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ABSTRACT: Anti-tubular basement membrane antibodies were determined by ELISA in 217 patients with different renal diseases. The assay for antibodies in serum was based on a 58 kD bovine tubular basement membrane antigen. Sera were studied from 69 patients with different forms of interstitial nephritis; 15 patients (10 women, 5 men) had anti-tubular basement membrane titers above the normal (compared with a reference group of healthy blood donors). Three patients are presented in greater detail. Thirty-four patients with pyelonephritis (confirmed by intravenous urogram) were investigated; one serum was positive. Sera from 114 patients with renal glomerular and/or vascular disease were studied; 12 had positive titers for tubular basement membrane and glomerular basement membrane or other kidney disease antibodies. This study supports the opinion that damage in the renal medulla can be caused by an autoimmune process. Circulating anti-TBM antibodies may be of value in the investigation of patients with tubulo-interstitial diseases but the cause and prognosis of this condition is, however, not known.
Clinical nephrology 05/1994; 41(4):199-204. · 1.17 Impact Factor
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ABSTRACT: This study was performed to evaluate the use of the glucose concentration versus glucose absorption in the dialysate to estimate ultrafiltration efficacy. In 26 patients (16 men, 10 women) on continuous ambulatory peritoneal dialysis, a total of 128 dwells were investigated. Each dwell lasted 5 hours, using 2 L of peritoneal dialysis fluid containing 140 mmol/L glucose. After the dwell, the removed peritoneal dialysis fluid was weighted. The concentrations of creatinine and glucose and the total amount of glucose were analyzed. The mean concentration of dialysate glucose for the whole group after a 5-hour dwell was 38.9 +/- 8.9 (SD) mmol/L. The ultrafiltration volume was inversely correlated to the glucose absorbed (r = -0.59, p = 0.002), but was not significantly correlated to the glucose concentration in the dialysate (r = 0.40, p = 0.057). The ultrafiltration volume was not related to the creatinine concentration in the dialysate or the body weight. The average dialysate glucose did not change during a one-year observation time. Patients with diabetes mellitus had significantly lower glucose absorption than nondiabetics (p = 0.045), and patients with low ultrafiltration efficacy had significantly greater glucose absorption than those with normal and high ultrafiltration (p = 0.038). There was no difference between those who had those who had not suffered from peritonitis. The results indicate that the glucose absorption from the dialysis fluid is the best parameter to calculate the peritoneal ultrafiltration efficacy and not the glucose concentration currently used.
Advances in peritoneal dialysis. Conference on Peritoneal Dialysis 02/1993; 9:62-4.
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Lakartidningen 01/1992; 88(49):4243-4.
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Clinical nephrology 01/1991; 34(6):279. · 1.17 Impact Factor
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Lakartidningen 11/1989; 86(40):3367.
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ABSTRACT: This study reports the cadmium concentration and histopathology of kidney tissue from 29 patients with clinical findings that motivated a diagnostic percutaneous kidney biopsy and/or a history of possible exposure to cadmium. Cadmium was found in all specimens examined including those from controls. In the patients, the mean cadmium concentration was 12.9 (0.6-45.0) micrograms cadmium per g wet kidney tissue. The highest concentrations (30-45 micrograms/g) were found in three patients with morphological and clinical findings of tubulo-interstitial damage. Patients with signs of tubulo-interstitial disease had higher mean cadmium concentrations than those with glomerular changes, and patients with normal blood pressure had higher concentrations than those with diastolic hypertension. In a control group of 22 autopsies, the mean cadmium concentration was 8.7 (2.9-22.4) micrograms/g. The mean difference between the right and the left kidney was 2.3 (0.9-9.6) micrograms/g. Laboratory findings in patients with cadmium nephropathy were nonspecific. Thus, in patients with interstitial nephritis and cadmium exposure, a biopsy for the analysis of kidney cadmium concentration may be motivated. The combination of morphological and clinical findings of interstitial nephritis and a high concentration of cadmium in biopsied kidney tissue indicates cadmium nephropathy.
