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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 36-year-old man with ankylosing spondylitis, amyloidosis and chronic renal failure on maintenance hemodialysis developed severe hypoglycemia while being treated with propoxyphene. Upon discontinuation of the drug blood glucose levels returned to normal and hypoglycemia did not recur. Simultaneously with hypoglycemia, plasma glucagon and growth hormone levels were appropriately raised and serum insulin levels were adequately suppressed, thus ruling out hyperinsulinemia as the cause of hypoglycemia. A review of the literature disclosed four similar cases of propoxyphene-induced hypoglycemia, two of them with renal dysfunction. Propoxyphene should be remembered as a potential cause of hypoglycemia, particularly in patients with renal failure.
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PMID:Propoxyphene-induced hypoglycemia in a patient with chronic renal failure. 279 48

The hormones regulating growth, growth hormone (hGH), IGF I, sex steroids, thyroxin (T4) and parathormone (PTH) have been measured in 23 adolescents aged from 13.5 to 20 years (14 boys, 9 girls), with chronic renal failure treated with haemodialysis. Growth velocity (GV) was (mean +/- DS) 4 +/- 2.1 cm/year in boys and 1.6 +/- 1.65 in girls, with a bone age of 12.9 +/- 2.4 cm/year. T4 and DHA sulfate (DHAS) differed according to sex (boys: T4 = 70 +/- 4.7 ng/ml; DHAS = 655 +/- 139 ng/ml; girls: T4 = 102 +/- 16.6 ng/ml; DHAS = 118 +/- 35 ng/ml). IGF I, within normal limits, was correlated to bone age and pubertal stage. T4 was negatively correlated to testosterone and SDHA in boys. GV expressed as SD according to bone age was negatively correlated to PTH.hGH deficiency was evidenced in one case, and GV increased under hHG therapy. It is concluded that measuring hormones is necessary in renal failure. Secondary hyperparathyroidism is an inhibiting growth factor. Possible hormonal deficiencies have to be treated.
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PMID:[Results of hormonal studies in 23 adolescents with renal failure treated by chronic dialysis]. 305 89

We examined the effects of methionyl-human growth hormone (met-hGH) and malnutrition on the growth of 5/6 nephrectomized rats and sham-operated controls. One group of sham-operated rats (PFS) was pair-fed with a group of nephrectomized rats in renal failure (RF); another group of sham-operated rats was fed ad libitum (ALS), and a final group of rats with renal failure (RF-GH) was treated with 4 IU/day met-hGH. After 4 weeks, RF-GH rats gained 12.3 +/- 1.7 cm in length; this was more than the 10.2 +/- 1.2 cm gain of RF rats (P less than 0.05). Ingested food was converted into weight gain more efficiently by RF-GH rats than RF rats (267 +/- 26 vs 235 +/- 38 mg weight gain/g food intake, P less than 0.05). RF-GH rats also gained more weight (122 +/- 25 g) than RF rats (98 +/- 27 g), but this difference was not significant (0.05 less than P less than 0.1). Insulin-like growth factor (IGF)-I, glucose and insulin levels were not different between RF and RF-GH rats. Food intake of RF and PFS rats was 64% of ALS intake and was associated with poor gains in weight and length by the PFS and RF groups (relative weight and length gains were ALS greater than PFS greater than RF, P less than 0.05 for all comparisons); this suggests that the poor growth of RF rats when compared with PFS rats was due to factors other than food intake. Serum IGF-I levels of 771 +/- 249 ng/ml in PFS rats were lower than levels of 1109 +/- 253 ng/ml found in the ALS group (P less than 0.05); this is consistent with the malnourished state of PFS rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of growth hormone therapy and malnutrition on the growth of rats with renal failure. 315 55

