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Sample records for absorption renal function

  1. Short bowel patients treated for two years with glucagon-like Peptide 2: effects on intestinal morphology and absorption, renal function, bone and body composition, and muscle function

    Jeppesen, P B; Lund, P; Gottschalck, I B; Nielsen, H B; Holst, Jens Juul; Mortensen, J; Poulsen, S S; Quistorff, B; Mortensen, P B

    2009-01-01

    offered, to eleven SBS patients keeping parenteral support constant. 72-hour nutritional balance studies were performed at baseline, weeks 13, 26, 52 during two years intermitted by an 8-week washout period. In addition, mucosal morphometrics, renal function (by creatinine clearance), body composition and......, GLP-2 significantly reduced the fecal wet weight from approximately 3.0 to approximately 2.0 kg/day. This was accompanied by a decline in the oral wet weight intake, maintaining intestinal wet weight absorption and urinary weight constant. Renal function improved. No significant changes were...... demonstrated in energy intake or absorption, and GLP-2 did not significantly affect mucosal morphology, body composition, bone mineral density or muscle function. CONCLUSIONS: GLP-2 treatment reduces fecal weight by approximately 1000 g/d and enables SBS patients to maintain their intestinal fluid and...

  2. Renal Function in Hypothyroidism

    Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

  3. Renal Function in Hypothyroidism

    Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

  4. Markers of renal function tests

    Shivaraj Gowda

    2010-01-01

    Full Text Available Background : The markers of renal function test assess the normal functioning of kidneys. These markers may be radioactive and non radioactive. They indicate the glomerular filtration rate, concentrating and diluting capacity of kidneys (tubular function. If there is an increase or decrease in the valves of these markers it indicates dysfunction of kidney. Aim: The aim of this review is to compare and analyze the present and newer markers of renal function tests which help in diagnosis of clinical disorders. Material & Methods: An extensive literature survey was done aiming to compare and compile renal function tests makers required in diagnosis of diseases. Results: Creatinine, urea, uric acid and electrolytes are makers for routine analysis whereas several studies have confirmed and consolidated the usefulness of markers such as cystatin C and β-Trace Protein. Conclusion: We conclude that further investigation is necessary to define these biomarkers in terms of usefulness in assessing renal function.

  5. Renal function after renal artery stenting

    George S. Hanzel; Mark Downes; Peter A. McCullough

    2005-01-01

    @@ Atherosclerotic renal artery stenosis (ARAS), a common clinical finding, is increasing in prevalence as the population ages. ARAS is seen in ~ 7% of persons over 65 years of age1 and in ~ 20% of patients at the time of coronary angiography.2 It is an important cause of chronic kidney disease and may result in 11-14% of cases of end stage renal disease.3

  6. Radionuclide renal dynamic and function study

    The radionuclide dynamic and function study, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were reported in 14 cases of renal and ureteral calculi patients before and after extracorporeal shock wave lithotripsy (ESWL). In 12 cases with normal renal blood flow, within 3 months after ESWL, the GFR of shock and non-shock side decreased with different extent, while the individual ERPF had little change. In 5 cases followed up 1 year after ESWL, the individual GFR and ERPF were normal. In 2 cases of severe renal function insufficiency, there was no improvement in renal function in shock side, after 5 months and 1 year, the renal function was still at low level. Thereby it is considered that ESWL is not suitable for the renal calculi patients with severe renal function insufficiency

  7. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  8. Influences of renal stone surgeries on renal function

    From 1984 to 1990, 99mTc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94±5.60%) was significantly lower than that of PNL (-0.06±3.92%), pyelolithotomy (-4.08±4.79%) (p<0.01) and ESWL (-7.72±3.87%) (p<0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80±4.21% nephrolithotomy 4.67±4.73%, pyelolithotomy -1.46±5.39% and ESWL -2.02±4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possibility of deterioration of renal function after ESWL was suggested. (author)

  9. Renal function and atherosclerotic renovascular disease

    Bax, L.

    2008-01-01

    Renovascular disease (RVD) is a potentially reversible cause of renal failure and renovascular hypertension. However, in the absence of definitive clinical trials, there is a lack of evidence regarding its optimal management. We first addressed the central role of renal function in cardiovascular disease (CVD) in part I of this thesis. Renal function seems to have a strong relationship with atherosclerosis, a generalized process which starts early in life. In patients with manifest vascular d...

  10. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    Botros, Fady T.; Dobrowolski, Leszek; Navar, L. Gabriel

    2012-01-01

    Heme oxygenases (HO-1; HO-2) catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n = 7) and hemin-treated rats (n = 6) were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF) was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115 ± 5 mmHg versus 112 ± 4 mmHg and 331 ± 16 versus 346 ± 10 bpm). However, RBF was significantly higher (9.1 ± 0.8 versus 7.0 ± 0.5 mL/min/g, P < 0.05), and renal vascular resistance was significantly lower (13.0 ± 0.9 versus 16.6 ± 1.4 [mmHg/(mL/min/g)], P < 0.05). Likewise, glomerular filtration rate was significantly elevated (1.4 ± 0.2 versus 1.0 ± 0.1 mL/min/g, P < 0.05), and urine flow and sodium excretion were also higher (18.9 ± 3.9 versus 8.2 ± 1.0 μL/min/g, P < 0.05 and 1.9 ± 0.6 versus 0.2 ± 0.1 μmol/min/g, P < 0.05, resp.). The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models. PMID:22518281

  11. 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging to evaluate split renal GFR of unilateral renal function failure patient

    Objective: To explore the use of evaluating split glomerular flow rate (GFB) in patients with unilateral renal function failure by 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging. Methods: Split GFR of 82 cases with unilateral renal function failure was evaluated by 99Tcm- DTPA renal dynamic imaging, and was correlated with serum creatinine (SCr). Beside, causes of renal function failure were analyzed. Results: Split CFR were negatively correlated with SCr(r=-0.643, P99Tcm-DTPA renal dynamic imaging to treat early and reserve renal function. (authors)

  12. Renal function in diabetic nephropathy.

    Dabla, Pradeep Kumar

    2010-05-15

    Diabetic nephropathy is the kidney disease that occurs as a result of diabetes. Cardiovascular and renal complications share common risk factors such as blood pressure, blood lipids, and glycemic control. Thus, chronic kidney disease may predict cardiovascular disease in the general population. The impact of diabetes on renal impairment changes with increasing age. Serum markers of glomerular filtration rate and microalbuminuria identify renal impairment in different segments of the diabetic population, indicating that serum markers as well as microalbuminuria tests should be used in screening for nephropathy in diabetic older people. The American Diabetes Association and the National Institutes of Health recommend Estimated glomerular filtration rate (eGFR) calculated from serum creatinine at least once a year in all people with diabetes for detection of kidney dysfunction. eGFR remains an independent and significant predictor after adjustment for conventional risk factors including age, sex, duration of diabetes, smoking, obesity, blood pressure, and glycemic and lipid control, as well as presence of diabetic retinopathy. Cystatin-C (Cys C) may in future be the preferred marker of diabetic nephropathy due differences in measurements of serum creatinine by various methods. The appropriate reference limit for Cys C in geriatric clinical practice must be defined by further research. Various studies have shown the importance of measurement of albuminuria, eGFR, serum creatinine and hemoglobin level to further enhance the prediction of end stage renal disease. PMID:21537427

  13. Renal function studies with radioisotopes: an appraisal

    The use of radioisotopes in renal disorders has grown out of the development of scintillation detectors and gamma cameras and the availability of appropriate radioactive pharmaceuticals. It is now time to approach these studies from a different point of view. What further information would the practising nephrologist or urologist, physician or surgeon like to know about patients' kidney function that is not easily obtainable by non-radioactive methods. He would like a simple and reliable measurement of individual renal function; a test to demonstrate the presence or absence of obstruction in a patient with oliguria or uraemia; some help as to whether nephrectomy or a more difficult restorative operation is better for the patient with hydronephrosis, calculus or renal artery stenosis; a measure of the degree to which an obstructive uropathy is causing an obstructive nephropathy; clarification of which kidney to operate upon first when bilateral obstructive nephropathy presents with uraemia; a quantitative index of the progress following an operation to relieve an outflow system disorder; a screening procedure for renal disorders in the hypertensive and other populations; a prognostic guide to the likely evolution of glomerulonephritis and pyelonephritis, a prediction of the onset of rejection in the renal transplant, particularly in the presence of acute tubular necrosis. This review attempts to define the extent to which renal function studies with radioisotopes meet or fail to meet these needs and to indicate areas for potential development. (author)

  14. Drawbacks of the use of indirect estimates of renal function to evaluate the effect of risk factors on renal function

    Verhave, JC; Gansevoort, RT; Hillege, HL; De Zeeuw, D; Curhan, GC; De Jong, PE

    2004-01-01

    Many epidemiologic studies presently aim to evaluate the effect of risk factors on renal function. As direct measurement of renal function is cumbersome to perform, epidentiologic studies generally use an indirect estimate of renal function. The consequences of using different methods of renal funct

  15. Computerized technique for evaluating renal transplant function

    This investigation was undertaken to improve the assessment of renal transplant function in the early post-operative period when the usual measures of renal function afford little useful information. A simplified mathematical model of I-131 hippurate transport allows separation of renal uptake and excretion. Uptake (U) is defined as the fraction of I-131 hippurate in the plasma picked up by the kidney per minute, and excretion (E), the fraction of I-131 hippurate in the kidney excreted into the bladder per minute. Scintillation camera data from the region of the renal allograft are framed at 4/min by a computer system for up to 30 minutes post injection. After regions of interest are flagged over the kidney, bladder and background regions, the activity-time curves are analyzed, and values for U and E are output in a report updated through punched paper tape for any values from previous studies. The entire analysis of a patient study requires about 5 minutes of technologist time. Over 150 studies on 24 patients have been analyzed using the above technique. In the immediate post-operative state when anuria or severe oliguria is often present, sequential estimation of U was found to be a sensitive measure of renal transplant viability. In the period beyond one week reductions in U and E appeared to be sensitive measures of rejection, while increases in U and E heralded amelioration of the rejection episode. Changes in U and E appeared to be more sensitive measures of changes in renal function than routine qualitative scintiphotographic analysis. This technique has proven useful in following the renal function status of the kidney transplant recipient through acute tubular necrosis and rejection episodes and has been a significant adjunct to routine scintigraphy

  16. Renal replacement therapy after cardiac surgery; renal function recovers

    Steinthorsdottir, Kristin Julia; Kandler, Kristian; Agerlin Windeløv, Nis;

    2013-01-01

    To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy.......To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy....

  17. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    Fady T. Botros

    2012-01-01

    Full Text Available Heme oxygenases (HO-1; HO-2 catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n=7 and hemin-treated rats (n=6 were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115±5 mmHg versus 112±4 mmHg and 331±16 versus 346±10 bpm. However, RBF was significantly higher (9.1±0.8 versus 7.0±0.5 mL/min/g, P<0.05, and renal vascular resistance was significantly lower (13.0±0.9 versus 16.6±1.4 [mmHg/(mL/min/g], P<0.05. Likewise, glomerular filtration rate was significantly elevated (1.4±0.2 versus 1.0±0.1 mL/min/g, P<0.05, and urine flow and sodium excretion were also higher (18.9±3.9 versus 8.2±1.0 μL/min/g, P<0.05 and 1.9±0.6 versus 0.2±0.1 μmol/min/g, P<0.05, resp.. The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models.

  18. Radiopharmaceuticals for quantitative study of renal function

    Some topics discussed are as follows: the role of glomerular filtration and tubular reabsorption in renal function; measurement of glomerular filtration rate using inulin and derivatives labeled with 14C, 125I, 131I, and 51Cr, radioactive vitamin B12, contrast agents such as diatrizoate labeled with 125I and 131I and iothalamate labeled with 125I, and complexes of EDTA, DTPA, and citrate with 57Co, 58Co, 68Ga,/sup 99m/Tc, 111In, /sup 113m/In, /sup 114m/In, /sup 115m/In, 169Yb, and 197Hg; tubular secretion; measurement of renal plasma flow using 131I-labeled orthoiodohippurate; and measurement of renal blood flow using 197Hg-chlormerodrin, /sup 99m/Tc-pertechnetate, /sup 99m/Tc-Fe-ascorbic acid, /sup 99m/Tc-penicillamine-acetazolamide, /sup 99m/Tc-glucoheptonate, and /sup 99m/Tc-dimercaptosuccinic acid

  19. Application of pharmacokinetics local model to evaluate renal function

    1999-01-01

    The pharmacokinetics local model was used to evaluate renal function.Some typical kinds of renal function cases, normal or disorder, were selected to be imaged with SPECT and those data measured were treated by the pharmacokinetics local model computer program (PLM).The results indicated that parameters, including peak value, peak time, inflexion time, half-excretion time, and kinetic equation played and importantrole in judging renal function.The fact confirms that local model isvery useful in evaluating renal function.

  20. Effect of pediatric liver transplantation on renal function

    Hasan M.A. Isa

    2016-01-01

    Full Text Available The aim of this review is to define the incidence of renal dysfunction among pediatric liver transplant (LT survivors, to identify the associated risk factors and to outline the therapeutic options. Renal dysfunction is a common problem after pediatric LT. The measured glomerular filtration rate is considered the "gold-standard" for assessment of renal function. Renal dysfunction in pediatric LT recipients is multifactorial. Renal-sparing immunosuppressive strategies are essential to reverse renal dysfunction and to prevent end-stage renal disease.

  1. Detecting reduced renal function in children

    Andersen, Trine Borup; Jødal, Lars; Erlandsen, Erland J;

    2013-01-01

    using two cut-off levels, dividing renal function into normal or reduced, with an intermediate "gray zone" of indeterminable results.Methods Glomerular filtration rate was measured by plasma clearance of 51Cr-EDTA (13.7–147.4 mL/min/1.73 m2) in 119 children (age range 2.3–14.9 years).Reduced renal...... function was defined as a GFR of<82 mL/min/1.73 m2. SCr, SCysC, age-normalized creatinine (SCr-ratio), and eight published GFR-models were compared for their ability to correctly classify renal function as normal or reduced. Cut-off levels were determined so as to give 99 % certainty outside the gray zone.......Results The multivariable GFR-models by Schwartz et al. (J Am Soc Nephrol 2009; 20:629–637) and Zappitelli et al. (Am J Kidney Dis 2006; 48:221–230) and two models by Andersen et al. [Am J Kidney Dis 2012; 59(1):50–57: body cell mass (BCM)-model and Weight-model] performed significantly better than all other...

  2. Late renal function following whole abdominal irradiation

    Sixty patients treated with whole abdominal radiotherapy who had remained disease-free since completion of treatment participated in a study to assess the late clinical and biochemical effects of bilateral renal irradiation. Minimum follow-up was 5 years with a maximum of 20 years and a median of 9 years. Fifty-two patients in the study group were treated for primary ovarian cancer. Seven had non-Hodgkins lymphoma arising in the gastrointestinal tract and one patient had a carcinoid tumour arising in small bowel. None of the patients received chemotherapy. Abdominal radiation was given using an open beam technique to a mean dose of 22.92 Gy (range 6.68-27.54 Gy) in 1.02 to 1.25 Gy fractions treated once daily. Posterior kidney shields were used in order to limit the renal dose to <20 Gy. Mean radiation dose to both kidneys (retrospectively calculated) was 19.28 Gy (range 6.68-22.99 Gy). Patients ranged in age from 32-81 years with a median of 61 years. No patient had clinical evidence of renal impairment. Nine patients were hypertensive prior to radiotherapy and a further five patients became hypertensive after treatment. Serum creatinine values ranged from 44-123 μmol/l, with a mean of 87 μmol/l. Creatinine clearance ranged from 0.61-2.38 ml/s (mean 1.28 ml/s). Tubular function tests revealed one borderline high 24-h protein excretion and normal 24-h phosphorous and uric acid. Using a multiple linear regression analysis with creatinine clearance as the endpoint, age was the only significant variable (P < 0.00001) and renal dose and interval from treatment were not independently significant. There was no evidence of late renal toxicity more than 5 years after whole abdominal radiotherapy delivered with this technique and dose/fractionation schedule, and using the clinical and biochemical endpoints assessed in this study

  3. Renal collecting duct carcinoma: Report of a case with unusual imaging findings regarding renal function

    Longwang Wang

    2013-01-01

    Full Text Available Renal collecting duct carcinoma (CDC is a rare and aggressive type of renal cell cancer (RCC, which is difficult to confirm before surgery. We present a case of CDC presenting a hypovascular mass on renal CTA and deteriorated renal function of the affected kidney on single photon emission computed tomography (SPECT, which are different from the most common RCC, clear cell RCC. Considering these findings, it would be worthwhile investigating the role of CTA and SPECT in CDC diagnosis.

  4. Renal collecting duct carcinoma: Report of a case with unusual imaging findings regarding renal function

    Longwang Wang; Li Peng; Teng Hou; Ying Shi

    2013-01-01

    Renal collecting duct carcinoma (CDC) is a rare and aggressive type of renal cell cancer (RCC), which is difficult to confirm before surgery. We present a case of CDC presenting a hypovascular mass on renal CTA and deteriorated renal function of the affected kidney on single photon emission computed tomography (SPECT), which are different from the most common RCC, clear cell RCC. Considering these findings, it would be worthwhile investigating the role of CTA and SPECT in CDC diagnosis.

  5. Anatrophic nephrolithotomy: preservation of renal function demonstrated by differential quantitative radionuclide renal scans

    Belis, J.A.; Morabito, R.A.; Kandzari, S.J.; Lai, J.C.; Gabriele, O.F.

    1981-06-01

    Differential quantitative radionuclide renal scans have been used to confirm that early removal of staghorn calculi by anatrophic nephrolithotomy preserves renal parenchyma without significant renal damage by the surgical procedure. The /sup 99m/technetium diethylenetriaminepentaacetic acid scan was useful in predicting recovery of function in the involved kidney, while the /sup 131/iodine orthoiodohippurate scan provided a quantitative evaluation of the effect of the surgical procedure on individual kidney function. All of 13 consecutive patients evaluated by /sup 131/iodine orthoiodohippurate renal scans had stable or improved effective renal plasma flow to the involved kidney and an unchanged or improved total excretory index 6 months after nephrolithotomy.

  6. Late renal function following whole abdominal irradiation.

    Irwin, C; Fyles, A; Wong, C S; Cheung, C M; Zhu, Y

    1996-03-01

    Sixty patients treated with whole abdominal radiotherapy who had remained disease-free since completion of treatment participated in a study to assess the late clinical and biochemical effects of bilateral renal irradiation. Minimum follow-up was 5 years with a maximum of 20 years and a median of 9 years. Fifty-two patients in the study group were treated for primary ovarian cancer. Seven had non-Hodgkins lymphoma arising in the gastrointestinal tract and one patient had a carcinoid tumour arising in small bowel. None of the patients received chemotherapy. Abdominal radiation was given using an open beam technique to a mean dose of 22.92 Gy (range 6.68-27.54 Gy) in 1.02 to 1.25 Gy fractions treated once daily. Posterior kidney shields were used in order to limit the renal dose to creatinine values ranged from 44-123 mumol/l, with a mean of 87 mumol/l. Creatinine clearance ranged from 0.61-2.38 ml/s (mean 1.28 ml/s). Tubular function tests revealed one borderline high 24-h protein excretion and normal 24-h phosphorous and uric acid. Using a multiple linear regression analysis with creatinine clearance as the endpoint, age was the only significant variable (P < 0.00001) and renal dose and interval from treatment were not independently significant. There was no evidence of late renal toxicity more than 5 years after whole abdominal radiotherapy delivered with this technique and dose/fractionation schedule, and using the clinical and biochemical endpoints assessed in this study. PMID:8693108

  7. The renal quantitative scintillation camera study for determination of renal function

    The renal quantitative scintillation camera study assesses glomerular filtration rate and effective renal plasma flow based upon renal uptake of 99mtechnetium-iron ascorbate and 131iodine-hippuran, respectively. The method was compared to inulin, para-aminohippuric acid and creatinine clearance studies in 7 normal subjects and 9 patients with various degrees of reduced renal function. The reproducibility of the technique was determined in 15 randomly selected pediatric patients. The values of glomerular filtration rate and effective renal plasma flow were not significantly different from those of inulin and para-aminohippuric acid studies. The reproducibility of the technique was comparable to that of inulin and para-aminohippuric acid studies. Patient acceptance of the technique is excellent and the cost is minimal. Renal morphology and excretory dynamics also are demonstrated. The technique is advocated as a clinical measure of renal function

  8. Quantitation of renal transplant function - the 'function index'

    Full text: Scintigraphic assessment of renal transplant perfusion and function is helpful for the physician in distinguishing acute tubular necrosis (ATN) from acute rejection. This assessment mainly involves qualitative comparison of graphs and images which may be quite difficult, especially if the allograft is poorly functioning. We propose that a new quantitative index of renal function, the Function Index (FI), may improve assessment of the graft. The FI is calculated from a Rutland-Patlak's plot of kidney counts versus integrated heart counts. The value is derived together with Renal Output Efficiency and no additional ROIs (regions of interest) are required for processing. Compared to the Hilson Perfusion Index and the kidney:artery slope ratio, calculation of the FI is less operator dependent, the data is less noisy and the value is valid when using a whole kidney ROI. The interactive program, which incorporates calculation of the other standard kidney indices, was written for the Siemens ICON environment. The data for 72 scans were analysed retrospectively. The FI correlated very well with clinical outcomes. In serial imaging, a pattern of sharp decrease in FIs predicted rejection events while a stable FI accompanied by an increase in Renal Output Efficiency corresponded to improvement in ATN. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  9. EVALUATION OF RENAL FUNCTION IN PATIENTS WITH RENAL CELL CARCINOMA BEFORE AND AFTER RADICAL NEPHRECTOMY

    M I Kogan; Gusev, A. A.; S. V. Evseyev

    2014-01-01

    There is an increase in the number of patients with renal cell carcinoma (RCC) every year. At the same time radical nephrectomy (RN) remains the standard treatment of renal malignancies and the most common surgical procedure for this pathology. A considerable number of patients with kidney cancer have diminished renal function that worsens after removal of functioning kidney tissue together with a tumor. This promotes retained low overall survival rates in patients with RCC, by improving canc...

  10. [Falls and renal function: a dangerous association].

    De Giorgi, Alfredo; Fabbian, Fabio; Pala, Marco; Mallozzi Menegatti, Alessandra; Misurati, Elisa; Manfredini, Roberto

    2012-01-01

    Falls are an important health problem and the risk of falling increases with age. The costs due to falls are related to the progressive decline of patients' clinical conditions, with functional inability inducing increasing social costs, morbidity and mortality. Renal dysfunction is mostly present in elderly people who often have several comorbidities. Risk factors for falls have been classified as intrinsic and extrinsic, and renal dysfunction is included among the former. Chronic kidney disease per se is an important risk factor for falls, and the risk correlates negatively with creatinine clearance. Vitamin D deficiency, dysfunction of muscles and bones, nerve degeneration, cognitive decline, electrolyte imbalance, anemia, and metabolic acidosis have been reported to be associated with falls. Falls seem to be very frequent in dialysis patients: 44% of subjects on hemodialysis fall at least once a year with a 1-year mortality due to fractures of 64%. Male sex, comorbidities, predialysis hypotension, and a history of previous falls are the main risk factors, together with events directly related to renal replacement therapy such as biocompatibility of the dialysis membrane, arrhythmias, fluid overload and length of dialysis treatment. Peripheral nerve degeneration and demyelination as well as altered nerve conduction resulting in muscular weakness and loss of peripheral sensitivity are frequent when the glomerular filtration rate is less than 12 mL/min. Moreover, depression and sleep disorders can also increase the risk of falls. Kidney function is an important parameter to consider when evaluating the risk of falls in the elderly, and the development of specific guidelines for preventing falls in the uremic population should be considered. PMID:22718453

  11. The rebirth of interest in renal tubular function.

    Lowenstein, Jerome; Grantham, Jared J

    2016-06-01

    The measurement of glomerular filtration rate by the clearance of inulin or creatinine has evolved over the past 50 years into an estimated value based solely on plasma creatinine concentration. We have examined some of the misconceptions and misunderstandings of the classification of renal disease and its course, which have followed this evolution. Furthermore, renal plasma flow and tubular function, which in the past were estimated by the clearance of the exogenous aryl amine, para-aminohippurate, are no longer measured. Over the past decade, studies in experimental animals with reduced nephron mass and in patients with reduced renal function have identified small gut-derived, protein-bound uremic retention solutes ("uremic toxins") that are poorly filtered but are secreted into the lumen by organic anion transporters (OATs) in the proximal renal tubule. These are not effectively removed by conventional hemodialysis or peritoneal dialysis. Residual renal function, urine produced in patients with advanced renal failure or undergoing dialysis treatment, may represent, at least in part, secretion of fluid and uremic toxins, such as indoxyl sulfate, mediated by proximal tubule OATs and might serve as a useful survival function. In light of this new evidence of the physiological role of proximal tubule OATs, we suggest that measurement of renal tubular function and renal plasma flow may be of considerable value in understanding and managing chronic kidney disease. Data obtained in normal subjects indicate that renal plasma flow and renal tubular function might be measured by the clearance of the endogenous aryl amine, hippurate. PMID:26936872

  12. Vesicoureteral reflux simulating renal function: CT appearance

    Hertz, M.; Rubinstein, Z.J.; Apter, S. (Chaim Sheba Medical Center, Tel Aviv (Israel). Dept. of Diagnostic Imaging)

    1991-02-01

    Urine may enter the pelvicalyceal system of the kidney either through renal excretion or via the ureter by vesicoureteral reflux. Opacified cyalyces and pelvis after the administration of intravenous contrast material are therefore not necessarily proof that the kidney is functioning. This phenomenon, well known from intravenous urography, may be observed on computed tomography studies as well. We present a case in which a CT scan showed a normal left and a contracted pyelonephritic right kidney with contrast material in pelvis and calydes of both kidneys without parenchymal enhancement on the right side. Subsequently marked vescioureteral reflux to the right kidney was demonstrated on cystourethrography and the kidney was shown to have no function on a nuclear scan. Contrast material in the collecting system associated with a small non-enhancing kidney on CT scan should suggest vesicoureteral reflux. (orig.).

  13. Vesicoureteral reflux simulating renal function: CT appearance

    Urine may enter the pelvicalyceal system of the kidney either through renal excretion or via the ureter by vesicoureteral reflux. Opacified cyalyces and pelvis after the administration of intravenous contrast material are therefore not necessarily proof that the kidney is functioning. This phenomenon, well known from intravenous urography, may be observed on computed tomography studies as well. We present a case in which a CT scan showed a normal left and a contracted pyelonephritic right kidney with contrast material in pelvis and calydes of both kidneys without parenchymal enhancement on the right side. Subsequently marked vescioureteral reflux to the right kidney was demonstrated on cystourethrography and the kidney was shown to have no function on a nuclear scan. Contrast material in the collecting system associated with a small non-enhancing kidney on CT scan should suggest vesicoureteral reflux. (orig.)

  14. Effects of transient post ESWL obstruction on renal function

    Introduction and Objectives: This study examined the effects of transient post SWL obstruction on renal function after its application for treatment of renal stones in one non-obstructed kidney, using two different lithotripters. Method: This study included one hundred consecutive patients with unilateral renal stones were treated by SWL monotherapy in our center. The patients had normal laboratory profile in terms of renal function, liver function, blood picture, bleeding and clotting time, prothrombin concentration, and no or controlled urinary tract infection. Also, the urinary tract was radiologically normal with no obstruction. 99mTechnetium mercaptoacetyl triglycine (99mTc-MAG3) and 99mTechnetium dimercaptosuccinic acid (99mTc-DMSA) renographic studies together with Doppler sonography were performed for all cases few days before, one week after and three months after SWL. Renal uptake, Tmax, split renal function, ERPF and detection of renal scarring can be obtained from renographic studies as well as resistive index which can be calculated using Doppler sonography. Patients were stratified into 2 groups; Group I). Patients with non obstructed kidneys after SWL (N = 84), Group II) Patients with obstructed kidneys one week after SWL. (N = 16). Results: In group I, we found slight but statistically significant improvement of renal function. In group II, a significant deterioration of ipsilateral renal function was observed one week after SWL. This was due to transient obstruction by stein strasse. This improved after 3 months, but still below the pre SWL baseline function. DMSA scan revealed no changes after 3 months in both groups. Furthermore, there were no significant changes of the resistive index in both groups. Conclusion: Post SWL obstruction although transient has a major effect on the renal function on the treated side and must be managed urgently. On the other hand, SWL of renal stones in normal kidneys, with no post treatment obstruction, has no

  15. Renal function in streptozotocin-diabetic rats

    Jensen, P K; Christiansen, J S; Steven, K;

    1981-01-01

    Renal function was examined with micropuncture methods in the insulin-treated streptozotocin-diabetic rat. Kidney glomerular filtration rate was significantly higher in the diabetic rats (1.21 ml/min) than in the control group (0.84 ml/min) Nephron glomerular filtration rate increased in proportion...... to the rise in kidney glomerular filtration rate (diabetic rats: 37.0 nl/min; control rats: 27.9 nl/min). Likewise renal plasma flow was significantly higher in the diabetic rats (4.1 ml/min) than in the control group (3.0 ml/min). Glomerular capillary pressure was identical in both groups (56.0 and...... 56.0 mmHg, respectively). The proximal intratubular pressure was significantly reduced in the diabetic rats (10.4 mmHg; control value: 12.5 mmHg). The effective glomerular ultrafiltration coefficient was slightly but not significantly higher in the diabetic rats (0.027 nl s-1mmHg-1) than in the...

  16. Evaluation of recovery in hydronephrosis using renal functional CT studies

    Using renal functional CT studies, we studied 22 patients who underwent surgical treatment for unilateral hydronephrosis. The tissue-plasma ratio of contrast enhancement (TPR), which is an indicator of renal function per unit of parenchymal volume, improved after the operation. On the other hand, the renal parenchymal volume (PV) decreased in proportion to the shrinkage of the kidney. The pre and postoperative values of renal functional index (RFI), the product of the TPR and PV, showed a good correlation (r=0.928, p<0.01). Therefore, RFI values were found to be useful for assessing the recovery of hydronephrosis. (author)

  17. Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

    Kneifel, M; Scholze, A; Burkert, A;

    2006-01-01

    It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...... photoplethysmography. Mean age was 51 +/- 2 years (mean +/- SEM), and studies were performed 17 +/- 1 months after transplantation. The stage of chronic kidney disease was based on the glomerular filtration rate. We observed a significant association between the stage of chronic kidney disease and arterial stiffness...... of large arteries S1 and small arteries S2 in renal transplant recipients (each p older...

  18. Spiral CT in kidney: assumption of renal function by objective evaluation of renal cortical enhancement

    To correlate the degree of renal cortical enhancement, objectively evaluated by means of spiral CT with the serum level of creatinine, and to determine the extent to which this degree of enhancement may be used to detect renal parenchymal disease. Eighty patients (M:F = 50:30; age + 25-19, (mean 53) years) with available serum level of creatinine who underwent spiral CT between September and October 1999 were included in this study. In fifty patients the findings suggested hepatic or biliary diseases such as hepatoma, biliary cancer, or stone, while in thirty, renal diseases such as cyst, hematoma, or stone appeared to be present. Spiral CT imaging of the cortical phase was obtained at 30-40 seconds after the injection of 120 ml of non-ionic media at a rate of 3 ml/sec. The degree of renal cortical enhancement was calculated by dividing the CT attenuation number of renal cortex at the level of the renal hilum by the CT attenuation number of aorta at the same level. The degree of renal cortical enhancement was compared with the serum level of creatinine, and the degree of renal cortical enhancement in renal parenchymal disease with that of the normal group. Among eighty patients there were five with renal parenchymal disease and 75 with normal renal function. The ratio of the CT attenuation number of renal cortex to that of aorta at the level of the renal hilum ranged between 0.49 and 0.99 (mean, 0.79; standard deviation, 0.15). while the serum level of creatinine ranged between 0.6 and 3.2 mg/dl. There was significant correlation (coefficient of -0.346) and a statistically significant probability of 0.002 between the ratio of the CT attenuation numbers and the serum level of creatinine. There was a significant difference (statistically significant probability of less than 0.01) between those with renal parenchymal disease and the normal group. The use of spiral CT to measure the degree of renal cortical enhancement provides not only an effective index for

  19. Assessment of renal function with 99Tcm-DTPA renal dynamic imaging in neonatal hydronephrosis

    Objective: To assess the renal function in neonatal hydronephrosis with 99Tcm-DTPA renal imaging. Methods: Eighteen unilateral hydronephrotic kidneys and 12 normal kidneys were studied by 99Tcm-DTPA renal dynamic imaging , and glomerular filtration rate (GFR) quantitative analysis was also performed. Blood urea nitrogen (BUN), serum creatinine (SCr) and hemoglobin (Hb) were determined simultaneously and the correlations between GFR and each of these parameters were analyzed. Results: Positive correlation was discovered between GFR and Hb in neonates with moderate or severe hydronephrosis (r=0.414, 0.667, P0.05). The renal function was decreased significantly in moderate and severe neonatal hydronephrosis (P99Tcm-DTPA renal dynamic imaging GFR is an ideal marker for estimating renal function in neonatal hydronephrosis; SCr could be a marker for renal damage especially in moderate and severe neonatal hydronephrosis; BUN could not be a marker for evaluating renal function in neonatal hydronephrosis. Neonates with hydronephrosis should be referred for surgical procedures as soon as possible in the early stage

  20. Quantitation of renal function using radioisotopic techniques.

    O'Malley, J P; Ziessman, H A

    1993-03-01

    Radioisotopic methods are practical for clinical use because they do not require continuous intravenous infusion or urine collection. This obviously is of great advantage in infants and small children, in whom accurate urine collection is difficult, but the techniques apply to adults as well. The ability to determine individual kidney function is a major benefit. Accuracies of the radioisotopic techniques vary but generally are within clinically acceptable ranges. The need for accuracy and reproducibility can be balanced with the desire for speed and convenience when choosing among the different techniques. Methods that use plasma sampling provide greater accuracy and are recommended in cases of severe dysfunction, whereas methods such as Gates' camera method, which eliminates plasma samples, can be completed in minutes. Radioisotopic techniques are most useful in the ranges of mild to moderately decreased function, in which serum creatinine concentration is nondiagnostic, and although they are much less accurate at markedly low renal function levels, so is 24-hour creatinine clearance. In conclusion, radiopharmaceutical agents offer a wide array of possible techniques for simple, accurate, and noninvasive measurement of global as well as individual GFR and ERPF. PMID:8462269

  1. Antireflux surgery does not change ongoing renal functional deterioration.

    Arslansoyu Çamlar, Seçil; Çağlar, Sevinç; Soylu, Alper; Türkmen, Mehmet Atilla; Kavukçu, Salih

    2016-04-01

    Aim Treatment modalities of vesicoureteral reflux (VUR) consist of antimicrobial prophylaxis and antireflux surgery. In this study, we aimed to determine if antireflux surgery changes the course of renal functional deterioration in children with VUR and urinary tract infections (UTI). Methods Medical files of patients with VUR diagnosed during evaluation for UTI were evaluated retrospectively for gender, age, follow-up period, and renal ultrasonography (US) and serial 99mTc-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy findings. Estimated glomerular filtration rate and urinary protein levels were determined at the initial and last visits, and before the operation in children who had antireflux surgery. The patients were divided into two groups as solely medically treated (Group 1) and both medically and surgically treated (Group 2). Group 2 was further divided as those with stable renal function (Group 2a) and with progressive renal injury (Group 2b). Results There were 140 patients (77 female; mean age 51.6 ± 51.9 months). Group 1 and Group 2 included 82 and 58 patients, respectively. In Group 2, the number of patients with the abnormal US, DMSA scintigraphy, and renal function was higher than in Group 1. Recurrent UTI rate was similar, but progressive scarring was more prominent in the antireflux surgery group. In Group 2, 31 patients had a stable renal function (Group 2a) while 27 had progressive deterioration of renal functions (Group 2b). These subgroups were not different with respect to the rate of high-grade VUR, the presence of a renal scar in DMSA, and UTI recurrence. However, the bilateral renal scar was more common in Group 2b. Conclusion Antireflux surgery does not change the course of ongoing renal injury and renal functional deterioration. PMID:26786885

  2. Effects of radiofrequency ablation on individual renal function: assessment by technetium-99m mercaptoacetyltriglycine renal scintigraphy.

    Nasu,Yasutomo

    2006-04-01

    Full Text Available We quantitatively evaluated total and individual renal function by technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3 renal scintigraphy before and after radiofrequency ablation (RFA of renal tumors. Eleven patients who underwent Tc-99m MAG3 renal scintigraphy 1 week before and after RFA were evaluated (7 men and 4 women ; age range : 23-83 years ; mean age : 60.6 years. Five patients had solitary kidneys, and five had normally or minimally functioning contralateral kidneys. One patient had a renal cell carcinoma in the contralateral kidney. One patient with a solitary kidney underwent RFA a second time for a residual tumor. In patients with a solitary kidney, MAG3 clearance decreased after 5 of 6 RFAs, and in patients with a normally functioning contralateral kidney, MAG3 clearance decreased after 4 of 5 RFAs, but no significant differences were observed between before and after treatments. In addition to the total MAG3 clearance, the split MAG3 clearance was evaluated in patients with a normally functioning contralateral kidney. MAG3 clearance decreased in 4 of 5 treated kidneys, while it adversely increased in the contralateral kidneys after 4 of 5 RFAs. No significant differences, however, were observed between before and after treatments. The results of our study revealed no significant differences in sCr, BUN, CCr, or MAG3 clearance between pre- and post-RFA values. These results support data regarding the functional impact and safety of renal RFA in published reports. We evaluated total and individual renal function quantitatively using Tc-99m MAG3 renal scintigraphy before and after treatment. This scintigraphy was very useful in assessing the effects of RFA on renal function.

  3. Copeptin, a Surrogate Marker of Vasopressin, Is Associated With Accelerated Renal Function Decline in Renal Transplant Recipients

    Meijer, Esther; Bakker, Stephan J. L.; de Jong, Paul E.; van der Heide, Jaap J. Homan; van Son, Willem J.; Struck, Joachim; Lems, Simon P. M.; Gansevoort, Ron T.

    2009-01-01

    Background. Chronically elevated vasopressin (VP) plasma levels have been shown to induce accelerated renal function decline in rats with chronic renal failure. Whether endogenous VP is a renal risk factor in humans has not been investigated yet. We aimed to investigate whether, in renal transplant

  4. A clinical study of the influence of percutaneous nephroureterolithotomy on renal function using 99mTc-DMSA renal scintigraphy

    To clarify the influence of percutaneous nephroureterolithotomy (PNL) on renal function, 99mTc-DMSA renal scientigraphy was performed preoperatively and 3, 6 and 12 months after the procedure. In 50 stone-containing renal units, 48 patients, changes of DMSA renal uptake rate were investigated for determination of individual renal function. In 3 cases with staghorn calculi which complicated with pyelonephritis during PNL procedure, DMSA renal uptake rate was decreased after PNL. On the other hand, DMSA renal uptake rate was almost stationary after PNL in other cases. In 21 renal units (42 %), the postoperative renal scintigrams showed low uptake or cold areas at nephrostomy tracts. These results indicate that control of infection during PNL is important to maintain renal function. (author)

  5. Renal Involvement in Leptospirosis: The Effect of Glycolipoprotein on Renal Water Absorption

    Cesar, Katia Regina; Romero, Eliete Caló; de Bragança, Ana Carolina; Blanco, Roberta Morozetti; Abreu, Patrícia Antonia Estima; Magaldi, Antonio José

    2012-01-01

    Background Leptospirotic renal lesions frequently produce a polyuric form of acute kidney injury with a urinary concentration defect. Our study investigated a possible effect of the glycolipoprotein, (GLPc) extracted from L. interrogans, on vasopressin (Vp) action in the guinea pig inner medullary collecting duct (IMCD). Methods The osmotic water permeability (Pf µm/s) was measured by the microperfusion in vitro technique. AQP2 protein abundance was determined by Western Blot. Three groups we...

  6. Worsening renal function in patients with baseline renal impairment treated with intravenous voriconazole: A systematic review.

    Turner, R Brigg; Martello, Jay L; Malhotra, Ashim

    2015-10-01

    The objective of this paper was to review the risk of worsening renal function in patients with pre-existing renal impairment receiving intravenous voriconazole (IVV). Controversy exists regarding the cause and risk of renal dysfunction in patients treated with IVV. Whilst some studies implicate renally excreted cyclodextrin, a pharmaceutical formulation stabiliser, as the cause of renal dysfunction following voriconazole administration, others provide contradicting evidence. Here we analyse the available literature to gain an insight into the significance of renal toxicity in patients treated with IVV. PubMed was searched for relevant studies to December 2014. To account for publication bias, abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy, the Infectious Diseases Society of America/ID Week, and the European Congress of Clinical Microbiology and Infectious Diseases from 2008-2014 were reviewed. Bibliographies of all identified articles were reviewed and cross-referenced for additional sources. Seven retrospective studies were identified for inclusion in the review; no prospective studies were identified. Based on the available evidence, we conclude that there is no strong evidence suggesting an increased incidence of worsening renal function with IVV use. No study thus far has provided direct conclusive evidence for cellular and physiological renal toxicity due to IVV at clinically prevalent doses. PMID:26253129

  7. Early impact of robot-assisted partial nephrectomy on renal function as assessed by renal scintigraphy.

    Luciani, Lorenzo G; Chiodini, Stefano; Donner, Davide; Cai, Tommaso; Vattovani, Valentino; Tiscione, Daniele; Giusti, Guido; Proietti, Silvia; Chierichetti, Franca; Malossini, Gianni

    2016-06-01

    To measure the early impact of robot-assisted partial nephrectomy (RAPN) on renal function as assessed by renal scan (Tc 99m-DTPA), addressing the issue of risk factors for ischemic damage to the kidney. All patients undergoing RAPN for cT1 renal masses between June 2013 and May 2014 were included in this prospective study. Renal function as expressed by glomerular filtration rate (GFR) was assessed by Technetium 99m-diethylenetriaminepentaacetic acid (Tc 99m-DTPA) renal scan preoperatively and postoperatively at 1 month in every patient. A multivariable analysis was used for the determination of independent factors predictive of GFR decrease of the operated kidney. Overall, 32 patients underwent RAPN in the time interval. Median tumor size, blood loss, and ischemia time were 4 cm, 200 mL, and 24 min, respectively. Two grade III complications occurred (postoperative bleeding in the renal fossa, urinoma). The GFR of the operated kidney decreased significantly from 51.7 ± 15.1 mL/min per 1.73 m(2) preoperatively to 40, 12 ± 12.4 mL/min per 1.73 m(2) 1 month postoperatively (p = 0.001) with a decrease of 22.4 %. On multivariable analysis, only tumor size (p = 0.05) was a predictor of GFR decrease of the operated kidney. Robotic-assisted partial nephrectomy had a detectable impact on early renal function in a series of relatively large tumors and prevailing intermediate nephrometric risk. A mean decrease of 22 % of GFR as assessed by renal scan in the operated kidney was found at 1 month postoperatively. In multivariable analysis, tumor size only was a significant predictor of renal function loss. PMID:26994776

  8. Renal Function in Children with Febrile Convulsions

    Ladan AFSHARKHAS

    2014-12-01

    Full Text Available How to Cite This Article: Afsharkhas L, Tavasoli A. Renal Function in Children with Febrile Convulsions.Iran J Child Neurol. 2014 Autumn;8(4:57-61.AbstractObjectiveFebrile convulsions (FC are the most frequent seizure disorder in children.Some studies have detected serum electrolyte disturbances in patients with FC.This study determines serum electrolytes, renal function tests, and frequency of urinary tract infection in hospitalized children with FC.Materials & MethodsIn this descriptive, cross sectional study, we evaluated 291 children with FC admitted to the Neurology ward of Ali-Asghar Children’s Hospital from 2008–2013. Data was recorded on age, sex, type (simple, complex, and recurrence of seizures, family history of FC and epilepsy, serum electrolytes, renal function tests, and urinary tract infections.ResultsA total of 291 patients with diagnosis of FC were admitted to our center. Of these 291 patients, 181 (62.2% were male. The mean age was 24.4 ± 14.6 months.There were simple, complex, and recurrent FCs in 215 (73.9%, 76 (26.1% and 61 (21% of patients, respectively. Urinary tract infections (UTI were found in 13 (4.5% patients, more present in females (p-value = 0.03 and under 12 months of age (p-value = 0.003. Hyponatremia, hypocalcemia, and hypokalemia was detected in 32 (11%, 16 (5.5%, and 4 (1.4% of cases, respectively. Twentyfour (8.2% patients had a glomerular filtration rate less than 60 ml/min/1.73m2.There were no abnormalities in serum magnesium, BUN, and creatinine levels.ConclusionDuring FCs, mild changes may occur in renal function but a serum electrolyte evaluation is not necessary unless patients are dehydrated. In children with FC, urinary tract infections should be ruled out. ReferencesGhofrani M. Febrile Convulsion: Another look at an old subject. Iran J Child Neurology 2006 June:1(1:5-9.Swaiman K, Ashwal S, Ferriero D, Schor N. Swaiman’s Pediatric Neurology: Principles and Practice. 5th edition

  9. Evaluation of renal function in children with vesicoureteral reflux

    Renal uptake rate was calculated by 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy in 100 kidneys from 58 patients with pediatric vesicoureteral reflux (VUR) to assess kidney function quantitatively for treatment selection and surgical timing. The conservatively treated group consisted of 42 patients (75 kidneys) who underwent DMSA renal scintigraphy twice at intervals of 2 years during their management. The surgically treated group consisted of 16 patients (25 kidneys) who underwent DMSA renal scintigraphy before and 2 years after surgery, Urine samples were collected at the time of initial DMSA renal scintigraphy for the simultaneous measurement of β2-microglobulin (β2-MG), α1-microglobulin and N-acetyl-β-glucosaminidase. Renal uptake ratio of DMSA did not differ in VUR grades during a 2-year follow-up period in the conservative group. In the age group of patients aged 2 or less, renal uptake ratio decreased 2 years later, with significant difference with that in the other age groups. According to VUR grade, there was no significant difference in DMSA renal kidney ratios between the conservative group and the surgical group. According to age, significant difference in renal uptake ratio was observed between the two groups; i.e., patients aged 2 or less had a significantly decreased renal uptake ratio in the conservative group than the surgical group. However, the renal uptake ratio did not differ in the other age groups. For patients aged 2 or less, surgery was considerd necessary to prevent reflux when urinary β2-MG indexes are increased. For those aged 3 years or more, on the other hand, conservative treatment was considered optimal regardless of VUR grades; surgery was considered recommended in the case of repeated urinary infection and decreased renal function. (N.K.)

  10. A re-appraisal of volume status and renal function impairment in chronic heart failure : combined effects of pre-renal failure and venous congestion on renal function

    Sinkeler, Steef J.; Damman, Kevin; van Veldhuisen, Dirk J.; Hillege, Hans; Navis, Gerjan

    2012-01-01

    The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal imp

  11. From anatomy to function: diagnosis of atherosclerotic renal artery stenosis.

    Odudu, Aghogho; Vassallo, Diana; Kalra, Philip A

    2015-12-01

    Atherosclerotic renal artery stenosis (ARAS) affects 7% of the over 65 s and will be increasingly common with an ageing population. ARAS obstructs normal renal perfusion with adverse renal and cardiovascular consequences. Drug therapy is directed at reducing atherosclerotic risk. Two recent major trials of revascularization for ARAS showed that clinical outcomes were not improved beyond those offered by optimal drug therapy in most patients. This reflects experimental data showing that restoration of blood flow alone may not attenuate a cascade of tissue injury. A shift from anatomic to functional imaging of ARAS coupled to novel therapies might improve clinical outcomes in selected patients. This review outlines the case for separately assessing hemodynamic significance of arterial stenosis and functional reserve of renal parenchymal tissue. The authors consider current and emerging diagnostic techniques for ARAS and their potential to allow individualized and functionally directed treatments. PMID:26480218

  12. Quantitative renal function study using TC-99mDTPA and TC-99mDMSA

    In quantitative renal function studies using Tc-99m DTPA and Tc-99m DMSA, the kidney depth is an important factor to control the gamma rays' absorption by the soft tissue. However, to date, this renal depth has been estimated from the patient's height and weight according to the formula of Toennesen. In the present study, we measured the kidney depth by ultrasonography and so determined the renal uptake of Tc-99m DTPA and Tc-99m DMSA. Using the kidney depth as measured by ultrasonography, the correlation coefficient between renal uptake of Tc-99m DTPA and GFR (determined by the clearance method) was 0.878 and that between renal uptake of Tc-99m DMSA and ERPF (determined from paraaminohippuran clearance) was 0.945. On the other hand, using the kidney depth as calculated by Toenneren's formula, the correlation coefficient between Tc-99m DTPA uptake and GFR was 0.849 and that between Tc-99m DMSA uptake and ERPF was 0.891. Thus, the renal depth measured by ultrasonography provided a closer correlation than that calculated according to Toenesen's formula. (author)

  13. Effect Of Prostaglandins On Renal Function In Uninephrectomized Sheep

    Immediately after unilateral nephrectomy, different mechanisms of compensatory adaptation begin to act followed by a restoration of sufficient kidney function in a short time period. Some animal studies showed that prostaglandins (PG) are important for renal function after unilateral nephrectomy. The aim of the present study was to investigate the role of prostaglandins on renal function in the fully adapted remnant kidney in healthy uninephrectomized sheep and the acute effect of indomethacin on renal haemodynamics. In order to investigate the importance of prostaglandins on the renal function in the fully adapted remnant kidney, indomethacin (0.8 mg/kg) was injected intravenously immediately before and after unilateral nephrectomy. Forty sheep with unilateral nephrectomy were divided randomly into two groups; twenty sheep (group 1) untreated with indomethacin (unsuppressed PG) and the other twenty ones (group 2) were treated with indomethacin (suppressed PG) before and after clamping the renal pedicle and then instantaneously, the glomerular filtration rate (GFR) and the effective renal plasma flow (ERPF) were measured using non-invasive radionuclide technique then the filtration fraction (FF) was calculated. The study showed that there was considerable and instantaneous increase in GFR (148%) and a proportionate increase in the ERPF (91%) in the remaining kidney post-uninephrectomy, and treatment with indomethacin for suppression of prostaglandins synthesis showed non-significant changes in these measured values. The present study showed enhanced function, as measured by GFR and ERPF, in the remaining kidney as a compensatory effect of unilateral nephrectomy and the changes are not prostaglandins mediated

  14. The colon: Absorptive, seccretory and metabolic functions.

    Cummings, J G

    1975-01-01

    The role which the human colon fulfils in digestion and metabolism remains largely undocumented. Its capacity to conserve water and electrolytes is well known although how this is controlled is uncertain. In the animal kingdom, calcium and magnesium absorption from the colon are improtant as are absorption and synthesis of vitamins. The abundant microflora of the human colon gives it unique properties. Dietary residue is metabolised forming short-chain fatty acids, hydrogen, carbon dioxide and methane; whilst 20% of urea synthesised in man is broken down in the colon to ammonia, which is reabsorbed, and carbonic acid. The microflora also degrades a wide variety of organic compounds including food additives, drugs, bile salts, and cholesterol which may be relevant to the development of colon cancer. Regional differences in colonic function also exist making interpretation of data from this relatively inaccessible organ more difficult. PMID:1205009

  15. Functional obstruction: the renal pelvis rules

    Mendelsohn, Cathy

    2004-01-01

    Failure in the peristaltic mechanism that conducts urine from the kidney to the bladder can lead to hydronephrosis, a common birth defect associated with obstructive nephropathy. New animal models reveal molecular pathways important for peristalsis and point to the central role of the renal pelvis in urine transport.

  16. Renal Artery Stenting in Patients with a Solitary Functioning Kidney

    Purpose: To retrospectively evaluate the results of renal artery stenting in patients with renovascular disease and a solitary functioning kidney.Methods: Palmazstents were placed in 16 patients with a solitary functioning kidney,renal artery stenosis, hypertension and renal failure. Stenoses were evaluated with color Doppler ultrasound, MR angiography and digital subtraction angiography (DSA). Indications for stenting were: recoil after percutaneous transluminal renal angioplasty (PTRA) (63%),arterial dissection after PTRA (13%) and primary stenting (25%).Immediate results were evaluated by DSA. On follow-up (6-36 months),patients underwent periodical evaluation of clinical conditions (blood pressure and serum creatinine level) and stent patency, by means of color Doppler ultrasound.Results: Stent placement was successful in all patients (100%). Cumulative primary patency rate was: 100% at 1 day, 93.75% at 6 months, 81.25% at 12 months and 75% at 24 months. A significant reduction in diastolic blood pressure occurred (mean ± SD 104 ± 6 vs 92 ± 3;p 0.05).Conclusion: Renal artery stenting, both after PTRA and as primary stenting, represents a safe procedure, able to preserve renal function in patients with a solitary functioning kidney

  17. Targeted reduction of advanced glycation improves renal function in obesity

    Harcourt, Brooke E; Sourris, Karly C; Coughlan, Melinda T;

    2011-01-01

    Obesity is highly prevalent in Western populations and is considered a risk factor for the development of renal impairment. Interventions that reduce the tissue burden of advanced glycation end-products (AGEs) have shown promise in stemming the progression of chronic disease. Here we tested if...... function and an inflammatory profile (monocyte chemoattractant protein-1 (MCP-1) and macrophage migration inhibitory factor (MIF)) were improved following the low-AGE diet. Mechanisms of advanced glycation-related renal damage were investigated in a mouse model of obesity using the AGE......, and renal oxidative stress. Alagebrium treatment, however, resulted in decreased weight gain and improved glycemic control compared with wild-type mice on a high-fat Western diet. Thus, targeted reduction of the advanced glycation pathway improved renal function in obesity....

