Kidney international. Supplement最新文献

筛选
英文 中文
Rapid normalization of interleukin-8 production after low-density lipoprotein apheresis in steroid-resistant nephrotic syndrome. 类固醇抵抗性肾病综合征低密度脂蛋白分离后白细胞介素-8生成的快速正常化
Kidney international. Supplement Pub Date : 1999-07-01
M Sakurai, E Muso, H Matushima, T Ono, S Sasayama
{"title":"Rapid normalization of interleukin-8 production after low-density lipoprotein apheresis in steroid-resistant nephrotic syndrome.","authors":"M Sakurai,&nbsp;E Muso,&nbsp;H Matushima,&nbsp;T Ono,&nbsp;S Sasayama","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Low-density lipoprotein apheresis (LDL-A) treatment combined with steroids demonstrated significant improvement of nephrotic proteinuria in steroid- or immunosuppressive-resistant patients from focal and segmental glomerulosclerosis (FGS). The mechanisms of the effect of LDL-A in nephrotic syndrome (NS) are unknown, but a reduction in inflammatory cytokines and chemokines secreted from macrophages has been supposed.</p><p><strong>Methods: </strong>Serum levels of interleukin (IL)-8, tumor necrosis factor-alpha (TNF-alpha), and monocyte chemoattractant protein-1 (MCP-1) were measured by enzyme-linked immunosorbent assay in 27 patients with NS [13 with FGS and 14 with minimal change nephrotic syndrome (MCNS)] before and after LDL-A and in 13 age-matched, healthy controls. We also selected three FGS patients who were resistant to steroid therapy for at least one month and who had undergone six LDL-A procedures. The effects of steroids and LDL-A on the production of IL-8, TNF-alpha, and MCP-1 by peripheral blood mononuclear cells (PBMCs) were also determined in some patients.</p><p><strong>Results: </strong>In NS, the serum levels of IL-8 and TNF-alpha, but not MCP-1, were significantly higher than in healthy controls. After LDL-A, IL-8 and TNF-alpha tended to decrease. IL-8 production by lipopolysaccharide (LPS)-stimulated PBMC, mainly adherent cells, was significantly reduced in both the steroid-resistant FGS group and nontreated NS group compared with controls, but TNF-alpha production was reduced in the only FGS group. After LDL-A, only IL-8 production recovered to the control group level.</p><p><strong>Conclusion: </strong>Significant amelioration of IL-8 production independent of any effect of steroids on LPS-stimulated PBMCs may reflect a beneficial effect of LDL-A in normalizing the function of circulating monocytes in steroid-resistant FGS.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"71 ","pages":"S210-2"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21279438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between hyperlipidemia and microalbuminuria in essential hypertension. 原发性高血压患者高脂血症与微量白蛋白尿的关系。
Kidney international. Supplement Pub Date : 1999-07-01
V M Campese, S Bianchi, R Bigazzi
{"title":"Association between hyperlipidemia and microalbuminuria in essential hypertension.","authors":"V M Campese,&nbsp;S Bianchi,&nbsp;R Bigazzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Some patients with essential hypertension manifest greater than normal urinary albumin excretion (UAE). A few retrospective studies have suggested that there is an association between microalbuminuria and cardiovascular risk. The reasons for this association are not well established, and they are the object of this review.</p><p><strong>Results: </strong>We found that hypertensive patients with microalbuminuria manifest greater levels of blood pressure, particularly at night. Serum levels of cholesterol, triglycerides, and uric acid in patients with microalbuminuria were higher than levels in those with normal UAE, whereas levels of high-density lipoprotein cholesterol in patients with microalbuminuria were lower than levels in patients with normal UAE. Patients with microalbuminuria manifest a greater incidence of insulin resistance, and thicker carotid arteries. After a follow-up of seven years we observed that 12 cardiovascular events occurred among 54 (21.3%) patients with microalbuminuria, and only two such events among 87 patients with normal UAE (P < 0.0002). Stepwise logistical regression analysis showed that UAE, cholesterol level and diastolic blood pressure were independent predictors of the cardiovascular outcome. The rate of clearance of creatinine from patients with microalbuminuria decreased more than did that from those with normal urinary albumin excretion.</p><p><strong>Conclusions: </strong>These studies suggest that hypertensive individuals with microalbuminuria manifest a variety of biochemical and hormonal derangements with pathogenic potential, which result in greater incidence of cardiovascular events and a greater decline in renal function than do patients with normal UAE.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"71 ","pages":"S10-3"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21279305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Importance of geranylgeranyl pyrophosphate for mesangial cell DNA synthesis. 香叶基焦磷酸基对系膜细胞DNA合成的重要性。
