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Biomedical subjects

K Olgaard

Publications and source records attributed to K Olgaard.

160 records · Page 9Linked to original sources
PubMed1975

Ovarian cysts in women on chronic intermittent haemodialysis.

In a consecutive material of 42 female patients, who were treated with intermittent dialysis for chronic renal failure between May 1964 and Nov. 1971, 21 developed ovarian cysts. The cysts were found only among the 29 women, who had menstrual periods from commencement of dialysis (16 cases) or who started menstruating on dialysis after a period of secondary amenorrhoea (13 cases). No cysts were found in the remaining 13 patients, who had amenorrhoea throughout, and of whom 6 were in all probability postmenopausal. Seven of the 21 patients with ovarian cysts had pronounced symptoms, necessitating acute surgery in 4. Fourteen asymptomatic cases were diagnosed at routine gynaecological examination, which was performed at regular intervals in all patients. There is strong evidence suggesting that the development of ovarian cysts was somehow related to the dialytic treatment and neither to the uraemic state nor to the nature of the primary renal disease. The mechanism by which dialytic treatment may be opertional in the development of this hitherto undescribed complication is discussed, but no clear-cut explanation can be given.

Adult↗
PubMed1975

Pituitary hormones in women with chronic renal failure: the effect of chronic intermittent haemo- and peritoneal dialysis.

Measurements of plasma prolactin (hPr), growth hormone (HGH), thyrotrophin (TSH), luteinizing (LH)--and follicle stimulating hormone (FSH) were performed in 20 women with chronic renal failure on regular dialysis. There was no significant difference in any of the hormone levels before and after the dialysis and no significant influence of the type of dialysis (haemodialysis and peritoneal dialysis) or the time of dialysis. Higher levels of plasma prolactin was found in the women on peritoneal dialysis than in the haemodialyzed women presumably due to the medical treatment. In the peritoneally dialyzed group four women had irregular menstruations and normal gonadotrophic levels, but elevated hPr and it is suggested that this finding is similar to that seen in the amenorrhoeagalactorrhoea syndrome, where hPr presumably in some way have antigonadotrophic actions at the gonadal level.

Adolescent↗
PubMed1975

Femoral head necrosis in renal transplanted patients. Evidence of a haemodynamic etiological factor.

In a material of 197 consecutive renal allotransplanted patients, 15 patients developed femoral head necrosis on X-ray examination. Eleven of these patients developed the femoral head necrosis ipsilateral to the renal allograft. It is therefore suggested that the altered haemodynamics caused by the transplantation may be of pathogenic importance in the development of the femoral head necrosis.

Adolescent↗
PubMed1975

Plasma aldosterone by radioimmunoassay determination in normal man and in patients on maintenance haemodialysis.

The plasma aldosterone concentration was measured by a radioimmunoassay in which paper chromatography was used for separation of the steroids. The method had a low blank value (1.3 plus or minus 2.8 pg/ml), and the sensitivity was 6 pg/ml. The variation coefficients for interassay and intraassay determinations were 13.0% and 9.4%, respectively. An accuracy study on fixed amounts of unlabelled aldosterone added to pool-plasma gave a linear correlation (slope equals 0.9973). In a normal material, the mean plasma aldosterone concentration was found to be 120 pg/ml. In 26 patients on maintenance haemodialysis the mean plasma aldosterone concentration was 68 pg/ml, in the group of anephric patients 36 pg/ml, and in the non-nephrectomized group 91 pg/ml. There was a significant difference (P smaller than 0.01) between the two groups as well as between the total group of patients on maintenance haemodialysis and the normal subjects.

Adolescent↗
PubMed1975

Plasma aldosterone in anephric and non-nephrectomized dialysis patients in relation to changes in plasma potassium without change in total potassium balance.

Plasma aldosterone concentration has been measured in 13 patients on regular hemodialysis, 7 anephric and 6 non-nephrectomized, following infusion of insulin-glucose. In all patients the plasma potassium fell about 16% within the first 60 min after the infusion, increasing again to about preinfusion levels within 180 min. All anephric patients showed a very low preinfusion value for plasma aldosterone (mean 33.3 pg/ml plasma), which increased significantly (p less than 0.01) after the infusion of insulin-glucose, to about 180% of the initial values, simultaneously with the fall in plasma potassium concentration. A significant inverse correlation (p less than 0.01) was found between changes in plasma aldosterone and potassium. The preinfusion in plasma aldosterone values were significantly higher (p less than 0.01) in the non-nephrectomized than in the anephric group--but of a wide range (26-700 pg/ml plasma). In this group the mean plasma aldosterone concentration showed a significant fall simultaneously with the fall in plasma potassium concentration, but with great variations between patients. There was a significant positive correlation (p less than 0.005) between the changes in plasma aldosterone and potassium. These studies indicate an extremely sensitive regulation of plasma aldosterone secretion in anephric patients, in all probability positively correlated to changes in intracellular adrenal potassium concentration.

Adult↗
PubMed1972

Lysozyme turnover in man.