  18. Angiography for renal artery stenosis: no additional impairment of renal function by angioplasty

    Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J. [Abteilung Nephrologie, Medizinische Hochschule Hannover (Germany); Hoogestraat-Lufft, Linda; Galanski, Michael [Abteilung Diagnostische Radiologie, Medizinische Hochschule Hannover (Germany)

    2002-04-01

    The aim of this study was to compare renal function between patients with renal angiography and patients with renal angiography and angioplasty (AP) for renal artery stenosis (RAS). Forty-seven patients with suspected RAS were prospectively investigated by digital subtraction angiography (DSA) using non-ionic low osmolar contrast media (CM). In 22 patients RAS was detected and in 16 cases an angioplasty was performed in the same session. The following parameters were determined 1 day prior to and after the DSA, respectively: serum creatinine (S-Crea, {mu}mol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, {mu}g/g Crea) and beta-N-acetyl-glucoseaminidase (beta-NAG, U/g Crea) as markers of tubular toxicity. Serum creatinine was measured additionally 2 days after CM had been injected. In both groups with and without AP 174{+-}65 and 104{+-}56 ml of CM (p<0.0005) were used, respectively. There were no differences with regard to renal function or risk factors for CM nephrotoxicity between both groups. In the group with AP S-Crea and In-Cl (each: mean{+-}SD) did not change significantly (before DSA: 171{+-}158 and 61{+-}24, after DSA: 189{+-}177 and 61{+-}25, respectively), beta-NAG (median) rose from 4 to 14 (p<0.05) and AMG from 8 to 55 (n.s., because of high SD). In the group without AP S-Crea increased from 134{+-}109 to 141{+-}113 (p<0.01), In-Cl dropped from 65{+-}26 to 62{+-}26 (p<0,01), beta NAG (median) rose from 4 to 8 (p=0.01), and AMG from 7 to 10 (n.s.). A rise in baseline S-Crea by more than 25% or 44 {mu}mol/l occurred in 4 and 2 patients in the group with and without AP, respectively. Creatinine increase was reversible in all cases within 7 days. In this study using sensitive methods to detect changes of renal function and tubular toxicity no additional renal function impairment in DSA with angioplasty for RAS compared with DSA alone could be demonstrated. Our data suggest

  19. Effects of renal depth difference on the split renal function in the measure of glomerular filtration rate through renal dynamic imaging

    Objective: To evaluate of the difference between right/left renal depth and split renal function estimated by Tonnesen formula using the renal depth directly taken by CT. Methods: Renal depth was measured by CT scan before dynamic 99Tcm-diethylenetriamine pentaacetic acid (DTPA) renal scintigraphy (DRS) was performed by SPECT/CT in 43 patients, and the difference between night/left renal depth was calculated. Renal depth and the depth difference between right/left kidneys estimated by Tonnesen formulation was compared with that of CT using Paired t-test. Glomerular filtration rate (GFR) was recalculated by Gates method using different values of the renal depth measured by CT. Simple correlation analysis was used between the CT renal depth difference and the variant of split function estimated by CT compared to Tonnesen formulation. A multivariate regression analysis was carried out to determine the relationship among the CT renal depth difference and age, the ratio of weight to height, body mass index (BMI) and body surface area (BAS), to discuss which factors could affect the renal depth difference. Results: Compared with CT, the renal depth was underestimated by Tonnesen formulation (right kidney: t=-10.83, P<0.01; left kidney: t= 11.56, P<0.01), and the difference between right/left renal depth was also substantially underestimated by Tonnesen formulation (t= -8.81, P<0.01). The proportion of patients that the CT renal depth difference was more than 1 cm was 20% . The variant of split function estimated by CT compared to Tonnesen formulation (|R(CT)-R(Tom)|) was positively correlated with the difference between right/left renal depth (r=0.564, P< 0.01). It accounts for that along with the increase of the difference between right/left renal depth, Tonnesen formulation was difficult to accurately reflect the variant of split function. The age, the ratio of weight to height, BMI and body surface area (BAS) were all uncorrelated with the difference between right

  20. Impaired renal function in relatives of chronic kidney disease patients

    Pradip Kumar Dutta; Md Shafiul Haider; Abul Kashem

    2015-01-01

    Background: Chronic kidney disease (CKD) is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR) and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD). Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional compa...

  1. The relationship between reduced renal function and cardiovascular disease

    Svensson, Patrik

    2014-01-01

    This thesis examines the relationship between measures of renal function and cardiovascular disease (CVD) in patients with hypertension (the NORDIL study) and in the healthy population (Malmö Diet and Cancer Study, MDC) and whether antihypertensive treatment response and the risk of CVD is affected by genetic variation of a regulator of the renal amiloroide sensitive sodium channel (NORDIL). In study 1 we tested creatinine, estimated glomerular filtration rate (eGFR) with Cockroft-Gault (CG) ...

  2. Serum Levels of the Adipokine Progranulin Depend on Renal Function

    Richter, Judit; Focke, Denise; Ebert, Thomas; Kovacs, Peter; Bachmann, Anette; Lössner, Ulrike; Kralisch, Susan; Kratzsch, Jürgen; Beige, Joachim; Anders, Matthias; Bast, Ingolf; Blüher, Matthias; Stumvoll, Michael; Fasshauer, Mathias

    2013-01-01

    OBJECTIVE Progranulin has recently been introduced as a novel adipokine inducing insulin resistance and obesity. In the current study, we investigated renal elimination, as well as association of the adipokine with markers of the metabolic syndrome. RESEARCH DESIGN AND METHODS Progranulin serum levels were quantified by enzyme-linked immunosorbent assay and correlated to anthropometric and biochemical parameters of renal function and glucose and lipid metabolism, as well as inflammation, in 5...

  3. Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

    Gupta, Pushpender, E-mail: pugupta@wakehealth.edu; Allen, Brian C., E-mail: bcallen2@wakehealth.edu; Chen, Michael Y., E-mail: mchen@wakehealth.edu; Childs, David D., E-mail: dchilds@wakehealth.edu; Kota, Gopi, E-mail: gkota@wakehealth.edu; Zagoria, Ronald J., E-mail: rzagoria@wakehealth.edu [Wake Forest University School of Medicine, Department of Radiology (United States)

    2013-10-15

    Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37-88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2-3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function.

  4. Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

    Purpose: To evaluate renal function changes related to radiofrequency ablation (RFA) for the treatment of multifocal renal neoplasms. Methods: This is an institutional review board-approved, Health Insurance Portability and Accountability Act compliant retrospective study of all patients treated with computed tomography guided RFA for multifocal renal neoplasms at one institution. Fifty-seven subjects, mean age 70 (range 37–88) years, underwent RFA of 169 renal neoplasms (average size 2.0 cm). Subjects had between 2 and 8 (mean 2.96) neoplasms ablated. Estimated glomerular filtration rate (eGFR) was measured before and after RFA. Complications related to RFA were recorded. Results: eGFR decreased on average of 4.4 % per tumor treated and 6.7 % per ablation session (average 1.76 tumors treated per session). For subjects with the largest neoplasm measuring >3 cm, eGFR decreased an average of 14.5 % during the course of their treatment. If the largest neoplasm measured 2–3 cm, eGFR decreased an average of 7.7 %, and if the largest neoplasm measured <2 cm, eGFR decreased an average of 3.8 %. Subjects with reduced baseline renal function were more likely to have a greater decline in eGFR after RFA. There was a minor complication rate of 6.3 % (6 of 96 sessions), none of which required treatment, and a major complication rate of 4.2 % (4 of 96 sessions). Conclusion: RFA for the treatment of multifocal renal neoplasms results in mild decline of renal function

  5. Renal involvement in leptospirosis: the effect of glycolipoprotein on renal water absorption.

    Katia Regina Cesar

    Full Text Available BACKGROUND: Leptospirotic renal lesions frequently produce a polyuric form of acute kidney injury with a urinary concentration defect. Our study investigated a possible effect of the glycolipoprotein, (GLPc extracted from L. interrogans, on vasopressin (Vp action in the guinea pig inner medullary collecting duct (IMCD. METHODS: The osmotic water permeability (Pf µm/s was measured by the microperfusion in vitro technique. AQP2 protein abundance was determined by Western Blot. Three groups were established for study as follows: Group I, IMCD from normal (ngp, n = 5 and from leptospirotic guinea-pigs (lgp-infected with L. interrogans serovar Copenhageni, GLPc, n = 5; Group II, IMCD from normal guinea-pigs in the presence of GLPc (GLPc group, n = 54; Group III, IMCD from injected animals with GLPc ip (n = 8. RESULTS: In Group I, PFS were: ngp--61.8±22.1 and lgp--8.8±12.4, p<0.01 and the urinary osmolalities were: lgp--735±64 mOsm/Kg and ngp--1,632±120 mOsm/Kg. The lgp BUN was higher (176±36 mg% than the ngp (56±9 mg%. In Group II, the Pf was measured under GLPc (250 µg/ml applied directly to the bath solution of the microperfused normal guinea-pig IMCDs. GLPc blocked Vp (200 pg/ml, n = 5 action, did not block cAMP (10(-4 M, and Forskolin (Fors--10(-9 M action, but partially blocked Cholera Toxin (ChT--10(-9 M action. GLP from L.biflexa serovar patoc (GLPp, non pathogenic, 250 µg did not alter Vp action. In Group III, GLPc (250 µg injected intraperitoneally produced a decrease of about 20% in IMCD Aquaporin 2 expression. CONCLUSION: The IMCD Pf decrease caused by GLP is evidence, at least in part, towards explaining the urinary concentrating incapacity observed in infected guinea-pigs.

  6. Evaluation of split renal function in models of unilateral renal injury

    Effective renal plasma flow (ERPF), glomerular filtration rate (GFR), and filtration fraction (FF) were measured using radionuclide techniques in rat models with ureteral obstruction and transient occlusion of the renal vein or artery to determine which parameter is helpful in evaluating changes in split renal function. Three microcuries of iodine-131 orthoiodohippuric acid (I-131 hipurran) and 7 μCi of technetium-99m dietylenetriaminepentaacetic acid (Tc-99m DTPA) were injected into the femoral vein 30 min, 3 hr, 6 hr, 2 days, and one week after obstruction of the left ureter, or after releasing occlusion of the left renal vein or artery for 30 min. Blood samples were serially obtained, and immediately after that, the kidneys, ureters, and urinary bladder were excised. Split ERPF and GFR were evaluated by obtaining blood clearances of I-131 hippuran and Tc-99m DTPA, respectively. With ureteral obstruction, the split ERPF, GFR, and FF on the obstructed side were decreased significantly 6 hr, 2 days and one week after the obstruction. With transient occlusion of the renal vein or artery, the split ERPF, GFR, and FF were decreased on the occluded side. The decrease in GFR was greater than that in ERPF on the obstructed or occluded side. Tc-99m DTPA, a glomerular agent, was more useful than I-131 hipurran, a tubular agent, in evaluating acute renal dysfunction. (N.K.)

  7. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  8. Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

    Urbania, Thomas H. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Ave., Box 0628, San Francisco, CA (United States); Kammen, Bamidele F.; Nancarrow, Paul A. [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Morrell, Rose Ellen [Children' s Hospital and Research Center Oakland, Department of Nephrology, Oakland, CA (United States)

    2009-02-15

    Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

  9. Epidermal growth factor enhances renal tubule cell regeneration and repair and accelerates the recovery of renal function in postischemic acute renal failure.

    Humes, H D; Cieslinski, D A; T.M. Coimbra; Messana, J M; Galvao, C.

    1989-01-01

    To determine the timing and location of renal cell regeneration after ischemic injury to the kidney and to assess whether exogenous epidermal growth factor (EGF) enhances this regenerative repair process to accelerate recovery of renal function, experiments were undertaken in rats undergoing 30 min of bilateral renal artery clamp ischemia followed by reperfusion for varying time intervals. Renal cell regeneration, as reflected by incorporation of radiolabeled thymidine within the kidney, bega...

  10. Functional genomics in renal transplantation and chronic kidney disease

    For the past decade, the development of genomic technology has revolutionized modern biological research. Functional genomic analyses enable biologists to study genetic events on a genome wide scale. Examples of applications are gene discovery, biomarker determination, disease classification, and drug target identification. Global expression profiles performed with microarrays enable a better understanding of molecular signature of human disease, including acute and chronic kidney disease. About 10 % of the population in western industrialized nations suffers from chronic kidney disease (CKD). Treatment of end stage renal disease, the final stage of CKD is performed by either hemo- or peritoneal dialysis or renal transplantation. The preferred treatment is renal transplantation, because of the higher quality of life. But the pathophysiology of the disease on a molecular level is not well enough understood and early biomarkers for acute and chronic kidney disease are missing. In my studies I focused on genomics of allograft biopsies, prevention of delayed graft function after renal transplantation, anemia after renal transplantation, biocompatibility of hemodialysis membranes and peritoneal dialysis fluids and cardiovascular diseases and bone disorders in CKD patients. Gene expression profiles, pathway analysis and protein-protein interaction networks were used to elucidate the underlying pathophysiological mechanism of the disease or phenomena, identifying early biomarkers or predictors of disease state and potentially drug targets. In summery my PhD thesis represents the application of functional genomic analyses in chronic kidney disease and renal transplantation. The results provide a deeper view into the molecular and cellular mechanisms of kidney disease. Nevertheless, future multicenter collaborative studies, meta-analyses of existing data, incorporation of functional genomics into large-scale prospective clinical trials are needed and will give biomedical

  11. Urgent revascularisation can preserve renal function in a patient with severe hypertension because of renal artery stenosis

    Jensen, Janni Majgaard; Pedersen, Erling B

    2013-01-01

    We present a case of a 61-year-old woman with renal artery stenosis in a solitary functional kidney. The patient was admitted with recurrent severe hypertension, flash pulmonary oedema and acute kidney failure. She underwent surgical intervention, after which blood pressure and plasma creatinine...... level remained normal during a 11-year follow-up. Renal artery stenosis may have a serious course with flash pulmonary oedema and dialysis-dependent renal failure. Urgent revascularisation may be the only option to avoid pulmonary oedema and preserve renal function in patients with renal artery stenosis....

  12. Renal functional CT studies of patients with nephrolithotomy

    Renal functions of 13 patients, who underwent nephrolithotomy, were examined by the functional CT study. The warm ischemic time was 41+/-10 (mean+/-SD). After the operation, the tissueplasma ratio of contrast enhancement values failed to improve satisfactorily compared to that of the nonischemic hydronephrosis patients. Parenchymal volume decreased as much as that in the non-ischemic patients. As a result, Renal Functional Index (RFI) decreased significantly after nephrolithotomy. As RFI does not usually change in non-ischemic hydronephrosis after release of obstruction, the postischemic decrease of RFI may be caused mainly by ischemic damage and the effects of parechymal incision may not be dominant. (author)

  13. Effect of TGF-β1 antisense oligodeoxynucleotide on renal function in chronic renal failure rats

    Law Chung HIONG; Kiew Lik VOON; Nor Azizan ABDULLAH; Munavvar A SATTAR; Nazarina AbduRAHMAN; Abdul Hye KHAN; Edward James JOHNS

    2008-01-01

    Aim:The aim of the present study was to investigate the effectiveness of trans-forming growth factor (TGF)-β1 antisense oligodeoxynucleotides (ODN) in ame-liorating deteriorated kidney function in rats with puromycin-induced chronic renal failure (CRF). Methods:Saline, puromycin, puromycin+TGF-β1 antisense ODN or puromycin+scrambled ODN were administered to unilaterally nephrecto-mized rats. Renal hemodynamic and excretory measurements were taken in the anaesthetized rats that had undergone surgical procedure. Results:It was ob-served that in the CRF rats, there was a marked reduction in the renal blood flow (RBF), glomerular filtration rate (GFR), severe proteinuria, and almost 6-fold in-creased fractional excretion of sodium (FE Na+) as compared to that in the control rats (all P<0.05). It was further observed that in the CRF rats, the treatment with TGF-β1 antisense, but not scrambled ODN, markedly attenuated the reduction of RBF, GFR, and proteinuria and markedly prevented the increase of the FE Na+ (all P<0.05). In addition, the renal hypertrophy in the CRF group (P<0.05 vs non-renal failure control) was markedly attenuated after treatment with TGF-1 antisense ODN (P<0.05). Focal segmental glomerulosclerosis was evident only in the un-treated and scrambled ODN-treated CRF groups. An interesting observation of this study was that in the CRF rats, although there was marked attenuating and preventive effects of the TGF-β1 antisense ODN on the deteriorated renal functions, the antisense treatment did not cause any marked change in the renal expression of TGF-β1 at the protein level. Conclusion:Collectively, the data obtained sug-gests that TGF-β1 antisense ODN possesses beneficial effects in puromycin-induced chronic renal failure and that the deterioration in morphology and im-paired renal function in this pathological state is in part dependent upon the action of TGF-β1 within the kidney.

  14. Incidence of renal carcinoma in non-functioning kidney due to renal pelvic stone disease

    Zengin, Kursad; TANIK, SERHAT; Sener, Nevzat Can; Albayrak, Sebahattin; Ekici, Musa; Bozkurt, Ibrahim Halil; Bakirtas, Hasan; Gurdal, Mesut; Imamoglu, Muhammed Abdurrahim

    2015-01-01

    The objective of This study was to report our pathological findings in nephrectomy specimens from patients treated for non-functioning hydronephrotic kidney due to renal pelvic stone disease. A total of 97 patients who underwent nephrectomy for non-functioning hydronephrotic kidneys between January, 2011 and June, 2014 were retrospectively reviewed. A non-functioning kidney was defined as one having paper-thin parenchyma on urinary ultrasound or computed tomography, exhibiting no contrast vis...

  15. EFFECT OF LITHIUM CARBONATE ON RENAL AND EXTRA-RENAL FUNCTIONS OF RATS

    Puri, V.N.

    1984-01-01

    SUMMARY Effect of high doses of lithium carbonate (40 rag/Kg.i.p. and p.o.) and lithium chloride (40 mg/Kg.i.p.) on renal and extra-renal functions were studied in normal male Charles Foster Strain of rats. Insignificant effect on urine output, creatinine clerance, sodium, potassium and lithium excretion was observed with these salts. Antidiuretic hormone levels were also not effected. However lithium clearance was significantly raised in both groups with lithium carbonate and with lithium ch...

  16. Effects of contrast media on renal graft function and survival after cerebral angiography of cadaveric donors

    The effects of intravascularly administered ionic contrast media on renal graft function and survival were retrospectively evaluated in 211 recipients of cadaveric renal transplants. The renal grafts were explanted from the donors within 24 hours (mean 16 hours) after cerebral angiography. There were no differences in renal function of graft survival between those exposed and those not exposed to contrast media before nephrectomy. (orig.)

  17. Gut-Microbiota-Metabolite Axis in Early Renal Function Decline

    Barrios, Clara; Beaumont, Michelle; Pallister, Tess; Villar, Judith; Goodrich, Julia K.; Clark, Andrew; Pascual, Julio; Ley, Ruth E.; Spector, Tim D; Bell, Jordana T.; Menni, Cristina

    2015-01-01

    Introduction Several circulating metabolites derived from bacterial protein fermentation have been found to be inversely associated with renal function but the timing and disease severity is unclear. The aim of this study is to explore the relationship between indoxyl-sulfate, p-cresyl-sulfate, phenylacetylglutamine and gut-microbial profiles in early renal function decline. Results Indoxyl-sulfate (Beta(SE) = -2.74(0.24); P = 8.8x10-29), p-cresyl-sulfate (-1.99(0.24), P = 4.6x10-16), and phe...

  18. Gut-Microbiota-Metabolite Axis in Early Renal Function Decline.

    Barrios Barrera, Clara; Beaumont, Michelle; Pallister, Tess; Villar Garc??a, Judit; Goodrich, Julia K.; Clark, Andrew; Pascual Santos, Julio; Ley, Ruth E.; Spector, Tim D; Bell, Jordana T.; Menni, Cristina

    2015-01-01

    INTRODUCTION: Several circulating metabolites derived from bacterial protein fermentation have been found to be inversely associated with renal function but the timing and disease severity is unclear. The aim of this study is to explore the relationship between indoxyl-sulfate, p-cresyl-sulfate, henylacetylglutamine and gut-microbial profiles in early renal function decline. RESULTS: Indoxyl-sulfate (Beta(SE) = -2.74(0.24); P = 8.8x10-29), p-cresyl-sulfate (-1.99(0.24), P = 4.6x10-16), and p...

  19. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

    Nevena Manevska

    2015-12-01

    Full Text Available BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR and reflux nephropathy (RN in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR.

  20. Increased renal production of C-type natriuretic peptide (CNP) in patients with cirrhosis and functional renal failure

    Gülberg, V; Møller, S; Henriksen, Jens Henrik Sahl;

    2000-01-01

    homeostasis. Therefore, the aim of the present study was to investigate the possible role of CNP in renal function disturbances in patients with cirrhosis of the liver. METHODS: Peripheral venous and urinary concentrations of CNP were determined in samples from 11 healthy controls, 20 cirrhotic patients with...... normal renal function (creatinine clearance 117 (8) ml/min), and 20 cirrhotic patients with impaired renal function (creatinine clearance 35 (4) ml/min). In a second protocol, arterial and renal venous plasma concentrations of CNP were determined in 37 patients with cirrhosis of the liver to estimate...... renal extraction ratios of CNP. A sensitive and specific radioimmunoassay was applied after solid phase extraction of samples. RESULTS: Plasma CNP was lower in cirrhotic patients with normal and impaired renal function than in controls (3.0 (0.4) and 2.7 (0.2) v. 4.2 (0.4) pg/ml, respectively; p<0...

  1. The correct renal function evaluation in patients with thyroid dysfunction.

    Simeoni, Mariadelina; Cerantonio, Annamaria; Pastore, Ida; Liguori, Rossella; Greco, Marta; Foti, Daniela; Gulletta, Elio; Brunetti, Antonio; Fuiano, Giorgio

    2016-05-01

    Thyroid dysfunction induces several renal derangements involving all nephron portions. Furthermore, dysthyroidism is a recognized risk factor associated with the development of chronic kidney disease. Current data, in fact, demonstrate that either subclinical or overt thyroid disease is associated with significant changes in creatinine, estimated glomerular filtration rate, measured glomerular filtration rate and Cystatin C. Herein, we systematically reviewed several relevant studies aiming at the identification of the most sensitive and specific parameter for the correct renal function evaluation in patients with thyroid dysfunction, that are usually treated as outpatients. Our systematic review indicates that estimated glomerular filtration rate, preferably with CKD-EPI equation, appears to be the most reliable and wieldy renal function parameter. Instead, Cystatin C should be better used in the grading of thyroid dysfunction severity. PMID:26511999

  2. Comprehensive evaluation of renal function in the transplanted kidney

    By means of a comprehensive renal function test based on the analysis of orthoiodohippurate kinetics carried out 223 times in 86 renal transplant patients, we have been able to separate clearly five clinical entities: normally functioning transplanted kidneys, acute tubular necrosis, cell-mediated rejection, humoral (chronic) rejection, and postrenal obstruction. Accurate prediction of the fate of the rejecting kidney can be made while still subclinical as much as a week before manifestations by other techniques are evident. Data on 22 donors studied 44 times are also presented. The comprehensive test consists of measurements of effective renal plasma flow (ERPF), sequential scintigraphy, calculations of excretory index (EI) (percent dose actually found in bladder and voided urine as a fraction of the percent dose expected at a given time after injection at the patient's specific ERPF), and residual urine volume. Formulas and regression equations for the calculation of ERPF, EI, residual urine, etc., are presented

  3. Imaging regional renal function parameters using radionuclide tracers

    Qiao, Yi

    A compartmental model is given for evaluating kidney function accurately and noninvasively. This model is cast into a parallel multi-compartment structure and each pixel region (picture element) of kidneys is considered as a single kidney compartment. The loss of radionuclide tracers from the blood to the kidney and from the kidney to the bladder are modelled in great detail. Both the uptake function and the excretion function of the kidneys can be evaluated pixel by pixel, and regional diagnostic information on renal function is obtained. Gamma Camera image data are required by this model and a screening test based renal function measurement is provided. The regional blood background is subtracted from the kidney region of interest (ROI) and the kidney regional rate constants are estimated analytically using the Kuhn-Pucker multiplier method in convex programming by considering the input/output behavior of the kidney compartments. The detailed physiological model of the peripheral compartments of the system, which is not available for most radionuclide tracers, is not required in the determination of the kidney regional rate constants and the regional blood background factors within the kidney ROI. Moreover, the statistical significance of measurements is considered to assure the improved statistical properties of the estimated kidney rate constants. The relations between various renal function parameters and the kidney rate constants are established. Multiple renal function measurements can be found from the renal compartmental model. The blood radioactivity curve and the regional (or total) radiorenogram determining the regional (or total) summed behavior of the kidneys are obtained analytically with the consideration of the statistical significance of measurements using convex programming methods for a single peripheral compartment system. In addition, a new technique for the determination of 'initial conditions' in both the blood compartment and the kidney

  4. RADIOLOGICAL INVESTIGATIONS, BIOCHEMICAL RENAL FUNCTION TESTS AND THE CHANGES AFTER SURGERY IN RENAL CALCULUS OBSTRUCTIVE UROPATHY

    Mahesh

    2016-01-01

    Full Text Available Urolithiasis has affected the mankind for long years. These stones cause progressive renal impairment. These patients usually present with characteristic loin pain, vomiting, and sometimes fever. Patients may also be asymptomatic at times. Urinary stones can be classified on the basis of their size, location, X-ray characteristics, aetiology, composition (Mineralogy and risk groups for recurrent stone formation. AIMS AND OBJECTIVES To evaluate the Preoperative and postoperative radiological and biochemical changes in renal calculus obstructive uropathy in patients with cortical thickness of minimum 4mm. MATERIAL AND METHODS All patients who were admitted in Department of Surgery, Rama Medical College Hospital and Research Centre, Kanpur, UP with diagnosis of obstructive uropathy due to stone disease and operated upon were included in this study. RESULTS After 1 month and 3 months the relief in obstruction was studied by repeating the tests. It was found that urea, creatinine levels took about 3 months to get normalized. USG and IVP at 3 months showed complete normalization of hydronephrosis, however, at one month few cases still had hydronephrosis. CONCLUSION Urea, creatinine levels along with USG and IVP form the basis of detection and management of obstructive uropathy. CT scan has a definitive role in few cases where urea creatinine levels are on higher side. Renal scan is mandatory in the cases of delayed/non-functioning on IVP. Nephrectomy should not be done without assessment of renal function (% on renal scan. After definitive management of relief of obstruction by various methods, it takes about three months for normalization of kidney function.

  5. Expression and function of renal and hepatic organic anion transporters in extrahepatic cholestasis

    Anabel Brandoni; María Herminia Hazelhoff; Romina Paula Bulacio; Adriana Mónica Torres

    2012-01-01

    Obstructive jaundice occurs in patients suffering from cholelithiasis and from neoplasms affecting the pancreas and the common bile duct.The absorption,distribution and elimination of drugs are impaired during this pathology.Prolonged cholestasis may alter both liver and kidney function.Lactam antibiotics,diuretics,non-steroidal anti-inflammatory drugs,several antiviral drugs as well as endogenous compounds are classified as organic anions.The hepatic and renal organic anion transport pathways play a key role in the pharmacokinetics of these compounds.It has been demonstrated that acute extrahepatic cholestasis is associated with increased renal elimination of organic anions.The present work describes the molecular mechanisms involved in the regulation of the expression and function of the renal and hepatic organic anion transporters in extrahepatic cholestasis,such as multidrug resistanceassociated protein 2,organic anion transporting polypeptide 1,organic anion transporter 3,bilitranslocase,bromosulfophthalein/bilirubin binding protein,organic anion transporter 1 and sodium dependent bile salt transporter.The modulation in the expression of renal organic anion transporters constitutes a compensatory mechanism to overcome the hepatic dysfunction in the elimination of organic anions.

  6. Role of hemodialysis in baclofen overdose with normal renal function

    Dias, Lorraine S.; Vivek, G; M Manthappa; Acharya, Raviraja V

    2011-01-01

    The treatment of baclofen overdose is primarily supportive. There have been case reports of hemodialysis being used in patients with chronic kidney disease with baclofen overdose. A case report of hemodialysis in a baclofen-overdose patient with normal renal function is presented. Review of literature has also been provided.

  7. Role of hemodialysis in baclofen overdose with normal renal function

    Lorraine S Dias

    2011-01-01

    Full Text Available The treatment of baclofen overdose is primarily supportive. There have been case reports of hemodialysis being used in patients with chronic kidney disease with baclofen overdose. A case report of hemodialysis in a baclofen-overdose patient with normal renal function is presented. Review of literature has also been provided.

  8. Impaired renal function in relatives of chronic kidney disease patients

    Pradip Kumar Dutta

    2015-01-01

    Full Text Available Background: Chronic kidney disease (CKD is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD. Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional comparative study conducted at Chittagong Medical College Hospital (CMCH, Chittagong, Bangladesh, a tertiary hospital in the southern part of Bangladesh. Materials and Methods: We screened the relatives of CKD patients, as a risk population, by urine albumin and estimated GFR (eGFR. Results: We observed a significant difference in urine albumin (29% vs 10% in relatives and nonrelatives, respectively and abnormal renal function [albuminuria/creatinine clearance (CCr criteria] (30% vs 11% in relatives and nonrelatives, respectively between relatives and nonrelatives. Relatives of glomerulonephritis-CKD (GN-CKD patients had more albuminuria than others. Risk factors like hypertension (HTN, impaired glucose tolerance (IGT/diabetes mellitus (DM, and family history of DM/HTN/cardiovascular disease (CVD were significant among relatives and might have some link to familial influence on developing CKD. Conclusion: Relatives of CKD patients should be screened as a risk population to evaluate abnormal renal function.

  9. Effects of dietary lipids on renal function of aged rats

    Valente Gamba C.

    2001-01-01

    Full Text Available Normal aging is accompanied by renal functional and morphological deterioration and dietetic manipulation has been used to delay this age-related decline. We examined the effects of chronic administration of diets containing 5% lipid-enriched diet (LD, w/w on renal function of rats at different ages. Three types of LD were tested: canola oil, fish oil and butter. Mean systemic tail-cuff blood pressure and glycemia remained within the normal range whatever the age and the diet of the animals. Proteinuria began to rise from the 8th month in the groups ingesting LD, while in the control group it increased significantly (above 10 mg/24 h only after the 10th month. With age, a significant and progressive decline in glomerular filtration rate (GFR and renal plasma flow was observed in the LD groups but after 6 months of lipid supplementation, the decline in these parameters was more marked in the butter and fish oil groups. By the 18th month, the lowest GFR level was observed in the group ingesting the butter diet (2.93 ± 0.22 vs 5.01 ± 0.21 ml min-1 kg-1 in control, P<0.05. Net acid excretion, evaluated in 9- and 18-month-old rats, was stimulated in the fish oil group when compared both to control and to the other two LD groups. These results suggest that even low levels of LD in a chronic nutritional regimen can modify the age-related changes in renal function and that the impact of different types of lipid-supplemented diets on renal function depends on the kind of lipid present in the diet.

  10. Urinary Peptidome May Predict Renal Function Decline in Type 1 Diabetes and Microalbuminuria

    Merchant, Michael L.; Perkins, Bruce A.; Boratyn, Grzegorz M; Linda H Ficociello; Wilkey, Daniel W.; Barati, Michelle T.; Bertram, Clinton C.; Page, Grier P.; Rovin, Brad H.; Warram, James H.; Krolewski, Andrzej S.; Klein, Jon B.

    2009-01-01

    One third of patients with type 1 diabetes and microalbuminuria experience an early, progressive decline in renal function that leads to advanced stages of chronic kidney disease and ESRD. We hypothesized that the urinary proteome may distinguish between stable renal function and early renal function decline among patients with type 1 diabetes and microalbuminuria. We followed patients with normal renal function and microalbuminuria for 10 to 12 yr and classified them into case patients (n = ...

  11. The effects of tempol on renal function and hemodynamics in cyclosporine-induced renal insufficiency rats.

    Chia, Tan Y; Sattar, Munavvar A; Abdulla, Mohammed H; Rathore, Hassaan A; Ahmad, Fiaz ud Din; Kaur, Gurjeet; Abdullah, Nor A; Johns, Edward J

    2013-08-01

    This study investigated the effects of tempol, a superoxide dismutase (SOD) mimetic and L-NAME, a nitric oxide (NO) synthase inhibitor on the renal function and hemodynamics in cyclosporine A (CsA) induced renal insufficiency rats. Male Sprague-Dawley rats were treated with either vehicle (C), tempol (T, 1 mmol/L in drinking fluid), L-NAME (L, 1 mmol/L in drinking fluid), CsA (Cs, 25 mg/kg/day via gavage), CsA plus tempol (TCs), CsA plus L-NAME (LCs) or CsA plus a combination of tempol and L-NAME (TLCs) for 21 consecutive days. At the end of treatment regimen, the renal responses to noradrenaline (NA), phenylephrine (PE), methoxamine and angiotensin II (Ang II) were determined. Cs and LCs rats had lower creatinine clearance (0.7 ± 0.1 and 0.6 ± 0.5 vs. 1.3 ± 0.2 mL/min/kg) and fractional excretion of sodium (0.12 ± 0.02 and 0.17 ± 0.01 vs. 0.67 ± 0.04%) but higher systolic blood pressure (145 ± 2 and 178 ± 4 vs. 116 ± 2) compared to the control (all p < 0.05), respectively. Tempol treatment in TCs or TLCs prevented the increase in blood pressure and improved creatinine clearance and sodium excretion compared to untreated Cs. The renal vasoconstriction in Cs or LCs to NA, PE and Ang II were lower than control by ∼35-48% (all p < 0.05). In TCs or TLCs, there was enhanced renal vasoconstriction to all agonist by ∼39-114% compared to Cs. SOD is important to counterbalance the hypertensive effect of a defective NO system and to allow the normal vasoconstrictor response of the renal vasculature to adrenergic agonists and Ang II in a model of CsA-induced renal insufficiency. PMID:23822648

  12. Targeting Sirtuin-1 prolongs murine renal allograft survival and function.

    Levine, Matthew H; Wang, Zhonglin; Xiao, Haiyan; Jiao, Jing; Wang, Liqing; Bhatti, Tricia R; Hancock, Wayne W; Beier, Ulf H

    2016-05-01

    Current immunosuppressive medications used after transplantation have significant toxicities. Foxp3(+) T-regulatory cells can prevent allograft rejection without compromising protective host immunity. Interestingly, inhibiting the class III histone/protein deacetylase Sirtuin-1 can augment Foxp3(+) T-regulatory suppressive function through increasing Foxp3 acetylation. Here we determined whether Sirtuin-1 targeting can stabilize biological allograft function. BALB/c kidney allografts were transplanted into C57BL/6 recipients with a CD4-conditional deletion of Sirtuin-1 (Sirt1(fl/fl)CD4(cre)) or mice treated with a Sirtuin-1-specific inhibitor (EX-527), and the native kidneys removed. Blood chemistries and hematocrit were followed weekly. Sirt1(fl/fl)CD4(cre) recipients showed markedly longer survival and improved kidney function. Sirt1(fl/fl)CD4(cre) recipients exhibited donor-specific tolerance, accepted BALB/c, but rejected third-party C3H cardiac allografts. C57BL/6 recipients of BALB/c renal allografts that were treated with EX-527 showed improved survival and renal function at 1, but not 10 mg/kg/day. Pharmacologic inhibition of Sirtuin-1 also improved renal allograft survival and function with dosing effects having relevance to outcome. Thus, inhibiting Sirtuin-1 can be a useful asset in controlling T-cell-mediated rejection. However, effects on non-T cells that could adversely affect allograft survival and function merit consideration. PMID:27083279

  13. Renal function imaging with radioisotopes - state of the art

    In modern nuclear medicine, iodine-131-hippurate is more and more replaced by alternative radiopharmaceuticals like iodine-123-hippurate and technetium-99m-MAG3. Lower photon energy and higher count rates produce better image quality by using these new substances. Other disadvantages of iodine-131-hippurate are the unnecessary irradiation of the patient - because of the beta ray component - and the environment - because of its long half-life. Because of these facts, nowadays only the technetium compounds MAG3, DTPA and DMSA or iodine-123-hippurate should be used in renal scanning. Tc-DMSA only allows static images. The glomerular filtration marker Tc-DTPA has an unfavourably low clearance. For this, Tc-MAG3 and iodine-123-hippurate are the most appropriate tracers for renal function scintigraphy. While the image quality of both is equal, Tc-MAG3 has the advantage of better availability and handling. Summarizing our experience in a large number of kidney investigations, Tc-MAG3 has been proved to be the radiopharmacon with the most universal range of indications. Iodine-hippurate and Tc-DTPA can be completely replaced by Tc-MAG3 in the scintigraphic imaging of kidney perfusion, renal function, urinary tract obstruction, renal artery stenosis, and vesicoureteral reflux. (orig.)

  14. Radiologic imaging of the renal parenchyma structure and function.

    Grenier, Nicolas; Merville, Pierre; Combe, Christian

    2016-06-01

    Radiologic imaging has the potential to identify several functional and/or structural biomarkers of acute and chronic kidney diseases that are useful diagnostics to guide patient management. A renal ultrasound examination can provide information regarding the gross anatomy and macrostructure of the renal parenchyma, and ultrasound imaging modalities based on Doppler or elastography techniques can provide haemodynamic and structural information, respectively. CT is also able to combine morphological and functional information, but the use of CT is limited due to the required exposure to X-ray irradiation and a risk of contrast-induced nephropathy following intravenous injection of a radio-contrast agent. MRI can be used to identify a wide range of anatomical and physiological parameters at the tissue and even cellular level, such as tissue perfusion, oxygenation, water diffusion, cellular phagocytic activity, tissue stiffness, and level of renal filtration. The ability of MRI to provide valuable information for most of these parameters within a renal context is still in development and requires more clinical experience, harmonization of technical procedures, and an evaluation of reliability and validity on a large scale. PMID:27067530

  15. Is antibiotic dosing appropriate for renal function in older adults?

    T.S.Dharmarajan; RanganathanRajendran; MarilouCorpuz; EdwardP.Norkus

    2000-01-01

    A retrospective observational study was used to detennine if antibiotic dosing practices in older adults were adjusted for age or disease related changes in renal function in 196 patients, 17 to 99 years, hospitalized for urosepsis or pneumonia. Appropriate or inappropriate antibiotic dosing, based on ereatinine clearance, was assessed in three groups categorized by age and renal function. Duration of antibiotic therapy (iv, oral and total) was statistically equivalent across the three age groups. Older patients had significantly higher serum BUN (P<0.0000), creatinine (P=0.0078), renal impairment (P<0.000), and hospital deaths (P<0.000) compared to the young. Older adults were prescribed inappropriately higher antibiotic dosages significantly more often (P<0.000) than the young. The very old, prescribed excessive antibiotic doses (P=0.005) not adjusted for renal status, had an increased rate of Clostridium difficile colitis infection (P=0.014). In conclusion, excessive antibiotic dosing, not adjusted for ereatinine clearance, occurs in the elderly and we believe that it is correctable.

  16. Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

    Pedrosa, Ivan [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Rafatzand, Khashayar; Robson, Philip; Alsop, David C. [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wagner, Andrew A. [Beth Israel Deaconess Medical Center and Harvard Medical School, Surgery, Division of Urology, Boston, MA (United States); Atkins, Michael B. [Beth Israel Deaconess Medical Center and Harvard Medical School, Hematology/Oncology, Boston, MA (United States); Rofsky, Neil M. [University of Texas Southwestern Medical Center, Departments of Radiology, Dallas, TX (United States)

    2012-02-15

    To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant. Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m{sup 2} (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

  17. Oncological and functional outcomes of salvage renal surgery following failed primary intervention for renal cell carcinoma

    Fernando G. Abarzua-Cabezas

    2015-02-01

    Full Text Available Purpose To assess the oncologic and functional outcomes of salvage renal surgery following failed primary intervention for RCC. Materials and Methods We performed a retrospective review of patients who underwent surgery for suspected RCC during 2004-2012. We identified 839 patients, 13 of whom required salvage renal surgery. Demographic data was collected for all patients. Intraoperative and postoperative data included ischemic duration, blood loss and perioperative complications. Preoperative and postoperative assessments included abdominal CT or magnetic resonance imaging, chest CT and routine laboratory work. Estimated glomerular filtration rate (eGFR was calculated according to the Modification of Diet in Renal Disease equation. Results The majority (85% of the patients were male, with an average age of 64 years. Ten patients underwent salvage partial nephrectomy while 3 underwent salvage radical nephrectomy. Cryotherapy was the predominant primary failed treatment modality, with 31% of patients undergoing primary open surgery. Pre-operatively, three patients were projected to require permanent post-operative dialysis. In the remaining 10 patients, mean pre- and postoperative serum creatinine and eGFR levels were 1.35 mg/dL and 53.8 mL/min/1.73 m2 compared to 1.43 mg/dL and 46.6 mL/min/1.73 m2, respectively. Mean warm ischemia time in 10 patients was 17.4 min and for all patients, the mean blood loss was 647 mL. The predominant pathological stage was pT1a (8/13; 62%. Negative surgical margins were achieved in all cases. The mean follow-up was 32.9 months (3.5-88 months. Conclusion While salvage renal surgery can be challenging, it is feasible and has adequate surgical, functional and oncological outcomes.

  18. Predictive capacity of pre-donation GFR and renal reserve capacity for donor renal function after living kidney donation

    Rook, M; Hofker, HS; van Son, WJ; van der Heide, JJH; Ploeg, RJ; Navis, GJ

    2006-01-01

    Kidney transplantation from living donors is important to reduce organ shortage. Reliable pre-operative estimation of post-donation renal function is essential. We evaluated the predictive potential of pre-donation glomerular filtration rate (GFR) (iothalamate) and renal reserve capacity for post-do

  19. Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function

    Purpose: To evaluate the relationship between renal cortical volume, measured by an automatic contouring software, with body mass index (BMI), age and renal function. Materials and methods: The study was performed in accordance to the institutional guidelines at our hospital. Sixty-four patients (34 men, 30 women), aged 19 to 79 years had their CT scans for diagnosis or follow-up of hepatocellular carcinoma retrospectively examined by a computer workstation using a software that automatically contours the renal cortex and the renal parenchyma. Body mass index and estimated glomerular filtration rate (eGFR) were calculated based on data collected. Statistical analysis was done using the Student t-test, multiple regression analysis, and intraclass correlation coefficient (ICC). Results: The ICC for total renal and renal cortical volumes were 0.98 and 0.99, respectively. Renal volume measurements yielded a mean cortical volume of 105.8 cm3 ± 28.4 SD, mean total volume of 153 cm3 ± 39 SD and mean medullary volume of 47.8 cm3 ± 19.5 SD. The correlation between body weight/height/BMI and both total renal and cortical volumes presented r = 0.6, 0.6 and 0.4, respectively, p < 0.05, while the correlation between renal cortex and age was r = -0.3, p < 0.05. eGFR showed correlation with renal cortical volume r = 0.6, p < 0.05. Conclusion: This study demonstrated that renal cortical volume had a moderate positive relationship with BMI, moderate negative relationship with age, and a strong positive relationship with the renal function, and provided a new method to routinely produce volumetric assessment of the kidney.

  20. Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function

    Muto, Natalia Sayuri, E-mail: nataliamuto@gmail.com [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Kamishima, Tamotsu, E-mail: ktamotamo2@yahoo.co.jp [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Harris, Ardene A., E-mail: ardene_b@yahoo.com [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Kato, Fumi, E-mail: fumikato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Onodera, Yuya, E-mail: yuyaonodera@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Terae, Satoshi, E-mail: saterae@yahoo.co.jp [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Hospital, N15 W7, kita-ku, Sapporo City, 0608638 (Japan)

    2011-04-15

    Purpose: To evaluate the relationship between renal cortical volume, measured by an automatic contouring software, with body mass index (BMI), age and renal function. Materials and methods: The study was performed in accordance to the institutional guidelines at our hospital. Sixty-four patients (34 men, 30 women), aged 19 to 79 years had their CT scans for diagnosis or follow-up of hepatocellular carcinoma retrospectively examined by a computer workstation using a software that automatically contours the renal cortex and the renal parenchyma. Body mass index and estimated glomerular filtration rate (eGFR) were calculated based on data collected. Statistical analysis was done using the Student t-test, multiple regression analysis, and intraclass correlation coefficient (ICC). Results: The ICC for total renal and renal cortical volumes were 0.98 and 0.99, respectively. Renal volume measurements yielded a mean cortical volume of 105.8 cm{sup 3} {+-} 28.4 SD, mean total volume of 153 cm{sup 3} {+-} 39 SD and mean medullary volume of 47.8 cm{sup 3} {+-} 19.5 SD. The correlation between body weight/height/BMI and both total renal and cortical volumes presented r = 0.6, 0.6 and 0.4, respectively, p < 0.05, while the correlation between renal cortex and age was r = -0.3, p < 0.05. eGFR showed correlation with renal cortical volume r = 0.6, p < 0.05. Conclusion: This study demonstrated that renal cortical volume had a moderate positive relationship with BMI, moderate negative relationship with age, and a strong positive relationship with the renal function, and provided a new method to routinely produce volumetric assessment of the kidney.

  1. Radionuclide assessment of renal function in the transplanted kidney

    The ability of radionuclide renal function to detect rejection and to presume the prognosis of the transplanted kidney was evaluated in 70 patients. Effective renal plasma flow (ERPF), excretory index (EI) and perfusion index (PI) were examined by I-123 OIH and Tc-99 m DTPA. Numbers of the study in various status were as follows; 51 studies in good function, 43 in acute rejection and 18 in chronic rejection. Significant reduction in ERPF and EI and increase of PI were observed in the acute rejection (p<0.01). In the chronic rejection, there was a progressive decrease of ERPF (p<0.01). The patients were divided into two groups: group A; 46 patients with good function more than 9 months after transplantation and group B; 20 patients of whom recurrence of hemodialysis or nephectomy was done. In living transplantation, ERPF of group B at the first week after transplantation was remarkably lower than group A (p<0.05). In cadaveric transplantation, ERPF of group B at the sixth week was lower than that of group B (p<0.05). This study indicates that serial measurements of renal function by radionuclide methods may provide the state of rejection and prognosis of the transplanted kidney. (author)

  2. DOES MEAN PERFUSION PRESSURE DURING CARDIOPULMONARY BYPASS AFFECT RENAL FUNCTION?

    Ramesh

    2015-10-01

    Full Text Available BACKGROUND: After cardiac surgery acute kidney injury (AKI is a common and serious condition carrying significant costs and is independently associated with increased morbidity and mortality. During cardiopulmonary bypass (CPB surgery, modifiable factors may contri bute to post - operative AKI. Their prevention might be a potential target for nephroprotection and any other morbidity after cardiac surgery. METHODS AND MATERIAL : The objective of the present study was to identify and determine whether intraoperative hypot ension or any other cofactor are independent risk factors for postoperative AKI defined by the RIFLE (renal Risk, Injury, Failure, Loss of renal function and End - stage renal disease. On basis of this patients were divided into two groups according to rise in serum creatinine >0.3 mg/dl till 72 hrs postoperatively. Group B patients have developed AKI (n=34 and the remaining patients were in Group A. RESULT : In our study we have found that mean arterial pressure during CPB were less in group B patients compare to group A patients which was statistically significant (p<0.001. And in this group ICU stay and mortality rate were also high compare to group A pati ent who had not developed AKI. CONCLUSION: Lower MAP during CPB is associated with development of postoperative renal derangement, leads to increase ICU stay and mortality. Larger studies are required to further support the evidence

  3. Renal pyramid echogenicity in ureteropelvic junction obstruction: correlation between altered echogenicity and differential renal function

    Improvement in resolution and use of high-frequency transducers in US has enabled visualization of previously unreported changes in medullary pyramid echogenicity in children with obstructive hydronephrosis. To determine whether these unreported changes in echogenicity and morphology of the renal pyramids in ureteropelvic junction (UPJ) obstruction correlate with differential renal function (DRF) of the kidney as determined by technetium-99m mercaptoacetyltriglycine (99mTc-MAG3) scan. Renal sonograms in 60 children with UPJ obstruction were retrospectively reviewed. Children were divided into three groups based on the echogenicity of the pyramids: (1) normal echogenicity of the pyramids, (2) increased echogenicity of the pyramids with maintained corticomedullary differentiation (CMD), and (3) loss of CMD. DRF, as determined by 99mTc-MAG3 scan, of the obstructed kidney of ≥45% was considered normal and of ≤44% was considered abnormal based on a published study correlating histological changes with DRF. Fisher's exact test was performed for assessing the association between DRF and altered echogenicity of the pyramids. In group 1, which consisted of 13 patients with normal pyramids on US, DRF was normal in 11 and abnormal in two. In group 2, which consisted of 33 patients with echogenic pyramids and preserved CMD, DRF was normal in 15 and abnormal in 18. In group 3, which consisted of 14 patients with complete loss of CMD, DRF was normal in 2 and abnormal in 12. There was a strong correlation between abnormal pyramids and DRF (P=0.0009). The risk ratio (RR) of DRF becoming abnormal for those kidneys with abnormal echogenicity of the pyramids with preserved CMD (group 2) compared to normal pyramid echogenicity (group 1) was 1.56 (95% CI 1.088-2.236). The RR of DRF becoming abnormal for those kidneys with loss of CMD (group 3) compared to normal pyramid echogenicity (group 1) was 5.571 (95% CI 1.530-20.294). We observed that in obstructed kidneys the echogenicity

  4. Gut-Microbiota-Metabolite Axis in Early Renal Function Decline.

    Clara Barrios

    Full Text Available Several circulating metabolites derived from bacterial protein fermentation have been found to be inversely associated with renal function but the timing and disease severity is unclear. The aim of this study is to explore the relationship between indoxyl-sulfate, p-cresyl-sulfate, phenylacetylglutamine and gut-microbial profiles in early renal function decline.Indoxyl-sulfate (Beta(SE = -2.74(0.24; P = 8.8x10-29, p-cresyl-sulfate (-1.99(0.24, P = 4.6x10-16, and phenylacetylglutamine(-2.73 (0.25, P = 1.2x10-25 were inversely associated with eGFR in a large population base cohort (TwinsUK, n = 4439 with minimal renal function decline. In a sub-sample of 855 individuals, we analysed metabolite associations with 16S gut microbiome profiles (909 profiles, QIIME 1.7.0. Three Operational Taxonomic Units (OTUs were significantly associated with indoxyl-sulfate and 52 with phenylacetylglutamine after multiple testing; while one OTU was nominally associated with p-cresyl sulfate. All 56 microbial members belong to the order Clostridiales and are represented by anaerobic Gram-positive families Christensenellaceae, Ruminococcaceae and Lachnospiraceae. Within these, three microbes were also associated with eGFR.Our data suggest that indoxyl-sulfate, p-cresyl-sulfate and phenylacetylglutamine are early markers of renal function decline. Changes in the intestinal flora associated with these metabolites are detectable in early kidney disease. Future efforts should dissect this relationship to improve early diagnostics and therapeutics strategies.

  5. Renal Function and Hemodynamic Study in Obese Zucker Rats

    Park, Sung Kwang; Kang, Sung Kyew

    1995-01-01

    Objectives To investigate the renal function and hemodynamic changes in obesity and hyperinsulinemia which are characteristics of type II diabetes. Methods Studies were carried out in two groups of female Zucker rats. Group 1 rats were obese Zucker rats with hereditary insulin resistance. Group 2 rats were lean Zucker rats and served as controls. In comparison with lean Zucker rats, obese Zucker rats exhibited hyperinsulinemia but normoglycemia. Micropuncture studies and morphologic studies w...

