Weldon D. Shelp

Diminished Renal Urate Secretion Per Nephron As a Basis for Primary Gout

Abstract In order to examine the role of the kidney in the pathogenesis of primary gout, the rate of uric acid turnover and renal transport were studied in 15 gouty patients. Uric acid turnover dat...

Factors influencing the increase in glomerular filtration rate in the remaining kidney of transplant donors

Measurement of glomerular filtration rate (GFR) in 49 kidney donors on 259 occasions before and at varying periods after nephrectomy revealed that the predominant increase in GFR after nephrectomy occurs within three weeks. This initial percentage increment was not influenced by age, sex or GFR before nephrectomy. However, multiple-linear regression analysis of data derived from subsequent studies, performed up to four years after nephrectomy, indicates that there is a modest secondary increase which occurs subsequently and is inversely related to age, with time after nephrectomy and the GFR before nephrectomy also comprising significant variables. Analysis of concomitant creatinine and urea clearance data reveals that these parameters bear an inconstant relationship to true GFR, although they follow the same general trend.

Comparison of urinary phosphate, urate and magnesium excretion following parathyroid hormone administration to normal man

Abstract A phosphaturic dose of parathyroid hormone (PTH) administered intravenously to 14 normal volunteers significantly decreased magnesium excretion and did not significantly alter urate excretion. Elevated plasma levels of endogenous PTH appear to mediate the increased excretion of phosphate per nephron observed in progressive chronic renal disease. In this setting, a similar pattern of urate and magnesium excretion is seen. Results of this study fail to support the concept that PTH might play a role in the enhanced urate and magnesium excretion per nephron of subjects with chronic renal failure.

Characteristics of couples with poor outcome in dialysis home training

Abstract Certain emotional reaction patterns of the couple , (rather than just that of the patient, as stated by Shea) [18] to the need for chronic dialysis may represent the greatest obstacle for successful rehabilitation. A selection procedure which considers the response of a spouse as part of a functional unit will enhance the chances of success, at least in the initial training. From this study several observations seem important. First, older couples generally handle the stress and demands of home training less well. Secondly, couples who respond to stress similarly (the identifiers) have more difficulty; in particular, this holds when the patient has a strong tendency toward excessive denial, dependency or regression. Conversely some hostility or anger on the part of the spouse may enhance rather than detract patient adaption to dialysis training and actually improve the chances of successful rehabilitation. Both of these factors may be of help in the successful selection of couples and prediction of a successful course of training for home dialysis.

The Suitability of Fixed-Bed Sorbers as Artificial Kidneys

Experimental and theoretical evaluations of fixed beds of granular dextran beads for the purification of uremic lymph are described. This work was inspired by reported success in treatment of chronic uremia by repeated collection, purification, and reinfusion of thoracic duct lymph. The experimental program demonstrated that a rapid and essentially complete separation of low molecular weight metabolites from lymph proteins in a gel bed is possible, but tJ:lat the protein-rich effluent is somewhat diluted by the occurrence of viscous flow instabilities in the trailing protein boundary. A complete theoretical description of the system which gave excellent agreement with observed behavior was achieved using a longitudinal dispersian model and parameters evaluated from available dispersion and mass transfer coefficient correlations and from analysis of some of the experimental data. The model and parameters were then used to investigate the effects of