Beitrag zur Pathogenese des akuten Nierenversagens

Jahnecke, J; Löffler, G.; Meisch, M.; Streicher, E

doi:10.1007/bf01717433

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…The high LDH concentration and the elevation of all five isoenzymes, in serum from patients with acute renal failure, confirm our previous findings, (14) and have also been observed by others (9,29,36).…”

Section: Ldh and Isoenzymes In Serumsupporting

confidence: 92%

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Lactic Dehydrogenase in Kidney Tissue and Renal Disease

Nielsen

Kemp

Laursen

1968

Journal of Internal Medicine

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The concentration of lactic dehydrogenase (LDH) and LDH isoenzymes was determined in different zones of normal human kidneys and in sera from patients with renal diseases. The isoenzyme pattern in renal tissue was characterized by an increasing, relative concentration of the M‐subunit from the cortex to the papilla. The outer non‐glomerular cortex corticis zone presented a medulla‐like isoenzyme pattern which has not been described hitherto. This correlated well with new data on renal blood flow in this zone. Patients with chronic renal failure had normal or slightly elevated serum concentrations of LDH, and the isoenzyme pattern was inconclusive. In patients with renal traumata, serum LDH concentration was very high, but the isoenzyme pattern did not differ from the normal. In acute oliguric glomerulonephritis, serum LDH was moderately elevated, while LDH concentrations were usually very high in acute renal failure of widely different pathogenesis. In both groups, however, the isoenzyme pattern exhibited a uniform relative increase of the M‐subunit concentration. Taking into consideration new data on (a) renal blood flow in acute renal failure, and (b) adaptation of LDH synthesis to varying oxygen tension, the hypothesis is advanced that the isoenzyme pattern reflects an altered synthesis of LDH in the kidneys as an adaptive response to hypoxia in the initial phase of acute renal failure.

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Section: Ldh and Isoenzymes In Serumsupporting

confidence: 92%

“…LDH was not correlated to the degree of azotaemia. Jahnecke et al (9) did not detect any rise of LDH.…”

Section: Ldh and Isoenzymes In Serummentioning

confidence: 84%

Lactic Dehydrogenase in Kidney Tissue and Renal Disease

Nielsen

Kemp

Laursen

1968

Journal of Internal Medicine

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“…other than glycolysis and respiration. -It has been observed that the activity of LDH in serum is increased in some renal diseases, and it has been suggested that this increase is due to release of LDH from the kidney (7,8,34). One would expect under these circumstances, the LDH-isoenzyme pattern of the serum to reflect to some extent the pattern which is characteristic for the part of the nephron in which the lesion occurs.…”

Section: Fig 1 Ldh-electropherograms Of the Human Kidneymentioning

confidence: 94%

“…RINGOIR reported on a few cases in which LDH-5 was indeed increased in homogenates from kidney cortex, but in our opinion this was not enough to justify the statement that the increase in serum was due to release from the kidney. JAHNECKE et al (34) believe that LDH is released from the kidney during acute renal failure of different causes and report that the "kidney specific" LDH-isoenzyme pattern is reflected in the serum. Their LDH-isoenzyme pattern is in disagreement with most of the data published, including the present study.…”

Section: Fig 1 Ldh-electropherograms Of the Human Kidneymentioning

confidence: 98%

The Isoenzymes of Lactate Dehydrogenase in the Nephton of the Healthy Human Kidney

