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Biomedical subjects

P Fauchald

Publications and source records attributed to P Fauchald.

At least 109 records · Page 6Linked to original sources

Renal effects of trimethoprim in ciclosporin- and azathioprine-treated kidney-allografted patients.

Sixteen stable renal transplant patients on chronic ciclosporin (CS, n = 8) or azathioprine (AZA, n = 8) treatment were given trimethoprim (TMP) 160 mg twice a day for 7 days. This TMP dose did not affect glomerular filtration, as 99mTc-DTPA clearance was unchanged in both groups. TMP did, however, increase serum creatinine and reduce creatinine clearance in all patients. This effect was most pronounced in CS-treated patients. We conclude that even at the moderate dosage, as employed presently, TMP blocks tubular secretion of creatinine. This route for creatinine excretion is quite important as the clearance ratio between creatinine and DTPA averaged 1.21 in CS-treated patients and 1.05 in AZA-treated patients before TMP treatment. During TMP the ratio was reduced to 0.95 and 0.99, respectively, suggesting a complete cessation of tubular creatinine secretion by TMP. TMP did not, however, significantly affect other markers of renal tubular function.

Adult↗

Renal replacement therapy in elderly patients.

The results of renal replacement therapy (RRT) in elderly patients in Norway were evaluated. During the 5-year period between 1981 and 1985, 368 patients at least 60 years of age (mean, 66.7 years) at the start of RRT were included and followed until 15 February 1987. Transplantation was planned for 249 patients; of these 127 were not grafted. The actuarial survival in this group was 64%, 44%, and 7% at 6, 12, and 48 months, respectively. Survival in 122 grafted patients was 93%, 87%, and 62%, respectively, and the corresponding graft survival was 70%, 67%, and 48%. The remaining 119 patients were allocated to long-term dialysis, with a survival of 63%, 48%, and 13%, respectively. Our results describe the outcome of a treatment program available to the entire elderly population accepted for RRT. In two-thirds of the patients transplantation was planned, and one-third of all patients were actually grafted, with good patient and graft survival. The results suggest that transplantation is the treatment of choice for most elderly patients.

Aged↗

Long-term blood pressure and renal function in kidney donors.

We have reexamined 68 (92%) of 74 donors accepted at this center nine to 15 years ago. There was a moderate but significant increase in BP, and ten donors (15%) were hypertensive at the follow-up. Twenty-six donors (38%) had albumin excretion over 10 micrograms/min or excretion of total protein over 185 mg/24 hr. In four of 16 with increased excretion of total protein, this exceeded 400 mg/24 hr, and in three donors this could be due to an intercurrent disease. Ccr averaged 78.4% of preoperative values, and was less than 50% (range 32 to 49%) in eight donors. The compensatory increase (median 30.5 mliter/min/1.73m2) was inversely correlated with age and BP. Aspects of tubular function were assessed by the diluting capacity during water diuresis and by urinary excretion of beta 2-microglobulin and N-acetyl-beta-glucosaminidase. No consistent abnormalities were observed. A subgroup of donors (N = 32) was compared with a matched control group. Urinary albumin excretion among the donors was significantly higher compared to the controls, both in absolute terms (5.4 vs. 3.3 micrograms/min, P less than 0.002) and as percent of total protein excretion (7.6 vs. 5.7%, P less than 0.05). Otherwise no consistent differences were observed. The development of BP over time warrants further observations, but there is no evidence that uninephrectomy represents a long-term risk to the donors' health.

Acetylglucosaminidase↗