  6. Investigation of change of renal function following percutaneous nephrolithotomy

    The percutaneous removal of renal calculi is a relatively new technique which may significantly decrease the morbidity due to calculous disease of the upper urinary tract. Over two hundred such procedures have been performed in our institution over the last two years. The authors have designed a prospective study of fifty patients with non-obstructing calculi referred for percutaneous nephrolithotomy in order to determine if there is any functional change of the kidney secondary to the operation itself. Each patient is studied using a standard Tc99m DTPA renogram and computer assisted analysis both before and four to six weeks after surgery. In order to make the selection of regions of interest (ROIs) as reproducible as possible, the ROI of the entire kidney is selected on a frame early in the study, and later frames are used to outline the collecting system. Using subtractive techniques, the contribution of the cortex of the side to be operated upon to total cortical function is derived from the previously defined regions. Renogram curves are drawn for the entire kidney as well as renal cortex. The analysis post-operatively is performed using the same ROIs generated on the pre-operative study. To date, the authors have studied twenty patients pre-operatively and followed up seven. A small but consistent decrease in renal function is seen post-operatively in both the entire kidney and cortex. A statistical analysis of the study group will be performed after further follow up and data processing of more patients

  7. Comparison of renal function following donor nephrectomy versus radical nephrectomy for renal tumor

    Mohamed Etafy

    2015-01-01

    Full Text Available In this study, we compared renal function in patients after donor nephrectomy (DN and radical nephrectomy (RN. We retrospectively reviewed 68 patients (mean follow-up 15 months, including 30 patients who had undergone DN and 38 patients who had undergone RN. The study was performed between April 2006 and July 2010 at a single institute. Patients were matched for age and co-morbidities (hypertension and diabetes mellitus. We calculated the estimated glomerular filtration rate (eGFR using the Modification of Diet in Renal Disease study group equation. Parameters studied included GFR (≥60 to 2.0 mg/dL, metabolic acidosis (serum bicarbonate 30 mg. There were no significant demographic differences between the two study groups. After a mean follow-up of 15 months, low eGFR (<60 mL/min/1.73 m 2 was seen in 28% and 6.7% of patients in the RN and DN groups, respectively (P = 0.03. Similarly, proteinuria was seen in 21% vs 0%, P = 0.007, and de novo elevated creatinine was seen in 13% vs 0%, respectively P = 0.04; thus the changes were greater in the RN group. Our study shows that undergoing RN had a significantly greater risk of developing renal insufficiency and proteinuria compared with age-and co-morbidity-matched patients undergoing DN. We concluded that patients undergoing RN show a significantly greater risk of developing renal insufficiency and proteinuria compared with the patients undergoing DN.

  8. Digital simulation method for analyzing renal function by using sup(99m)Tc-DMSA

    Ishine, Masahiro (Ehime Univ., Matsuyama (Japan))

    1984-10-01

    A digital simulation method for quantitative evaluation of renal function by using sup(99m)Tc-DMSA was proposed. The ultimate renal DMSA uptake rate, saturation time, and percent renal blood volume were calculated by this method, and its clinical usefulness was evaluated. This analytical method was thought to be reliable from the fact that calculated renal uptake rates showed a significant correlation with observed values after 2hrs' administration. Furthermore, calculated renal uptake rates were significantly correlated with the values of renal plasma flow and creatinine clearance. In the cases with obstructive uropathy, calculated renal uptake rate, saturation time, and percent renal blood volume were thought to reflect the grade and the feature of the disease. From these results, my proposed method was considered to be clinically useful as a quantitative renal function test.

  9. Improvement in renal function after everolimus introduction and calcineurin inhibitor reduction in maintenance thoracic transplant recipients

    Arora, Satish; Gude, Einar; Sigurdardottir, Vilborg;

    2012-01-01

    The NOCTET (NOrdic Certican Trial in HEart and lung Transplantation) trial demonstrated that everolimus improves renal function in maintenance thoracic transplant (TTx) recipients. Nevertheless, introduction of everolimus is not recommended for patients with advanced renal failure. We evaluated...

  10. The tacrolimus metabolism rate influences renal function after kidney transplantation.

    Gerold Thölking

    Full Text Available The effective calcineurin inhibitor (CNI tacrolimus (Tac is an integral part of the standard immunosuppressive regimen after renal transplantation (RTx. However, as a potent CNI it has nephrotoxic potential leading to impaired renal function in some cases. Therefore, it is of high clinical impact to identify factors which can predict who is endangered to develop CNI toxicity. We hypothesized that the Tac metabolism rate expressed as the blood concentration normalized by the dose (C/D ratio is such a simple predictor. Therefore, we analyzed the impact of the C/D ratio on kidney function after RTx. Renal function was analyzed 1, 2, 3, 6, 12 and 24 months after RTx in 248 patients with an immunosuppressive regimen including basiliximab, tacrolimus, mycophenolate mofetil and prednisolone. According to keep the approach simple, patients were split into three C/D groups: fast, intermediate and slow metabolizers. Notably, compared with slow metabolizers fast metabolizers of Tac showed significantly lower estimated glomerular filtration rate (eGFR values at all the time points analyzed. Moreover, fast metabolizers underwent more indication renal biopsies (p = 0.006 which revealed a higher incidence of CNI nephrotoxicity (p = 0.015 and BK nephropathy (p = 0.024 in this group. We herein identified the C/D ratio as an easy calculable risk factor for the development of CNI nephrotoxicity and BK nephropathy after RTx. We propose that the simple C/D ratio should be taken into account early in patient's risk management strategies.

  11. The tacrolimus metabolism rate influences renal function after kidney transplantation.

    Thölking, Gerold; Fortmann, Christian; Koch, Raphael; Gerth, Hans Ulrich; Pabst, Dirk; Pavenstädt, Hermann; Kabar, Iyad; Hüsing, Anna; Wolters, Heiner; Reuter, Stefan; Suwelack, Barbara

    2014-01-01

    The effective calcineurin inhibitor (CNI) tacrolimus (Tac) is an integral part of the standard immunosuppressive regimen after renal transplantation (RTx). However, as a potent CNI it has nephrotoxic potential leading to impaired renal function in some cases. Therefore, it is of high clinical impact to identify factors which can predict who is endangered to develop CNI toxicity. We hypothesized that the Tac metabolism rate expressed as the blood concentration normalized by the dose (C/D ratio) is such a simple predictor. Therefore, we analyzed the impact of the C/D ratio on kidney function after RTx. Renal function was analyzed 1, 2, 3, 6, 12 and 24 months after RTx in 248 patients with an immunosuppressive regimen including basiliximab, tacrolimus, mycophenolate mofetil and prednisolone. According to keep the approach simple, patients were split into three C/D groups: fast, intermediate and slow metabolizers. Notably, compared with slow metabolizers fast metabolizers of Tac showed significantly lower estimated glomerular filtration rate (eGFR) values at all the time points analyzed. Moreover, fast metabolizers underwent more indication renal biopsies (p = 0.006) which revealed a higher incidence of CNI nephrotoxicity (p = 0.015) and BK nephropathy (p = 0.024) in this group. We herein identified the C/D ratio as an easy calculable risk factor for the development of CNI nephrotoxicity and BK nephropathy after RTx. We propose that the simple C/D ratio should be taken into account early in patient's risk management strategies. PMID:25340655

  12. Low dose aspirin therapy and renal function in elderly patients

    Akinwusi PO

    2013-01-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Rotimi Oluyombo,2 Paul Sunday Ogunro,3 Adetunji Oladeni Adeniji,4 Oluyomi Olusola Okunola,5 Olugbenga Edward Ayodele21Department of Medicine, Osun State University, Osogbo, Osun State, Nigeria; 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria; 3Department of Chemical Pathology, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria; 4Department of Obstetrics and Gynecology, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria; 5Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, NigeriaPurpose: To determine whether low dose aspirin has any deleterious effects on renal function in elderly patients.Methods: We conducted a prospective pilot study of 30 Nigerians older than 60 years with various chronic ailments necessitating the use of low dose aspirin. Patients gave their consent, and institutional ethical clearance was obtained. Each patient's baseline samples at enrolment (before commencing aspirin use served as a control, and subsequent weekly samples were compared. The weekly mean of each parameter was calculated, and the differences of means from baseline were determined, and values were compared for statistical differences with the Statistical Package for the Social Sciences, version 16.Results: We found that a majority of patients (86.67% had basal renal functions at chronic kidney disease stages 1 and 2. When compared with the corresponding baseline parameters, the mean weekly serum and urinary electrolytes, urea, creatinine, and uric acid parameters did not change, and the P-value did not show any statistical significance. However, there was positive statistical significance for the creatinine clearance (P = 0.025. Also, unlike in previous studies, anemia and hypoalbuminemia did not affect the renal function parameters.Conclusion: This study did not show any deleterious effects with short-term, low dose (75 mg daily aspirin use on kidney functions in

  13. Effects of renal artery stenting on renal function and blood pressure in patients with atherosclerotic renovascular disease

    张奇; 沈卫峰; 张瑞岩; 张建盛; 胡健; 张宪

    2003-01-01

    Objective To study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis. Methods Eighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing ≥70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.Results Renal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176±21) μmol/L to (179±11) μmol/L (P=0.15) 48 hours after the procedure, but significantly decreased to (149±15) μmol/L at 6 months (P<0.001). CCr was also greatly improved [(37±11) ml/min before versus (51±8) ml/min at 6 months, P<0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163±23)/(96±13) mm Hg before versus (148±12)/(79±15) mm Hg at 6 months, all P<0.001], and hypertension was well controlled in 67% of the patients at 6 months ' follow-up.Conclusion Renal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.

  14. Genetic association for renal traits among participants of African ancestry reveals new loci for renal function.

    Ching-Ti Liu

    2011-09-01

    Full Text Available Chronic kidney disease (CKD is an increasing global public health concern, particularly among populations of African ancestry. We performed an interrogation of known renal loci, genome-wide association (GWA, and IBC candidate-gene SNP association analyses in African Americans from the CARe Renal Consortium. In up to 8,110 participants, we performed meta-analyses of GWA and IBC array data for estimated glomerular filtration rate (eGFR, CKD (eGFR 30 mg/g and interrogated the 250 kb flanking region around 24 SNPs previously identified in European Ancestry renal GWAS analyses. Findings were replicated in up to 4,358 African Americans. To assess function, individually identified genes were knocked down in zebrafish embryos by morpholino antisense oligonucleotides. Expression of kidney-specific genes was assessed by in situ hybridization, and glomerular filtration was evaluated by dextran clearance. Overall, 23 of 24 previously identified SNPs had direction-consistent associations with eGFR in African Americans, 2 of which achieved nominal significance (UMOD, PIP5K1B. Interrogation of the flanking regions uncovered 24 new index SNPs in African Americans, 12 of which were replicated (UMOD, ANXA9, GCKR, TFDP2, DAB2, VEGFA, ATXN2, GATM, SLC22A2, TMEM60, SLC6A13, and BCAS3. In addition, we identified 3 suggestive loci at DOK6 (p-value = 5.3×10(-7 and FNDC1 (p-value = 3.0×10(-7 for UACR, and KCNQ1 with eGFR (p = 3.6×10(-6. Morpholino knockdown of kcnq1 in the zebrafish resulted in abnormal kidney development and filtration capacity. We identified several SNPs in association with eGFR in African Ancestry individuals, as well as 3 suggestive loci for UACR and eGFR. Functional genetic studies support a role for kcnq1 in glomerular development in zebrafish.

  15. Dynamic renal scintigraphy, using Tc-99m-MAG3, for renal insufficiency. Excretory index as a parameter of renal function

    The value of the examination of renal function in insufficient kidneys with Tc-99m-mercaptoacetyltriglycine (MAG3) was evaluated. In correlation with increased creatinine level, there are typical morphological findings in scintigraphy. Simultaneous the time-activity-curves over the kidneys showed a prolonged decrease. The percentual decrease (Excretionsindex, EI) of the curves between maximum and level at the 25. minute is a good and reproducible measure of renal function and correlate with creatinine. (orig.)

  16. Improvement of Renal Functions After Embolization of Renal AVF in a Patient Who had been on Dialysis for 5 Years

    Recently, ultrasound-guided percutaneous renal biopsy has been used in the diagnosis of renal diseases. Development of an arteriovenous fistula (AVF), which is one of the post-biopsy complications, is not frequently encountered. AVFs are usually asymptomatic; however, they may lead to serious outcomes. We report a 21-year-old patient, who had been on dialysis for 5 years. Due to high blood pressure (230/160 mmHg) and a thrill in the lumbar area detected on physical examination, Doppler examination was performed and a renal AVF was detected. Because the patient had a history of renal biopsy 5 years previously, the fistula was thought to be secondary to the biopsy. After embolization of the AVF, renal functions improved enough to terminate dialysis treatment.

  17. Renal function study by sup(99m)Tc-DMSA renal scintigraphy in non-obstructive upper urinary tract infection

    Kidney function study was carried out in 90 patients with non-obstructive upper urinary tract infection using sup(99m)Tc-DMSA (dimercaptosuccinic acid) renal scintigraphy. sup(99m)Tc-DMSA renal scintigram demonstrated well pyelonephritic cortical lesions which were not easily visualized on IVP. A variety of sup(99m)Tc-DMSA renal uptake paralleled the grading of pyelonephritic changes in IVP, however, there was a discrepancy between some of grade II pyelonephritic changes in reflux kidneys and DMSA renal uptake. This may be partly attributed to hydrodynamic effects of VUR in addition to inflammatory changes. The severity of reflux and changes in pelviocaliceal system on VCG also paralleled DMSA renal uptake in reflux kidneys. A ratio of sup(99m)Tc-DMSA renal uptake in the healthy side to that in pathological side was observed in 23 cases with VUR before and after the anti-VUR operation was performed. In patients with more than 3.5 of preoperative DMSA uptake ratio, there were few increments postoperatively in kidney functions of the pathological side, while the contralateral healthy kidney showed a compensatory increase in kidney function. This DMSA renal uptake ratio between healthy and pathological side seems to be one of predictable determinants for postoperative recovery of the pathological side. Thus, by comparing the DMSA uptake between right and left kidney in the chronic course or pre- and postoperative periods, an effect of renal function in the pathological side on that in the healthy side was investigated from the point of renal counterbalance. (author)

  18. Sequential and functional renal scintiscanning in diabetic and hypertensive patients

    47 diabetics (94 kidneys), 30 diabetics with concurrent hypertension (60 kidneys), and 23 hypertensives (46 kidneys) were examined by renal serial functional scintiscanning with 131I-ortho-iodo-hippuric acid. For evaluation, camera nephrographs of the whole kidney, renal hemispheres, and renal cortex were used according to the technique of 'regions of interest', and the parameters of secretory value, maximum secretion, and elimination half-life were determined on this basis. With regard to the extent of hypertension, there are significant differences between all three groups for the elimination half-life; as far as the secretory value was concerned, there was a difference between the group with high hypertension and the two other groups. Significant differences in secretory value and elimination half-life were also observed in hypertensives with and without changes in the fundus of the eye. There was no noticeable difference between the three parameters in groups with and without albuminuria. (orig./AJ) 891 AJ/orig.- 892 MKO

  19. Postprandial hyperoxaluria and intestinal oxalate absorption in idiopathic renal stone disease

    Calcium and oxalate were studied in daily, fasting and postprandial urine specimens from healthy subjects and patients with idiopathic renal calcium stones in response to a test meal free of oxalate, and supplemented with calcium and 14carbon-oxalic acid. The data showed that the amount of oxalate in fasting urine of patients with stones did not differ from that in controls. Generally, patients with stones had considerable postprandial hyperoxaluria in terms of excretion and concentration, associated with a significantly higher degree of supersaturation with regard to calcium oxalate compared to controls. These findings were paralleled by decreased intestinal absorption of 14carbon-oxalate and by unchanged 24-hour urinary oxalate. Although the source of increased postprandial oxalate in patients with stones is not clear the possibility of enhanced de novo synthesis from oxalate precursors is discussed. In patients with different types of calciuria the 2 main risk factors (hyperoxaluria and hypercalciuria) for the process of stone formation are recognizable more readily in the postprandial urine specimens than in fasting or daily urine specimens

  20. RENAL-FUNCTION AND KIDNEY SIZE IN GLYCOGEN-STORAGE-DISEASE TYPE-I

    REITSMABIERENS, WCC; SMIT, GPA; TROELSTRA, JA

    1992-01-01

    Renal failure has been reported recently as a late complication of glycogen storage disease type I (GSD I). We studied the renal function of 23 patients, mean age 10.9 years (range 2.2-21.6 years). The mean glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were 188 +/- 50 and 9

  1. The association between atherosclerotic risk factors and renal function in the general population

    Verhave, JC; Hillege, HL; Burgerhof, JGM; Gansevoort, RT; de Zeeuw, D; de Jong, PE

    2005-01-01

    Background. Generalized atherosclerosis is increasingly recognized as an important cause of end-stage renal disease (ESRD). We questioned to what extent atherosclerotic risk factors determine renal function in the general population. Methods. We used baseline data of the Prevention of Renal and Vasc

  2. A Population- and Hospital-based Cross-sectional Study of Renal Function in Hidradenitis Suppurativa

    Miller, Iben M; Carlson, Nicholas; Mogensen, Ulla Brasch; Ellervik, Christina; Jemec, Gregor B E

    2015-01-01

    similar basement membrane defects might occur in renal tissue. Our objective was to investigate a possible association between HS and renal dysfunction. We performed a hospital and population-based cross-sectional study using estimated Glomerular-Filtration-Rate (eGFR) to assess renal function. Thirty...

  3. MR velocity mapping measurement of renal artery blood flow in patients with impaired kidney function

    Cortsen, M; Petersen, L.J.; Stahlberg, F;

    1996-01-01

    . MR velocity mapping was performed in both renal arteries using an ECG-triggered gradient echo pulse sequence previously validated in normal volunteers. Effective renal plasma flow was calculated from the clearance rate of PAH during constant infusion and the split of renal function was evaluated by...

  4. Renal Function Descriptors in Neonates: Which Creatinine-Based Formula Best Describes Vancomycin Clearance?

    Bhongsatiern, Jiraganya; Stockmann, Chris; Yu, Tian; Constance, Jonathan E; Moorthy, Ganesh; Spigarelli, Michael G; Desai, Pankaj B; Sherwin, Catherine M T

    2016-05-01

    Growth and maturational changes have been identified as significant covariates in describing variability in clearance of renally excreted drugs such as vancomycin. Because of immaturity of clearance mechanisms, quantification of renal function in neonates is of importance. Several serum creatinine (SCr)-based renal function descriptors have been developed in adults and children, but none are selectively derived for neonates. This review summarizes development of the neonatal kidney and discusses assessment of the renal function regarding estimation of glomerular filtration rate using renal function descriptors. Furthermore, identification of the renal function descriptors that best describe the variability of vancomycin clearance was performed in a sample study of a septic neonatal cohort. Population pharmacokinetic models were developed applying a combination of age-weight, renal function descriptors, or SCr alone. In addition to age and weight, SCr or renal function descriptors significantly reduced variability of vancomycin clearance. The population pharmacokinetic models with Léger and modified Schwartz formulas were selected as the optimal final models, although the other renal function descriptors and SCr provided reasonably good fit to the data, suggesting further evaluation of the final models using external data sets and cross validation. The present study supports incorporation of renal function descriptors in the estimation of vancomycin clearance in neonates. PMID:26412385

  5. Renal hemodynamics, function, and oxygenation during cardiac surgery performed on cardiopulmonary bypass: a modeling study

    Sgouralis, Ioannis; Evans, Roger G.; Gardiner, Bruce S; Smith, Julian A.; Fry, Brendan C.; Layton, Anita T.

    2015-01-01

    Abstract Acute kidney injury, a prevalent complication of cardiac surgery performed on cardiopulmonary bypass (CPB), is thought to be driven partly by hypoxic damage in the renal medulla. To determine the causes of medullary hypoxia during CPB, we modeled its impact on renal hemodynamics and function, and thus oxygen delivery and consumption in the renal medulla. The model incorporates autoregulation of renal blood flow and glomerular filtration rate and the utilization of oxygen for tubular ...

  6. Effect of renal function on the bioavailability of ciprofloxacin.

    Plaisance, K I; Drusano, G. L.; Forrest, A.; Weir, M R; Standiford, H C

    1990-01-01

    The effect of renal function on the bioavailability of ciprofloxacin was studied in 21 subjects with measured creatinine clearances ranging from 0 to 8.99 liters/h per 1.73 m2. Each subject received ciprofloxacin, 200 mg intravenously and 750 mg orally, separated by at least 1 week. Serial (12 to 15) blood samples were obtained over 24 to 48 h. Concentrations in serum were assayed by high-pressure liquid chromatography. Area under the curve was calculated by the trapezoidal rule with extrapol...

  7. Effect of renal function on pemetrexed-induced haematotoxicity

    Ando, Yosuke; Hayashi, Takahiro; Ujita, Moeko; Murai, Sumie; Ohta, Hideki; Ito, Kaori; Yamaguchi, Teppei; Funatsu, Minori; Ikeda, Yoshiaki; Imaizumi, Kazuyoshi; Kawada, Kenji; Yasuda, Kimio; Yamada, Shigeki

    2016-01-01

    Purpose Pemetrexed (PEM) is an anticancer agent used for the treatment of non-small cell lung cancer, malignant pleural mesothelioma and thymoma. Reportedly, PEM has higher efficacy and safety when used in combination with platinum-based agents. However, there are only few reports on the safety of PEM in patients with an eGFR of ≤45 mL/min. We examined the effect of renal function on the safety of regimens containing PEM. Methods We retrospectively reviewed 221 patients with lung cancer, mali...

  8. Renal Function and Ultrasound Imaging in Elderly Subjects

    Luca Zanoli; Giulia Romano; Marcello Romano; Stefania Rastelli; Francesco Rapisarda; Antonio Granata; Pasquale Fatuzzo; Mariano Malaguarnera; Pietro Castellino

    2014-01-01

    We evaluated in elderly subjects (a) the ability of GFR formulas to discriminate chronic kidney disease (CKD), (b) the correlation between renal morphology and function, and (c) the usefulness of combined r-US and GFR formulas to detect CKD. A total of 72 patients were enrolled (mean age 80 ± 7 years, male sex 44%, serum creatinine 0.98 ± 0.42 mg/dL, and CKD 57%). Cockcroft-Gault showed the highest sensitivity (78%) and specificity (94%) for CKD and was correlated with kidney volume (R = 0.68...

  9. Periodontal disease characterization in dogs with normal renal function or chronic renal failure

    Barbudo-Selmi Glenda Ramalho

    2004-01-01

    Full Text Available The purpose of this study was to evaluate periodontal disease (PD in dogs with chronic renal failure (CRF and to compare it to PD in dogs with normal renal function (NRF. Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivitis, gingival recession, pocket, calculus, dental mobility, dental loss, and ulcers. These data were used to calculate plaque index (PI, gingival index (GI and periodontal destruction index (PDI. PD was graded as mild, moderate or severe based on the results. Mild, moderate or severe PD was observed in dogs with NRF, whereas dogs with CRF presented either mild or severe PD. Dogs with NRF showed higher involvement of the maxillary teeth, whereas dogs with CRF showed a higher involvement of the mandibular teeth. Plaque index was significantly higher in dogs with NRF. It was concluded that lesion distribution and periodontal disease progression may be altered in dogs with CRF, and gingival inflammatory response differs in dogs with NRF and CRF regarding to the stage of periodontal disease.

  10. Atorvastatin improves renal organic anion transporter 3 and renal function in gentamicin-induced nephrotoxicity in rats.

    Jaikumkao, Krit; Pongchaidecha, Anchalee; Chattipakorn, Nipon; Chatsudthipong, Varanuj; Promsan, Sasivimon; Arjinajarn, Phatchawan; Lungkaphin, Anusorn

    2016-06-01

    What is the central question of this study? This study was designed to determine the renoprotective effects of atorvastatin treatment in an experimental model of gentamicin-induced nephrotoxicity through modulating the Nrf2 pathway by decreasing the oxidative stress. What is the main finding and its importance? Atorvastatin exerts a nephroprotective effect by attenuating oxidative stress, protecting renal function and renal organic anion transporter 3 function from the effects of gentamicin. Atorvastatin might protect the tissues via its antioxidant property and by modulating the antioxidant enzymes through the Nrf2 signalling pathway, which may be the underlying mechanisms of these protective effects. Recent evidence demonstrates that statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, exert not only lipid-lowering effects but also antioxidant, anti-inflammatory and anti-apoptotic effects. Nephrotoxicity, a serious side-effect of gentamicin, is related to an increase in reactive oxygen species in the kidney. This study was designed to determine the renoprotective effects of atorvastatin treatment in an experimental model of gentamicin-induced nephrotoxicity. Male Sprague-Dawley rats were used. Nephrotocixity was induced by i.p. injection of gentamicin, 100 mg kg(-1)  day(-1) , for 15 days. Atorvastatin, 10 mg kg(-1)  day(-1) , was administered by gavage 30 min before gentamicin injection (pretreatment) for 15 days or only on days 10-15 (post-treatment). Renal function and renal organic anion transporter 3 (Oat3) function and expression were examined. Gentamicin-treated rats demonstrated impaired renal function by attenuation of creatinine clearance and increased oxidative stress. Gentamicin treatment also decreased renal Oat3 function and expression as shown by decreased [(3) H]estrone sulfate uptake into renal cortical slices and decreased expression. The protein expressions of protein kinase C, Nrf2, NAD(P)H:quinone oxidoreductase 1

  11. Qualitative evaluation of renal function using dynamic MRI

    A study of quantitative analysis of renal function using dynamic-enhanced MR imaging was performed on a 1.5 T superconducting MR system. To determine the best suitable pulse sequence and dose of Gd-DTPA to injection, preliminary study using phantom was done before clinical application. As the aim of this study was quantitative evaluation, S/N ratio and contrast resolution were most important factors to decide pulse sequence. Consequently, spin echo technique (TR/TE=200/15, INEX, 128 x 128) was adopted without respiratory suspension. Eleven patients with slightly impaired renal function and 12 patients with grafted kidneys were included in this clinical study. Time-intensity curve of renal parenchyma obtained by dynamic MRI (=MRI renogram) was intended to mathematical analysis. First, 2 compartment model was established for washout of Gd-DTPA. Then a formula as below can be formed for expressing theoretical time-intensity curve. X(t)=A·exexp (-k1·t)+B·exp (-k2·t)-C·exp (-k3·t). The parameters of A, B, C and k1, k2, k3 can be figure out by calculation of measured data by means of nonlinear least squares method. A new parameter (named MRI-GFR), expressed in formula as befow, was settled for representing GFR. MRI-GFR=k1·k2/A·k1+B·k2. The MRI-GFR was correlated well with GFR obtained by renogram using 99mTc-DTPA (correlation coefficient: r=0.901). In conclusion, MRI renogram was useful to calculate GFR by using mathematical analysis. (author)

  12. Renal Tubular Functions in Children with Primary Nocturnal Enuresis

    Süleyman Kalman

    2012-03-01

    Full Text Available Introduction: The etiology of primary nocturnal enuresis (PNE is multifactorial. The effects of genetic and hormonal factors, sleep disorders, and bladder dysfunction have been claimed. The other factors include increased urine production at night and impairment of the circadian rhythm of antidiuretic hormone. Aim: To investigate renal tubular functions in children with PNE. Methods: Forty patients with PNE were included in the study. Urine density, FENa, FEK and TRP were analyzed in daytime and nighttime urine. Results: The mean nighttime urine density was 1020.12±7.38 and the mean daytime urine density was 1013.20±7.11 (p0.05. Conclusion: Urine density in children with PNE was lower at night. However, there was no difference in of FENa, FEK and TRP. Further studies are needed in order to investigate renal tubular functions in children with PNE (The Me di cal Bul le tin of Ha se ki 2012; 50: 10-3

  13. Can a structured questionnaire identify patients with reduced renal function?

    Azzouz, Manal; Rømsing, Janne; Thomsen, Henrik

    2014-01-01

    To evaluate a structured questionnaire in identifying outpatients with renal dysfunction before MRI or CT in various age groups.......To evaluate a structured questionnaire in identifying outpatients with renal dysfunction before MRI or CT in various age groups....

  14. Sequence computerized tomography in the evaluation of renal transplant function

    Thirty patients with a transplanted kidney were examined with a sequence computerized tomography after an intravenous injection of the contrast medium in a bolus form. Characteristic time density curves for renal cortex, medulla and internal iliac artery in patients with a normally functioning kidney transplant are given. Changes of time density curves in acute and massive rejection and in acute tubular necrosis are presented. Two parameters: an index Q tangens i.e. a ratio of the cortical enhancement segment of the curve to the injection time, and G duration of the enhancement gradient between cortex and medulla have been proposed for the quantitative evaluation of the curve. Rejection of the transplant is characterized by a flattening of the first segment of the curve and a prolongation of duration of the cortico-medullary enhancement gradient. In acute tabular necrosis time density curve resembles the curve in a normally functioning transplant. (author)

  15. Comparison of renal toxicity after injection of CT contrast medium and MR contrast medium: change of renal function in acute renal failure rat models

    To determine renal toxicity through changes in renal function after the injection of CT and MRI contrast media into rats in which acute renal failure (ARF) was induced. To cause acute renal failure, the abdominal cavity of 110 male rats each weighing 250-300 gm was opened via a midline incision under anesthesia. Microvascular clamps were placed on both renal arteries and veins to completely block renal blood flow for 45 minutes, and were then removed, allowing blood flow to return to the kidneys. ARF, defined as a two-fold difference in the creatinine level before ARF and 48 hours after, was successfully induced in 60 of the rats. These were divided into two groups: one was injected with CT contrast medium and the other with MRI contrast medium. Each CT and MRI group was divided into a low dose (0.5 cc/kg, 0.2 ml/kg), standard dose (2 cc/kg, 0.8 ml/kg), and high dose (8 cc/kg, 3.2 ml/kg) sub-group; thus, there was a total of six groups with ten rats in each. Blood samples were obtained before ARF, 48 hours after, and 48 hours after contrast injection, and CT scanning and MRI were performed after blood sampling at 48 hours. In each group, creatinine levels 48 hours after contrast injection were compared by means of the ANOVA test. There were no significant differences in creatinine levels between the CT and MRI contrast medium groups (p=0.116), nor between the animals to which different doses of CT and MRI contrast medium, were administered. After both standard and high doses, CT and MRI provided good images. In rats in which acute renal failure was induced, renal function did not change according to whether CT or MRI contrast medium was injected. Thus, the two media induce similar levels of toxicity

  16. 99mTc-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children

    Authors retrospectively analysed 20 cases of follow-up 99mTc-DMSA renal scans to evaluate renal function recovery after treatment in urological disorders of infants and children. There were 20 cases with both 99mTc-DMSA renal scans prior to and after therapy in 15 patients below 9 years old. Among them, 10 patients underwent ureteroneocystostomy under the diagnosis of vesicoureteral reflux, two patients pyeloplasty because of obstructive uropathy and one was treated with antibiatics even diagnosis of UPJ stricture. We have got the quantified uptake rate of Tc-DMSA renal scan by using the regression equation as y=0.591 X 2.105 (y=the quantified uptake rate, x=the sirnple uptake rate). The number of kidneys performed proper therapy were 29, and the cases with more increased radiotracer uptake rate in the follow-up 99mTc-DMSA renal scans were 20 in number as 69% in frequency. 19 cases with improved renal function on 99mTc-DMSA renal scans didn't show any significant difference related to aging or recovery duration after therapy. The 99mTc-DMSA renal scans were not useful to evaluate renal function recovery in infants and children, but could be good tests to assess residual renal function prior to or after treatment.

  17. Effect of cisplatin on renal haemodynamics and tubular function in the dog kidney

    Daugaard, G; Abildgaard, U; Holstein-Rathlou, N H;

    1987-01-01

    Administration of cisplatin (5 mg/kg) to dogs results in polyuric renal failure due initially to a proximal tubular functional impairment. 48-72 h after the cisplatin administration the depressed renal function can be attributed to impairment of proximal as well as distal tubular reabsorptive...... capacities associated with increased renal vascular resistance. The polyuria seems to be due to the impaired reabsorption rate in the distal nephron segments....

  18. Estimation of renal function in the intensive care unit: the covert concepts brought to light

    Sunder, Sham; Jayaraman, Rajesh; Mahapatra, Himanshu Sekhar; Sathi, Satyanand; Ramanan, Venkata; Kanchi, Prabhu; Gupta, Anurag; Daksh, Sunil Kumar; Ram, Pranit

    2014-01-01

    Frantic efforts have been made up to this date to derive consensus for estimating renal function in critically ill patients, only to open the Pandora's box. This article tries to explore the various methods available to date, the newer concepts, and the uncared issues that may still prove to be useful in estimating renal function in intensive care unit patients. The concept of augmented renal clearance, which is frequently encountered in critically ill patients, should always be taken into ac...

  19. Roles of estrogen and progesterone in modulating renal nerve function in the rat kidney

    The maintenance of extracellular Na+ and Cl- concentrations in mammals depends, at least in part, on renal function. It has been shown that neural and endocrine mechanisms regulate extracellular fluid volume and transport of electrolytes along nephrons. Studies of sex hormones and renal nerves suggested that sex hormones modulate renal function, although this relationship is not well understood in the kidney. To better understand the role of these hormones on the effects that renal nerves have on Na+ and Cl- reabsorption, we studied the effects of renal denervation and oophorectomy in female rats. Oophorectomized (OVX) rats received 17β-estradiol benzoate (OVE, 2.0 mg·kg-1·day-1, sc) and progesterone (OVP, 1.7 mg·kg-1·day-1, sc). We assessed Na+ and Cl- fractional excretion (FENa+ and FECl-, respectively) and renal and plasma catecholamine release concentrations. FENa+, FECl-, water intake, urinary flow, and renal and plasma catecholamine release levels increased in OVX vs control rats. These effects were reversed by 17β-estradiol benzoate but not by progesterone. Renal denervation did not alter FENa+, FECl-, water intake, or urinary flow values vs controls. However, the renal catecholamine release level was decreased in the OVP (236.6±36.1 ng/g) and denervated rat groups (D: 102.1±15.7; ODE: 108.7±23.2; ODP: 101.1±22.1 ng/g). Furthermore, combining OVX + D (OD: 111.9±25.4) decreased renal catecholamine release levels compared to either treatment alone. OVE normalized and OVP reduced renal catecholamine release levels, and the effects on plasma catecholamine release levels were reversed by ODE and ODP replacement in OD. These data suggest that progesterone may influence catecholamine release levels by renal innervation and that there are complex interactions among renal nerves, estrogen, and progesterone in the modulation of renal function

  20. 99Tcm-DTPA renal dynamic imaging in judgment of renal functions in patients with diabetes mellitus

    Objective: To evaluate 99Tcm-diethylenetriamine-pentaacetic acid (99Tm-DTPA) renal dynamic imaging in judgment of the renal function inpatients with diabetes mellitus (DM) so as to provide reference for clinical treatment and prognosis predicting. Methods: Ninety patients with DM were divided into four groups according to values of urinary albumin excretion rate (UAER). 1) Group DM1: UAER-1, 25 cases. 2) Group DM2: UAER 20 ∼200 μg ·min-1, 24 cases. 3) Group DM3: UAER>200 μg ·min-1, 23 cases. 4) a renal function failure group (DM4), 18 cases. Fourty healthy people were chosen as normal control (NC) group. 99Tcm-DTPA radionuclide renal dynamic imaging of glomerular filtration rate (GFR) was performed and the levels of serum creatinine (Scr), blood urea nitrogen (Bun) and blood β2-microglobulin (β2-Mg) were measured in the five groups. Results: GFR were significantly increased in group DM1 than those in Nc (t=12.5, P2 GFR was not different from Nc. The half activity time (T1/2) of the renogram was significantly prolonged. The 20 min retention rate (C20) of the renogram increased compared with Nc. In group DM3 and DM4, GCFR was remarkably decreased. The peak time (Tp) of the renogram delayed. T1/2 distinctly prolonged and C20 increased, comparing with Nc (r=-0.497, P<0.05). Conclusion: Radionuclide renal dynamic imaging is helpful for the evaluation of renal damage in early stage of diabetic nephropathy (D N), judge the injury of the renal function and provide reference for clinical treatment and follow-up. (authors)

  1. Rapid improvement in renal function in patients with multiple myeloma and renal failure treated with bortezomib

    Qayum Abdul

    2010-01-01

    Full Text Available Multiple Myeloma (MM frequently presents with renal dysfunction apart from other manifestations. Development of renal failure in patients with MM carries a poor prognosis. Bortezo-mib is a new addition to drugs used in MM and has shown good efficacy and safety profiles. Previous trials have shown its efficacy in relapsed and refractory MM as well. Studies have also shown that bortezomib is also effective in patients with MM who present with renal failure. We report here six cases of renal failure secondary to MM treated with bortezomib. All patients had poor performance status of 3-4 on ECOG scale. Five out of six patients showed satisfactory anti-myeloma response to bortezomib. Reversal of renal failure was observed in all six patients. Adverse effects to bortezomib were mild and manageable. Reversal of renal failure persisted despite incomplete response to MM in two cases, and progression of disease in one patient. It appears that bortezomib may have an effect on the kidneys in reversal of renal failure, other than its anti-myeloma effect. In conclusion, borte-zomib appears to be an effective treatment for patients with advanced MM and renal failure irres-pective of performance status and age.

  2. Changes in Renal Function and Blood Pressure in Patients with Stone Disease

    Worcester, Elaine M.

    2007-04-01

    Stone disease is a rare cause of renal failure, but a history of kidney stones is associated with an increased risk for chronic kidney disease, particularly in overweight patients. Loss of renal function seems especially notable for patients with stones associated with cystinuria, hyperoxaluria, and renal tubular acidosis, in whom the renal pathology shows deposits of mineral obstructing inner medullary collecting ducts, often diffusely. However, even idiopathic calcium oxalate stone formers have a mild but significant decrease in renal function, compared to age, sex and weight-matched normals, and appear to lose renal function with age at a slightly faster rate than non-stone formers. There is also an increased incidence of hypertension among stone formers, although women are more likely to be affected than men.

  3. Functional imaging of the renal transplant; Nuklearmedizinische Beurteilung der Nierentransplantatfunktion

    Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2009-03-15

    Evaluation of renal transplants by nuclear medicine techniques has been important in differential diagnosis of medical and surgical complications of the early post-transplantation period and in the long-term follow up, mainly in patients with anuric acute tubular necrosis and in patients with developing chronic rejection. Early recognition of this condition should permit treatment and delay of retransplantation. It is recommended to perform a flow study, scintigraphy of the kidneys, prevoid and postvoid bladder images, time activity curves of the graft and bladder and quantitative data of perfusion function and tracer transit. {sup 99m}Tc-MAG3 and {sup 99m}Tc-DTPA can be used for this studies. (orig.)

  4. Volume regulation and renal function at high altitude across gender.

    Bernd Haditsch

    Full Text Available We investigated changes in volume regulating hormones and renal function at high altitudes and across gender.Included in this study were 28 subjects (n = 20 males; n = 8 females. ages: 19 - 65 yrs, who ascended to a height of 3440m (HA1, on the 3rd day and to 5050m (HA2, on the 14th day. Plasma and urinary creatinine and urinary osmolality as well as plasma levels of plasma renin activity (PRA, Aldosterone, antidiuretic hormone (ADH, and atrial natriuretic peptide (ANP were measured. The plasma volume loss (PVL was estimated from plasma density and hematocrit. Glomerular filtration rate (GFR was measured based on nocturnal (9 hour creatinine clearance; this was compared with various methods for estimation of GFR.The mean 24-hour urine production increased significantly in both sexes across the expedition. But PVL reached significance only in males. No changes in Na+ in plasma, urine or its fractional excretion were seen at both altitudes. Urinary osmolality decreased upon ascent to the higher altitudes. ADH and PRA decreased significantly at both altitudes in males but only at HA2 in females. However, no changes in aldosterone were seen across the sexes and at different altitudes. ANP increased significantly only in males during the expedition. GFR, derived from 9-h creatinine clearance (CreaCl, decreased in both sexes at HA1 but remained stable at HA2. Conventional Crea[p]-based GFR estimates (eGFR showed only poor correlation to CreaCl.We report details of changes in hormonal patterns across high altitude sojourn. To our knowledge we are not aware of any study that has examined these hormones in same subjects and across gender during high altitude sojourn. Our results also suggest that depending on the estimation formula used, eGFR underestimated the observed decrease in renal function measured by CreaCl, thus opening the debate regarding the use of estimated glomerular filtration rates at high altitudes.

  5. Renal function in children with congenital neurogenic bladder

    Karen Previdi Olandoski

    2011-01-01

    Full Text Available AIMS: Preservation of renal function in children with congenital neurogenic bladder is an important goal of treatment for the disease. This study analyzed the evolution of renal function in patients with congenital neurogenic bladder. METHODS: We reviewed the records of 58 pediatric patients with respect to the following attributes: gender, age, etiology of neurogenic bladder, reason for referral, medical/surgical management, episodes of treated urinary tract infections, urodynamics, DMSA scintigraphy, weight, height, blood pressure, glomerular filtration rate, microalbuminuria and metabolic acidosis. Statistical analysis was performed, adopting the 5% significance level. RESULTS: The mean age at presentation was 4.2 ± 3.5 years. Myelomeningocele was the most frequent etiology (71.4%. Recurrent urinary tract infection was the reason for referral in 82.8% of the patients. Recurrent urinary tract infections were diagnosed in 84.5% of the patients initially; 83.7% of those patients experienced improvement during follow-up. The initial mean glomerular filtration rate was 146.7 ± 70.1 mL/1.73 m²/min, and the final mean was 193.6 ± 93.6 mL/1.73 m²/min, p = 0.0004. Microalbuminuria was diagnosed in 54.1% of the patients initially and in 69% in the final evaluation. Metabolic acidosis was present in 19% of the patients initially and in 32.8% in the final assessment. CONCLUSIONS: Patient referral to a pediatric nephrologist was late. A reduction in the number of urinary tract infections was observed with adequate treatment, but microalbuminuria and metabolic acidosis occurred frequently despite adequate management.

  6. Rapid estimation of split renal function in kidney donors using software developed for computed tomographic renal volumetry

    Kato, Fumi, E-mail: fumikato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kamishima, Tamotsu, E-mail: ktamotamo2@yahoo.co.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Morita, Ken, E-mail: kenordic@carrot.ocn.ne.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Muto, Natalia S., E-mail: nataliamuto@gmail.com [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Okamoto, Syozou, E-mail: shozo@med.hokudai.ac.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Omatsu, Tokuhiko, E-mail: omatoku@nirs.go.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Oyama, Noriko, E-mail: ZAT04404@nifty.ne.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Terae, Satoshi, E-mail: saterae@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kanegae, Kakuko, E-mail: IZW00143@nifty.ne.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Nonomura, Katsuya, E-mail: k-nonno@med.hokudai.ac.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan)

    2011-07-15

    Purpose: To evaluate the speed and precision of split renal volume (SRV) measurement, which is the ratio of unilateral renal volume to bilateral renal volume, using a newly developed software for computed tomographic (CT) volumetry and to investigate the usefulness of SRV for the estimation of split renal function (SRF) in kidney donors. Method: Both dynamic CT and renal scintigraphy in 28 adult potential living renal donors were the subjects of this study. We calculated SRV using the newly developed volumetric software built into a PACS viewer (n-SRV), and compared it with SRV calculated using a conventional workstation, ZIOSOFT (z-SRV). The correlation with split renal function (SRF) using {sup 99m}Tc-DMSA scintigraphy was also investigated. Results: The time required for volumetry of bilateral kidneys with the newly developed software (16.7 {+-} 3.9 s) was significantly shorter than that of the workstation (102.6 {+-} 38.9 s, p < 0.0001). The results of n-SRV (49.7 {+-} 4.0%) were highly consistent with those of z-SRV (49.9 {+-} 3.6%), with a mean discrepancy of 0.12 {+-} 0.84%. The SRF also agreed well with the n-SRV, with a mean discrepancy of 0.25 {+-} 1.65%. The dominant side determined by SRF and n-SRV showed agreement in 26 of 28 cases (92.9%). Conclusion: The newly developed software for CT volumetry was more rapid than the conventional workstation volumetry and just as accurate, and was suggested to be useful for the estimation of SRF and thus the dominant side in kidney donors.

  7. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine

    Tepel, Martin; van der Giet, M; Schwarzfeld, C;

    2000-01-01

    Radiographic contrast agents can cause a reduction in renal function that may be due to reactive oxygen species. Whether the reduction can be prevented by the administration of antioxidants is unknown.......Radiographic contrast agents can cause a reduction in renal function that may be due to reactive oxygen species. Whether the reduction can be prevented by the administration of antioxidants is unknown....

  8. Equimolar carbon dioxide absorption by ether functionalized imidazolium ionic liquids

    A series [C3Omim][X] of imidazolium cation-based ILs, with ether functional group on the alkyl side-chain have been synthesized and structure of the materials were confirmed by various techniques like 1H, 13C NMR spectroscopy, MS-ESI, FTIR spectroscopy and EA. More specifically, the influence of changing the anion with same cation is carried out. The absorption capacity of CO2 for ILs were evaluated at 30 and 50 .deg. C at ambient pressure (0-1.6 bar). Ether functionalized ILs shows significantly high absorption capacity for CO2. In general, the CO2 absorption capacity of ILs increased with a rise in pressure and decreased when temperature was raised. The obtained results showed that absorption capacity reached about 0.9 mol CO2 per mol of IL at 30 .deg. C. The most probable mechanism of interaction of CO2 with ILs were investigated using FTIR spectroscopy, 13C NMR spectroscopy and result shows that the absorption of CO2 in ether functionalized ILs is a chemical process. The CO2 absorption results and detailed study indicates the predominance of 1:1 mechanism, where the CO2 reacts with one IL to form a carbamic acid. The CO2 absorption capacity of ILs for different anions follows the trend: BF4 6 2N. Moreover, the as-synthesized ILs is selective, thermally stable, long life operational and can be recycled at a temperature of 70 .deg. C or under vacuum and can be used repeatedly

  9. Comparison of Renal Function and Other Health Outcomes in Vegetarians versus Omnivores in Taiwan

    Lin, Chih-Kuang; Lin, Deng-Juin; Yen, Chi-Hwa; Chen, Shiuan-Chih; Chen, Chun-Chieh; Wang, Tsun-Yen; Chou, Ming-Chih; Chang, Horng-Rong; Lee, Meng-Chih

    2010-01-01

    Renal disease is one of the top 10 leading causes of death, and the incidence of end-stage renal disease in Taiwan is the highest in the world. Many dietitians consider the diet of plant origin consumed by vegans to be ‘lighter’ and ‘more healthful’ than the diet of both plant and animal origin consumed by omnivores. Dietary protein has significant effects on renal functions. The study explored the effects of both the diets on renal functions. The study subjects included 102 Buddhist nun vege...

  10. Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

    Samia Rafael Yamashita

    2015-02-01

    Full Text Available Objective: To determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs and to assess the reproducibility of these measurements using ultrasonography. Materials and Methods: Ultrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r was determined in order to establish the relationship between the different renal measurements and estimated GFR. Results: The correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001, poor (r = 0.380; p = 0.004, and poor (r = 0.277; p = 0.116. The interobserver agreement was considered excellent (0.754 for measurements of cortical thickness and bipolar length (0.833, and satisfactory for parenchymal thickness (0.523. Conclusion: The interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

  11. Evaluation of renal function by factor analysis using 99mTc-MAG3

    The kinetics of 99mTc-mercapto-acetyltriglycine (MAG3), a new renal scintigraphic agent, was studied by factor analysis in patients with chronic renal disorders, and its applecation to assessment of the renal function was evaluated. Data were collected for 30 minutes from immediately after intravenous injection of MAG3 at 370 MBq, the first pass image and serial renal scintigrams were obtained, and factor analysis was attempted simultaneously. Since most of MAG3 is excreted via the kidney during the first pass, factor analysis was performed. Two factors reflecting renal parenchymal components and pelvic components could be separated in 8 (Cre≤2.9 mg/dl) of 10 patients, and they corresponded with respective segmental renograms. In the remaining 2 (Cre≤3.0 mg/dl), separation was impossible by 2 factor analysis, and 3 factor analysis was needed. Factor analysis is considered to allow objective evaluation of renal function without setting the ROI. (author)

  12. Formoterol Restores Mitochondrial and Renal Function after Ischemia-Reperfusion Injury

    Jesinkey, Sean R.; Funk, Jason A.; Stallons, L. Jay; Wills, Lauren P.; Megyesi, Judit K.; Beeson, Craig C.; Schnellmann, Rick G.

    2014-01-01

    Mitochondrial biogenesis may be an adaptive response necessary for meeting the increased metabolic and energy demands during organ recovery after acute injury, and renal mitochondrial dysfunction has been implicated in the pathogenesis of AKI. We proposed that stimulation of mitochondrial biogenesis 24 hours after ischemia/reperfusion (I/R)–induced AKI, when renal dysfunction is maximal, would accelerate recovery of mitochondrial and renal function in mice. We recently showed that formoterol,...

  13. Quantitation of renal function with glomerular and tubular agents

    Quantitative methods to measure the glomerular and tubular function of the kidneys with radionuclides have been available for many years. They have not been widely used because the techniques and the calculations exceeded the scope of routine nuclear medicine practice. Validation of simplified methods and the introduction of computer technology have made measurement of the effective renal plasma flow (ERPF) and the glomerular filtration rate (GFR) simple enough so that they can be performed reproducibly in most nuclear medicine departments. The estimation of ERPF with radioiodinated OIH and GFR with /sup 99m/TcDTPA can be achieved in many ways, all of which yield clinically useful results. How to get the best results using the simplest methods is still unclear. The required accuracy depends on the intended clinical use. Our preference at the present time is to use a single or double plasma sample to calculate global ERPF or GFR, and to use the 1-2 min OIH or 1-3 min Tc-DTPA uptake to calculate relative function of the two kidneys (split function ERPF or GFR). The choice of method will be influenced by local factors, such as the nature of the patient population, the case volume, and the resources available. A desirable goal for future studies is to document carefully the capabilities and limitations of each alternative method, so that the choice can be rational

  14. Changes in renal function in cats following treatment of hyperthyroidism using 131I.

    Adams, W H; Daniel, G B; Legendre, A M; Gompf, R E; Grove, C A

    1997-01-01

    Changes in renal function of twenty-two cats treated for hyperthyroidism using radioiodine were evaluated. Serum thyroxine (T4), serum creatinine, blood urea nitrogen (BUN) and urine specific gravity were measured before treatment and 6 and 30 days after treatment. Twenty-two cats had pretreatment and 21 cats had 6 day posttreatment measurement of glomerular filtration rate (GFR) using nuclear medicine imaging techniques. There were significant declines in serum T4 at 6 days following treatment, but the changes in GFR, serum creatinine and BUN were not significant. At 30 days following treatment, there were significant increases in BUN and serum creatinine and further significant declines in serum T4. Nine cats were in renal failure prior to treatment and 13 cats were in renal failure 30 days following treatment. Renal failure was defined as BUN greater than 30 mg/dl and/or serum creatinine greater than 1.8 mg/dl with concurrent urine specific gravity less than 1.035. These 13 cats included eight of 9 cats in renal failure prior to treatment and 5 cats not previously in renal failure. Follow up information beyond 30 days following treatment on 9 of these 13 cats indicated that all remained in renal failure. Based on receiver operating curve analysis of pretreatment glomerular filtration rate (GFR) in predicting posttreatment renal failure, a value of 2.25 ml/kg/min as a point of maximum sensitivity (100%) and specificity (78%) was derived. Fifteen of 22 cats had pretreatment GFR measurements of less than 2.25 ml/kg/min. These 15 cats included all 9 cats in renal failure and 5 cats with normal renal clinicopathologic values prior to treatment. At 30 days following treatment, 13 of these 15 cats were in renal failure. The 2 cats not in renal failure had persistently increased serum T4 values. Seven of 22 cats had pretreatment GFR measurements greater than 2.25 ml/kg/min. None of these 7 cats was in renal failure at 30 days following treatment, all cats having normal

  15. Risks of rapid decline renal function in patients with type 2 diabetes

    Yi-Jing; Sheen; Wayne; HH; Sheu

    2014-01-01

    Progressive rising population of diabetes and related nephropathy, namely, diabetic kidney disease and associated end stage renal disease has become a major global public health issue. Results of observational studies indicate that most diabetic kidney disease progresses over decades; however, certain diabetes patients display a rapid decline in renal function, which may lead to renal failure within months. Although the definition of rapid renal function decline remained speculative, in general,it is defined by the decrease of estimated glomerular filtration rate(e GFR) in absolute rate of loss or percent change. Based on the Kidney Disease: Improving Global Outcomes 2012 clinical practice guidelines, a rapid decline in renal function is defined as a sustained declinein e GFR of > 5 m L/min per 1.73 m2 per year. It has been reported that potential factors contributing to a rapid decline in renal function include ethnic/genetic and demographic causes, smoking habits, increased glycated hemoglobin levels, obesity, albuminuria, anemia, low serum magnesium levels, high serum phosphate levels, vitamin D deficiency, elevated systolic blood pressure, pulse pressure, brachial-ankle pulse wave velocity values, retinopathy, and cardiac autonomic neuropathy. This article reviews current literatures in this area and provides insight on the early detection of diabetic subjects who are at risk of a rapid decline in renal function in order to develop a more aggressive approach to renal and cardiovascular protection.

  16. Mesenchymal Stem Cells (MSC) Prevented the Progression of Renovascular Hypertension, Improved Renal Function and Architecture

    Oliveira-Sales, Elizabeth B.; MAQUIGUSSA, EDGAR; Semedo, Patricia; PEREIRA, LUCIANA G; Ferreira, Vanessa M; Câmara, Niels O.; Bergamaschi, Cassia T.; Campos, Ruy R.; Mirian A. Boim

    2013-01-01

    Renovascular hypertension induced by 2 Kidney-1 Clip (2K-1C) is a renin-angiotensin-system (RAS)-dependent model, leading to renal vascular rarefaction and renal failure. RAS inhibitors are not able to reduce arterial pressure (AP) and/or preserve the renal function, and thus, alternative therapies are needed. Three weeks after left renal artery occlusion, fluorescently tagged mesenchymal stem cells (MSC) (2×105 cells/animal) were injected weekly into the tail vein in 2K-1C hypertensive rats....

