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Biomedical subjects

H Klinkmann

Publications and source records attributed to H Klinkmann.

At least 163 records · Page 9Linked to original sources
PubMed1980

[Technic and indication for controlled ultrafiltration].

The isolated ultrafiltration with commercial dialysators gives a possibility of the massive dehydration in a short time without disturbing the well-being of the patient. If in patients undergoing a dialysis a following haemodialysis (sequential ultrafiltration haemodialysis) is necessary, particularly in patients with acute complications hypotonic circulatory conditions may develop. An infusion of a fourfold concentrated human dry plasma during the ultrafiltration may prevent these hypotensions, since reduction of osmolality and losses of circulation-effective substances are prevented during haemodialysis. With the help of this kind of treatment conditions of hyperhydration of different genesis may be removed also in patients with inclination to hypotension.

Acute Kidney Injury↗
PubMed1980

[Conservative therapeutic possibilities in chronic renal failure].

The three main points of the conservative therapy of the chronic renal insufficiency are the treatment of the basic disease, the dietary therapy and the symptomatic medicamentous measures. The possibilities of treatment of the basic disease, however, are restricted in advanced renal insufficiency, but they may reduce the progression of the nephropathy. Decisive for the success of the conservative therapy are the dietary measures, in which case the restriction of the quantity of proteins with consideration of the biological value, the caloric intake of at last 35 Cal/kg body weight/day and the equalized fluid balance must be particularly emphasized. The different possibilities of the protein restriction and possibilities of control of the protein metabolism are explained. Depending on the degree of the chronic renal insufficiency and the present clinical symptomatology symptomatic medicamentous measures are used. Following in indications for the beginning of the therapy of dialysis it is referred to the importance of the system of renal dispensaries for the optimum performance of the conservative therapy.

Acidosis, Renal Tubular↗
PubMed1980

[Experimental studies of the treatment of hypotensive blood circulation disorders during sequential ultrafiltration hemodialysis].

Particularly in risk patients who in the condition of hyperhydration underwent sequential ultrafiltrations-haemodialysis treatment the decrease of blood pressure which appears in individual cases under the treatment is negatively decisive for the success in therapy. In 33 hyperhydrated patients who underwent dialysis, therefore, with the help of the fourfold concentrated human dry plasma DAB 7 the influence of a combined osmo- and substitution therapy on this circulatory complication was investigated. Under the sequential ultrafiltration by means of application of human dry plasma also at an initial decrease of blood pressure not only a stabilisation, but also an increase of blood pressure is achieved. This favourable circulatory behaviour continues also during the following haemodialysis, Apparently by the application of the human dry plasma physiological compensation mechanisms are evoked by various factors such as pharmacological effects on the excitable structures by sodium, potassium and catecholamines and physical effects on the plasma volume by increase of the osmolality and increase of the oncotic pressure. The use of human dry plasma allows the performance of an ultrafiltration treatment as well as of a haemodialysis in hyperhydrated risk patients who are in a circulatory collapse and thus considerably enlarges the area of indication of the sequential ultrafiltration dialysis treatment.

Adult↗
PubMed1980

Diagnostic value of urinary fibrin degradation products.

The concentrations of fibrin degradation products (FDP) in the urine were determined by the passive hemagglutination test in 115 patients with biopsy-proven chronic proliferating glomerulonephritis (GN), 93 patients with urinary tract infection (UTI) and 23 patients who received kidney transplants. The active GN values (12.3 micrograms/ml) are significantly higher than those for latent GN (0.3 micrograms/ml). Those for acute UTI (9.2 micrograms/ml) are significantly higher than for chronic UTI (1.3 micrograms/ml). In contrast to the reports published by others, the numerous 'false-positive' and 'false-negative' values make diagnosis of the activity questionable. Prognostic value can be expected in GN with the nephrotic syndrome (NS): patients with steroid-sensitive NS excrete FDP and patients with steroid-resistant NS excrete larger quantities of FDP. We have confirmed that a rise in the urinary FDP level in transplantation is indicative of rejection. However, since 10 of 27 rejections were FDP-negative, the absence of FDP in the urine does not preclude rejection.

False Negative Reactions↗
PubMed1979

[Therapy of primary glomerulonephritis. Comparative study on the effect of cytostatics-prednisone and cytostatics-anticoagulant-aggregation inhibitor combination].

The result of the treatment with chlorambucil, dipyridamol, heparin/warfarin and prednisone on 50 patients as well as with imuran and prednisone on 32 patients is compared. Basis for this is a detailed morphological and clinical subdivision. With the help of therapy results is tried to derive regions of indication: the therapy with cytostatics, anticoagulants and aggregation inhibitors is above all suitable for patients with a short duration of the disease and with sign of activity, also in renal insufficiency. On the other hand the therapy with cytostatics and prednisone is also successful in patients with longer duration of the disease and missing signs of activity.

