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Biomedical subjects

M Lao

Publications and source records attributed to M Lao.

At least 109 records · Page 6Linked to original sources
PubMed1993

Effect of enalapril on proteinuria after kidney transplantation.

We studied the effect of enalapril, an inhibitor of angiotensin-converting enzyme (iACE), on proteinuria and renal function in recipients of renal allografts. Twenty-two patients with post-transplant nephrotic syndrome were treated with incremental doses of enalapril for 1 year. Urinary protein excretion decreased after 2 months of treatment from a mean of 8.9 g/day (range 4.0-18.9 g/day) to 4.5 g/day (range 0.4-10.0 g/day; P < 0.01) and remained significantly low for the rest of the study. However, in the same period, creatinine clearance did not change significantly; it went from 47.8 ml/min (range 17.1-110.3 ml/min) before treatment to 44.2 ml/min (range 16.5-88.5 ml/min) after 2 months of iACE therapy. Analysis of individual data showed that there was a significant reduction in proteinuria in 14 of the 22 patients and that the rate of deterioration of renal function did not increase in 17 of the 22 patients. We did not observe any serious side effects of enalapril administration. The results of our study prove that iACE can be used safely and effectively to reduce post-transplant proteinuria.

Adult↗
PubMed1993

Value of urine sediment phenotyping in renal allograft recipients.

Leukocytes excreted in urine of renal transplant recipients were phenotyped and the results were correlated with their post-transplant course. The majority of excreted cells were monocytes, a phenomenon that bore no relationship to clinical status of the patients. T-lymphocyturia was associated with both acute rejection and urinary tract infection. In contrast, B cells were excreted in low numbers.

Cell Count↗
PubMed1993

[Levels of beta-2-microglobulin (B2MG) in blood serum of patients during the early phase after kidney transplantation].

In uremic subjects serum B2MG levels was significantly higher than in normals. In kidney transplant patients (KTP) serum B2MG levels was 3-4 times higher than in normals. Elevated serum B2MG levels in KTP seems to depend not only on the kind of immunosuppressive therapy but also on other factors. In the present study we aimed to asses serum B2MG levels immediately after KT. B2MG were assessed in 25 uremic patients at the early phase after KT and in 12 controls (patients immediately after cholecystectomy). All uremic patients were divided on two groups: group I-patients with immediately graft function after transplantation (12 patients) and group II--patients with acute failure of the transplanted kidney (13 patients). In all examined subjects immediately before and 1, 2, 3, 4, 5, 10, 15, 20, 25, and 30 days after transplantation serum B2MG levels were assessed using RIA methods. In group I we observed gradually decline of B2MG concentrations parallel with creatinine after KT while in group II normalization of B2MG and creatinine levels were delayed (approximate 10 days). The significant positive correlation was found between plasma B2MG and creatinine levels in all examined patients. We concluded: 1. In all examined groups the tendency to normalization of B2MG levels after KT was observed. 2. Acute failure transplanted kidney delayed normalization of B2MG concentrations. 3. Normalization of B2MG levels was preferentially dependent on the graft function.

Adult↗
PubMed1993

[Prostaglandins and the kidney].

The prostaglandins are fatty acid products of cellular phospholipids and act as local hormones. The purpose of the paper is to review its biochemistry. Additionally, the role of PG in physiology and pathophysiology of the kidney are discussed. Its effect on transplanted kidney and regulation of immune response is also included.

Animals↗
PubMed1993

Low dose heparin: efficacious treatment for chronic renal allograft rejection.

Recent data indicate that aside from its anti-coagulant action heparin has potent immunobiological activities inhibiting cell trafficking to a site of antigen. In addition, heparin inhibits smooth muscle cell proliferation and decreases the synthesis of the extracellular matrix proteins. As those phenomena are thought to play a major role in the pathogenesis of chronic allograft rejection, we performed a trial evaluating the efficacy of low dose heparin (5 U/kg/day) in 23 recipients of renal allografts with biopsy-proven rejection. In 16 patients (70%) a tendency for improvement was seen which in 57% was statistically significant. Our data suggest that low dose non-anticoagulant heparin may be an efficacious means for treatment of chronic rejection.