  17. How does your kidney smell? Emerging roles for olfactory receptors in renal function.

    Shepard, Blythe D; Pluznick, Jennifer L

    2016-05-01

    Olfactory receptors (ORs) are chemosensors that are responsible for one's sense of smell. In addition to this specialized role in the nose, recent evidence suggests that ORs are also found in a variety of additional tissues including the kidney. As this list of renal ORs continues to expand, it is becoming clear that they play important roles in renal and whole-body physiology, including a novel role in blood pressure regulation. In this review, we highlight important considerations that are crucial when studying ORs and present the current literature on renal ORs and their emerging relevance in maintaining renal function. PMID:26264790

  18. Evaluation of renal first pass blood flow with a functional image technique in hypertensive patients

    The renal circulation of patients with essential hypertension and renovascular hypertension was evaluated using 99mTc-DTPA. The first renal peak count (the first Cmax; FCmax), time phase distribution (the first Tmax; FTmax), and blood velocity (the FCmax/FTmax) were calculated by digital imaging. This yields a visual image of the renal circulation. We consider that the increase in the renal first pass blood flow in patients with essential hypertension is best observed pixel by pixel. The FCmax and FCmax/FTmax images before and after treatment by percutaneous transluminal renal angioplasty in patients with renovascular hypertension clearly show its therapeutic effect. The FI technique, therefore, has the advantage that it can be performed at the same time as the conventional routine examinations of renal function. This makes it very useful clinically. (orig.)

  19. New developments in renal physiopathology acquired using a quantitative renal functional test: the 197Hg uptake test

    The renal function of 331 obstructive uropathies, of which 112 were unilateral, were studied using the radioactive Hg renal uptake technique. The results obtained lead to the following observations: kidneys silent because of a chronic pelvi-ureteric-obstruction maintain a minimum function representing approximately one quarter of the normal value, which does not seem to be improved following the removal of the obstacle. Operative relief of obstruction on unilateral obstructive uropathies, except for cases of silent kidneys, are followed by a significative improvement in the function of the kidney on the operated side in more than a third of the cases studied. In 43% of obstructive uropathies considered as unilateral, the functional value of the two kidneys is decreased

  20. Percutaneous renal artery stenting reduces arterial blood pressure, but what about renal function? A single-center experience

    Erkan Dervişoğlu

    2010-02-01

    Full Text Available Objective: To assess the effects of percutaneous transluminal angioplasty and stenting (PTRA/S on arterial blood pressure and renal function.Methods: A retrospective chart review of patients undergoing PTRA/S at our institution between December 2003 and September 2006 was done. Follow-up data were derived from hospital records. Estimated glomerular filtration rate (EGFR was used as the marker of renal function. To evaluate the pre- and post-procedure values in individual patients the paired t test and Wilcoxon signed-rank tests were used.Results: Thirty-six patients (16 women, 30 men; mean age 59±15 years, range: 25-83 years underwent 43 PTRA/S interventions at our institution. The mean duration of follow-up was 9.3±8.6 (range 2-28 months. We observed no significant change in EGFR from pre-procedure to that obtained at follow-up (71.4±40.2 mL/min vs.73.3±39.0 mL/min; p=0.483. Mean arterial blood pressure (MABP, however, was reduced significantly: pre-procedure MABP-123±22 mmHg; post-procedure follow-up value of 101±14 mmHg (p <0.001. The mean number of antihypertensive medications used at the time of intervention was 2.1±1.0 (range: 0-4, whereas at follow-up, this number had decreased to 1.3±1.0 (range: 0-4; p<0.001. In patients with renal impairment (EGFR ≤59 mL/min, 41% showed improvement, 29% showed no change and 29% demonstrated deterioration in EGFR. Conclusion: PTRA/S may preserve renal function, especially in patients with pre-procedural impaired renal function.

  1. Quantitative evaluation of relative separate renal perfusion and function with Tc-99m-DTPA

    A new method of quantitative measurement of relative separate renal perfusion and function, using Tc-99m-DTPA and a scintillation camera interfaced to a computer was evaluated in various unilateral renal diseases. 1) Relative separate renal perfusion and function ratios with Tc-99m-DTPA were correlated well with I-131-Hippuran (r = 0.974). 2) Normal values in the subjects with healthy kidneys (n = 42) were as follows; Left kidney: 52.22 +- 2.5%, Right kidney: 47.8 +- 2.5%. No significant difference was noted between sexes. 3) Relative separate renal perfusion and function ratios and count densities of the diseased kidneys in unilateral obstructive uropathy (n = 28) and renal artery stenosis (n = 5) were significantly decreased (p < 0.001) in comparison with normal kidneys. Renal sizes of the diseased kidneys in renal artery stenosis were also significantly decreased (p < 0.001). However, no significant decrease was noted in unilateral obstructive uropathy. This method is simple, atraumatic and of great clinical value to detect unilateral renal disease and to evaluate or follow-up the functioning state of the diseased kidney. (author)

  2. Renal function after unilateral nephrectomy for Wilms' tumour : The influence of radiation therapy

    deGraaf, SSN; vanGent, H; ReitsmaBierens, WCC; vanLuyk, WHJ; Dolsma, WV; Postma, A

    1996-01-01

    The effect of therapy on renal function after unilateral nephrectomy for Wilms' tumour was studied. In the second year following unilateral nephrectomy, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were estimated simultaneously by measuring I-125-iothalamate clearance and

  3. Influence of renal impairment on myocardial function in outpatients with systolic heart failure

    Bosselmann, Helle; Tønder, Niels; Sölétormos, György;

    2014-01-01

    BACKGROUND: Renal dysfunction (RD) is associated with poor outcome in systolic heart failure (HF). Left ventricular ejection fraction (LVEF) is not depressed to a greater extent in patients with RD compared to patients with normal renal function, but it is relatively unknown whether other measures...

  4. The relationship between the renal clearance of creatinine and the apparent renal clearance of beta-2-microglobulin in patients with normal and impaired kidney function.

    Vree, T B; Guelen, P J; Jongman-Nix, B; Walenkamp, G H

    1981-07-18

    The renal clearances of creatinine and beta 2-microglobulin of patients with either normal or impaired kidney function were measured. The renal clearance of beta 2-microglobulin depends on the urinary pH and must be considered as an apparent renal clearance because after tubular reabsorption the compound is metabolized in the kidney. Impaired kidney function reduces the percentage of tubular reabsorption of beta 2-microglobulin. PMID:6166414

  5. Renal function maturation in children: is normalization to surface area valid?

    Full text: Gamma camera DTPA renograms were analysed to measure renal function by the rate at which the kidneys took up tracer from the blood. This was expressed either directly as the fractional uptake rate (FUR), which is not related to body size, or it was converted to a camera-based GFR by the formula GFR blood volume x FUR, and this GFR was normalized to a body surface area of 1.73 m2. Most of the patients studied had one completely normal kidney, and one kidney with reflux but normal function and no large scars. The completely normal kidneys contributed, on average, 50% of the total renal function. The results were considered in age bands, to display the effect of age on renal function. The camera-GFR measurements showed the conventional results of poor renal function in early childhood, with a slow rise to near-adult values by the age of 2 years, and somewhat low values throughout childhood. The uptake values showed a different pattern, with renal function rising to adult equivalent values by the age of 4 months, and with children having better renal function than adults throughout most of their childhood. The standard deviations expressed as coefficients of variation (CV) were smaller for the FUR technique than the GFR (Wilcoxon rank test, P < 0.01). These results resemble recent published measurements of absolute DMSA uptake, which are also unrelated to body size and show early renal maturation. The results also suggest that the reason children have lower serum creatinine levels than adults is that they have better renal function. If this were confirmed, it would raise doubts about the usefulness of normalizing renal function to body surface area in children

  6. Regulation of Vascular and Renal Function by Metabolite Receptors.

    Peti-Peterdi, János; Kishore, Bellamkonda K; Pluznick, Jennifer L

    2016-01-01

    To maintain metabolic homeostasis, the body must be able to monitor the concentration of a large number of substances, including metabolites, in real time and to use that information to regulate the activities of different metabolic pathways. Such regulation is achieved by the presence of sensors, termed metabolite receptors, in various tissues and cells of the body, which in turn convey the information to appropriate regulatory or positive or negative feedback systems. In this review, we cover the unique roles of metabolite receptors in renal and vascular function. These receptors play a wide variety of important roles in maintaining various aspects of homeostasis-from salt and water balance to metabolism-by sensing metabolites from a wide variety of sources. We discuss the role of metabolite sensors in sensing metabolites generated locally, metabolites generated at distant tissues or organs, or even metabolites generated by resident microbes. Metabolite receptors are also involved in various pathophysiological conditions and are being recognized as potential targets for new drugs. By highlighting three receptor families-(a) citric acid cycle intermediate receptors, (b) purinergic receptors, and PMID:26667077

  7. Evaluation of intravenous voriconazole in patients with compromised renal function

    Lilly Craig M

    2013-01-01

    Full Text Available Abstract Background Incorporation of the solubilizing excipient, sulfobutylether-β-cyclodextrin (SBECD, in the intravenous (IV formulation of voriconazole has resulted in the recommendation that this formulation be used with caution in patients with creatinine clearances (Clcr  Methods A total of 128 patients aged 11–93 years who had a baseline Clcr cr and Clcr levels while on therapy were compared with baseline values and between groups. Results The groups had similar characteristics apart from the larger proportion of females that received fluconazole. Baseline Scr was higher in those receiving caspofungin, but maximal increases of Scr and decreases in Clcr were greatest for the fluconazole group. Acute kidney injury (AKI, assessed by RIFLE criteria, was more frequent in the fluconazole vs. the caspofungin group (p  Conclusions Treatment of fungal infections in patients with compromised renal function with an SBECD-containing antifungal agent was not associated with AKI in clinical practice. Since the infecting organism was associated with AKI, decision on which antifungal to use should be determined by susceptibilities to the organism and not the incorporation of SBECD in the IV formulation.

  8. Renal Function and Ultrasound Imaging in Elderly Subjects

    Luca Zanoli

    2014-01-01

    Full Text Available We evaluated in elderly subjects (a the ability of GFR formulas to discriminate chronic kidney disease (CKD, (b the correlation between renal morphology and function, and (c the usefulness of combined r-US and GFR formulas to detect CKD. A total of 72 patients were enrolled (mean age 80 ± 7 years, male sex 44%, serum creatinine 0.98 ± 0.42 mg/dL, and CKD 57%. Cockcroft-Gault showed the highest sensitivity (78% and specificity (94% for CKD and was correlated with kidney volume (R=0.68, P<0.001. All formulas failed to provide a reliable estimate of GFR. In multivariate analysis, Cockcroft-Gault < 52 mL/min and kidney sinus section area < 28 cm2 showed the highest accuracy for the identification of CKD subjects (AUC 0.90, P<0.001. MDRD and CKD-EPI differed significantly for GFR ≥90 mL/min. Conclusions. Cockcroft-Gault < 52 mL/min was able to discriminate subjects with CKD but all formulas failed to provide a reliable estimate of GFR. The combined use of r-US and Cockcroft-Gault formula improved the ability to discriminate CKD in elderly subjects.

  9. Longitudinal change in renal function after nephroureterectomy in patients with upper tract urothelial carcinoma

    Chih-Yuan Chou

    2015-06-01

    Conclusion: In this study, it was found that the average renal function of the patients with upper tract urothelial carcinoma is not as good as the general population. More than half of the normal renal function patients have new onset chronic kidney disease after surgery. For preventing further deterioration of renal function, the implication of partial nephrectomy or segmental ureterectomy for selected patients with localized urothelial carcinoma should be re-examined. Besides, neoadjuvant chemotherapy should be considered for those who are not good candidates for local treatment.

  10. Radionuclide investigation of renal function in patients with lymphogranulomatosis subjected to radiotherapy

    An analysis of the results of renography in 68 patients with lymphogranulomatosis is presented. In 57 patients, a radionuclide investigation of renal function was carried out after irradiation of the spleen, paraaortic and ilac lymph nodes. Renograms were evaluated both qualitatively and quantitatively. The investigation established an impaired renal function in 18% of patients examined prior to radiotherapy. According to radionuclide renography, the excretory function of the tubular renal apparatus remains quite satisfactory after partial irradiation of kidneys in a dose of 38-40 Gy

  11. The influence of percutaneous nephrolithotomy on renal function evaluated by 99m-Tc-DTPA renoscintigram

    The influence of percutaneous nephrolithotomy (PNL) on renal function was evaluated by 99m-Tc-DTPA renoscintigraphy. The renoscintigram was recorded and regions of interest of both kidneys (R) and background (BKG) were settled. Renal uptake ratio was calculated. The renal uptake ratio of 50 patients were compared before and up to 6 months after PNL. Most cases showed an increase or no change in post-PNL renal uptake ratio in operated kidney. Five cases (10 %) showed decreased renal uptake ratio of post-PNL. No risk factors for the renal damage caused by PNL such as age, sex, stone size, number of nephrostomy and course of PNL were detected when compared with increased or no change groups. In cases of complete staghorn calculi in the decreased renal uptake ratio group, compensatory hypertrophy of contralateral kidney PNL might occur, and the function of the operated kidney might not have recovered. More during cases and longer follow-up is necessary for the recovery of renal function. (author)

  12. Effect of severe anaemia on renal function: a case-control study

    Aim: Anaemia, if severe, causes multi systemic functional changes. We tried to find out the effect of severe anaemia on renal function. Materials and Methods: A total of 66 patients with severe anemia and 10 healthy controls were recruited in this study. The cases were divided into following groups: group A: patients with Hb≤3 gm/dl (n=33); group B: patients with Hb≤6 but > 3 gm/dl (n=33); group C: healthy controls with normal renal function and Hb>12gm/dl. Out of 66 anaemic patients, 36 had nutritional anaemia (mainly iron deficiency; group A=20, group B=16), 24 patients were suffering from aplastic anaemia (group A=11, group B=13) and rest 6 had megaloblastic anaemia (group A=2, group B=4). No subject had hypertension, diabetes, primary renal dysfunction or any other systemic illness, affecting kidney. Various renal function test parameters and diagnostic renal failure indices were obtained for all subjects. GFR with 2-sample method after injection of 99m-Tc DTPA and ERPF with single sample method after injection of 131-I OIH were also calculated. Results: Fourteen patients had mild to moderate pedal edema (10 in group A and 4 in group B). Out of these patients, 8 had palpable liver and signs of systemic congestion. Signs of raised systemic venous pressure (raised JVP) were found in 7 patients of group A. In about 55% of patients, chest x-ray showed mild to moderately enlarged heart with disturbed cardiophrenic angle. Urine output was >600 ml/day in all cases. Results are presented. All renal functional parameters and indices were significantly reduced in anaemic patients and were suggestive of pre-renal failure. The reduction was correlating well with the severity of anaemia.Conclusion: Severe anaemia leads to renal dysfunction with alteration of minor and major renal failure indices, which can be characterized by sub-clinical and pre-biochemical non-oliguric pre-renal failure

  13. The affects of contrast medium on renal function in selective coronary angiography and intervention

    Selective coronary angiography and intervention with injection of contrast medium into the coronary arteries has become very common in dealing with coronary cardiac diseases. The excretion of contrast medium through kidneys may lead to acute renal functional insufficiency, especially for those suffering from chronic nephropathy, diabetes and cardiac functional disorder to form the so called 'contrast medium nephropathy' which is considered as the number second drug induced acute renal functional failure. Although routine preventive measure including low osmotic contrast medium and fine hydrotherapy have been taken, 14% incidences still occur with renal functional damage. The majority could be reversible but the minority needs emergent hemodialysis or even with persistent renal functional damage in a few ones. (authors)

  14. Evaluation of the relationship between renal function and renal volume-vascular indices using 3D power Doppler ultrasound

    Cansu, Aysegul, E-mail: drcansu@gmail.com; Kupeli, Ali; Kul, Sibel; Eyuboglu, Ilker; Oguz, Sukru; Ozturk, Mehmet Halil; Dinc, Hasan

    2014-07-15

    Purpose: To investigate the relationship between renal function and total renal volume-vascular indices using 3D power Doppler ultrasound (3DPDUS). Materials and methods: One hundred six patients with hypertensive proteinuric nephropathy (HPN) (49 male, 57 female) and 65 healthy controls (32 male, 33 female) were evaluated prospectively using 3DPDUS. Total renal volume (RV), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated using Virtual Organ Computer-aided Analysis (VOCAL). The estimated glomerular filtration rates (GFRs) of the patients with HPN and the control group were calculated. The patients with HPN were divided into two groups on the basis of GFR, normal (≥90) or reduced (<90). Differences between groups were compared using ANOVA. Correlations between GFR, renal volume and vascular indices were analyzed using Pearson's correlation analysis. Significance was set at p < 0.05. Results: The mean total RV, VI, FI and VFI values in the reduced GFR, normal GFR and control groups were RV (ml): 234.7, 280.7 and 294.6; VI: 17.6, 27.6 and 46.8; FI: 79.1, 88.7 and 93.9 and VFI: 7.1, 12.7 and 23.8. There were statistically significant differences between the groups (p < 0.001). Total RVs and vascular indices exhibited significant correlations with estimated GFR (r = 0.53–0.59, p < 0.001) Conclusion: Three-dimensional power Doppler ultrasound is a reliable predictive technique in renal function analysis.

  15. Improved Structure and Function in Autosomal Recessive Polycystic Rat Kidneys with Renal Tubular Cell Therapy.

    K J Kelly

    Full Text Available Autosomal recessive polycystic kidney disease is a truly catastrophic monogenetic disease, causing death and end stage renal disease in neonates and children. Using PCK female rats, an orthologous model of autosomal recessive polycystic kidney disease harboring mutant Pkhd1, we tested the hypothesis that intravenous renal cell transplantation with normal Sprague Dawley male kidney cells would improve the polycystic kidney disease phenotype. Cytotherapy with renal cells expressing wild type Pkhd1 and tubulogenic serum amyloid A1 had powerful and sustained beneficial effects on renal function and structure in the polycystic kidney disease model. Donor cell engraftment and both mutant and wild type Pkhd1 were found in treated but not control PCK kidneys 15 weeks after the final cell infusion. To examine the mechanisms of global protection with a small number of transplanted cells, we tested the hypothesis that exosomes derived from normal Sprague Dawley cells can limit the cystic phenotype of PCK recipient cells. We found that renal exosomes originating from normal Sprague Dawley cells carried and transferred wild type Pkhd1 mRNA to PCK cells in vivo and in vitro and restricted cyst formation by cultured PCK cells. The results indicate that transplantation with renal cells containing wild type Pkhd1 improves renal structure and function in autosomal recessive polycystic kidney disease and may provide an intra-renal supply of normal Pkhd1 mRNA.

  16. Validation of a simple isotopic technique for the measurement of global and separated renal function

    Schlegel and Gates described an isotopic method for the measurement of global and separated glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) based on the determination by scintillation camera of the fraction of the injected dose (99mTc-DTPA-[131I]hippuran) present in the kidneys 1-3 min after its administration. This method requires counting of the injected dose and attenuation correction, but no blood or urine sampling. We validated this technique by the simultaneous infusion of inulin and para-amino hippuric acid (PAH) in patients with various levels of renal function (anuric to normal). To better define individual renal function we studied 9 kidneys in patients either nephrectomized or with a nephrostomy enabling separated function measurement. A good correlation between inulin, PAH clearance, and isotopic GFR-ERPF measurement for both global and separate renal function was observed

  17. Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients

    Olsen, Tom Skyhøj; Lund, P; Praestholm, J

    1981-01-01

    Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression...

  18. Clinical values of renal function study with 123I-orthoiodohippurate (123I-OIH)

    Renography was performed with 123I-Orthoiodohippurate (123I-OIH) using a gamma camera and digital data acquisition system for the evaluation of renal structure and function. As for sequential renal scintigrams, both high-quality parenchymal and excretory images were simultaneously obtained with a single radiopharmaceutical. They were assessed to be useful in morphological evaluation of not only renal parenchymal diseases but also obstructive nephropathy. Regional renograms and functional images derived with image processing were useful in the evaluation of regional function and extension of the regional disorder, and also in the evaluation of parenchymal function independently of pelvic function. Furthermore, calculation of renal Mean Transit Time (M.T.T.) was applied by means of determining transfer function by using the direct operational method and the values of M.T.T. were compared in various renal disorders. The mean value of M.T.T. in healthy cases was 2.99 + 1.72 (mean +- S.D.) minutes. The mean values of the cases with hydronephrosis and diffuse parenchymal disease were significantly prolonged. It was thought that estimation of M.T.T. was useful in quantitative assessment of renal functions. (author)

  19. Roles of estrogen and progesterone in modulating renal nerve function in the rat kidney

    Graceli, J.B. [Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Cicilini, M.A.; Bissoli, N.S.; Abreu, G.R.; Moysés, M.R. [Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil)

    2013-07-02

    The maintenance of extracellular Na{sup +} and Cl{sup -} concentrations in mammals depends, at least in part, on renal function. It has been shown that neural and endocrine mechanisms regulate extracellular fluid volume and transport of electrolytes along nephrons. Studies of sex hormones and renal nerves suggested that sex hormones modulate renal function, although this relationship is not well understood in the kidney. To better understand the role of these hormones on the effects that renal nerves have on Na{sup +} and Cl{sup -} reabsorption, we studied the effects of renal denervation and oophorectomy in female rats. Oophorectomized (OVX) rats received 17β-estradiol benzoate (OVE, 2.0 mg·kg{sup -1}·day{sup -1}, sc) and progesterone (OVP, 1.7 mg·kg{sup -1}·day{sup -1}, sc). We assessed Na{sup +} and Cl{sup -} fractional excretion (FE{sub Na{sup {sub +}}} and FE{sub Cl{sup {sub -}}}, respectively) and renal and plasma catecholamine release concentrations. FE{sub Na{sup {sub +}}}, FE{sub Cl{sup {sub -}}}, water intake, urinary flow, and renal and plasma catecholamine release levels increased in OVX vs control rats. These effects were reversed by 17β-estradiol benzoate but not by progesterone. Renal denervation did not alter FE{sub Na{sup {sub +}}}, FE{sub Cl{sup {sub -}}}, water intake, or urinary flow values vs controls. However, the renal catecholamine release level was decreased in the OVP (236.6±36.1 ng/g) and denervated rat groups (D: 102.1±15.7; ODE: 108.7±23.2; ODP: 101.1±22.1 ng/g). Furthermore, combining OVX + D (OD: 111.9±25.4) decreased renal catecholamine release levels compared to either treatment alone. OVE normalized and OVP reduced renal catecholamine release levels, and the effects on plasma catecholamine release levels were reversed by ODE and ODP replacement in OD. These data suggest that progesterone may influence catecholamine release levels by renal innervation and that there are complex interactions among renal nerves, estrogen

  20. Elimination of 3H-methylguanidine at limited renal function

    The serum levels, hepatic and renal excretions and the tissue concentrations of 3H methyl guanidine 60 to 90 minutes after intravenous injection were measured in rats with healthy kidneys and rats with experimental renal insufficiences. The following results were obtained: Methyl guanidine is quickly eliminated through the kidney and the liver of organisms with healthy kidneys. In the case of experimental renal insufficiency, the renal excretion of methyl guanidine is reduced, whilst the hepatic excretion is increased. Methyl guanidine is subject to an enterohepatic circuit. Methyl guanidine can accumulate to much higher levels in various tissues examined than in serum. The highest organ accumulation level of methyl guanidine was found in the case of renal insufficiency. The most important finding of the study accordingly is the partial rehabilitation of methyl guanidine as a potential uremic poison. In the author's opinion, too much attention has so far been paid to the serum concentration, and too little attention to the tissue level of the substance. (orig.)

  1. Multiple loci associated with renal function in African Americans.

    Daniel Shriner

    Full Text Available The incidence of chronic kidney disease varies by ethnic group in the USA, with African Americans displaying a two-fold higher rate than European Americans. One of the two defining variables underlying staging of chronic kidney disease is the glomerular filtration rate. Meta-analysis in individuals of European ancestry has identified 23 genetic loci associated with the estimated glomerular filtration rate (eGFR. We conducted a follow-up study of these 23 genetic loci using a population-based sample of 1,018 unrelated admixed African Americans. We included in our follow-up study two variants in APOL1 associated with end-stage kidney disease discovered by admixture mapping in admixed African Americans. To address confounding due to admixture, we estimated local ancestry at each marker and global ancestry. We performed regression analysis stratified by local ancestry and combined the resulting regression estimates across ancestry strata using an inverse variance-weighted fixed effects model. We found that 11 of the 24 loci were significantly associated with eGFR in our sample. The effect size estimates were not significantly different between the subgroups of individuals with two copies of African ancestry vs. two copies of European ancestry for any of the 11 loci. In contrast, allele frequencies were significantly different at 10 of the 11 loci. Collectively, the 11 loci, including four secondary signals revealed by conditional analyses, explained 14.2% of the phenotypic variance in eGFR, in contrast to the 1.4% explained by the 24 loci in individuals of European ancestry. Our findings provide insight into the genetic basis of variation in renal function among admixed African Americans.

  2. The effect of gold nanoparticle on renal function in rats

    Monir Doudi

    2014-04-01

    Full Text Available   Objective(s: This study aimed to address the gold nanoparticle(GNP-dose and exposure duration effect on the kidney function of rats: in vivo.   Materials and Methods: A total of 32 healthy male Wistar rats were used in this study. Animals were randomly divided into groups, three GNP-treated groups and control group. Group 1, 2 and 3 received. /5 cc of solution containing 5, 10,100 ppm Au via IP injection for 7 successive days, respectively. The control group was treated with 0.5% normal saline. Several biochemical parameters such as BUN (blood urea nitrogen, creatine and uric acid were evaluated at various time points (7 and 14 days. After 14 days, the tissue of kidney was collected and investigated. Results: There was no significant difference between the control and the intervention group regarding the amount of creatine-BUN and uric acid. The amount of creatine-BUN and uric acid showed increase in all the groups [except group1 (creatine and group 2 (uric acid] in the 7 and 14 days after intervention compared to the control group, but this difference was not significant. Results of histopatological tissue kidney showed: in group 1 and 3, complete destruction of the proximal tubules and distal cortical, in group 2, almost complete destruction of proximal tubules and distal. Conclusions: The induced histological alterations might be an indication of injured renal tubules due to GNPs toxicity that become unable to deal with the accumulated residues resulting from metabolic and structural disturbances caused by these NPs.

  3. Impaired renal function impacts negatively on vascular stiffness in patients with coronary artery disease

    Rossi, Sabrina H.; McQuarrie, Emily P.; Miller, William H.; Mackenzie, Ruth M; Dymott, Jane A.; Moreno, María U.; Taurino, Chiara; Miller, Ashley M.; Neisius, Ulf; Berg, Geoffrey A.; Valuckiene, Zivile; Hannay, Jonathan A; Dominiczak, Anna F.; Delles, Christian

    2013-01-01

    Background Chronic kidney disease (CKD) and coronary artery disease (CAD) are independently associated with increased vascular stiffness. We examined whether renal function contributes to vascular stiffness independently of CAD status. Methods We studied 160 patients with CAD and 169 subjects without CAD. The 4-variable MDRD formula was used to estimate glomerular filtration rate (eGFR); impaired renal function was defined as eGFR <60 mL/min. Carotid-femoral pulse wave velocity ...

  4. Hypolipidemic and Renal Functionality Potentials of the Hexane Extract Fractions of Elephantopus Scaber Linn

    Daisy, P.; Edel Priya, Cecilia

    2010-01-01

    Background: Abnormalities in lipid profile are one of the most common complications in diabetes mellitus. In STZ-induced diabetic rats, the rise in blood glucose is accompanied by a disturbance in lipid profile. Further still is the disturbance in the renal functions which includes abnormality in the serum urea,protein and creatinine levels The aim of the present study is to prove the hypolipidemic and the renal functionality effect of the root of Elephantopus scaber Linn. Procedure: Fraction...

  5. RENAL FUNCTION AND ADAPTIVE CHANGES AFTER RADICAL OR PARTIAL NEPHRECTOMY: A SINGLE CENTRE STUDY

    Suraj; Harish; Shameer; Sadasukhi; Manish; Gupta

    2016-01-01

    OBJECTIVES To study the renal function before partial or total nephrectomy and to study change in renal function and adaptive change in the retained kidney after partial or total nephrectomy. Place and Duration: The prospective study of 40 patients was conducted by the Dept. of Nephrology and Dept. of Urology, Mahatma Gandhi Medical College and Hospital, Jaipur from July 2012 to July 2014 METHODS The data for the study was obtained from all the patients undergoing...

  6. Assessing renal function in children with hydronephrosis – additional feature of MR urography

    Hadjidekov, George; Hadjidekova, Savina; Tonchev, Zahari; Bakalova, Rumiana; Aoki, Ichio

    2011-01-01

    Background. Magnetic resonance urography (MRU) is one of the most attractive imaging modalities in paediatric urology, providing largest diagnostic information in a single protocol. Therefore, the aim of our study was to assess the diagnostic value of MRU in children with urogenital anomalies (especially anomalies of the renal pelvis and ureter) and the renal function using different post-processing functional software. Patients and methods. Ninety six children (7 days - 18 years old) were ex...

  7. Effects of dietary salt intake on renal function: a 2-year study in healthy aged cats.

    Chetboul, V; Nguyen, P.; Testault, I; Concordet, Didier; Carlos Sampedrano, C; Elliott, J.; Trehiou-Sechi, E; Abadie, J.; Biourge, V; Lefebvre, H.P.

    2013-01-01

    Increasing salt intake to promote diuresis has been suggested in the management of feline lower urinary tract disease. However, high dietary salt intake might adversely affect blood pressure and renal function The objective of this study was to assess the long-term effects of increased salt intake on renal function in healthy aged cats This study was controlled, randomized, and blinded. Twenty healthy neutered cats (10.1 ± 2.4 years) were randomly allocated into 2 matched groups. One group...

  8. Intra-Parenchymal Renal Resistive Index Variation (IRRIV) Describes Renal Functional Reserve (RFR): Pilot Study in Healthy Volunteers

    Samoni, Sara; Nalesso, Federico; Meola, Mario; Villa, Gianluca; De Cal, Massimo; De Rosa, Silvia; Petrucci, Ilaria; Brendolan, Alessandra; Rosner, Mitchell H.; Ronco, Claudio

    2016-01-01

    An increase of glomerular filtration rate after protein load represents renal functional reserve (RFR) and is due to afferent arteriolar vasodilation. Lack of RFR may be a risk factor for acute kidney injury (AKI), but is cumbersome to measure. We sought to develop a non-invasive, bedside method that would indirectly measure RFR. Mechanical abdominal pressure, through compression of renal vessels, decreases blood flow and activates the auto-regulatory mechanism which can be measured by a fall in renal resistive index (RRI). The study aims at elucidating the relationship between intra-parenchymal renal resistive index variation (IRRIV) during abdominal pressure and RFR. In healthy volunteers, pressure was applied by a weight on the abdomen (fluid-bag 10% of subject's body weight) while RFR was measured through a protein loading test. We recorded RRI in an interlobular artery after application of pressure using ultrasound. The maximum percentage reduction of RRI from baseline was compared in the same subject to RFR. We enrolled 14 male and 16 female subjects (mean age 38 ± 14 years). Mean creatinine clearance was 106.2 ± 16.4 ml/min/1.73 m2. RFR ranged between −1.9 and 59.7 with a mean value of 28.9 ± 13.1 ml/min/1.73 m2. Mean baseline RRI was 0.61 ± 0.05, compared to 0.49 ± 0.06 during abdominal pressure; IRRIV was 19.6 ± 6.7%, ranging between 3.1% and 29.2%. Pearson's coefficient between RFR and IRRIV was 74.16% (p < 0.001). Our data show the correlation between IRRIV and RFR. Our results can lead to the development of a “stress test” for a rapid screen of RFR to establish renal susceptibility to different exposures and the consequent risk for AKI. PMID:27458386

  9. What physicians need to know about renal function in outpatients with heart failure.

    Waldum-Grevbo, Bård

    2015-01-01

    The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction. PMID:25966919

  10. The association between renal impairment and cardiac structure and function in patients with acute myocardial infarction

    Ersbøll, Mads; Valeur, Nana; Hassager, Christian;

    2014-01-01

    BACKGROUND: Renal dysfunction in patients with acute myocardial infarction (MI) is an important predictor of short- and long-term outcome. Cardiac abnormalities dominated by left ventricular (LV) hypertrophy are common in patients with chronic renal dysfunction. However, limited data exists on the...... association between LV systolic- and diastolic function assessed by comprehensive echocardiography and renal dysfunction in contemporary unselected patients with acute MI. METHODS: We prospectively included 1054 patients with acute MI (mean age 63 years, 73% male) and performed echocardiographic assessment of...... fraction or GLS attenuated its importance considerably. CONCLUSION: Renal dysfunction in patients with acute MI is independently associated with echocardiographic evidence of increased LV filling pressure. However, the prognostic importance of renal dysfunction is attenuated to a greater degree by LV...

  11. RADIOLOGICAL INVESTIGATIONS, BIOCHEMICAL RENAL FUNCTION TESTS AND THE CHANGES AFTER SURGERY IN RENAL CALCULUS OBSTRUCTIVE UROPATHY

    Mahesh; Pawan; Pooja; Manoj

    2016-01-01

    Urolithiasis has affected the mankind for long years. These stones cause progressive renal impairment. These patients usually present with characteristic loin pain, vomiting, and sometimes fever. Patients may also be asymptomatic at times. Urinary stones can be classified on the basis of their size, location, X-ray characteristics, aetiology, composition (Mineralogy) and risk groups for recurrent stone formation. AIMS AND OBJECTIVES To evaluate the Preoperative and postoperative radiolo...

  12. Wolf-Hirschhorn syndrome with improvement of renal function.

    Ferrara, P; Del Bufalo, F; Nicoletti, A; Romano, V; Gatto, A; Leoni, C; Zampino, G

    2010-05-01

    Wolf-Hirschhorn syndrome (WHS) is a chromosomal disorder characterized by partial deletion of the short arm of chromosome 4. We describe a girl with a de novo unbalanced traslocation t(4;7)(p16.2;p22), associated with a mild version of a classical WHS phenotype. She did not present major urinary tract abnormalities but had parenchymal hyperechogenicity at renal ultrasound at the birth with normal renal scintigraphy. She had also a reduction of GFR with elevated levels of blood urea nitrogen and serum potassium until the age of 6 months. We followed the patient with periodic clinical examination and laboratory and radiological investigations and observed at the age of 5 years a normal renal ultrasound without parenchymal hyperechogenicity. PMID:20425837

  13. Detection of the dynamic renal function using MRI by gadolinium-DTPA

    Torii, Shinichiro; Machida, Toyohei; Ohoishi, Yukihiko; Tateno, Yukio; Fukuda, Nobuo.

    1988-06-01

    The mathematical study of dynamic renal function and the simulation of renal disorder in rabbit kidney using MRI by Gd-DTPA were performed. T1 of rabbit kidney, which had been operated (complete unilateral ureteral occlusion or incomplete unilateral occlusion of renal artery) was calculated before and after intravenous injection of 0.05 mmol/kg Gd-DTPA, continuously for 90 minutes. All images were obtained by the 0.1 Tesla resistive type MRI. The changes of 1/T1 of cortex and medulla of both kidneys were calculated (MRI renogram). The 4 compartment model of bilateral kidneys was established by 6 normal MRI renogram and renal blood flow-glommelurar function parameter and tubural excration function parameter were calculated by the Runge-Kutta-Gill method and the nonlinear least squares method (Simplex method). The change of renogram pattern was observed by the mathematical change of such parameters and comparative study was performed between such mathematical simulation and practical cases. The actual change of such parameters were calculated by the experimental model of rabbit kidney. It was concluded that the change of MRI renogram pattern was sensitive for unilateral hydronephrosis, renal parenchymal dysfunction by obstructive uropathy and unilateral renal arterial stenosis. Quantitative observation of focal renal parenchymal dysfunction, which was induced by ureteral obstruction, was possible. In the near future it will be also possible to detect acculate ERBF and GFR by the measurement of T1 of human kidney.

  14. The detection of the dynamic renal function using MRI by gadolinium-DTPA

    The mathematical study of dynamic renal function and the simulation of renal disorder in rabbit kidney using MRI by Gd-DTPA were performed. T1 of rabbit kidney, which had been operated (complete unilateral ureteral occlusion or incomplete unilateral occlusion of renal artery) was calculated before and after intravenous injection of 0.05 mmol/kg Gd-DTPA, continuously for 90 minutes. All images were obtained by the 0.1 Tesla resistive type MRI. The changes of 1/T1 of cortex and medulla of both kidneys were calculated (MRI renogram). The 4 compartment model of bilateral kidneys was established by 6 normal MRI renogram and renal blood flow-glommelurar function parameter and tubural excration function parameter were calculated by the Runge-Kutta-Gill method and the nonlinear least squares method (Simplex method). The change of renogram pattern was observed by the mathematical change of such parameters and comparative study was performed between such mathematical simulation and practical cases. The actual change of such parameters were calculated by the experimental model of rabbit kidney. It was concluded that the change of MRI renogram pattern was sensitive for unilateral hydronephrosis, renal parenchymal dysfunction by obstructive uropathy and unilateral renal arterial stenosis. Quantitative observation of focal renal parenchymal dysfunction, which was induced by ureteral obstruction, was possible. In the near future it will be also possible to detect acculate ERBF and GFR by the measurement of T1 of human kidney. (author)

  15. Recovery of function renal post pyeloplasty, benefit of the prenatal diagnosis

    Introduction: Prenatal detection of hydronephrosis has raised new questions upon the indications for operation. Moreover, there is controversy whether or not pyeloplasty improves renal function. Objective: to correlate improvement of the renal function after pyeloplasty with the demographic data, age of the surgery, the sex, the symptoms and the renal function initial. Materials and Methods: 58 children (55%). 12 kidneys improved after surgery (24,8%). The average age of surgery was 29 months. Results: Twelve kidneys improved after pyeloplasty (24%) and 46 kidney unimproved (76%). In the group with improvement of RRF after surgery the antenatal diagnosis is significantly more frequent (83%) and the age average at the moment of the surgery is smaller (4 months v/s 35 months) than the group without improvement. In the group with improvement 83% were operated before one year of age, however in the group without improvement only a 45% were operated before 1 year of age. On the contrary we don't find correlation among improvement and RRF initial. Not there was significant difference in the RRF initial in both groups. Conclusion: The improvement of renal function after pyeloplasty in the UPJ obstruction is independent of the renal function initial. Pyeloplasty improves the renal function in the group of prenatal diagnostic, improvement associated to a smaller surgical age

  16. Influence of X-radiation on the renal function as studied in the unilaterally nephrectomized rat

    The effects of X-ray radiation on the renal function was studied in 83 Wistar rats. The rats received either only whole-body irradiation or were exposed to whole-body irradiation at certain intervals after unilateral nephrectomy. When the interval between operation and irradiation was shortened from 10 to 2 days, early lethality increased, although it has not yet been established whether the operation or the lack of a kidney plays a greater role here. The weight behaviour of non-nephrectomized or unilaterally nephrectomized rats is a function of the radiation dose; inappetence, dehydration and decreased intestinal absorption are influencing factors. Animals that died had exhibited another loss of weight after the 10th day p.r. The non-nephrectomized rats having undergone whole-body irradiation exhibited a decrease in serum urea on the 2nd and 10th day p.r. Animals unilaterally nephrectomized and then exposed to whole-body irradiation exhibited an increase in serum urea which was the more pronounced the earlier irradiation had taken place after unilateral nephrectomy. This raised urea level in the nephrectomized animals may be attributed to the compensatory hypertrophy not yet existing and to the reduced filtrate. (orig.)

  17. Green tea inhibited the elimination of nephro-cardiovascular toxins and deteriorated the renal function in rats with renal failure.

    Peng, Yu-Hsuan; Sweet, Douglas H; Lin, Shiuan-Pey; Yu, Chung-Ping; Lee Chao, Pei-Dawn; Hou, Yu-Chi

    2015-01-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are highly protein-bound nephro-cardiovascular toxins, which are not efficiently removed through hemodialysis. The renal excretions of IS and PCS were mediated by organic anion transporters (OATs) such as OAT1 and OAT3. Green tea (GT) is a popular beverage containing plenty of catechins. Previous pharmacokinetic studies of teas have shown that the major molecules present in the bloodstream are the glucuronides/sulfates of tea catechins, which are putative substrates of OATs. Here we demonstrated that GT ingestion significantly elevated the systemic exposures of endogenous IS and PCS in rats with chronic renal failure (CRF). More importantly, GT also significantly increased the levels of serum creatinine (Cr) and blood urea nitrogen (BUN) in CRF rats. Mechanism studies indicated that the serum metabolites of GT (GTM) inhibited the uptake transporting functions of OAT1 and OAT3. In conclusion, GT inhibited the elimination of nephro-cardiovascular toxins such as IS and PCS, and deteriorated the renal function in CRF rats. PMID:26552961

  18. Effect of medical ozone therapy on renal blood flow and renal function of patients with chronic severe hepatitis

    GU Xi-bing; YANG Xiao-juan; ZHU Hong-ying; XU Yue-qin; LIU Xia-ying

    2010-01-01

    Background Medical ozone therapy system was reported to have certain effects on the treatment of severe hepatitis,but its mechanism is not very clear. One of the causes of death of severe hepatitis is complication of renal damage or hepatorenal syndrome. The present study aimed to observe effects of medical ozone therapy system on plasma renin activity (PRA), angiotensin Ⅱ (AⅡ), aldosterone (ALD), renal blood flow and renal function of patients with chronic severe hepatitis and explore mechanisms of medical ozone therapy in the treatment of severe hepatitis.Methods Eighty-five cases with chronic severe hepatitis were randomly divided into ozone therapy group (43 cases)and control group (42 cases). The patients in the ozone therapy group were treated with basic treatments plus ozone therapy system. Basic autohemotherapy was used. One hundred milliliter venous blood was drawn from each patient,and was mixed with 100 ml (35 μg/ml) medical ozone and then was returned the blood to the patient intravenously, once every other day for 20 days. Only the basic treatments were given to the control group. PRA, All, ALD, renal blood flow and damage to renal function of the two groups before treatment and 20 days after treatment were compared. Survival rates were also compared.Results Twenty days after the treatment, in ozone therapy group, PRA was (1.31±0.12) ng·ml-1·h-1, All (111.25±17.35)pg/ml, ALD (251.31 ±22.60) pg/ml, which decreased significantly compared with those before treatment (PRA (2.23±0.13)ng·ml-1 ·h1, AⅡ (155.18±19.13) pg/ml, ALD (405.31±29.88) pg/ml, t=4.67-14.23, P <0.01), also lower than those of control group 20 days after the treatment (PRA (2.02±0.11) ng·ml-1·h-1, All (162.21±15.32) pg/ml, ALD (401.20±35.02) pg/ml,t=4.97-15.61, P <0.01); renal blood flow was (175.15±28.20) ml/min, which increased compared with that before the treatment ((125.68±21.25) ml/min) and was higher than that of control group 20 days after the treatment

  19. P wave dispersion and maximum P wave duration are independently associated with rapid renal function decline.

    Ho-Ming Su

    Full Text Available The P wave parameters measured by 12-lead electrocardiogram (ECG are commonly used as noninvasive tools to assess for left atrial enlargement. There are limited studies to evaluate whether P wave parameters are independently associated with decline in renal function. Accordingly, the aim of this study is to assess whether P wave parameters are independently associated with progression to renal end point of ≥25% decline in estimated glomerular filtration rate (eGFR. This longitudinal study included 166 patients. The renal end point was defined as ≥25% decline in eGFR. We measured two ECG P wave parameters corrected by heart rate, i.e. corrected P wave dispersion (PWdisperC and corrected P wave maximum duration (PWdurMaxC. Heart function and structure were measured from echocardiography. Clinical data, P wave parameters, and echocardiographic measurements were compared and analyzed. Forty-three patients (25.9% reached renal end point. Kaplan-Meier curves for renal end point-free survival showed PWdisperC > median (63.0 ms (log-rank P = 0.004 and PWdurMaxC > median (117.9 ms (log-rank P<0.001 were associated with progression to renal end point. Multivariate forward Cox-regression analysis identified increased PWdisperC (hazard ratio [HR], 1.024; P = 0.001 and PWdurMaxC (HR, 1.029; P = 0.001 were independently associated with progression to renal end point. Our results demonstrate that increased PWdisperC and PWdurMaxC were independently associated with progression to renal end point. Screening patients by means of PWdisperC and PWdurMaxC on 12 lead ECG may help identify a high risk group of rapid renal function decline.

  20. Post re-anastomosis demonstration of regain in function in non-visualized upper half of kidney in a dual arterial allogenic renal graft on renal scintigraphy

    A young male patient with end stage renal disease underwent renal allograft having dual arterial supply. Immediate post-operative urine output dropped, an urgent Technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) renogram revealed non-visualized upper-half and the preserved perfusion and parenchymal function of the small transplant kidney. Patient was re-explored and re-anastomosis was performed. A renogram at 24h post re-anastomosis revealed increase in the size of renal allograft, with preserved perfusion to the upper-half of transplant. Transplant kidney biopsy of the Upper-half showed acute tubular necrosis. 99mTc-MAG3renogram at 10 days post re-vascularization remains unchanged with persistent improvement at 2 months follow-up. We conclude that early recognition of renal functional loss allows early management and the high probability of salvaging the renal function

  1. Radionuclide Diuretic Renogram: Can Visual Interpretation of the Renal Parenchymal Transit Time and Split Renal Function Improves the Interpretation?

    Introduction: Obstructive Uropathy is a common clinical and surgical problem in many countries. The decision to intervene surgically versus medical treatment has to be supported by radiological, ultrasound, radionuclide, and urodynamic studies. Measurements of urodynamics by Whitaker test is an invasive procedure that also has limitations and requires expertise. The radionuclide diuretic renogram has many limitations and drawbacks. Unreliable results from the currently widely used programs are related to calculation of split renal function, lack of confidence in quantitative analysis of renal function parameters especially when there is retention of activity in the renal pelvis, timing of injection of Lasix, percentage of remaining functioning renal tissue, output of urine on affected side, size of the dilated pelvis and duration of obstruction. Inaccurate reports that do not reflect the true urodynamics of the obstructed kidneys and dilated renal pelvis especially after previous surgical corrections resulted in loss of confidence of the surgeons. Transit time measurements of the cortical, tubular, parenchymal and pelvis had been tried before and found to increase the accuracy of the interpretation. However, it requires complex deconvaluation analysis programs that had been clinically verified. Few institutions have access to these deconvaluation analysis programs. An alternative is visual measurement of the cortical tubular and parenchymal transit time from the diuretic renograms images, which is the subject of this presentation and the aim of a retrospective analysis of the diuretic renograms performed at St. Vincent's Medical Center, Manhattan, New York from September 2005 through December 2008. This is part of an ongoing analysis. Materials and Methods: Radionuclide renogram studies of 204 patients who underwent 253 studies with suspected obstructive uropathy (OU) were reviewed. 49 patients had repeated studies, 19 had non-functioning kidneys that were excluded

  2. Effect of hypoxaemia on water and sodium homeostatic hormones and renal function

    Olsen, Niels Vidiendal

    1995-01-01

    Changes in body fluid homeostasis during acute hypoxaemia suggest a crucial role of renal function in acclimatization processes. Hypoxaemia stimulates sympathetic nervous activity, and also the cardiovascular system is affected with increases in heart rate and cardiac output. In most subjects...... the advantage of opposing excessive sodium and water retention, which characterizes acute mountain sickness. Short-term isocapnic or hypocapnic hypoxaemia in spontaneously breathing humans causes moderate if any increases in renal blood flow and only minor changes in GFR. In contrast, renal blood flow and GFR...

  3. Dopamine-1 and dopamine-2 mechanisms in the control of renal function.

    Carey, R M; Siragy, H M; Ragsdale, N V; Howell, N L; Felder, R A; Peach, M J; Chevalier, R L

    1990-06-01

    Dopamine (DA), a catecholamine produced in the kidney, is a renal vasodilator and natriuretic substance, but its action at dopamine-1 (DA-1), dopamine-2 (DA-2) and alpha- and beta-adrenergic receptors limits its effectiveness as a heuristic tool and pharmacologic agent. We have studied the effects of highly selective DA-1 and DA-2 receptor agonists and antagonists in normal human subjects and experimental animals to determine the precise physiological role of renal dopamine at DA-1 and DA-2 receptors within the kidney. We studied fenoldopam, a selective DA-1 agonist, in normal human subjects in metabolic balances at high (300 mEq/day) and low (10 mEq/day) sodium (Na) intake. Selective DA-1 receptor stimulation during high Na intake resulted in renal vasodilation, natriuresis and diuresis in a sustained manner for 3 hours. The natriuresis was mediated by a reduction in Na reabsorption at both proximal and distal tubular sites. In contrast, during low Na intake, DA-1 receptor stimulation did not engender a natriuretic or diuretic response. Thus, sodium depletion may inhibit the function of renal tubular cells in response to DA-1 stimulation. DA-1 receptors are present in the medial layer of the renal vasculature, proximal tubule and cortical collecting duct; DA-2 receptors are localized to the glomerulus, the renal nerves surrounding renal blood vessels and possibly the renal vascular endothelium. We have performed studies in conscious dogs with indwelling renal arterial catheters to identify the physiological role of renal DA to DA-1 and DA-2 receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1974444

  4. Risk Factors for Renal Functional Decline in Chronic Hepatitis B Patients Receiving Oral Antiviral Agents.

    Shin, Jung-Ho; Kwon, Hee Jin; Jang, Hye Ryoun; Lee, Jung Eun; Gwak, Geum-Youn; Huh, Wooseong; Jung, Sin-Ho; Lee, Joon Hyeok; Kim, Yoon-Goo; Kim, Dae Joong; Oh, Ha Young

    2016-01-01

    Renal functional decline that is frequently seen during chronic hepatitis B (CHB) treatment can exert adverse effects on overall prognosis. It, however, is difficult to distinguish vulnerable patients who may experience renal dysfunction because most previous CHB studies were conducted in relatively healthy individuals. In this retrospective observational study, renal functional decline in CHB patients receiving oral antiviral agents for more than 6 months was analyzed and risk factors of chronic kidney disease (CKD) progression were determined. Renal functional decline was defined when the estimated glomerular filtration rate (eGFR) decreased by more than 25% from baseline and rapid CKD progression was defined as eGFR decreased by more than 5 mL/min/1.73 m2/y among patients who experienced renal functional decline. A total of 4178 patients were followed up for a median 23 months. Antiviral agents included lamivudine (17.0%), adefovir (3.7%), entecavir (70.4%), telbivudine (0.6%), tenofovir (4.0%), or clevudine (4.3%). Renal functional decline occurred in 706 (16.9%) patients. Based on multivariate Cox regression analysis, age, hypertension, diabetes, history of liver or kidney transplantation, underlying underlying CKD, and simultaneous administration of diuretics increased the hazard ratio for renal functional decline; however, clevudine reduced risk. The eGFR significantly increased over time in patients receiving telbivudine or clevudine compared with lamivudine. Among the 3175 patients followed up for more than 1 year, 407 (12.8%) patients experienced rapid CKD progression. Patients with rapid CKD progression showed lower serum albumin, higher total bilirubin, and prolonged prothrombin time compared with patients with stable renal function, but hepatitis B envelope antigen positivity and hepatitis B virus deoxyribonucleic acid level did not differ between the control and rapid CKD progression groups. Age, diabetes, kidney transplantation, underlying CKD, and

  5. Smoking and renal function in people living with human immunodeficiency virus

    Ahlström, Magnus Glindvad; Feldt-Rasmussen, Bo; Legarth, Rebecca; Kronborg, Gitte; Pedersen, Court; Larsen, Carsten Schade; Gerstoft, Jan; Obel, Niels

    2015-01-01

    the association between smoking status and 1) overall renal function and risk of chronic kidney disease (CKD), 2) risk of any renal replacement therapy (aRRT), and 3) mortality following aRRT. We calculated estimated creatinine clearance using the Cockcroft-Gault equation (CG-CrCl), and evaluated...... renal function graphically. We calculated cumulative incidence of CKD (defined as two consecutive CG-CrCls of ≤60 mL/min, ≥3 months apart) and aRRT and used Cox regression models to calculate incidence rate ratios (IRRs) for risk of CKD, aRRT, and mortality rate ratios (MRRs) following aRRT. RESULTS......INTRODUCTION: Smoking is a main risk factor for morbidity and mortality in people living with human immunodeficiency virus (PLHIV), but its potential association with renal impairment remains to be established. METHODS: We did a nationwide population-based cohort study in Danish PLHIV to evaluate...