Lysozyme turnover studies with (125)I-labeled human lysozyme were carried out on 22 patients, viz. nine control patients, seven nephrological patients with varying degrees of renal insufficiency, including three bilaterally nephrectomized patients, and six hematological patients with disturbed turnover of the neutrophilic granulocytes. It was found that plasma lysozyme has a rapid turnover with a fractional catabolic rate of 76%/hr of the plasma content. Lysozyme catabolism varied with the endogenous creatinine clearance; in addition however, extrarenal sites of catabolism were demonstrated since lysozyme could be broken down in the anephric patients, although only at a rate amounting to about 15% of the rate found in persons with intact kidneys. In the uremic patients the increased plasma lysozyme concentration was due to decreased rates of catabolism; in the hematological patients the increased plasma lysozyme level was due to increased rates of synthesis which supports the hypothesis that plasma lysozyme mainly stems from disintegrating neutrophilic granulocytes. Furthermore, it was shown that in the nonhematological patients examined, the rate of synthesis varied with the endogenous creatinine clearance.

Adolescent↗
PubMedDate not supplied

Clearance of prednisone in isolated perfused livers of normal and uremic rats. Effects of acute and chronic cyclosporin A administration.

The influence of cyclosporin A (CsA) on the hepatic clearance of prednisone (HCP) was studied in isolated perfused livers of normal and chronic uremic rats perfused with a hemoglobin-free medium containing prednisone at an initial concentration of 635 +/- 129 micrograms/liter. Prednisone concentration was measured by a normal phase HPLC technique. Addition of CsA to the perfusate in livers of normal rats resulted in an increase of HCP by 38% from 10.8 +/- 2.4 to 14.9 +/- 3.4 ml/min/liver (p less than 0.01). In livers of uremic rats no effect was observed. Acute pretreatment with a large dose (120 mg) of CsA/kg/day ip for 1 day resulted in a 41% increase of HCP in livers of normal rats from 10.8 +/- 2.4 to 15.2 +/- 3.2 ml/min/liver (p less than 0.01). No effect was observed in livers of uremic rats. Chronic pretreatment with a CsA dose of 16 mg/kg/day ip continuously infused for 1 week reduced the HCP by 26% in livers obtained from normal rats and by 29% in livers of uremic rats, 10.8 +/- 2.4 to 8.0 +/- 1.7 ml/min/liver (p less than 0.01) and 14.7 +/- 1.1 to 10.4 +/- 1.2 ml/min/liver (p less than 0.01), respectively, whereas pretreatment with 7 mg/kg/day sc of CsA for 4 weeks resulting in blood CsA concentrations below 350 ng/ml had no influence.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Metabolism of intact PTH by isolated perfused kidney and liver from uremic rats.

The metabolism of synthetic human intact PTH (1-84), 1,000 or 3 pmol/l, was studied in isolated perfused livers and in filtering and nonfiltering kidneys from normal rats and rats made chronically uremic by 5/6 nephrectomy. Clearances were measured by assays specific for intact PTH, and NH2-terminal, mid-molecule, and COOH-terminal iPTH. Release of PTH fragments was analyzed by HPLC. Clearance of the added intact PTH by the uremic kidneys was reduced by the same order of magnitude as GFR. Neither the uremic nor the normal kidneys released any iPTH fragments. No peritubular metabolism of intact PTH was found in the uremic nonfiltering kidneys. Clearance of intact PTH by uremic and control livers was not significantly different. The uremic and control livers released equal amounts of COOH-terminal iPTH fragments, but no NH2-terminal fragments. Thus, uremia per se did not influence the renal and hepatic metabolism of PTH.

Animals↗
PubMedDate not supplied

Calcium concentration in the CAPD dialysate: what is optimal and is there a need to individualize?

OBJECTIVE: To evaluate risk/benefit of various continuous ambulatory peritoneal dialysis (CAPD) dialysate calcium concentrations. DATA SOURCES: A review of the literature on the effects of various CAPD dialysate Ca concentrations on plasma Ca, plasma phosphate, plasma parathyroid hormone (PTH), doses of calcium carbonate, doses of vitamin D analogs, and requirements of aluminum-containing phosphate binders. STUDY SELECTION: Eleven studies of nonselected CAPD patients, and 13 studies of CAPD patients with hypercalcemia were reviewed. RESULTS: In nonselected CAPD patients, treatment with a reduced dialysate Ca concentration (1.00, 1.25, or 1.35 mmol/L) improved the tolerance to calcium carbonate and/or vitamin D metabolites and reduced the need for Al-containing phosphate binders. When using dialysate Ca 1.25 or 1.35 mmol/L, the initial decrease of plasma Ca and increase of PTH could easily be reversed with an immediate adjustment of the treatment. After 3 months, stable plasma Ca and PTH levels could be maintained using only monthly investigations. In patients with hypercalcemia and elevated PTH levels, treatment with dialysate Ca concentrations below 1.25 mmol/L implied a considerable risk for the progression of secondary hyperparathyroidism. When hypercalcemia was present in combination with suppressed PTH levels, a controlled increase of PTH could be obtained with a temporary discontinuation of vitamin D and/or a reduction of calcium carbonate treatment in combination with a dialysate Ca concentration of 1.25 or 1.35 mmol/L. CONCLUSION: Most CAPD patients can be treated effectively and safely with a reduced dialysate Ca concentration of 1.35 or 1.25 mmol/L. Treatment with dialysate Ca concentrations below 1.25 mmol/L should not be used. A small fraction of patients with persistent hypocalcemia need treatment with high dialysate Ca, such as 1.75 mmol/L.

Calcium↗