Kidney international. Supplement Pub Date : 1999-07-01
Z A Massy, C Guijarro, H Oda, B L Kasiske, W F Keane, M P O'Donnell
{"title":"Importance of geranylgeranyl pyrophosphate for mesangial cell DNA synthesis.","authors":"Z A Massy,&nbsp;C Guijarro,&nbsp;H Oda,&nbsp;B L Kasiske,&nbsp;W F Keane,&nbsp;M P O'Donnell","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Farnesyl pyrophosphate (FPP) and geranylgeranyl pyrophosphate (GGPP) are isoprenoid products of the intracellular mevalonate pathway used for prenylation of several low molecular weight G proteins, including Ras. It is likely that platelet-derived growth factor (PDGF) stimulation of mesangial cell proliferation requires prenylated, low molecular weight G proteins. The purpose of this study was to investigate the dependence of platelet-derived growth factor-stimulated mesangial cell DNA synthesis and cell membrane Ras incorporation on FPP and GGPP.</p><p><strong>Methods: </strong>Quiescent human mesangial cells were exposed to PDGF (25 ng/ml) to stimulate DNA synthesis. Some cells were also treated with the HMG-CoA reductase inhibitor lovastatin (2.5 to 10.0 microM), which inhibits isoprenoid synthesis, in the presence or absence of exogenous FPP or GGPP. DNA synthesis was assessed by thymidine incorporation, and Western blot analysis was used to measure total cell membrane Ras.</p><p><strong>Results: </strong>Stimulation of mesangial cells with PDGF did not increase total cell membrane Ras. Lovastatin reduced cell membrane Ras, and this was prevented by simultaneous exposure of mesangial cells to exogenous FPP (2.5 to 10.0 microM) or GGPP (1 to 5 microM). Lovastatin also reduced PDGF-stimulated mesangial cell DNA synthesis by 90%, and this was completely prevented by simultaneous exposure of cells to exogenous GGPP (1 microM), but not to FPP.</p><p><strong>Conclusions: </strong>The results of this study suggest that both FPP and GGPP can provide for mesangial cell membrane Ras localization and that PDGF-stimulated mesangial cell DNA synthesis requires the isoprenoid GGPP.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"71 ","pages":"S80-3"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21279749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lipophilic statins induce apoptosis of human vascular smooth muscle cells. 亲脂性他汀类药物诱导人血管平滑肌细胞凋亡。
Kidney international. Supplement Pub Date : 1999-07-01
C Guijarro, L M Blanco-Colio, Z A Massy, M P O'Donnell, B L Kasiske, W F Keane, J Egido
{"title":"Lipophilic statins induce apoptosis of human vascular smooth muscle cells.","authors":"C Guijarro,&nbsp;L M Blanco-Colio,&nbsp;Z A Massy,&nbsp;M P O'Donnell,&nbsp;B L Kasiske,&nbsp;W F Keane,&nbsp;J Egido","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The accumulation of vascular smooth muscle cells (VSMC) in the intima is an early feature of atherosclerosis that results from a balance of migration from the media, proliferation, and eventual death (including programmed cell death) of VSMC. Several reports have described that HMG-CoA reductase inhibitors (statins) attenuate both the migration and proliferation of VSMC. However, the potential effect of statins on VSMC programmed cell death has received little attention.</p><p><strong>Methods: </strong>Human and rat VSMC were incubated with different concentration of statins in the presence of fetal bovine serum as a survival factor. The presence of apoptosis was evaluated by morphological criteria, flow cytometry and DNA electrophoresis.</p><p><strong>Results: </strong>Lipophilic statins induced, in a dose-dependent manner the appearance of VSMC apoptosis. The effect of statins was fully reversed by mevalonate, farnesylpyrophosphate, and geranylgeranypyrophosphate, but not by cholesterol or other mevalonate metabolites, suggesting a role for isoprenoids in VSMC apoptosis. In addition, the induction of apoptosis by statins was associated with the inhibition of prenylation of Rho B.</p><p><strong>Conclusions: </strong>The present results suggest that protein prenylation inhibition by statins may be involved in statin-induced VSMC apoptosis. These data provide a new potential mechanism by which statins may modulate the evolution of atherosclerotic lesions.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"71 ","pages":"S88-91"},"PeriodicalIF":0.0,"publicationDate":"1999-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21279751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evidence-based recommendations for the management of glomerulonephritis. Introduction. 基于证据的肾小球肾炎治疗建议。介绍。
