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Armstrong V, Buschmann U, Ebert R, Fuchs C, Rieger J, Scheler F. Biochemical investigations of CAPD: Plasma levels of trace elements and amino acids and impaired glucose tolerance during the course of treatment. Int J Artif Organs 2020. [DOI: 10.1177/039139888000300412] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Investigations have been initiated into the effect of CAPD on the plasma concentrations of trace elements and amino acids, and in particular the response of patients to an oral glucose tolerance test (OGTT) during the course of treatment. Six months CAPD had no effect on the plasma concentrations of aluminium, fluoride, zinc and copper. Levels of aluminium and fluoride were above the normal range. Loss of amino acids in the dialysate correlated with their plasma concentrations. No changes were observed in the E/NE, Val/Gly or Tyr/Phe ratios during nine months treatment. Five CAPD patients demonstrated an impaired glucose tolerance in response to an OGTT after one month of treatment and a further deterioration occurred in the glucose tolerance of three patients after another six months CAPD. In a preliminary investigation with fructose substituted for glucose in the dialysate of one patient, an improvement in the OGTT and rate of insulin secretion was observed after 3 days dialysis against fructose.
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Affiliation(s)
- V.W. Armstrong
- University Medical Clinic Göttingen, Federal Republic of Germany
| | - U. Buschmann
- University Medical Clinic Göttingen, Federal Republic of Germany
| | - R. Ebert
- University Medical Clinic Göttingen, Federal Republic of Germany
| | - C. Fuchs
- University Medical Clinic Göttingen, Federal Republic of Germany
| | - J. Rieger
- University Medical Clinic Göttingen, Federal Republic of Germany
| | - F. Scheler
- University Medical Clinic Göttingen, Federal Republic of Germany
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2
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Mínguez-Bacho I, Scheler F, Büttner P, Bley K, Vogel N, Bachmann J. Ordered nanopore arrays with large interpore distances via one-step anodization. Nanoscale 2018; 10:8385-8390. [PMID: 29696279 PMCID: PMC5944388 DOI: 10.1039/c8nr02215a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 03/28/2018] [Indexed: 06/01/2023]
Abstract
Preparation of pre-patterned alumina substrates using bottom-up techniques compatible with nanotechnology applications is still a challenge. We present a novel methodology to achieve superior order in 'anodic' alumina with large interpore distances by a convenient one-step anodization process. The use of transparent insulators renders such anodic layers applicable as templates for nanostructured photovoltaic or photoelectrochemical devices.
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Affiliation(s)
- I. Mínguez-Bacho
- Department of Chemistry and Pharmacy , Friedrich-Alexander University of Erlangen-Nürnberg , Egerlandstr. 1 , 91058 Erlangen , Germany .
| | - F. Scheler
- Department of Chemistry and Pharmacy , Friedrich-Alexander University of Erlangen-Nürnberg , Egerlandstr. 1 , 91058 Erlangen , Germany .
| | - P. Büttner
- Department of Chemistry and Pharmacy , Friedrich-Alexander University of Erlangen-Nürnberg , Egerlandstr. 1 , 91058 Erlangen , Germany .
| | - K. Bley
- Institute of Particle Technology , Friedrich-Alexander University of Erlangen-Nürnberg , Haberstr. 9a , 91058 Erlangen , Germany .
| | - N. Vogel
- Institute of Particle Technology , Friedrich-Alexander University of Erlangen-Nürnberg , Haberstr. 9a , 91058 Erlangen , Germany .
| | - J. Bachmann
- Department of Chemistry and Pharmacy , Friedrich-Alexander University of Erlangen-Nürnberg , Egerlandstr. 1 , 91058 Erlangen , Germany .
- Institute of Chemistry , Saint Petersburg State University , 26 Universitetskii Prospect , Saint Petersburg , Petergof 198504 , Russia
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3
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Weber MH, Rothkegel S, Verwiebe R, Tewes C, Scheler F. Urinary protein patterns in diabetic nephropathy. Contrib Nephrol 2015; 73:30-42; discussion 42-4. [PMID: 2689096 DOI: 10.1159/000417377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M H Weber
- Zentrum Innere Medizin der Universität Göttingen, BRD
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4
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Fuchs C, Armstrong VW, Quellhorst E, Scheler F. Prophylaxis and methods for early recognition of aluminium intoxication. Contrib Nephrol 2015; 38:81-94. [PMID: 6713903 DOI: 10.1159/000408070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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5
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Reichel W, Wolfrum D, Weber M, Scheler F, Neuhoff V. Proteinuria and distribution of fibrinogen split products in various forms of glomerulonephritis. Contrib Nephrol 2015; 1:109-18. [PMID: 1235084 DOI: 10.1159/000398236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The microelectrophoresis on gradient gels allows differentiation between the different types of proteinuria in 1 h in a one-step procedure. Due to their different molecular weights and forms, fibrinogen split products are separated by this method. The determination of fibrinogen split products not only offers a possibility for dicrimination between the various forms of glomerulonephritis but also offers a possibility for following the course of the disease.
