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Biomedical subjects

G R Catto

Publications and source records attributed to G R Catto.

At least 127 records · Page 7Linked to original sources
PubMed1983

Acute renal failure due to continuous rifampicin.

We describe the clinical and pathological features of acute renal failure which occurred in a patient receiving a first course of antituberculous therapy, including daily rifampicin. Renal biopsy specimens demonstrated an interstitial nephritis. The renal lesion resolved three weeks after the cessation of rifampicin, as evidenced by improvement in renal function and the return of nuclear magnetic resonance tomographic studies to normal. This is only the fifth reported instance of renal impairment following continuous rifampicin therapy, despite widespread use of the drug in a daily dose. The possible toxic interaction of rifampicin and antituberculous drugs which are excreted predominantly by the kidneys is also described.

Acute Kidney Injury↗
PubMed1982

Possible mechanism of action of transfusion effect in renal transplantation.

The mechanism by which blood transfusions given before renal transplantation improves allograft survival was studied in 31 transplant recipients. The presence of non-cytotoxic, Fc receptor blocking antibodies to donor and leukaemic B lymphocytes in pre-transplant sera correlated with both improved graft survival (p less than 0.03 and less than 0.1, respectively) and the number of blood transfusions given (p less than 0.05 and less than 0.03, respectively). Moreover, 6 out of 10 previously untransfused prospective transplant recipients developed these potentially protective antibodies during a course of elective blood transfusions. These results indicate that such non-cytotoxic, Fc receptor blocking antibodies in pretransplant recipient sera (a) are associated with improved allograft survival, (b) correlate with the number of blood transfusions given, and (c) can develop in response to blood transfusion.

B-Lymphocytes↗
PubMed1982

Nuclear magnetic resonance tomographic imaging in renal disease.

The non-invasive diagnostic technique of whole body nuclear magnetic resonance (NMR) imaging was evaluated in 60 patients. 30 of these patients were known to have various renal diseases and the remainder had normal renal function. In the demonstration of space-occupying lesions of the kidney, NMR proved to be as diagnostically accurate as ultrasound and intravenous urography; it was, moreover, as specific as ultrasound in differentiating malignant tumours from benign cystic lesions. The specificity of NMR was superior to both ultrasound and IVU in the diagnosis of parenchymal disease in normally situated kidneys and in renal transplants. Hydronephrotic kidneys were readily demonstrated.

Graft Rejection↗
PubMed1982

Long-term effects of 1,25-dihydroxy vitamin D3 and 24,25-dihydroxy vitamin D3 in renal osteodystrophy.

Twenty-three patients with end-stage renal failure on maintenance haemodialysis were treated with 1,25-dihydroxy vitamin D3 or 24-25-dihydroxy vitamin D3 for 3-32 months (total 232 patient months). Treatment with 1,25-dihydroxy vitamin D3 was marked by symptomatic, biochemical and histological improvements in the majority of patients. In contrast, treatment with 24,25-dihydroxy vitamin D3 produced no biochemical or histological improvements and such patients developed severe symptomatic bone disease. Successful renal transplantation resulted in rapid improvement in symptoms, biochemistry and bone histology in nine of 10 patients irrespective of whether prior treatment was with 1,25-dihydroxy vitamin D3, 24,25-dihydroxy vitamin D3 or both. During treatment with 1,25-dihydroxy vitamin D3 progressive reduction in dosage was required in the majority of patients because of hypercalcaemia, which was rapidly corrected by stopping treatment for a few days. Hypercalcaemia did not occur until serum alkaline phosphatase (AP) and amino terminal parathyroid hormone (N-PTH) had fallen towards normal. Treatment failure was uncommon in 1,25-dihydroxy vitamin D3-treated patients and was characterized by the early development of hypercalcaemia. Addition of 24,25-dihydroxy vitamin D3 in such patients rendered the hypercalcaemia more manageable but did not lead to any further improvement in biochemistry or bone histology. Treatment with 24,25-dihydroxy vitamin D3 was accompanied by the development of severe symptomatic bone disease in the majority of patients and a characteristic pattern of biochemical abnormalities with hypocalcaemia and rises in AP and N-PTH. Substitution of 1,25-dihydroxy vitamin D3 treatment for 24,25-dihydroxy vitamin D3 in these patients resulted in prompt improvement in clinical, biochemical and histological abnormalities. Successful renal transplantation was accompanied by rapid resolution of clinical, biochemical and histological features of renal osteodystrophy irrespective of whether previous treatment was with 1,25-dihydroxy vitamin D3 or 24,25-dihydroxy vitamin D3. Hypophosphataemia was common in the early months after renal transplantation without evidence of continuing hyperparathyroidism. The studies have confirmed that 1,25-dihydroxy vitamin D3 is effective in controlling clinical, biochemical and histological features of renal osteodystrophy while 24,25-dihydroxy vitamin D3 did not have a useful therapeutic effect in the dose used.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Effect of dihydroxylated metabolites of vitamin D3 on calcium absorption in uraemic man.

