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Biomedical subjects

F P Brunner

Publications and source records attributed to F P Brunner.

At least 127 records · Page 7Linked to original sources
PubMed1976

[Diagnosis and pathophysiology of renal concentration disorders].

Basic physiology and pathophysiological mechanisms of renal concentrating ability and its defects are discussed. Normal urinary concentration depends on the concerted action of a variety of factors. Consequently, many different causes may underly the symptom of polyuria. Clinical tests of concentrating ability (water deprivation, pitressin test) are of diagnostic importance in diabetes insipidus and polydipsia, but have little practical value in the work-up for chronic renal disease. A critical analysis of maximal concentrating capacity (TcH2O) during induced osmotic diuresis is conducted. It is inferred that the height and shape of the normal TcH2O curve results basically from two physiological processes: It is raised by increasing NaCL transport out of the medullary parts of the ascending limbs of Henle's loops and lowered by influx of hypotonic tubular urine into the collecting ducts. Preponderance of hypotonic influx may result in hypotonic final urine in the absence of tubular functional abnormalitiy. It is not appropriate, therefore, to classify renal concentrating defects according to the shape and height of the TcH2O curve. A synopsis and short description of the known renal concentrating defects is given. They are classified into hereditary, metabolic, diuretic-induced, and toxic disturbances, as well as those seen in renal disease of various etiology. Each defect is discussed in terms of the underlying pathophysiological mechanism as far as currently understood. The most important mechanisms are either disturbed NaCL transport in the ascending limb of Henle's loop, or antidiuretic hormone (ADH) dependent or ADH independent decrease in water permeability of the enddistal convolutions and collecting ducts, or osmotic diuresis.

Diabetes Insipidus↗
PubMed1976

Dialysis and renal transplantation of children in Europe, 1974.

About a third of all children with end-stage renal failure in Europe were accepted for treatment by regular dialysis or transplantation during 1974. The number of specialised paediatric dialysis centres increased. The number of renal transplants also increased, but fewer living donor grafts and retransplants were performed in 1974. The best survival was again observed on home dialysis. Patient survival after a cadaver graft improved. Children more than ten years old appeared to have a better survival on dialysis and a somewhat better graft function than younger patients. Rehabilitation was similar on home dialysis and after transplantation, but full school activity in ordinary school was reported in only 40% of all children on hospital dialysis. Children on haemodialysis tended to dialyse more frequently in 1974, than before, but for fewer hours per week. Hepatitis was still a problem and only a small reduction in the incidence was noted during 1974. Children on dialysis required more blood transfusions than adults. Body growth on haemodialysis was retarded to a similar degree on boys and in girls; 70% of the haemodialysed and 63% of the transplanted children had a growth velocity below the third percentile. Growth rate was noted to fall after the first year on dialysis.

Adolescent↗
PubMed1975

[Dialysis and kidney transplantation in Switzerland in 1973].

A separate computer print-out for Switzerland of the EDTA registry concerning all patients on dialysis or carrying a renal transplant has been analysed. Of a total number of 857 registered patients, 584 or 91 per million inhabitants were alive on 31 December 1973; 306 patients were on hospital hemodialysis, 68 on home hemodialysis and 2 on peritoneal dialysis. 353 patients had received 385 renal transplants, 208 of which were still functioning at the end of 1973. No major change was noted in cumulative survival rates of Swiss patients, who, as expected, showed lower survival with increasing age. Graft survival in a group of 148 first cadaver transplants with poor tissue match (2 or fewer HL-A identities) was better with 66+/-4% at one year than the 53+/-7% survival in the 63 grafts with at least 3 HL-A identities. The number of patients alive on home dialysis increased by 74% through 1973; one year survival equalled the European average at 93+/-4%. Rehabilitation was rather poor in dialysed patients, 21% of whom were reported to be working full time in the hospital-dialysed group and 42% in the home-dialysed group. Patients with functioning transplants, on the other hand, showed very satisfactory rehabilitation (75% working full time). Hepatitis among staff appeared be on the decrease, with only 9 cases in 1973 despite the fact that some 20% of dialysed and transplanted patients were still reported as hepatitis B antigen carriers. The number of new patients accepted for treatment in Switzerland has stabilized at 25-27 per million population per year since 1971. Average mortality was 15.3% in 1973. At the beginning of 1980 we can thus expect to be treating some 135 patients per million population with dialysis and renal transplantation.

Female↗
PubMed1973

[Home dialysis].

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Economics↗