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Verwiebe R, Weber MH, Kallerhoff M, Ruschitzka F, Warneke G, Scheler F. Differentiation between renal and postrenal type of hematuria and proteinuria measuring urinary apolipoprotein A1 excretion. Contrib Nephrol 2015; 101:151-7. [PMID: 8467669 DOI: 10.1159/000422124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- R Verwiebe
- University of Göttingen, Department of Nephrology and Rheumatology, FRG
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Affiliation(s)
- M H Weber
- University of Göttingen, Department of Nephrology, FRG
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Ruschitzka F, Schrader J, Lüders S, Schulz E, Gronau C, Talartschik J, Eisenhauer T, Verwiebe R, Warneke G, Scheler F. Effects of endothelin on coagulation, prostaglandins and hemodynamics. Contrib Nephrol 2015; 101:30-6. [PMID: 8467685 DOI: 10.1159/000422104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- F Ruschitzka
- Department of Nephrology and Rheumatology, University of Göttingen, FRG
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Matthaei D, Kramer P, Grieben K, Schrader J, Ansorg R, Scheler F. Advantages of continuous arteriovenous hemofiltration in the management of acute renal failure. Contrib Nephrol 2015; 32:175-80. [PMID: 7128155 DOI: 10.1159/000406921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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10
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Armstrong VW, Fuchs C, Klüver H, Nussbaumer D, Perl H, Rieger J, Scheler F. A synthetic resorcinol-formaldehyde resin for the absorption of urea from hemofiltrate. Contrib Nephrol 2015; 32:181-5. [PMID: 7128156 DOI: 10.1159/000406922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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11
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Böhler J, Kramer P, Götze O, Schwartz P, Scheler F. Leucocyte counts and complement activation during pump-driven and arteriovenous haemofiltration. Contrib Nephrol 2015; 36:15-25. [PMID: 6839771 DOI: 10.1159/000407576] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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12
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13
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14
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Scheler F. [1996 Drug Prescription Report. Reflection of medical treatment]. Internist (Berl) 1997; 38:88-91. [PMID: 9119666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- F Scheler
- Medizinische Universitätsklinik, Göttingen
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15
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Scheler F. [Comment on the interview with R. F. Schmidt and G. Thews. Clinical principles and medical decision making]. Internist (Berl) 1995; 36:1018. [PMID: 7499068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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16
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Scheler F. [Effective and safe drugs. A constant challenge]. Internist (Berl) 1995; 36:511-5. [PMID: 7601624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- F Scheler
- Abteilung Nephrologie/Rheumatologie, Medizinische Universitäts-klinik, Göttingen
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17
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Abstract
Lipid peroxidation products, both lipid hydroperoxides and thiobarbituric acid reactive substances (TBARS) were determined in the plasma of 31 uremic patients treated with maintenance hemodialysis. Whereas patients had significantly elevated TBARS compared to 93 healthy controls (4.25 +/- 1.53 vs. 1.66 +/- 0.50 mumol/l; p < 0.01) lipid hydroperoxides were not detected in the plasma of patients before dialysis. After hemodialysis, a slight increase in TBARS was observed (4.50 +/- 1.97 mumol/l, p > 0.01). However, when the TBARS were corrected for hemoconcentration by relating TBARS to the plasma cholesterol concentrations a statistically significant decrease of TBARS was observed (1.02 +/- 0.63 mumol TBARS/mmol cholesterol vs. 0.84 +/- 0.60 mumol TBARS/mmol cholesterol; p < 0.01) after 240 min of hemodialysis. There was no evidence for the formation of plasma lipid hydroperoxides in the extracorporeal circulation. It is therefore suggested that elevated TBARS in chronic renal failure are not caused by the dialysis therapy.
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Affiliation(s)
- V Schettler
- Department of Clinical Chemistry, University Hospital, Georg-August-Universität, Göttingen, FRG
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18
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Scheler F, Verwiebe R. [Classification, mode of action and side effects of analgesics]. Internist (Berl) 1994; 35:8-19. [PMID: 7908280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- F Scheler
- Medizinische Universitätsklinik, Universität Göttingen
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Funke M, Mäurer J, Grabbe E, Scheler F. [Comparative studies with quantitative computed tomography and dual-energy x-ray absorptiometry on bone density in renal osteopathy]. ROFO-FORTSCHR RONTG 1992; 157:145-9. [PMID: 1515623 DOI: 10.1055/s-2008-1032987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Measurements of bone density were carried out in 25 patients on dialysis for terminal renal insufficiency, using quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA). Unlike in subjects with normal kidneys, there was no significant correlation between these methods in this series. Ten patients showed an increase in bone density of the vertebral spongiosa on QCT measurements, which was interpreted as due to osteosclerotic bone changes in renal osteopathy. QCT showed advantages over DXA in demonstrating these changes.
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Affiliation(s)
- M Funke
- Abteilung Röntgendiagnostik I, Georg-August-Universität Göttingen
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20
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Weber MH, Ammon A, Oppermann M, von Rothkirch T, Scheler F. [Panhypogammaglobulinemia: a rare complication of parenteral gold therapy]. Z Rheumatol 1991; 50:207-10. [PMID: 1746169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Secondary antibody deficiency is one of the rare adverse effects of chrysotherapy in rheumatoid arthritis. The plasma levels of all immunoglobulins fall into ranges significantly lower than the tolerable physiological minimum. The long-lasting panhypogammaglobulinemia can increase the risk of infection in the patient and, therefore, should be closely monitored. Hence, a record of immunoglobulin levels before and during therapy with gold compounds seems to be mandatory.
