Thirty-seven osteodystrophic and chronically haemodialyzed patients have been treated for 1-22 months by means of 1,25(OH)2D3. Under treatment a marked improvement of symptomatology and radiographic findings has been observed in the majority of cases; from the haematochemical viewpoint a rise of calcemia and phosphoremia, a fall in alkaline phosphatase and a variable course of PTH have been observed. Several episodes of asymptomatic hypercalcemia ceased with posology reduction; only 3 cases needed stopping the treatment for this reason, one of them definitively; 12/37 cases needed hypophosphoric diets and increase in oral aluminium hydroxide doses to control hyperphosphoremia. The Authors conclude that, to achieve a correct management of a 1,25(OH)2D3 therapy for renal osteodystrophy, is mandatory a strict and accurate biochemical control: in this way is possible to obtain an effective modulation of the posology avoiding the appearance of side-effects as hypercalcemia and ectopic calcifications.

Adult↗

PubMedDate not supplied

[Circulating immune complexes in glomerulonephritis].

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Antigen-Antibody Complex↗

PubMedDate not supplied

[Neoplasms in chronic kidney failure].

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Female↗

PubMedDate not supplied

[Specificity, sensitivity and reproducibility of 2 methods of determining serum immunocomplexes (solid-phase C1q and polyethylene glycol precipitation)].

In the last years a few tests for the detection of circulating immune complexes (CIC) have been published. Nevertheless the data concerning their sensitivity and reproductibility are often partial. The Authors have here analysed, following this point of view, two methods for the detection of CIC, based on different mechanisms and therefore able to identify different kinds of CIC; the tests are: the PEG precipitation test and the C1q solid phase method. The reproductibility of the two methods is good, even when the samples have been many times thawn or kept at 20 degrees C for a few weeks; C1q test sensibility appears distinctly better than PEG test sensibility. By the two methods, but particularly with the PEG, it is possible to identify fluctuation of the IC levels during the day. The contemporaneous use of these two techniques can give results really useful to clinically monitorize some immune complexes diseases, such as many human glomerulonephrites.

Antigen-Antibody Complex↗

PubMedDate not supplied

[Quantitative and qualitative determinations and clinical and histological correlations of cryoglobulins in glomerulonephritis].

The Authors have investigated the presence of cryoglobulins in sera from 91 GN patients, 69 of whom had a renal biopsy. Cryoglobulins have been found in 12.5% of the idiopathic glomerulonephritis (GN), in 22.2% of the ones related to systemic diseases. Also 4 cases of GN with mixed essential cryoglobulinemia have been studied. Quantitative analysis has shown a IgG and IgM prevalence, the last ones of monoclonal type in 77.8% of the cases, with anti IgG activity in 44.4%. Concerning cryoglobulins found in idiopathic GN, the Authors observed a high incidence in the forms with cellular proliferation and glomerular exudation, as rapidly progressing GN, the acute post-infectious GN, and the mesangio-capillary GN. Among the GN related to systemic diseases, high incidence of cryoglobulins has been observed in lupus nephritis and polyartheritis. In both diseases (idiopathic GN and GN related to systemic diseases) a good correlation was found between clinical-ordinary activity and immunological parameters such as circulating immune complexes and complement breakdown products. The correlation between cryoglobulins level and disease activity is less evident in the mixed essential cryoglobulinemia G.N. Furthermore the Authors discuss here the pathogenesis of cryoglobulins in human G.N.

Antigen-Antibody Complex↗

PubMedDate not supplied

[Cellular and humoral immunity in glomerulonephritis with minimal lesions].

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Adult↗

PubMedDate not supplied

[Use of corticotherapy in the treatment of idiopathic glomerulonephritis].

Corticosteroids have multiform effects on traffic and functional capabilities of inflammatory or immunologically reactive cells, on various soluble factors, vascular and tissue responses. There is a different sensitivity of various populations and subpopulations of cells to the corticosteroid modulation. These mechanisms are still under discussion, but the final effects appear to support the use of corticosteroids in a number of idiopathic glomerulonephritis (GN). In the minimal change GN the 10 years after onset survival was not significantly increased by introducing corticosteroids, but the prompt disappearance of proteinuria (80% of adults by 8 weeks in our own series) supported their use. The problem of corticosteroid treatment in the focal sclerosing GN is complicated by the probable coexistence of two histologically undistinguishable forms (one of the these nonsteroid sensitive). In our own series the corticosteroid response, although transient, was present in 44% of 16 patients. We obtained a high number of total remissions (57%) and partial remissions (14%), in membranous GN, where the conflicting data of the literature suggest differences in the criteria of selection and admission of patients to corticosteroid treatment, calling attention to further controlled trials. In rapidly progressive GN the combined use of corticosteroids, immuno suppressants and heparin has elicited a stabilization or improvement of renal function in 40% of the treated patients. By the same treatment we observed a total remission in 19% and a partial remission in 62% of severely nephrotic patients with histological appearance of membranoproliferative GN characterized by massive subendothelial deposits of the early complement fractions (C1, C4). Although it is impossible to draw firm conclusions both on pathogenesis of idiopathic GN or on the biochemical, cellular and tissue effects of corticosteroid, these drugs appear sometimes effective in clinical practice.

Adrenal Cortex Hormones↗

PubMedDate not supplied

[Semeiotic significance of the clinical use of methods of determining serum immunocomplexes in human glomerulonephritis].

The application of tests for the determination of serum immune complexes in nephrology has supplied fresh pathogenetic and symptomatological information. An account is given of results obtained in primary and secondary glomerulonephritis using four methods; the solid-phase Clq test, the polyethylene glycol precipitation test, the immunofluorescence on polymorphonucleates tests, and the solid-phase conglutinins test (with anti-IgA antibodies). The results take on a symptomatological meaning in many classes of human glomerulonephritis, both in the differentiation of primary forms and those secondary to systemic diseases, and in prognosis. A critical review is made of the data obtained in a personal series in the light of a long-term follow-up. The limits and specificity of each test are also discussed.

Antigen-Antibody Complex↗