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Biomedical subjects

V M Reznik

Publications and source records attributed to V M Reznik.

At least 37 records · Page 2Linked to original sources
PubMed1990

Treatment of steroid-resistant focal segmental glomerulosclerosis with pulse methylprednisolone and alkylating agents.

In children, steroid-resistant nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS) is frequently a progressive condition resulting in end-stage renal disease. There have been no reports of effective treatment for this condition. For the past several years, the Pediatric Nephrology services at the University of California, San Diego and Stanford University Schools of Medicine have treated these patients with a protocol involving infusions of high doses of methylprednisolone, often in combination with oral alkylating agents. Twenty-three children have been treated in this manner with a follow-up of 46 +/- 5 months. Twelve of these children are in complete remission. Six have minimal to moderate proteinuria. Four children remain nephrotic. Each of these children has a normal glomerular filtration rate. One child developed chronic renal failure and subsequently died while on dialysis. These results appear significantly better than previous series of children with FSGS. A controlled, multi-center trial of this protocol has been proposed.

Adolescent↗
PubMed1990

Trimethoprim/sulfamethoxazole-induced renal tubular acidosis.

A child was evaluated for growth failure at the University of California, San Diego. On two occasions the patient had renal bicarbonate wasting, acidosis, and growth failure associated with trimethoprim/sulfamethoxazole (TMP/SMZ) administration. On both occasions, the acidosis resolved and the growth rate normalized following a period without receiving TMP/SMZ. Renal tubular acidosis and growth failure may occur as a result of TMP/SMZ therapy in children.

Acidosis, Renal Tubular↗
PubMed1989

Severe bilateral renal disease: correlation of antenatal and autopsy findings.

We report 20 infants with severe bilateral renal disease examined by prenatal ultrasound and by autopsy. In 17, the prenatal and pathologic diagnoses correlated well. Although the prenatal and autopsy findings differed in the three remaining cases, the autopsy confirmed the presence of severe bilateral renal abnormalities. All 20 pregnancies were complicated by oligohydramnios, which was severe in 60 per cent. Most of these fetuses had malformation of other organ systems. This series supports the utility of prenatal ultrasound examinations, but emphasizes the need for postnatal evaluation of congenital renal disease including pathologic examination of tissue when possible for correct classification and genetic counselling.

Female↗
PubMed1989

Cyclosporine induces abnormal facial bone growth in children: a preliminary study.

Using cephalometric radiography, facial bony structure of a group of pediatric renal transplant recipients immunosuppressed with cyclosporine (CsA) and prednisone was studied and compared with a control group of children. A pattern of abnormal facial growth was demonstrated on cephalometry in eight of nine transplant recipients receiving CsA. The abnormalities included shortening of posterior facial height and increased anterior facial height with a deep mandibular plane angle. There was also an absolute shortening in the mandibular body and mandibular retrognathia. These findings may be consistent with inhibition of mandibular condylar growth inhibiting the anteroinferior growth of the mandible. Similar changes were present in two children with end-stage renal disease and none of the remaining nine control patients (P less than 0.01, chi-squared analysis). The affected area appears to be the lower third of the face. The role of CsA in affecting facial bony growth in children needs to be evaluated further.

Adolescent↗
PubMed1989

Follow-up of infants with obstructive uropathy detected in utero and treated surgically postnatally.

Thirty-four infants with obstructive uropathy detected by prenatal ultrasonography at 34 +/- 0.56 weeks (SE) had surgery during the first 2 years of life. The growth and renal function of the 25 children after being followed for over 1 year are described. Twelve children had unilateral disease, and 13 had bilateral disease. All 12 children with unilateral disease grew at or above the fifth percentile and had normal renal function (glomerular filtration rate, 101 +/- 7 mL/min/1.73 m2). Thirteen children with bilateral disease were followed for 26.1 +/- 3.4 months. Growth was good: 10 of the 13 grew at or above the fifth percentile. The serum creatinine was 0.7 +/- 0.2 mg/dL, and the glomerular filtration rate was 91 +/- 10 mL/min/1.73 m2. One child required chronic dialysis. The prenatal diagnosis of urinary tract anomalies followed by early intervention may improve the long-term outcome of children with obstructive uropathy.

Child, Preschool↗
PubMed1988

Follow-up of infants with bilateral renal disease detected in utero. Growth and renal function.

We studied 69 infants who had urinary tract abnormalities detected by antenatal ultrasound examination. There were 21 intrauterine or immediate neonatal deaths; in all 21 infants, severe bilateral renal disease incompatible with life was found at autopsy. Six of the live-born infants with abnormal results of antenatal ultrasound examinations had a normal urinary tract after birth. Of the remaining 42 infants, the prenatal diagnosis was confirmed with renal ultrasound and other studies during the first week of life. Twenty-one of 42 infants had bilateral renal disease. We obtained follow-up data on 19 of 21 of these infants. Twelve of 19 had obstructive uropathy that was treated surgically. After one to 51 (mean, 18) months of follow-up, renal function varied. Ten of 19 patients had a calculated glomerular filtration rate greater than or equal to 79 mL/min/1.73 m2. One infant required long-term ambulatory peritoneal dialysis. Renal function (glomerular filtration rate, 74 +/- 5 mL/min/1.73 m2) and growth (height percentile, 41 +/- 8) were unexpectedly good considering the severity of the urinary tract abnormalities. Prenatal detection of bilateral renal disease followed by careful medical and surgical management results in a favorable outcome with good growth and renal function.