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Affiliation(s)
- M H Weber
- Zentrum Innere Medizin, Abt. Nephrologie und Rheumatologie, Georg-August-Universität, Göttingen
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21
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Kallerhoff M, Müller-Siegel K, Verwiebe R, Weber MH, Wassmann K, Blech M, Scheler F, Ringert RH. [Localization and extent of tissue damage caused by extracorporeal lithotripsy (ESWL)]. Urologe A 1991; 30:85-8. [PMID: 1711730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Extracorporeal shock wave lithotripsy (ESWL) causes proteinuria. In our study we investigated the protein fractions and the electrolyte composition of the urine in patients who had been treated with ESWL. The aim was to obtain information on the degree and the localisation of the glomerular, tubular or vascular destruction caused by ESWL in humans. A total of 34 patients with stones had been treated with ESWL. As parameters we used: urine output, creatinine clearance, total protein, albumin, immunoglobulin G, N-acetyl-beta-D-glucosaminidase (beta-NAG), alpha-1-microglobulin, the fractional excretion of Na+ and apolipoprotein-A-1. After ESWL treatment proteinuria and albuminuria are found. Our parameters show no deterioration of the glomerula or the tubulus. The increase in apolipoprotein-A-1, a postglomerular parameter, however, is interpreted as a manifestation of vascular destruction after ESWL; this is normally temporary, leaving no permanent damage.
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Affiliation(s)
- M Kallerhoff
- Urologische Klinik und Poliklinik, Georg-August-Universität Göttingen
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22
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Schrader J, Schoel G, Scheler F. [The significance of 24-hour blood pressure monitoring in the diagnosis and therapy of arterial hypertension]. Klin Wochenschr 1990; 68:1119-26. [PMID: 2280576 DOI: 10.1007/bf01798062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of ABPM allows an improved assessment of blood pressure (BP) and therefore of the individual cardiovascular risk. It is able to identify patients who truly need therapy more exactly. Mostly patients with white coat hypertension who don't need therapy are identified. Furthermore, ABPM correlates more closely to target organ damage and to cardiovascular morbidity and mortality. This may be helpful to treat especially those patients who truly need therapy. BP exhibits a typical circadian rhythm with the highest values during the early morning hours and a decline during the night. A change of the day/night rhythm during shift work leads to an adaptation of BP rhythm. The early morning rise of BP and heart rate is accompanied by hemodynamic, rheological and biochemical alterations, which together may contribute to the increased frequency of vascular complications during the morning hours. The nightly decline of BP is often absent in patients with secondary hypertension and cardiac or renal organ damage. A lack of the nocturnal BP decline should therefore lead to further patients' evaluation. Elevated nocturnal BP seems to worsen the prognosis. ABPM offers better individual control of BP in patients on treatment and therefore is helpful to optimize the treatment. A more exact individual BP control during the awakening and sleeping period is possible as well as an avoidance of overtreatment. Patients could be protected both from prescription of too many drugs and from lowering BP too much. A further advantage lies in an improved control of patients with nocturnal hypertension.
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Affiliation(s)
- J Schrader
- Abteilung für Nephrologie und Rheumatologie, Medizinische Universitätsklinik Göttingen
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23
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Scheler F. [Evaluation of blood pressure in stress]. Internist (Berl) 1990; 31:723. [PMID: 2289860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F Scheler
- Abteilung Nephrologie und Rheumatologie, Universität Göttingen, Bundesrepublik Deutschland
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Schrader J, Schoel G, Buhr-Schinner H, Kandt M, Warneke G, Armstrong VW, Scheler F. Comparison of the antihypertensive efficiency of nitrendipine, metoprolol, mepindolol and enalapril using ambulatory 24-hour blood pressure monitoring. Am J Cardiol 1990; 66:967-72. [PMID: 2220621 DOI: 10.1016/0002-9149(90)90935-t] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In a randomized 6-month study of 201 patients, the antihypertensive efficiency of the calcium antagonist nitrendipine, the beta 1-selective blocker metoprolol, mepindolol, the beta blocker with intrinsic activity and the angiotensin-converting enzyme inhibitor enalapril were compared as monitored by 24-hour ambulatory blood pressure (BP) measurements. The study was designed so that a comparable decrease in casual BP values was obtained with all 4 drugs. If normotension was not achieved with monotherapy, a diuretic also was administered. Pretreatment casual BP and mean 24-hour ambulatory BP values did not differ between the 4 groups. Normotension as assessed by casual BP measurements was observed in all 4 groups after 6 months of therapy, there being no significant differences between the groups. However, significantly more diuretics were required in the mepindolol (n = 14) and in the enalapril (n = 20) groups compared to the nitrendipine (n = 5) and metoprolol (n = 7) groups. Despite comparable casual BP control, the 4 groups differed significantly in their mean 24-hour measurements. The greatest systolic and diastolic BP decreases were seen in the metoprolol group. Metoprolol was also the most effective drug in decreasing the frequency of systolic pressure peaks greater than 180 mm Hg. Both beta blockers and enalapril significantly decreased the morning BP increase compared to the values before treatment, while nitrendipine did not. These data show that casual BP measurement is not a good predictor of 24-hour BP in patients taking hypertensive therapy. Despite an equal degree of "office" BP control, different antihypertensive regimens do not confer the same degree of "nonoffice" BP control.
