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A marked improvement of renal osteodystrophy was achieved after a combined treatment with keto acids and vitamin D in patients with chronic renal failure. Results were checked by histological investigations. The biochemical background of the successful treatment was analysed. A regression of hyperparathroidism and improvement in vitamin D status are the cause of this phenomenon.

In 24 patients with a functioning kidney transplant and in 33 healthy subjects plasma renin activity (PRA), plasma aldosterone and vasopressin (AVP) levels were assessed under basal conditions and after dietary sodium restriction. Twelve patients were treated with azathioprine and another 12 with cyclosporine A. From the results obtained it seems that immunosuppressive drugs used in transplanted patients are involved in the pathogenesis of endocrine abnormalities and that the kind of immunosuppressive therapy is of minor importance in their development or maintenance. Transplanted kidneys show a preserved reaction pattern of renin secretion to sodium deprivation and upright position.

The postinsulin secretion pattern of the human growth hormone (HGH) was examined in 14 healthy and 27 diabetic children. Significantly higher HGH levels were found in diabetic than in healthy subjects before insulin injection as well as in the early phase of the test. This abnormality in HGH secretion increased with the duration of diabetes. No sex-related differences in HGH secretion were found in healthy or diabetic children.

Summary Sodium cellulose phosphate (SCP) was administered in a dose of 15 g per day to 2 patients with hyperoxaluria and to 11 stone-formers (8 with and 3 without hypercalciuria). Urinary calcium excretion decreased in all patients up to 50 per cent or less of basal values. Attacks of renal colic and the passage of small stones became less frequent. In the course of treatment a trend towards lower, although statistically not significantly lower, levels of serum magnesium, iron, copper and zinc concentrations was observed. In 2 patients with primary hyperparathyroidism symptomatic improvement of hypercalcaemia was observed. No subjective side-effects were noted; renal and liver function tests, blood cells and serum electrolytes did not show any change in the course of prolonged treatment with SCP. Four out of 10 patients exhibited lower levels of oxaluria after treatment. An increase of oxaluria was found mainly in those patients in whom a fall of magnesium levels developed in the course of treatment.

Water immersion (WI) induced alterations of plasma atrial natriuretic peptide (ANP), circulating plasma volume (PV), plasma, sodium and potassium level and mean blood pressure (MAP) were examined in 12 patients with noninflammatory acute renal failure (ARF) and in 15 healthy persons. In patients with ARF a significantly elevated basal ANP level (138.67 +/- 12.9 pg/ml versus 74.54 +/- 4.1 pg/ml in healthy persons and elevated MAP (111.9 +/- 3.5 mmHg in patients versus 87.3 +/- 1.8 mmHg in healthy persons) were found. WI induced a significant increase of plasma ANP level in both examined groups which was significantly more marked in healthy persons (152.42 +/- 12.82 pg/ml) than in patients with ARF (85.75 +/- 12.62 pg/ml). WI was accompanied by a significantly more marked reduction of MAP (22.6 +/- 2.9 mmHg) and sodium level (6.09 +/- 0.63 mmol/l) in patients with ARF than in healthy persons (12.07 +/- 1.52 mmHg and 4.2 +/- 0.11 mmol/l respectively). In contrast to healthy persons in patients with ARF WI did not induce enhanced diuresis. In patients with ARF a significantly more marked increase of PV was found than in controls. Data obtained in this study seem to prove preservation of the physiological regulatory mechanism of ANP secretion in ARF patients but reduction of ANP release induced by central volume expansion. The importance of elevated basal plasma levels in the maintenance of ARF has not been proven.