Abstract:
:Five patients with the clinical patterns of Bartter's syndrome underwent a series of clearance studies in order to characterize the underlying tubule defect. Free water generation during maximal water diuresis (CH2O), expressed as percentage of the distal delivery (CH2O + CCl), was lower in the patients (72.5 +/- 3.2%) than in controls (84.4 +/- 5.5, p < 0.0001). During maximal water diuresis and furosemide administration (40 mg i.v. as bolus), NaCl reabsorption along the diluting nephron segments could be separated into 2 components, that occurring in the loop of Henle (DRNaHL) and that occurring in tubule segments beyond the macula densa (DRNaDT): DRNaHL was normal, while DRNaDT was reduced (3.1 +/- 0.8 vs. 6.2 +/- 2.5 ml/min in controls, p < 0.015). Thus, according to this furosemide protocol, our patients had normal solute reabsorption in the loop of Henle but reduced NaCl reabsorption in tubule segments beyond the macula densa. During 0.9% saline infusion (2 liters in 2 h, after stimulation of distal Na reabsorption with fludrocortisone) fractional excretion (FE) of K showed a linear rise with the increase of FECl-FEK, however, was much higher in the patients than in controls for every FECl level. In contrast, the infusion of Na2SO4, after fludrocortisone administration, induced similar FEK increases in patients and in controls. Thus, in these patients Na reabsorption in the distal nephron (possibly the cortical collecting tubule) was associated with the generation of a higher than normal electric potential gradient in the presence of Cl but not of another poorly reabsorbable anion, such as SO4(2-). These observations indicate that, in our patients, Henle's loop function is normal, while the collecting tubule function is abnormal. We suggest that NaCl wasting and enhanced tubular secretion of H+ and K in our patients might result from an abnormally low conductance to Cl in distal nephron site(s) where Na reabsorption is electrogenic, possibly the cortical collecting tubule. A larger than normal transtubular electric gradient would be generated by Na reabsorption, causing: (1) a direct stimulation of tubular secretion of K and H+ (leading to hypokalemia and alkalosis) and (2) inhibition of the reabsorption of Na ('trapped' into the tubular lumen by electric forces), with consequent extracellular volume contraction, hyperreninemia and hyperaldosteronism.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Colussi G,Rombolà G,Verde G,Airaghi C,Loli P,Minetti Ldoi
10.1159/000168451subject
Has Abstractpub_date
1992-01-01 00:00:00pages
229-39issue
4eissn
0250-8095issn
1421-9670journal_volume
12pub_type
杂志文章abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract::The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the co...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168491
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND/AIMS:Upregulation of transforming growth factor beta (TGF-beta)/Smad signaling has been implicated in the primary pathogenesis of renal fibrosis. The ubiquitin-proteasome pathway has an important influence on TGF-beta signaling through regulating Smad degradation. As E3 ubiquitin ligases, both Arkadia and Sm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000100518
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Growth hormone (GH) resistance in CKD is partly due to increased expression of SOCS2, a GH signaling negative regulator. In SOCS2 absence, body growth is exaggerated. However, GH overexpression in mice causes glomerulosclerosis. Accordingly, we tested whether lack of SOCS2 improves body growth, but accelerat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000508224
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:The value of neutrophil-gelatinase-associated lipocalin (NGAL), a novel biomarker in the detection of acute renal failure in children after cardiac surgery, has been highlighted in previous studies. The incidence of percutaneous coronary intervention (PCI) increases, which may possibly result in increas...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
doi:10.1159/000093961
更新日期:2006-01-01 00:00:00
abstract::Renal function and life expectancy can be improved by aggressive antihypertensive therapy in severe hypertension. However, most reports of severe hypertension and renal failure concern primary hypertensive states. 3 cases of primary renal disease, 1 glomerular, 1 obstructive and 1 of chronic pyelonephritis, are descri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166576
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Death with a functioning graft (DWF) has been reported as a major cause of graft loss after renal transplantation. It has been reported to occur in 9-30%. METHODS:From March 1976 to January 2002, a total of 1400 living donor renal transplants were performed in our center. Out of 257 reported deaths among ou...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000070864
更新日期:2003-05-01 00:00:00
abstract::The acid-base balance of 199 patients with cystic fibrosis, seen from 1987 through 1992 at the Bern Outpatient Clinic, were evaluated. Simple metabolic alkalosis was demonstrated in 16 and mixed metabolic alkalosis and respiratory acidosis in 9 patients. When compared with 10 patients with simple respiratory acidosis ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168839
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescr...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000486647
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND/AIMS:Anthropometric measures such as body mass index (BMI) and waist circumference (WC) have differential associations with incident chronic kidney disease (CKD) and mortality. We examined the associations of BMI and WC with various CKD complications. METHODS:We conducted a cross-sectional analysis of 2,853...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341862
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:We previously reported that patients with chronic kidney disease (CKD) receiving warfarin therapy and whose international normalized ratio increases to >3.0 may develop acute kidney injury (AKI) as a result of glomerular hemorrhage and formation of obstructive red blood cell (RBC) casts. We named this c...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000337918
更新日期:2012-01-01 00:00:00
abstract::Several medical inventors in Europe and North America brought the artificial kidney (hemodialysis) to practical usefulness in the late 1940s, but there were very few early successes. It was used at first for only desperate cases of acute renal failure. Renal authorities in the 'metabolic' tradition favored newly quant...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
doi:10.1159/000169117
更新日期:1997-01-01 00:00:00
abstract::Therapeutic use of D-penicillamine has been associated with a range of adverse effects. We present a patient with scleroderma, treated with D-penicillamine for 5 years, who developed severe renal failure due to rapidly progressive glomerulonephritis with both crescents and subepithelial immune deposits on renal biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169183