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Affiliation(s)
- J Schrader
- University of Goettingen, Department of Nephrology, West Germany
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25
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Schrader J, Scheler F. [Circadian changes in blood pressure and therapeutic consequences]. Internist (Berl) 1990; 31:662-8. [PMID: 2283211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- J Schrader
- Abteilung für Nephrologie und Rheumatologie, Medizinische Universitätsklinik, Göttingen
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Schrader J, Andersson LO, Armstrong VW, Kundt M, Stibbe W, Scheler F. Lipolytic effects of heparin and low molecular weight heparin and their importance in hemodialysis. Semin Thromb Hemost 1990; 16 Suppl:41-5. [PMID: 1962903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence and the degree of uremic hypertriglyceridemia in a hemodialysis population are exacerbated by the use of UF heparin as anticoagulant therapy. This hypertriglyceridemia is associated with an increase in the levels of triglyceride-rich remnant particles that are thought to be particularly atherogenic. Since arteriosclerosis and its related diseases are the major causes of morbidity and mortality in this dialysis population, the LMW heparins with their reduced stimulation of plasma lipolytic activity may provide a clinically superior alternative to UF heparin for anticoagulation therapy in long-term hemodialysis. One may also speculate that it may be more advantageous to use LMW heparin for all long-term treatments with heparin.
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Affiliation(s)
- J Schrader
- Department of Nephrology, University Clinic, Göttingen, FRG
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Rumpf KW, Quentin E, Janning G, Krone B, Pfautsch C, Scheler F, Thomssen R. [Hantaan virus infection--also in Germany a cause of acute renal failure]. Med Klin (Munich) 1990; 85 Suppl 1:156-8. [PMID: 1971417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- K W Rumpf
- Abteilung Nephrologie und Rheumatologie, Medizinischen Klinik, Universitätsklinik, Göttingen
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Talartschik J, Eisenhauer T, Schrader J, Schoel G, Buhr-Schinner H, Scheler F. Low atrial natriuretic peptide plasma concentrations in 100 patients with essential hypertension. Am J Hypertens 1990; 3:45-7. [PMID: 2137343 DOI: 10.1093/ajh/3.1.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Although atrial natriuretic peptide (ANP) plays a key role in electrolyte and volume regulation and causes direct vasorelaxation, controversial results have been reported in hypertensive patients. We studied 58 men and 42 women, aged 19 to 78 years, with essential hypertension (blood pressure: 150 to 210/95 to 110 mm Hg) using 24 h blood pressure recording, treadmill exercise and x-ray of the chest. In 70 patients ANP plasma concentrations were found to be completely within the normal range of healthy controls (17 to 38 fmol/mL; n = 50) and 52% were detected within the lower third or even below the normal range. In mild to moderate essential hypertension a diminished secretion of ANP may be responsible for an elevated blood pressure in these patients.
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Affiliation(s)
- J Talartschik
- Department of Nephrology, University Clinic, Göttingen, West Germany
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Schrader J, Stibbe W, Kandt M, Warneke G, Armstrong V, Müller HJ, Scheler F. Low molecular weight heparin versus standard heparin. A long-term study in hemodialysis and hemofiltration patients. ASAIO Trans 1990; 36:28-32. [PMID: 2155017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The influence of low molecular weight (LMW) heparin (Braun 21-23, Mulsungen, West Germany) and unfractionated standard heparin (SH) on blood clotting and other routine laboratory parameters was investigated in a 30 week cross-over study in 30 hemodialysis patients. The LMW heparin dose necessary (anti FXa-activity) for effective anticoagulation was two thirds of the standard heparin dose. Using these doses, both substances displayed identical antithrombotic effects. Complications were not seen in either group. PTT and thrombin time were only marginally effected by LMW heparin, whereas they were markedly prolonged by SH heparin. Factor VIII activity was significantly lower in the LMW heparin group as compared to the standard heparin group after 18, 24, and 30 weeks. Antithrombin III, fibrinogen, fibrin monomers, plasminogen, and alpha 2-antiplasmin were comparable in both groups. Creatinine, urea, hemoglobin, and hematocrit were also unchanged, excluding differences in dialysis efficacy or occult blood loss. Equal numbers of blood transfusions were necessary, but bleeding complications did not occur in either group. In conclusion, safe and effective dialysis can be performed using this low molecular weight heparin for anticoagulation in hemodialysis and hemofiltration. The possible benefits of LMW heparin (reduced frequency of bleeding, alleviation of hypertriglyceridemia) were not, however, apparent, possibly because of the short observation period and the low incidence of hemorrhagic complications in routine dialyses.
