more frequently in both hospital and home dialysis and rehabilitation in these patients seemed to be better than for those dialysed at other times. Renal osteodystrophy was present in at least half of all children dialysed for more than 1 year. The degree of grouth retardation was affected by sex, chronological age and the primary renal disease. Body height on dialysis and after transplantation progressively reduced in the majority of children. Growth seemed to be more impaired in boys than in girls on dialysis. Bone age advanced faster than height age especially in girls. The pubertal growth spurt was usually delayed and depressed on long-term dialysis and the development of genitalia and pubic hair as well as menarche was retarded.

Bone Development↗
PubMed1978

HgCl2-induced acute renal failure studied by split drop micropuncture technique in the rat.

Proximal tubular reabsorption was studied by the split drop micropuncture technique in HgCl2-induced severe as well as mild acute renal failure. 4 mg/kg of HgCl2 given subcutaneously to normal rats resulted in severe and usually oliguric acute renale failure at 48 h, mean plasma creatinine and urea having risen to 6.9 +/- 0.4 and 420 +/- 30 mg%. On inspection of the kidney surface, usually more than 50% of the convolutions appeared white opaque and collapased. Split drop reabsorption of 0.9% NaCl, 20% mannitol and 20% albumin was markedly accelerated in these necrotic tubular segments, while reabsorptive rates were usually quite reduced in the normal-looking red transparent convolutions. DOCA/saline-pretreated rats developed mild renal failure, with plasma creatinine and urea rising slightly to 1.6 +/-0.3 and 83 +/- 14 mg%, respectively, at 48 h after 4 mg/kh HgCl2. Reabsorptive rates were almost uniformly reduced from 0.55 +/- 0.02 in controls to 0.32 +/- 0.03 nl-mm-2 sec-1 in mild HgCl2-induced acute renale failure. Mild proximal tubular injury features decreased reabsorptive rate while severely damaged tubules appear to be leaky to the extent of allowing rapid disappearance from the tubular lument of the normally barely reabsorbable 20% albumin. Although compatible with unrestricted passive backflow being an additional factor in the pathogenesis of HgCl2-induced acute renal failure, these results do not challenge the importance of primary filtration failure.

Acute Kidney Injury↗
PubMed1977

[Kidney biopsy from the viewpoint of a clinician].

Technique, indications, contraindications and complications of percutaneous biopsy of the kidney and the renal transplant are reviewed. In Basle, after introducing fluoroscopic control, 347 consecutive percutaneous biopsies were followed by two serious complications only: persistent bleeding led to partial nephrectomy of the lower pole in one case and nephrectomy in a second case where spontaneous hemorrhage had occurred at the upper pole (temporally but not causally related to the biopsy of the lower pole). A further 110 biopsies of renal transplants done also with fluoroscopic control resulted in no complication whatsoever.

Biopsy↗