Adolescent↗
PubMed1979

[Possibilities of using hemoperfusion in the treatment of chronic kidney insufficiency].

A survey of the administration possibilities of the activated charcoal haemoperfusion in the treatment of the chronic renal insufficiency is given. Various coating methods for activated charcoal as well as important adsorption abilities of the activated charcoal for uraemia-specific metabolites are described in detail. Then comes a classification of the haemoperfusion in the treatment of ureamia. The result is that at present the use of haemoperfusion with activated charcoal in the therapy of uraemia may be regarded only as a supplementary therapy of the haemodialysis and the haemofiltration, respectively.

Adsorption↗
PubMed1979

[Treatment of glomerulonephritis].

The therapeutic effect of the prednisone therapy, of the short-time (duration of treatment 2-4 months) and of the long-term (duration of treatment 1.5 to 2 years) imuran and prednisone therapy was investigated on 218 patients with chronic, functionally compensated glomerulonephritis. The importance of the urine symptomatology for the control of the therapeutic success and for the prognosis of the disease was elaborated. Corresponding to the clinical picture the experiment of a clinical classification of the chronic glomerulonephritis was performed.

Azathioprine↗
PubMed1979

Serum complement and protein metabolism in chronic dialysis patients.

1. Patients receiving regular hemodialysis treatment who are permitted to select their own diets are in danger of a protein deficiency manifested by a significant reduction in serum transferrin and in complement C3c. 2. Correlation analysis within the dialysis group revealed no secure connexion between the complement C3c and total hemolytic activity respectively, and transferrin levels. 3. Analysis of diets showed that protein intake and the serum transferrin level correlate. No such correlation was found for the complement C3c or total hemolytic activity. 4. Low transferrin levels in the serum appear to result in more severe anemia among dialysis patients. 5. Knowledge of the serum transferrin level permits much more exact assessment of the protein metabolism in regular hemodialysis patients than knowledge of the total hemolytic activity or the level of the complement C3c.

Blood Proteins↗
PubMed1979

Blood purification by haemoperfusion.

Blood purification by haemoperfusion is considered, principally in terms of the European effort. The development of the different approaches which have emerged and the assessment of adsorbents and devices are described. The application of haemoperfusion is examined in the areas of acute poisoning, liver failure and uraemia.

Adsorption↗
PubMed1978

[Developing trends in the active therapy of kidney failure. Hemodialysis--hemofiltration--hemoperfusion].

A survey is given on the modern level and the developmental trend in the apparative therapy of renal insufficiency. Apart from the description of the actual medical, technical and organisational problems in the haemodialysis the methods of the haemofiltration and the haemoperfusion are investigated with regard to the modern experimental and clinical state of knowledge as well as to the theoretical possibilities of their clinical use alone or in combination together.

Albumins↗
PubMed1978

[Hemodialysis and metabolic disorders].

On the basis of investigations of the water and electrolyte balance, of the protein balance, the lipid metabolism and the hormone metabolism at the instance of aldosterone a concept of specific dialysis-conditioned pathophysiological disturbances is developed in patients undergoing a chronic programma of dialysis. The changes of metabolism induced by apparative therapy have a decisive influence on the pathophysiological mechanisms in the uraemic organism and condition a specific pathophysiology of the patient undergoing dialysis.

Aldosterone↗
PubMed1978

[Diagnostic value of determining urinary fibrin split products in glomerulonephritis, pyelonephritis and graft rejection].

On 112 patients with bioptically ascertained chronic proliferative glomerulonephritis, 94 with pyelonephritis and 23 patients with kidney transplantation altogether 1,050 times the fibrin fission products in the urine were estimated by the passive haemagglutination after Merskey. It was the aim of the investigation to test the diagnostic evidence described in literature concerning the floridity diagnostics in glomerulonephritis and the recognition of rejection in kidney transplantation as to its reproducibility. In comparison to the latent glomerulonephritis (0.3 microgram/ml) the florid glomerulonephritis (12.3 microgram/ml) as well as the acute pyelonephritis (9.2 microgram/ml) in comparison to the chronic pyelonephritis (1.3 microgram/ml) has significantly higher values. On account of the numerous "falsely positive" and "falsely negative" values in contrast to the data of other authors an activity diagnostics is not possible. Only in the glomerulonephritis with nephrotic syndrome a prognostic use is to be expected: Patients with steroid-sensitive nephrotic syndrome do not secrete any fibrin fission products in the urine and patients with steroid-resistant nephrotic syndrome secrete them in a large number. We could confirm that an increase of the fibrin fission products in the urine after kidney transplantation refers to an acute rejection crisis. Since 10 of 27 rejections were fibrin fission product-negative, in the lacking fibrin fission products in the urine a rejection is not be excluded, by which the diagnostic value is restricted.

Fibrin Fibrinogen Degradation Products↗