Kidney international. Supplement Pub Date : 1999-06-01
D C Cattran
{"title":"Evidence-based recommendations for the management of glomerulonephritis. Introduction.","authors":"D C Cattran","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"70 ","pages":"S1-2"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21237338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inherited disorders of iron metabolism. 遗传性铁代谢紊乱。
Kidney international. Supplement Pub Date : 1999-03-01
M Födinger, G Sunder-Plassmann
{"title":"Inherited disorders of iron metabolism.","authors":"M Födinger,&nbsp;G Sunder-Plassmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent molecular studies have resulted in the identification of genetic alterations underlying hereditary disorders of iron metabolism. One example is the discovery of the HFE gene that is mutated in patients suffering from hereditary hemochromatosis. This autosomal recessive disorder has an estimated carrier frequency that varies between 0.07 and 0.13, thus representing one of the most common genetically determined metabolic disorders. The identification of the hemochromatosis mutations has encouraged efforts to investigate other conditions with iron overload for a putative interaction with these genetic variants. Few data are already available suggesting, for example, that iron overload in patients with sporadic porphyria cutanea tarda is associated with mutations in the hereditary hemochromatosis gene. However, it is obvious that disorders of iron metabolism have a multifactorial pathogenesis, including environmental and genetic factors. Thus, many questions remain to be answered about whether a genetic predisposition exists for development of various iron-loading or iron-deficiency phenotypes. This review focuses on the most recent advances in the field of hereditary disorders of iron metabolism and discusses their potential implications for nephrologists.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"69 ","pages":"S22-34"},"PeriodicalIF":0.0,"publicationDate":"1999-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20957242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erythropoietin hyporesponsiveness: from iron deficiency to iron overload. 促红细胞生成素反应低下:从缺铁到铁超载。
Kidney international. Supplement Pub Date : 1999-03-01
D C Tarng, T P Huang, T W Chen, W C Yang
{"title":"Erythropoietin hyporesponsiveness: from iron deficiency to iron overload.","authors":"D C Tarng,&nbsp;T P Huang,&nbsp;T W Chen,&nbsp;W C Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Iron deficiency is the most frequently encountered cause of suboptimal response to recombinant human erythropoietin (rHuEPO). Carefully assessing iron status is of paramount importance in chronic renal failure patients prior to or during rHuEPO therapy. Because there is great need for iron in the EPO-stimulated erythroid progenitors, it is essential that serum ferritin and transferrin saturation levels should be maintained over 300 microg/liter and 30%, respectively. Investigators have shown that oral iron is unlikely to keep pace with the iron demand for an optimal rHuEPO response in uremics. Therefore, patients with iron deficiency will always require intravenous iron therapy. The early and prompt iron supplementation can lead to reductions in rHuEPO dose and hence cost. After the iron deficiency has been corrected or excluded, we must remember all of the possible causes of hyporesponsiveness in every rHuEPO-treated patient. As dose requirements vary, it is not clear which dose of rHuEPO causes this hyporesponsiveness. However, if the patient with iron repletion does not respond well after the induction period, the major causes blunting the response to rHuEPO should be investigated. Most factors are reversible and remediable, except resistant anemia associated with hemoglobinopathy or bone marrow fibrosis, which requires a further increase in the rHuEPO dose. By means of early detection and correction of the possible causes, the goal of increasing therapeutic efficacy can be achieved. Iron overload may lead to an enhanced risk for infection, cardiovascular complication, and cancer. Over-treatment with iron should