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Biomedical subjects

G Mourad

Publications and source records attributed to G Mourad.

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

Pharmacokinetics of sulpiride after intravenous administration in patients with impaired renal function.

Single intravenous doses of sulpiride 100 mg were administered to 18 patients with renal function impairment, and 6 healthy volunteers. The plasma concentration-time profile is described by a 2-compartment open model. The differences between the pharmacokinetic parameters of sulpiride for the 2 groups were statistically significant. Elimination half-life, mean residence time and area under the plasma concentration-time curve are significantly greater in renal failure; renal and total clearance, and the cumulative amount of unchanged sulpiride in urine, are significantly reduced but volume of distribution remains unchanged. Creatinine clearance was strongly correlated with renal clearance of sulpiride, elimination rate constant, area under the curve and cumulative amount excreted in urine. For patients with impaired or physiologically reduced renal function receiving long term sulpiride treatment, a 35 to 70% reduction in dose, or extension of the dosage interval by a factor of 1.5 to 3, may be required.

Adult↗
PubMed1989

Contrasting effects of acute angiotensin converting enzyme inhibitors and calcium antagonists in transplant renal artery stenosis.

Deterioration of renal function is a major concern during treatment by converting enzyme inhibitors of hypertensive kidney recipients with transplant renal artery stenosis. However, there has been no assessment of the frequency of this complication and its specificity for converting enzyme inhibitors as compared to other antihypertensive drugs. The effect of acute administration of captopril on mean arterial pressure, glomerular filtration rate (GFR) (creatinine clearance) and effective renal plasma flow (clearance of 131I-hippuran) was assessed in eight hypertensive patients with transplant renal artery stenosis. Captopril induced a decrease in mean arterial pressure (128 +/- 6-121 +/- 7 mmHg) and a reduction in GFR (59 +/- 8-44 +/- 8 ml/min per 1.73 m2, P less than 0.05). The decrease in GFR was observed in seven out of eight patients and varied between 0% and 100% of the pre-captopril value. Effective renal plasma flow was maintained (157 +/- 47-141 +/- 24 ml/min per 1.73 m2) and filtration fraction decreased by 15 +/- 7%. The effect of captopril was compared to that of nifedipine (N = 20 mg) in four patients. Despite a larger decrease in mean arterial pressure (130 +/- 7-109 +/- 10 mmHg), no reduction in GFR was observed (68 +/- 13-71.4 +/- 8). Effective renal plasma flow was unchanged and filtration function slightly increased. Surgical or percutaneous transluminal angioplasty in five patients suppressed the captopril-induced decrease in GFR.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Arterial hypertension, renal function and angiotensin-converting enzyme inhibition].

Several effects of the antihypertensive treatment with angiotensin converting-enzyme inhibitors (ACEI)--whether beneficial or detrimental--are best explained at the renal level. In the presence of a renal artery stenosis, the activation of the intrarenal renin-angiotensin system is first directed at maintaining glomerular filtration and intracapillary hydrostatic pressure through post-glomerular vasoconstriction. Long-term elevation of blood pressure is associated with a shift of the renal function curve, possibly linked with an alteration of the intrarenal renin-angiotensin system. Inhibition of the converting enzyme does affect the mechanisms of sodium conservation. In a subset of essential hypertensive subjects, ACEI may correct a subtle primary abnormality in modulation by sodium of renal (and adrenal) response(s) to angiotensin. Finally, the possibility of renal protection in circumstances such as diabetes mellitus, provides an exciting area of investigations for antihypertensive treatment with ACEI.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1988

Contrasting acute effects of captopril and nifedipine on renal function in renovascular hypertension.

In order to assess the determinants of renal function deterioration induced by angiotensin-converting enzyme inhibition (ACEI) in renovascular hypertension, studies were performed in patients with bilateral stenosis (BS; n = 12) and stenosis of a solitary kidney (SK; n = 10). Acute administration of captopril was associated with a consistent fall in glomerular filtration rate in 5 of 12 patients with BS and 8 of 10 with SK. Overall, glomerular filtration rate decreased by 22 +/- 7%, while mean arterial pressure decreased by only 8 +/- 2% and renal plasma flow remained unaltered. The ACEI-induced change in glomerular filtration rate was unrelated to blood pressure or basal plasma renin activity, but it was inversely related to pre-ACEI filtration fraction. In a comparative study conducted in 6 BS and 4 SK patients, acute administration of nifedipine was associated with a change in glomerular filtration rate of 13 +/- 5% and no change in renal plasma flow, despite a marked decrease in mean arterial pressure of 19 +/- 4%. In contrast, in the same patients, glomerular filtration rate fell by 23 +/- 12%, renal plasma flow did not change and mean arterial pressure fell slightly by 7 +/- 3% after ACEI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Kaposi's sarcoma of the bronchial tree in a renal transplant recipient.

An unusual case of disseminated Kaposi's sarcoma with endobronchial lesions is presented; these localizations are quite uncommon in the course of the disease, particularly in kidney transplant recipients. Some of the multifactorial etiologies of Kaposi's sarcoma are present: immunosuppression, ethnic origin and CMV infection. We emphasize that the diagnosis of bronchial involvement can be made during fiberoptic bronchoscopy and confirmed by biopsy without excessive complications.

Bronchial Neoplasms↗
PubMed1988

[Acute cytomegalovirus glomerulonephritis in a renal transplant patient].

