1991年 · 第07卷第04期

EPO, made in Nanjing University, China, was administered in 32 chronic renal failure patients (19 of hemodialysis, 8 of CAPD, 5 of predialysis). The mean initial Hb levele was 48.2g/L with blood transfusion at least 200ml/mth/cases. Each patient received EPO intravenously, at the dose of 150u/kg, 3 times a week for 5-13 mths. After EPO treatment, blood transfusion was not needed for any of the patients and anemia was ameliorated with increase of Hb and hematocrit levels. The increasement of hematocrit was positively correlated with reticulocyctes. It was found that the minimum effective dose of the EPO was 150u/kg. Hypertension was seen in some cases, which was mild and easily controlled. The locally made EPO is no doubt safe and effective in treating uremia. Influencing the efficacy of EPO are: dose courseof EPO, duration of dialysis, styles of dialysis, severity of anemia and the presence of Fe deficiency, aluminum toxicity, pericarditis, severe infection and or renal osteodystrophy.

Eighty-eight renal biopsies from various type of glomerular diseases were studied for deposition of immunoglobulin kappa and lambda light chain by the direct IF technic with the use of FITC-conjugated monospecific goat anti-human kappa and lambda anti-sera (Cappel USA). NO significant predominance of lambda or kappa light chain IF were demonstrated in mesangial proliferative glomerular nephritis, membrano-proliferative glomerular nephritis, focal sclerosis nephritis and lupus nephritis. In 12 specimens of primary IgA nephropathy, 7 specimens (58%) were positive for lambda light chain alone. Only 1 specimen (8%) showed mesangial kappa light chain IF. These results suggest that the glomerular IgA deposits in IgA nephropathy were composed predominantly of lambda light chain-containing IgA and only partially of kappa light-chaincontaining IgA. One patient with crescentic nephritis demonstrated deposit for lambda light chain alone and one patient with amyloid showed deposit of only kappa light chain in glomeruli.

A experimental model of acute renal failure (ARF) has been developed by injection of oleic acid to left renal artery. The effects of Anisodine, Buscopan and Anisodamine on ARF were studied. The results are as following: The use of three drugs reduced the damage of renal microvessels and edema of renal tissue, improved the function of renal pulsing blood vessels, increased renal tissue blood flow and PGI₂ concentration in blood, extenuated renal tissue ischemia, protected the epithelium cells of tu bular from ischemic injury. The effect of Anisodine was the best in three drugs.

Amount of CD₄⁺, CD₈⁺ and B cells in the sections of renal biopsies obtained from 20 patients with IgA nephropathy, 10 with nephrotic syndrome (NS) and 10 with recurrent gross hematuria (GH) were inves tigated by PAP (4 layer) method and monoclonal antibodies. It was found that CD₄⁺; CD₈⁺ and B cells were distributed mainly in the interstitium and rarely in the glomeruli. Their number was increased in IgA nephropathy than normal control, being more abundant in NS (CD₈⁺ 4.65±2.98/25mm²; CD₈ 4.61±2.98/25mm²; B cells 2.73±2.26/25mm²) than GH (CD₄⁺ 2.02±1.17/25mm²; CD⁺₈ 2.08±1.17/25mm²; B cell 0.62±0.75/25mm²). Interstitial fibrosis, tubular damage and CD₄⁺ focal cluster were more common in NS than GH. No association was found between interstitial immune deposits and infiltrating cells in these two groups.

It was suggested that interstitial infiltrating lymphocytes may play a role in the pathogenesis of IgA nephropathy and that cellular immune mechanism may be important determinants for the impairment. It may also explain the fact why the prognosis of NS patisents was not so good as GH.

In this study, the peripheral lymphocyte subsets in the uremic patients undergoing maintenance hemodialysis were measured using mononclonal antibodies, meanwhile, the ability of peripheral blood lymphocytes to produce IL-2 and the activity of their IL-2R after PHA stimulation were determined. Heparinized blood was drawn before the start of hemodialysis.

The results showed that the average relative proportions of T₁₁ and T₄ and T₈ subsets are not different between the control and uremic groups. The relative proportions and absolute numbers of T lymphocyte subsets are not different in patients undergoing dialysis for less than one year or for a longer time. The absolute numbers of T₁₁ and T₄ and T₈ subsets were significantly reduced in the total population of dialysis patients as conpared with control subjects. The ability to produce IL-2 and the activity of IL-2R proliferation are not different between the control and uremic groups.

The results suggested that a pronounced lymphopenia exists in uremic patients. The effect of hemodialysis on the altered immune status in uremia are rather small.

This paper reports a study of peripheral blood Iymphocyte surface markers in 20 patients with chronic renal failure (CRF) together with 15 normal controls. In CRF patients, a significant decrease in T cells wree observed as well as a significantly lowered percentage of CD₄ and a higher percentage of CD₈ cells, leading to a decrease in the CD₄/CD₈, showed a negative correlation with serum creatinine. The results indicate That cell mediated-immune response is defective in the CRF patients.