  6. Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function

    Nielsen, Lene Ryom; Mocroft, A.; Kirk, O.;

    2013-01-01

    Background. Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown.Methods. D:A:D study participants with an estimated...... glomerular filtration rate (eGFR) of ≥90 mL/min after 1 January 2004 were followed until they had a confirmed eGFR of ≤70 mL/min (the threshold below which we hypothesized that renal interventions may begin to occur) or ≤60 mL/min (a value indicative of moderately severe chronic kidney disease [CKD]) or...... until the last eGFR measurement during follow-up. An eGFR was considered confirmed if it was detected at 2 consecutive measurements ≥3 months apart. Predictors and eGFR-related ARV discontinuations were identified using Poisson regression.Results. Of 22 603 persons, 468 (2.1%) experienced a confirmed e...

  7. Impaired renal function in owl monkeys (Aotus nancymai infected with Plasmodium falciparum

    R. E. Weller

    1992-01-01

    Full Text Available Impaired renal function was observed in sixteen Aotus nancymai 25 and 3 months following infection with the Uganda Palo Alto strain of Plasmodium falciparum. Decrease were noted in the clearance of endogenous creatinine, creatinine excretion, and urine volume while increases were observed in serum urea nitrogen, urine protein, urine potassium, fractional excretion of phosphorus and potassium, and activities of urinary enzymes. The results were suggestive of glomerulonephropathy and chronic renal disease.

  8. P Wave Dispersion and Maximum P Wave Duration Are Independently Associated with Rapid Renal Function Decline

    Su, Ho-Ming; Tsai, Wei-Chung; Lin, Tsung-Hsien; Hsu, Po-Chao; Lee, Wen-Hsien; Lin, Ming-Yen; Chen, Szu-Chia; Lee, Chee-Siong; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

    2012-01-01

    The P wave parameters measured by 12-lead electrocardiogram (ECG) are commonly used as noninvasive tools to assess for left atrial enlargement. There are limited studies to evaluate whether P wave parameters are independently associated with decline in renal function. Accordingly, the aim of this study is to assess whether P wave parameters are independently associated with progression to renal end point of ≥25% decline in estimated glomerular filtration rate (eGFR). This longitudinal study i...

  9. Urinary NGAL Levels Correlate with Differential Renal Function in Patients with Ureteropelvic Junction Obstruction Undergoing Pyeloplasty

    Cost, Nicholas G.; Noh, Paul H.; Devarajan, Prasad; Ivancic, Vesna; Reddy, Pramod P.; Minevich, Eugene; Bennett, Michael; Haffner, Christopher; Schulte, Marion; DeFoor, W. Robert

    2014-01-01

    Purpose: Recent investigations described the use of NGAL, a sensitive biomarker for kidney injury, in the setting of ureteropelvic junction obstruction. We prospectively evaluated urinary NGAL levels in the affected renal pelvis and bladder of children with ureteropelvic junction obstruction undergoing unilateral dismembered pyeloplasty. Our hypothesis was that higher NGAL in the kidney and bladder would correlate with decreased ipsilateral differential function. Materials and Methods: We performed a prospective cohort study in patients treated with unilateral dismembered pyeloplasty from 2010 to 2012. Urine was obtained intraoperatively from the bladder and obstructed renal pelvis. A control population of unaffected children was recruited to provide a voided bladder specimen. Bladder NGAL levels were compared between the study and control populations. We tested our study hypothesis by correlating bladder and renal pelvic NGAL levels with the differential renal function of the affected kidney. Results: A total of 61 patients with a median age at surgery of 1.62 years (range 0.12 to 18.7) were enrolled in the study. Median bladder NGAL was 18.6 ng/mg (range 1.4-1,650.8) and median renal pelvic NGAL was 26.2 ng/mg (range 1.2-18,034.5, p = 0.004). Median bladder NGAL was significantly higher than in controls (p = 0.004). The correlation of bladder and renal pelvic NGAL with differential renal function was r = −0.359 (p = 0.004) and r = −0.383 (p = 0.002), respectively. Conclusions: Bladder NGAL is increased in children with ureteropelvic junction obstruction. Renal pelvic and bladder normalized urinary NGAL levels correlate inversely with the relative function of the affected kidney in cases of unilateral ureteropelvic junction obstruction. PMID:23791906

  10. Hemodynamic and neurochemical determinates of renal function in chronic heart failure.

    Gilbert, Cameron; Cherney, David Z I; Parker, Andrea B; Mak, Susanna; Floras, John S; Al-Hesayen, Abdul; Parker, John D

    2016-01-15

    Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications. PMID:26561645

  11. Evaluation of Renal Function Determined by Relative Renal Uptake of '99mTc-DMSA and Relative Glomerular Filteration Rate of 99mTc-DTPA

    The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. We measured 2 hour, 4 hour and 24 hour relative renal uptake of '99mTc-DMSA and relative glomerular filtration rate of 99mTc-DTPA with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of 99mTc-DMSA and relative glomerular filtration rate. The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of 99mTc-DMSA and relative glomerular filtration rate of 99mTc-DTPA were R=0.9190 (p99mTc-DMSA had the best correlation with relative glomerular filtration rate of 99mTc-DTPA and that might be useful in evaluation of chronic renal disease in which showed increased background activity or acute obstructive uropathy.

  12. Effects of glucagon-like peptide-1 receptor agonists on renal function

    Theodosios; D; Filippatos; Moses; S; Elisaf

    2013-01-01

    Glucagon-like peptide-1(GLP-1)receptor agonists result in greater improvements in glycemic control than placebo and promote weight loss with minimal hypoglycemia in patients with type 2 diabetes mellitus.A number of case reports show an association of GLP-1receptor agonists,mainly exenatide,with the development of acute kidney injury.The present review aims to present the available data regarding the effects of GLP-1 receptor agonists on renal function,their use in subjects with chronic renal failure and their possible association with acute kidney injury.Based on the current evidence,exenatide is eliminated by renal mechanisms and should not be given in patients with severe renal impairment or end stage renal disease.Liraglutide is not eliminated by renal or hepatic mechanisms,but it should be used with caution since there are only limited data in patients with renal or hepatic impairment.There is evidence from animal studies that GLP-1 receptor agonists exert protective role in diabetic nephropathy with mechanisms that seem to be independent of their glucose-lowering effect.Additionally,there is evidence that GLP-1 receptor agonists influence water and electrolyte balance.These effects may represent new ways to improve or even prevent diabetic nephropathy.

  13. The Role of Vitamin D in Blood Pressure, Endothelial and Renal Function in Postmenopausal Women

    Suzanne C. Ho

    2013-07-01

    Full Text Available Background: Vitamin D is a pro-hormone that plays an essential role in the vasculature and in kidney function. Aims: To review the extra-skeletal effects of vitamin D on blood pressure, endothelial and renal function with emphasis on recent findings in postmenopausal women. Methods: Included in this review was a PubMed database search for English language articles through March 2013. This review discussed the physiology and definition of vitamin D deficiency, the recent evidence for the role vitamin D in blood pressure, vascular and renal function. Results: Experimental and epidemiological data suggest that vitamin D plays an important role in the vasculature and in kidney function. Low vitamin D concentrations appear to significantly associate with hypertension, endothelial and renal dysfunction. However, the results of clinical trials have generally been mixed. Studies specifically conducted among postmenopausal women are limited and findings are still inconsistent. Conclusions: Definitive studies are warranted to elucidate the effects of vitamin D supplementation on vascular and renal function and a more detailed work is needed to outline the route, duration and optimal dose of supplementation. It is premature to recommend vitamin D as a therapeutic option in the improvement of vascular and renal function at the current stage.

  14. SDF-1/CXCR4 signaling preserves microvascular integrity and renal function in chronic kidney disease.

    Li-Hao Chen

    Full Text Available The progressive decline of renal function in chronic kidney disease (CKD is characterized by both disruption of the microvascular architecture and the accumulation of fibrotic matrix. One angiogenic pathway recently identified as playing an essential role in renal vascular development is the stromal cell-derived factor-1α (SDF-1/CXCR4 pathway. Because similar developmental processes may be recapitulated in the disease setting, we hypothesized that the SDF-1/CXCR4 system would regulate microvascular health in CKD. Expression of CXCR4 was observed to be increased in the kidneys of subtotally nephrectomized (SNx rats and in biopsies from patients with secondary focal segmental glomerulosclerosis (FSGS, a rodent model and human correlate both characterized by aberration of the renal microvessels. A reno-protective role for local SDF-1/CXCR4 signaling was indicated by i CXCR4-dependent glomerular eNOS activation following acute SDF-1 administration; and ii acceleration of renal function decline, capillary loss and fibrosis in SNx rats treated with chronic CXCR4 blockade. In contrast to the upregulation of CXCR4, SDF-1 transcript levels were decreased in SNx rat kidneys as well as in renal fibroblasts exposed to the pro-fibrotic cytokine transforming growth factor β (TGF-β, the latter effect being attenuated by histone deacetylase inhibition. Increased renal SDF-1 expression was, however, observed following the treatment of SNx rats with the ACE inhibitor, perindopril. Collectively, these observations indicate that local SDF-1/CXCR4 signaling functions to preserve microvascular integrity and prevent renal fibrosis. Augmentation of this pathway, either purposefully or serendipitously with either novel or existing therapies, may attenuate renal decline in CKD.

  15. Evaluation of renal function in children with vesicoureteral reflux; Changes in renal uptake rate using [sup 99m]Tc-dimercaptosuccinic acid scintigraphy

    Hioki, Takuichi (Mie Univ., Tsu (Japan). School of Medicine)

    1993-09-01

    Renal uptake rate was calculated by [sup 99m]Tc-dimercaptosuccinic acid (DMSA) scintigraphy in 100 kidneys from 58 patients with pediatric vesicoureteral reflux (VUR) to assess kidney function quantitatively for treatment selection and surgical timing. The conservatively treated group consisted of 42 patients (75 kidneys) who underwent DMSA renal scintigraphy twice at intervals of 2 years during their management. The surgically treated group consisted of 16 patients (25 kidneys) who underwent DMSA renal scintigraphy before and 2 years after surgery, Urine samples were collected at the time of initial DMSA renal scintigraphy for the simultaneous measurement of [beta][sub 2]-microglobulin ([beta][sub 2]-MG), [alpha][sub 1]-microglobulin and N-acetyl-[beta]-glucosaminidase. Renal uptake ratio of DMSA did not differ in VUR grades during a 2-year follow-up period in the conservative group. In the age group of patients aged 2 or less, renal uptake ratio decreased 2 years later, with significant difference with that in the other age groups. According to VUR grade, there was no significant difference in DMSA renal kidney ratios between the conservative group and the surgical group. According to age, significant difference in renal uptake ratio was observed between the two groups; i.e., patients aged 2 or less had a significantly decreased renal uptake ratio in the conservative group than the surgical group. However, the renal uptake ratio did not differ in the other age groups. For patients aged 2 or less, surgery was considerd necessary to prevent reflux when urinary [beta][sub 2]-MG indexes are increased. For those aged 3 years or more, on the other hand, conservative treatment was considered optimal regardless of VUR grades; surgery was considered recommended in the case of repeated urinary infection and decreased renal function. (N.K.).

  16. Pregnancy after renal transplantation: Effects on mother, child, and renal graft function.

    El Houssni, Siham; Sabri, Siham; Benamar, Loubna; Ouzeddoun, Naima; Bayahia, Rabia; Rhou, Hakima

    2016-01-01

    The aim of this study was to report our experience of pregnancy in renal transplant (RT) patients and its medium and long-term effects on the renal graft as well as the maternal fetal complications. We studied 21 pregnancies in 12 RT patients with mean age of 29.9 ± 5.3 years. The mean duration of RT to 1 st pregnancy was 42 (21-68.5) months and the median follow-up period was 112.5 (138-165) months. The pregnancy was planned in 28.6% of the cases. At the time of the diagnosis of the pregnancy, all the patients were maintained on corticosteroids and cyclosporine, 14.3% of the patients were on mycophenolate mofetil, and 71.4% of the patients were on azathioprine. The high blood pressure was present before the pregnancy in 33.3% of the patients. During pregnancy, proteinuria appeared in 20% of the cases, urinary tract infection in 33.3%, and preeclampsia in 5%. Anemia was present in all the patients during pregnancy. The doses of cyclosporine were increased during pregnancy. The mean term of delivery was 37 ± 2 weeks. Premature delivery was observed in 19% of the cases, fetal death in utero in 10%, and abortion in 15%. The number of living children was 16, with a mean birth weight of 3014 ± 515 g; the weight was lower than 2500 g in three (15%) cases. In the long-term follow-up, we noticed two cases of acute rejection related to patients' noncompliance, and four cases of chronic allograft nephropathy, without a switch to dialysis. We conclude that pregnancy in RT patients requires multidisciplinary care because of the increased risks of maternal and fetal complications. Each pregnancy needs to be planned; all parameters have to be studied and evaluated in order to allow for optimization of outcome and minimization of complications. PMID:26997374

  17. Atlas of nuclear methods for renal function tests in paediatric medicine

    The atlas is based on more than six years of routine 123I-hippurane renal function testing in infants. This new commercial radiopharmaceutical has the advantages of good morphological detail imaging, exact quantification of the global, unilateral and regional renal function, and comparatively low radiation exposure. 123I-hippurane also enables an assessment of the postrenal urinary passage - an important element of information which may reduce the number of radiological examinations. There is a short methodological section on the principles, procedures and errors of nuclear renal clearance testing, the diagnostic value of functional scintiscanning, and the radiation exposure of the patients. The main section is a systematic treatment of the main indications for renal function scintiscanning in paediatry. Case histories are presented which illustrate the diagnostic value of renal function scintiscanning and its importance as a decision aid in selecting the proper therapy. Clear and definitive findings, as well as diagnostic limits are outlined for the various indications, including rare diseases of the kidneys and the efferent urinary pathways. In view of the importance of the nuclear diagnosis of vesicoureteral reflux, a special chapter is dedicated to this subject. (orig./MG)

  18. Accurate determination of renal function in patients with intestinal urinary diversions

    The regular determination of renal function is a critical part of the management of patients who have had the urinary tract reconstructed with intestinal segments. These intestinal segments reabsorb urinary solutes and, thereby, complicate the determination of renal function by conventional methods. Urinary clearances of urea, creatinine and inulin were performed in patients with intestinal segments in the urinary tract and controls under varying diuretic conditions. Patients with intestinal diversions also underwent radioisotopic determination of renal function. The urinary clearances of urea, creatinine and inulin are highly dependent on the rate of urine flow in patients with intestinal segments in the urinary tract. Diuresis maximizes the urinary clearances of these solutes by minimizing intestinal reabsorption. Creatinine clearance prediction from the serum creatinine underestimates true glomerular filtration rate. Radioisotopic determination of renal function correlates poorly with true glomerular filtration rate. Only creatinine clearance measured under diuretic conditions correlates well with true renal function. Urine concentrating ability cannot be assessed accurately in patients with intestinal segments in the urinary tract, since osmolality rapidly equilibrates across the segments

  19. Structural and functional MRI in children with renal disease. First experience

    This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides. We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR. We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%). We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF. (orig.)

  20. Structural and functional MRI in children with renal disease. First experience

    Joergensen, Bettina; Froekiaer, Joergen [Aarhus Univ. Hospital (Denmark). Inst. of Clinical Medicine; Karstoft, Kristian; Pedersen, Michael [Aarhus Univ. Hospital (Denmark). Inst. of Clinical Medicine; Aarhus Univ. Hospital (Denmark). MR Research Centre; Joergensen, Troels Munch [Aarhus Univ. Hospital (Denmark). Dept. of Urology; Rittig, Soeren [Aarhus Univ. Hospital (Denmark). Dept. of Paediatrics

    2010-07-01

    This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides. We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR. We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%). We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF. (orig.)

  1. Renal and cardiac function during alpha1-beta-blockade in congestive heart failure

    Heitmann, M; Davidsen, U; Stokholm, K H;

    2002-01-01

    The kidney and the neurohormonal systems are essential in the pathogenesis of congestive heart failure (CHF) and the physiologic response. Routine treatment of moderate to severe CHF consists of diuretics, angiotensin-converting enzyme (ACE) inhibition and beta-blockade. The need for control of...... renal function during initiation of ACE-inhibition in patients with CHF is well known. The aim of this study was to investigate whether supplementation by a combined alpha1-beta-blockade to diuretics and ACE-inhibition might improve cardiac function without reducing renal function....

  2. Mesenchymal Stem Cells (MSC) Prevented the Progression of Renovascular Hypertension, Improved Renal Function and Architecture

    Oliveira-Sales, Elizabeth B.; Maquigussa, Edgar; Semedo, Patricia; Pereira, Luciana G.; Ferreira, Vanessa M.; Câmara, Niels O.; Bergamaschi, Cassia T.; Campos, Ruy R.; Boim, Mirian A.

    2013-01-01

    Renovascular hypertension induced by 2 Kidney-1 Clip (2K-1C) is a renin-angiotensin-system (RAS)-dependent model, leading to renal vascular rarefaction and renal failure. RAS inhibitors are not able to reduce arterial pressure (AP) and/or preserve the renal function, and thus, alternative therapies are needed. Three weeks after left renal artery occlusion, fluorescently tagged mesenchymal stem cells (MSC) (2×105 cells/animal) were injected weekly into the tail vein in 2K-1C hypertensive rats. Flow cytometry showed labeled MSC in the cortex and medulla of the clipped kidney. MSC prevented a further increase in the AP, significantly reduced proteinuria and decreased sympathetic hyperactivity in 2K-1C rats. Renal function parameters were unchanged, except for an increase in urinary volume observed in 2K-1C rats, which was not corrected by MSC. The treatment improved the morphology and decreased the fibrotic areas in the clipped kidney and also significantly reduced renal vascular rarefaction typical of 2K-1C model. Expression levels of IL-1β, TNF-α angiotensinogen, ACE, and Ang II receptor AT1 were elevated, whereas AT2 levels were decreased in the medulla of the clipped kidney. MSC normalized these expression levels. In conclusion, MSC therapy in the 2K-1C model (i) prevented the progressive increase of AP, (ii) improved renal morphology and microvascular rarefaction, (iii) reduced fibrosis, proteinuria and inflammatory cytokines, (iv) suppressed the intrarenal RAS, iv) decreased sympathetic hyperactivity in anesthetized animals and v) MSC were detected at the CNS suggesting that the cells crossed the blood-brain barrier. This therapy may be a promising strategy to treat renovascular hypertension and its renal consequences in the near future. PMID:24223811

  3. Early release of neonatal ureteral obstruction preserves renal function

    Shi, Yimin; Pedersen, Michael; Li, Chunling;

    2004-01-01

    .05) after 24 wk. Similarly, glomerular filtration rate of the obstructed kidney was severely reduced at 24 wk: 172 ± 36 vs. 306 ± 42 μl·min−1·100 g body wt−1 (P reduction in total protein content...... downregulation of Na-K-ATPase to 62 ± 7%, aquaporin-1 to 53 ± 3%, and aquaporin-3 to 53 ± 7% of sham levels. Release after 1 wk completely prevented development of hydronephrosis, reduction in RBF and glomerular filtration rate, and downregulation of renal transport proteins, whereas release after 4 wk had...

  4. Quantification of [18F]-FDG uptake in atherosclerotic plaque. Impact of renal function

    Impaired renal function causes both increased and prolonged tracer availability in the blood-pool which might result in increased tracer accumulation in atherosclerotic lesions. Therefore, the aim of this study was to investigate a possible correlation between the intensity of tracer uptake in atherosclerotic lesions and renal function. Data from 50 [18F]-fluoro-2-deoxy-D-glucose (FDG) scans were visually evaluated for tracer uptake in vessel wall alterations. Lesions were analyzed semiquantitatively by determining the blood-pool standardized uptake values (SUVblood-pools), maximum SUVs (SUVmaxs), and the target-to-background ratio (TBR). These parameters were tested for correlation with estimated glomerular filtration rate (eGFR), and cardiovascular risk factors. Both SUVblood-pools (rs=-0.32, p=0.03) and SUVmaxs for [18F]-FDG (rs=-0.50, p18F]-FDG demonstrated a significant positive correlation with eGFRs (rs=0.21, p=0.02). This study found that both intravascular tracer availability (SUVblood-pool) and intralesional tracer uptake (SUVmax) are influenced by renal function. Calculation of TBR to account for that effect may result in overcorrection in case of [18F]-FDG. Renal insufficiency or subclinical changes in renal function have to be considered as a confounding factor in PET of atherosclerotic lesions. (author)

  5. Assessing renal function in children with hydronephrosis – additional feature of MR urography

    Magnetic resonance urography (MRU) is one of the most attractive imaging modalities in paediatric urology, providing largest diagnostic information in a single protocol. Therefore, the aim of our study was to assess the diagnostic value of MRU in children with urogenital anomalies (especially anomalies of the renal pelvis and ureter) and the renal function using different post-processing functional software. Ninety six children (7 days – 18 years old) were examined. In 54 patients of them, a static T2 MRU was completed by excretory T1 MRU after gadolinium administration and functional analysis has been performed using two functional analysis softwares “CHOP-fMRU” and “ImageJ” software. MRU showed suspicious renal and the whole urinary tract anomalies with excellent image quality in all children. In ureteropelvic obstruction, MRU was confirmatory to the other imaging techniques, but it was superior modality concerning the evaluation of end-ureteral anomalies. There was an excellent correlation between the MRU data and diagnosis, determined by surgery. The renal transit times, renal volumes and volumetric differential renal function were assessed separately by “CHOP-fMRU” and “ImageJ” with excellent agreement with 99mTc-DTPA and among them. MRU overcomes a lot of limitations of conventional imaging modalities and has a potential to become a leading modality in paediatric uroradiology. Synthesis of both anatomical and functional criteria in MR urography enables to select the best candidates for surgical treatment. Even small kidney dysfunction can be detected by functional analysis software

  6. Prenatal programming-effects on blood pressure and renal function.

    Ritz, Eberhard; Amann, Kerstin; Koleganova, Nadezda; Benz, Kerstin

    2011-03-01

    Impaired intrauterine nephrogenesis-most clearly illustrated by low nephron number-is frequently associated with low birthweight and has been recognized as a powerful risk factor for renal disease; it increases the risks of low glomerular filtration rate, of more rapid progression of primary kidney disease, and of increased incidence of chronic kidney disease or end-stage renal disease. Another important consequence of impaired nephrogenesis is hypertension, which further amplifies the risk of onset and progression of kidney disease. Hypertension is associated with low nephron numbers in white individuals, but the association is not universal and is not seen in individuals of African origin. The derangement of intrauterine kidney development is an example of a more general principle that illustrates the paradigm of plasticity during development-that is, that transcription of the genetic code is modified by epigenetic factors (as has increasingly been documented). This Review outlines the concept of prenatal programming and, in particular, describes its role in kidney disease and hypertension. PMID:21283139

  7. Role of radiopharmaceutical renal function studies in the medical surveillance of patients with transplanted kidneys

    In a study group of 35 patients having received a total of 37 kidneys 204 renal function scintiscans were obtained following administration of 99mTc DTPA and analysed with regard to the question as to whether radiopharmaceutical investigations using a gamma camera are a useful auxiliary tool to detect and diagnose functional disorders in the transplant that occur soon after surgery. In all of 13 patients showing complications in the form of prolonged anuria or oliguria during a period of up to 14 days following surgical intervention, the renal function scintiscans either permitted as firm diagnosis to be established or revealed conclusive findings that pointed to the necessity of further specific tests. Long-term follow-up studies carried out in 33 individuals failed or were slow to reveal acute or chronic rejection processes in one quarter of the patients, whereas the renal function scintiscans gave the earliest warning of functional disorders, unfavourable developments and complications in another quarter of patients; in the remaining part, the test results were in keeping with the clinical findings. Renal function scintiscans were thus judged to be a valuable diagnostic tool to ascertain and identify disorders occurring soon after surgery as well as to detect the early signs of functional disorders in the transplant during long-term follow-up studies. In view of the fact, however, that the sensitivity of the method in this field of application only is of the order of 75%, further research work appears to be required here. (TRV)

  8. The Mechanisms of Human Renal Epithelial Cell Modulation of Autologous Dendritic Cell Phenotype and Function.

    Sandeep Sampangi

    Full Text Available Proximal tubule epithelial cells (PTEC of the kidney line the proximal tubule downstream of the glomerulus and play a major role in the re-absorption of small molecular weight proteins that may pass through the glomerular filtration process. In the perturbed disease state PTEC also contribute to the inflammatory disease process via both positive and negative mechanisms via the production of inflammatory cytokines which chemo-attract leukocytes and the subsequent down-modulation of these cells to prevent uncontrolled inflammatory responses. It is well established that dendritic cells are responsible for the initiation and direction of adaptive immune responses. Both resident and infiltrating dendritic cells are localised within the tubulointerstitium of the renal cortex, in close apposition to PTEC, in inflammatory disease states. We previously demonstrated that inflammatory PTEC are able to modulate autologous human dendritic cell phenotype and functional responses. Here we extend these findings to characterise the mechanisms of this PTEC immune-modulation using primary human PTEC and autologous monocyte-derived dendritic cells (MoDC as the model system. We demonstrate that PTEC express three inhibitory molecules: (i cell surface PD-L1 that induces MoDC expression of PD-L1; (ii intracellular IDO that maintains the expression of MoDC CD14, drives the expression of CD80, PD-L1 and IL-10 by MoDC and inhibits T cell stimulatory capacity; and (iii soluble HLA-G (sHLA-G that inhibits HLA-DR and induces IL-10 expression by MoDC. Collectively the results demonstrate that primary human PTEC are able to modulate autologous DC phenotype and function via multiple complex pathways. Further dissection of these pathways is essential to target therapeutic strategies in the treatment of inflammatory kidney disorders.

  9. Estimation of the Functional Renal Condition by Glomerular Filtration Rate in the Pregnant with Preeclampsy

    Oksana G. Cherniukh

    2015-03-01

    Full Text Available Creatitine clearance (CC by Reberg-Tareyev test has been analyzed with an essential condition to take urine analysis during 24 hours from pregnant women with various degree of preeclampsia. To characterize the renal excretory function in the regulation of nitrogen balance the indices of proteinemia and proteinuria have been used. Probable changes of the renal functional condition depending on the volume of 24-hour diuresis have been found. The necessity to analyze the indices using the standards for the pregnant according to the trimester of pregnancy is indicated.

  10. Impact of intensive care on renal function before graft harvest: results of a monocentric study

    Blasco, Valéry; Leone, Marc; Bouvenot, Julien; Geissler, Alain; Albanèse, Jacques; Martin, Claude

    2007-01-01

    Background The aim of life-support measures in brain-dead donors is to preserve the functional value of their organs. In renal transplantation, serum creatinine level is one of the criteria for graft harvest. The aim of this study was to assess the impact of intensive care on donor renal function through two criteria: preharvesting serum creatinine level above 120 μmol/L and the elevation of serum creatinine level above 20% between intensive care unit (ICU) admission and graft harvest. Method...

  11. The use of dynamic renoscintigraphy for diagnosis renal function in children with vesicoureteral reflux after surgery

    The article considers the problem of dynamic of renal function in children who were operated for unilateral vesicoureteral reflux (VUR) grade III-V. Patients underwent dynamic renoscintigraphy with 99mTc-DTPA. Results of studies carried out in different periods (from 1 to 5 years) after anti reflux surgery revealed that the obligatory diagnostic studies must include dynamic renoscintigraphy in all patients with VUR grade III-V in order to assess the existing decline i renal function; dynamic monitoring of patients should be conducted no later than 12 months after surgery, and then - annually

  12. {sup 99m}Tc-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children

    Moon, Tae Yong; Son, In Ju; Yoon, Chong Byung; Lee, Surk Hong; Kim, Byung Soo [Busan National University College of Medicine, Busan (Korea, Republic of)

    1994-03-15

    Authors retrospectively analysed 20 cases of follow-up {sup 99m}Tc-DMSA renal scans to evaluate renal function recovery after treatment in urological disorders of infants and children. There were 20 cases with both {sup 99m}Tc-DMSA renal scans prior to and after therapy in 15 patients below 9 years old. Among them, 10 patients underwent ureteroneocystostomy under the diagnosis of vesicoureteral reflux, two patients pyeloplasty because of obstructive uropathy and one was treated with antibiatics even diagnosis of UPJ stricture. We have got the quantified uptake rate of Tc-DMSA renal scan by using the regression equation as y=0.591 X 2.105 (y=the quantified uptake rate, x=the sirnple uptake rate). The number of kidneys performed proper therapy were 29, and the cases with more increased radiotracer uptake rate in the follow-up {sup 99m}Tc-DMSA renal scans were 20 in number as 69% in frequency. 19 cases with improved renal function on {sup 99m}Tc-DMSA renal scans didn't show any significant difference related to aging or recovery duration after therapy. The {sup 99m}Tc-DMSA renal scans were not useful to evaluate renal function recovery in infants and children, but could be good tests to assess residual renal function prior to or after treatment.

  13. Magnetisation transfer MR imaging of the kidney: evaluation at 3.0 T in association with renal function

    Ito, Katsuyoshi [Kawasaki Medical School, Department of Diagnostic Radiology, Kurashiki, Okayama (Japan); Kurashiki Daiichi Hospital, Department of Radiology, Kurashiki, Okayama (Japan); Hayashida, Minoru; Izumitani, Shogo; Fujimine, Tomoko; Onishi, Takeo; Genba, Katsuhiro [Kurashiki Daiichi Hospital, Department of Radiology, Kurashiki, Okayama (Japan)

    2013-08-15

    To evaluate the feasibility of using magnetisation transfer (MT) MRI of the kidney at 3.0 T to assess renal function. Forty-four patients who underwent abdominal MRI on a 3.0-T system including gradient-echo (GRE) sequences with and without MT pulse were included. In each patient, MT ratio (MTR) of the renal cortex and medulla was measured by using regions of interest (ROIs) placed on the MTR map image. Regression analysis showed good correlation between estimated glomerular filtration rate (eGFR) and MTR of the renal cortex (r = -0.645, P < 0.0001). Among 44 patients, 22 were categorised as the normal renal function group and 22 were classified as the decreased eGFR group. The mean MTR of the renal cortex in patients with decreased eGFR (mean MTR, 30.7 {+-} 3.2 %) was significantly higher (P < 0.0001) than that in patients with normal renal function (mean MTR, 25.3 {+-} 2.2 %), although the mean MTRs of the renal medulla in the two groups were not significantly different. There was good correlation between eGFR and MTR of the renal cortex derived from MT MRI at 3.0 T. This technique may have the potential to evaluate the degree of renal function non-invasively in patients with renal impairment. (orig.)

  14. Major influence of renal function on hyperlipidemia after living donor liver transplantation

    Qi Ling; Kai Wang; Di Lu; Hai-Jun Guo; Wen-Shi Jiang; Xiang-Xiang He; Xiao Xu

    2012-01-01

    AIM:To investigate the impact of renal and graft function on post-transplant hyperlipidemia (PTHL) in living donor liver transplantation (LDLT).METHODS:A total of 115 adult patients undergoing LDLT from January 2007 to May 2009 at a single center were enrolled.Data were collected and analyzed by the China Liver Transplant Registry retrospectively.PTHL was defined as serum triglycerides ≥ 150 mg/dL or serum cholesterol ≥ 200 mg/dL or the need for pharmacologic treatment at the sixth month after LDLT.Early renal dysfunction (ERD) was defined as serum creatinine ≥ 2 mg/dL and/or the need for renal replacement therapy in the first post-transplant week.RESULTS:In 115 eligible patients,the incidence of PTHL was 24.3%.Recipients with PTHL showed a higher incidence of post-transplant cardiovascular events compared to those without PTHL (17.9% vs 4.6%,P=0.037).Serum creatinine showed significant positive correlations with total serum triglycerides,both at posttransplant month 1 and 3 (P < 0.01).Patients with ERD had much higher pre-transplant serum creatinine levels (P < 0.001) and longer duration of pre-transplant renal insufficiency (P < 0.001) than those without ERD.Pretransplant serum creatinine,graft-to-recipient weight ratio,graft volume/standard liver volume ratio,body mass index (BMI) and ERD were identified as risk factors for PTHL by univariate analysis.Furthermore,ERD [odds ratio (OR) =9.593,P < 0.001] and BMI (OR =6.358,P =0.002) were identified as independent risk factors for PTHL by multivariate analysis.CONCLUSION:Renal function is closely associated with the development of PTHL in LDLT.Post-transplant renal dysfunction,which mainly results from pre-transplant renal insufficiency,contributes to PTHL.

  15. Impact of arterial occlusion during partial nephrectomy on residual renal function. An evaluation with 99mtechnetium-dimercaptosuccinic acid scintigraphy

    Partial nephrectomy (PNx) has been performed with temporary renal arterial occlusion and in situ renal hypothermia (conventional PNx). However, the impact of temporary renal arterial occlusion on residual renal function has not been well assessed. To address this question, we performed renal scintigraphy with 99mtechnetium-dimercaptosuccinic acid (DMSA) for the quantitative measurement of postoperative residual renal function after conventional PNx and partial nephrectomy without arterial occlusion (non-clamping PNx). Thirty-four patients underwent postoperative DMSA scintigraphy after PNx for renal cell carcinoma. No obvious difference in preoperative renal function between the diseased kidney and the contralateral kidney was found in any of the patients. Of these patients, 24 underwent conventional PNx, and 10 underwent non-clamping PNx. Residual renal function was evaluated using the relative DMSA uptake of the operated kidney. The relative DMSA uptake of the operated kidney was 39.9±7.3% (25.1-58.8) after conventional PNx compared to 34.8±8.9% (13.5-45.5) after non-clamping PNx. This difference was not statistically significant (P=0.15). Total ischemic time during conventional PNx had no adverse influence on the residual renal function. In the analysis of the other determinant factors influencing residual renal function, tumor size was the only significant factor that inversely correlated with the relative DMSA uptake. Our results showed that arterial clamping during PNx has no negative impact on the functional residual capacity as long as in situ renal hypothermia is adequately performed. (author)

  16. Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy.

    Lee, Chanwoo; Kwon, Taekmin; Yoo, Sangjun; Jung, Jaeyoon; Lee, Chunwoo; You, Dalsan; Jeong, In Gab; Kim, Choung-Soo

    2016-05-01

    We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time. PMID:27134496

  17. Determination of Lead in Human Calculi and Its Effects on Renal Function of Lead Occupational Workers

    F. Memon

    2016-06-01

    Full Text Available Seventy five samples of renal and eighteen samples of supra gingival calculi of lead recycling workers were collected over the period of seven years (2008-2014 and studied for the accumulation of lead. The results were compared with those of non exposed subjects. The lead content of calculi was investigated for its dependence on type and composition of calculi, blood lead, job status and duration of exposure. The effect of blood lead and renal calculi was also investigated in relation to kidney function of respective subjects. The mean lead levels of various types of calculi were found to follow the order as phosphate > oxalate > urate .> cystine while single principal group of supra gingival calculi resulted in lower levels of metal. The lead content of calculi positively correlated with phosphate content of both of the renal (r = 0.655 and supra gingival calculi (r= 0.866, Impaired renal function was more pronounced in active workers and depended on blood lead levels in addition to presence of metal in renal calculi

  18. Creatinine, arsenic metabolism, and renal function in an arsenic-exposed population in Bangladesh.

    Brandilyn A Peters

    Full Text Available Kidney disease is emerging as an arsenic (As-linked disease outcome, however further evidence of this association is warranted. Our first objective for this paper was to examine the potential renal toxicity of As exposure in Bangladesh. Our second objective relates to examining whether the previously reported positive association between urinary creatinine (uCrn and As methylation may be explained by renal function. We had hypothesized that these associations relate to supply and demand for s-adenosylmethionine, the methyl donor for both creatine synthesis and As methylation. Alternatively, renal function could influence both As and creatinine excretion, or the As metabolites may influence renal function, which in turn influences uCrn. We conducted a cross-sectional study (N = 478 of adults, composed of a sample recruited in 2001 and a sample recruited in 2003. We assessed renal function using plasma cystatin C, and calculated the estimated glomerular filtration rate (eGFR. Consistent with renal toxicity of As, log-uAs had a marginal inverse association with eGFR in the 2003 sample (b = -5.6, p = 0.07, however this association was not significant in the 2001 sample (b = -1.9, p = 0.24. Adjustment for eGFR did not alter the associations between uCrn and the %uAs metabolites, indicating that GFR does not explain these associations. Increased eGFR was associated with increased odds of having %uInAs >12.2% (2001: OR = 1.01, 95%CI (1.00,1.03; 2003: OR = 1.04, 95%CI (1.01,1.07. In the 2003 sample only, there was a negative association between eGFR and %uDMA (b = -0.08, p = 0.02. These results may indicate differential effects of renal function on excretion of InAs and DMA. Alternatively, a certain methylation pattern, involving decreased %InAs and increased %DMA, may reduce renal function. Given that these studies were cross-sectional, we cannot distinguish between these two possibilities. Discrepancies between the

  19. 131I-orthoiodohippurate renogram exploring the relationship among the radionuclide renography, hydronephrosis and renal function

    Objective: To investigate the 131I-orthoiodohippurate renography with hydronephrosis and renal function, in order to further clarify the clinical diagnosis and treatment of hydronephrosis and provide a reliable basis. Methods: Retrospective analysis the results of 131I-orthoiodohippurate renography in 120 patients whose urology inpatients. In accordance with the side of hydronephrosis, bilateral hydronephrosis and light, moderate and severe packet. The features of renography and the changes of functional parameter values in each group was analysised. And compared with the results of clinical evaluation about renal function and blood urea nitrogen (BUN), creatinine (Cr) levels. SPSS.16 statistical software was used for statistical analysis. Results: The incidence of abnormal renal function in varying degrees of hydronephrosis were significantly higher than those without hydronephrosis (98.9% vs. 39.3%, χ2=87.492, P2=13.848, P131I-orthoiodohippurate renography there is a higher sensitivity on the assessment of hydronephrosis and renal function, but lack of specificity. The analysis should be combination with clinical situation. (authors)

  20. Acetylcysteine reduces plasma homocysteine concentration and improves pulse pressure and endothelial function in patients with end-stage renal failure

    Scholze, Alexandra; Rinder, Christiane; Beige, Joachim;

    2004-01-01

    Increased oxidative stress, elevated plasma homocysteine concentration, increased pulse pressure, and impaired endothelial function constitute risk factors for increased mortality in patients with end-stage renal failure.......Increased oxidative stress, elevated plasma homocysteine concentration, increased pulse pressure, and impaired endothelial function constitute risk factors for increased mortality in patients with end-stage renal failure....

  1. Determinants and consequences of renal function variations with aldosterone blocker therapy in heart failure patients after myocardial infarction

    Rossignol, Patrick; Cleland, John G F; Bhandari, Sunil; Tala, Stéphane; Gustafsson, Finn; Fay, Renaud; Lamiral, Zohra; Dobre, Daniela; Pitt, Bertram; Zannad, Faiez

    2012-01-01

    We evaluated the effect of the selective mineralocorticoid receptor antagonist eplerenone on renal function and the interaction between changes in renal function and subsequent cardiovascular outcomes in patients with heart failure and left ventricular systolic dysfunction after an acute myocardial...... infarction in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS)....

  2. Renal function at the time of a myocardial infarction maintains prognostic value for more than 10 years

    Kümler, Thomas; Gislason, Gunnar H; Kober, Lars; Gustafsson, Finn; Schou, Morten; Torp-Pedersen, Christian

    2011-01-01

    Renal function is an important predictor of mortality in patients with myocardial infarction (MI), but changes in the impact over time have not been well described.We examined the importance of renal function by estimated GFR (eGFR) and se-creatinine as an independent long-term prognostic factor....

  3. Experimental renal kinetic function analysis using Gd-DTPA enhanced MRI

    The transitions of relaxation rate (R1 = 1/T1) on successive renal MRI (magnetic resonance imaging) can afford an information concerning renal function when excretory contrast media are used. Time-relaxation rate curves also make the MRI renography. A new calculation method for the GFR (glomerular filtration ratio) values from the MRI renography has been previously reported by our group. In this study, we experimentally applied the calculation method to MRI renography of rabbits for separating measurements of glomerular and tubular functions. Gd-DTPA (Gd-diethylene triamin pentaacetic acid) was prepared by our group. This compound was used as an excretory contrast media of MRI for measuring renal function, 0.05 mmol/kg of the compound was i.v. injected to each rabbit in experiments. Thirty-one rabbits' kidneys were grouped into 5 groupes: 17 controles, 8 with a ureter occlusion, 3 with a stenosis of renal artery, 2 with renal disorder by means of cisplatina injection and 1 with local irradiation of kidney. The longitudinal relaxation rate values were continuously measured on several portions of bilateral kidneys during 60 minutes after the injection of the Gd-DTPA, using T1 (Tr = 1,000 msec, Td = 300 msec) pulse sequences. Regional renographies were successfully obtained on the cortex and medulla. Not only the GFR values but also the following 3 parameters; the tubular volume parameter, the urine flow parameter and the reverse diffusion parameter were calculated by new methods of analysis on regional renographies. The animal studies disclosed positive correlation between the GFR parameter and the urine flow parameter, and also negative correlation between the GFR parameter and the reverse diffusion parameter. These results suggested that the differentiation between each stage of renal kinetic dysfunction could be achieved by this method of analysis on MRI regional renography. (author)

  4. One-year follow-up of renal function in endemic nephropathy families

    Arsenović Aleksandra

    2009-01-01

    Full Text Available Introduction. Endemic nephropathy is familial, chronic tubulointerstitial disease with an insidious onset and asymptomatic, slow progressive course. Objective. The present study was undertaken with the aim to find out whether new persons with renal disorders can be detected among members of endemic families in the village of Šopić (Kolubara River region, Serbia. Methods. The study involved 44 members of five endemic families without history of renal disorders. Objective survey and laboratory analyzes that enabled determination of kidney functions (creatinine clearance, proteinuria, urine specific gravity and osmolality, fractional sodium excretion (FENa, the rate of tubular phosphate reabsorption (TRP, urine N-acetil-D-glycosaminidase and intestinal alkaline phosphatase were done in all examined persons three times during the 6-month intervals. Results. At the first examination, hypertension was detected in 23 (52% person, decreased creatinine clearance in two and proteinuria in 10 persons included in the study. In addition, proteinuria and tubular disorders were detected in 6, hypertension, proteinuria and/or tubular disorders in 9 persons. The analysis of the results obtained by three check-ups undertaken during one year showed that proteinuria and tubular disorders appeared intermittently in half of the examined endemic family members. All persons with detected renal disorders required further examination in order to establish accurate diagnosis of renal disease. Conclusion. Three check-ups performed at six-month intervals in the members of five endemic families detected various renal disorders including renal hypofunction. Regular systematic check-ups of endemic families could enable early detection of the disease and early initiation of measures for slowing down chronic renal disease progression.

  5. Vascular endothelial cell function and cardiovascular risk factors in patients with chronic renal failure

    Haaber, A B; Eidemak, I; Jensen, T;

    1995-01-01

    Cardiovascular risk factors and markers of endothelial cell function were studied in nondiabetic patients with mild to moderate chronic renal failure. The transcapillary escape rate of albumin and the plasma concentrations of von Willebrand factor, fibrinogen, and plasma lipids were measured in 29...

  6. Renal function and incidence of chronic kidney disease in HIV patients

    Rasch, Magnus G; Engsig, Frederik Neess; Feldt-Rasmussen, Bo;

    2012-01-01

    Abstract Background: Impaired renal function is of major concern in human immunodeficiency virus (HIV)-infected patients. Methods: We used a mixed effects linear regression model to determine estimated glomerular filtration rates (eGFRs) in a population-based cohort of incident Danish HIV patient...

  7. Relationship between blood pressure variability and different renal function impairment stages in elderly hypertension patients

    王云

    2014-01-01

    Objective To observe the change of blood pressure variability(BPV)in elderly hypertension patients,and to analyze the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD)were divided into three groups:stage 2 CKD group(aged 60-

  8. Deteriorating renal function and clinical outcomes in HIV-positive persons

    Mocroft, A.; Ryom, L.; Begovac, J.; Monforte, A.D.; Vassilenko, A.; Gatell, J.; Florence, E.; Ormaasen, V.; Kirk, O.; Lundgren, J.D.; Burger, D.M.

    2014-01-01

    OBJECTIVES: To determine the relationship between measures of renal function [current estimated glomerular filtration rate (eGFR) and proportion of follow-up with a low eGFR (%FU

  9. Bowel preparation in CT colonography: electrolyte and renal function disturbances in the frail and elderly patient.

    Mc Laughlin, Patrick

    2010-03-01

    Elderly patients are at increased risk of biochemical disturbances secondary to cathartic medications. This study investigates the renal function, electrolyte and clinical disturbances associated with CT colonography (CTC) with sodium picosulphate-magnesium citrate (SPS-MC) in a subgroup of frail, elderly patients.

  10. Effect of donor GFR on early renal function of recipients with living donor transplantation

    侯敬财

    2012-01-01

    Objective To study the influence of donor GFR on the early renal function in recipients undergoing living donor transplantation. Methods A total of 172 living donor transplant recipients in our kidney transplantation center from 2006 to 2011 were enrolled into this study. Among them,166 were genetically related

  11. Functional significance of erythropoietin in renal cell carcinoma

    One of the molecules regulated by the transcription factor, hypoxia inducible factor (HIF), is the hypoxia-responsive hematopoietic factor, erythropoietin (EPO). This may have relevance to the development of renal cell carcinoma (RCC), where mutations of the von Hippel-Lindau (VHL) gene are major risk factors for the development of familial and sporadic RCC. VHL mutations up-regulate and stabilize HIF, which in turn activates many downstream molecules, including EPO, that are known to promote angiogenesis, drug resistance, proliferation and progression of solid tumours. HIFs typically respond to hypoxic cellular environment. While the hypoxic microenvironment plays a critical role in the development and progression of tumours in general, it is of special significance in the case of RCC because of the link between VHL, HIF and EPO. EPO and its receptor, EPOR, are expressed in many cancers, including RCC. This limits the use of recombinant human EPO (rhEPO) to treat anaemia in cancer patients, because the rhEPO may be stimulatory to the cancer. EPO may also stimulate epithelial-mesenchymal transition (EMT) in RCC, and pathological EMT has a key role in cancer progression. In this mini review, we summarize the current knowledge of the role of EPO in RCC. The available data, either for or against the use of EPO in RCC patients, are equivocal and insufficient to draw a definitive conclusion

  12. Validation of the calculation of the renal impulse response function. An analysis of errors and systematic biases

    The renal impulse response function (Renal IRF) is the time-activity curve measured over one kidney after injection of a radiopharmaceutical in the renal artery. If the tracer is injected intravenously it is possible to compute the renal IRF by deconvoluting the kidney curve by a blood curve. In previous work we demonstrated that the computed IRF is in good agreement with measurements made after injection in the renal artery. The goal of the present work is the analysis of the effect of sampling errors and the influence of extra-renal activity. The sampling error is only important for the first point of the plasma curve and yields an ill-conditioned function P-1. The addition of 50 computed renal IRF's demonstrated that the three first points show a larger variability due to incomplete mixing of the tracer. These points should thus not be included in the smoothing process. Subtraction of non-renal activity does not modify appreciably the shape of the renal IRF. The mean transit time and the time to half value are almost independent of non-renal activity and seem to be the parameters of choice

  13. Complex radioisotopic examination of renal functions using SOPHA MEDICAL program system

    Repeated isotopic scanning of the kidneys were made on a patient with complex renal diseases, on two consecutive days, in sitting and in lying position, resp. The scanning was done with 99mTc-MAG3 administered intravenously to the patient, starting computer scanning of gamma camera frames simultaneously. The data were evaluated by the SOPHA MEDICAL software of Sopha Medical GmbH, Frankfurt, Germany. It was observed that, in sitting position, the kidney perfusion, the early uptake, the tubular clearance and the ureter peristaltic are disturbed because of the compression of renal artery and ureter. These functions were recovered in the lying position. (R.P.) 14 refs.; 8 figs

  14. Renal hemodynamics, tubular function, and response to low-dose dopamine during acute hypoxia in humans

    Olsen, Niels Vidiendal; Hansen, J M; Kanstrup, I L; Richalet, J P; Leyssac, P P

    1993-01-01

    Renal function was investigated in eight normal subjects before and during infusion of dopamine (3 micrograms.kg-1 x min-1) at sea level (SL) and at high altitude (HA, 4,350 m). Lithium clearance (CLi) was used as an index of proximal tubular outflow. HA significantly increased arterial pressure......, heart rate, and plasma norepinephrine. Effective renal plasma flow (ERPF) decreased at HA by 10% (P <0.05), but glomerular filtration rate (GFR), CLi, sodium clearance (CNa), and urine flow remained unchanged compared with SL. Dopamine at SL and HA increased ERPF by 47% (P <0.001) and 30% (P <0...

  15. Influence of renal function on the elimination of morphine and morphine glucuronides

    Wolff, Jesper; Bigler, Dennis Richard; Christensen, C B; Rasmussen, S N; Andersen, H B; Tønnesen, K H

    1988-01-01

    The influence of renal function, measured by 51Cr-EDTA clearance, on morphine and morphine glucuronide kinetics has been studied in 13 patients after a single i.v. injection of morphine. Unconjugated morphine and morphine glucuronides were measured by a sensitive, specific RIA after extraction from...... plasma. No significant correlation was found between total body clearance of unconjugated morphine and 51Cr-EDTA clearance. However, patients with renal insufficiency had impaired elimination of morphine glucuronides, and the apparent clearance was significantly correlated with the 51Cr-EDTA clearance (r...

  16. Study of the renal function in diabetic patients by 99sup(m)Tc-DTPA and 131I-Hippuran

    Twenty-six patients with diabetes in different stages were studied by radioisotopic techniques in an attempt to detect early alterations of renal function. Renal scintillography, 99sup(m)Tc-DTPA glomerular filtration rate, renogram and 131I-Hippuran effective renal plasma flow were the techniques employed. Renal evaluation was filled out by biochemical analysis of plasmatic urea and creatinine, 24 h-proteinuria and funduscopy of patients. The renal disease of diabetic patient is a result of the sum of many factors and subclinical functional alterations that appear can be ascribed to reversible hemodynamic alterations, such as decrease of plasma flow with increase of ultrafiltrated plasma fraction and of glomerular filtration. Mechanisms that lead to these alterations are not yet stablished. This work suggests that the diabetic patients well metabolic compensated present less incidence of degenerative complications, among them renal lesions. (Author)

  17. Pharmacokinetic disposition of 14C-glyburide in patients with varying renal function

    The pharmacokinetics of 14C-labeled glyburide were studied in 13 men with varying degrees of renal impairment. Patients received a single, 5 mg oral dose of glyburide as a solution (10 microCi/ml/mg) after a high-carbohydrate breakfast. Serial plasma and breath samples were collected for 48 hours and urine and feces were collected for 5 to 7 days. Patients with normal to moderately impaired renal function (creatinine clearance [CLCR] of 29 to 131 ml/min/1.7 m2) had glyburide plasma t1/2 values of 2.0 to 5.0 hours, with no relationship between CLCR and glyburide clearance. One subject with severe renal impairment (CLCR = 5 ml/min/1.7 m2) had decreased glyburide clearance that resulted in a t1/2 of 11 hours. The elimination of metabolites was more dependent on renal status but was only significantly affected in the patient with severe renal impairment

  18. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease

    Houda Mbarki

    2015-01-01

    Full Text Available Fasting during Ramadan is prohibited when an individual′s health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD. We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years. All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF, active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of <60 mL/min/1.73 m 2 . However, the small sample size does not allow us to draw any firm conclusions on fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended.