Adult↗
PubMed1993

[Effect of immunosuppression method on levels of plasma erythropoietin (EPO) and parathyroid hormone (PTH) during acute graft rejection in kidney transplantation (KTP)].

UNLABELLED: Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. On the other side during acute rejection (AR) the plasma PTH level (which is incriminated as an uraemic toxin) increases. This facts justified our present study which aimed to assess: 1. the influence of acute graft rejection (AR) on plasma EPO and PTH levels in KTP and 2. the influence of kind of antirejection therapy i.e. high dose of methylprednisolone (MP) vs thymoglobuline (TG) + moderate dose of methylprednisolone on plasma EPO and PTH levels respectively. A total of 28 KTP were studied who were divided into two groups: the first one designed as group MP comprised 17 KTP treated by high doses of MP while the second one designed as group ATG--consisted of 11 KTP treated by thymoglobulin+moderate doses of MP. The control group consisted of 16 healthy subjects. Before AR KTP showed inappropriately reduced EPO plasma levels when related to the degree of anaemia. AR was accompanied by a significant increase of plasma EPO and PTH levels in all examined KTP groups. After subsidence of AR normalization of plasma EPO and a significant decline of plasma PTH was noticed. A significant positive correlation was found between plasma EPO and PTH levels before the AR period in both examined groups. CONCLUSIONS: 1. KTP are characterized by relative EPO deficiency at the immediate (2-3 weeks) post transplantation period. 2. AR episodes are characterized by a significant rise of both plasma EPO and PTH levels. 3. Changes in plasma EPO and PTH do not seem to be interrelated at the AR episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Acute failure of transplanted kidney after administration of angiotensin converting enzyme inhibitors (iACE)].

Treatment of kidney transplant recipients with inhibitors of angiotensin-converting enzyme (iACE) is associated with increased risk of deterioration of renal function. Between 1988-1992 in Transplantation Institute, 71 renal allograft recipients were treated with iACE. 44 of them received iACE in order to reduce proteinuria, 18 due to secondary polycythemia and 9 recipients received iACE because of hypertension resistant to at least 3 hypotensive drugs. Acute renal failure developed in 5 patients and all of them received iACE as treatment of resistant hypertension. After resumption of renal function, in 3 of 5 patients artery stenosis of the transplanted kidney was found. In 1 recipient acute renal failure occurred despite normal renal arteriography and normal indexes of the flow through renal arteries determined by Doppler ultrasound examination. In 2 patients acute renal failure appeared after a single minimal dose of iACE. Severe arterial hypertension in patients with transplanted kidney is a particular risk factor for development of acute renal failure after iACE. The normal arteriography in transplanted kidney and normal arterial blood flow measured by means of Doppler ultrasound do not exclude the possibility of development of acute renal failure after iACE.

Acute Kidney Injury↗
PubMed1991

[Level of erythropoietin and parathormone in blood plasma during acute rejection of kidney transplant].

The acute rejection of kidney transplant is accompanied by kidney ischaemia which in turn is a triggering factor for erythropoietin (EPO) synthesis. It was shown, on the other hand, that during the rejection an increase in blood serum parathormone (PTH) concentration takes place. The present study was aimed at answering the question what is the effect of acute rejection of kidney transplant on blood serum concentrations of EPO i PTH. Seventeen patients with kidney transplant participated in the study. In all the patients the investigations were carried out four times: 1--few days before rejection, 2--after ascertaining that kidney transplant is being rejected, 3--immediately after rejection, and 4--few days after completing the anti-rejection therapy. High doses of methylprednisolone were used as anti-rejection therapy. Control group consisted of 16 healthy persons. Acute rejection of kidney transplant was accompanied by a significant increase in blood serum concentrations of EPO and PTH. After methylprednisolone therapy, normalization of EPO and decrease in PTH concentration were observed in kidney transplant patients. Significant positive correlations were found between EPO and PTH concentrations in blood serum. It was concluded that acute rejection of kidney transplant is characterized by a significant increase in blood serum concentrations of EPO and PTH. Despite the existence of a significant positive correlation between blood serum concentrations of EPO and PTH in patients with kidney transplant, any pathogenic relation between the observed disturbances of secretion of the two hormones seems to be of little probability.

