Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-five adult patients (5 women, 50 men) on chronic peritoneal dialysis, mostly continuous ambulatory peritoneal dialysis (CAPD), for 2 to 155 mon were asked whether or not they wanted to have mechanical cardiopulmonary resuscitation (CPR) in case of sudden death. Thirty-five patients (65%) opted for CPR and 20 (36%) declined. Statistically, sex (although the number of women interviewed was too small for a valid sample) and duration of dialysis had no effect on choice of CPR, whereas older age, the presence of diabetes, advanced medical disability, and advanced socioeconomic disability were associated with a tendency to decline CPR. Among the 10 patients who had CPR, 5 developed flail chest, 4 had multiple rib fractures, and only 1 had no chest wall trauma from CPR. Two patients left the hospital alive. One third of the patients on chronic peritoneal dialysis do not want CPR. Advanced age, diabetes, and poor medical and socioeconomic states predispose peritoneal dialysis patients to decline CPR.
Perit Dial Int 1990
PMID:Mechanical cardiopulmonary resuscitation choice of patients on chronic peritoneal dialysis. 209 33

At post-mortem we examined heart tissue of (i) 31 patients with uraemia not on dialysis, (ii) 42 patients on haemodialysis for less than 6 months, (iii) 60 patients on haemodialysis for more than 6 months, (iv) 16 patients after renal transplantation, and (v) 11 patients on CAPD. Patients with stenosing coronary lesions were excluded. Diffuse non-coronary intermyocardiocytic fibrosis, assessed by a score system in trichrome-stained sections, was found in 91% of chronically uraemic patients, but not in non-hypertensive, non-diabetic controls. The lesion was present even in non-dialysed uraemic patients; in dialysed patients its severity was related to the duration of dialysis; it was demonstrable even years after renal transplantation. On electron-microscopy, collagen fibres were seen, while beta 2-M amyloid was consistently absent. Logistic regression analysis showed that uraemia was a determinant of intermyocardiocytic fibrosis independent of hypertension, diabetes mellitus, anaemia, heart weight, and presence or absence of dialysis procedure.
Nephrol Dial Transplant 1990
PMID:Diffuse intermyocardiocytic fibrosis in uraemic patients. 210 83

The clinical relevance of regular serum aluminium monitoring in dialysis patients was investigated in a multicentre study by 6-monthly determination of the serum aluminium during 4 consecutive years. In a group totalling 1193 patients, a striking decrease of mean serum aluminium was observed the last 2 years of the study. This phenomenon was accompanied by a substantial reduction of the prescribed dose of aluminium hydroxide (Al(OH)3) and its partial replacement by calcium carbonate (CaCO3) and/or magnesium hydroxide (Mg(OH)2). Under this policy serum phosphate control remained satisfactory. In all the centres, water treatment was found to be adequate, yielding dialysate aluminium around 2 micrograms/l. Dialysis patients with clinically overt liver disease showed a significantly greater median serum aluminium concentration than that observed in a control dialysis population. Compared to the latter group, the median serum aluminium concentration of dialysis patients with diabetes mellitus did not differ significantly. Results further indicated that patients with biopsy-proven osteomalacia presented a significantly greater median serum aluminium compared to that of patients without osteomalacia. We demonstrated that a serum aluminium of 60 micrograms/l provides a relatively sensitive (82%) and specific (86%) index for the detection of aluminium-related bone disease (ARBD). Provided the aluminium determinations are performed by a qualified laboratory, serum monitoring in dialysis patients (a) allows the safer use of aluminium-containing phosphate binders, and (b) is of value in the diagnosis of overload/toxicity.
Nephrol Dial Transplant 1990
PMID:Value of serum aluminium monitoring in dialysis patients: a multicentre study. 131 84

To investigate the time relationships involved in cyclosporin-induced nephrotoxicity we studied changes in blood pressure, renal haemodynamics and sodium excretion in 22 adult patients with insulin-dependent diabetes mellitus treated with cyclosporin (CsA) for 4 +/- 2 days, compared to 22 insulin-dependent diabetic patients receiving conventional insulin therapy, who were matched for age and duration of diabetes. To further clarify the pathogenic role of the renin-angiotensin system, insulin-dependent diabetic patients receiving CsA were studied before and after sublingual administration of 75 mg captopril. An average of 4 days CsA treatment markedly increased blood pressure and renal vascular resistance, but did not alter glomerular filtration rate, renal plasma flow, sodium urinary excretion, or body-weight. The marked renal vasoconstriction without early changes in GFR suggests that the late decrease in GFR may involve other factors in addition to renal hypoperfusion. Acute inhibition of angiotension II formation was still able to decrease blood pressure and renal vascular resistance, although not to normal control values. These results indicate that a physiological concentration of angiotensin II may potentialise but may not be the sole factor involved in the vasopressor effect of CsA.
Nephrol Dial Transplant 1990
PMID:Renal haemodynamic effects of short term cyclosporin A administration in patients with insulin-dependent diabetes mellitus. 211 42

