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Biomedical subjects

J Crosnier

Publications and source records attributed to J Crosnier.

At least 55 records · Page 3Linked to original sources
PubMed1978

Kidney-graft rejection: has the need for steroids to be re-evaluated?

In a group of azathioprine-treated patients whose renal allografts functioned immediately, 53 received prophylactic steroid treatment while 54 were given steroids only at the onset of the first renal failure. Three types of renal failure were identified, and their distribution in the patient groups was different, but the incidence of both reversible and irreversible renal failure episodes was identical in the two groups, suggesting that steroid treatment of early rejection episodes may not be necessary.

Azathioprine↗
PubMed1978

[Urinary lithiasis after renal transplantation. 9 cases (author's transl)].

Nine cases of urinary lithiasis following renal transplantation are reported. They differ from 15 cases in the literature in their development late after transplantation and in that no relation with hyperparathyroidism could be clearly demonstrated. We emphasise the difficulty of the clinical and radiological diagnosis of this little-known complication. The course is essentially similar to that in non-transplant patients with lithiasis.

Adult↗
PubMed1978

[Long-term survey of renal transplant preserved with Collins solution (author's transl)].

Collins solution is one of the world methods used for kidney preservation. A long term survey of transplanted kidneys thus preserved has never been reported. Clinical, biological, radiological and pathological data collected from 225 cadaver kidney tranplantations were analysed according to the total ischemic time (T.I.T) groupe I: TIT less than or equal to 12 hours, groupe II: TIT from 12 to 30 hours). No difference could be demonstrated between the two groups whether considering the percentage of immediate function, the serum creatinine level which was normal up to two years, the incidence of abnormal blood pressure, the pathological changes on routine biopsies performed at 6 months and 2 years and arteriographic features at 2 years. A better graft survival rate was consistently found at 6 months one year and 2 years when TIT was between 12 and 30 hours. This could be related to the higher indicence of well matched kidneys in this group of patients. The efficiency of exchange programs for compatible kidneys is thus emphasized.

Blood Pressure↗
PubMed1978

Porphyria cutanea tarda-like syndrome in hemodialyzed patients.

Among 500 patients on maintenance hemodialysis, 6 patients (5 young women and a 49-year-old man) developed bullous dermatosis, 2-54 months after initiating dialysis treatment. The skin lesions occurred mainly in sunlight-exposed areas, and 4 out of the 6 patients showed increased cutaneous fragility in response to trauma. Skin biopsy revealed subepidermal blisters for all of them, and skin immunofluorescence studies were negative for 2 patients. No increase in fecal or red cell coproporhyrin and protoporphyrin levels was found in any of the 6 patients. The syndrome was clinically and histologically indistinguishable from porphyria cutanea tarda.

Adult↗
PubMed1977

Congestive cardiomyopathy in uraemic patients on long term haemodialysis.

Five uraemic patients who developed progressive cardiac failure with clinical evidence of congestive cardiomyopathy at the start or during haemodialysis treatment were studied. The diagnosis of cardiomyopathy, for which there was no apparent cause, was confirmed by angiocardiographic and haemodynamic studies. These showed a significant increase in left ventricular end-diastolic volume over normal values obtained in 12 patients without uraemia. The mean velocity of myocardial fibre shortening was significantly decreased, as was the index of normalised rigidity. Three of the five patients presented the complete picture of the disease. The other two also had considerable ventricular dilatation and a decreased index of normalised rigidity but normal ejection fraction and only moderately decreased myocardial contractility indices. This suggests that there may be primary involvement of normalised heart muscle rigidity followed by secondary changes in myocardial contractility in uraemic patients with congestive cardiomyopathy.

Adult↗
PubMed1977

Biologic, pathologic, and radiologic studies of cadaver kidneys preserved in Collins' solution.

