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J Zabka

Publications and source records attributed to J Zabka.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Lithium clearance in polycystic kidney disease].

Disorders of tubular transport of sodium are thought to be involved in pathogenesis of cyst formation and development of hypertension in autosomal dominant polycystic kidney disease (ADPKD). Recently lithium has been proposed as a quantitative marker of proximal tubular reabsorption of sodium and lithium clearance as a method to analyze tubular sodium handling. To evaluate tubular sodium handling in early stage of ADPKD, lithium clearance (600 mg of Lithium carbonicum p.o.) was performed in a control group of pts. with ADPKD and normal glomerular filtration rate (n = 28), age 19.9 +/- 8.8 years) and in a control group of healthy volunteers (n = 43), age 30.3 +/- 9.0 years). Both groups did not differ in plasma or urine concentrations of electrolytes; plasma creatinine levels were slightly higher in ADPKD group than in controls (83.4 +/0 18.0 mumol/l vs. 93.4 +/- 24.2 mumol/l, p < 0.05). We did not demonstrate any statistically significant difference between the group of ADPKD and control group in lithium clearance and in fraction excretion of lithium (23.6 +/- 14.5 vs. 19.5 +/- 8.7 ml/min, resp. 15.3 +/- 8.8 vs 13.8 +/- 7.8%). Nor proximal tubular resorption of sodium, neither distal tubular resorption of sodium did differ between the group of ADPKD and control group (86.18 +/- 2.2 vs 84.7 +/- 1.80% resp. 94.7 +/- 2.6 vs. 94.5 +/- 3.6%). When comparing parameters of sodium handling between pts. with ADPKD and hypertension (6/28) and pts. with ADPKD without hypertension no difference was found. In conclusion, we could not demonstrate any statistically significant difference in tubular handling of sodium, when based on lithium clearance between the groups of ADPKD with normal glomerular filtration rate and control group.

Adolescent↗
PubMed1992

[Rapidly progressing glomerulonephritis with antibodies against cytoplasm of neutrophilic leukocytes].

The authors describe the clinical, laboratory and morphological findings, the clinical course and response to treatment in three patients with rapidly progressing glomerulonephritis where positive antibodies against the cytoplasm of neutrophil granulocytes (ANCA) were found. The authors confront their own clinical experience with data in the literature. Examination of ANCA is not only a significant contribution towards a more accurate diagnosis of renal vasculitis, but also an indicator of the activity of the disease and thus of the effectiveness of immunosuppressive treatment.

Adult↗
PubMed1991

[Hypertension in patients with polycystic kidneys--the effect of volume expansion].

Arterial hypertension is found in as many as 75% patients with autosomal dominant polycystic kidneys with normal renal function, its pathogenesis is however not quite clear so far. The authors examined 16 patients with polycystic kidneys with normal or only slightly reduced renal function (plasma creatinine lower than 140 umol/l), 8 of these patients were normotonic (N) and 8 hypertonic (H). In all examined subjects right-sided cardiac catheterization was performed with assessment of the minute cardiac volume by thermodilution. To all patients in the course of one hour 1500 ml saline per 70 kg body weight were administered and the haemodynamic examinations were repeated after termination of the infusion. In all subjects before and after expansion the plasma renin activity was assessed (PRA), as well as plasma aldosterone (PA), plasma catecholamines (PC) and the atrial natriuretic factor (ANF), the renal blood flow and glomerular filtration by means of clearance and extraction of PAH and inulin clearance. The authors did not find differences in plasma concentrations, cardiac output and splanchnic and renal ANF extraction in groups N and H, nor in PRA, PA and PC. Volume expansion led in both groups to a comparable rise of ANF and suppression of PRA and PA. Group H did not differ from group N in any of the investigated haemodynamic and renal parameters except for systemic vascular resistance. In hypertensive patients before expansion a close correlation was found between pressure in the pulmonary artery in a wedged position and diuresis (r = 0.935, p less than 0.01) and natriuresis (r = 0.895, p less than 0.01). The volume expansion was in both groups associated with a comparable rise of diuresis, the haemodynamic response of patients N and H was however quite different. While in patients of group N a decline of the systemic vascular resistance occurred as well as an increase of the minute volume without a change of the renal flow and glomerular filtration, in hypertonic patients the systemic vascular resistance and minute volume did not change but there was a significant rise of the renal flow and glomerular filtration. The relationship of diuresis and natriuresis of hypertensive patients with polycystic kidneys to volume parameters and the rise of the renal perfusion pressure during volume expansion indicates the importance of pressure natriuresis for ensuring the sodium and volume homeostasis in these patients.