Cardiovascular and Renal function were examined in two populations of long-term insulin-dependent diabetics, those with microalbuminuria, a sign of early, subclinical nephropathy and those with clinically manifest diabetic nephropathy. In addition, clinical variables of possible importance for the occurrence and prognosis of diabetic nephropathy were analyzed. Microalbuminuria - a mean of three over-night urinary albumin excretion rates greater than 20 micrograms/min - was found in 16% of Albustix-negative, normotensive, insulin-dependent diabetics. The microalbuminurics had higher supine blood pressures than normoalbuminurics. The albumin excretion rate in microalbuminurics correlated to blood pressure at rest but not to glycosylated haemoglobin. The cardiovascular responses to five different test manoeuvres revealed more evident signs of autonomic nerve dysfunction in microalbuminurics than in normoalbuminurics. The circulatory reactions during mental stress however, were almost identical in the two subgroups. Despite similar glomerular filtration rate and renal plasma flow the albumin excretion during mental stress increased in microalbuminurics, but remained unchanged in normoalbuminurics. It is postulated that a disturbance of glomerular basement membrane permeability is a pre-requisite for the elevated albumin excretion seen in microalbuminurics. Inability to regulate glomerular haemodynamics, due to autonomic nerve dysfunction, may also be a contributing factor. Such dysfunction perhaps even explains why microalbuminurics have higher blood pressures at rest compared with normoalbuminurics. In manifest diabetic nephropathy the rate of renal functional decline correlated to arterial blood pressure, while glycemic control showed no such relation. Patients with rapidly progressive nephropathy showed higher values of growth hormone than slow progressors. In patients with diabetic renal failure, cardiac catheterization revealed reduced stroke work and elevated left ventricular end-distolic pressure during exercise. Autonomic nerve dysfunction and arterial hypertension possibly contributed to the impaired cardiac performance. The existence of a specific diabetic cardiopathy must even be considered. There was a male predominance both in subclinical and manifest diabetic nephropathy. Age at onset of diabetes was lower in micro- as compared to normoalbuminurics. Duration of diabetes had no prognostic implication in subclinical or manifest nephropathy. The mortality rate was high in patients with manifest nephropathy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Studies of cardiovascular and renal function in subclinical and manifest diabetic nephropathy. 316 65

Forty percent of patients with insulin-dependent diabetes will develop nephropathy during the course of their disease, thus being the most important single disorder leading to end-stage renal failure (ESRF). Intensive metabolic control delays onset of diabetic nephropathy, the first omen of which is appearance of subclinical albuminuria, also termed microalbuminuria. Moreover, it is now established that intensive treatment of hypertension reduces rate of decline in GFR and thus postpones ESRF. When uremia eventually sets in, a range of biochemical and endocrine abnormalities can be included among those characteristics of diabetes mellitus per se. These include elevated plasma levels of growth hormone, glucagon and free fatty acids, which may participate in the uremic insulin resistance superimposed on the preexisting diabetic carbohydrate intolerance. Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are two established modalities of renal replacement therapy in diabetes mellitus. Controlled clinical trials for comparison of CAPD versus HD treatment of diabetics are, however, still needed. The survival rate is approximately 80 and 65-95% in insulin-dependent diabetic patients at 1 year during treatment with HD and CAPD, respectively. However, it is general experience that diabetics on CAPD exhibit a glycemic control, superior to that attained during HD. It has not been proved that patient survival after cadaveric renal transplantation is better than on dialysis. The degree of vascular heart disease seems to be the major determinant for survival of kidney-transplanted diabetic patients.
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PMID:End-state renal failure in diabetic nephropathy: pathophysiology and treatment. 391 47

In a prospective study of eight patients with type I diabetic renal failure, metabolic and blood pressure monitoring was evaluated during progression to end-stage renal disease (ESRD). The mean observation time was 37 months. The mean glomerular filtration rate (GFR) fell significantly (from 33 to 16 ml/min) implying a mean deterioration rate of 0.57 ml/min/month. This rate showed significant correlation with mean arterial blood pressure at out-patient observations, but not with blood glucose monitored as 24-hour profile or with glycosylated hemoglobin. Patients with growth hormone values within the upper limit of the normal range showed faster decline of GFR than patients with low values. The study demonstrated that advanced diabetic renal failure may progress slowly to ESRD. The blood pressure pattern, but not blood glucose values, influenced significantly the deterioration rate of glomerular function.
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PMID:Metabolic and blood pressure monitoring in diabetic renal failure. 408 82

