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Biomedical subjects

K Vetter

Publications and source records attributed to K Vetter.

At least 91 records · Page 5Linked to original sources

Relation between middle molecules and parathyroid hormone in patients with chronic renal failure.

In 10 moderately and 41 severely uremic patients the relation between serum parathyroid hormone (PTH) and middle molecule fraction 2 (MMS fr. 2-corresponding to MMS peak 7 of Fürst) was investigated. A significant correlation between PTH and MMS fr. 2 levels was found. This correlation was even better between PTH levels and MMS fr. 2/creatinine ratios. We would like to propose that PTH is one of several factors regulating middle molecule levels in uremic patients and that some 'toxic' effects of PTH may be mediated by middle molecules.

Blood Urea Nitrogen↗

Conservative treatment with ketoacid and amino acid supplemented low-protein diets in chronic renal failure.

Twenty-six patients with advanced renal failure (glomerular filtration rate less than 6 ml/min) were treated with a mixed quality low protein diet and ketoacid analogues. An improvement in nitrogen balance, serum transferrin and phosphate, and base excess was observed after 2 weeks of treatment. In a longer term study, the result of 20 patients treated with ketoacids for up to 14 months were compared to a group 40 patients who received a low-protein diet with essential amino acids. Patients responded similarly to the two diets; however, the group receiving ketoacids had a significantly lower glomerular filtration rate. There was improvement in calcium and phosphate metabolism with ketoacid treatment. The patients were able to tolerate treatment with both the ketoacids and vitamin D.

Adult↗

Perinatal parathyroid hormone, vitamin D metabolites, and calcitonin in man.

Plasma levels of calcium and of parathyroid hormone (PTH) were comparable in the mothers at delivery and in nonpregnant controls; magnesium was decreased (P < 0.001) in maternal blood; and phosphate (P < 0.001), 1,25-dihydroxyvitamin D (1,25(OH)2D) (P < 0.001), and calcitonin (CT) (P < 0.01) were raised. Cord levels of calcium (P < 0.01), magnesium (P < 0.05), and CT (P < 0.01) were higher, and PTH (P < 0.01) was lower than in the maternal blood. Levels of 25(OH)D, 1,25(OH)2D, and 24,25(OH)2D lower in fetal than in maternal blood (P < 0.01) and significant linear correlations between the vitamin D metabolites examined in mothers and neonates (P < 0.001) are consistent with a diffusion barrier across the placenta and/or different affinities of binding proteins. Plasma levels of 25(OH)D and 24,25(OH)2D were significantly related (P < 0.01), suggesting precursor product type, relationships. Levels of 1,25(OH)2D higher in arterial than in venous umbilical blood (P = 0.06, sign test; P < 0.005, paired t test) suggest that the fetus participates in the synthesis of 1,25(OH)2D. Maternal PTH was significantly related to the arteriovenous difference of 1,25(OH)2D levels (P < 0.01) in cord blood, and it possibly enhances the synthesis of 1,25(OH)2D during the final stage of fetal development.

Adolescent↗

Serum 25-hydroxyvitamin D in patients with chronic renal failure on long-term treatment with high doses of vitamin D2.

The present study was aimed at answering the following two questions: (1) What is the effect of high dose vitamin D treatment on the serum level of 25-hydroxyvitamin D (25-OH-D) in patients with chronic renal failure (CRF)? (2) Is there any effect of urinary protein loss on the serum 25-OH-D levels during treatment with pharmacological doses of vitamin D? 42 patients with CRF were studied. They were treated conservatively by a low protein diet and received 15 mg of vitamin D2 once a week. Long-term administration of vitamin D caused a significant (5- to 7-fold) increase of plasma 25-OH-D level irrespective of the degree of proteinuria. This increase was noted only during the first 5 months of vitamin D2 treatment. Surprisingly only in some patients moderate hypercalcemia (> 2.75 mmol/l) was found. From the results obtained it is concluded that (1) patients with CRF differ from normal subjects in handling of high doses of vitamin D and (2) high dosage treatment with vitamin D may prevent hypocalcemia in patients with CRF in spite of high proteinuria.

Adult↗

[Critical notes on diet therapy in gastrointestinal diseases].

The reasons for a transformation of the dietary therapy in gastroenterologic diseases are in the reduction of forms of mild diet related to organs (mild diet for stomach, intestine, liver and gall-bladder), which are based on connections between complaints and organic diseases no more up to date. In their place enters the gastroenterologic basis diet which, according to the course of the diseases (subacute, chronic) is represented in two steps as strong and dilated basic diet. The displacement of the emphasis of multifarious formed of.