Acute Disease↗
PubMed1991

Immune monitoring after renal transplantation. I. HLA-D expression on T cells from renal allograft recipients.

The expression of class II antigens (HLA-DR, DP and DQ) on resting and PHA-activated T cells from renal allograft recipients was studied. A tendency for increase in DR+/DQ+ T cells was noted in azathioprine and cyclosporine-treated recipients undergoing rejection. Low inducible HLA-D expression (especially DP) was associated with CMV infection. Cyclosporine (but not azathioprine) lowered the rate of synthesis of HLA-D by T cells activated in vitro.

Biomarkers↗
PubMed1991

[Serum erythropoietin level during acute rejection of transplanted kidney].

Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. This fact justified our present studies which aimed to assess the influence of acute rejection (AR) on plasma EPO level in KTP. A total of 17 KTP were examined some days before AR (I), at the onset of AR (II), immediately (III) and some days after (IV) discontinued therapy of AR episodes by methylprednisolone. The control group consisted of 16 healthy subjects. KTP 2-3 weeks after renal transplantation showed relative EPO deficiency both during efficient excretory function and rejection episodes. At acute graft rejection episodes a marked increase of plasma EPO level was found. Results presented in this study suggest absence of the physiological relationship between EPO secretion and erythropoiesis 2-3 weeks after transplantation.

Acute Disease↗
PubMed1991

[Plasma erythropoietin levels of kidney transplant patients in the early period after transplantation].

Plasma erythropoietin (EPO) levels were assessed in 51 uraemic patients immediately after kidney transplantations and in 16 healthy subjects. Before transplantation EPO levels were significantly higher than in normals. In patients with acute renal failure of the transplanted kidney, a significant increase of plasma EPO level was noticed. Such an increase of plasma EPO was absent in patients with a normally functioning kidney transplant. In these last patients normalization of plasma EPO was found during the first month after transplantation. No significant correlation was found between plasma EPO level and the haematocrit value in kidney transplant patients. From results obtained in this study it seems, that factors other than EPO are also involved in the pathogenesis of anaemia in patients at the early phase after kidney transplantation.

Acute Kidney Injury↗
PubMed1991

[Plasma erythropoietin levels in patients with stabilized function of the transplanted kidney].

Plasma erythropoietin level was assessed in 96 kidney transplant patients with stabilized function of the graft 3 months up to 5 years after transplantation and in 16 healthy subjects. In kidney transplant patients on CyA or azathioprine respectively, plasma erythropoietin levels were significantly higher during the first three months after transplantation than in normals. Normalization of erythropoietin levels were observed 6 to 12 month after kidney transplantation. As compared with patients on CyA, in azathioprine treated patients plasma erythropoietin levels were significantly higher 12 to 60 months after transplantation. These elevated erythropoietin levels in azathioprine treated patients seem to be due also to factors other than higher prednisone dosage.

Adult↗
PubMed1991

[Plasma erythropoietin levels in kidney transplant patients with impaired function of the renal graft].

In 81 patients with failing kidney transplant, plasma levels of erythropoietin, iron, ferritin and TIBC were assessed. Progression of failure of the excretory function of the kidney transplant was accompanied by decreasing Hb and Ht values but increasing plasma levels of erythropoietin. In all examined patients presence of iron deficiency could be excluded. Results obtained in this study suggest that relative erythropoietin deficiency is the major cause of anaemia in patient with a failing kidney transplant.

Acute Kidney Injury↗