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Affiliation(s)
- J Schrader
- Department of Nephrology, Medical University Hospital Göttingen, West Germany
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Schrader J, Schuster S, Schoel G, Buhr-Schinner H, Warneke G, Kandt M, Haupt A, Scheler F. [24-hour blood pressure behavior in patients with untreated and treated hypertension in comparison with normotensive patients]. Z Kardiol 1989; 78:804-10. [PMID: 2560289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Blood pressure was continuously monitored over 24 h in 201 patients with mild to moderate essential hypertension using a noninvasive method. Measurements were made both before and after 6 months of antihypertensive treatment and the data were compared to results from 100 normotensive patients. The frequency with which blood pressure values above 140/90 mm Hg occurred during the 24-h period proved to be the most reliable parameter for distinguishing between hypertensive and normotensive profiles. The blood pressures of all patients could be normalized (less than 140/90 mm Hg) on single or combined drug therapy as assessed by casual measurement. However, significant differences were observed between the 24-h profiles of the treated patients and the control group. The mean 24-h blood pressure, the mean day and nighttime blood pressures, the mean hourly pressure, and the frequency of increased blood pressure values were all significantly higher in the patients on medication as compared to the normotensive controls. This would suggest that normotension, as defined by the control group, cannot be attained with antihypertensive medication. In conclusion, 24-h continuous blood pressure monitoring allows a better evaluation of blood pressure profiles and consequently, will be of greater value in assessing cardiovascular risk than occasional random measurements.
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Affiliation(s)
- J Schrader
- Medizinische Universitätsklinik Göttingen, Abt. Nephrologie und Rheumatologie
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31
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Henning HV, Meinhold J, Eisenhauer T, Scheler F, Gröne HJ. [Chronic interstitial nephritis after treatment with 5-aminosalicylic acid]. Dtsch Med Wochenschr 1989; 114:1091. [PMID: 2737099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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32
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Schrader I, Person C, Pfertner U, Buhr-Schinner H, Schoel G, Warneke G, Haupt A, Scheler F. [Absence of nocturnal decrease in blood pressure in 24-hour blood pressure monitoring: an indication of secondary hypertension]. Klin Wochenschr 1989; 67:659-65. [PMID: 2666727 DOI: 10.1007/bf01718026] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Non invasive 24 hours ambulatory blood pressure monitoring was performed in 81 patients with secondary hypertension (renoparenchymatous nephropathy n = 15, diabetic nephropathy n = 10, Conn's disease n = 4, renal artery stenosis n = 15, pheochromocytoma n = 2, hemodialysis patients n = 15 and patients after kidney transplantation n = 20). The results were compared to 201 patients with essential hypertension. The results showed that 98.5% of patients with essential hypertension have a nightly decline in blood pressure of at least 15 mmHg (systolic + diastolic), whereas 69% of patients with secondary hypertension showed either an attenuated circadian rhythm or no circadian rhythm. Patients with pheochromocytoma who had a night time increase in blood pressure demonstrated the greatest difference to the essential hypertension collective followed by patients with diabetic nephropathy, Conn's disease and the group of patients after kidney transplantation. After successful treatment of the condition leading to hypertension circadian periodicity returned in some patients. In summary these results suggest that the absence of a night time decline in blood pressure during 24-hour-ambulatory monitoring is an indication of secondary hypertension.
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Affiliation(s)
- I Schrader
- Abteilung für Nephrologie und Rheumatologie, Medizinische Universitätsklinik Göttingen
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33
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Meinhold J, Eisenhauer T, Scheler F. [Diabetic glomerulopathy]. Internist (Berl) 1989; 30:168-79. [PMID: 2654059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J Meinhold
- Abteilung für Nephrologie und Rheumatologie, Zentrum Innere Medizin, Universitätsklinik Göttingen
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34
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Schrader J, Warneke G, Kandt M, Isemer FK, Scheler F. Results of antithrombin III treatment in patients after kidney transplantation. Nephron Clin Pract 1989; 52:192-3. [PMID: 2662044 DOI: 10.1159/000185634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- J Schrader
- Department of Nephrology, Medical University Hospital, Göttingen, FRG
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35
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Weber MH, Reetze P, Neumann F, Warneke G, Scheler F. Influence of CAPD and residual diuresis on the serum levels of alpha-1-microglobulin in end-stage renal disease. Nephron Clin Pract 1989; 51:367-9. [PMID: 2465498 DOI: 10.1159/000185324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The chronic retention of proteins of low molecular weight (LMWP) seems to be connected with some unsolved problems of end-stage renal disease (e.g. reduced immune function, AB amyloidosis, hormonal imbalances), irrespective of the type of renal replacement therapy. Therefore, several recently discovered LMWPs such as alpha 1-microglobulin have to be evaluated concerning their contribution to the uremic syndrome. Although we observed a considerable daily loss of total protein into the CAPD dialysate, no differences were found in the removal of small proteins (MW less than 68 kilodaltons) when compared to conventional hemodialysis. Maintenance of renal function (residual diuresis greater than 100 ml/day) seems to be more potent keeping the serum concentrations of LMWP low than CAPD or hemodialysis.