Diet Therapy↗

[Nutrition and arteriosclerosis].

Issuing from the present state of the influence of the basic nutritive substances (protein, fat, carbohydrates) and various nutritive factors discussed again and again (cholesterol, erucaic acid, sodium, calcium/magnesium quotient, pressor amines) on the development of the arteriosclerosis, the indididual factors of influence are critically evaluated. The investigations are getting under way, so that ascertained results are standing beside insufficiently claified or open problems, From the abundance of the observations conclusions are drawn which are of significance for practice. Unfavourable influences of nutrition on the factors of risk (hyperlipoproteinaemia, disturbance of the carbohydrate tolerance, hyperuricaemia, hyperalimentation) and on the manifest diseases (hypertension, diabetes mellitus, uric arthritis, obesity) of the metabolic syndrome which finally contribute to the development of arteriosclerosis are emphasized. In front of this background a clinically and ambulatorily tested basic metabolic diet is described. About 20% of the energy content (kcal or kJ) of this diet are protein, 35% fat and 45% are carbohydrates. The saturated fatty acids lie below 30%, the manifold saturated fatty acids, however, above 20% of the total fat proportion. The cholesterol content is below 400 mg, the purin-nitrogen below 200 mg, and the sodium content is about 2g per day. This diet can be produced for the treatment of persons with normal weight and overweight in different energetic degradations.

Arteriosclerosis↗

[Conservative therapy of chronic kidney failure].

The optimum performance of the conservative therapy of the chronic renal insufficiency demands a good cooperation between the patients, the dietician and the physician. The foundation of centres of the nephrological care for patients with renal insufficiency guarantees the possibility of a continuous control. In the conservative therapy the measures in question are symptomatic ones, excluding the medicamentous therapy of the basic disease in acute episodes. The dietetic measures are the basis of the conservative therapy. The diet moderately poor in protein should be given at creatinine values in the serum 4 mg/100ml and the diet strongly poor in protein from 8 mg/100 ml (prophylactically perhaps from 6 mg/100 ml). In the dietetic measures apart from the protein restriction the calorie intake (35 to 40 calories/kg body weight a day), the intake and output of fluids and the electrolyte metabolism as well as the vitamin intake should particularly be taken into consideration. Additional symptomatic medicamentous measures are necessary in order to improve the clinical symptomatology of the chronic renal insufficiency. By means of the conservative therapy the period to the necessary dialytic treatment can be delayed. Apart from this a lengthening of life and an improvement of the rehabilitation is possible in those patients, in whom an active therapy is not taken into consideration.

Dietary Proteins↗

[Therapy of obesity--effectiveness of calorie-reducing diets with various basic nutritional relations].

Within the research project nutrition and performance on altogether 80 test persons during a three weeks' test period the problem was examined, whether the relations of the basal nutrients have an influence on the effectiveness of a diet with an only moderate reduction of calories. The relations of the nutrients were tested in four variants. The daily caloric intake orients at the optimum weight of the test person: 30 kcal/kg optimum weight a day. It was shown that the so-called optimum weight caloric diet led to a sufficient continuous decrease of weight without disturbances of the general state of health. The variation of the relations of the basal nutrients had no decisive influence on the effectiveness.

Adult↗

[Therapy of obesity--indication and effectiveness of calorically-reduced mixed diets].

Extreme caloric reduction diets with a daily content of calories of less than one third of the calories calculated with regard to the optimum weight (per kg optimum weight 30 kcal are used) lead principally to the same changes as the initial diet. Only in a daily addition of calories of at least one third of the calories calculated to the optimum weight no further loss of protein takes place, and scarcely appear side-effects. Thus the limit of the riskless reduction for adults is marked, when at the same time all essential constituents of nutrition are given in a sufficient quantity. A diet called metabolic basic diet (protein 20 kcal%, fat 35 kcal%, carbohydrates 45 kcal%, linoleic acid 20% of the total proportion of fats, cholesterol 400 mg a day, purine-N 200 mg a day, dissaccharides 10% of the carbohydrate addition) decreases or normalises risk factors depending on nutrition such as hyperlipoproteinaemia and hyperuricaemia in a constancy of body-weight. In simultaneous caloric reduction the effect on risk factors depending on nutrition is practically identical with that one of a normal diet calorically reduced in the same extent.

Body Weight↗