Scandinavian Journal of Urology and Nephrology 02/1989; 23(3):213-7. · 0.99 Impact Factor
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ABSTRACT: The course of uraemia in 47 patients with renal amyloidosis has been studied. The median survival with a S-creatinine of 150 mumol/l was approximately 18 months, but 15% survived for more than 3 years. Deterioration arose often suddenly and was of unclear cause. Approximately 25% of the patients improved for a while and the reason for this temporary improvement is also unclear. The unsteady course during the uraemia period for amyloidosis patients makes prognosis calculations very much less accurate than for patients with cystic kidneys.
International Urology and Nephrology 02/1989; 21(5):555-9. · 1.47 Impact Factor
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ABSTRACT: 7 middle-aged males with bilateral, polycystic, nonfamilial kidneys without enlargement are described. The histological examination revealed multiple cysts of varying sizes and changes such as in interstitial nephritis. 6 of the patients had hematuria and/or calculi in the urinary tract. The etiology of the cysts is not clear. The picture does not conform to that of congenital cystic kidney. The cysts might possibly be a final phenomenon in contracted kidneys, so-called acquired cystic disease, but it should be noted that in 4 of the 7 cases the cystic degeneration was demonstrated log before the uremia appeared. Another possibility is that the cystic transformation described here might be attributed to a specific type of interstitial nephritis.
Nephron 02/1985; 39(2):134-40. · 13.26 Impact Factor
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ABSTRACT: Severe reactions to contrast media in two diabetic patients with azotemia are described. Both patients also showed signs of immunopathy. The reaction was fatal in one of them. Little is known about contrast media reactions and their natural history. Patients with diabetes mellitus and impaired renal function should be studied with caution and with careful consideration of the indication for the procedure. If an examination with contrast media is considered unavoidable, all diabetic patients with renal failure should be supervised closely to detect the development of acute renal failure. Dehydration should be avoided. Careful monitoring of blood glucose, serum electrolytes, serum creatinine and blood pressure will aid in the early detection of the adverse reaction.
Acta medica Scandinavica 02/1982; 212(3):179-81.
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ABSTRACT: Quantitative urinary amino acid excretion has been studied in 23 adult patients with mild phosphate diabetes (MPD), in 22 adult control patients with various renal disorders and in 15 children, 7--19 years old, with atopic disorders (normal controls). Statistically significant increases in urinary excretion of glutamine (p < 0.01), glycine (p < 0.01) and cystine (p < 0.05) were found in the MPD patients compared to the normal controls. The urinary excretion of glutamine was significantly increased while the increases in cystine and glycine excretions were non-significant when MPD patients were compared to the control patients. In addition to clinical signs and analyses of plasma and urinary phosphate, a quantitative evaluation of urinary amino acids might be a tool in the diagnosis of MPD. The significance of the increased urinary amino acid excretion in MPD is discussed.
Acta medica Scandinavica 01/1980; 207(6):489-91.
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ABSTRACT: Phosphate diabetes has been considered as rare and to occur almost exclusively in children. Upon examination of adult patients with rheumatic or kidney diseases it has, however, been found that the combination of hypophosphataemia and hyperphosphaturia is not so rare. This paper deals with 24 adult patients of this type, whom we have found during 6 months. Their mean serum phosphorus concentration was 0.7 mmol/l (range 0.5--0.8). Mean phosphate clearance was 31 ml/min/1.73 m2 (range 16--51). The diagnoses were myalgia, dorsalgia (n = 7), papillitis calcificans (n = 5), prostatitis or prostate accretions (n = 4), dizziness (n = 2), kidney stones, tubular defect, interstitial nephritis, medullary sponge kidney (1 case each), two patients had transplanted kidneys. Asthenia was a common additional diagnosis. The patients' complaints have been pain in the muscles, joints, bones (18 cases), tiredness (10 cases), dizziness (8 cases), shakyness, numbness, burning sensation (7 cases), tenderness in the muscles and bones ("the princess-on-the-pea syndrome") (7 cases). The most common findings upon examination were bone tenderness (13 cases), reduced manual power (8 cases), positive Romberg test (3 cases), slight muscle atrophy (2 cases), waddling gait (2 cases). The most common findings encountered in the laboratory, besides hypophosphataemia and hyperphosphaturia, were high pH in the urine, hyperaminoaciduria, and phosphate crystals in dried urine.