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Affiliation(s)
- M H Weber
- University Medical Center, Department of Nephrology and Rheumatology, Göttingen, FRG
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36
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Eisenhauer T, Talartschik J, Hartmann H, Quentin E, Scheler F. [Loss of renal functional reserve following kidney transplantation and in patients with advanced disorders of liver function]. Klin Wochenschr 1988; 66:946-52. [PMID: 3054278 DOI: 10.1007/bf01728959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Renal functional reserve capacity was evaluated in healthy controls, kidney transplant recipients and patients with impaired liver function by simultaneous measurements of periodic clearances of inulin, PAH and creatinine every 30 minutes before, during and after infusion of an amino acid (AA) solution. During AA infusion glomerular filtration rate rose in 10 healthy controls to about 35% above basal values (inulin clearance from 107 +/- 6 to 144 +/- 7 ml/min, p less than or equal to 0.0005), renal plasma flow increased by 27% (PAH clearance from 530 +/- 25 to 675 +/- 40 ml/min, p less than or equal to 0.002). 8 renal transplant recipients with good and stable renal function (creatinine clearance above 65 ml/min) showed no rise in GFR and RPF, as did 10 patients with severe impairment of liver function and normal basal kidney function (creatinine clearance above 100 ml/min). The lack of renal functional reserve in kidney transplant recipients might indicate a hyperfiltration of the transplanted kidney. This could affect the longtime prognosis of these patients. The liver seems to play a role in the mediation of the amino acid-induced rise of GFR, supporting the hypothesis of a putative liver hormone regulating GFR after protein ingestion or AA infusion.
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Affiliation(s)
- T Eisenhauer
- Abteilung Nephrologie und Rheumatologie, Universitätsklinik Göttingen
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37
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Schrader J, Schoel G, Buhr-Schinner H, Warneke G, Kandt M, Haupt A, Scheler F. [Ambulatory continuous 24-hour blood pressure monitoring in the diagnosis and therapy of arterial hypertension and modification by the antihypertensive agents enalapril, metoprolol, mepindolol and nitrendipine]. Klin Wochenschr 1988; 66:928-39. [PMID: 2846947 DOI: 10.1007/bf01728957] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
After improvement of technical equipment continuous ambulatory blood pressure monitoring is more and more used in the diagnosis of hypertension. New fully automatic systems permit a reliable registration and evaluation of 24-h blood pressure profiles. Typical circadian rhythmics of blood pressure, independent of a variability with different grades of activity, can be demonstrated in normotensive persons and also in patients with essential hypertension. Patients with secondary forms of hypertension show a nivellation or offset of circadian blood pressure rhythmics. A study was performed to examine the antihypertensive efficacy of the calcium antagonist Nitrendipine, the beta 1-adrenoceptor-selective blocker Metoprolol, the beta-blocker with intrinsic activity Mepindolol and the angiotensin converting enzyme inhibitor Enalapril in patients with mild to moderate hypertension over a period of 6 month. Continuous ambulatory blood pressure monitoring was performed before and after 6 month of therapy. 98 of 299 included patients broke off therapy, 47 of those because of side effects. Hydrochlorothiazide was given additionally if the antihypertensive effect of monotherapy was not sufficient after a period of 4 weeks. Morning blood pressure controls at the end of the treatment period showed normotensive values in all groups without significant differences between the groups before and at the end of the treatment period. The number of prescriptions of diuretics necessary to achieve normotension differed between the four treatment groups: Nitrendipine (n = 5), Metoprolol (n = 7), Mepindolol (n = 14), Enalapril (n = 20). In contrast to the morning blood pressure values the continuous 24-h blood pressure monitoring demonstrated significant differences between the therapy groups. Metoprolol turned out as most effective in lowering blood pressure and in reducing the number of systolic blood pressure peaks above 180 mmHg, but on the other hand showed the highest incidence of relative hypotension (less than 100 mmHg systolic, less than 80 mmHg diastolic). Mepindolol demonstrated a significant lower efficacy. In the Nitrendipin group least of all prescriptions of diuretics were necessary and the lowest number of hypotensive systolic blood pressure values occurred. Enalapril showed the most significant reduction of diastolic values above 100 mmHg and the lowest number of diastolic values below 80 mmHg, but the highest number of prescription of diuretics was necessary in the Enalapril group. In none of the four therapy groups a neutralisation of circadian blood pressure rhythmics was demonstrable.
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Affiliation(s)
- J Schrader
- Abteilung für Nephrologie, Medizinische Universitätsklinik, Göttingen
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38
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Eisenhauer T, Talartschik J, Quentin E, Kreutzfeldt W, Scheler F. [Modification of atrial natriuretic peptide (ANP) and cyclic GMP by hemofiltration and hemodialysis]. Klin Wochenschr 1988; 66:940-5. [PMID: 2846948 DOI: 10.1007/bf01728958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
ANP and c-GMP concentrations in 7 patients with chronic renal failure (CRF) undergoing regular hemofiltration (HF) were determined. After switching to hemodialysis (HD) under identical ultrafiltration and treatment time no significant difference of the ANP and c-GMP profiles was detected, suggesting that the type of treatment does not affect ANP and c-GMP plasma levels. In both procedures a continuous decrease of ANP and c-GMP was observed. Head down tilting to compensate hypotension during HD was immediately followed by an increase in ANP and c-GMP during ultrafiltration. An acute onset of tachyarrhythmia absoluta during HD was also accompanied by a rise in ANP plasma concentrations. This demonstrates that ANP secretion is not altered in patients with CRF. Since ANP plasma levels closely correlate with intravascular volume, periodic determination of this hormone in HD/HF patients may provide diagnostic information to detect volume overload.
