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Biomedical subjects

N Gretz

Publications and source records attributed to N Gretz.

At least 109 records · Page 6Linked to original sources
PubMed1989

Rate of deterioration of renal function in juvenile nephronophthisis.

The rate of deterioration of renal function was determined in 29 patients with juvenile nephronophthisis presenting before the age of 18.5 years. The analysis was based on 618 serial determinations of serum creatinine (SCR). By application of a new statistical method the time elapsing between different successive SCR levels was calculated. A more or less homogeneous increase of SCR was noted starting from the time when a SCR of 4 mg/dl was reached. The median time elapsing between an SCR of 2 and 4 mg/dl was 32 months, between 4 and 6 mg/dl 10 months and between 6 and 8 mg/dl 5 months. The median age at the start of renal replacement therapy or death due to uraemia, evaluated by survival analysis, was similar in both sexes.

Adolescent↗
PubMed1989

Low-dose cyclosporin A therapy in cadaver renal transplantation in children.

Fifty-one pediatric patients undergoing a first cadaveric kidney transplantation were followed for at least 2 years after grafting. They were divided into two groups: those treated with methylprednisolone plus azathioprine (AZA) and those treated with methylprednisolone plus low-dose cyclosporin A (CyA; median dose 109 mg/m2 per day = 3.4 mg/kg per day after 1 year). The steroid dosage given was significantly lower in the second group. The 4-year graft survival rate was 68% for the AZA group and 78% for the CyA group. Renal function did not differ significantly in the two groups; after 1, 2, and 3 years, the median 24-h creatinine clearance was 79, 69, and 51 ml/min/1.73 m2, respectively, for the AZA group and 78, 63, and 68 ml/min/1.73 m2, respectively, for the CyA group. Linear growth was similar in the two groups. We conclude that in pediatric patients the results of low-dose CyA immunosuppression do not differ significantly from those obtained with AZA in terms of graft survival, renal function, or growth.

Adolescent↗
PubMed1989

Is gender a determinant for evolution of renal failure? A study in autosomal dominant polycystic kidney disease.

More males than females enter renal replacement therapy programs. This may reflect greater propensity of men to acquire renal disease, faster progression of renal disease, or a combination of both. In order to address this problem, autosomal dominant polycystic kidney disease (ADPKD), a well-defined genetically homogenous hereditary disorder, was studied. One hundred fifty-eight cases of the disease in adults were diagnosed by sonography and studied (73 men, 85 women); 58 of the patients had reached end-stage renal failure. Survival analysis of age at renal death revealed a significant gender difference (log-rank test, P = 0.0072): median age at renal death was 52.5 years in men and 58.0 years in women. In 64 patients with adequate sequential measurements of serum creatinine, progression of renal failure was followed retrospectively. When serum creatinine was greater than 3 mg/dL, the average rate of progression was similar in both sexes. In contrast to ADPKD, a sex difference for the age at renal death was not found in prepubertal individuals with hereditary renal diseases, ie, cystinosis or nephronophthisis. The data suggest that sex (hormones) influences evolution of renal failure.

Creatinine↗
PubMed1989

Does a low protein diet really slow down the rate of progression of chronic renal failure?

In this paper we present evidence from data obtained by different study groups, indicating that a low protein diet slows down the rate of progression of chronic renal failure. These data also demonstrate that the delay of progression is highly dependent on the underlying renal disease. In absolute terms, patients suffering from polycystic kidney disease experienced most benefit from a low protein diet, while in relative terms, the natural course of the renal disease of patients suffering from chronic glomerulonephritis is significantly more delayed than in other disease groups. Furthermore, a vegetarian diet seems to be superior to a meat-containing diet. Thus, we conclude that there are sufficient data from the literature to suggest that a low protein diet delays the progression of chronic renal failure.

Amino Acids↗
PubMed1988

Caloric supplements for patients on low-protein diets?

Protein-calorie malnutrition (PCMN) in patients suffering from chronic renal failure treated with a low-protein diet (LDP) is generally considered to be the major adverse effect of such a diet. One cause of PCMN might be that these protein-restricted diets do not supply enough energy, although all of them are supposed to provide at least 35 kcal/kg body weight (BW). In order to test this hypothesis, we analyzed the hypothetical protein and energy intake of a patient on different LPDs. The food intake of such a patient was simulated by analyzing the average composition of 28 complete daily menus. The daily menus simulating 9 dietary schedules (0.3 g protein/kg BW; n = 6; 0.6 g protein/kg BW; n = 3) were taken from 5 different German cookery books. Our analysis revealed that only 2 schedules supplied enough energy. All others were deficient in energy by about 500 kcal/day. The deficiency occurred to the same extent in schedules for diets providing 0.3 and 0.6 g of protein/day. Therefore we conclude that PCMN in patients on LPDs is often due to an insufficient energy supply. The use of less protein-restricted diets does not necessarily prevent PCMN, as also these diets may be low in calories. Thus the use of caloric supplements, e.g. wine or polysaccharides, and correct dietary counseling by a skilled dietitian are recommended.

Dietary Carbohydrates↗