Collins' solution is one of the world-wide methods used for kidney preservation. A long-term survey of transplanted kidneys thus preserved has never been reported. Clinical, biologic, radiologic, and pathologic data collected from 225 cadaver kidney transplantations were analyzed according to the total ischemic time (group 1: TIT less than or equal to 12 hr; group 2: TIT 12-30 hr). No differences could be demonstrated between the two groups, whether considering the percentage of immediate function, the serum creatinine level that was normal up to 2 years, the incidence of abnormal blood pressure, the pathologic changes on routine biopsies performed at 6 months and 2 years, or arteriographic features at 2 years. A better graft survival rate was consistently found at 6 months, 1 year, and 2 years when TIT was between 12 and 30 hr. This could be related to the higher incidence of well-matched kidneys in this group of patients, thereby emphasizing the efficiency of exchange programs for compatible kidneys.

Biopsy↗
PubMed1977

Clofibrate treatment of hyperlipidemia in chronic renal failure.

The pharmacokinetics of the hypolipidemic agent, clofibrate have been studied in anuric patients on intermittent hemodialysis. In addition we have tried to determine whether the treatment of hyperlipidemia of chronic renal failure with clofibrate was safe and efficacious. Seven healthy volunteers and five uremic patients received a single dose of 25 mg/kg body weight of clofibrate. Mean peak plasma levels of clofibrate were comparable in both groups and were reached 3.5 hr after drug ingestion in the control subjects and after 6.5 hr in the uremic patients. The mean plasma half-life of clofibrate was 16.7 hr and 68.4 hr in the control subjects and in the patients, respectively (P less than 0.001). Following a short loading period a daily oral maintenance dose of 5 mg/kg body weight was given leading to a plasma clofibrate level of 75-100 microgram/100 ml. Five hyperlipidemic uremic patients received this dose for 3 months. Their plasma clofibrate and creatine kinase levels were constantly monitoried to detect clofibrate myotoxicity which we have observed in uremic patients at plasma levels generally considered safe in patients with normal renal function. Significant decreases in serum total lipid, triglyceride, and cholesterol levels were observed when compared to pretreatment values. In two of the 5 patients serum lipids remained decreased for 10 and 14 months. It is concluded that clofibrate treatment of hyperlipidemia in uremic patients, when carefully monitored, is safe and efficacious.

Adult↗
PubMed1977

The response of heart rate to isoproterenol in hemodialyzed patients before and after parathyroidectomy.

The response of the heart rate to intravenous isoproterenol was studied in seven chronic hemodialysis patients with severe hyperparathyroidism, before and after subtotal parathyroidectomy (PTX). Before PTX, significantly higher doses of isoproterenol were needed to achieve a standardized increase in heart rate when compared with the doses needed following PTX. A similar difference was observed before and after removal of a parathyroid adenoma in an additional nonuremic patient with primary hyperparathyroidism. This decreased cardiac responsiveness to a beta-adrenergic stimulus seemed to be related to the hyperparathyroid state.

Adenoma↗
PubMed1976

T lymphocytes in kidney allograft recipients.

The spontaneous sheep erythrocyte (E) rosette test was used on 340 occasions to measure T cell levels in 28 renal allograft recipients. The E rosette counts were reduced by high-dose steroids but usually returned towards normal under maintenance treatment with azathioprine and low-dose prednisone. Unexpectedly, rejection crises were more often associated with a decrease in E rosettes before steroid treatment (12 cases) than with an increase in E rosettes (5 cases). Our results show the need for caution in using the E rosette test and more generally B and T cell markers for monitoring anti-graft immunity in renal allograft recipients.

Azathioprine↗
PubMed1976

Measles virus and Guillain-Barré syndrome during long-term hemodialysis.

In a black man, recently receiving long-term hemodialysis, a severe, rapidly progressive polyradiculoneuritis (Guillain-Barre syndrome) developed. Routine virologic study revealed a high antimeasles virus antibody titer (1:1280 by hemagglutination-inhibition) which progressively decreased. There was no clinical evidence of measles. Discussed here is the possible relationship between the Guillain-Barre syndrome and clinically inapparent measles associated with and perhaps modified by the uremic state.

Adult↗