Adolescent↗
PubMed1987

Changes in facial appearance during cyclosporin treatment.

Substantial changes in facial appearance developed in a group of children treated with prednisone and cyclosporin for immunosuppression after renal transplantation. In general, the children's features became coarse. There was thickening of the nares, lips, and ears, puffiness of the cheeks, prominence of the supraorbital ridges, and mandibular prognathism. The extent of the changes varied, but all eleven children followed up for more than 6 months from transplantation showed some of the changes. Patients treated with prednisone and azathioprine did not show any changes, clearly implicating cyclosporin in their aetiology. This dysmorphic syndrome along with the well-known hirsutism induced by cyclosporin may increase the risk of non-compliance with this immunosuppressive therapy.

Adolescent↗
PubMed1987

Treatment of childhood prednisone-resistant nephrotic syndrome and focal segmental glomerulosclerosis with intravenous methylprednisolone and oral alkylating agents.

Patients with prednisone-resistant nephrotic syndrome and biopsy-proven focal segmental glomerulosclerosis were treated with intravenous methylprednisone. After the first 2 weeks of therapy, the average urine protein excretion decreased from 247 to 96 mg/m2/h (p less than 0.04). Two of the 7 patients have had long-term, nearly complete remissions. The other patients relapsed. One relapsing patient was retreated with methylprednisolone and is now in remission. Four relapsing patients were treated with alkylating agents, in combination with methylprednisolone. All of these patients entered complete or partial remissions. Methylprednisolone causes a significant decrease in the proteinuria of children with focal segmental glomerulosclerosis. In addition, although the follow-up period is relatively short, it would appear that methylprednisolone, often in conjunction with an alkylating agent, has significantly improved the clinical status of these patients.

Administration, Oral↗
PubMed1986

K dependence of the Na-K pump is abnormal in erythrocytes from patients with cystic fibrosis and obligate heterozygotes.

The affinity of the Na-K pump for K was significantly (P less than .001) lower in erythrocytes from patients with cystic fibrosis (Km 4.6 +/- 0.35 mM; n = 26) or from heterozygotes (Km 3.9 +/- 0.57 mM; n = 12) than in controls (Km 2.2 +/- 0.10 mM; n = 20). The affinity of the Na-K pump for K was lower in normal erythrocytes than in normal fibroblasts which may explain the variability in the severity of involvement of different organs in cystic fibrosis. We have now shown in human skin fibroblasts and erythrocytes, that the K affinity of the Na-K pump is lower in patients with cystic fibrosis than in controls. Since the abnormality is also present in erythrocytes from heterozygotes who are clinically normal, it is likely that this abnormality is closely related to the genetic defect in cystic fibrosis.

Cystic Fibrosis↗
PubMed1985

Vasopressin stimulates DNA synthesis and ion transport in quiescent epithelial cells.

The mitogenic effect of vasopressin was studied in subconfluent quiescent renal epithelial cells (MDCK). Vasopressin stimulated DNA synthesis in the presence of low concentrations of serum. Vasopressin increased the entry of Na into the cells and increased ouabain-sensitive 86Rb uptake, a measure of Na-K pump activity. Because the activity of the Na-K pump in MDCK cells is steeply dependent on intracellular Na, it is likely that stimulation of the Na-K pump by vasopressin was mediated by the increase in Na entry into the cells. Thus both serum and vasopressin stimulate Na uptake and Na-K pump activity in quiescent MDCK cells with a subsequent increase in DNA synthesis. It is concluded that growth regulation in epithelial cells may be mediated in part by changes in monovalent ion transport.

Animals↗
PubMed1985

Glomerulonephritis with absent glomerular basement membrane antigens.

This is a report of a child with glomerulonephritis and no family history of renal disease. On renal biopsy there was splitting and thinning of glomerular basement membrane antigens. These findings are similar to those seen in patients with familial nephritis and may be part of a spectrum of primary glomerular basement membrane defects.

Antigens↗
PubMed1983

Serum stimulates Na entry and the Na-K pump in quiescent cultures of epithelial cells (MDCK).

The growth of an epithelial canine kidney line (MDCK) was reversibly arrested by gradually lowering the serum concentration in the medium over a 3-day period. The cells were demonstrably quiescent by autoradiography after an additional 24 hours in serum-free media. Addition of fresh serum produced DNA synthesis after an 18-hour lag period. The quiescent cells then grew to confluency retaining their transport capacities as seen by the formation of "domes." This system allows for measurement of monovalent ion fluxes and its relationship to growth regulation. The addition of fresh serum to quiescent MDCK cells increased the uptake of 86Rb, a measure of Na-K pump activity. This stimulation was mediated by increased uptake of Na into the cells. Serum-stimulated DNA synthesis was blocked by the addition of ouabain in concentrations that inhibit the Na-K pump. Serum appears to stimulate growth in epithelial cells by increasing the amount of intracellular Na available to the Na-K pump. Monovalent ion transport may play a role in the regulation of epithelial cell proliferation.

Animals↗
PubMed1982

Glomerulocystic disease - a case report with 10 year follow-up.

The diagnosis of glomerulocystic disease was made by renal biopsy in a one-year-old girl with bilateral abdominal masses. She has been followed for 10 years with normal growth and development, stable renal function (creatinine clearance - 88 ml/min/1.73 m2) and demonstration of persistence of cysts by intravenous pyelogram. This is the first report of long-term follow-up in this form of renal cystic disease.

Female↗