The incidence of post-transplant diabetes mellitus was evaluated retrospectively in 901 consecutive renal transplant recipients. Thirty-two (3.6%) patients developed diabetes mellitus requiring drug therapy. 18 of 32 became hyperglycaemic within 3 months of transplantation. Post-transplant diabetes mellitus occurred in 24 of 628 (3.8%) patients treated with conventional therapy consisting in azathioprine and prednisone, and in 8 of 273 (2.9%) patients receiving cyclosporin A (CsA) in addition (triple therapy). To identify predisposing factors 32 non-diabetic patients matched for age, sex, number of graft, immunosuppressive protocol, and graft function at onset of diabetes were used as case controls. Thirteen of 32 patients with diabetes mellitus and 5 of 32 control patients had abnormal glucose tolerance pretransplant (P less than 0.025). HLA-B8 was significantly more frequent in patients with post-transplant diabetes mellitus than in control patients (9 of 29 vs 2 of 31, P less than 0.02). Twelve (38%) patients became diabetic during or immediately after anti-rejection therapy with intravenous pulse prednisone. Four diabetic patients experienced chronic pancreatitis pre-transplant. Family history of diabetes mellitus, bodyweight, number of rejection episodes, and immunosuppressive drug doses were similar in both groups. Actuarial patient and graft survival was not significantly different in diabetic patients and controls, although 10-year data tended to be better in controls. Thus, post-transplant diabetes mellitus was not a frequent complication in patients sometimes predisposed by an impaired glucose tolerance pre-transplant and was triggered by pulse prednisone therapy in 38%.
Nephrol Dial Transplant 1990
PMID:Post-transplant diabetes mellitus in renal allograft recipients: a matched-pair control study. 211 51

Endothelin is a 21-residue peptide vasoconstrictor produced by endothelium. Using a radioimmunoassay, endothelin values were measured in four groups of individuals: normal controls (0.54 +/- 0.12 pmol/l, n = 20); undialysed patients with chronic renal failure (CRF) (0.82 +/- 0.13 pmol/l, n = 38); chronic renal failure patients on continuous ambulatory peritoneal dialysis (CAPD) (2.81 +/- 0.63 pmol/l, n = 20); and patients with CRF on haemodialysis (HD) (4.52 +/- 1.21 pmol/l, n = 14). The endothelin values were significantly greater in undialysed patients with CRF when compared with controls (P less than 0.001) and significantly greater in both dialysis groups when compared with controls and the undialysed CRF group (P much less than 0.001). The difference between the two dialysis groups was not significant (P = 0.07). There was no correlation between endothelin and serum creatinine, mean arterial pressure, presence of chronic hypertension and/or diabetes, use of calcium-channel blockers and/or ACE inhibitors, or primary renal diagnostic category. A single haemodialysis session had no significant effect on endothelin values in the ten patients in whom this was assessed. Fast protein liquid chromatography (FPLC) appeared to confirm that the molecular species found in chronic renal failure were the same as those found in diabetic patients.
Nephrol Dial Transplant 1990
PMID:Endothelin in renal failure. 212 16