1. Peak 47Ca absorption and 7 day 47Ca retention were measured by a whole-body radioactivity counting technique in 10 haemodialysis patients before and after treatment with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25-(OH)2D3]. 2. Before treatment all patients had low peak 47Ca absorption and 7 day 47Ca retention. 3. After treatment with 1,25-(OH)2D3 (0 . 25-l microgram/day for 4-12 months) peak 47Ca absorption and 7 day 47Ca retention returned to normal. 4. After treatment with 24,25-(OH)2D3 (2 microgram/day for 4-12 months) peak 47Ca absorption and 7 day 47Ca retention remained at pretreatment levels. 5. It is concluded that physiological doses of 24,25-(OH)2D3 have no effect on calcium absorption or retention in uraemic man.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

HLA and renal transplantation: yet another approach.

Renal allografts obtained from living related donors have considerably better chances of success than allografts from cadavers. The genetic factors that influence graft survival are linked to the HLA gene complex. Although results of cadaver transplants have not improved significantly when donor and recipient are matched for HLA-A and -B antigens, accumulating data suggest that matching for the more recently recognised HLA-DR antigens may produce increased graft survival.

Graft Survival↗
PubMed1981

Lipid relation ships in dialysis and renal transplant patients.

The relationship of high density lipoprotein cholesterol (HDL-CHOL) to other lipid fractions and the factos influencing post-transplant hyperlipidaemia have been explored in 28 chronic haemodialysis patients and 20 stable renal allograft recipients. In both groups of patients mean triglyceride (TG) and very low density lipoprotein cholesterol VLDL-CHOL) were elevated, but total CHOL and low density lipoprotein cholesterol (LDL-CHOL) were elevated only in transplanted patients. HDL-CHOL was uniformly low in dialysis patients irrespective of TG, whereas after transplantation mean HDL-CHOL was normal and varied inversely with TG and VLDL-CHOL. Serum creatinine correlated with TG and VLDL-CHOL in transplant patients, and was inversely related to HDL-CHOL. No factors correlated with CHOL or LDL-CHOL in transplant patients, but these lipids were only moderately elevated. Hyperlipidaemia in dialysis and transplant patients is not invariable; its importance for atherogenesis remains to be determined.

Adolescent↗
PubMed1980

Patterns of N-acetyl-beta-D-glucosaminidase excretion after renal transplantation.

N-Acetyl-beta-D-glucosaminidase activity (NAG) was assayed in 750 early morning urine samples from 25 renal transplant patients during the post operative period. Eighty four per cent of all acute rejection episodes were preceded or accompanied by a greater than two-fold rise in NAG activity; similar increases were caused by dialysis, gentamicin therapy and ureteric dehiscence. Only 9% of all significant increases in NAG excretion could not be accounted for by any of these four processes. Analysis of the day-to-day pattern of NAG activity as opposed to individual NAG values provided a clue to the occurrence of rejection during immediate post-transplantation oliguria.

Acetylglucosaminidase↗
PubMed1980

Integrated dialysis and renal transplantation: small is beautiful.

Many patients in Britain with chronic renal failure suitable for renal replacement treatment die because not enough treatment facilities are available. Moreover, the number of renal transplants performed is insufficient to meet even present needs, so the number of patients on dialysis is rising. The integrated dialysis and transplant unit in Aberdeen, which has a population base much smaller than the average British unit, meets community needs for dialysis and transplantation. The problem of harvesting cadaver kidneys has been solved; the present supply has not only enabled the number of patients on dialysis to remain stable but has resulted in a net export of kidneys. The Aberdeen unit shows how estimated needs for chronic dialysis and renal transplantation may be met.

Graft Survival↗
PubMed1980

Accelerated atherosclerosis in long-term dialysis and renal-transplant patients: fact or fiction?

The causes of death and morbidity in a series of 104 patients with end-stage renal disease were analysed in an attempt to determine whether dialysis and renal transplantation accelerate atherogenesis. Only 4 of 37 deaths were due to myocardial infarction; a further 2 were due to other manifestations of occlusive arterial disease; and severe atheroma was an incidental finding at necropsy in only 3 other patients. Symptomatic arterial disease developed during treatment in only 3 of 61 patients at present alive; 2 other patients with myocardial infarctions before dialysis treatment have survived uneventfully for long periods. These data suggest that dialysis and transplantation may allow previously acquired atherosclerosis to manifest itself clinically; but the hypothesis that atheroma is accelerated is not yet proven.

Adolescent↗
PubMed1980

Staphylococcal septicaemia, endocarditis, and osteomyelitis in dialysis and renal transplant patients.

Septicaemia is a common and potentially lethal hazard of haemodialysis and renal transplantation; it is usually caused by Staphylococcus pyogenes. In 6 patients with S. pyogenes septicaemia, fatal endocarditis and spinal osteomyelitis have each occurred once, and 3 patients have had recurrent episodes of septicaemia. The management of septicaemia in these patients must include a search for metastatic infection, and prolonged therapy with 2 antistaphylococcal agents is necessary to ensure eradication of infection. Access site infection in dialysis patients must be treated vigorously, and recognized as potentially hazardous by patients. The risk of sepsis in dialysis and transplant patients cannot be excluded, but devastating consequences may be avoided by simple measures.

Adult↗