Acta medica Scandinavica 02/1978; 204(1-2):93-6.
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ABSTRACT: Cystic puncture was performed percutaneously in 18 patients with solitary renal cysts and in 22 with multiple, congenital renal cysts. With the aid of tritiated water it was possible to estimate the fluid turnover in the cysts and compare it with their volume, pressure and potassium and creatinine levels. Fluid turnover was rapid in all the renal cysts. Two to five hours after i.v. injection of tritium, the tritium concentration in cystic fluid averaged 88% of the concentration in plasma fluid in patients with polycystic kidneys and 73 percent in patients with solitary cysts. Fluid turnover was more rapid in small than in large cysts, but there was no such difference between cysts with high and low pressure. It is possible that the fluid turnover was slightly faster in cysts with high potassium and creatinine levels than in those with low levels. The results show that the fluid turnover in a renal cyst of 10 ml is considerable--probably more than 100 ml/24 hours. This indicates that fluid inflow to the cyst comes mainly from cells in the cyst wall and not from a single glomerule. Fluid probably leaves the cyst actively via cells in the cyst wall, since the fluid turnover does not increase with high cyst pressure. The fluid turnover is probably secondary to the active solute transportation, which is performed by the cyst cells. This means that these cells have a tubular cell-like function and should respond to pharmacotherapy.
Acta medica Scandinavica 02/1977; 202(4):327-9.
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Acta medica Scandinavica 02/1977; 202(1-2):51-4.
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ABSTRACT: NBT test values in blood samples from 25 cases of endemic benign (epidemic) nephropathy (EBN) were high, i.e. more than 19% NBT-positive neutrophils, in 22 (88%) of the patients, intermediate, i.e. 13-19%, in two (8%) and normal in one patient (4%); in eight patients (32%) the NBT test values were 50% or more. The test values remained elevated, i.e. 13% or more, for more than one month after the onset of illness in three of ten patients on whom serial tests were performed. Among 18 patients with kidney diseases other than EBN and 16 with kidney transplant, high NBT test values, 20 and 22%, respectively, were found in two (5.9%), intermediate values in two and normal test values in 30 patients (88.2%). This paper is the first published report on NBT test values in cases of EBN. The test was rated to be of diagnostic value in patients in whom EBN might be suspected, highly elevated test values (larger than or equal to 50% NBT-positive neutrophils) lending support to the diagnosis.
Acta medica Scandinavica 02/1976; 199(3):147-9.
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ABSTRACT: A total of 291 urine sediments from 255 patients with various renal or urinary tract diseases have been studied by phase contrast microscopy. Based upon morphological criteria, leucocytes were distinguished from renal epithelial cells and the white blood cells were classified either as mononuclear or polynuclear in 179 patients. The percentage of the different cell types varied considerably between and within the different diseases. The median values for polynuclear granulocytes were higher than 90% in bacterial renal or urinary tract disease and in polycystic kidney disease. In interstitial nephritis, nephrosclerosis and in renal transplanted patients the percentage of polynuclear granulocytes was somewhat lower, 76-85%. In diabetes, amyloidosis, tubular nephrosis (necrosis) glomerulonephritis, lupus nephritis and endemic benign nephropathy there were 14-66% polynuclear granulocytes. 29-33% mononuclear leucocytes were found in lupus nephritis and endemic benign nephropathy. The greatest proportion of renal epithelial cells was found in endemic benign nephropathy, namely 49%. 36% renal epithelial cells were found in tubular nephrosis (necrosis) and in glomerulonephritis. The technique is rapid and inexpensive. It facilitates differential diagnostics of urinary tract disease with pyuria.
Acta medica Scandinavica 01/1976; 198(6):505-9.
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Scandinavian Journal of Urology and Nephrology 02/1973; 7(2):160-4. · 0.99 Impact Factor
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Acta radiologica: diagnosis 02/1973; 14(1):106-12.
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International Urology and Nephrology 02/1972; 4(1):83-6. · 1.47 Impact Factor
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Nordisk medicin 11/1971; 86(40):1163.
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Scandinavian Journal of Clinical and Laboratory Investigation 05/1971; 27(2):135-8. · 1.38 Impact Factor
