In the framework of a multicentric retrospective study between selected clinics of the Republic Austria and the GDR anamnestic, clinical and paraclinical data were investigated in their valency for the early recognition of glomerulonephritis. Data of 583 patients were evaluated. Hereby it was shown that independent of the size of excretion and the reproducibility the findings "proteinuria" are of particular significance for the early recognition. The serological investigations usually performed within the diagnostic of glomerulonephritis proved as insignificant for the early recognition. Since the establishing of an exact diagnosis is up to now possible only with the help of invasive methods, a call on research is made to develop reliable, non-invasive diagnostic methods.

Arthritis & RheumatismVolume 28, Issue 6 p. 710-712 Brief ReportFree to Read Oral gold therapy in a patient with rheumatoid arthritis and preexisting uremia Winfried Graninger MD, Winfried Graninger MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorGerald Seidl MD, Gerald Seidl MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorJosef Kovarik MD, Josef Kovarik MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorWulf Pinggera MD, Wulf Pinggera MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorJosef S. Smolen MD, Corresponding Author Josef S. Smolen MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSecond Department of Internal Medicine, University of Vienna, A-1090 Vienna, Garnisongasse 13, AustriaSearch for more papers by this author Winfried Graninger MD, Winfried Graninger MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorGerald Seidl MD, Gerald Seidl MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorJosef Kovarik MD, Josef Kovarik MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorWulf Pinggera MD, Wulf Pinggera MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSearch for more papers by this authorJosef S. Smolen MD, Corresponding Author Josef S. Smolen MD Second Department of Internal Medicine, University of Vienna, Vienna, AustriaSecond Department of Internal Medicine, University of Vienna, A-1090 Vienna, Garnisongasse 13, AustriaSearch for more papers by this author First published: June 1985 https://doi.org/10.1002/art.1780280618Citations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume28, Issue6June 1985Pages 710-712 RelatedInformation

The efficacy and safety of a hepatitis B vaccine (Pasteur Institute) has been evaluated in 93 healthy members of the medical staff and in 28 patients undergoing chronic haemodialysis. Following 3 injections of vaccine (each 5 micrograms) at monthly intervals, 94% of the healthy subjects and 61% of the patients were already successfully immunized 4 months after commencement of the vaccination course. Those who did not respond initially received an additional dose at 6 months, which induced seroconversion in several more cases, resulting in the successful immunization of 98% of healthy subjects and 75% of haemodialysis patients. Immune response was sex- and age-dependent. Peak anti-HBs concentrations in responders at 6 months were 643, 325, and 194 mU/ml in healthy women, healthy men, and in patients, respectively. None of the staff members developed clinical or biochemical signs of hepatitis or of any other disease. Markers of hepatitis B virus infection were detected in 3 healthy subjects and in 6 dialysis patients.

The concentration of circulating immune complexes were determined by Clq solid phase assay in 30 patients with systemic lupus erythematosus (n = 15), glomerulonephritis (n = 5), and after kidney transplantation (n = 10). Elevated immune complex concentrations were found in glomerulonephritis and systemic lupus erythematosus correlating with disease activity. In the posttransplant period the level of immune complexes was increased after antilymphocyte globulin therapy. The function of the transplanted kidney or rejection crises showed no effect on immune complex formation. The presence of circulating immune complexes indicates a high activity of disease in cases of glomerulonephritis and systemic lupus erythematosus.

Treatment of renal transplant patients with the H2-antagonist cimetidine has previously been assumed to be of reasonable prophylactic value in controlling the incidence of the postoperative complications of gastric or duodenal ulceration. We attempted to evaluate the performance of the drug in a controlled trial by treating transplant patients with either cimetidine or a placebo. Of the 59 patients accepted for the trial, four had to be excluded eventually because of irregularities in the administration of the drug and, in on case, nonfatal respiratory failure. Six of 27 from the cimetidine group had erosions or ulcers by the third day after surgery and two more had them by the end of the fourth week. Three of 28 placebo patients developed lesions after 3 days and three more developed them after 7 weeks. In the months after transplantation, one cimetidine and two placebo patients developed ulcers. Bleeding occurred three times with cimetidine and twice with the placebo. Renal function was similar in both groups as was the necessity of transplantectomy because of irreversible rejection. We conclude that cimetidine does not lower the incidence of gastroduodenal mucosal lesions and upper gastrointestinal bleeding after renal transplantation, nor does it influence rejection of the allograft.

In haemodialysis an interaction between platelets and the dialysator membrane occurs, which is not prevented by heparin. This can be demonstrated by parietal depositions of platelets in the capillaries of the artificial kidney by scanning electron microscopy, as well as in a marked increase of reversible platelet microaggregates during the first phase of dialysis. Some patients are prone to develop thrombosis of the capillary kidneys in spite of a high-dose heparinization. In these cases the use of diclofenac, a cyclooxygenase inhibitor, prevents these adverse platelet reactions.

In acute and chronic kidney transplant rejection renal cortical and medullary tissue samples were examined for their prostacyclin (PGI2) generation by bioassay and compared with normal tissue. In acute rejection PGI2 formation was significantly enhanced, particularly in the cortex. In chronic rejection the PGI2 formation was comparable with control tissue. Since PGI2 is a very potent platelet aggregation inhibitor and vasodilator, it is concluded that the increase in PGI2 generation in acute rejection might be a self protecting mechanism which is, however, overwhelmed in irreversible rejection.