  19. Effects of fasting during Ramadan on renal function of patients with chronic kidney disease.

    Mbarki, Houda; Tazi, Nada; Najdi, Adil; Tachfouti, Nabil; Arrayhani, Mohamed; Sqalli, Tarik

    2015-03-01

    Fasting during Ramadan is prohibited when an individual's health is endangered. Little work has been published in this direction in patients with chronic kidney disease (CKD). We aimed to evaluate the impact of fasting during Ramadan on the renal function of patients with CKD, adjusting for the initial degree of renal impairment. We prospectively studied 60 patients with CKD (35 females; mean age 45.6 ± 15.8 years). All study patients were older than 15 years, being followed-up at the nephrology clinic for more than six months, having a stable CKD during the preceding six months and who had fasted during Ramadan the previous year. Patients who had a medical contra-indication for fasting were excluded from the study [severe or resistant arterial hypertension, insulin-requiring diabetes, acute renal failure (ARF), active renal disease, repetitive urolithiasis or terminal chronic renal failure]. Statistical analysis was performed in collaboration with the epidemiology lab at the Fez Medical School using the SPSS software version 17. Three of the study patients developed ARF in the first week and four of them at the end of the month of the study period. The risk of developing ARF was significantly higher for patients with baseline creatinine clearance of fasting during Ramadan in stable CKD patients. Studies on larger numbers of patients are recommended. PMID:25758882

  20. Effects of iodinated contrast media on renal function in patients with multiple myeloma

    Case histories of 89 patients with definite myoloma of the years 1959 to 1974 were investigated in a retrospective study. 41 intravenous urographies were carried out in 31 of these patients. There was no correlation between deterioration of the renal function and contrast medium application. Relevant literature on the subject has been compiled. By 1979, 19 case studies and 5 general studies had been published which have been summarized in tables in the present study. Analyses of these case histories have shown that acute renal failure was often due to other causes and not to contrast medium application. If these cases are left out of account 8 cases remain in which lethal renal failure occurred after intravenous urography of myeloma patients. The diiodinated contrast media formerly used was less well tolerated than the present triiodinated contrast media. Further risk factors were dehydratation and/or abdominal compression. Both measures are no longer employed in intravenous urography. (orig./MG)

  1. Evaluation of renal function by dynamic MR imaging. Effect of water load

    The aim of this study was to investigate the usefulness of magnetic resonance (MR) imaging in the evaluation of renal function, with particular attention to the effects of water load. Ten healthy volunteers underwent dynamic MR imaging after an injection of gadolinium diethylenetriaminepenta-acetic acid (Gd-DTPA) as a contrast agent to evaluate renal function by the following four methods: the positive method [longitudinal relaxation time (T1) shortening is the dominant effect], the negative method [transverse relaxation time (T2) shortening is the dominant effect] and two intermediate methods by switching the Gd-DTPA concentrations used in the positive and negative methods. A prolonged cortical peak time and a reduced medullary peak level were observed by the positive method under a dehydrated condition, suggesting that these variables were slightly influenced by Gd-DTPA concentrated in the medulla. By the negative method, low signals due to T2* (T2* is the effective transverse relaxation time, typically shorter than T2) shortening appeared in the medulla under normal conditions, but these signals were unclear when the subject was under an overhydrated condition. These results indicate that water metabolism, in addition to imaging parameters and Gd-DTPA dose levels, should be considered when renal function is evaluated by dynamic MR imaging. Analysis of both the pattern of MR images and the time-signal intensity curves may be useful in the evaluation of renal function. The results also indicate that the positive method is perferred when the patient is overhydrated as it allows the evaluation of the local renal kinetic function by recording changes in the regional contract agent levels. (author)

  2. Association of ABCB1 genetic variants with renal function in Africans and in Caucasians

    Elston Robert C

    2008-06-01

    Full Text Available Abstract Background The P-glycoprotein, encoded by the ABCB1 gene, is expressed in human endothelial and mesangial cells, which contribute to control renal plasma flow and glomerular filtration rate. We investigated the association of ABCB1 variants with renal function in African and Caucasian subjects. Methods In Africans (290 subjects from 62 pedigrees, we genotyped the 2677G>T and 3435 C>T ABCB1 polymorphisms. Glomerular filtration rate (GFR was measured using inulin clearance and effective renal plasma flow (ERPF using para-aminohippurate clearance. In Caucasians (5382 unrelated subjects, we analyzed 30 SNPs located within and around ABCB1, using data from the Affymetrix 500 K chip. GFR was estimated using the simplified Modification of the Diet in Renal Disease (MDRD and Cockcroft-Gault equations. Results In Africans, compared to the reference genotype (GG or CC, each copy of the 2677T and 3435T allele was associated, respectively, with: GFR higher by 10.6 ± 2.9 (P P = 0.06 mL/min; ERPF higher by 47.5 ± 11.6 (P P = 0.007 mL/min; and renal resistances lower by 0.016 ± 0.004 (P P = 0.004 mm Hg/mL/min. In Caucasians, we identified 3 polymorphisms in the ABCB1 gene that were strongly associated with all estimates of GFR (smallest P value = 0.0006, overall P = 0.014 after multiple testing correction. Conclusion Variants of the ABCB1 gene were associated with renal function in both Africans and Caucasians and may therefore confer susceptibility to nephropathy in humans. If confirmed in other studies, these results point toward a new candidate gene for nephropathy in humans.

  3. Sexual hormones modulate compensatory renal growth and function

    Pablo J. Azurmendi

    2013-12-01

    Full Text Available The role played by sexual hormones and vasoactive substances in the compensatory renal growth (CRG that follows uninephrectomy (uNx is still controversial. Intact and gonadectomized adult Wistar rats of both sexes, with and without uNx, performed at 90 days age, were studied at age 150 days. Daily urine volume, electrolyte excretion and kallikrein activity (UKa were determined. Afterwards, glomerular filtration rate and blood pressure were measured, the kidneys weighed and DNA, protein and RNA studied to determine nuclei content and cell size. When the remnant kidney weight at age 150 days was compared with the weight of the kidney removed at the time of uNx, male uNx rats showed the greatest CRG (50% while growth in the other uNx groups was 25%, 15% and 19% in orchidectomized, female and ovariectomized rats, respectively. The small CRG observed in the uNx female rats was accompanied by the lowest glomerular filtration value, 0.56 ± 0.02 ml/min/g kwt compared, with the other uNx groups, p < 0.05. Cell size (protein or RNA/DNA was similar for all the groups except for uNx orchidectomized rats. In this group the cytoplasmatic protein or RNA content was lower than in the other groups while DNA (nuclei content was similar. Some degree of hyperplasia was determined by DNA content in the uNx groups. Male sexual hormones positively influenced CRG and its absence modulated cell size. Female sexual hormones, instead, did not appear to stimulate CRG. The kallikrein kinin system may not be involved in CRG.

  4. Extrarenal citrulline disposal in mice with impaired renal function

    Didelija, Inka C.; Fiorotto, Marta L.

    2014-01-01

    The endogenous synthesis of arginine, a semiessential amino acid, relies on the production of citrulline by the gut and its conversion into arginine by the kidney in what has been called the “intestinal-renal axis” for arginine synthesis. Although the kidney is the main site for citrulline disposal, it only accounts for ∼60–70% of the citrulline produced. Because the only known fate for citrulline is arginine synthesis and the enzymes that catalyze this reaction are widespread among body tissues, we hypothesized that citrulline can be utilized directly by tissues to meet, at least partially, their arginine needs. To test this hypothesis, we used stable and radioactive tracers in conscious, partially nephrectomized (½ and ⅚) and anesthetized acutely kidney-ligated mouse models. Nephrectomy increased plasma citrulline concentration but did not affect citrulline synthesis rates, thus reducing its clearance. Nephrectomy (⅚) reduced the amount of citrulline accounted for as plasma arginine from 88 to 42%. Acute kidney ligation increased the half-life and mean retention time of citrulline. Whereas the rate of citrulline conversion into plasma arginine was reduced, it was not eliminated. In addition, we observed direct utilization of citrulline for arginine synthesis and further incorporation into tissue protein in kidney-ligated mice. These observations indicate that a fraction of the citrulline produced is utilized directly by multiple tissues to meet their arginine needs and that extrarenal sites contribute to plasma arginine. Furthermore, when the interorgan synthesis of arginine is impaired, these extrarenal sites are able to increase their rate of citrulline utilization. PMID:25056350

  5. Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

    Maria Paparoupa

    2014-01-01

    Full Text Available We report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice a day. On the 8th day of hospitalization the patient presented with acute severe rhabdomyolysis requiring an intensive care support. After discontinuation of levofloxacin and concomitant medication with simvastatin 80 mg/day, clinical and laboratory effects were totally reversible. Up to now, levofloxacin has been reported to induce rhabdomyolysis mainly in patients with impaired renal function, as the medication has a predominant renal elimination. In our case renal function remained normal during the severe clinical course. According to a recent case report rhabdomyolysis was observed due to interaction of simvastatin and ciprofloxacin. To our best knowledge this is the first case of interaction between simvastatin and levofloxacin to be reported. This case emphasizes the need of close monitoring of creatine kinase in patients under more than one potentially myotoxic medication especially when patients develop muscle weakness.

  6. Correlation of DTPA renogram with urinary jet index for evaluation of differential renal function

    DTPA Renogram by Gamma Camera is an established procedure for evaluation of differential renal function. Urinary Jet Index is a newly developed technique done by Color Doppler Ultrasound which can also evaluate individual renal function. The present study was done to correlate the new ultrasonographic technique with the DTPA study. 36 subjects, 24 patients with different renal problems and 12 healthy volunteers were included in the study. Renogram was performed with Tc-99m DTPA. Urinary Jet Index was calculated by counting the number of urinary jets from each side as shown in the bladder and was done by a Toshiba Color Doppler Ultrasound Scanner. In DTPA Renogram relative renal function was calculated with reference to right kidney and that was the 'scintigraphic index'. Values for right scintigraphic and right ureteric jet index was then compared. Statistical analysis by correlation coefficient 'r' was done.Mean right scintigraphic index was 50.67 and mean right ureteric jet index was 51.92. Correlation Coefficient 'r' was 0.79 (p value <0.001) which is highly significant. Evaluation of ureteric jet index is a very simple test and can be performed in any department equipped with Color Doppler Ultrasonogram. Though scintigraphic index is considered as gold standard but ureteric jet index is also found well correlated with DTPA Renogram. This is a very preliminary report of an ongoing study in our institute. The initial experience of the study is reported. (authors)

  7. Renal function markers and thyroid hormone status in undialyzed chronic kidney disease

    Balaji Rajagopalan

    2013-01-01

    Full Text Available Objective: The study was undertaken to quantify thyroid hormones in undialyzed chronic kidney disease patients’ verses controls and to study the correlation between renal function markers and thyroid hormones. Background: Chronic kidney disease (CKD is associated with a higher prevalence of primary hypothyroidism (HT, but at the same studies on thyroid hormone status in uremic patients has reported conflicting results. Methods: Thyroid hormones and renal function parameters like serum urea, creatinine, creatinine clearance, total protein and albumin were estimated and correlations between thyroid hormones and renal function parameters were studied in 60 undialyzed chronic kidney disease patients’ verses 100 healthy controls. Results: We found both T3 and T4 were significantly reduced (p<0.0001 for T3 and 0.007 for T4 whereas TSH remains to be unchanged in patient group compared to controls. We also observed that urea and creatinine were negatively correlated whereas creatinine clearance was positively correlated with both T3 and T4 that has high statistical (two-tailed significance at 0.01 level. But urea alone is negatively correlated with TSH that has statistical (two-tailed significance at 0.05 level. Conclusion: From our data, we speculate that renal insufficiency may lead to thyroid hormone disturbances.

  8. Elevated urine heparanase levels are associated with proteinuria and decreased renal allograft function.

    Itay Shafat

    Full Text Available Heparanase is an endo-β-glucuronidase that cleaves heparan sulfate side chains, leading to structural modifications that loosen the extracellular matrix barrier and associated with tumor metastasis, inflammation and angiogenesis. In addition, the highly sulfated heparan sulfate proteoglycans are important constituents of the glomerular basement membrane and its permselective properties. Recent studies suggest a role for heparanase in several experimental and human glomerular diseases associated with proteinuria such as diabetes, minimal change disease, and membranous nephropathy. Here, we quantified blood and urine heparanase levels in renal transplant recipients and patients with chronic kidney disease (CKD, and assessed whether alterations in heparanase levels correlate with proteinuria and renal function. We report that in transplanted patients, urinary heparanase was markedly elevated, inversely associated with estimated glomerular filtration rate (eGFR, suggesting a relationship between heparanase and graft function. In CKD patients, urinary heparanase was markedly elevated and associated with proteinuria, but not with eGFR. In addition, urinary heparanase correlated significantly with plasma heparanase in transplanted patients. Such a systemic spread of heparanase may lead to damage of cells and tissues alongside the kidney.The newly described association between heparanase, proteinuria and decreased renal function is expected to pave the way for new therapeutic options aimed at attenuating chronic renal allograft nephropathy, leading to improved graft survival and patient outcome.

  9. Hemodynamic evaluation of uterine artery and renal artery in preeclampsia patients and its relationship with endothelial function and invasive function

    Ping-Feng Shu; Peng Wang

    2015-01-01

    Objective:To study the hemodynamic condition of uterine artery and renal artery in preeclampsia patients and its relationship with endothelial function and invasive function. Methods:Preeclampsia puerperas were enrolled in observation group of the research, including 20 cases each with mild preeclampsia, moderate preeclampsia and severe preeclampsia; healthy puerperas were enrolled in control group. Then color Doppler ultrasound was used to detect hemodynamic parameters of uterine spiral artery and bilateral renal interlobar artery, enzyme-linked immunosorbent assay was used to detect endothelial function indexes in serum, and PCR was used to detect invasive function parameters in placenta.Results: S/D, PI and RI of uterine spiral artery and bilateral renal interlobar artery in mild, moderate and severe preeclampsia patients were all higher than those of control group; the more severe the preeclampsia condition was, the higher the S/D, PI and RI of uterine spiral artery and bilateral renal interlobar artery were; mRNA contents of Cst L, Cst D and MMP-9 in placenta of mild, moderate and severe preeclampsia patients were lower than those of control group, and mRNA contents of RECK as well as serum sFlt-1, sEng, AT1-AA and AngII contents were higher than those of control group; the more severe the disease degree was, the lower the mRNA contents of Cst L, Cst D, and MMP-9 were, the higher the mRNA contents of RECK as well as serum sFlt-1, sEng, AT1-AA and AngII contents were.Conclusion:Resistance of uterine artery and renal artery in preeclampsia patients increases, and it is closely related to endothelial dysfunction and invasive function loss.

  10. Clinical evaluation of renal function study using I-123 orthoiodohippurate (I-123 OIH) in patients with obstructive uropathy

    Okada, Junichi; Uchiyama, Guio (Yamanashi University School of Medicine (Japan)); Katsurai, Hiroshi; Uno, Koichi; Uematsu, Sadao

    1984-06-01

    Functional images and regional renograms using I-123 OIH were evaluated by comparing with patients' clinical courses, intravenous pyelographies and Creatinine clearances. Twenty-one patients with obstructive uropathy were studied. Functional images were processed in three parameters of Tmax, T 1/2 and ERBF (effective renal blood flow). ERBF images were composed of regional counts in early blood flow phase of renograms. Regional renograms were produced on renal parenchyma and pelvis. ERBF images represented the functioning distributions of renal tissue after the surgery and the recoveries in the renal parenchyma. Tmax and T 1/2 images and pelvic regional renograms showed the good correlations with IVP findings which presented the dilatation of pelvis and the delay of excretion. Parenchymal regional renograms showed the poor correlations with Creatinine clearances and caused sometimes errors in ROI settings. The evaluation of renal function only by the parenchymal regional renogram seemed to be inappropriated.

  11. Clinical evaluation of renal function study using I-123 orthoiodohippurate (I-123 OIH) in patients with obstructive uropathy

    Functional images and regional renograms using I-123 OIH were evaluated by comparing with patients' clinical courses, intravenous pyelographies and Creatinine clearances. Twenty-one patients with obstructive uropathy were studied. Functional images were processed in three parameters of Tmax, T 1/2 and ERBF (effective renal blood flow). ERBF images were composed of regional counts in early blood flow phase of renograms. Regional renograms were produced on renal parenchyma and pelvis. ERBF images represented the functioning distributions of renal tissue after the surgery and the recoveries in the renal parenchyma. Tmax and T 1/2 images and pelvic regional renograms showed the good correlations with IVP findings which presented the dilatation of pelvis and the delay of excretion. Parenchymal regional renograms showed the poor correlations with Creatinine clearances and caused sometimes errors in ROI settings. The evaluation of renal function only by the parenchymal regional renogram seemed to be inappropriated. (author)

  12. Renal function in high dose chemotherapy and autologous hematopoietic cell support treatment for breast cancer.

    Merouani, A; Shpall, E J; Jones, R B; Archer, P G; Schrier, R W

    1996-09-01

    Autologous and allogeneic bone marrow grafting both require cytoreductive therapy but only the allogeneic procedure requires immunosuppressive agents. Allogeneic bone marrow transplantation has been reported to be associated with a high incidence of both renal failure and veno-occlusive disease (VOD) of the liver, the combination of which is associated with a high morbidity and mortality. There is less known about the frequency and severity of these complications in patients undergoing autologous bone marrow transplantation. In the present study renal, hepatic and other complications were examined in 232 patients with Stages II/III and IV breast cancer who were treated with high-dose chemotherapy and autologous hematopoietic cell support with either marrow or peripheral blood progenitor cells. The post-treatment severity of the renal dysfunction was classified as follows: Grade 0, normal renal function [ 25% decrement in GFR but twofold rise in serum creatinine but no need for dialysis; Grade 3 > than twofold rise in serum creatinine and need for dialysis. There were 102 patients (44%) who were classified as Grade 0 and 81 patients (35%) who were classified as Grade 1 renal dysfunction. Severe renal dysfunction (Grades 2 and 3) was observed in 49 of the 232 patients (21%). This severe renal dysfunction of 21% compares with a previously reported 53% incidence of severe renal dysfunction for allogeneic bone marrow transplantation. Similarly, the frequency of hepatic VOD was less (4.7% or 11 of 232 patients) in this autologous bone marrow transplant study as compared to a reported incidence of hepatic VOD ranging from 22 to 53% in large series of allogeneic bone marrow transplant patients. The severe renal dysfunction (Grades 2 and 3) in the present autologous hematopoietic cell support study correlated most significantly with sepsis, liver and pulmonary dysfunction. The major fall in GFR occurred during chemotherapy but before hematopoietic cell support, thus

  13. Recovery of Native Renal Function in Patients with Hepatorenal Syndrome Following Combined Liver and Kidney Transplant with Mercaptoacetyltriglycine-3 Renogram: Developing a Methodology

    Aparici, Carina Mari; Bains, Sukhkarn N.; Carlson, David; Qian, Jesse; Liou, Douglas; Wojciechowski, David; Werner, Jacob; Khan, Sana; Kroll, Cameron; Sandhu, Manreet; Nguyen, Nhan; Hawkins, Randall

    2016-01-01

    Many patients with hepatorenal syndrome (HRS) end up receiving a combined liver and kidney transplant (CKLT) with preservation of native kidneys, specially type 1 HRS since is characterizes by a very rapid deterioration of renal function. Eventually, most of the patients regain renal function, but it is unknown if this is due to the transplanted kidney, the recovery of native renal function, or both. The aim of this study is to evaluate if there is recovery of native renal function in patient...

  14. Effect of Low-Dose Dopamine on Renal Function and Electrolyte Extraction During Cardiopulmonary Bypass

    Türker EMRE

    2015-09-01

    Full Text Available OBJECTIVE: Kidney damage after cardiac surgery can cause acute renal failure, increase the morbidity and mortality, and prolong the hospital stay. Various methods have therefore been used to prevent renal failure. One of the most frequently used drugs for this purpose is low-dose dopamine (2-4 mcg/kg/min but it has various disadvantages in addition to advantages. One disadvantage is the increased urinary excretion of electrolytes. We studied the use low-dose dopamine on renal function in patients who had undergone coronary artery bypass surgery. MATERIAL and METHODS: We included 40 patients who were planned to undergo open heart surgery, had developed kidney damage for any reason before the surgery, and had normal ejection fraction (EF in the study. The data were recorded before and 1, 24, and 48 hours after the operation. RESULTS: When we compared the postoperative 24th hour data, urinary K and Cl were higher in the control group than the dopamine group (p<0.05. Postoperative 24th hour creatinine clearance was higher in the dopamine group than the control group (p<0.05. CONCLUSION: We conclude that the use of low-dose dopamine in cardiopulmonary bypass patients in the postoperative period does not have a positive effect on the renal function and does not affect urinary electrolyte excretion.

  15. Study on the assessment of renal tubular function with combined determination of multiple markers

    Objective: To investigate the degree of tubular injury in patients with glomerular diseases by measuring the urinary contents of various tubular function markers (THP, RBP, α1-m, β2-m, NAG, ET-1 ) and IL-6 as well as free water clearance. Methods: Twenty four hour urinary contents of THP, α1-m, β2-m, ET-1, IL-6 (with RIA) RBP (with ELISA) and NAG (with colorimetry) as well as free water clearance were determined in 353 patients with various kinds of primary glomerular diseases and 32 controls. Results: Renal tubular injury was most pronounced in patients with chronic renal failure followed by patients with lupus nephritis. In patients with chronic renal failure (n=36 ), urinary contents of all these markers were significantly different from those in controls (P<0.01). In other patients, urinary contents of at least one or several markers were significantly different from those in controls with the exception of patients with latent nephritis (n=8). Conclusion: Renal tubular function damage could be demonstrated in most of the patients with primary glomerular diseases. (authors)

  16. Renal function imaging with radioisotopes - state of the art. Nuklearmedizinische Nierenfunktionsdiagnostik - aktueller Stand

    Hahn, K.; Piepenburg, R. (Mainz Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin)

    1991-10-01

    In modern nuclear medicine, iodine-131-hippurate is more and more replaced by alternative radiopharmaceuticals like iodine-123-hippurate and technetium-99m-MAG3. Lower photon energy and higher count rates produce better image quality by using these new substances. Other disadvantages of iodine-131-hippurate are the unnecessary irradiation of the patient - because of the beta ray component - and the environment - because of its long half-life. Because of these facts, nowadays only the technetium compounds MAG3, DTPA and DMSA or iodine-123-hippurate should be used in renal scanning. Tc-DMSA only allows static images. The glomerular filtration marker Tc-DTPA has an unfavourably low clearance. For this, Tc-MAG3 and iodine-123-hippurate are the most appropriate tracers for renal function scintigraphy. While the image quality of both is equal, Tc-MAG3 has the advantage of better availability and handling. Summarizing our experience in a large number of kidney investigations, Tc-MAG3 has been proved to be the radiopharmacon with the most universal range of indications. Iodine-hippurate and Tc-DTPA can be completely replaced by Tc-MAG3 in the scintigraphic imaging of kidney perfusion, renal function, urinary tract obstruction, renal artery stenosis, and vesicoureteral reflux. (orig.).

  17. Renal failure (chronic)

    Clase, Catherine

    2009-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  18. Dynamic magnetic resonance imaging in the assessment of chronic medical nephropathies with impaired renal function

    Dalla-Palma, L.; Pozzi-Mucelli, R.S.; Cova, M.; Meduri, S. [Dept. of Radiology, University of Trieste (Italy); Panzetta, G.; Galli, G. [Hemodialysis Service, Ospedale Maggiore, Trieste (Italy)

    2000-02-01

    We examined the value of dynamic magnetic resonance imaging (MRI) in chronic renal disease with renal insufficiency. In 33 consecutive patients (21 vascular nephropathy, 12 glomerular nephropathy) MRI was performed using a 1.5-T unit and a body coil, with SE T1-weighted (TR/TE = 600/19 ms) and dynamic TFFE T1-weighted sequences (TR/TE = 12/5 ms, flip angle = 25 ) after manual bolus injection (via a cubital vein) of 0.1 mmol/kg Gd-DTPA-BMA. Morphological evaluation was performed in unblinded fashion by three radiologists, evaluating renal size, cortical thickness, and corticomedullary differentiation. Functional analysis was performed by one reviewer. Time-signal intensity curves, peak intensity value (P), time to peak intensity (T), and the P/T ratio were obtained at the cortex, medulla, and pyelocaliceal system of each kidney. The relationship of these parameters to serum creatinine and with creatinine clearance was investigated. A good correlation between morphological features of the kidneys and serum creatinine values was found. Morphological findings could not distinguish between vascular and glomerular nephropathies. A statistically significant correlation (P <0.01) between cortical P, cortical P/T, medullary P, and serum creatinine and creatinine clearance was found. A significant correlation (P <0.01) was also found between cortical T, medullary P/T, T of the excretory system, and creatinine clearance. The cortical T value was significantly higher (P <0.01) in vascular nephropathy than in glomerular nephropathy. Thus in patients with chronic renal failure dynamic MRI shows both morphological and functional changes. Morphological changes are correlated with the degree of renal insufficiency and not with the type of nephropathy; the functional changes seem to differ in vascular from glomerular nephropathies. (orig.)

  19. Development of program for renal function study with quantification analysis of nuclear medicine image

    In this study, we developed a new software tool for the analysis of renal scintigraphy which can be modified more easily by a user who needs to study new clinical applications, and the appropriateness of the results from our program was studied. The analysis tool was programmed with IDL5.2 and designed for use on a personal computer running Windows. For testing the developed tool and studying the appropriateness of the calculated glomerular filtration rate (GFR), 99mTc-DTPA was adminstered to 10 adults in normal condition. In order to study the appropriateness of the calculated mean transit time (MTT). 99mTc-DTPA and 99mTc-MAG3 were administered to 11 adults in normal condition and 22 kidneys were analyzed. All the images were acquired with ORBITOR, the Siemens gamma camera. With the developed tool, we could show dynamic renal images and time activity curve (TAC) in each ROI and calculate clinical parameters of renal function. The results calculated by the developed tool were not different statistically from the results obtained by the Siemens application program (Tmax: p=0.68, Relative Renal Function: p=1.0 GFR: p=0.25) and the developed program proved reasonable. The MTT calculation tool proved to be reasonable by the evaluation of the influence of hydration status on MTT. We have obtained reasonable clinical parameters for the evaluation of renal function with the software tool developed in this study. The developed tool could prove more practical than conventional, commercial programs

  20. Effects of gentamicin on the recovery of renal function after unilateral hydronephrosis

    Urinary tract infection is one of complications in hydronephrosis, and antibiotics such as gentamicin are indicated for the treatment. However, gentamicin is known to cause drug-induced nephropathy. Using a rat kidney model, we investigated the effects of gentamicin treatment on the functional recovery from unilateral hydronephrosis. Quantitative separate renal function study by means of Technetium-99m DMSA renoscintigraphy revealed that contralateral kidney was affected by the treatment right after the release of complete ureteral obstruction. Moreover, in the case of incomplete ureteral obstruction, bilateral kidneys were affected by the treatment. Morphological studies using in situ DNA3' -end labeling and immunohistochemical methods showed that regeneration in the bilateral kidney followed gentamicin treatment right after the release. These results suggest that we should take account of separate renal function failure after gentamicin administration in the perihydronephrotic periods. (author)

  1. Effects of gentamicin on the recovery of renal function after unilateral hydronephrosis

    Seki, Nobumitsu [Ehime Univ., Shigenobu (Japan). School of Medicine

    2002-06-01

    Urinary tract infection is one of complications in hydronephrosis, and antibiotics such as gentamicin are indicated for the treatment. However, gentamicin is known to cause drug-induced nephropathy. Using a rat kidney model, we investigated the effects of gentamicin treatment on the functional recovery from unilateral hydronephrosis. Quantitative separate renal function study by means of Technetium-99m DMSA renoscintigraphy revealed that contralateral kidney was affected by the treatment right after the release of complete ureteral obstruction. Moreover, in the case of incomplete ureteral obstruction, bilateral kidneys were affected by the treatment. Morphological studies using in situ DNA3' -end labeling and immunohistochemical methods showed that regeneration in the bilateral kidney followed gentamicin treatment right after the release. These results suggest that we should take account of separate renal function failure after gentamicin administration in the perihydronephrotic periods. (author)

  2. Percutaneous Access: Acute Effects on Renal Function and Structure in a Porcine Model

    Handa, Rajash K.; Willis, Lynn R.; Evan, Andrew P.; Connors, Bret A.; Ying, Jun; Fat-Anthony, William; Wind, Kelli R.; Johnson, Cynthia D.; Blomgren, Philip M.; Estrada, Mark C.; Paterson, Ryan F.; Kuo, Ramsay L.; Kim, Samuel C.; Matlaga, Brian R.; Miller, Nicole L.; Watkins, Stephanie L.; Handa, Shelly E.; Lingeman, James E.

    2007-04-01

    Percutaneous nephrolithotomy (PCNL) involves gaining access into the urinary collecting system to remove kidney stones. Animal studies demonstrated that a reduction in renal filtration and perfusion in both kidneys, and a decline in tubular organic anion transport in the treated kidney characterizes the acute (hours) functional response to unilateral percutaneous access. The acute morphologic and histological changes in the treated kidney were consistent with blunt trauma and ischemia. Only tubular organic anion transport remained depressed during the late (3-day) response to the access procedure. Human studies revealed an acute decline in glomerular function and bilateral renal vasoconstriction following unilateral PCNL. Therefore, percutaneous access is not a benign procedure, but is associated with acute functional and structural derangements.

  3. Increased urinary orosomucoid excretion is not related to impaired renal function in patients with type 2 diabetes

    Hommel, Eva; Friberg, Lars; Mølvig, Jens;

    2010-01-01

    Increased urinary orosomucoid excretion rate (UOER) independently predicted cardiovascular mortality in patients with type 2 diabetes at 5-years of follow-up. To further explore UOER in relation to local renal physiological phenomena, we studied renal glomerular and tubular functions in patients...... with type 2 diabetes and normal or increased UOER....

  4. Estimation of renal function in the intensive care unit: the covert concepts brought to light.

    Sunder, Sham; Jayaraman, Rajesh; Mahapatra, Himanshu Sekhar; Sathi, Satyanand; Ramanan, Venkata; Kanchi, Prabhu; Gupta, Anurag; Daksh, Sunil Kumar; Ram, Pranit

    2014-01-01

    Frantic efforts have been made up to this date to derive consensus for estimating renal function in critically ill patients, only to open the Pandora's box. This article tries to explore the various methods available to date, the newer concepts, and the uncared issues that may still prove to be useful in estimating renal function in intensive care unit patients. The concept of augmented renal clearance, which is frequently encountered in critically ill patients, should always be taken into account, as correct therapeutic dosage of drugs sounds vital which in turn depends on correctly calculated glomerular filtration rate. Serum creatinine and creatinine-based formulae have their own demerits that are well known and established. While Cockcroft-Gault and 4-variable modification of diet in renal diseases formulae are highly inadequate in the intensive care setup for estimating glomerular filtration rate, employing isotopic methods is impractical and cumbersome. The 6-variable modification of diet in renal diseases formula fairs better as it takes into account the serum albumin and blood urea nitrogen, too. Jelliffe's and modified Jelliffe's equations take into account the rate of creatinine production and volume of distribution which in turn fluctuates heavily in a critically ill patient. Twenty-four-hour and timed creatinine clearances offer values close to reality although not accurate and cannot provide immediate results. Cystatin C is a novel agent that offers a sure promise as it is least influenced by factors that affect serum creatinine to a major extent. Aminoglycoside clearance, although still in the dark area, may prove a simple yet precise way of estimating glomerular filtration rate in those patients in whom these drugs are therapeutically employed. Optic ratiometric method has emerged as the most sophisticated one in glomerular filtration rate estimation in critically ill patients. PMID:25520843

  5. Sulphasalazine induced renal failure.

    Dwarakanath, A D; Michael, J.; Allan, R. N.

    1992-01-01

    Two men with longstanding ulcerative colitis who were treated with sulphasalazine for several years and who developed chronic renal failure are reported. Renal biopsy specimens showed histological changes consistent with drug induced chronic intestinal nephritis. Extensive investigation made other causes of chronic renal failure unlikely. One of these patients underwent renal transplantation, the other has impaired but stable renal function.

  6. Galectin-3, Renal Function, and Clinical Outcomes: Results from the LURIC and 4D Studies.

    Drechsler, Christiane; Delgado, Graciela; Wanner, Christoph; Blouin, Katja; Pilz, Stefan; Tomaschitz, Andreas; Kleber, Marcus E; Dressel, Alexander; Willmes, Christoph; Krane, Vera; Krämer, Bernhard K; März, Winfried; Ritz, Eberhard; van Gilst, Wiek H; van der Harst, Pim; de Boer, Rudolf A

    2015-09-01

    Galectin-3 has been linked to incident renal disease, experimental renal fibrosis, and nephropathy. However, the association among galectin-3, renal function, and adverse outcomes has not been described. We studied this association in two large cohorts of patients over a broad range of renal function. We measured galectin-3 concentrations in baseline samples from the German Diabetes mellitus Dialysis (4D) study (1168 dialysis patients with type 2 diabetes mellitus) and the Ludwigshafen Risk and Cardiovascular Health (LURIC) study (2579 patients with coronary angiograms). Patients were stratified into three groups: eGFR of ≥90 ml/min per 1.73 m(2), 60-89 ml/min per 1.73 m(2), and <60 ml/min per 1.73 m(2). We correlated galectin-3 concentrations with demographic, clinical, and biochemical parameters. The association of galectin-3 with clinical end points was assessed by Cox proportional hazards regression within 10 years (LURIC) or 4 years (4D) of follow-up. Mean±SD galectin-3 concentrations were 12.8±4.0 ng/ml (eGFR≥90 ml/min per 1.73 m(2)), 15.6±5.4 ng/ml (eGFR 60-89 ml/min per 1.73 m(2)), 23.1±9.9 ng/ml (eGFR<60 ml/min per 1.73 m(2)), and 54.1±19.6 ng/ml (dialysis patients of the 4D study). Galectin-3 concentration was significantly associated with clinical end points in participants with impaired kidney function, but not in participants with normal kidney function. Per SD increase in log-transformed galectin-3 concentration, the risks of all-cause mortality, cardiovascular mortality, and fatal infection increased significantly. In dialysis patients, galectin-3 was associated with the combined end point of cardiovascular events. In conclusion, galectin-3 concentrations increased with progressive renal impairment and independently associated with cardiovascular end points, infections, and all-cause death in patients with impaired renal function. PMID:25568176

  7. Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease

    Fernandes, Sheila Marques; Martins, Daniel Malisani; da Fonseca, Cassiane Dezoti; Watanabe, Mirian; Vattimo, Maria de Fátima Fernandes

    2016-01-01

    Iodinated contrast (IC) is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI). Chronic kidney disease (CKD) and chronic hyperglycemia (CH) are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH); Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL) and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance) were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI. PMID:27034930

  8. GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

    Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R2=0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

  9. Study of renal functions in preterm and full term new born in relation to parity of the mother

    Jitendra P. Bhatnagar; Virendra K. Gupta; Shagun Gupta; Alok Purohit

    2016-01-01

    Background: During the intrauterine life, placenta performs the function of maintaining fluid and electrolyte balance and removing harmful waste products. The renal function is related more closely to gestational age, postnatal age and parity of mother. Objective of the study was to study renal functions in preterm and full term new born in relation to the parity of mother (primiparous versus multiparous mother). Methods: The study was conducted from January 2015 to December 2015 on 500 he...

  10. Severe Hydronephrosis Caused by Uterine Prolapse with Non Specific Symptoms and Normal Renal Function

    Muammer Altok

    2013-09-01

    Full Text Available Pelvic organ prolapse (POP, is the descent of pelvic organs (bladder, uterus, rectum until protrusion through the vagina and related to the loss of normal attachment and support of the pelvic floor. Pelvic organ prolapse (POP is a common problem in elderly women and usually causes various urologic symptoms. One of the most important complications of POP is hydronephrosis. The hydronephrosis is usually mild. Severe hydronephrosis is very rare. Hydronephrosis caused by POP may lead to renal dysfunction and serious urinary infections. Early detection and treatment is very important for preventing irreversible renal damage.Hereby, we report a case of 65-years-old woman who had massive uterine prolapse with silent severe bilateral hydronephrosis. She had no complaint except a protruding tissue out of her vagina. Renal function was normal and hydronephrosis was detected incidentally. The symptoms may be non-specific and silent until a serious infection or renal dysfunction. Therefore patients with a POP especially with severe POP need to have evaluation and imaging about the condition or the urinary system before a serious pathology occur

  11. Evaluation of Renal Functions in Adolescent Suicide Attempts by Drug Overdose

    Ahmet Keskinoğlu

    2012-12-01

    Full Text Available Aim: To determine reasons for adolescent suicide attempts and to investigate renal functions in adolescents admitted to Emergency Service after a suicide attempt. Methods: A total of 148 cases were enrolled in this cross-sectional study. Data were collected from hospital records and from “Emergency Services Suicide Attempts Data Form”. The variables of the study were sociodemographic characteristics, reasons for suicidal attempts, drugs used, medical procedures, and prognosis of the patients. The descriptive findings are presented as the evaluation of distributions. Chi-square and t-tests were used for analysis of variables. Results: The mean age of 148 adolescents was 16.7 years. 84.3% of subjects were female. Adolescent suicides were common in subjects older than 15 years of age. Suicides in January and July were more frequent than in the other months. The time interval between poisoning and admission to hospital was 0-3 hours. The leading cause of suicidal attempts was family problems (33.8%. Antidepressants were the most commonly used drugs in suicide attempts. Although, some ion disturbances were detected in some patients, renal failure or renal dysfunction was not observed in any subject. Conclusion: Family problems were the most significant risk factor for adolescent suicide. Immediate transportation to emergency services and early treatment were important for the prevention of multiorgan deficiency and renal failure. (The Me di cal Bul le tin of Ha se ki 2012; 50: 96 -100

  12. Agmatine improves renal function in gentamicin-induced nephrotoxicity in rats.

    El-Kashef, Dalia H; El-Kenawi, Asmaa E; Abdel Rahim, Mona; Suddek, Ghada M; Salem, Hatem A

    2016-03-01

    The present study was designed to explore the possible protective effects of agmatine, a known nitric oxide (NO) synthase inhibitor, against gentamicin-induced nephrotoxicity in rats. For this purpose, we quantitatively evaluated gentamicin-induced renal structural and functional alterations using histopathological and biochemical approaches. Furthermore, the effect of agmatine on gentamicin-induced hypersensitivity of urinary bladder rings to acetylcholine (ACh) was evaluated. Twenty-four male Wistar albino rats were randomly divided into 3 groups, namely control, gentamicin (100 mg/kg, i.p.), and gentamicin plus agmatine (40 mg/kg, orally). At the end of the study, all rats were sacrificed and then blood and urine samples and kidneys were taken. Administration of agmatine significantly decreased kidney/body mass ratio, serum creatinine, lactate dehydrogenase (LDH), renal malondialdehyde (MDA), myeloperoxidase (MPO), NO, and tumor necrosis factor-alpha (TNF-α) while it significantly increased creatinine clearance and renal superoxide dismutase (SOD) activity when compared with the gentamicin-treated group. Additionally, agmatine ameliorated tissue morphology as evidenced by histological evaluation and reduced the responses of isolated bladder rings to ACh. Our study indicates that agmatine administration with gentamicin attenuates oxidative-stress associated renal injury by reducing oxygen free radicals and lipid peroxidation, restoring NO level and inhibiting inflammatory mediators such as TNF-α. PMID:26641937

  13. Angiotensin converting enzyme (ACE) inhibitors and renal function. A review of the current status

    Kamper, A L

    1991-01-01

    Angiotensin converting enzyme (ACE) inhibitors are well established in the treatment of hypertension and cardiac failure. Experimental studies in rats have suggested that these agents may protect renal function in chronic nephropathy by a mechanism other than simply lowering the systemic blood...... pressure. In human studies of incipient diabetic nephropathy, worsening of microalbuminuria was prevented during 3 years of ACE inhibition. ACE inhibitors reduce arterial blood pressure in chronic nephropathy, and may cause a fall in glomerular filtration rate. In diabetic nephropathy, proteinuria...... was reduced by 2 months' treatment with enalapril to less than half of the values obtained in a control group treated with metoprolol. Nonrandomised trials have suggested that ACE inhibitors may slow the deterioration of renal function, but no comparisons with other antihypertensive agents in prospective...

  14. Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons

    Kamara, David A; Nielsen, Lene Ryom; Ross, Michael; Kirk, Ole; Reiss, Peter; Morlat, Philippe; Moranne, Olivier; Fux, Christoph A; Mocroft, Amanda; Sabin, Caroline; Lundgren, Jens D; Smith, Colette J

    2014-01-01

    No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90ml/min/1.73m2 (using Cockcroft Gault) in the Data Collec...... Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study from 2004 to 2011.......No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90ml/min/1.73m2 (using Cockcroft Gault) in the Data...

  15. Evaluation of radioimmunoassay for renal functions in senile patients with cor pulmonale without respiratory failure

    The results of RIA about serum β2-MG and urine β2-MG, Alb, IgG in the senile patients with cor pulmonale are reported. The contents of sβ2-MG, uβ2-MG, uAlb in non-respiratory failure group are higher than that of the control group. The contents of sβ2-MG, uβ2-MG, uAlb and uIgG in the respiratory failure group are higher than that of the non-respiratory failure group. The results show that the renal glamorous and renal tubules functions are slightly damaged in non-respiratory failure group, while functions of the respiratory failure group become worse

  16. Studies of an aspect of renal function with the aid of dynamic CT and renogram.

    Satoh,Nobuo

    1991-06-01

    Full Text Available Dynamic CT scans were conducted on 94 persons who had been randomly selected among the patients and the volunteers. The test results were used to obtain the time-density curve. A part of the subjects (20 cases underwent the renogram examination for the comparative studies. The cortico-aortic (CA ratio derived from the time-density curve demonstrated good correlation between the dynamic CT and the renal function (r = 0.68. When the dynamic CT studies and the renogram were compared, the vascular phase of the renogram showed strong correlation with CA ratio. Consequently the dynamic CT study the CA ratio was believed to demonstrate the renal function.

  17. RENAL FUNCTION IMPAIRMENT IN INSULIN DEPENDENT AND NON INSULIN DEPENDENT DIABETIC PATIENTS

    Rasool Mohammad

    2015-01-01

    Full Text Available The research study was undertaken to investigate the effect of renal function impairment in insulin dependent and non insulin dependent diabetic patient in biochemistry department Hazara University Mansehra, Khyber pakhtunkhwa, Pakistan. For the study a District Head Quarter Hospital Bannu is selected. A total samples were taken from 100 individuals i.e. 33 insulin dependent, 33 non insulin dependent diabetic patients and 34 were control group. The blood samples from the individuals were collected for estimation of glucose in sodium flurried tube while urine, creatine and uric acid lithium heparin coated tube. Relevant data was recorded throughout the experiment till the termination of experiment; data was subjected to statistical analysis using ANOVA design. Level of significance (P0.05 value between the different groups. It is concluded that renal function were affected in both groups of diabetic patients on the basis of receiving data from the above different parameters.

  18. Kidney-to-liver ratio. A simple scintigraphic parameter for routine individual renal function assessment in children.

    Yung, B C; Sostre, S

    1994-03-01

    DTPA renography is commonly used for measuring relative renal function. However, in patients with bilateral renal disease or solitary kidneys, split function studies are of no value. Available techniques to quantify individual renal function are either time consuming or inaccurate. The authors validate the kidney-to-liver ratio at 3 minutes (K3/L3) as an index of renal function, showing excellent correlation with GFR. Normal K3/L3 ranges were then computed in 113 pediatric kidneys (age 2 days to 16 years) and 24 adults. Indicative of renal maturation, the K3/L3 rapidly rose from a value of 1.32 at birth to 2.02 at 6 months. Subsequently, it increased slowly to reach a peak of 2.34 at age 2, followed by gradual decline to adult values after age 5. This decrease is due likely to continued growth of the hepatic blood pool after renal maturation. GFR followed the same maturation pattern to reach a plateau around 2 years of age. K3/L3 reflects individual kidney function, and it requires no blood sampling or urine collection. By establishing normal values at different stages of maturity, this method provides identification and quantification of renal dysfunction in infants, children, and adults. PMID:8033475

  19. Epigenetic Markers of Renal Function in African Americans

    Samantha M. Bomotti

    2013-01-01

    Full Text Available Chronic kidney disease (CKD is an increasing concern in the United States due to its rapidly rising prevalence, particularly among African Americans. Epigenetic DNA methylation markers are becoming important biomarkers of chronic diseases such as CKD. To better understand how these methylation markers play a role in kidney function, we measured 26,428 DNA methylation sites in 972 African Americans from the Genetic Epidemiology Network of Arteriopathy (GENOA study. We then evaluated (1 whether epigenetic markers are associated with estimated glomerular filtration rate (eGFR, (2 whether the significantly associated markers are also associated with traditional risk factors and/or novel biomarkers for eGFR, and (3 how much additional variation in eGFR is explained by epigenetic markers beyond established risk factors and biomarkers. The majority of methylation markers most significantly associated with eGFR (24 out of the top 30 appeared to function, at least in part, through pathways related to aging, inflammation, or cholesterol. However, six epigenetic markers were still able to significantly predict eGFR after adjustment for other risk factors. This work shows that epigenetic markers may offer valuable new insight into the complex pathophysiology of CKD in African Americans.

  20. Evaluation of Renal Functions in Adolescent Suicide Attempts by Drug Overdose

    Ahmet Keskinoğlu; Feyzullah İnan

    2012-01-01

    Aim: To determine reasons for adolescent suicide attempts and to investigate renal functions in adolescents admitted to Emergency Service after a suicide attempt. Methods: A total of 148 cases were enrolled in this cross-sectional study. Data were collected from hospital records and from “Emergency Services Suicide Attempts Data Form”. The variables of the study were sociodemographic characteristics, reasons for suicidal attempts, drugs used, medical procedures, and progn...

  1. IGFBP2 is a biomarker for predicting longitudinal deterioration in renal function in type 2 diabetes

    Narayanan, Ram P; Fu, Bo; Heald, Adrian H; Siddals, Kirk W.; Oliver, Robert L.; Hudson, Julie E; Payton, Antony; Anderson, Simon G; White, Anne; Ollier, William E R; Gibson, J Martin

    2012-01-01

    Objective Insulin-like growth factors are implicated in the development of diabetic nephropathy. IGF-binding protein 2 (IGFBP2) and IGF2 are expressed in the kidney, but their associations with diabetic nephropathy are unclear. We therefore tested the hypothesis that circulating levels of IGF2 and IGFBP2 predict longitudinal renal function in individuals with type 2 diabetes. Design and methods IGFBP2 and IGF2 measurements were performed in 436 individuals (263 males) with type 2 diabetes. Li...

  2. Risk factors for deterioration of renal function after coronary artery bypass grafting

    van Straten, Albert; Hamad, Mohamed; Van Zundert, Adrien; Martens, Elisabeth; Schönberger, Jacques; de Wolf, Andre

    2010-01-01

    Abstract Objective: Various definitions of impairment of renal function after coronary artery bypass grafting (CABG) are used in the literature. Depending on the definition, several risk factors are identified. We analysed our data to determine the risk factors for postoperative deterioration of the creatinine clearance of 10% or more. Methods: All patients undergoing isolated coronary surgery in a single centre between January 1998 and December 2007 are included. Clinical data, including ...

  3. Comparison of renal function between normal-weight and overweight children

    Falakaflaki, B.; Mazloomzadeh, S.; Moradzade, A.

    2012-01-01

    Obesity in children is associated with hypertension, dyslipidemia, cardiovascular disease, diabetes mellitus, colon cancer, and kidney disease. Most of the studies that evaluate the association between obesity and kidney disease have been done in adults. This study was planned to compare renal function between normal-weight and overweight children. In this case-control study, 92 children (45 boys, 47 girls) aged 7-12 years were included in the analysis. 46 children (23 boys, 23 girls) with BM...

  4. ROLE OF ATP IN REGULATING RENAL MICROVASCULAR FUNCTION AND IN HYPERTENSION

    Guan, Zhengrong; Inscho, Edward W.

    2011-01-01

    Adenosine triphosphate (ATP) is an essential energy substrate for cellular metabolism but it can also influence many biological processes when released into the extracellular milieu. Research has established that extracellular ATP acts as an autocrine/paracrine factor that regulates many physiological functions. Alternatively, excessive extracellular ATP levels contribute to pathophysiological processes such as inflammation, cell proliferation and apoptosis, and atherosclerosis. Renal P2 rece...

  5. The relationship between adiponectin, ageing and renal function in a bi-ethnic sample

    Huisman, Hugo Willem; Kruger, Iolanthe Marike; Schutte, Aletta Elisabeth

    2011-01-01

    Ageing is associated with elevated adiponectin levels. Our aim was to assess whether age-related increase in adiponectin is associated with a decrease in renal function. The study comprised African (N = 277) and Caucasian (N = 326) men and women. Adiponectin levels, estimated creatinine clearance rate and obesity indices were determined. African men revealed significantly higher adiponectin levels compared to Caucasian men (p < 0.01), reflecting the lower adiposity levels of the African men. ...

  6. Tests of renal function in patients with quiescent colitis: effects of drug treatment.

    Riley, S.A.; Lloyd, D R; Mani, V.

    1992-01-01

    Mesalazine has structural similarities to aspirin and phenacetin and is nephrotoxic when given intravenously in high doses to rats. A number of cases of nephrotoxicity has been reported recently in patients taking oral mesalazine. Sensitive indicators of renal function in a group of patients maintained on long term, delayed release mesalazine and a comparable group on sulphasalazine have been studied. Sixty two patients (32 men, aged 28-82 years) with quiescent colitis were studied. Thirty fo...

  7. Simulation of the pharmacokinetics of bisoprolol in healthy adults and patients with impaired renal function using whole-body physiologically based pharmacokinetic modeling

    Guo-fu LI; Kun WANG; Rui CHEN; Hao-ru ZHAO; Jin YANG; Qing-shan ZHENG

    2012-01-01

    Aim:To develop and evaluate a whole-body physiologically based pharmacokinetic (WB-PBPK) model of bisoprolol and to simulate its exposure and disposition in healthy adults and patients with renal function impairment.Methods:Bisoprolol dispositions in 14 tissue compartments were described by perfusion-limited compartments.Based the tissue composition equations and drug-specific properties such as log P,permeability,and plasma protein binding published in literatures,the absorption and whole-body distribution of bisoprolol was predicted using the ‘Advanced Compartmental Absorption Transit’ (ACAT)model and the whole-body disposition model,respectively.Renal and hepatic clearances were simulated using empirical scaling methods followed by incorporation into the WB-PBPK model.Model refinements were conducted after a comparison of the simulated concentration-time profiles and pharmacokinetic parameters with the observed data in healthy adults following intravenous and oral administration.Finally,the WB-PBPK model coupled with a Monte Carlo simulation was employed to predict the mean and variability of bisoprolol pharmacokinetics in virtual healthy subjects and patients.Results:The simulated and observed data after both intravenous and oral dosing showed good agreement for all of the dose levels in the reported normal adult population groups.The predicted pharmacokinetic parameters (AUC,Cmax,and Tmax) were reasonably consistent (<1.3-fold error) with the observed values after single oral administration of doses ranging from of 5 to 20 mg using the refined WB-PBPK model.The simulated plasma profiles after multiple oral administration of bisoprolol in healthy adults and patient with renal impairment matched well with the observed profiles.Conclusion:The WB-PBPK model successfully predicts the intravenous and oral pharmacokinetics of bisoprolol across multiple dose levels in diverse normal adult human populations and patients with renal insufficiency.

  8. Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies

    Preda, Lorenzo [Division of Radiology, European Institute of Oncology, IRCCS, Milan (Italy); Agazzi, Alberto; Martinelli, Giovanni [Division of Haematology, European Institute of Oncology, IRCCS, Milan (Italy); Raimondi, Sara [Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, Milan (Italy); University of Milan, Department of Occupational Medicin ' ' Clinica del Lavoro Luigi Devoto' ' Section of Medical Statistics and Biometry ' ' GA Maccacaro' ' , Milan (Italy); Lanfranchi, Carla Federica [University of Milan, IRCCS, School of Medicine, Milan (Italy); Passerini, Rita [Unit of Laboratory Medicine, European Institute of Oncology, IRCCS, Milan (Italy); Calvetta, Albania [Nephrology and Dialysis Unit, Istituto Clinico Humanitas, IRCCS, Rozzano, Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, IRCCS, Milan (Italy); University of Milan, IRCCS, School of Medicine, Milan (Italy)

    2011-01-15

    To assess the safety of the non-ionic iso-osmolar contrast agent iodixanol on renal function in patients with monoclonal gammopathies undergoing CT. We explored the effect of iodixanol on renal function in 30 patients with monoclonal gammopathies and 20 oncological patients with a normal electrophoretic profile (control group). The parameters used to estimate renal function were: serum creatinine, eGFR (determined 24 h before and 48 h after the administration of iodixanol), and urinary excretion of Neutrophil Gelatinase-Associated Lipocalin (NGAL) determined 2 h and 24 h after. Serum creatinine was also determined 1 month after the administration of iodixanol. No significant increase in serum creatinine values were observed in the monoclonal gammopathies group and in 19/20 patients in the control group. Only 1 patient in the control group developed a transient contrast agent-induced nephropathy. We found no statistically significant difference between the two groups regarding the percentage variation from baseline values of serum creatinine, creatinine clearance, NGAL 2 h after, and eGFR. Whereas NGAL at 24 h showed a statistically significant increase in patients with Monoclonal gammopathies. The use of iodixanol appears to be safe in patients with monoclonal gammopathies and an eGFR {>=} 60 ml/min/1.73 mq. (orig.)

  9. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil......A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated......-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography...... (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions....