Humans↗
PubMed1989

Changes in renal haemodynamics in the nephrotic syndrome.

It has repeatedly been found that haemodynamic changes during hypoproteinaemia in the chronic phase of the nephrotic syndrome are different from those during hypoproteinaemia in the acute phase. In our series of patients, a decrease in the filtration fraction and relative hyperperfusion of the kidneys were associated with the presence of the nephrotic syndrome. No significant changes in renal haemodynamics were observed in patients with chronic glomerulonephritis without the nephrotic syndrome or in a group of healthy volunteers. The question of whether relative hyperperfusion of the kidneys in a repeatedly relapsing nephrotic syndrome can lead to the development of focal segmental glomerulosclerosis needs to be elucidated.

Acute Disease↗
PubMed1988

Percutaneous transluminal angioplasty of renal transplant artery stenosis in patients with rejection nephropathy.

A total of 13 procedures of percutaneous transluminal angioplasty were performed in 11 kidney graft recipients with renal transplant artery stenosis. Nine procedures were technically successful in eight patients (one redilatation was necessary because of restenosis). Graft biopsy confirmed rejection nephropathy in all cases. The outcome could not be evaluated in one patient who died of a concomitant disease shortly after angioplasty. The remaining seven patients (eight percutaneous transluminal angioplasties) showed improvement in hypertension in 63% and in glomerular filtration rate in 50% of procedures, persisting for 6-13 months. A single major complication encountered was a loss of graft related to unsuccessful percutaneous transluminal angioplasty. The results suggest that percutaneous transluminal angioplasty may bring prolonged increase in effective renal plasma flow and glomerular filtration rate even in patients experiencing rejection nephropathy.

Adolescent↗
PubMed1986

Embolization of the kidney in secondary renal hypertension as an alternative to surgical nephrectomy. An experimental study.

Embolization of the renal arterial bed with embolization agent Vilan 500 was performed in 13 dogs. Embolized kidneys shrink after the procedure and the functional parenchyma is extinguished. Peripheral PRA values were followed to find out whether renin production by the embolized kidney is extinguished (the non-embolized kidney was surgically removed). In nine of the thirteen dogs peripheral PRA decreased below 0.5 ng/ml/h; this renin activity can be considered extrarenal. Embolization of the kidneys with Vilan 500 can thus substitute surgical nephrectomy in patients with secondary renal hypertension.

Animals↗
PubMed1985

Hypertension rate in renal graft recipients operated on at the Transplantation Centre, IKEM, in 1976-1981.

A group of 198 renal transplantations performed et our Centre in 1976-1981 was evaluated. Arterial hypertension within the first two weeks following transplantation developed in 83% of patients, in 43% being severe. Later, towards the end of the first year, less patients suffered from arterial hypertension, especially of severe hypertension. In this period, hypertension occurred in about 63%, in most cases in the mild form (50%). Patients with graft functioning for more than a year had hypertension, mostly mild, in about 43%. The incidence of hypertension in our group was, however, increased if "normotensives" taking antihypertensives were included. We may conclude that in the first year following renal transplantation true normotensive patients formed approximately 10% of the total and their number in the subsequent years raised up to 50%. The values of blood pressure in the 3rd to 4th months had a predictive significance for the further course of hypertension. In this period, patients with hypertension had a markedly worse cumulative graft survival compared with the remaining subjects. This finding supports the importance of energetic antihypertensive therapy.

Blood Pressure↗
PubMed1985

Effect of combined immunosuppressive anticoagulant and antiplatelet therapy of the course of chronic mesangial-proliferative glomerulonephritis.

