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Biomedical subjects

M Broyer

Publications and source records attributed to M Broyer.

At least 307 records · Page 17Linked to original sources
PubMed1982

[Osteomalacia as a result of aluminum poisoning during chronic hemodialysis].

The iliac crest biopsy of an uremic child, suffering from nephronophtisis, and hemodialyzed since the age of 11 1/2 years, was examined by histomorphometry, electron-probe X-ray microanalysis and ion microscopy. The results have been compared with those obtained with the same techniques in the bone tissue of 11 hemodialyzed aluminum-intoxicated adults. In this child, radiology of the skeleton and plasma biochemistry suggested secondary hyperparathyroidism; by contrast, histology showed impaired mineralization, little bone resorption, and aluminum deposits at the limit between osteoid and calcified tissue similar to those observed in the bone tissue of the adults. This observation, and the fact that the child had a high plasma aluminum level, and that dialysis was performed with softened aluminum-rich water, strongly suggests that the severe osteomalacia of this child was due to aluminum toxicity.

Adolescent↗
PubMed1982

Renal abnormalities in the Bardet-Biedl syndrome.

Four cases of BARDET-Biedl syndrome (BBS) are described which all suffer from renal abnormalities. Polyuria or polydipsia with impairment of renal concentration capacity were the earliest signs of renal dysfunction. Renal insufficiency developed in 3 cases and hypertension in two. Urographic abnormalities were demonstrated in all patients. The most remarkable features were cystic spaces communicating with the calices and lobulation of kidney. Caliceal clubbing and caliectasis surrounded by narrowed, unscarred parenchyma were frequent findings. Previous investigators reported various renal histological pictures in BBS. We found tubulo- interstitial lesions in all cases. Features of dysplasia and cystic formations were less frequent. Mesangial proliferation was not noted. Ultra-structural changes in the glomerular basement membrane were not observed in this study. Thirty-one of 32 recently reported cases of BBS included renal lesions which are the major cause of death. It is therefore suggested that renal abnormalities are accepted as the cardinal feature of this syndrome.

Adolescent↗
PubMed1982

Importance of proteins in the deterioration of the remnant kidneys, independently of other nutrients.

Several experiments have shown that deterioration of renal parenchyma after reduction of functional mass is affected by the protein content of the diet. The respective role of proteins and that of other nutrients particularly phosphorus which varies with proteins was never clearly separated. Three groups of 9 uremic rats U I, U II, U III, received three diets differing exclusively in their protein content, which was supplied by casein and was respectively 8%, 16% and 32%. Other nutrients were maintained identical, including energy and minerals. Food intake was similar in U I and U II rats and was lower in U III rats. Mortality rate remained closely related to protein intake. Of U III rats, 78% died within 10 weeks and 100% within 15 weeks. Of U II rats, 56% were dead at week 15, and 100% at week 30. Mortality occurred significantly later in U I rats fed the lowest protein diet. Histology of remnant kidneys showed severe glomerular and tubular damage, with no or little calcium deposits despite normal phosphorus diet and frequent hyperphosphoremia. In conclusion, protein intake influences survival by accelerating the renal damage in rats with reduced kidney mass independently of any other nutrient.

Animals↗
PubMed1981

Inheritance of abnormal erythrocyte cation transport in essential hypertension.

Net fluxes of sodium and potassium ions were determined in sodium-loaded, potassium-depleted erythrocytes from 370 white subjects, 194 of whom had essential hypertension or had been born to parents with essential hypertension. Findings were compared with those in 86 controls who were normotensive and did not have a family history of hypertension. Compared with controls all patients with essential hypertension had a low sodium to potassium ratio secondary to a deficit in the sodium-potassium cotransport system. A similar abnormality was found in subjects born to parents with essential hypertension, the prevalences of a deficient cotransport system in such subjects being 53.6% (52 out of 97) among those with one hypertensive parent and 73.7% (14 out of 19) among those with two hypertensive parents. Both sexes were equally affected. Studies in 14 families over two or three generations showed the erythrocyte cation abnormality in one or more members of each consecutive generation. No close association was evident between the deficient erythrocyte sodium-potassium cotransport system and either blood groups ABO, Rh, Kidd, Duffy, P, and MNS or the major histocompatibility HLA antigens. Out of 90 consecutive unrelated and normotensive white blood donors, 36 showed a low erythrocyte sodium-potassium net flux ratio. It is concluded that in white people abnormal erythrocyte cation transport is a biochemical disorder characteristic of essential hypertension and transmitted by a dominant and autosomal mode expressing a single abnormal gene.