  10. The Role of Endothelin System in Renal Structure and Function during the Postnatal Development of the Rat Kidney.

    Albertoni Borghese, María F; Ortiz, María C; Balonga, Sabrina; Moreira Szokalo, Rocío; Majowicz, Mónica P

    2016-01-01

    Renal development in rodents, unlike in humans, continues during early postnatal period. We aimed to evaluate whether the pharmacological inhibition of Endothelin system during this period affects renal development, both at structural and functional level in male and female rats. Newborn rats were treated orally from postnatal day 1 to 20 with vehicle or bosentan (Actelion, 20 mg/kg/day), a dual endothelin receptor antagonist (ERA). The animals were divided in 4 groups: control males, control females, ERA males and ERA females. At day 21, we evaluated renal function, determined the glomerular number by a maceration method and by morphometric analysis and evaluated possible structural renal alterations by three methods: 〈alpha〉-Smooth muscle actin (α-SMA) immunohistochemistry, Masson's trichrome and Sirius red staining. The pharmacological inhibition of Endothelin system with a dual ERA during the early postnatal period of the rat did not leads to renal damage in the kidneys of male and female rats. However, ERA administration decreased the number of glomeruli, the juxtamedullary filtration surface area and the glomerular filtration rate and increased the proteinuria. These effects could predispose to hypertension or renal diseases in the adulthood. On the other hand, these effects were more pronounced in male rats, suggesting that there are sex differences that could be greater later in life. These results provide evidence that Endothelin has an important role in rat renal postnatal development. However these results do not imply that the same could happen in humans, since human renal development is complete at birth. PMID:26872270

  11. Residual renal function and nutritional status in patients on continuous ambulatory peritoneal dialysis

    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction During the last years, an increasing number of patients with end-stage renal failure caused by various underlying diseases, all over the world, is treated by renal replacement therapy. Nutritional status Malnutrition is often found in patients affected by renal failure; it is caused by reduced intake of nutritional substances due to anorexia and dietary restrictions hormonal and metabolic disorders, comorbid conditions and loss of proteins, amino-acids, and vitamins during the dialysis procedure itself. Nutritional status significantly affects the outcome of patients on chronic dialysis treatment. Recent epiodemiological trials have proved that survival on chronic continuous ambulatory peritoneal dialysis program depends more on residual renal function (RRF than on peritoneal clearances of urea and creatinine. Material and methods The aim of the study was to analyze the influence of RRF on common biochemical and anthropometric markers of nutrition in 32 patients with end-stage renal failure with various underlying diseases during the first 6 months on continuous ambulatory peritoneal dialysis (CAPD. The mean residual creatinine clearance was 8,3 ml/min and the mean RRF was 16,24 week in our patients at the beginning of the chronic peritoneal dialysis treatment. Results and conclusion During the follow-up, the RRF slightly decreased, while the nutritional status of patients significantly improved. Gender and age, as well as the leading disease and peritonitis didn't influence the RRF during the first 6 months of CAPD treatment. We found several positive correlations between RRF and laboratory and anthropometric markers of nutrition during the follow-up, proving the positive influence of RRF on nutritional status of patients on chronic peritoneal dialysis.

  12. Early drop in systolic blood pressure and worsening renal function in acute heart failure : renal results of Pre-RELAX-AHF

    Voors, Adriaan A.; Davison, Beth A.; Felker, G. Michael; Ponikowski, Piotr; Unemori, Elaine; Cotter, Gadi; Teerlink, John R.; Greenberg, Barry H.; Filippatos, Gerasimos; Teichman, Sam L.; Metra, Marco

    2011-01-01

    Aims We aimed to determine the relation between baseline systolic blood pressure (SBP), change in SBP, and worsening renal function (WRF) in acute heart failure (AHF) patients enrolled in the Pre-RELAX-AHF trial. Methods and results The Pre-RELAX-AHF study enrolled 234 patients within 16 h of admiss

  13. Effect of strenuous maternal exercise before and during pregnancy on rat progeny renal function

    Oliveira A.O.

    2004-01-01

    Full Text Available The effects of strenuous exercise before and during pregnancy on the renal function and morphological alterations of the progeny were determined in a study on female Wistar rats. This research was done based on a previous study carried out in our laboratory, which showed morphological alterations in rats submitted to this kind of exercise. As the form is related to the function, the physiological relevance of submitting a pregnant female to a high-intensity exercise training regimen could be explained by the fact that morphological alterations can influence kidney function. The animals were assigned to one of two groups: control animals that did not exercise during pregnancy and trained animals that swam for 120 min 5 days a week for 8 weeks before pregnancy and daily for 60 min over a period of 8 weeks starting on the second day of pregnancy. Seven rats of each group were analyzed for morphological alterations and for renal function. The progeny of the rats used for morphological evaluation were born by cesarean section and the progeny of the animals used to evaluate renal function were born normally. The progeny were two months old when renal function was evaluated. Fertility and morbidity were the same for both groups. Strenuous maternal exercise had no significant influence on glomerular filtration rate (GFR but renal plasma flow was lower in the progeny of the trained group (mean ± SD, 16.65 ± 3.77 ml min-1 kg-1 compared to the progeny of the control group (33.42 ± 2.56 ml min-1 kg-1. Antidiuretic and antinatriuretic effects on the progeny of the trained group were observed, since urine flow as percentage of GFR and the fraction of urinary sodium excretion were lower in this group (1.38 ± 0.10 and 0.60 ± 0.04%, respectively compared to the progeny of the control group (2.36 ± 0.11 and 1.55 ± 0.20%, respectively. Moreover, in this exercise program, fetuses from trained animals were small-sized (2.45 ± 0.19 vs 4.66 ± 2.45 g for

  14. Expression profiling of human renal carcinomas with functional taxonomic analysis

    Madore Steven J

    2002-09-01

    Full Text Available Abstract Background Molecular characterization has contributed to the understanding of the inception, progression, treatment and prognosis of cancer. Nucleic acid array-based technologies extend molecular characterization of tumors to thousands of gene products. To effectively discriminate between tumor sub-types, reliable laboratory techniques and analytic methods are required. Results We derived mRNA expression profiles from 21 human tissue samples (eight normal kidneys and 13 kidney tumors and two pooled samples using the Affymetrix GeneChip platform. A panel of ten clustering algorithms combined with four data pre-processing methods identified a consensus cluster dendrogram in 18 of 40 analyses and of these 16 used a logarithmic transformation. Within the consensus dendrogram the expression profiles of the samples grouped according to tissue type; clear cell and chromophobe carcinomas displayed distinctly different gene expression patterns. By using a rigorous statistical selection based method we identified 355 genes that showed significant (p Conclusions Affymetrix GeneChip profiling differentiated clear cell and chromophobe carcinomas from one another and from normal kidney cortex. Clustering methods that used logarithmic transformation of data sets produced dendrograms consistent with the sample biology. Functional taxonomy provided a practical approach to the interpretation of gene expression data.

  15. The determination of relative renal function in a pediatric population using Tc-99m DTPA and Tc-99m DMSA

    Rosen, P.R.; Kuruc, A.; Treves, S.T.

    1985-05-01

    Three methods for evaluating relative renal function in a pediatric population were compared. The clinical and nuclear medicine data of 73 patients were reviewed. Pertinent data included patient age, serum creatinine and the referral diagnosis (reflux, hypertension, obstructive uropathy). Time activity curves for renal regions of interest (ROI) were obtained by renography with Tc-99m DTPA, and deconvolved by an externally detected blood pool curve Furosemide was then administered to evaluate the renal collecting system (if indicated). This was followed by DMSA administration. Relative function was determined in 3 ways: 1) Accumulated renal DTPA activity 60-120 sec. following injection. 2) Amplitude of the tubular phase of the deconvolved renal curve and, 3) Accumulated Tc-99m DMSA activity in renal ROI 4 or 24 hrs. post-injection. Regression analysis revealed: 1) The basic relationship of relative functional data obtained by all three methods was not affected by creatinine, age or other factors. 2) The relationship between the three methods is linear and highly correlated. 3) The DMSA values may be predicted from either method of analyzing the DTPA study using appropriate predictor equations. The authors conclude that Tc-99m DMSA, due to its higher cost and more radiation exposure should not be used for the routine evaluation of relative renal function.

  16. Effects of environmental levels of cadmium, lead and mercury on human renal function evaluated by structural equation modeling

    Trzeciakowski, Jerome P.; Gardiner, Lesley; Parrish, Alan R.

    2014-01-01

    A relationship between exposure to heavy metals, including lead and cadmium, and renal dysfunction has long been suggested. However, modeling of the potential additive, or synergistic, impact of metals on renal dysfunction has proven to be challenging. In these studies, we used structural equation modeling (SEM), to investigate the relationship between heavy metal burden (serum and urine levels of lead, cadmium and mercury) and renal function using data from the NHANES database. We were able to generate a model with goodness of fit indices consistent with a well-fitting model. This model demonstrated that lead and cadmium had a negative relationship with renal function, while mercury did not contribute to renal dysfunction. Interestingly, a linear relationship between lead and loss of renal function was observed, while the maximal impact of cadmium occurred at or above serum cadmium levels of 0.8 µg/L. The interaction of lead and cadmium in loss of renal function was also observed in the model. These data highlight the use of SEM to model interaction between environmental contaminants and pathophysiology, which has important implications in mechanistic and regulatory toxicology. PMID:24769258

  17. Comparative scintigraphic study of renal function with 99mTc-Mercaptoacetyl-triglycine and 99mTc-Ethylenedicysteine

    Beiki D.; Eftekhari M; Fallahi B.; Gheisari F.; Hozhabrosadati M.; Fard-Esfahani A.; Takavar A; Gholamrezanezhad A.; Saghari M. Ansari Gilani K.

    2008-01-01

    99mTc-MAG3 is a standard radiotracer for renal dynamic functional study. Despite its"nproperties for clinical uses, it has numerous technical limitations. 99mTc-EC is also a tubular"nradiotracer for renal imaging, which has not been used worldwide. In this study, the use of 99mTc-EC"nand 99mTc-MAG3 for renal functional study were compared."nMethods: Thirty five patients (20 male, 15 female; mean age of 34.63 ±10.69 years) were entered in"nthe study. About 1...

  18. Architecture of the human renal inner medulla and functional implications.

    Wei, Guojun; Rosen, Seymour; Dantzler, William H; Pannabecker, Thomas L

    2015-10-01

    The architecture of the inner stripe of the outer medulla of the human kidney has long been known to exhibit distinctive configurations; however, inner medullary architecture remains poorly defined. Using immunohistochemistry with segment-specific antibodies for membrane fluid and solute transporters and other proteins, we identified a number of distinctive functional features of human inner medulla. In the outer inner medulla, aquaporin-1 (AQP1)-positive long-loop descending thin limbs (DTLs) lie alongside descending and ascending vasa recta (DVR, AVR) within vascular bundles. These vascular bundles are continuations of outer medullary vascular bundles. Bundles containing DTLs and vasa recta lie at the margins of coalescing collecting duct (CD) clusters, thereby forming two regions, the vascular bundle region and the CD cluster region. Although AQP1 and urea transporter UT-B are abundantly expressed in long-loop DTLs and DVR, respectively, their expression declines with depth below the outer medulla. Transcellular water and urea fluxes likely decline in these segments at progressively deeper levels. Smooth muscle myosin heavy chain protein is also expressed in DVR of the inner stripe and the upper inner medulla, but is sparsely expressed at deeper inner medullary levels. In rodent inner medulla, fenestrated capillaries abut CDs along their entire length, paralleling ascending thin limbs (ATLs), forming distinct compartments (interstitial nodal spaces; INSs); however, in humans this architecture rarely occurs. Thus INSs are relatively infrequent in the human inner medulla, unlike in the rodent where they are abundant. UT-B is expressed within the papillary epithelium of the lower inner medulla, indicating a transcellular pathway for urea across this epithelium. PMID:26290371

  19. Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

    Sijpkens Yvo WJ

    2011-08-01

    Full Text Available Abstract Background To investigate whether high blood pressure accelerates renal function decline in patients with advanced chronic kidney disease (CKD, we studied the association of systolic (SBP and diastolic blood pressure (DBP with decline in renal function and time until the start of renal replacement therapy (RRT in patients with CKD stages IV-V on pre-dialysis care. Methods In the PREPARE-1 cohort 547 incident pre-dialysis patients, referred as part of the usual care to outpatient clinics of eight Dutch hospitals, were included between 1999 and 2001 and followed until the start of RRT, mortality, or end of follow-up (January 1st 2008. Main outcomes were rate of decline in renal function, estimated as the slope of available eGFR measurements, and time until the start of RRT. Results A total of 508 patients, 57% men and median (IQR age of 63 (50-73 years, were available for analyses. Mean (SD decline in renal function was 0.35 (0.75 ml/min/1.73 m2/month. Every 10 mmHg increase in SBP or DBP resulted in an accelerated decline in renal function (adjusted additional decline 0.04 (0.02;0.07 and 0.05 (0.00;0.11 ml/min/1.73 m2/month respectively and an earlier start of RRT (adjusted HR 1.09 (1.04;1.14 and 1.16 (1.05;1.28 respectively. Furthermore, patients with SBP and DBP above the BP target goal of 2/month and an earlier start of RRT (adjusted HR 2.08 (1.25;3.44, compared to patients who achieved the target goal (11%. Comparing the decline in renal function and risk of starting RRT between patients with only SBP above the target (≥ 130 mmHg and patients with both SBP and DBP below the target (2/month and adjusted HR 2.24 (1.26;3.97. Therefore, it seems that especially having SBP above the target is harmful. Conclusions In pre-dialysis patients with CKD stages IV-V, having blood pressure (especially SBP above the target goal for CKD patients (

  20. Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

    Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Péchère-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier

    2014-01-01

    Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Pa...

  1. Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures

    Kim, Bum Soo; Yoo, Eun Sang; Kim, Tae-Hwan; Kwon, Tae Gyun

    2010-01-01

    Purpose Laparoscopic donor nephrectomy is associated with less postoperative pain and faster recovery times in living kidney donors. However, pneumoperitoneum, which is required in laparoscopic donor nephrectomy, can result in adverse effects on renal function in donors and recipients. We compared renal function in donors and recipients after hand-assisted laparoscopic donor nephrectomy (HALDN) and open donor nephrectomy (ODN). Materials and Methods Between January 1997 and January 2008, 241 ...

  2. Comparative study of unilateral renal tubule function using 131I-o-hippuran and sup(99m)Tc-dimercaptosuccinic acid with regard to renal depth and excretion relations

    Good agreement was found between sonographic and nuclear renal depth data. In patients with undisturbed postrenal urodynamics, the data of unilateral renal clearance obtained by DMSA and OIH are in good agreement after depth correction. With OIH, the activity measured for unilateral congestion kidneys was higher than with DMSA. However, both methods may overestimate unilateral congestion kidneys. The OIH method should be favoured in nuclear renal diagnostics. In patients with mobile kidneys, the lower function calculated for the ptotic kidney can be evaluated only after depth correction. To reduce the radiation exposure, renal depth data required for depth correction should be determined by sonographic methods. The peak/scatter method of renal depth determination cannot be employed in practice in the 131J hippurane test; in the sup(99m)Tc-DMSA test, sufficient agreement between peak/scatter quotient and renal depth is only obtained after background correction. The result does not warrant the tedious procedure. DMSA studies of the kidneys are appropriate in the following cases: 1. Emergency studies of unilateral renal function in cases of acute anuria due to postrenal stoppage. 2. Assessment of unilateral parenchymal function in patients with mobile kidneys if the ptotic kidney cannot be imaged by sonographic processes. 3. Search for extremely displaced renal tissue. 4. Unilateral renal function studies in patients with unilateral kidney diseases if the postrenal situation and the global renal function can be assessed by other methods. (orig./MG)

  3. Renal Function and NODM in De Novo Renal Transplant Recipients Treated with Standard and Reduced Levels of Tacrolimus in Combination with EC-MPS

    Laurence Chan

    2012-01-01

    Full Text Available Information is lacking concerning concomitant administration of enteric-coated mycophenolate sodium with tacrolimus (EC-MPS+Tac in renal transplant recipients (RTxR. In this 6-month, prospective, open-label, multicenter study, de novo RTxR were randomized (1 : 1 to low-dose (LD or standard-dose (SD Tac with basiliximab, EC-MPS 720 mg bid, and steroids. Primary objective was to compare renal function at 6-month posttransplantation. Secondary objectives were to compare the incidences of biopsy-proven acute rejection (BPAR, graft loss and death, and new-onset diabetes mellitus (NODM. 292 patients (LD n=151, SD n=141 were included. Mean Tac levels were at the low end of the target range in standard-exposure patients (SD, n=141 and exceeded target range in low-exposure patients (LD = 151 throughout the study. There was no significant difference in mean glomerular filtration rate (GFR between treatments (ITT-population: 63.6 versus 61.0 mL/min. Incidence of BPAR was similar (10.6% versus 9.9%. NODM was significantly less frequent in LD Tac (17% versus 31%; P=0.02; other adverse effects (AEs were comparable. EC-MPS+Tac (LD/SD was efficacious and well tolerated with well-preserved renal function. No renal function benefits were demonstrated, possibly related to poor adherence to reduced Tac exposure.

  4. Renal Function and NODM in De Novo Renal Transplant Recipients Treated with Standard and Reduced Levels of Tacrolimus in Combination with EC-MPS

    Chan, Laurence; Andres, Amado; Bunnapradist, Suphamai; Gugliuzza, Kristene; Parasuraman, Ravi; Peddi, V. Ram; Cassuto, Elisabeth; Hart, Marquis

    2012-01-01

    Information is lacking concerning concomitant administration of enteric-coated mycophenolate sodium with tacrolimus (EC-MPS+Tac) in renal transplant recipients (RTxR). In this 6-month, prospective, open-label, multicenter study, de novo RTxR were randomized (1 : 1) to low-dose (LD) or standard-dose (SD) Tac with basiliximab, EC-MPS 720 mg bid, and steroids. Primary objective was to compare renal function at 6-month posttransplantation. Secondary objectives were to compare the incidences of biopsy-proven acute rejection (BPAR), graft loss and death, and new-onset diabetes mellitus (NODM). 292 patients (LD n = 151, SD n = 141) were included. Mean Tac levels were at the low end of the target range in standard-exposure patients (SD, n = 141) and exceeded target range in low-exposure patients (LD = 151) throughout the study. There was no significant difference in mean glomerular filtration rate (GFR) between treatments (ITT-population: 63.6 versus 61.0 mL/min). Incidence of BPAR was similar (10.6% versus 9.9%). NODM was significantly less frequent in LD Tac (17% versus 31%; P = 0.02); other adverse effects (AEs) were comparable. EC-MPS+Tac (LD/SD) was efficacious and well tolerated with well-preserved renal function. No renal function benefits were demonstrated, possibly related to poor adherence to reduced Tac exposure. PMID:23227307

  5. Morphological and functional analyses of two infants with obstructive renal dysplasia.

    Miura, Kenichiro; Sekine, Takashi; Nishimura, Riki; Kanamori, Yutaka; Yanagisawa, Atsuhiro; Sakai, Kiyohide; Nagata, Michio; Igarashi, Takashi

    2011-08-01

    Renal dysplasia associated with urinary tract obstruction comprises two distinct phenotypes, i.e., multicystic dysplastic kidney (MCDK) and obstructive renal dysplasia (ORD). MCDK is a common manifestation in infants with renal dysplasia, which is characterized by multiloculated thin-walled cysts with no functional parenchyma and an atretic ureter owing to pyelocalyceal occlusion early in fetal life. In contrast, ORD is an extremely rare condition which is caused by severe obstruction of the distal ureter or urethra. Here, we report two infants with ORD. Both patients manifested unilateral kidney enlargement with multiple cortical cysts, mild hydronephrosis, and marked dilatation of the ipsilateral ureter. Contralateral kidneys and urinary tracts revealed no apparent radiological abnormalities. Serial ultrasonographic studies of fetal and neonatal kidneys in both cases revealed that ureteral dilatation was evident at gestational week 16 and 27, respectively, and most of the cortical cysts disappeared within 1-3 months after birth. The functions of the affected kidneys were severely impaired but evident at the time of birth. These manifestations were consistent with a diagnosis of ORD, and were distinct from the features of MCDK. Our observation of fetal and infantile kidneys in these two cases provides us with a better understanding of the pathogenesis of ORD. PMID:21455661

  6. STUDY OF RENAL FUNCTION TESTS IN PATIEN TS OF ACUTE HAEMORRHAGIC STROKE

    Aditya Vardhan

    2015-05-01

    Full Text Available OBJECTIVE: To study renal function tests in patients with acute haemorrhagic stroke and to find association of abnormal renal function with adverse outcome in patients with acute haemorrhagic stroke . MATERIAL AND METHODS: The study was conducted at Darbhanga Medical College & Hospital , Laheriasarai , Darbhanga during the period from January 2012 to September 2013 . This was an observational study . A total of 100 patients presenting with acute haemorrhagic stroke admitted to the hospital or reporting in OPD/Emergency for stroke were included in this study after having taken written informed consent . Cases were selected by random sampling . OBSERVATION: Out of 100 patients with acute haemorrhagic stroke 92 patients had intracerebral haemorrhage and 8 patie nts had subarachnoid haemorrhage . Patients were divided into two groups on the basis of estimated glomerular filtration rate ( eGFR . Group A ( eGFR > 60 ml/min/1 . 73 m 2 BSA comprised of 71% of total stroke patients and group B ( eGFR 98umol/L and 15 ( 68 . 60% patients had blood urea >6 . 8mmol/L . CONCLUSION: This study clearly indicated that renal dysfunction as evidenced by ( a eGFR 98umol/L & c Blood urea >6 . 8mmol/L , are not only an important risk factor for acute haemorrhagic stroke but are also an independent predictor of mortality within 30 days of presentation .

  7. Imaging fetal renal function by means of a fast MR imaging sequence with Gd-DTPA

    Although the use of magnetic resonance (MR) imaging in obstetrics has been reported, this modality has not yet been shown to offer more or different information than ultrasound. The authors studied fetal renal function by injecting Gd-DTPA (100 μg/kg) into a fetal lamb indwelling femoral vein catheter at the start of a fast low-angle shot (FLASH) sequence (repetition time, 06 sec; echo time, 13 msec; flip angle, 400 or 200, one acquisition). Identically positioned images were generated every 8 seconds for 5 minutes and less frequently thereafter. Newborn and older lambs and some adult sheep were similarly studied for comparison. Time-intensity curves from several distinct regions of interest in the kidney demonstrate maturation-related changes in renal handling of the contrast agent

  8. The influence of angiotensin-converting enzyme inhibition on renal tubular function in progressive chronic nephropathy

    Kamper, A L; Holstein-Rathlou, N H; Leyssac, P P; Strandgaard, S

    1996-01-01

    The influence of angiotensin-converting enzyme (ACE) inhibition on renal tubular function in progressive chronic nephropathy was investigated in 69 patients by the lithium clearance (C(Li)) method. Studies were done repeatedly for up to 2 years during a controlled trial on the effect of enalapril...... on progression of renal failure. The pattern of proteinuria was followed over the first 9 months. At baseline, the glomerular filtration rate (GFR) was 5 to 68 mL/min. Absolute proximal tubular reabsorption rate of fluid (APR), estimated as the difference between GFR and C(Li), was 1 to 54 m......L/min. Calculated fractional proximal reabsorption (FPR) was moderately subnormal. During the study, GFR decreased and sodium clearance was unchanged; fractional excretion of sodium therefore increased. In the group of patients randomized to treatment with enalapril (n = 34), GFR at 1 month was 83% (P < 0.001) and...

  9. Chemistry and biology of Tc-99m renal function agents. Final report

    A major aim of the project was to develop a Tc-99m renal tubular function radiopharmaceutical. Progress was made in synthesizing and evaluating Tc-99m 2,3-dimercaptoaceta-midoprepanoate (CO2DADS). In animals and clinical studies the A epimer (early component on reversed phase HPLC) demonstrated high efficiency and specificity for renal tubular secretion. We were unable to obtain only the desired stereoisomer. Synthesis of about twenty diamide dimercaptide N2S2 ligand analogs suggested two others that were of comparable efficiency in humans, but with less difference between stereoisomers; Tc-99m 1,3-dimercaptoacetamide-2-hydroxypropane (HoDADS) and 1,8-dithiol- 2,7-dioxo-3,6-diazanonanoate (α -S-CO2DADS). 15 refs

  10. Renal function is impaired in normotensive chronic HCV patients: role of insulin resistance.

    Sciacqua, Angela; Perticone, Maria; Tassone, Eliezer J; Cimellaro, Antonio; Caroleo, Benedetto; Miceli, Sofia; Andreucci, Michele; Licata, Anna; Sesti, Giorgio; Perticone, Francesco

    2016-06-01

    Renal dysfunction is an independent predictor for cardiovascular morbidity and mortality. We investigated whether chronic hepatitis C virus (HCV) infection and the related insulin resistance/hyperinsulinemia influence renal function in comparison with a group of healthy subjects and with another group with metabolic syndrome. We enrolled 130 newly diagnosed HCV outpatients matched for age and gender with 130 patients with metabolic syndrome and 130 healthy subjects. Renal function was evaluated by calculation of glomerular filtration rate (e-GFR, mL/min/1.73 m(2)) using the CKD-EPI equation. The following laboratory parameters were measured: fasting plasma glucose and insulin, total, LDL- and HDL-cholesterol, triglyceride, creatinine, and HOMA to evaluate insulin sensitivity. HCV patients with respect to both healthy subjects and metabolic syndrome patients have a decreased e-GFR: 86.6 ± 16.1 vs 120.2 ± 23.1 mL/min/1.73 m(2) (P analysis, the correlation between e-GFR and HOMA is similar in the metabolic syndrome (r = -0.555, P analysis, HOMA is the major determinant of e-GFR in both groups, accounting for, respectively, 30.8 and 27.8 % of its variation in the metabolic syndrome and HCV. In conclusion, we demonstrate that HCV patients have a significant reduction of e-GFR and that insulin resistance is the major predictor of renal dysfunction. PMID:26597876

  11. Renal Function Reserve in Chronic Obstructive Pulmonary Disease with Type II Respiratory Failure

    Manal Mahmoud*, Nesriene El Margoushy**, Hassan Shalby* and Aya

    2007-06-01

    Full Text Available Background and objective: increase in renal blood flow in response to certain stimuli such as dopamine infusion, oral protein load, and amino acid infusion. Reduced or absent renal functional reserve (RFR is an early index of renal impairment. Our work studies the (RFR in Chronic Obstructive Pulmonary Disease (COPD patients with chronic compensated type II respiratory failure. Methods: Our study included 15 COPD patients with compensated type II respiratory failure and 5 normal controls. The patient group had mean Pa O2 56.5±6.4 and Pa CO2 56.5±3.2, while in normal controls the mean Pa O2 was 97.4 ± o.3 and Pa CO2 was 42.3 ± 1.2. Hypoxic patients (Pa O2or = 60 mm Hg and Sa O2 > or = 90 % without rise of PaCO2 within 2 hours before and during the study. The pulsatility index (PI, an index of reno-vascular resistance (RVR, was measured non invasively by Doppler Ultrasonograghy at baseline and 20 minutes after infusion of dopamine in diuretic dose. Results: The baseline PI was nearly similar in the control group and in COPD patients (no significant difference, the PI fell significantly in the control group after dopamine infusion from 1.03 ± 0.14 to 0.83 ± 0.1(P< 0.05, but increased significantly in COPD patients from 1.02 ± 0.12 to1.18 ± 0.13 (P<0.05 after dopamine infusion. Conclusion: Renal functional reserve is impaired in hypercapnic COPD patients and this may be a factor in the development of edema frequently seen in these patients

  12. Prospective Randomized Trial Comparing Hepatic Venous Outflow and Renal Function after Conventional versus Piggyback Liver Transplantation.

    Marília D'Elboux Guimarães Brescia

    Full Text Available This randomized prospective clinical trial compared the hepatic venous outflow drainage and renal function after conventional with venovenous bypass (n = 15 or piggyback (n = 17 liver transplantation.Free hepatic vein pressure (FHVP and central venous pressure (CVP measurements were performed after graft reperfusion. Postoperative serum creatinine (Cr was measured daily on the first week and on the 14th, 21st and 28th postoperative days (PO. The prevalence of acute renal failure (ARF up to the 28th PO was analyzed by RIFLE-AKIN criteria. A Generalized Estimating Equation (GEE approach was used for comparison of longitudinal measurements of renal function.FHVP-CVP gradient > 3 mm Hg was observed in 26.7% (4/15 of the patients in the conventional group and in 17.6% (3/17 in the piggyback group (p = 0.68. Median FHVP-CVP gradient was 2 mm Hg (0-8 mmHg vs. 3 mm Hg (0-7 mm Hg in conventional and piggyback groups, respectively (p = 0.73. There is no statistically significant difference between the conventional (1/15 and the piggyback (2/17 groups regarding massive ascites development (p = 1.00. GEE estimated marginal mean for Cr was significantly higher in conventional than in piggyback group (2.14 ± 0.26 vs. 1.47 ± 0.15 mg/dL; p = 0.02. The conventional method presented a higher prevalence of severe ARF during the first 28 PO days (OR = 3.207; 95% CI, 1.010 to 10.179; p = 0.048.Patients submitted to liver transplantation using conventional or piggyback methods present similar results regarding venous outflow drainage of the graft. Conventional with venovenous bypass technique significantly increases the harm of postoperative renal dysfunction.ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT01707810.

  13. Rapid decline in 51Cr-EDTA measured renal function during the first weeks following lung transplantation

    Hornum, M.; Iversen, M.; Steffensen, I.;

    2009-01-01

    We previously described a 54% decline in renal function at 6 months after lung transplantation (LTx). We hypothesized that this decline is a very early event following LTx. Thirty-one consecutive patients (16 females/15 males), mean age 49 (+/-13) years, with emphysema, cystic fibrosis....../bronchiectasis or idiopathic pulmonary fibrosis were included in an analysis of renal function before and after LTx. The glomerular filtration rate (GFR) was measured using the (51)Cr-ethylenediaminetetra acetic acid plasma clearance single injection technique (mGFR) at baseline before transplantation and at 1, 2.......0001), acute renal failure within 2 weeks post-LTx (p = 0.0003), use of heart and lung machine (p = 0.04), and the use of ephedrine (p = 0.048), as well as increasing age, older than 18 years at LTx (p = 0.006). These data demonstrate that renal function, measured with an isotope method, decreases dramatically...

  14. Effects of hyperuricemia on renal function of renal transplant recipients: a systematic review and meta-analysis of cohort studies.

    Yan Huang

    Full Text Available BACKGROUND: Hyperuricemia is an independent risk factor of nephropathy, but its role in renal transplant recipients (RTRs is controversial. METHODS: Based on the methods of Cochrane systematic reviews, we searched MEDLINE (1948-2011.6, EMBASE (1956-2011.6, CBM (Chinese Biomedicine Database (1978-2011.6 to identify cohort studies assessing the association between uric acid level and kidney allograft. Two authors independently screened the studies, assessed the risk of bias of included studies and extracted data. Unadjusted odds ratio (OR, mean difference (MD, adjusted hazard ratio (aHR and their corresponding 95%CI were pooled to assess the effects of hyperuricemia on kidney allograft. RESULTS: Twelve cohort studies were included and the quality was moderate to high based on the NEWCASTLE-OTTAWA quality assessment scale. RTRs with hyperuricemia had lower eGFR (P<0.0001, 95%CI-16.34∼6.14 and higher SCr (P<0.00001, 95%CI 0.17∼0.31 than those with normal uric acid level. Meta-analysis showed that hyperuricemia was a risk factor of chronic allograft nephropathy (Unadjusted OR = 2.85, 95%CI 1.84∼4.38, adjusted HR = 1.65, 95%CI 1.02∼2.65 and graft loss (Unadjusted OR = 2.29, 95%CI 1.55∼3.39; adjusted HR = 2.01, 95%CI 1.39∼2.94. CONCLUSIONS: Current evidence suggests that hyperuricemia may be an independent risk factor of allograft dysfunction. Hyperuricemia may modestly increase the risk of poor outcomes of RTRs. Future research is needed to verify whether lowering uric acid level could improve the kidney function and prognosis of RTRs with hyperuricemia.

  15. Relative renal function estimate by renal scintigraphy with 99mTc-DMSA: influence of attenuation correction methods

    Andreia Amaro

    2015-05-01

    Full Text Available Introduction – The estimate of relative renal function (RRF through scintigraphy with dimercaptosuccinic acid labelled with Technetium-99 metastable (99mTc-DMSA may be influenced by kidney depth (KD, due to attenuation by soft tissue surrounding the kidneys. Considering that rarely this KD is known, several methods for attenuation correction (AC have been developed, namely those using empirical formulae, such as Raynaud, Taylor or Tonnesen methods, or by direct calculation of the geometric mean (GM. Objectives – To identify the influence of different AC methods on RRF estimateby scintigraphy with 99mTc-DMSA and to evaluate the respective KD variability. Methods: Thirty-one patients were referred for 99mTc-DMSA scintigraphy and underwent the same acquisition protocol. Processing was performed by 2 independent operators, three times per exam, changing for the same processing the methods for the FRR determination: Raynaud’s method, Taylor’s method, Tonnesen´s method, GM and without AC (WAC. Friedman’s test was used to identify the influence of the different AC methods on RRF estimate and Pearson’s correlation test was used to evaluate the association and significance between KD and the variables age, weight and height. Results – Friedman’s test indicated that there were significant differences between methods (p=0.000, except for WAC/Raynaud, Tonnesen/GM and Taylor/GM (p=1.000 comparisons, for both kidneys. Pearson’stest showed a strong positive correlation between weight and the three methods of KD estimation. Conclusions – Taylor’s method, regarding the three methods of KD calculation, is the closest to GM. The choice of the attenuation correction method influences significantly the quantitative parameters of FRR.

  16. RENAL CRYOABLATION

    A. V. Govorov

    2014-08-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  17. Repeated administrations of peptide receptor radionuclide therapy: long term follow-up of renal function

    Full text of publication follows. Aim: the aim of this study is to evaluate renal function modifications at renal dynamic scintigraphy (RDS) with GFR estimation in neuroendocrine tumor (NET) patients treated with peptide receptor radionuclide therapy (PRRT). Materials and methods: we reviewed clinical records of 31 patients with NET (15 Females and 16 Males, mean age 59.8 years, range 37-79) referred to the Unit of Nuclear Medicine of our University Hospital for PRRT. Histological diagnoses were: pancreatic neuroendocrine carcinoma (NEC) in 10, ileal NEC in 4, NEC of unknown origin in 4, duodenal NEC in 1, mediastinal NEC in 1, thymic NEC in 1, mesenterial NEC in 1, lung carcinoid in 2, carcinoid of unknown origin in 2, pancreatic carcinoid in 1, ileal carcinoid in 1, medullary thyroid carcinoma in 1 and intracranial meningiomatosis in 2 patients. All patients were treated with 111In-Pentetreotide (1-7 cycles, median 4 cycles, activity range per cycle 1.1-7.5 GBq, median activity per cycle 5.5 GBq, mean cumulative activity 16.2 GBq) and/or 90Y-DOTATOC/DOTATATE (1-7 cycles, median 3 cycles, activity range per cycle 0.74-2.6 GBq, median activity per cycle 1.9 GBq, mean cumulative activity 10.3 GBq) and/or 177Lu-DOTATATE (1-4 cycles, median 2 cycles, activity range per cycle 3.7-7.0 GBq, median activity per cycle 5.5 GBq, cumulative activity 11.9 GBq). Each patient underwent 1 to 13 PRRT cycles. Intravenous aminoacids were always administered prior to PRRT for reducing tubular peptide uptake and minimize renal damage. 19 patients had co-morbidity factors (diabetes, hypertension, dyslipidemia). Renal function evaluation by RDS was performed before each PRRT cycle; creatinine and azotaemia serum levels were also recorded. Results. Baseline GFR ranged 58 to 129 ml/min/1.73 m2. GFR decrease ranged 4 to 52.4% (mean: 22.7%). A statistical significant correlation between GFR percentage reduction with cumulative administered activity was found only for 90Y

  18. Cholesterol-crystal embolism presenting with delayed graft function and impaired long-term function in renal transplant recipients: two case reports

    Pliquett Rainer U

    2009-03-01

    Full Text Available Abstract Introduction Impaired renal function and/or pre-existing atherosclerosis in the deceased donor increase the risk of delayed graft function and impaired long-term renal function in kidney transplant recipients. Case presentation We report delayed graft function occurring simultaneously in two kidney transplant recipients, aged 57-years-old and 39-years-old, who received renal allografts from the same deceased donor. The 62-year-old donor died of cardiac arrest during an asthmatic state. Renal-allograft biopsies performed in both kidney recipients because of delayed graft function revealed cholesterol-crystal embolism. An empiric statin therapy in addition to low-dose acetylsalicylic acid was initiated. After 10 and 6 hemodialysis sessions every 48 hours, respectively, both renal allografts started to function. Glomerular filtration rates at discharge were 26 ml/min/1.73m2 and 23.9 ml/min/1.73m2, and remained stable in follow-up examinations. Possible donor and surgical procedure-dependent causes for cholesterol-crystal embolism are discussed. Conclusion Cholesterol-crystal embolism should be considered as a cause for delayed graft function and long-term impaired renal allograft function, especially in the older donor population.

  19. Renal function affects absorbed dose to the kidneys and haematological toxicity during {sup 177}Lu-DOTATATE treatment

    Svensson, Johanna; Berg, Gertrud [Sahlgrenska University Hospital, Department of Oncology, Goeteborg (Sweden); Waengberg, Bo [Sahlgrenska University Hospital, Department of Surgery, Goeteborg (Sweden); Larsson, Maria [University of Gothenburg, Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy, Goeteborg (Sweden); Forssell-Aronsson, Eva; Bernhardt, Peter [University of Gothenburg, Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy, Goeteborg (Sweden); Sahlgrenska University Hospital, Department of Medical Physics and Medical Bioengineering, Goeteborg (Sweden)

    2015-05-01

    Peptide receptor radionuclide therapy (PRRT) has become an important treatment option in the management of advanced neuroendocrine tumours. Long-lasting responses are reported for a majority of treated patients, with good tolerability and a favourable impact on quality of life. The treatment is usually limited by the cumulative absorbed dose to the kidneys, where the radiopharmaceutical is reabsorbed and retained, or by evident haematological toxicity. The aim of this study was to evaluate how renal function affects (1) absorbed dose to the kidneys, and (2) the development of haematological toxicity during PRRT treatment. The study included 51 patients with an advanced neuroendocrine tumour who received {sup 177}Lu-DOTATATE treatment during 2006 - 2011 at Sahlgrenska University Hospital in Gothenburg. An average activity of 7.5 GBq (3.5 - 8.2 GBq) was given at intervals of 6 - 8 weeks on one to five occasions. Patient baseline characteristics according to renal and bone marrow function, tumour burden and medical history including prior treatment were recorded. Renal and bone marrow function were then monitored during treatment. Renal dosimetry was performed according to the conjugate view method, and the residence time for the radiopharmaceutical in the whole body was calculated. A significant correlation between inferior renal function before treatment and higher received renal absorbed dose per administered activity was found (p < 0.01). Patients with inferior renal function also experienced a higher grade of haematological toxicity during treatment (p = 0.01). The residence time of {sup 177}Lu in the whole body (range 0.89 - 3.0 days) was correlated with grade of haematological toxicity (p = 0.04) but not with renal absorbed dose (p = 0.53). Patients with inferior renal function were exposed to higher renal absorbed dose per administered activity and developed a higher grade of haematological toxicity during {sup 177}Lu-DOTATATE treatment. The study confirms the

  20. Partial Recovery of Delayed Graft Function due to Cholesterol Emboli after Renal Transplantation

    Ackoundou-N'Guessan C

    2008-01-01

    Full Text Available A 65-year-old man who received a deceased renal allograft in September 2001. The donor of the allograft was a 54-year-old hypertensive man who expired from intracerebral hemorrhage. Atheroma with hard plaques was present in both renal arteries and aortic patches. After vascular anastomosis and clamp release, the allograft recolo-ration was inadequate, and the patient remained anuric. Computerized tomography scan demonstrated disseminated infarction areas, suggesting cholesterol emboli, which was confirmed later by a graft biopsy. As approximately 50% of the renal parenchyma was perfused, graft nephrectomy was not indicated and dialysis was restarted. Diuresis was over 3000 ml/day and serum creatinine decreased and stabilized at 360 µmol/L by the 32 nd postoperative day. The allograft supported the patient for only two years, and he eventually was successfully retransplanted in June 2003. We believe that delayed graft function due to cholesterol emboli disease may be reversible if areas of infarction are not too large.

  1. Does injection of metanephric mesenchymal cells improve renal function in rats?

    Yu-qing Jiao

    2011-01-01

    Full Text Available Chronic kidney disease (CKD is a massive global health-care problem. Cell therapy offers a potential treatment for CKD. The aim of this study was to investigate whether the administration of a population of stem cells could be used to treat adriamycin (ADR-induced glomerulopathy in rats, a form of CKD. We intravenously transplanted metanephric mesenchymal cells (MMCs into rats treated with ADR. We also induced MMC differentiation in vitro using a medium derived from serum and homogenates of ADR-induced glomerulopathy rats. We detected the induction of an early epithelial phenotype (cytokeratin-18 expression and a proximal tubule phenotype (vitamin D receptor expression in vitro, and MMC-derived epithelial cells corresponding to the proximal tubule and glomeruli in vivo. Transplantation of MMCs after induction of glomerulopathy significantly increased the creatinine clearance rate (Ccr, a marker for glomerular filtration rate, but had no significant effect on other parameters (24-hour urinary protein excretion, serum albumin, total cholesterol. In addition, there was no significant difference in blood urea nitrogen or serum creatinine levels in rats with and without ADR administration. Our results indicate that MMCs might survive, engraft and differentiate into renal epithelia in vivo when transplanted into ADR-treated rats. However, further studies are needed to determine whether MMC transplantation improves renal function and causes renal repair in this model.

  2. Long-term follow-up of patients after acute kidney injury: patterns of renal functional recovery.

    Etienne Macedo

    Full Text Available BACKGROUND AND OBJECTIVES: Patients who survive acute kidney injury (AKI, especially those with partial renal recovery, present a higher long-term mortality risk. However, there is no consensus on the best time to assess renal function after an episode of acute kidney injury or agreement on the definition of renal recovery. In addition, only limited data regarding predictors of recovery are available. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: From 1984 to 2009, 84 adult survivors of acute kidney injury were followed by the same nephrologist (RCRMA for a median time of 4.1 years. Patients were seen at least once each year after discharge until end stage renal disease (ESRD or death. In each consultation serum creatinine was measured and glomerular filtration rate estimated. Renal recovery was defined as a glomerular filtration rate value ≥60 mL/min/1.73 m2. A multiple logistic regression was performed to evaluate factors independently associated with renal recovery. RESULTS: The median length of follow-up was 50 months (30-90 months. All patients had stabilized their glomerular filtration rates by 18 months and 83% of them stabilized earlier: up to 12 months. Renal recovery occurred in 16 patients (19% at discharge and in 54 (64% by 18 months. Six patients died and four patients progressed to ESRD during the follow up period. Age (OR 1.09, p<0.0001 and serum creatinine at hospital discharge (OR 2.48, p = 0.007 were independent factors associated with non renal recovery. The acute kidney injury severity, evaluated by peak serum creatinine and need for dialysis, was not associated with non renal recovery. CONCLUSIONS: Renal recovery must be evaluated no earlier than one year after an acute kidney injury episode. Nephrology referral should be considered mainly for older patients and those with elevated serum creatinine at hospital discharge.

  3. Thyroid function modifies the association between ratio of triglyceride to high-density lipoprotein cholesterol and renal function: a multicenter cross-sectional study.

    Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun

    2015-01-01

    Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism. PMID:26179571

  4. Absorption Spectra of Ni and Co Nanoparticles using Density Functional Theory

    Metal nanoparticles (NPs) demonstrate excellent electronic properties due to quantum confinement effects and have tremendous applications in catalysts, optics, single-electron devices, bio-chemical sensors, etc. We propose quantum mechanics method for the calculation of absorption spectra of conduction electrons of some transition metal NPs using time-independent Schrodinger equation and approximate the solution by density functional theory. The total energy functional is obtained from the ground-state energy functional of Thomas-Fermi-Dirac- Weizsaecker atomic system. The absorption function was derived and replaced the density function in the final Euler-Lagrange equation. The total energy functional can then be computed numerically for isolated Ni and Co NPs having fcc lattice structure and different nano sizes. The results show a red-shift absorption peak increase with increasing diameter of nanosphere correspond to the number of atoms required to form nanoparticles of respective sizes. (author)

  5. The changes in renal function after a single dose of intravenous furosemide in patients with compensated liver cirrhosis

    Mejirisky Yoram; kayal Mohib; Assy Nimer; Gorenberg Miguel; Hussein Osamah; Schlesinger Sorina

    2006-01-01

    Abstract Background Patients with compensated Child-A cirrhosis have sub clinical hypovolemia and diuretic treatment could result in renal impairment. Aim To evaluate the changes in renal functional mass as reflected by DMSA uptake after single injection of intravenous furosemide in patients with compensated liver cirrhosis. Methods Eighteen cirrhotic patients were divided in two groups; eight patients (group 1, age 56 ± 9.6 yrs, Gender 5M/3F, 3 alcoholic and 5 non alcoholic) were given low i...

  6. Association between microalbuminuria and subclinical atherosclerosis evaluated by carotid artery intima-media in elderly patients with normal renal function

    Kong XiangLei; Jia XiaoYan; Wei Yong; Cui MeiYu; Wang ZunSong; Tang LiJun; Li WenBin; Zhu ZhuXian; Chen Ping; Xu DongMei

    2012-01-01

    Abstract Background Moderate to severe renal insufficiency and albuminuria have been shown to be independent risk factors for atherosclerosis. However, little is known about the direct association between subclinical atherosclerosis evaluated by carotid artery intima-media thickness (IMT) and microalbuminuria in elderly patients with normal renal function. Methods Subjects were 272 elderly patients (age  ≥ 60 years) with normoalbuminuria (n = 238) and microalbuminuria (n = 34). Carotid IMT wa...

  7. Effect of naringin on hemodynamic changes and left ventricular function in renal artery occluded renovascular hypertension in rats

    Asjad Visnagri; Mohammad Adil; Amit D Kandhare; Subhash L. Bodhankar

    2015-01-01

    Background: Renal artery occlusion (RAO) induced hypertension is a major health problem associated with structural and functional variations of the renal and cardiac vasculature. Naringin a flavanone glycoside derived possesses metal-chelating, antioxidant and free radical scavenging properties. Objective: The objective of this study was to investigate the antihypertensive activity of naringin in RAO induced hypertension in rats. Material and Methods: Male Wistar rats (180-200 g) were divided...

  8. Assessment of beta-cell function and insulin secretion in subjects that underwent renal transplantation.

    Tura, Andrea; Hecking, Manfred; Wolzt, Michael; Saemann, Marcus D; Pacini, Giovanni

    2015-08-01

    In this study we aimed to assess the performance of various indices of beta-cell function derived from oral glucose tolerance test (OGTT) in subjects that underwent renal transplantation. Impaired insulin secretion seems in fact central for development of new onset diabetes after transplantation, but its assessment has not been systematically evaluated. Twenty subjects underwent a 75 g 2h-OGTT for measurement of glucose, insulin, C-peptide. OGTT indices of beta-cell function were either derived by mathematical modeling (yielding the reference index: glucose sensitivity) or were empirical: insulinogenic index (IGI), IGI derived indices, whole shape C-peptide (WHOSH_CP). Indices of beta cell function, showed significant correlation with glucose sensitivity (R(2)=0.40-0.86, all Pbody mass index, mean glycemia. In conclusion, in transplanted subjects OGTT empirical indices are typically acceptable for the estimation of beta-cell function. PMID:26736770

  9. Value of detection of myocardial enzymes, troponin T, liver and renal function in children with severe pneumonia

    Zhen Wang; Bin Wang; Lin Fu; Xue Ren

    2016-01-01

    Objective:To analyze the significance of myocardial enzymes, cardiac troponin T (Troponin T, cTnT), liver and renal function in children with severe pneumonia. Methods:A total of 164 children with pneumonia who were admitted in our hospital from March, 2014 to March, 2015 were included in the study and divided into the severe pneumonia group (n=82) and the common pneumonia group (n=82). The myocardial enzymes (AST,α-HBDH, LD, CK-MB), troponin T, and liver and renal function indicators (UCr, Alb, ALT) in the two groups were observed and compared. According to the arterial partial pressure of oxygen, the children with severe pneumonia were divided into the varying degrees of hypoxia groups, i.e. mild hypoxia group, moderate hypoxia group, and severe hypoxia group. The myocardial enzymes, troponin T, and liver and renal function in the three groups were compared. The correlation of partial pressure of blood oxygen with myocardial enzymes, troponin T, and liver and renal function was analyzed. Results:In the severe pneumonia group, the myocardial enzymes AST, LD, CK, HBDH, CK-MB was significantly higher than that in the ordinary pneumonia group;UCr, Alb ALT troponin T was significantly higher than that in the ordinary pneumonia group;With the increasing hypoxia degree, the levels of myocardial enzymes, troponin T, and liver and renal function indicators in the mild hypoxia group, moderate hypoxia group, and severe hypoxia group were elevated. In the severe pneumonia group, the partial pressure of blood oxygen was negatively correlated with myocardial enzymes, troponin T, and liver and renal function. Conclusions:Timely monitoring of the levels of myocardial enzymes, troponin T, and liver and renal function indicators in the clinic is extremely crucial to evaluate the progression in children with severe pneumonia.

  10. Can Tc 99m DTPA be Used in Adult Patients in Evaluation of Relative Renal Function Measurement as the Reference Tc99 DMSA Method ?

    Hülya Yalçın

    2011-04-01

    Full Text Available Objective: In the literature, there are many reports comparing relative renal function calculated with Tc 99m DTPA and Tc 99m DMSA in adults and children. However, there is no consensus about the results. As there is indeterminacy in the reliability of Tc 99m DTPA for the calculation of the relative renal functions, we retrospectively designed a study to compare the relative renal functions measured with Tc 99m DMSA and Tc 99m DTPA in adult patients with renal diseases Material and Methods: We retrospectively analyzed the data of 144 patients who applied to Nuclear Medicine Department of three hospitals between 2009 and 2010 and who had both dynamic and static renal imaging. Renal dynamic scintigraphies were compared to the relative function measured using Tc 99m DMSA static scintigraphy. Comparison of relative renal function measurements using dynamic and static renal scintigraphies was performed using Pearson correlation test. The comparison results were expressed with Bland-Altman analysis. Results: The study was conducted with 144 patients and 288 kidneys. Fifty six of patients were male. Mean age was 39.9±15.2 years. Thirty four patients had hydronephrosis, 28 pyelonephritis, 53 renal calculi, 3 chronic renal failure, 2 acute renal failure, 1 benign renal neoplasia, 15 renal atrophy, 8 ureteropelvic junction stenosis. Relative renal function was calculated in Tc 99m DMSA and 99m Tc-DTPA studies. The mean relative renal functions measured with Tc 99m DTPA was 52.54±23.09% and 47.25±23.09, with Tc 99m DMSA 52.85±21.80% and 47.07±21.77% for right and left kidneys, respectively. In bivariate correlation analysis (Pearson a significant positive correlation was found between the relative renal functions calculated with Tc 99m DTPA and Tc 99m DMSA (r =0.937, p< 0.001. In Bland-Altman plots, the mean difference between two methods was 0.3 and the correlation limits were between 16.2 to -15.5. Conclusion: As a result, we concluded that Tc 99m

  11. Chronic sleep restriction during pregnancy--repercussion on cardiovascular and renal functioning of male offspring.

    Ingrid L B Lima

    Full Text Available Changes in the maternal environment can induce fetal adaptations that result in the progression of chronic diseases in the offspring. The objective of the present study was to evaluate the effects of maternal chronic sleep restriction on blood pressure, renal function and cardiac baroreflex response on male offspring at adult age. Female 3-month-old Wistar rats were divided in two experimental groups: control (C and chronic sleep restricted (CSR. Pregnancy was confirmed by vaginal smear. Chronic sleep restricted females were subjected to sleep restriction by the multiple platform technique for 20 h daily, between the 1st and 20th day of pregnancy. After birth, the litters were reduced to 6 rats per mother, and were designated as offspring from control (OC and offspring from chronic sleep restricted (OCSR. Indirect blood pressure (BPi - tail cuff was measured by plethysmography in male offspring at 3 months old. Following, the renal function and cardiac baroreflex response were analyzed. Values of BPi in OCSR were significantly higher compared to OC [OC: 127 ± 2.6 (19; OCSR: 144 ± 2.5 (17 mmHg]. The baroreflex sensitivity to the increase of blood pressure was reduced in OCSR [Slope: OC: -2.6 ± 0.15 (9; OCRS: -1.6 ± 0.13 (9]. Hypothalamic activity of ACE2 was significantly reduced in OCSR compared to OC [OC: 97.4 ± 15 (18; OSR: 60.2 ± 3.6 (16 UAF/min/protein mg]. Renal function alteration was noticed by the increase in glomerular filtration rate (GFR observed in OCSR [OC: 6.4 ± 0.2 (10; OCSR: 7.4 ± 0.3 (7]. Chronic sleep restriction during pregnancy caused in the offspring hypertension, altered cardiac baroreflex response, reduced ACE-2 activity in the hypothalamus and renal alterations. Our data suggest that the reduction of sleeping time along the pregnancy is able to modify maternal homeostasis leading to functional alterations in offspring.

  12. Biological markers for kidney injury and renal function in the intensive care unit

    Schultz, M.J.; Spronk, P.E.; Royakkers, A.A.N.M.

    2014-01-01

    The purpose of the investigations described in this thesis was to seek for answers to two relevant questions in ICUs in resource-rich settings, i.e., can new biological markers play a role in early recognition of AKI, and can new biological markers predict recovery of renal function in patients who receive CVVH? A second aim was to answer a relevant question in ICUs in resource-poor settings, i.e., can novel biological markers predict development of AKI and need for RRT in patients with sever...