Thirty-one patients with chronic mesangial-proliferative glomerulonephritis, histologically and clinically active, confirmed on biopsy, were included in a randomized therapeutic experiment. Of the total, 15 were treated by a combined prednisone, azathioprine, cyclophosphamide, Heparoid Spofa forte ling., Heparin retard Spofa and dipyridamole therapy. The control group comprised 16 untreated patients. One year later, a similar progression of glomerulonephritis was seen in both groups. Both treated and control patients exhibited a slight, but significant, decrease in proteinuria and a slow fall in the glomerular filtration rate. Despite a short period of follow-up, we succeeded to demonstrate, convincingly enough, that combined cyclophosphamide, azathioprine, prednisone, Heparoid ling., Heparin retard Spofa and dipyridamole therapy should not be indicated in chronic mesangial-proliferative glomerulonephritis.

Adolescent↗
PubMed1981

Peripheral plasma renin activity (PRA) in recipients with allograft artery stenosis; its diagnostic value in acute stage hypertension.

Peripheral PRA was examined in 11 patients with graft artery stenosis after the onset and throughout the course of hypertension. In the acute stage PRA was elevated in 9 patients and decreased to normal in the later stage of hypertension in all but 1 patient with malignant hypertension. The findings suggest that the determination of peripheral PRA is helpful in diagnosing graft artery stenosis only in the acute stage of hypertension, but it has no unequivocal value to the prognosis of hypertension or indication for operation.

Adult↗
PubMed1981

Response of peripheral plasma renin activity (PRA) to furosemide stimulation; reduction of the renal parenchyma as a limiting factor.

The authors examined 34 patients with arterial hypertension, whose glomerular filtration rate ranged from normal to renal failure. The peripheral plasma renin activity (PRA) values were determined before and 30 and 90 min after injecting furosemide. In 17 patients with chronic renal failure treated by haemodialysis and with arterial hypertension, PRA was likewise determined before and after injecting furosemide. In 18 patients, including 13 from this latter group, PRA was determined before and after dialysis. It was found that: 1) In the group of non-dialysed patients, mean PRA rose significantly after the injection of furosemide. In dialysed patients it was not affected either by furosemide or by dialysis. 2) In non-dialysed patients, the ability of PRA to be stimulated by furosemide fell together with inulin clearance (Cin) in a significant hyperbolic relationship. 3) PRA changes in dialysed patients were indistinct and variable. A significant direct correlation was found between the absolute change in PRA after furosemide and after dialysis. These findings show that the degree of damage to the renal parenchyma must be taken into account when evaluating the response of PRA to furosemide stimulation.

Adult↗
PubMed1981

Renal artery stenosis of the transplanted kidney. Diagnosis and therapy of the hypertension.

Indications for the angiography, probability, of the diagnosis of renovascular hypertension and results of the surgical and medical treatment were considered in 16 patients with renal artery stenosis of the transplanted kidney. The evaluation shows that an increase in the blood pressure in patients with good, stabilized graft function is the most essential clinical symptom of the stenosis. An increase in the peripheral plasma renin activity is of diagnostic value only in the acute phase of the hypertension. The examination of the plasma renin activity in renal veins is valuable when deciding the indication for surgical therapy of hypertension. The results of surgical interventions in two patients with renal artery stenosis in the anastomosis supported the diagnosis of the renovascular hypertension and indicated that reason of the increased blood pressure and deterioration of the graft function need not be the same. In the course of the medical therapy 14 patients were followed--out of them ten patients for 1 to 4 years. The results showed the medical therapy had a good prognosis in these risk patients. Thus, the reconstruction of the artery is indicated only in the case of serious stenosis threatening the loss of graft function and in the case of the accelerated hypertension.

Adult↗
PubMed1981

Determination of plasma renin activity in renal veins of kidney graft recipients.

Renal vein plasma renin activity (PRA) was examined in 10 cadaver kidney recipients with graft artery stenosis detected by angiography in 8 of them. A significantly higher PRA in the graft versus the autologous renal veins occurred only in 1 patient: 4 patients showed significantly higher PRA values in autologous renal veins and 4 showed only insignificant differences. In 1 patient PRA could be determined only in the graft vein. Bilateral autologous nephrectomy was performed in 2 patients. The effect of surgery on hypertension agreed with the results of PRA determination. Renal Vein PRA is a valuable criterion in the indication for surgery. In some patients its determination does not help to decide whether the causative factor of hypertension is the graft or autologous kidneys.

Adult↗