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Affiliation(s)
- T Eisenhauer
- Abteilung Nephrologie und Rheumatologia, Medizinische Universitätsklinik Göttingen
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39
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Abstract
During her second pregnancy a 27-year-old woman had recurrent acute pancreatitis, in the course of which primary hyperparathyroidism was diagnosed. After regression of the acute signs and under conservative treatment a parathyroid tumour was removed in the 26th week of pregnancy. Comparison of surgical and conservative treatment of primary hyperparathyroidism during pregnancy has indicated that the risk of complications in the neonate is much lower after surgical removal of the adenoma than with an attempt to postpone by symptomatic drug treatment the parathyroidectomy until after delivery.
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Affiliation(s)
- G Warneke
- Abteilung für Nephrologie und Rheumatologie, Zentrum Chirurgie der Universität Göttingen
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40
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Schrader J, Stibbe W, Armstrong VW, Kandt M, Muche R, Köstering H, Seidel D, Scheler F. Comparison of low molecular weight heparin to standard heparin in hemodialysis/hemofiltration. Kidney Int 1988; 33:890-6. [PMID: 2838681 DOI: 10.1038/ki.1988.81] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Low molecular weight (LMW) heparin has been compared to standard unfractionated (UF) heparin in hemodialysis/hemofiltration in a 12 month, randomized study. Seventy patients with end-stage chronic renal failure starting dialysis treatment were randomly assigned to one of two groups treated with either LMW or UF heparin. The LMW and UF heparin doses used produced similar plasma anti-FXa levels, and comparable antithrombotic effectiveness was observed in the two groups as reflected in similar incidences of thrombus formation in the extracorporeal circulation: 1.59% and 1.33% for LMW and UF heparin, respectively. No bleeding complications were seen with either heparin, but significantly (P less than 0.05) fewer erythrocyte concentrates were needed in the LMW heparin patients. Mean factor VIII activities had risen significantly (P less than 0.001) after 12 months in the UF heparin group, whereas they were unchanged in the LMW heparin group. A significant (P less than 0.05) increase in plasma triglycerides was observed in the UF heparin group which was attributable to six (18.8%) of the patients in this group. Triglyceride concentrations remained relatively constant in the LMW heparin group. Post-heparin lipolytic activity, and in particular hepatic lipase activity, was not stimulated to the same extent in the LMW heparin-treated patients as compared to the UF heparin group. We conclude that LMW heparin is a suitable alternative to standard UF heparin for anticoagulation in hemodialysis/hemofiltration therapy. It may offer potential advantages with regard to a lower requirement for erythrocyte concentrates and less derangement of certain metabolic parameters, such as factor VIII, triglycerides and plasma lipase activity.
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Affiliation(s)
- J Schrader
- Department of Nephrology, University Clinic, Göttingen, Federal Republic of Germany
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41
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Schrader J, Gallimore MJ, Eisenhauer T, Isemer FE, Schoel G, Warneke G, Brüggemann M, Scheler F. Parameters of the kallikrein-kinin, coagulation and fibrinolytic systems as early indicators of kidney transplant rejection. Nephron Clin Pract 1988; 48:183-9. [PMID: 3281044 DOI: 10.1159/000184909] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In order to find early indicators of kidney transplant rejection before clinical symptoms were noticed, parameters of the coagulation, fibrinolytic and kallikrein-kinin systems were measured. Nineteen patients were followed before and daily after kidney transplantation during the first week and every second day in the following weeks. All patients received immunosuppressive therapy with cyclosporin and corticoids. Ten patients suffered from transplant rejection. The first rejection occurred on the 7th day after transplantation. Of all the parameters measured, kallikrein inhibition, beta-FXIIa inhibition, plasminogen and antithrombin III were early indicators of kidney transplant rejections. A rise in these parameters could be demonstrated 2-3 days before clinical signs were noticed. In the other 9 patients no significant rises in antithrombin III, plasminogen, kallikrein inhibition and beta-FXIIa inhibition could be found.
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42
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Schilling H, Eisenhauer T, Schrader J, Scheler F. [What is safe in therapy with conversion inhibitors?]. Internist (Berl) 1987; 28:810-7. [PMID: 3325447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- H Schilling
- Abteilung für Nephrologie und Rheumatologie, Medizinischen Universitätsklinik Göttingen
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43
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Eisenhauer T, Schuff-Werner P, Armstrong VW, Talartschik J, Scheler F, Seidel D. Long-term experience with the HELP system for treatment of severe familial hypercholesterolemia. ASAIO Trans 1987; 33:395-7. [PMID: 3675971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- T Eisenhauer
- Department of Nephrology, University Hospital, Göttingen, West Germany
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44
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Eisenhauer T, Armstrong VW, Wieland H, Fuchs C, Scheler F, Seidel D. Selective removal of low density lipoproteins (LDL) by precipitation at low pH: first clinical application of the HELP system. Klin Wochenschr 1987; 65:161-8. [PMID: 3104660 DOI: 10.1007/bf01728226] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The first clinical application of a new extracorporeal procedure (HELP) for the selective elimination of low-density lipoproteins by heparin precipitation at acid pH is described. Plasma, obtained by filtration of whole blood through a 0.2 mu filter, is continuously mixed with an equal volume of an acetate buffer (pH 4.85) containing heparin. After removal of the precipitated heparin complex by filtration, excess heparin is adsorbed to a specially developed filter and the clear plasma filtrate is subject to bicarbonate dialysis/ultrafiltration to restore physiologic pH and remove excess fluid. The calculated efficiency for the elimination of low-density lipoproteins from plasma by HELP is 100% and is therefore comparable to conventional plasmapheresis. The HELP system shows a high degree of specificity with over 80% of total protein being returned to the patient. Over 130 treatment procedures have now been performed. Patient compliance and acceptance have been excellent and no major complications have been observed.