be avoided in dialysis patients, despite the fact that the safe upper limit of serum ferritin to avoid iron overload is not clearly defined. On the other hand, functional iron deficiency may develop even when serum ferritin levels are increased. Controversy remains as to whether intravenous iron therapy can overcome this form of hyporesponsiveness in iron-overloaded patients. Moreover, a treatment option of iron supplementation is not warranted in these patients, as the potential hazards of iron overload will be worsened. We demonstrated that the mean hematocrit significantly increased from 25.1+/-0.9% to 31+/-1.2% after eight weeks of intravenous ascorbate therapy (300 mg three times a week) in 12 hemodialysis patients with serum ferritin levels of more than 500 microg/liter. The enhanced erythropoiesis paralleled with a rise in transferrin saturation (27.8+/-2.5% vs. 44.8+/-9.5%, P < 0.05) and reductions in erythrocyte zinc protoporphyrin (130+/-32 vs. 72+/-19 micromol/mol heme, P < 0.05) and monthly rHuEPO dose (24.2+/-4.5 vs. 16.8+/-3.4 x 10(3) units, P < 0.05) at the end of study. It is speculated that ascorbate supplementation not only facilitates the iron release from storage sites and its delivery to hematopoietic tissues, but also increases iron utilization in erythroid cells. Our study provides a more complete understan","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"69 ","pages":"S107-18"},"PeriodicalIF":0.0,"publicationDate":"1999-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20956292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anemia and carnitine supplementation in hemodialyzed patients. 血液透析患者贫血和肉碱补充。
Kidney international. Supplement Pub Date : 1999-03-01
J Kletzmayr, G Mayer, E Legenstein, G Heinz-Peer, T Leitha, W H Hörl, J Kovarik
{"title":"Anemia and carnitine supplementation in hemodialyzed patients.","authors":"J Kletzmayr,&nbsp;G Mayer,&nbsp;E Legenstein,&nbsp;G Heinz-Peer,&nbsp;T Leitha,&nbsp;W H Hörl,&nbsp;J Kovarik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carnitine supplementation in hemodialyzed patients was studied in a double-blinded, randomized, controlled trial in order to elucidate the effect of intravenous carnitine on renal anemia in patients treated with recombinant human erythropoietin (rHuEPO). Twenty stable hemodialysis (HD) patients received intravenous L-carnitine after each dialysis session in a dosage of 5 (N = 15) and 25 (N = 5) mg/kg, respectively, together with intravenous iron saccharate (20 mg/HD session) for four months and without iron for a further four months. Twenty patients received placebo instead of carnitine with an identical iron regimen. After a run-in phase of six months with a stable rHuEPO requirement, the rHuEPO dose was adjusted monthly when necessary to maintain target hemoglobin levels. At study entry (T0), plasma and red blood cell carnitine levels did not correlate significantly with the rHuEPO requirement. However, plasma free and total carnitine levels showed a significant negative correlation with erythrocyte survival time at T0. After four months of coadministration of intravenous iron and L-carnitine (T4), the rHuEPO requirement decreased in 8 of 19 evaluable HD patients. In these responders, the weekly rHuEPO dose was decreased significantly by 36.9+/-23.3% (183.7+/-131.7 at T0 vs. 126.6+/-127.9 U/kg/week at T4, P < 0.001). The rHuEPO requirement, however, was unchanged when all carnitine-treated patients were compared between T0 and T4 (T0: 172.0+/-118.0 vs. T4: 152.3+/-118.8 U/kg/week, P = 0.07, NS), but the erythropoietin resistance index decreased significantly in this group (T0: 16.0+/-11.0 vs. T4: 13.6+/-10.5 U/kg/week/g of hemoglobin, P < 0.02). The erythrocyte survival time was measured in five HD patients treated with iron and carnitine at T0 and T4. Two out of these patients were carnitine responders and showed an increase of erythrocyte survival time of 15 and 20%, respectively. After the withdrawal of iron supplementation, the rHuEPO requirement increased comparably in both L-carnitine- and placebo-treated patients during four more months. According to our data, L-carnitine, in addition to iron supplementation, may have an effect on erythropoietin resistance and erythrocyte survival time in HD patients. More than half of our patients, however, showed no benefit. Further studies to identify those HD patients who might have a benefit of carnitine supplementation, as well as studies concerning the optimal dosage, duration, and way of administration of carnitine supplementation and its mechanism of action, are required.</p>","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"69 ","pages":"S93-106"},"PeriodicalIF":0.0,"publicationDate":"1999-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20956291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tumor necrosis factor-alpha during continuous high-flux hemodialysis in sepsis with acute renal failure. 脓毒症合并急性肾功能衰竭患者持续高通量血液透析中的肿瘤坏死因子- α。