We report on an acute glomerulonephritis with renal failure in a living-related renal allograft recipient with a cytomegalovirus infection. The clinical presentation was typical of an acute nephritis. Renal biopsy showed lesions of diffuse endocapillary proliferative glomerulonephritis. The disease resolved spontaneously. The pathogenesis of cytomegalovirus glomerulopathy is briefly discussed.

Adult↗
PubMed1988

Dose-dependent salidiuretic efficacy of torasemide in comparison to furosemide and placebo in advanced renal failure.

In a controlled randomized double-blind clinical trial the salidiuretic efficacy of 20 and 100 mg torasemide (1-isopropyl-3-([4-(3-methyl-phenylamino)pyridine]-3-sulfonyl)urea) and 60 mg furosemide, respectively, was compared including a control group with placebo after a single i.v. administration in 46 patients with advanced chronic renal failure (creatinine clearance less than or equal to 30 ml/min). 20 mg torasemide exerted a significant natriuretic activity within the first 6 h, whereas 100 mg torasemide induced a significant 24-h extra-excretion if compared to placebo. The sodium excretion induced by 100 mg torasemide was superior to the one by 60 mg furosemide. The duration of action of torasemide was longer than that of furosemide. The tolerance was good in all groups.

Adult↗
PubMed1987

Acute adaptative changes to unilateral nephrectomy in humans.

Renal function was monitored in 20, living-related kidney donors before and after uninephrectomy. Urinary protein excretion and retinoid metabolism respectively were studied in 10 and 6 of these donors. The functional adaptation was characterized by an increase in glomerular filtration rate and tubular function, which began in the first two days after uninephrectomy. Changes in tubular function were also demonstrated by significant increases in the urinary excretion of beta 2 microglobulin (beta 2M), retinol binding protein (RBP), kappa and lambda light chains of immunoglobulins. In addition, a protein identical to or homologous to cellular retinoic acid binding protein (CRABP), appeared in the urine after nephrectomy. We did not find CRABP in serum samples either before or after nephrectomy, suggesting that urinary CRABP was synthesized by the remaining kidney. Increases in serum levels of Vitamin A and RBP were also observed in the post-nephrectomy period. These modifications in retinol metabolism suggest that these substances could have a role as renotropic growth factors in compensatory hypertrophy.

Adult↗
PubMed1987

Haemodialysis-associated amyloidosis: beta 2-microglobulin alone or associated with globin chains?

1. The protein constituents of amyloid fibrils were characterized in amyloid deposits extracted from surgical material obtained from a 66-year-old patient undergoing maintenance haemodialysis and operated for a carpal tunnel syndrome. 2. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis disclosed the presence of bands at 12 and 14 kDa. Two-dimensional electrophoresis and Western blotting confirmed that the proteins were beta 2-microglobulin (beta 2M) and globin chains. 3. When the effluent of high-performance gel filtration chromatography corresponding to molecular masses of 10-15 kDa was subjected to Edman degradation, only one amino acid residue was found at each step. The 18 residues determined corresponded to the N-terminal sequence of beta 2M. 4. Although globin chains were clearly present in the amyloid material, they were not accessible for sequence determination. The identification of the other protein constituents present in the amyloid material, along with beta 2M, should provide a better understanding of haemodialysis-associated amyloidosis, the mechanisms of formation of which have not yet been completely determined.

Aged↗
PubMed1987

[Determinant factors in the acute functional deterioration caused by the inhibition of the conversion enzyme in reno-vascular arterial hypertension].

Deterioration of renal function may be elicited by converting enzyme inhibition (CEI) in patients with bilateral (BI) or solitary kidney (SK) renal artery stenosis, but the determinants of this complication are not clearly delimited. The effect of acute administration of captopril on arterial pressure, glomerular filtration rate (GFR) and effective renal plasma flow was assessed in 10 BI and 10 SK hypertensive patients with a mean GFR of 64 +/- 5 ml/min. CEI induced a decrease in MAP of 8 +/- 2 p. 100 and a fall in GFR of 25 +/- 8 p. 100; GFR fell by more than 20 p. 100 in 5/10 BI and 8/10 SK. Filtration fraction (FF) decreased by 16 +/- 5 p. 100. CEI-induced change in GFR was not related to the change in MAP, but was inversely correlated with pre-C FF; GFR always fell when FF was higher than 0.28. Surgical correction of the stenosis suppressed the C-induced decrease in GFR in 5 SK patients in whom it initially fell. In conclusion, basal FF, a probable index of intrarenal angiotensin II activity, rather than a fall in systemic blood pressure, is the main predictor of acute deterioration of renal function after converting enzyme inhibition.

Adult↗
PubMed1987

[Amyloid deposits in hemodialysis patients: immunochemical analysis].

We have analyzed 9 amyloid deposits isolated from 7 patients treated by long-term hemodialysis [6] and/or hemofiltration [1] for 8 to 19 years. Amyloid deposits were extracted from carpal tunnel synovitis [7] or femoral bone [2]. Proteins were analyzed by SDS-PAGE, two-dimensional electrophoresis and the identification was made by Western Blotting and specific antibody fixation. Several proteins were found: immunoglobulin light chains, beta 2 microglobulin (B2M), as well as globin chains, albumin and hemopexin. These findings suggest that amyloid deposits are not only made of B2M, but also with other protein species not cleared by dialysis membranes. Among these proteins, B2M and immunoglobulin light chains have well known amyloidogenic properties. We suggest that the role played by the remaining proteins on the pathogenesis of dialysis associated amyloidosis should also be considered.

Adult↗