Adolescent↗
PubMed1981

Changes in plasma 1,25 and 24,25-dihydroxyvitamin D after renal transplantation in children.

The purpose of this investigation is to analyze changes in plasma 1,25-(OH)2D and 24,25-(OH)2D after successful renal transplantation in 20 children and young adults. Studies were performed on 8 subjects between the 1st and 10th month and on 12 others between the 20th and 30th to 36th month. Samples were assayed for plasma and urinary calcium, inorganic phosphate, creatinine, plasma bicarbonate, immunoreactive parathyroid hormone, 25-(OH)D, 24,25-(OH)2D, and 1,25-(OH)2D concentrations. Results showed the following: (1) All subjects had normal or high plasma levels of dihydroxyvitamin D metabolites. (2) In subjects with normal GFR's there was a significant inverse correlation between plasma 1,25-(OH)2D concentrations and tubular reabsorption of phosphorus. (3) These correlations were not found in subjects with subnormal creatinine clearances (50 to 100 ml/min/1.73 m2) even though plasma 1,25-(OH)2D concentrations in these subjects were similar to those with normal creatinine clearances. (4) In subjects with subnormal creatinine clearances, an increase in plasma 1,25-(OH)2D concentrations to very high levels was observed during the first months following renal transplantation.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Urea synthesis in moderate experimental uremia.

Urea synthesis rates (USR) were examined in relation to individual variations in energy and nitrogen intakes. Rats made uremic by 7/8 nephrectomy (N = 12) were pairfed with sham-operated controls (N = 11) and divided into two diet groups: diet 1 (4 kcal/g, 18% protein) and diet 2 (4 kcal/g, 42% protein). Nitrogen intake (NI) and energy intake (EI) were varied according to the quantity of feed given and the addition of a nonprotein gavage supplement. The USR was determined by 14C-urea excretion during four periods when EI ranged from 20 to 50 kcal/day and NI ranged from 150 to 675 mg/day. Although USR did not correlate directly with either dietary protein or energy, the percent of protein-derived calories allowed the prediction of USR from NI. Fractional urea synthesis was not related to NI but rather to total EI. The nonlinear regression described a critical EI of 30 kcal/day below which USR increased to 75% of the NI. USR was not different between control and uremic animals. These data suggest an advantage in maintaining an appropriate protein: energy ratio (2.5 g per 100 kcal) to minimize the fractional urea synthesis. The utilization of nitrogen at different levels of protein and energy intake was not altered by the state of experimental uremia.

Animals↗
PubMed1981

Plasma lipids in kidney transplanted children and adolescents: influence of pubertal development, dietary intake and steroid therapy.

Plasma triglycerides and/or cholesterol were significantly increased in twenty-four of thirty kidney transplanted children and adolescents with stable renal function, at least one year after the last rejection crisis who received low dose prednisone therapy. The cholesterol increment was related to both low density and high density lipoproteins. However, similar to findings in adult allograft recipients, these increases were very variable: six subjects had normal levels, eight had increased triglycerides, five increased triglycerides and cholesterol, and eleven increased cholesterol. No influence of renal function was found in this series of patients all of whom had plasma creatinine below 160 mumol/l. Subjects who had achieved sexual development had lower cholesterol values. An insignificant difference was observed between patients receiving daily and alternate-day steroid therapy, but a significant negative correlation was found between plasma triglycerides and fractional urinary excretion of 17 OH corticosteroids in the first 6 h after an oral dose of prednisone. Finally, no correlation was found between energy intake and triglycerides; but a significant correlation was observed between protein intake and plasma cholesterol. In conclusion, some patients show a high level of triglycerides and/or cholesterol after renal transplantation, possibly due to a different individual response to steroid therapy.

Adolescent↗
PubMed1981

[Hemolytic-uremic syndrome in children and arterial hypertension].

Seventy patients (55 infants and 15 children) with the hemolytic uremic syndrome (HUS) were reviewed to evaluate the incidence of hypertension in HUS. Refractory hypertension was only observed in 5 infants (3 at onset and 2 after several months), whereas it was present in 9 children (4 at onset and 5 in the course of the disease). Controllable hypertension was present in 10 patients (8 infants and 2 children). Histopathological examination of renal specimens in 52 patients showed 3 patterns: cortical necrosis in 10, Thrombotic microangiopathy (TMA) with predominant glomerular involvement in 29 and TMA with predominant arterial involvement in 13. Clinicopathologic correlations showed that severe hypertension was almost exclusively observed in the patients with "vascular TMA". Bilateral nephrectomy performed in 8 patients led to the rapid disappearance of hypertension, thus demonstrating the role of hyperreninaemia in the development of hypertension in the HUS.

Child↗