Kidney international. Supplement Pub Date : 1999-01-01 DOI: 10.1046/j.1523-1755.1999.07213.x
G. Lonnemann, Mikko Bechstein, S. Linnenweber, M. Burg, K. Koch
{"title":"Tumor necrosis factor-alpha during continuous high-flux hemodialysis in sepsis with acute renal failure.","authors":"G. Lonnemann, Mikko Bechstein, S. Linnenweber, M. Burg, K. Koch","doi":"10.1046/j.1523-1755.1999.07213.x","DOIUrl":"https://doi.org/10.1046/j.1523-1755.1999.07213.x","url":null,"abstract":"UNLABELLED Suppressed ex vivo endotoxin (ET)-induced production of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha), in isolated mononuclear cells (PBMCs) is associated with fatal outcome in severe sepsis. PBMCs from surviving patients, but not those from nonsurviving patients, recover their capacity to produce normal amounts of TNF-alpha. We tested the influence of two modalities of continuous renal replacement therapy (CRRT) on ex vivo-induced whole-blood production of TNF-alpha and inhibitory TNF-soluble receptor type I (TNFsRI) in 12 patients with acute renal failure and sepsis (APACHE II score 22 to 30). METHODS Standard continuous venovenous hemofiltration (CVVH; 36 liters of bicarbonate substitution fluid per day) was performed in 7 patients using polyamid hemofilters (FH66; Gambro). In an additional five patients, we performed daily 18 hours of high-flux hemodialysis (CHFD) using polysulfon F60S dialyzers (Fresenius) and 75 liters of bicarbonate dialysate using the GENIUS single-pass batch dialysis system. Samples were separated from the blood circuit as well as from the ultrafiltrate/spent dialysate lines at the start, during, and end of treatment. Whole-blood samples were incubated with 1 ng/ml of ET for three hours at 37 degrees C. Ultrafiltrate or dialysate samples were incubated with donor whole blood in the presence of ET to measure suppressing activity in ultrafiltrate and spent dialysate. RESULTS At the start of CRRT, ET-induced whole-blood TNF-alpha production was suppressed to approximately 10% of that in normal controls. During CVVH, median ET-induced TNF-alpha production increased from 0.35 ng/ml at the start to 1.2 ng/ml at three hours, but decreased to pre-CVVH levels at the end of a 24-hour period. In contrast, in patients on CHFD, the median ET-induced TNF-alpha production was 0.5 ng/ml at the start, 1.1 ng/ml at 3 hours, 1.6 ng/ml at six hours, and 1.5 ng/ml at the end of 18 hours of treatment. The ultrafiltrate obtained after three hours of CVVH did not contain suppressing activity. In CHFD, the spent dialysate as compared with fresh dialysate suppressed ET-induced TNF-alpha production in donor blood by 33% throughout the 18 hours of treatment. Whole-blood production of TNFsRI did not change significantly at any time point during CVVH or CHFD. CONCLUSION These data suggest that high-volume CHFD is superior to standard CVVH in removing a suppressing factor of proinflammatory cytokine production. As CVVH only transiently improves TNF-alpha production, it is most likely that the putative suppressing factor is removed because of saturable membrane adsorption in CVVH. In CHFD, there is a combination of adsorption and detectable diffusion into the dialysate. It remains to be shown whether a further increase in the volume of dialysate per day is able to not only improve but normalize the cytokine response and improve outcome in septic patients with acute renal failure.","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"64 1","pages":"S84-7"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91138410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 20
Klaus Thurau Festschrift. Renal Hemodynamics: Cellular and Molecular Determinants. Bavaria, September 18-21, 1997. Klaus Thurau Festschrift。肾血流动力学:细胞和分子决定因素。巴伐利亚,1997年9月18日至21日。
Kidney international. Supplement Pub Date : 1998-09-01
{"title":"Klaus Thurau Festschrift. Renal Hemodynamics: Cellular and Molecular Determinants. Bavaria, September 18-21, 1997.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":17704,"journal":{"name":"Kidney international. Supplement","volume":"67 ","pages":"S1-249"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20749851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信