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Biomedical subjects

M Broyer

Publications and source records attributed to M Broyer.

At least 325 records · Page 18Linked to original sources
PubMed1981

Treatment of the idiopathic nephrotic syndrome.

Most of the paediatric patients presenting with nephrotic syndrome (NS) have a nephrosis (minimal glomerular changes with or without focal lesion NS) and most of them are characterized by a clear-cut steroid response: a complete remission is rapidly obtained with high dose of glucocorticoids. Many of them, however, relapse during or after the treatment's withdrawal. Most often, these patients can be managed for several years with long-term alternate-day steroid therapy. Alkylating agents must be used exclusively when the doses of steroids required result in severe toxicity. In other types of NS (steroid resistant nephrosis, membranous and membranoproliferative glomerulonephritides) the efficiency of drugs is not established. Whatever the cause for the NS, adequate supportive therapy is necessary. The constant aim is to allow the patient a normal physical, school and social activity.

Alkylating Agents↗
PubMed1981

[Captopril in severe arterial hypertension of childhood (authors transl)].

Twenty patients with severe arterial hypertension were treated with Captopril (an inhibitor of angiotensin 1 converting enzyme). Decrease in blood pressure occurred early and was sometimes important. Significant changes in plasma renin activity, plasma aldosterone and converting enzyme activity were observed. There was a significant inverse correlation between the action of Captopril on blood pressure and the level of extra-cellular volumes. Eighteen patients received long-term treatment (m = 10.05 +/- 1.32 mo.). Side-effects consisted of positive antinuclear antibodies and a possible kidney failure in cases with stenosis of the renal artery.

Adolescent↗
PubMed1981

Prolonged renal survival and stunting, with protein-deficient diets in experimental uremia. Reversal of these effects by addition of essential amino acids.

The aim of dietary therapy of chronic renal failure is to reduce uremic symptoms while avoiding malnutrition. The possible toxic effects of the diet on the kidney are rarely taken into consideration. The present experiment compared the long-term effects of three low-protein diets in nephrectomized rats (UI, UII, UIII) and in controls: diet I containing 7.5% protein, diet II containing 7.5% protein + 1% EEAs, and diet III containing 14% protein. Nephrectomized rats gained less weight than corresponding controls. UI rats had a decrease in the rate of length gain as opposed to groups UII and UIII. UI, however, maintained a relatively constant GFR, whereas groups UII and UIII had severe reductions in renal function. There were no significant differences between either UII or UIII rats in terms of growth and survival, despite lower consumption not only of proteins but also of all nutrients in the former group measured in a previous study. Thus semisynthetic diet appeared of little benefit. A diet consistent with both normal growth and preservation of renal function remains to be defined.

Amino Acids, Essential↗
PubMed1980

Plasma and muscle free amino acids in children at the early stages of renal failure.

Plasma and muscle free amino acid analyses have been performed on four groups of children with different levels of renal failure. Mean plasma creatinine of the groups 1 to 4 was respectively 1.3, 2.3, 3.3, and 4.9 mg/100 ml. Significant but different alterations of plasma and muscle amino acid pattern were found in the four groups of patients. In plasma, aspartic acid, citrulline, OH-proline, 1- and 3-methyl histidine were regularly increased, while threonine, valine, phenylalanine, isoleucine, leucine, tryptophane, tyrosine, and tyrosine/phenylalanine ratio were generally decreased. In muscle, glutamine was usually increased and alanine, valine and valine/glycine ratio decreased; significant increase of total amino acid content was only noted in group 4. Some amino acid alterations became worse with renal failure such as 3-methylhistidine increase or tyrosine/phenylalanine decrease, but group 3 patients had the greatest number of individual amino acid alternations. This group of patients also had the highest protein intake. Relationship between growth velocity and muscle amino acid pattern was found, a poor growth rate was associated with an increase of nonessential and essential amino acids with the exception of valine.

Adolescent↗
PubMed1980

[Continuous enteral feeding in pediatric nephrology. Long-term results in children with congenital nephrotic syndrome, severe cystinosis and renal failure (author's transl)].

This is the report of the results obtained with continuous enteral feeding in congenital nephrotic syndrome (3 cases), cystinosis (3 cases) and renal failure (3 cases). Ages of patients at the beginning of treatment ranged from 10 days to 3 years. Enteral nutrition was given for periods ranging from 4 to 37 months; mean energetic intake was 116% of the levels recommended according to developmental age and protein diets were 138%; 115% and 84% of the recommended amounts in nephrotic syndromes, cystinosis and renal failure, respectively. This treatment obtained the survival of most patients. In congenital nephrotic syndromes, growth improved clearly with acceleration of the curve and restoration of plasma albumin level. In cystinosis, a better fluid and electrolyte balance was obtained and growth curve sometimes improved in a spectacular fashion. Finally, in renal failure, effect on growth was favourable in 2 cases and nil in the third: these findings show that normalization of energetic intakes does not induce normal growth in children with uremia.

Child, Preschool↗
PubMed1980

Deficiency of the second component of complement. Its occurrence with membranoproliferative glomerulonephritis.

We studied glomerulonephritis in a child with a deficiency of the second component of complement (C2) who was without clinical or serologic evidence of systemic disease. The clinical course was severe, with malignant hypertension and terminal renal failure when the child was 14 years old. Results of histologic studies were typical of membranoproliferative glomerulonephritis with subendothelial deposits. Immunofluorescence microscopy showed diffuse and intense localization of IgG, C1q, and C4 as granular deposits along the glomerular capillary walls and within the mesanguim. Diffuse deposits of C3 were also found along the capillary walls. Nine months after transplantation, the graft biopsy specimen showed glomerular lesions with IgG, C1q, C4, and C3 deposits, which suggests the possibility of a recurrence. The analysis of the previously reported cases of glomerulonephritis with C2 deficiency showed variable, but generally mild, glomerular lesions. Progression of the glomerulonephritis to severe renal insufficiency, as in the present case, is exceptional.

Adolescent↗