Thiele¹,

Mattenheimer²

1968

Clinical Chemistry and Laboratory Medicine

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Die Isoenzymmuster der LDH wurden in mikrosezierten anatomischen und f unktionellen Einheiten des Nephrons der gesunden Mehschenniere bestimmt. In denGlomeruli war die Aktivität von LDH-2 undLDH-5 niedrig, während die anderen Fraktionen wesentlich stärker und ungefähr gleich aktiv waren. In den gewundenen Harnkanälchen und in den Medullarstrahlen warLDH-1 die aktivste Fraktion, gefolgt von LDH-2, während nur wenig LDH-3 und fast keine Aktivität von LDH-4 und LDH-5 gefunden wurde. Zur Papille hin nahm die Aktivität von LDH-1 und LDH-2 ab, während LDH-3 und LDH-4 stärker hervortraten. Auch LDH^S nahm zu, jedoch war der höchste Einzel wert in der äußersten Spitze der Papille nur 19% der Gesamt-LDH-Aktivität. In der Menschenniere besteht kein direkter Zusammenhang zwischen Stoffwechseltyp, respiratorisch oder glykolytisch, und den LDHIsoenzymmustern. Der insgesamt niedrige Prozentsatz der LDH-5 in der Menschenniere ist bemerkenswert, und es ist schwer verständlich, daß andere Autoren bei bestimmten Nierenerkrankungen einen Anstieg der LDH-5, deren Ursprung sie in der Niere glauben, im Serum fanden.Isoenzyme patterns of LDH have been determined in micro dissected anatomical and functional units of the nephron of the healthy human kidney. In glomeruli the activities of LDH-2 and LDH-5 were low, while the other fractions were considerably more and about equally active. In convoluted tubules and medullary rays LDH-1 was the most active fraction, followed by LDH-2. There was little activity of LDH-3 and almost no activity of LDH-4 and LDH-5. Towards the papilla the activity of LDH-1 and LDH-2 decreased, while LDH-3 and LDH-4 became increasingly prominent. LDH-5 also increased, but the highest single value in the very tip of the papilla was only 19% of the total LDH activity. There ist no strict relation between the LDH-isoenzyme patterns and the type of metabolism, respiratory or glycolytic, in the human kidney. The overall low percentage of LDH-5 in the human kidney is remarkable, and makes it difficult to understand the results of other authors who found that in certain kidney diseases the activity of LDH-5, which they believe to originate from the kidney, is increased in serum.The presence of four or five isoenzymes of LDH 3 ) in the kidney and differences in blood flow, oxygen supply the human kidney has been demonstrated by several and oxygen consumption in the various areas lead one authors. While LDH-1 and/or LDH-2 were found to be to expect differences in the isoenzyme patterns in the predominant in most investigations (1-8) WIEME and structurally and functionally different parts of the MAERCKE (9) reported the lowest activities in these nephron. fractions and about equal activities in WIELAND et al. (1) and RICHTERICH et al. (5) found no and LDH-5. The very complex anatomical structure of differences in the LDH-isoenzyme patterns between cortex and medulla of the human kidney, but a separation | 1) Supported by Grant HE 03912, HE 05529 and 5-K3-GM-15, i n j ust these two areas is very coarse and does not take ...

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Alterations in Serum Enzymes in Chronic Renal Failure

Bailey¹,

Katz²,

Hampers³

et al. 1970

JAMA

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A lthough numerous biochemical /\ alterations have been de-X JL scribed in chronic renal fail¬ ure, the clinical significance of many of these variations and their role in the pathophysiology of uremia remain unknown. During the past few years, we have noted a remarkable tendency for eleva¬ tions in serum lactic dehydrogenase (LDH) levels to occur in patients with far-advanced renal insuffici¬ ency. This finding has often led to costly investigations of its origin but only in a few cases could a causative factor be elucidated. It is the purpose of this communica¬ tion to report the frequency of ab¬ normal activity of several serum enzymes in uremic patients and to delve into its possible etiology. Materials and Methods Hospital charts of 76 patients with far-advanced chronic renal failure (endogenous creatinine clearance less than 5 ml/minute) admitted to the Peter Bent Brigham Hospital, Boston, during the past five years (through 1968) were reviewed. The patients were divided into four groups according to the type of treatment they received: (a) conservative management; (b) hemodialysis; (c) hemodialysis after bilateral nephrectomy; and (d) hemodialysis after kidney transplantation. In the majority, observations in each of the four categories are available, as the pa¬ tients belonged to all the groups in succession in the course of their management. There were 58 males and 18 females, aged 15 to 82 years in this group. The effect of hemo¬ dialysis with both the twin coil and the Kiil dialyzer on serum enzymes was evaluated in paired predialysis and postdialysis samples, in 17 and 8 patients, respectively. Lactic dehydrogenase levels were determined with automatic chem¬ ical analysis according to the meth¬ od of Morganstern et al.1 Glutamic oxaloacetic transaminase (GOT) was measured by reacting the dialyzed oxalic acid produced by the enzyme with the diazonium salt of N butyl -14-methoxymetanilamide as described by Morgenstern et al,2 and the amylase levels by the stable starch method of Caraway.3 Upper limits of normal values for these enzymes in our laboratory are: LDH, 231 Wacker units at 37 C; GOT, 33 Henry units; and amylase, 120 Somogyi units. Statistical sig¬ nificance was determined with the Student's t test and in the predialysis and postdialysis samples with the paired t test. ResultsSerum LDH activity was deter¬ mined 486 times and was increased in 77% of the determinations (Fig 1). Only 10.2% of the raised values could be explained by a concurrent condition known to elevate LDH levels, mainly liver disease, septi¬ cemia, and pulmonary infarction. Uremic patients who did not have dialysis had a significantly higher value (376 units ±19 SE) than patients maintained by hemodialy¬ sis (317 units ± 12 SE; P <0.05) (Fig 2), and there was a correla¬ tion (r = 0.348; P0.01) between the levels of LDH and blood urea nitrogen (BUN) in patients who did not undergo dialysis. Bilateral nephrectomy did not affect the LDH levels. Posttransplant values, although elevated, did not correlate with the level of posttran...

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Beitrag zur Pathogenese des akuten Nierenversagens

Cited by 6 publications

References 21 publications

Lactic Dehydrogenase in Kidney Tissue and Renal Disease

Lactic Dehydrogenase in Kidney Tissue and Renal Disease

The Isoenzymes of Lactate Dehydrogenase in the Nephton of the Healthy Human Kidney

Alterations in Serum Enzymes in Chronic Renal Failure

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