The aim of the present study was to evaluate the insulin and glucagon responses to various stimuli in patients following pancreatic transplantation. Four Type 1 (insulin-dependent) diabetic patients with end-stage renal failure who had received a cadaveric segmental, neoprene-injected, pancreas transplant, in association with kidney transplantation, were investigated. Free-insulin, pancreatic glucagon, and growth hormone concentrations were measured after both oral and intravenous glucose tolerance tests, and following tolbutamide, arginine and arginine plus somatostatin infusions. Tests were performed 1 month (three cases) and 30 months (one case) after surgery, when no insulin administration was required. Four non-diabetic kidney grafted patients, matched for duration of graft survival and immunosuppressive treatment (steroids, azathioprine and anti-lymphocyte-globulins), served as control subjects. Impaired glucose tolerance was present in all diabetic and control patients. This was possibly related to immunosuppressive treatment. In comparison with control subjects, insulin release was normal in response to arginine and tolbutamide but was reduced in response to oral and intravenous glucose, while glucagon and growth hormone release were similar in both groups. Somatostatin was less effective in diabetic patients than in control subjects in suppressing insulin and glucagon release.
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PMID:Endocrine responses of type 1 (insulin-dependent) diabetic patients following successful pancreas transplantation. 613 51

Prolactin, growth hormone and thyroid stimulating hormone responses to thyrotropin releasing hormone (TRH) and metoclopramide were determined in 12 alcoholic men with biopsy proven liver disease and were compared to those of 8 age matched normal controls. All subjects were challenged with TRH (400 micrograms) and metoclopramide (10 mg) given as an intravenous bolus each on a separate day. Alcoholics had increased basal prolactin and growth hormone levels compared to controls. Alcoholics had a brisk and statistically significant (p less than 0.01) response for each of the 3 hormones studied in response to TRH. In contrast to the alcoholics, the controls did not demonstrate a growth hormone response to TRH. Moreover, the TSH response to TRH of the alcoholics was exaggerated (p less than 0.05) compared to that of the controls. In response to metoclopramide, alcoholics had a brisk prolactin response, failed to demonstrate a TSH response, and had a decline in growth hormone when compared to controls. These results for alcoholics with liver disease differ from those reported for individuals with renal failure while those for the controls are similar to previously reported normal responses. These data suggest that liver disease and renal disease must differ in terms of their patterns of hypothalamic-pituitary neuroregulation as documented by their differing pituitary hormone responses to TRH and metoclopramide.
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PMID:Lack of dissociation of prolactin responses to thyrotropin releasing hormone and metoclopramide in chronic alcoholic men. 681 70

Exogenous insulin sensitivity as well as the dynamics of blood serum levels of immunoreactive insulin and growth hormone (GH) after oral glucose loading were studied in patients with glomerulonephritis of different clinical manifestations and varying renal functions. A correlation between disturbances in carbohydrate metabolism on the one hand, and the degree of renal failure and protein depletion on the other, was established. Disturbances in carbohydrate metabolism were detected as early as in the preazotemic phase of the disease. The clinical significance of the disorders and methods for evaluation of insulin response to oral glucose are discussed.
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PMID:Carbohydrate metabolism in glomerulonephritis. 702 19

Two cases of bilateral slipping of the upper femoral epiphysis in boys with end-stage renal failure due to megacystis and mega-ureter with severe renal osteodystrophy are reported. In one patient the lesion emerged after a dystonic reaction to drugs and in the other after bilateral nephro-ureterectomy. Neither showed marked elevation of growth hormone levels, but both had evidence of renal rickets with severe secondary hyperparathyroidism. Both had a satisfactory response to bilateral internal fixation. The complication should be borne in mind in all young patients with renal osteodystrophy.
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PMID:Bilateral slipping of the upper femoral epiphysis in end-stage renal failure. A report of two cases. 735 29


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