Renal and hormonal responses were studied in a group of healthy individuals fed, in random order, for three weeks, a vegetable protein diet (N = 10), an animal protein diet (N = 10), or an animal protein diet supplemented with fiber (N = 7), all containing the same amount of total protein (chronic study). In seven additional subjects the acute renal, metabolic and hormonal response to ingestion of a meat or soya load of equivalent total protein content was investigated (acute study). In the chronic study GRF, RPF and fractional clearance of albumin and IgG were significantly higher on the animal than the vegetable protein diets (GFR: 121 +/- 4 vs. 111 +/- 4 ml/min/1.73 m2, P less than 0.001; RPF: 634 +/- 29 vs. 559 +/- 26 ml/min/1.73 m2, P less than 0.001; theta alb: 19.5 +/- 3.1 vs. 10.2 +/- 1.6 x 10(-7), P less than 0.01; theta IgG: 11.6 +/- 3.1 vs. 7.5 +/- 1.7 x 10(-7), P less than 0.05). Renal vascular resistance was lower on the animal than vegetable protein diet (82 +/- 5 vs. 97 +/- 5 mmHg/min/liter; P less than 0.001). Fiber supplementation to APD did not have any effect on the renal variables measured which were indistinguishable from APD. In the acute study, GFR and RPF both rose significantly by approximately 16% (P less than 0.005) and approximately 14% (P less than 0.05), respectively, after the meat load, while RVR fell by approximately 12% (P less than 0.05). There were no significant changes in these parameters following the soya load.(ABSTRACT TRUNCATED AT 250 WORDS)
The renal response to 100 g/1.73 m2 protein load in the form of a meat meal was studied in 19 normal subjects and 35 normoalbuminuric insulin-dependent diabetic patients (IDDs) under conditions of sustained euglycemia. The area under the glomerular filtration rate (GFR) curve rose above base line by 1,904 +/- 292 in normals and 502 +/- 237 ml/1.73 m2 in IDDs (P less than 0.01). The meat meal induced a greater increment in the area under the glucagon curve in normals (14,930 +/- 186 pg.ml-1.min-1) than in IDDs (7,227 +/- 67, P less than 0.01); similarly urinary excretion of prostaglandin E2 and 6-ketoprostaglandin F1 alpha rose by 119 and 98%, respectively, in normals but only by 2% (P less than 0.01 vs. normals) and 10% (P less than 0.01 vs. normals) in IDDs. The fractional albumin clearance rose by 102 and 251% in normals and IDDs, respectively. In five normal subjects indomethacin administration abolished the GFR, glucagon, prostaglandin, and albuminuric response to meat ingestion. Glucagon replacement under indomethacin treatment failed to restore these responses. In five diabetic patients, selected for having a flat glucagon and GFR response to a meat meal, replacement of glucagon to postprandial levels increased urinary vasodilatory prostaglandins and restored a normal GFR response. Thus in normal subjects renal vasodilatory prostaglandins appear to be the final effector of the renal hemodynamic and albuminuric response to a meat meal. The prostaglandin increase is likely to be mediated under physiological conditions by a glucagon rise, which, however, has no effect per se on renal hemodynamics.(ABSTRACT TRUNCATED AT 250 WORDS)
Phaeohyphomycosis is an infection caused by a filamentous fungus that contains
pigment melanin in its cell wall. We report two cases caused by Exophiala sp.
emphasizing the clinical variability of the disease, as well as diagnostic and
therapeutic difficulties of this opportunistic infection in immunosuppressed
patients (kidney transplant).
The effects of nadolol on renal haemodynamics and function, and on the renin-angiotensin-aldosterone system and on renal prostaglandin production were studied in eighteen cirrhotics. After 1 month of treatment, nadolol had significantly decreased cardiac output by 25% without affecting arterial pressure, renal plasma flow or renal vascular resistance. Glomerular filtration rate, filtration fraction and the proportion of the cardiac output delivered to the kidneys were significantly increased. The renin-angiotensin-aldosterone system was suppressed and urinary PGE2 excretion was slightly increased. The latter effects were not correlated with those on renal haemodynamics and function.
Defibrotide (DF) has been proposed as a new antithrombotic agent in renal transplantation. Because it was also found to increase prostacyclin synthesis, a reduction in ciclosporin (CS) nephrotoxicity could be supposed. To ascertain this hypothesis, renal function and urinary prostanoids were evaluated in four groups of rats after 10 days of oral treatment (doses in mg/kg/day): CS 50 (group A), CS 50 + DF 400 (group B), DF 400 (group C) and controls (group D). Compared to controls, creatinine clearance (CCr) was significantly lower in groups A and B (In CCr: A = 6.62 ± 0.28, B = 6.83 ± 0.24 vs. 8.17 ± 0.13 μl/min, p < 0.01), whereas it did not change in group C (8.03 ± 0.24 μl/min). The urinary excretion of prostaglandin E2 (PGE2) was significantly (p < 0.05) higher in group A (In PGE2: 3.98 ± 0.98 nmol/mol Cr) and more evidently in groups B and C (6.89 ± 0.38 and 6.01 ± 0.32 nmol/mol Cr, respectively) compared to controls (1.43 ± 0.45 nmol/mol Cr). The urinary excretion of 6-keto-PGF1α and of thromboxane B2 (TxB2) were higher only in groups A and B (In 6-keto-PGF1α and In TxB2: A = 6.45 ± 0.22 and 4.97 ± 0.20, B = 7.06 ± 0.31 and 5.43 ± 0.41 vs. group D = 5.53 ± 0.22 and 3.79 ± 0.42 nmol/mol Cr; p < 0.05). The 6-keto-PGF1α/Tx molar ratio was not significantly affected, although a trend for a reduction in the ratio was found in the treated rats. In conclusion, DF enhanced urinary prostanoid excretion in CS-treated rats but did not significantly affect renal function.
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