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115. 1. Study design and renal structural-functional relationships in patients with long-standing type 1 diabetes. (Cellular Basis of Diabetic Nephropathy)

Author

Caramori, M. Luiza, Kim, Youngki, Huang, Chunmei, Fish, Alfred J., Rich, Stephen S., Miller, Michael E., Russell, Greg, and Mauer, Michael

Subjects
Genetic disorders -- Development and progression -- Genetic aspects -- Research, Type 1 diabetes -- Research -- Genetic aspects -- Development and progression, Diabetic nephropathies -- Genetic aspects -- Development and progression -- Research, Health, Development and progression, Genetic aspects, Research
Abstract

This study was designed to elucidate the cellular basis of risk of or protection from nephropathy in patients with type 1 diabetes. Entry criteria included diabetes duration of ≥ 8 [...]

Published
2002

142. Hypogammaglobulinemia in uremic infants receiving peritoneal dialysis

Author

Katz, Avi, Kashtan, Clifford E., Greenberg, Leonard J., Shapiro, Ralph S., Nevins, Thomas E., and Kim, Youngki

Subjects
Immunoglobulins -- Measurement, Acute renal failure in children -- Complications, Peritoneal dialysis -- Adverse and side effects, Acute renal failure in children -- Physiological aspects, Health
Abstract

Patients with kidney disease who are receiving peritoneal dialysis (PD) usually have normal levels of antibodies, or immunoglobulins, even though immunoglobulins are known to be lost during PD. Immunoglobulin levels had not been measured in children under two years who have kidney disease, or uremia. To determine whether PD affects immunoglobulin levels, 13 infants with end-stage kidney disease who were treated with PD and 8 uremic infants not treated with PD were evaluated. The average age of the young patients was seven to nine months. Infants treated with PD had significantly lower levels of immunoglobulin of the G subtype, or gamma globulin, compared with nondialyzed infants. Levels of immunoglobulin subtype A were very low in three dialyzed infants and one infant who was not on PD. Losses of gamma globulin were measurable in dialysis fluid, but were not proportionally greater than losses from adults. Immunoglobulin G and A levels improved in patients who received kidney transplants or who stopped PD. Significant bacterial infections occurred in three of eight patients with very low levels of immunoglobulin G. In all of the infants immunoglobulin M levels were within the normal range. These results suggest that suppression of gamma globulin synthesis may occur in uremic infants, but further research is needed to establish the mechanism and outcome of this association. Uremic infants treated with PD may need preventive treatment with immunoglobulin replacement therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

150. Short-Term PTH(1-34) Therapy in Children to Correct Severe Hypocalcemia and Hyperphosphatemia due to Hypoparathyroidism: Two Case Studies

Author

Mishra, Pooja E., Schwartz, Betsy L., Sarafoglou, Kyriakie, Hook, Kristen, Kim, Youngki, and Petryk, Anna

Subjects
Article Subject
Abstract

The standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] for long-term control of hypocalcemia has been established, the benefits of short-term rhPTH(1-34) treatment in children have not been explored. We report two patients with hypoparathyroidism treated with rhPTH(1-34). Patient 1 is a 10-year-old female with polyglandular autoimmune syndrome type 1. Patient 2 is a 12-year-old female with hypoparathyroidism after total thyroidectomy. Both patients showed poor response to i.v. and oral calcium and calcitriol, and patient 1 did not respond to phosphate binders. Patient 1 had rapid increase in serum calcium with a decrease in serum phosphate after a 3-day course of subcutaneous rhPTH(1-34). Patient 2 had normalization of calcium and phosphate levels after a 7-day course of rhPTH(1-34). These cases support a role for rhPTH(1-34) in the acute management of hypoparathyroidism in hospitalized patients to more rapidly correct hypocalcemia and hyperphosphatemia, shorten hospitalization, and reduce the need for frequent i.v. calcium boluses.

Published
2016
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