A study was carried out in 25 patients on chronic intermittent haemodialysis on the effect of increasing the dialysate calcium concentration from 1.5 to 1.75 mMol/l on calcium and phosphorus metabolism. In 16 patients the increase in the dialysate calcium resulted in a sufficiently large increase in the plasma Ca level to suppress the parathyroid glands. The calcium influx during dialysis in these patients was sufficient to abolish the effects of diminished calcium absorption from the intestine due to loss of endocrine renal function. The remaining 9 patients showed no suppression of parathyroid gland activity and could be separated into two different groups, one requiring calcium supplementation and the other group manifesting signs of autonomic hyperparathyroidism. The five patients showing a higher calcium requirement were started on active vitamin D metabolites. In the remaining 4 patients parathyroidectomy will probably be inevitable if progression of the clinical manifestations of hyperparathyroidism occurs. Close control of plasma phosphorus levels is mandatory to avoid an increase in the calcium phosphate product or the danger of hypophosphataemic osteomalacia.

A study was carried out in 25 patients on chronic intermittent haemodialysis on the effect of increasing the dialysate calcium concentration from 1.5 to 1.75 mMol/l on calcium and phosphorus metabolism. In 16 patients the increase in the dialysate calcium resulted in a sufficiently large increase in the plasma Ca level to suppress the parathyroid glands. The calcium influx during dialysis in these patients was sufficient to abolish the effects of diminished calcium absorption from the intestine due to loss of endocrine renal function. The remaining 9 patients showed no suppression of parathyroid gland activity and could be separated into two different groups, one requiring calcium supplementation and the other group manifesting signs of autonomic hyperparathyroidism. The five patients showing a higher calcium requirement were started on active vitamin D metabolites. In the remaining 4 patients parathyroidectomy will probably be inevitable if progression of the clinical manifestations of hyperparathyroidism occurs. Close control of plasma phosphorus levels is mandatory to avoid an increase in the calcium phosphate product or the danger of hypophosphataemic osteomalacia.

Recently prostacyclin (PHI2), an unstable prostaglandin with a strong inhibitory effect on platelet aggregation, has been demonstrated in the wall of blood vessels. We estimated the PGI2 availability of arteries and veins in 10 uraemic patients and 12 nephrectomised rats. The production of PGI2 after long-term incubation of the vessels was markedly enhanced and prolonged. This alteration is probably one key mechanism for the deterioration of haemostasis in uraemics. Preliminary results of further studies indicate that substances in uraemic plasma--presumably middle molecules--may enhance the PGI2 availability of normal vessels in vitro.

Haemodynamics and renal function have been examined before and during i.v. infusion of dopamine (175 microgram/min) in 11 patients admitted as potential kidney donors to an intensive care unit. The findings of the control period revealed an extreme decrease of renal tubular function which points to a cessation of central regulation. The cardiovascular system showed a slight increase of blood pressure and heart rate during dopamine. Urine flow and renal blood flow increased significantly as well as the excretion of sodium while inulin-clearance showed only a minimal rise. The functional renal impairment under conditions of brain death as well as the influence of dopamine on circulation and renal function are discussed. The results indicate that dopamine may exert a favourable effect in preparation of kidney donors for the withdrawal of the organs.

: Haemodynamics and renal function have been examined before and during i.v. infusion of dopamine (175 microgram/min) in 11 patients admitted as potential kidney donors to an intensive care unit. The findings of the control period revealed an extreme decrease of renal tubular function which points to a cessation of central regulation. The cardiovascular system showed a slight increase of blood pressure and heart rate during dopamine. Urine flow and renal blood flow increased significantly as well as the excretion of sodium while inulin-clearance showed only a minimal rise. The functional renal impairment under conditions of brain death as well as the influence of dopamine on circulation and renal function are discussed. The results indicate that dopamine may exert a favourable effect in preparation of kidney donors for the withdrawal of the organs.

An 11 Patienten an der Intensivbehandlungsstation als potentielle Nierenspender aufgenommen, wurden Kreislauf- und Nierenfunktion vor und während Dopamininfusion (175 µg/min) untersucht. Die Befunde der Kontrollperiode zeigten eine hochgradige Einschränkung der renalen Tubulusfunktion, die auf den Wegfall der zentralen Regulation hinweist. Während der Dopamininfusion zeigten die Kreislaufmessungen einen geringgradigen Anstieg von Blutdruck und Frequenz. Harnzeitvolumen und Nierendurchblutung stiegen ebenso wie die Natriumexkretion signifikant an, während die Inulin-Clearance nur eine geringe Zunahme aufwies. Die renale Funktionseinschränkung unter „Hirntod“-Bedingungen sowie der Einfluß von Dopamin auf Kreislauf und Nierenfunktion werden diskutiert. Die Ergebnisse weisen darauf hin, daß Dopamin bei der Vorbereitung des Nierenspenders für die Organentnahme einen günstigen Effekt besitzt.

This paper outlines the procedure for the preparation of leucocyte-free reticulocytes and normocytes and details the activities of the key enzymes in reticulocytes, normocytes and leucocytes. An assesment of the error in normocyte enzyme analyses due to contamination with reticulocytes and leucocytes is enabled by these means.