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND/AIMS:Few published data describe survival rates for pediatric end-stage renal disease (ESRD) patients. We aimed to describe one-year mortality rates for US pediatric ESRD patients over a 15-year period. METHODS:In this retrospective cohort study, we used the US Renal Data System database to identify period-...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000380828
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Patients with diabetic nephropathy are at high risk for further progressive renal function loss. Treatments that decrease albuminuria have been linked with renal and cardiovascular protection. However, even when taking optimal treatment, residual renal and cardiovascular risk remains high which correlates wi...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000225903
更新日期:2009-01-01 00:00:00
abstract::In general, nonrheumatic atrial fibrillation is associated with a high risk of stroke. However, its impact on stroke in the setting of chronic hemodialysis treatment is insufficiently addressed in the literature. We assessed the incidence of stroke among 430 chronic hemodialysis patients and the impact of atrial fibri...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046216
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Telomere attrition is a novel risk factor for cardiovascular disease. Studies of telomere length in relation to kidney function are limited. We explored the association of kidney function with telomere length and telomere shortening. METHODS:The Heart and Soul Study is a longitudinal study of patients with ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000343495
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Evidence using real-world data is sparse regarding the effects of oral anticoagulants (OACs) among patients with kidney disease. The aim of this study was to investigate the effects of kidney disease on ischemic stroke (IS) or systemic embolism (SE) among patients taking OAC, using large-scale real-world d...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000509567
更新日期:2020-01-01 00:00:00
abstract::Resistance to the action of PTH is encountered in chronic renal failure (CRF). This was attributed to downregulation of PTH receptor due to the state of secondary hyperparathyroidism of CRF. The present study examined whether the amount of PTH-PTH-related peptide (PTH-PTHrP) mRNA in a traditional (kidney) and a nontra...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168684
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Three million people in the United States are estimated to have chronic kidney disease (CKD). Management of these CKD patients in the outpatient primary care clinic setting has not been well studied. HYPOTHESIS:Primary care management of CKD can be assessed and opportunities for improvement can be identifie...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000066296
更新日期:2003-01-01 00:00:00
abstract::Pasteurella multocida has been reported only once previously as a cause of peritonitis in a patient undergoing chronic peritoneal dialysis. The present report describes findings associated with a case of P. multocida peritonitis in a human immunodeficiency virus (HIV)-positive patient in which renal replacement therap...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168274
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:There is a higher risk of gastrointestinal (GI) bleeding in patients treated with dabigatran versus warfarin. We analyzed the impact of renal function on the relative risk of bleeding in patients converted to dabigatran. METHODS:Patients aged ≥65 years who received anticoagulation with warfarin for a minimu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000446848
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Insufficient evidenced-based information is available for the treatment of osteoporosis in hemodialysis (HD) patients. METHODS:In 102 HD patients, bone mineral density (BMD) was measured twice 16 ± 3 months apart. In the second BMD measurement 66 of them had a femoral neck (FN) T-score <-2.5. Of these 66 pa...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000341864
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Anthropometric parameters may play a role in modulating the risk of kidney dysfunction. The aim of this study was to evaluate whether anthropometric indices and the metabolic syndrome are associated with alterations of the renal resistive index (RI) in normoalbuminuric type 2 diabetic (T2DM) patients. METHOD...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000109239
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a critical need for more noninvasive biomarkers to identify nephritis in patients with systemic lupus erythematosus (SLE). Recent studies in a model mouse and an adult SLE patient cohort suggest that anti-basement membrane antibody levels correlate well with lupus activity and kidney injury. Th...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000381965
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/AIMS:Patients on chronic hemodialysis have a high prevalence of heart disease and poor self-reported physical function. The association between structural heart disease and self-reported physical function in patients on hemodialysis is unknown. METHODS:We studied the association between elevated pulmonary a...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000431334
更新日期:2015-01-01 00:00:00
abstract::Tuberculosis associated with dialysis was studied at the Artificial Kidney Unit (AKU) in Abha, Saudi Arabia. There were 13 tuberculosis patients out of 270 patients on maintenance hemodialysis from August 1986 to July 1993, a prevalence of 4.8%. Ten (77%) were female and 3 (23%) were male, mean age of 51.23 +/- 11.62 ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169068
更新日期:1997-01-01 00:00:00
abstract::Ion-selective electrodes have been designed for determining the ionized concentration of magnesium in blood, the biologically active form of this ion. The effect of acute acidosis induced by ammonium loading on circulating and urinary magnesium was investigated in 11 volunteers. No changes in plasma total and ionized ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013342
更新日期:1998-01-01 00:00:00
abstract::Hyperlipidemia is common in patients with glomerular proteinuria. It may contribute to atherosclerotic complications and accelerate glomerular damage. Early trials of the fibric acid derivative clofibrate led to a myositis syndrome causing many nephrologists to abandon attempts at treatment of nephrotic hyperlipidemia...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,评审
doi:10.1159/000168204
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND/AIMS:HFE protein controls iron absorption and cycling, and HFE mutations influence iron status. The aim was to evaluate the effect of the HFE genotype on the need for iron and erythropoietin in Italian hemodialysis patients. METHODS:Ninety-six prevalent patients were evaluated at the time of enrolment and p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111387
更新日期:2008-01-01 00:00:00