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45
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Forssmann K, Hock D, Herbst F, Schulz-Knappe P, Talartschik J, Scheler F, Forssmann WG. Isolation and structural analysis of the circulating human cardiodilatin (alpha ANP). Klin Wochenschr 1986; 64:1276-80. [PMID: 2950274 DOI: 10.1007/bf01785708] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A new method was applied to isolate a polypeptide hormone from human blood. The polypeptides from 1,000 1 of hemofiltrate with a molecular weight lower than 20 kDaltons were adsorbed to 2.5 kg alginic acid, then eluted, precipitated, and desalted on a G-25 Sephadex column, thus obtaining a crude lyophilised plasma polypeptide extract. These polypeptides were further submitted to ion-exchange chromatography. Thereafter, two steps of HPLC were carried out to purify a distinct polypeptide which was the circulating form of cardiodilatin (CDD) in this case. The amino acid analysis, C-terminal enzymatic cleavage by carboxypeptidase A, and sequence analysis showed that the only form of circulating cardiodilatin is the 28 amino acid residue containing molecule, cardiodilatin-99-126 cleaved from the C-terminus of cardiodilatin-126 and identical with alpha-ANP (alpha atrial natriuretic polypeptide). Other bioactive molecular forms of the polypeptide hormones of the cardiodilatin family were not detected in the hemofiltrate. The isolation procedure was followed up by a bioassay using in vitro vascular smooth muscle relaxation.
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46
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Scheler F, Schoel G. [Abuse of analgesics with special reference to analgesic nephropathy]. Internist (Berl) 1986; 27:770-7. [PMID: 3546179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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47
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Schrader J, Schoel G, Scheler F. [Results of a 5-year study with captopril in patients with severe therapy-resistant hypertension]. Klin Wochenschr 1986; 64:695-700. [PMID: 3020311 DOI: 10.1007/bf01712054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The angiotensin converting enzyme (ACE) inhibitor captopril proved to be an effective antihypertensive drug during a 5-year follow-up study of patients with severe hypertension who had been resistant to a triple-drug regimen. Of the 42 patients, 41 had to be treated additionally with diuretics. Because of hypokalemia, potassium supplements were necessary in 26 patients, despite the use of "potassium-saving" diuretics in 12 patients. Blood pressure was controlled sufficiently in 3/4 of the patients during the 5 years. Patients with a large elevation in plasma renin activity showed the best response to the treatment. Six patients died during the 5 years. Therapy had to be stopped in 11 patients because of complications. The following complications and adverse effects were observed: cerebral ischemia (n = 10), vertigo and orthostasis (10), exanthema (9), hypogeusia (7), circulatory failure (7), myocardial infarction (6), and scintigraphically demonstrable decrease of renal perfusion (5). One patient with bilateral renal artery stenosis suffered from acute renal failure, which was reversible after withdrawal of captopril. Significant changes of red and white blood cell counts, transaminases, lipids, urine protein excretion, and heart rate were not observed.
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48
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Abstract
In 50 patients without renal insufficiency, fibrinolytic activity, as reflected by euglobulin lysis time, was determined in blood obtained from the renal veins, the renal artery and a peripheral vein. Fibrinolytic activity was found to be significantly higher in the renal veins than in the renal artery and the peripheral vein. Other coagulation and fibrinolysis parameters did not show such differences. In addition, a patient with acute oligoanuric renal failure was investigated. This patient demonstrated reduced overall fibrinolytic activity, but there were no differences between the activity in the blood of the renal veins and that of the renal artery or peripheral vein. It seems, therefore, that the kidneys release plasminogen activators into the systemic circulation. This may be decreased in renal failure, probably contributing to the well-known diminished fibrinolysis in some kidney diseases.
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49
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Eisenhauer T, Armstrong VW, Wieland H, Fuchs C, Nebendahl K, Scheler F, Seidel D. Selective continuous elimination of low density lipoproteins (LDL) by heparin precipitation: first clinical application. ASAIO Trans 1986; 32:104-7. [PMID: 3778691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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50
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Rumpf KW, Henze T, Kaiser H, Klein H, Spaar U, Soballa R, Prange H, Henning HV, Scheler F. [Rhabdomyolysis as a complication of chronic alcoholism. Observations in 19 cases]. Dtsch Med Wochenschr 1986; 111:379-82. [PMID: 3948697 DOI: 10.1055/s-2008-1068459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In 19 chronic alcoholics with rhabdomyolysis the clinical picture demonstrated markedly different degrees of severity of myolysis. Muscle pain, muscle swellings and brown-coloured urine were rare. But symptoms of delirium, at times with cerebral seizures, were frequent at the onset. Renal failure of different degrees was common; five patients had to be dialysed. Two patients died in irreversible shock. Respiratory insufficiency and hypercalcaemia were other complications. Early recognition of the disease is important, because early treatment can prevent acute "myoglobinuric" renal failure.
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