Little is known about renal transplantation activity in developing countries. The objective of this study was to evaluate patient and graft survival among the different types of renal transplant recipients in Brazil. The study population consisted of 1563 patients receiving renal grafts for the first time between 1 October 1987 and 31 December 1989 in 49 transplant centres in Brazil. Data were prospectively collected through individual patient questionnaires. Of the 1563 transplantations performed, 1051 (67%) were from living donors, 467 (30%) from cadaver donors, and 45 (3%) unspecified. A total of 963 (62%) transplants came from living related donors (10% HLA-identical, 45% HLA-haploidentical and 6% HLA-distinct). Among the transplant recipients, only 7% were more than 55 years old, 5% were younger than 15 and 4% had diabetes mellitus. Blacks accounted for 24% of patients receiving transplants. An immunosuppressive regimen, including cyclosporin was used in 75% of cadaver kidney recipients, in 42% of living donor kidney recipients; and in 43% and 75% of HLA-haploidentical and HLA-distinct living related donor recipients, respectively. At 2 years, patient survival for living donor and cadaver donor transplant recipients was 89% and 80% respectively, and graft survival was 76% and 61% respectively. Patient survival for recipients of HLA-identical, haploidentical, and distinct living related donor kidneys was respectively 94%, 90%, and 81% at 2 years, and graft survival was 90%, 75%, and 65% respectively. Graft survival for recipients of HLA-distinct living related donor and non-related donor kidneys compared to cadaver donor kidneys was not significantly different at 2 years (63% vs 61%, P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1990
PMID:Survival analysis of 1563 renal transplants in Brazil: report of the Brazilian Registry of Renal Transplantation. 212 33

The renal selectivity properties towards albumin were evaluated in ten diabetic patients with arterial hypertension before and after the pharmacological normalisation of blood pressure, and were compared to 12 subjects with essential hypertension. While all patients of the control group were normoalbuminuric during hypertension, six of the diabetic group were microalbuminuric when hypertensive and became almost normoalbuminuric after blood pressure pharmacological control. All microalbuminuric diabetic patients presented altered properties of renal selectivity as epitomised by a non-preferential urinary excretion of glycosyl albumin (GA) (urinary GA/serum GA less than or equal to 1). At variance the selectivity properties were normal in normoalbuminuric diabetic patients and in essential hypertension. It was concluded that in diabetes mellitus arterial hypertension is associated with microalbuminuria when the renal properties of selectivity are altered, but does not implicate any proteinuric effect in those cases where the GBM function is preserved.
Nephrol Dial Transplant 1990
PMID:Hypertension and renal selectivity properties in diabetic microalbuminuria. 212 64

Multiple vascular access failure is a frequent problem and we report our experience with 32 Hemasite devices implanted in 28 patients with end-stage renal disease. All of the patients were on maintenance haemodialysis or haemofiltration with a range of treatment of 1-17 years. Their mean age was 58 +/- 14 years (range 28-72 years). The main indication for using this device as an alternative vascular access was the presence of high-risk patients with a high incidence of previous access failure (1-8 accesses per patient). The majority of the patients were considered as high risk, due either to old age (more than 60 years) (60%) or to the presence of diabetes mellitus (29%). The results of 5 years' experience and follow-up showed that the Hemasite device could be successfully used as a secondary vascular access in high-risk patients who have problems of multiple access failures. The 1-year cumulative survival of the device (55%) was affected by complications such as thrombosis and infection (47% and 16%) which were noted mostly among patients with diabetes mellitus. These complications are the major ones endangering the longevity of the Hemasite implant and were important causes of implant loss (31% and 6% respectively). Being needleless and painless, the Hemasite was well-accepted by the patients and it functioned well, with adequate blood flow. We conclude that the Hemasite device is a valuable alternative when vascular access becomes a problem in haemodialysis patients.
Nephrol Dial Transplant 1990
PMID:Experience with the Hemasite device in haemodialysis and haemofiltration patients with vascular access problems. 213 Feb 97

A novel enzyme-linked immunosorbent assay (ELISA [Dialbumin]) for rapid office measurement of microalbuminuria was evaluated and its performance compared with that of a commercially available radioimmunoassay (double-antibody albumin). Urine samples containing between 0.75 and 1800 micrograms/ml of albumin were obtained from 31 diabetic patients and assayed by both methods. A comparison of the paired values obtained from the two methods gave a correlation coefficient of greater than 0.99. The Dialbumin assay, which used detachable eight-well strips (1 strip/sample), 10-min incubation, tap water wash, and a 2-min color development step, was read on both an ELISA reader and a hand-held analytical device (Acc-U-Dial) designed specifically for this test. The findings of this study indicate that the Dialbumin assay, used in conjunction with the Acc-U-Dial device, affords a rapid, convenient, and sensitive method for quantitative determination of a broad range (0.3-1280 micrograms/ml) of urinary albumin levels in the office setting.
Diabetes Care 1990 Oct
PMID:Evaluation of new rapid office test for microalbuminuria and its comparison to fully quantitative radioimmunoassay. 220 4


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