  13. Effects of Acute Grayanotoxin-I Administration on Hepatic and Renal Functions in Rats

    AŞÇIOĞLU, Meral

    2000-01-01

    The effects of acute Grayanotoxin-I (GTX-I) administration on hepatic and renal functions in rats were investigated. GTX-I was administrated to the animals of groups 1, 2 and 3 at a single i.p. dose of 1 mg/kg, 0.5 mg/kg and 0.25 mg/kg respectively, and group 4 (control) received i.p. saline (0.9 %) solution only. One hour following the administration of GTX-I or saline, urine analysis (leukocytes, urobilinogen, protein, pH, blood, ketone, glucose, nitrites) was performed and serum...

  14. The Impact of Nonalcoholic Fatty Liver Disease on Renal Function in Children with Overweight/Obesity.

    Pacifico, Lucia; Bonci, Enea; Andreoli, Gian Marco; Di Martino, Michele; Gallozzi, Alessia; De Luca, Ester; Chiesa, Claudio

    2016-01-01

    The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR disease. PMID:27472326

  15. Changes of blood Cys C, creatinine and hemoglobin levels in patients with different degrees of renal function impairment

    Objective: To study the changes of blood cystatin C(Cys C),creatinine and hemoglobin levels in patients with different levels of GFR. Methods: GFR levels were examined with renal dynamic imaging(with 99mTc-DTPA) in 201 patients with various kinds of chronic renal diseases. Blood Cys C, creatinine and hemoglobin levels were determined with biochemistry in these patients.The patients were divided into 5 groups according to their GFR levels: Group A, GFR≥80 min/ml(renal function normal, n = 21), Group B, 60 ml/min≤GFR0.05). Anemia with significant decrease of hemoglobin levels developed in Group D and Group E patients. Blood levels of both Cys C and creatinine were significantly negatively correlated with GFR levels. However, in patients with mild renal function impairment, Cys C was a more sensitive indicator. In this study, among the 39 Group B patients, Cys C levels were increased in 32 cases (82.1%), but creatinine levels were increased in 14 cases (35.9%) only: the difference was significantly(χ2=17.168, P<0.01). Conclusion: Changes of blood Cys C levels could reflect renal function impairment better than changes of blood creatinine level did, especially at the initial stage. Anemia developed later in the course of chronic renal failure. (authors)

  16. Evaluation of factors causing delayed graft function in live related donor renal transplantation

    Sharma A

    2010-01-01

    Full Text Available To determine the incidence and determinants of delayed graft function due to post-transplant acute tubular necrosis in live related donor renal transplantation. This is a retrospective study of 337 recipients of live related donor renal graft performed between1986 and 2006. Of these recipients, 24 (7.1% subjects developed delayed graft function with no evidence of acute rejection, cyclosporin toxicity, vascular catastrophe or obstructive cause and had evidence of acute tubular necrosis (ATN Group. These subjects were compared with recipients (n= 313, 92.9% who had no clinical or biochemical evidence of ATN. Mean age, and gender distribution of recipients was similar in the two groups (ATN group 35.7 ± 8.3, non-ATN group 34.3 ± 7.5, P= 0.43. Gender distribution of the recipients (men 279, 89.1% vs. 21, 87.5%, P= 0.80 as well as donors (women 221, 70.6% vs. 18, 75.0%, P= 0.75 was also similar. In ATN group as compared with non-ATN group the donor age was significantly greater (56.6 ± 8.3 vs. 46.6 ± 11.2 years, P< 0.0001. There was marginal difference in pre-operative systolic BP (154.5 ± 18.3 vs. 147.4 ± 20.2 mm Hg, P= 0.077 and significant difference in diastolic BP (87.8 ± 9.5 vs. 83.4 ± 11.4 mmHg, P= 0.041. Incidence of multiple renal arteries was similar (16.7% vs. 7.3%, P= 0.22. The warm ischemia time was significantly greater in ATN group (33.3 ± 6.2 min as compared to non-ATN group (30.4 ± 5.7 min, P= 0.042. Duration of hospital stay was more in ATN group (19.9 ± 6.7 vs. 16.8 ± 8.4 days, P= 0.04 but there was no difference in 1 year survival (284 subjects, 90.7% vs. 21 subjects, 87.5%, P= 0.873. This study shows that greater donor age, higher baseline diastolic BP and greater warm ischemia time are major determinants of delayed graft function due to acute tubular necrosis after related donor renal transplantation.

  17. Technical parameters affecting differential renal function estimation using Tc 99m MAG3 scintigraphy

    Introduction: Differential renal function (DRF) is an important parameter that is assessed from virtually every dynamic renal scintigraphy. Standardization of DRF estimation is very important, as this is a measurement of individual kidney function used in gamma camera based techniques for estimating Tc99m MAG3 clearance. The aim of this study was to assess the effect of different acquisition and processing parameters on the estimation of DRF. Material and methods: Retrospective study of 24 patients (2.5-73 yrs). The patients were divided into 3 groups: 1)Normal renogram pattern (DRF within 45/55). 2) Abnormal renogram patterns (DRF>20%). 3) One kidney with DRF<20% (poor functioning). In each group we investigated the effect on DRF of the following parameters in all patients: renal ROIs (rectangular or fitting), background ROIs (manual subrenal, perirenal, lateral and automated elliptical), with and without correction for kidneys depth attenuation, time interval (1-2, 2-3 min) for calculation of renal counts, and matrix size (128 x 128, 64 x 64). Results: Two experienced readers evaluated the results: 1. DRF did not differ among the two time intervals. 2. DRF calculated in group 1 using subrenal background ROI was significantly different from that of perirenal and flanking background ROI's on 64x64 matrix (p= 0.0095, 0.055 respectively), whereas no difference was found in 128x128 where all types of background ROI's gave almost the same results. 3. Mean left kidney depth from height and weight formula (7.6+ 2.57 cm)was significantly different (p= 0.000237,t test) from formula of age, height and weight ( 8.7±3.18 cm), yet DRF did not change significantly, when attenuation correction was applied using these formulas. 4. Good correlation (r = 0.98) was observed between the two readers. Conclusion: Matrix size of 128x128 increased the reliability and accuracy for drawing ROIs. It eliminated the differences found within different locations and size of background (ROI

  18. Long-term effects of pediatric extracorporeal shockwave lithotripsy on renal function

    Akin Y

    2014-04-01

    Full Text Available Yigit Akin,1 Selcuk Yucel21Department of Urology, Harran University School of Medicine, Sanliurfa, Turkey; 2Department of Urology, Acibadem University School of Medicine, Istanbul, TurkeyIntroduction: Extracorporeal shock wave lithotripsy (ESWL is a well-known and successful treatment modality. In addition, it can be used in premature infants. ESWL is used to treat kidney and ureter stones in children. However, although it is a preferred noninvasive treatment in that setting, there is debate about its long-term effects on growing kidneys in children.Objectives: To investigate the long-term effects of pediatric ESWL on renal function in light of updated literature.Methods: PubMed and Medline were searched for studies on ESWL in a pediatric population with keywords including efficacy, child, kidney calculi, ureter calculi, lithotripsy, injury, vascular trauma, and shock waves. The research was limited to the English literature during a period from 1980 to 2014. In total, 3,000 articles were evaluated, but only 151 papers were considered. Only the manuscripts directly related to the reviewed subjects were included in the current study.Results: However, the acute effects of ESWL in kidney are well-described. Although there are limited studies on the long-term effects of ESWL in children, there is a widespread opinion that ESWL is not affecting renal functions in the long-term.Conclusion: ESWL is a safe, effective, and noninvasive treatment option in children. Although ESWL can cause some acute effects in the kidney, there is no long-term effect on the growing kidneys of children.Keywords: child, lithotripsy, nephrolithiasis, renal injury, vascular trauma

  19. Lovastatin protects mithochondrial and renal function in kidney ischemia-reperfusion in rats Lovastatina protege a função renal e mitocondrial na isquemia/reperfusão renal em ratos

    Silvio Tucci Junior

    2012-07-01

    Full Text Available PURPOSE: To investigate the effect of lovastatin on renal ischemia followed by reperfusion. METHODS: Thirty one Wistar rats submitted to left renal ischemia for 60 minutes followed by contralateral nephrectomy were divided into two groups: A (n =17, control, no treatment, and B (n=14, lovastatin 15 mg/kg/day p.o. ten days before ischemia. The animals were sacrificed at the end of ischemia, after 24 hours and at seven days after reperfusion. Survival, serum urea and creatinine levels and renal mitochondrial function were evaluated. RESULTS: Mortality was 29.4% in group A and 0.7% in group B. Urea and creatinine levels were increased in both groups, but the values were significantly lower in group B. Mitochondrial function showed decoupling in 83.4% of group A, as opposed to 38.4/% of group B. CONCLUSIONS: The result shows a protective action of renal function by lovastatin administered before ischemia/reperfusion. Since most of the mitochondrial fraction presented membranes with the ability to maintain ATP production in group B, stabilization of the mitochondrial membrane should be considered as part of the protective action of lovastatin on renal function in ischemia/reperfusion.OBJETIVO: Investigar a ação da lovastatina na isquemia renal seguida de reperfusão. MÉTODOS: Trinta e um ratos Wistar submetidos à isquemia renal esquerda durante 60 minutos, seguida da nefrectomia contralateral, foram distribuídos em dois grupos: A (n=17, controle, sem tratamento e B (n=14, recebendo 15 mg/Kg/dia de lovastatina via oral, durante os dez dias que antecederam a isquemia. Os animais foram mortos ao final da isquemia, e com 24 horas e sete dias após a reperfusão. Foram avaliadas a sobrevida, os valores séricos de uréia e creatinina e a função mitocondrial renal. RESULTADOS: A mortalidade foi 29,4% no grupo A e 0,7% no grupo B. Os níveis de uréia e creatinina elevaram-se nos dois grupos, mas foram significativamente menores no grupo B. No grupo

  20. Pharmacokinetics and safety of olodaterol administered with the Respimat Soft Mist inhaler in subjects with impaired hepatic or renal function

    Kunz, Christina; Luedtke, Doreen; Unseld, Anna; Hamilton, Alan; Halabi, Atef; Wein, Martina; Formella, Stephan

    2016-01-01

    Purpose In two trials, the influences of hepatic and renal impairment on the pharmacokinetics of olodaterol, a novel long-acting inhaled β2-agonist for treatment of COPD, were investigated. Subjects and methods The first trial included eight subjects with mild hepatic function impairment (Child–Pugh A), eight subjects with moderate impairment (Child–Pugh B), and 16 matched healthy subjects with normal hepatic function. The second trial included eight subjects with severe renal impairment (creatinine clearance <30 mL·min−1) and 14 matched healthy subjects with normal renal function. Subjects received single doses of 20 or 30 μg olodaterol administered with the Respimat Soft Mist inhaler. Results Olodaterol was well tolerated in all subjects. The geometric mean ratios and 90% confidence intervals of dose-normalized area under the plasma concentration-time curve from time zero to 4 hours (AUC0–4) for subjects with mild and moderate hepatic impairment compared to healthy subjects were 97% (75%–125%) and 105% (79%–140%), respectively. Corresponding values for dose-normalized maximum concentration (Cmax) were 112% (84%–151%) (mild impairment) and 99% (73%–135%) (moderate impairment). The geometric mean ratio (90% confidence interval) of AUC0–4 for subjects with severe renal impairment compared to healthy subjects was 135% (94%–195%), and for Cmax was 137% (84%–222%). There was no significant relationship between creatinine clearance and AUC0–4 or Cmax. Renal clearance of olodaterol was reduced to 20% of normal in severe renal impairment. Conclusion Mild to moderate hepatic function impairment or severe renal function impairment did not result in a clinically relevant increase of olodaterol systemic exposure after a single inhaled dose. PMID:27051282

  1. Atlas of nuclear methods for renal function tests in paediatric medicine. Atlas der nuklearmedizinischen Nierenfunktionsdiagnostik im Kindesalter

    Lauer, O.; Langhammer, H.; Fendel, H.; Devens, K.

    1984-01-01

    The atlas is based on more than six years of routine /sup 123/I-hippuran renal function testing in infants. This new commercial radiopharmaceutical has the advantages of good morphological detail imaging, exact quantification of the global, unilateral and regional renal function, and comparatively low radiation exposure. /sup 123/I-hippuran also enables an assessment of the postrenal urinary passage - an important element of information which may reduce the number of radiological examinations. There is a short methodological section on the principles, procedures and errors of nuclear renal clearance testing, the diagnostic value of functional scintiscanning, and the radiation exposure of the patients. The main section is a systematic treatment of the main indications for renal function scintiscanning in pediatry. Case histories are presented which illustrate the diagnostic value of renal function scintiscanning and its importance as a decision aid in selecting the proper therapy. Clear and definitive findings, as well as diagnostic limits are outlined for the various indications, including rare diseases of the kidneys and the efferent urinary pathways. In view of the importance of the nuclear diagnosis of vesicoureteral reflux, a special chapter is dedicated to this subject. 156 figures, 2 tables.

  2. Assessment of renal function in mice with unilateral ureteral obstruction using 99mTc-MAG3 dynamic scintigraphy

    Tantawy Mohammed N

    2012-12-01

    Full Text Available Abstract Background Renal scintigraphy using 99mTc-mercaptoacetyltriglycine (99mTc-MAG3 is widely used for the assessment of renal function in humans. However, the application of this method to animal models of renal disease is currently limited, especially in rodents. Here, we have applied 99mTc-MAG3 renal scintigraphy to a mouse model of unilateral ureteral obstruction (UUO and evaluated its utility in studying obstructive renal disease. Methods UUO mice were generated by complete ligation of the left ureter. Sham-operated mice were used as a control. Renal function was investigated on days 0, 1, 3, and 6 post-surgery using dynamic planar imaging of 99mTc-MAG3 activity following retro-orbital injection. Time-activity curves (TACs were produced for individual kidneys and renal function was assessed by 1 the slope of initial 99mTc-MAG3 uptake (SIU, which is related to renal perfusion; 2 peak activity; and 3 the time-to-peak (TTP. The parameters of tubular excretion were not evaluated in this study as 99mTc-MAG3 is not excreted from UUO kidneys. Results Compared to sham-operated mice, SIU was remarkably (>60% reduced in UUO kidneys at day 1 post surgery and the TACs plateaued, indicating that 99mTc-MAG3 is not excreted in these kidneys. The plateau activity in UUO kidneys was relatively low (~40% of sham kidney’s peak activity as early as day1 post surgery, demonstrating that uptake of 99mTc-MAG3 is rapidly reduced in UUO kidneys. The time to plateau in UUO kidneys exceeded 200 sec, suggesting that 99mTc-MAG3 is slowly up-taken in these kidneys. These changes advanced as the disease progressed. SIU, peak activity and TTPs were minimally changed in contra-lateral kidneys during the study period. Conclusions Our data demonstrate that renal uptake of 99mTc-MAG3 is remarkably and rapidly reduced in UUO kidneys, while the changes are minimal in contra-lateral kidneys. The parametric analysis of TACs suggested that renal perfusion as well as tubular

  3. Functional transient receptor potential vanilloid 1 and transient receptor potential vanilloid 4 channels along different segments of the renal vasculature

    Chen, L; Kaßmann, M; Sendeski, M; Tsvetkov, D; Marko, L; Michalick, L; Riehle, M; Liedtke, W B; Kuebler, W M; Harteneck, C; Tepel, Martin; Patzak, A; Gollasch, M

    2015-01-01

    AIM: Transient receptor potential vanilloid 1 (TRPV1) and vanilloid 4 (TRPV4) cation channels have been recently identified to promote endothelium-dependent relaxation of mouse mesenteric arteries. However, the role of TRPV1 and TRPV4 in the renal vasculature is largely unknown. We hypothesized...... that TRPV1/4 plays a role in endothelium-dependent vasodilation of renal blood vessels. METHODS: We studied the distribution of functional TRPV1/4 along different segments of the renal vasculature. Mesenteric arteries were studied as control vessels. RESULTS: The TRPV1 agonist capsaicin relaxed mouse...... mesenteric arteries with an EC50 of 25 nm, but large mouse renal arteries or rat descending vasa recta only at >100-fold higher concentrations. The vasodilatory effect of capsaicin in the low-nanomolar concentration range was endothelium-dependent and absent in vessels of Trpv1 -/- mice. The TRPV4 agonist...

  4. Green tea inhibited the elimination of nephro-cardiovascular toxins and deteriorated the renal function in rats with renal failure

    Yu-Hsuan Peng; Sweet, Douglas H.; Shiuan-Pey Lin; Chung-Ping Yu; Pei-Dawn Lee Chao; Yu-Chi Hou

    2015-01-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are highly protein-bound nephro-cardiovascular toxins, which are not efficiently removed through hemodialysis. The renal excretions of IS and PCS were mediated by organic anion transporters (OATs) such as OAT1 and OAT3. Green tea (GT) is a popular beverage containing plenty of catechins. Previous pharmacokinetic studies of teas have shown that the major molecules present in the bl...

  5. Combined radioisotope method for investigation of the renal function with 99mTc-DTPA

    An exact combined method is suggested for determination of the gromerular filtration rate, the time for active transfer through the tubular epithelial cells and the rate of elimination them through the pyelocalycial system. The method is applicable for gamma camera. By the conventionnaly recorded time/activity curve (20 min) for each kidney the differential glomerular filtration rate could be determined, while the drawn relative coeficients of accumulation and elimination give notion for the functional capabilities of the renal parenchyma and drainage system. A control group of 29 individuals has been investigated for finding of the normal values of the renal function by the use of 99mTc-DTPA. The direct measurement of the depth of each kidney is proposed, allowing to introduce some corrections in parameter calculations in the computer programme. This not only improves the accuracy of the glomerular filtration rate determination, but orientates for the presence of dystopias, too. The method assures a rapid and easy data processing of the information for individual patient and is easily fulfilled because of the lack of necessity of blood sampling and the use of radiopharmaceutical causing a low radiation burden

  6. The Effect of Mannitol Treatment on Renal Functions in Acute Stroke

    Neslihan Eşkut

    2010-06-01

    Full Text Available OBJECTIVE: Mannitol is an osmotic diuretic agent and reduces intracranial pressure. The most serious side effect of mannitol is kidney dysfunction. In this study, renal functions in acute stroke patients treated with mannitol were evaluated. METHODS: One hundred and twenty-two patients followed in the neurology intensive care unit with the diagnosis of stroke and treated with fractionated mannitol for 5 days were evaluated retrospectively. Ninety-six patients had ischemic and 26 had hemorrhagic stroke. Mean age was 69.9 ± 11.8 (18-91 years. Serum urea, creatinine and electrolyte levels measured before and on the second, third, fourth, fifth and tenth days of treatment were compared statistically with paired sample t test. RESULTS: The average urea and creatinine levels on the second, third, fourth and fifth days of treatment were significantly higher than the baseline (p< 0.05. On the other hand, mannitol treatment did not change average sodium, potassium and chlorine levels. The creatinine levels had returned to the normal range on the tenth day of treatment, but the urea levels, although decreased, did not fall to the normal range. CONCLUSION: Our results support the view that close monitoring of renal function is necessary in patients treated with mannitol.

  7. Anthropometric measurements and markers of renal function in adults and older adults

    Victoria Araujo Ganzaroli AMADOR

    2016-04-01

    Full Text Available Objective: To determine whether anthropometric indicators are associated with markers of renal function in adults and older adults. Methods: This cross-sectional study included 279 adults and older adults attending eight primary healthcare units in eastern Goiânia, Góias. Sociodemographic, lifestyle, and clinical data were collected using a standard questionnaire. Body mass index was categorized as overweight (≥25 kg/m² or non-overweight. Waist circumference was classified as normal or high; chronic kidney disease was defined as a glomerular filtration rate below 60 mL/minutes/1.73 m²; micro/macroalbuminuria was defined as an albumin/creatinine ratio above 30 mg/g. The association between anthropometric indicators and renal function markers was assessed by multiple linear regression analysis. Results: Chronic kidney disease was present in 8.9% and micro/macroalbuminuria in 34.8% of the sample. The prevalence of overweight was 57.0%. Waist circumference and body mass index were positively associated with glomerular filtration rate, characterized as glomerular hyperfiltration. Microalbuminuria was positively associated with body mass index in women. Conclusion: The prevalences of chronic kidney disease and overweight were high in the study population. Overweight was positively associated with glomerular filtration rate.

  8. Early renal function recovery and long-term graft survival in kidney transplantation.

    Wan, Susan S; Cantarovich, Marcelo; Mucsi, Istvan; Baran, Dana; Paraskevas, Steven; Tchervenkov, Jean

    2016-05-01

    Following kidney transplantation (KTx), renal function improves gradually until a baseline eGFR is achieved. Whether or not a recipient achieves the best-predicted eGFR after KTx may have important implications for immediate patient management, as well as for long-term graft survival. The aim of this cohort study was to calculate the renal function recovery (RFR) based on recipient and donor eGFR and to evaluate the association between RFR and long-term death-censored graft failure (DCGF). We studied 790 KTx recipients between January 1990 and August 2014. The last donor SCr prior to organ procurement was used to estimate donor GFR. Recipient eGFR was calculated using the average of the best three SCr values observed during the first 3 months post-KTx. RFR was defined as the ratio of recipient eGFR to half the donor eGFR. 53% of recipients had an RFR ≥1. There were 127 death-censored graft failures (16%). Recipients with an RFR ≥1 had less DCGF compared with those with an RFR <1 (HR 0.56; 95% CI 0.37-0.85; P = 0.006). Transplant era, acute rejection, ECD and DGF were also significant determinants of graft failure. Early recovery of predicted eGFR based on donor eGFR is associated with less DCGF after KTx. PMID:26988072

  9. Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults.

    Xie, Di; Yuan, Yan; Guo, Jiangnan; Yang, Shenglin; Xu, Xin; Wang, Qin; Li, Youbao; Qin, Xianhui; Tang, Genfu; Huo, Yong; Deng, Guangpu; Wu, Shengjie; Wang, Binyan; Zhang, Qin; Wang, Xiaobin; Fang, Pu; Wang, Hong; Xu, Xiping; Hou, Fanfan

    2015-01-01

    Hyper-homocysteinemia (HHcy) is associated with microalbuminuria and glomerular injury in general and diabetic populations. However, HHcy's role in hypertensive patients was not studied. We investigated whether HHcy is an independent risk factor for renal function decline and development of chronic kidney disease (CKD) in hypertensive men and women. This was a community-based prospective cohort study of 2,387 hypertensive adults without CKD at baseline, with a mean follow-up of 4.4 years. Baseline and follow-up levels of plasma Hcy, folate, vitamin B12, blood pressure and other pertinent covariables were obtained. CKD was defined as an estimated glomerular filtration rate (eGFR) 1 ml/min/per 1.73 m(2)/year. There was a graded association between Hcy tertiles and eGFR decline. Subjects in the 3(rd) tertile of Hcy levels had an accelerated rate of eGFR decline and an increased risk of incident CKD, as compared with those in the 1st tertile, after adjusting for age, gender, baseline diabetes, SBP, BMI, smoking, dyslipidemia, eGFR, folate and vitamin B12 levels. In conclusion, in this prospective cohort of Chinese hypertensive adults, elevated baseline plasma Hcy can serve as an independent biomarker to predict renal function decline and incident CKD. PMID:26553372

  10. Evaluation of three algorithms to calculate the relative renal function with 99Tc-DTPA

    The aim of our study is to estimate the reproducibility and the exactitude of three algorithms to determine with 99mTc-DTPA the relative function of each kidney. Methods: a prospective study was carried out in voluntary patients. Reproducibility was studied in 11 patients who underwent had two examinations with 99mTc-DTPA. Exactitude was evaluated in 35 patients who had an additional scintigraphy with 99mTc-DMSA taken as a reference. To determine the relative renal function with 99mTc-DTPA, three algorithms using various background subtraction methods and time intervals were applied. Results and conclusion: the method of the integral was the most reproducible and exact. It was little influenced by the choice of the interval of time. The reproducibility and the exactitude of the Patlak method were worse, especially in case of renal insufficiency or hydronephrosis. A high background and poor counting statistics explain why Patlak was less powerful with 99mTc-DTPA than with 99mTc-MAG3. The method of the slopes should not be recommended any more. (author)

  11. Voigt Profile Fitting to Quasar Absorption Lines: A Simple Approximation to the Voigt-Hjerting Function

    García, T T

    2006-01-01

    The Voigt-Hjerting function is fundamental in order to correctly model the profiles of absorption lines imprinted in the spectra of bright background sources (e.g quasars) by intervening neutral hydrogen. In this work we present a simple analytical approximation to this function in the context of intergalactic neutral hydrogen absorption-line profiles. Using basic calculus tools, we derive an expression that contains only fourth order polynomial and Gaussian functions, and that approximates this function with an accuracy better than $10^{-3}$ per cent. In connection with the absorption coefficient of intergalactic neutral hydrogen, $\\tau_{\\mathrm{H I}}(\\lambda)$, this approximation is valid for an arbitrary wavelength baseline, for column densities up to $\

  12. The Role of Endothelin System in Renal Structure and Function during the Postnatal Development of the Rat Kidney

    Albertoni Borghese, María F.; Ortiz, María C.; Balonga, Sabrina; Moreira Szokalo, Rocío; Majowicz, Mónica P.

    2016-01-01

    Renal development in rodents, unlike in humans, continues during early postnatal period. We aimed to evaluate whether the pharmacological inhibition of Endothelin system during this period affects renal development, both at structural and functional level in male and female rats. Newborn rats were treated orally from postnatal day 1 to 20 with vehicle or bosentan (Actelion, 20 mg/kg/day), a dual endothelin receptor antagonist (ERA). The animals were divided in 4 groups: control males, control females, ERA males and ERA females. At day 21, we evaluated renal function, determined the glomerular number by a maceration method and by morphometric analysis and evaluated possible structural renal alterations by three methods: 〈alpha〉-Smooth muscle actin (α-SMA) immunohistochemistry, Masson's trichrome and Sirius red staining. The pharmacological inhibition of Endothelin system with a dual ERA during the early postnatal period of the rat did not leads to renal damage in the kidneys of male and female rats. However, ERA administration decreased the number of glomeruli, the juxtamedullary filtration surface area and the glomerular filtration rate and increased the proteinuria. These effects could predispose to hypertension or renal diseases in the adulthood. On the other hand, these effects were more pronounced in male rats, suggesting that there are sex differences that could be greater later in life. These results provide evidence that Endothelin has an important role in rat renal postnatal development. However these results do not imply that the same could happen in humans, since human renal development is complete at birth. PMID:26872270

  13. The Role of Endothelin System in Renal Structure and Function during the Postnatal Development of the Rat Kidney.

    María F Albertoni Borghese

    Full Text Available Renal development in rodents, unlike in humans, continues during early postnatal period. We aimed to evaluate whether the pharmacological inhibition of Endothelin system during this period affects renal development, both at structural and functional level in male and female rats. Newborn rats were treated orally from postnatal day 1 to 20 with vehicle or bosentan (Actelion, 20 mg/kg/day, a dual endothelin receptor antagonist (ERA. The animals were divided in 4 groups: control males, control females, ERA males and ERA females. At day 21, we evaluated renal function, determined the glomerular number by a maceration method and by morphometric analysis and evaluated possible structural renal alterations by three methods: 〈alpha〉-Smooth muscle actin (α-SMA immunohistochemistry, Masson's trichrome and Sirius red staining. The pharmacological inhibition of Endothelin system with a dual ERA during the early postnatal period of the rat did not leads to renal damage in the kidneys of male and female rats. However, ERA administration decreased the number of glomeruli, the juxtamedullary filtration surface area and the glomerular filtration rate and increased the proteinuria. These effects could predispose to hypertension or renal diseases in the adulthood. On the other hand, these effects were more pronounced in male rats, suggesting that there are sex differences that could be greater later in life. These results provide evidence that Endothelin has an important role in rat renal postnatal development. However these results do not imply that the same could happen in humans, since human renal development is complete at birth.

  14. Comparison of the Relative Renal Function Calculated with 99mTc-Diethylenetriaminepentaacetic Acid and 99mTc-Dimercaptosuccinic Acid in Children.

    Çelik, Tanju; Yalçin, Hülya; Günay, Emel Ceylan; Özen, Aynur; Özer, Cahit

    2014-09-01

    The aim was to compare the relative renal functions measured with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) and technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) in children with renal diseases. Relative renal function of 128 children who applied to three hospitals from 2009 to 2011 were analyzed retrospectively. The mean value measured with 99mTc-DTPA and 99mTc-DMSA were 51.58 ± 14.95 and 51.96 ± 14.99 for the right kidney, 47.87 ± 15.27 and 47.94 ± 15.17 for the left kidney, respectively. A significant positive correlation was found between the relative renal functions (r = 0.963, P renal function, 99mTc-DTPA can be another choice for the calculation of relative renal function without a complementary DMSA scan particularly in pediatric patients who require renogram curve and GFR calculations. PMID:25538484

  15. Absorption, metabolism, and functions of β-cryptoxanthin.

    Burri, Betty J; La Frano, Michael R; Zhu, Chenghao

    2016-02-01

    β-Cryptoxanthin, a carotenoid found in fruits and vegetables such as tangerines, red peppers, and pumpkin, has several functions important for human health. Most evidence from observational, in vitro, animal model, and human studies suggests that β-cryptoxanthin has relatively high bioavailability from its common food sources, to the extent that some β-cryptoxanthin-rich foods might be equivalent to β-carotene-rich foods as sources of retinol. β-Cryptoxanthin is an antioxidant in vitro and appears to be associated with decreased risk of some cancers and degenerative diseases. In addition, many in vitro, animal model, and human studies suggest that β-cryptoxanthin-rich foods may have an anabolic effect on bone and, thus, may help delay osteoporosis. PMID:26747887

  16. Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

    Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Péchère-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier

    2015-01-01

    Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=−2.1; 95% confidence interval [95% CI], −3.3 to −0.8; P=0.002) and kidney length (β=−1.2; 95% CI, −1.9 to −0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. PMID:25270071

  17. Comparison of clearance and arteriovenous extraction techniques for measurements of renal hemodynamic functions

    No previous studies have directly compared timed urine collections (UV/P) vs. arteriovenous (A-V) extraction methods for determination of renal function in whole kidney preparations. We examined different markers and techniques for assessing renal plasma flow (RPF), filtration fraction (FF), and glomerular filtration rate (GFR) in both steady-state and rapidly changing conditions following 2 ml/kg bolus intravenous injections of either Renografin 76% (meglumine/sodium diatrizoate-76%) or hypertonic mannitol 25%. During steady-state conditions, excellent correlations were obtained when comparing markers and techniques. Thus, timed urinary clearances of inulin vs. 99m-technetium DTPA (Tc) had a correlation coefficient (R) of .96 (P less than .01; n = 16), and the A-V extraction technique of inulin vs. Tc as determinants of GFR showed a correlation of R = .98 (P less than .01; n = 15). The timed urinary clearance of inulin vs. the A-V extraction of inulin for glomerular filtration gave a correlation of R = .93 (P less than .01; n = 15). The clearance of para-aminohippurate (PAH) divided by the extraction of PAH vs. flow determinations using the electromagnetic flowmeter gave a correlation of R = .92 (P less than .01; n = 16). The anticipated decrease in GFR following contrast medium and hypertonic mannitol was observed using the A-V extraction technique, whereas an artifactual, exaggerated increase in GFR was observed using the timed urine collection technique. Similarly, we noted an exaggerated increase in RPF using CPAH/EPAH as the methodology. We conclude that rapid changes in renal hemodynamics may be measured accurately using the A-V extraction technique but not with clearance techniques requiring timed urine collections

  18. Aquatic models for the study of renal transport function and pollutant toxicity.

    Miller, D S

    1987-04-01

    Studies of renal cell transport mechanisms and their impairment by xenobiotics are often limited by technical difficulties related to renal tubule complexity. Problems include the juxtaposition of multiple tubule segments with different transport functions and severely limited access to the tubular lumen. Some limitations can be overcome by the careful selection of an appropriate aquatic experimental system. Two aquatic models for the vertebrate proximal segment are discussed here. The first is the kidney from certain marine flounder, which offers the following advantages: long-term viability, little tissue of nonproximal origin, and easy tubule isolation. Data are presented to demonstrate how studies with flounder kidney can be used to elucidate cellular mechanisms whereby different classes of toxic pollutants may interact. Results from these experiments indicate that the excretion of certain anionic xenobiotics can be delayed by other anionic xenobiotics that compete for secretory transport sites and by compounds that disrupt cellular ion gradients and energy metabolism needed to drive transport. The second system is the crustacean urinary bladder, a simple, flatsheet epithelium. Bladder morphology and transport physiology closely resemble those of vertebrate proximal segment. Electron micrographs show a brush border membrane at the luminal surface, numerous mitochondria, and an infolded serosal membrane, while in vivo and in vitro transport studies show reabsorption of NaCl, nutrients and water and secretion of organic cations; organic anions are secreted in bladders from some species and reabsorbed in others. Moreover, since bladders can be mounted as flat sheets in flux chambers, studies with this tissue avoid the problems of complex renal tubule geometry and tissue heterogeneity that limit transport studies in proximal tubule. PMID:3297665

  19. Aquatic models for the study of renal transport function and pollutant toxicity

    Miller, D.S.

    1987-04-01

    Studies of renal cell transport mechanisms and their impairment by xenobiotics are often limited by technical difficulties related to renal tubule complexity. Problems include the juxtaposition of multiple tubule segments with different transport functions and severely limited access to the tubular lumen. Some limitations can be overcome by the careful selection of an appropriate aquatic experimental system. Two aquatic models for the vertebrate proximal segment are discussed here. The first is the kidney from certain marine flounder, which offers the following advantages: long-term viability, little tissue of nonproximal origin, and easy tubule isolation. Data are presented to demonstrate how studies with flounder kidney can be used to elucidate cellular mechanisms whereby different classes of toxic pollutants may interact. Results from these experiments indicate that the excretion of certain anionic xenobiotics can be delayed (1) by other anionic xenobiotics that compete for secretory transport sites and (2) by compounds that disrupt cellular ion gradients and energy metabolism needed to drive transport. The second system is the crustacean urinary bladder, a simple, flatsheet epithelium. Bladder morphology and transport physiology closely resemble those of vertebrate proximal segment. Electron micrographs show a brush border membrane at the luminal surface, numerous mitochondria, and an infolded serosal membrane, while in vivo and in vitro transport studies show reabsorption of NaCl, nutrients and water and secretion of organic cations; organic anions are secreted in bladders from some species and reabsorbed in others. Moreover, since bladders can be mounted as flat sheets in flux chambers, studies with this tissue avoid the problems of complex renal tubule geometry and tissue heterogeneity and tissue heterogeneity that limit transport studies in proximal tubule.

  20. Assessment of Renal Functional Status with the ''Kidney to Liver Ratio'' - A comparative study with Tc-99m DTPA Renography

    For the assessment of renal functional status, DTPA renography is widely used. Split function provides excellent information, but it has certain shortcomings especially in bilateral renal disease or in solitary kidney. This study demonstrates the importance of kidney to liver ratio as a functional parameter. In 65 patients, a total of 123 kidney were studied. Renographic studies were done after a bolus of Tc-99m DTPA. The kidney to liver ratios was calculated at 3 minutes (K3/L3). The ratios and renography curve patterns correlated well in 101 (82%) kidneys, both normal in 42 and both abnormal in 59 kidneys. Only 22 (18%) kidneys had discrepancies and among them 12 showed abnormal ratios but having normal renogram curves. The findings display the usefulness of K3/L3 ratio. The authors advocate that it is a good parameter for renal studies. (author) 9 refs., 3 tabs

  1. Hemodynamic and glucometabolic factors fail to predict renal function in a random population sample

    Pareek, M.; Nielsen, M.; Olesen, Thomas Bastholm;

    2015-01-01

    , hemodynamic factors (systolic blood pressure (SBP), heart rate (HR)), glucometabolic factors (fasting plasma glucose and insulin, 2-hour plasma glucose and insulin during oral glucose tolerance test (OGTT), a modified 40 minute oral disposition index (DIo), and Homeostatic Model Assessment (HOMA) derived...... indices of beta-cell function (HOMA-2B), insulin sensitivity (HOMA-2S), and insulin resistance (HOMA-2IR)), traditional cardiovascular risk factors (age, sex, smoking status, body mass index, diabetes mellitus, total serum cholesterol), and later renal function determined as serum cystatin C in 238 men...... positively associated with age, female sex, SBP, HOMA-2B, creatinine, and the time elapsed between inclusion and follow-up. In multivariable analysis, age (beta = 0.013 (95% confidence interval (CI), 0.002 to 0.024); p <0.02), female sex (beta = 0.271 (95% CI, 0.036 to 0.506); p = 0.02), creatinine (beta = 0...

  2. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment...

  3. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    Petersen, L J; Petersen, J R; Talleruphuus, U; Møller, M L; Ladefoged, S D; Mehlsen, J; Jensen, H A

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment with a...

  4. Hypomagnesemia is a risk factor for nonrecovery of renal function and mortality in AIDS patients with acute kidney injury

    M.S. Biagioni Santos

    2010-03-01

    Full Text Available The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72% were males, 59% had been HIV-infected for >5 years, 72% had CD4 counts <200 cells/mm³, 87% developed electrolyte disturbances, 33% recovered renal function, and 56% survived. ICU admission, dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.

  5. Polarized Synchrotron Emissivities and Absorptivities for Relativistic Thermal, Power-Law, and Kappa Distribution Functions

    Pandya, Alex; Chandra, Mani; Gammie, Charles F

    2016-01-01

    Synchrotron emission and absorption determine the observational appearance of many astronomical systems. In this paper, we describe a numerical scheme for calculating synchrotron emissivities and absorptivities in all four Stokes parameters for arbitrary gyrotropic electron distribution functions, building on earlier work by Leung, Gammie, and Noble. We use this technique to evaluate the emissivities and the absorptivities for a thermal (Maxwell-J\\"uttner), isotropic power-law, and isotropic kappa distribution function. The latter contains a power-law tail at high particle energies that smoothly merges with a thermal core at low energies, as is characteristic of observed particle spectra in collisionless plasmas. We provide fitting formulae and error bounds on the fitting formulae for use in codes that solve the radiative transfer equation. The numerical method and the fitting formulae are implemented in a compact C library called ${\\tt symphony}$. We find that: the kappa distribution has a source function th...

  6. Heritable influence of DBH on adrenergic and renal function: twin and disease studies.

    Dalal N Pasha

    Full Text Available BACKGROUND: Elevated sympathetic activity is associated with kidney dysfunction. Here we used twin pairs to probe heritability of GFR and its genetic covariance with other traits. METHODS: We evaluated renal and adrenergic phenotypes in twins. GFR was estimated by CKD-EPI algorithm. Heritability and genetic covariance of eGFR and associated risk traits were estimated by variance-components. Meta-analysis probed reproducibility of DBH genetic effects. Effect of DBH genetic variation on renal disease was tested in the NIDDK-AASK cohort. RESULTS: Norepinephrine secretion rose across eGFR tertiles while eGFR fell (p<0.0001. eGFR was heritable, at h(2 = 67.3±4.7% (p = 3.0E-18, as were secretion of norepinephrine (h(2 = 66.5±5.0%, p = 3.2E-16 and dopamine (h(2 = 56.5±5.6%, p = 1.8E-13, and eGFR displayed genetic co-determination (covariance with norepinephrine (ρG = -0.557±0.088, p = 1.11E-08 as well as dopamine (ρG = -0.223±0.101, p = 2.3E-02. Since dopamine β-hydroxylase (DBH catalyzes conversion of dopamine to norepinephrine, we studied functional variation at DBH; DBH promoter haplotypes predicted transcriptional activity (p<0.001, plasma DBH (p<0.0001 and norepinephrine (p = 0.0297 secretion; transcriptional activity was inversely (p<0.0001 associated with basal eGFR. Meta-analysis validated DBH haplotype effects on eGFR across 3 samples. In NIDDK-AASK, we established a role for DBH promoter variation in long-term renal decline rate (GFR slope, p = 0.003. CONCLUSIONS: The heritable GFR trait shares genetic determination with catecholamines, suggesting new pathophysiologic, diagnostic and therapeutic approaches towards disorders of GFR as well as CKD. Adrenergic activity may play a role in progressive renal decline, and genetic variation at DBH may assist in profiling subjects for rational preventive treatment.

  7. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Damianovich, Maya; Ziv, Ilan; Aloya, Tali; Grimberg, Hagit; Levin, Galit; Reshef, Ayelet; Bentolila, Alfonso; Cohen, Avi; Shirvan, Anat [NeuroSurvival Technologies (NST) Ltd., Petah Tikva (Israel); Heyman, Samuel N.; Shina, Ahuva [Mt.Scopus and the Hebrew University Medical School, Department of Medicine, Hadassah Hospital, Jerusalem (Israel); Rosen, Seymour [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Pathology, Boston, MA (United States); Kidron, Dvora [Meir Hospital, Department of Pathology, Kfar-Saba (Israel)

    2006-03-15

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  8. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  9. Evaluation of renal transplant function by 99sup(m)Tc-DTPA dynamic imaging

    In 60 patients with a kidney transplant 86 perfusion studies with 99sup(m)Tc-DTPA were performed during the early postoperative period. Correlative data and clinical differentation were obtained by isotope nephrograms, laboratory values and clinical presentation. In addition to evaluation of scintiphotos, time-activity curves were derived from the transplant and evaluated quantitatively, obtaining a perfusion ratio by a computer program. A ratio of greater than 0.80 was found to be normal. In 20 patients with acute rejection, the ratio was decreased. In 13 patients with acute tubalar necrosis, the perfusion ratio was between 0.39 and 0.65, decreasing further during and added rejection crisis. Follow-up examinations confirmed rejection through a decrease of the perfusion ratio. In 9 cases, successful rejection therapy was documented by an increase. In addition to quantitative evaluation, visual analysis revealed acute occlusion of the renal artery, renal infarction, urinoma, ureteral stenosis or necrosis. Quantitative scintigraphy with 99sup(m)Tc-DTPA broadened the methods of describing kidney transplant function. Its quantitative evaluation enables the definition of acute rejection and its differentiation from acute tubular necrosis combined with acute rejection in the early postoperative period. Since the method recognizes morphological alterations as well, it usefully complements isotope nephrography. (orig./MG)

  10. Dynamic noninvasive monitoring of renal function in vivo by fluorescence lifetime imaging

    Goiffon, Reece J.; Akers, Walter J.; Berezin, Mikhail Y.; Lee, Hyeran; Achilefu, Samuel

    2009-03-01

    Kidneys normally filter the blood of excess salts and metabolic products, such as urea, while retaining plasma proteins. In diseases such as multiple myeloma and diabetes mellitus, the renal function is compromised and protein escapes into the urine. In this study, we present the use of fluorescence lifetime imaging (FLI) to image excess serum protein in urine (proteinuria). The near-infrared fluorescent dye LS-288 has distinct lifetimes when bound to protein versus free in solution, providing contrast between the protein-rich viscera and the mostly protein-free bladder. FLI with LS-288 in mice revealed that fluorescence lifetime (FLT) differences in the bladder relative to surrounding tissues was due to the fractional contributions of the bound and unbound dye molecules. The FLT of LS-288 decreased in the case of proteinuria while fluorescence intensity was unchanged. The results show that FLI can be useful for the dynamic imaging of protein-losing nephropathy due to diabetes mellitus and other renal diseases and suggest the potential use of the FLI to distinguish tumors from fluid-filled cysts in the body.

  11. Renal function in 153 manic-depressive patients treated with lithium for more than five years.

    Løkkegaard, H; Andersen, N F; Henriksen, E; Bartels, P D; Brahm, M; Baastrup, P C; Jørgensen, H E; Larsen, M; Munck, O; Rasmussen, K

    1985-04-01

    Renal function was examined in 153 manic-depressive patients treated with lithium for more than 5 years, mean 10 years. No significant change was detectable in plasma creatinine. Glomerular filtration rate (GFR) decreased slightly, but significantly, and not until after 17 years of treatment did the regression line reach the lower confidence limit in the reference material. GFR was generally only moderately decreased. Renal concentrating capacity was significantly reduced during the whole investigation period and did not change with time. GFR was independent of the dosage pattern. The diuresis did not differ markedly in patients given one or three daily doses. In a two-dose group predominantly treated with slow-release tablets, the diuresis was somewhat higher in 75% of the patients but much higher for the rest of the group. Since the prophylactic effect of lithium was the same in the one-dose group (mean dosage 21 mmol/day) as in the two-dose and three-dose groups (mean dosage 27-28 mmol/day), our data indicate that generally employed lithium doses may be reduced somewhat without loss of prophylactic efficacy. PMID:4003100

  12. ASSOCIATION OF LOWER ANTIOXIDANT STATUS WITH ESTIMA TED GFR IN HYPERTENSIVES WITH PRESERVED RENAL FUNCTION

    Roma

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND AND OBJECTIVES : Renal dysfunction is end organ damage in hypertension. We investigated the association of oxi dative stress with estimated glomerular filtration rate in hypertension. METHODS : A total of 116 hypertensive individuals (age 47 ± 10.2 years; 68% males; BMI < 25; without diabetes m ellitus, CVD were included. All the hypertensive subjects were albustix negative. Fastin g blood glucose, lipid profile, urea and creatinine was estimated. Serum oxidant load was es timated by ferrous oxidation products in xylenol orange version 2(FOX2 and antioxidant power of serum was estimated by ferric reducing capacity, FRAP assay. Data is represented as mean± SD. Data was analysed by unpaired two-tailed students t test, Pearson’s correlation a nd linear regression. The estimated GFR was calculated by simplified modification of diet in ren al disease study prediction equation and Cockroft- Gault formula. RESULT : Systolic and diastolic blood pressure, lipid profile , serum creatinine and oxidant load was significantly highe r in hypertensive subjects (p < 0.001. Total Antioxidant status and estimated GFR was significan tly lower in hypertensive subjects. A significant negative correlation was present between oxidative stress and eGFR. INTERPRETATION AND CONCLUSION : Among hypertensive subjects with preserved renal function increased oxidative stress is associated w ith decreased eGFR. Whether estimation of oxidative stress and adjuvant antioxidant therapy ar e better prognostic markers requires further research.

  13. Rapid decline in 51Cr-EDTA measured renal function during the first weeks following lung transplantation

    Hornum, Mads; Iversen, Martin; Steffensen, Ida; Hovind, Peter; Carlsen, Jørn; Andersen, Lars Willy; Steinbrüchel, Daniel Andreas; Feldt-Rasmussen, Bo Friis

    2009-01-01

    /bronchiectasis or idiopathic pulmonary fibrosis were included in an analysis of renal function before and after LTx. The glomerular filtration rate (GFR) was measured using the (51)Cr-ethylenediaminetetra acetic acid plasma clearance single injection technique (mGFR) at baseline before transplantation and at 1, 2......We previously described a 54% decline in renal function at 6 months after lung transplantation (LTx). We hypothesized that this decline is a very early event following LTx. Thirty-one consecutive patients (16 females/15 males), mean age 49 (+/-13) years, with emphysema, cystic fibrosis...

  14. Hemodynamics, functional state of endothelium and renal function, platelets depending on the body mass index in patients with chronic heart failure and preserved systolic function

    Kushnir Yu.

    2014-03-01

    Full Text Available The aim of the study was to evaluate hemodynamics, endothelium function of kidneys and platelets depending on the body mass index (BMI in patients with chronic heart failure (CHF and preserved systolic function. 42 patients (mean age - 76,690,83 years with CHF II-III FC NYHA with preserved systolic function (LVEF>45% were enrolled. Echocardiography was performed, endothelial function, serum creatinine levels and microalbuminuria were determined in patients. BMI and glomerulation filtration rate were calculated by formulas. The morphological and functional status of platelets was estimated by electronic microscopy. It was defined that increased BMI in patients with CHF and preserved systolic function determines the structural and functional changes of the myocardium and leads to the endothelial and renal functional changes. An increased risk of thrombogenesis was established in patients with overweight and obesity.

  15. Fluctuation of the renal function after discharge from hospital and its effects on drug dosing in elderly patients--study protocol

    Eppenga, W.L.; Wester, W.N.; Derijks, H J; Hoedemakers, R.M.; Wensing, M J; de Smet, P A G M; van Marum, R.J.

    2015-01-01

    BACKGROUND: Chronic kidney disease (CKD) is associated with an increased mortality rate, risk of cardiovascular events and morbidity. Impaired renal function is common in elderly patients, and their glomerular filtration rate (GFR) should be taken into account when prescribing renally excreted drugs. In a hospital care setting the GFR may fluctuate substantially, so that the renal function group and therefore the recommended dose, can change within a few days. The magnitude and prevalence of ...

  16. Evaluation of Renal Function Determined by Relative Renal Uptake of '9{sup 9m}Tc-DMSA and Relative Glomerular Filteration Rate of {sup 99m}Tc-DTPA

    Chung, Byung Chun; Choi, Chang Il; Kim, Kwang Weon; Lee, Jae Tae; Lee, Kyu Bo; Kwon, Tae Hwan; Cho, Dong Kyu [Kyungpook National University School of Medicine, Seoul (Korea, Republic of)

    1991-07-15

    The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. We measured 2 hour, 4 hour and 24 hour relative renal uptake of '9{sup 9m}Tc-DMSA and relative glomerular filtration rate of {sup 99m}Tc-DTPA with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of {sup 99m}Tc-DMSA and relative glomerular filtration rate. The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of {sup 99m}Tc-DMSA and relative glomerular filtration rate of {sup 99m}Tc-DTPA were R=0.9190 (p<0.001), R=0. 9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 hour were poor as R=0.1812 (p<0.05) and R=0.4923 (p<0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake of {sup 99m}Tc-DMSA had the best correlation with relative glomerular filtration rate of {sup 99m}Tc-DTPA and that might be useful in evaluation of chronic renal disease in which showed increased background activity or acute obstructive uropathy.

  17. A suplementação de creatina prejudica a função renal? Does creatine supplementation harm renal function?

    Bruno Gualano

    2008-02-01

    Full Text Available Enquanto o consumo de creatina por atletas e praticantes de atividade física tem crescido vertiginosamente, os efeitos adversos desse suplemento continuam sendo alvos de calorosos debates científicos, sobretudo no que se refere à função renal. O objetivo dessa revisão é descrever as falhas metodológicas e lacunas na literatura, que contribuem para a divergência do tema. Relatos de caso sugerem que a creatina é um potencial agente nefrotóxico. Em contrapartida, estudos longitudinais, embora possuam diversas limitações, indicam o oposto. Pesquisas com humanos não demonstram efeitos deletérios da suplementação de creatina à função renal, porém a falta de controle experimental e o caráter retrospectivo da maioria delas comprometem as conclusões dos autores. Já os estudos experimentais com ratos empregam bons marcadores de função renal e possuem controle de variáveis satisfatório. Contudo, os resultados destes são contraditórios. Estudos futuros devem investigar os efeitos da suplementação de creatina em diversas patologias renais, assim como em idosos, diabéticos do tipo 2 e hipertensos, cuja propensão a nefropatia é bem descrita. Não há evidências de que a suplementação de creatina prejudique a função renal em sujeitos saudáveis, quando consumida na dosagem preconizada. Diante disso, questiona-se a legitimidade científica da proibição do comércio de creatina no Brasil.While creatine consumption has been greatly increasing among athletes and physical activity practitioners, the adverse effects of this supplement remain scientifically controversial, especially concerning renal function. The aim of this review is to describe the methodological limitations and gaps in the literature which contribute to the topic’s divergence. Case reports suggest that creatine is a nephrotoxic agent. On the other hand, despite having several limitations, longitudinal studies have indicated the opposite. Research with

  18. Functional Assessment in End-Stage Renal Disease: Enhancing Quality of Life.

    Saby, Adam; Miller, Lawrence S

    2016-01-01

    Why do functional assessments in patients with end-stage renal disease (ESRD) matter? Multiple studies show that new dialysis patients undergo a substantial decline among activities of daily living. Moreover, poor functional status in ESRD patients is associated with early morality. That is why CMS has developed new criteria to assess ESRD patients in regards to their functional, psychologic, and cognitive capabilities. Functional assessments by health providers have been used in field of Rehabilitation Medicine for over 50 years; rehabilitation physicians have found them effective in establishing goals and monitoring improvement. Assessments can provide guidance by identifying the needs and types of intervention most suited for patients. Impairments can be addressed with referrals to physical therapy for gross motor issues, occupational therapy for self-care problems, psychiatry for mental disorders, and neurology for cognitive deficits. The more accurate the assessments over time, the more targeted and effective the therapies become. We believe that the new CMS goals to assess functionality will improve ESRD patient's quality of life, longevity, and long-term healthcare costs. PMID:26756940

  19. Appraisal of the renal function in health donors of the Specialities Hospital Centro Medico La Raza, IMSS

    The techniques of Nuclear Medicine (MN) represent the most reliable and sure forms in measurement of the glomeruli filtrate (FG) and of the effective renal plasmatic flow (FPRE), by means of a simple, practical, innocuous and economic method that doesn't require urine gathering, available in the services of (MN). The renal gamma gram is at the moment the election procedure in the diagnosis and evaluation of diverse nephro urological pathologies since it provides objective information of the renal function as well as of the characteristics of the drainage of the urinal tract. They provide to the clinical doctor a real measurement of the state of the purifying renal function. their determinations are not affected by the habitual protein ingesta, they can be made with any level of seric creatinine, the exercise, size, sex. Their methodology uses the unique injection technique for each one, in which the renal purification is determined by means of Gary Gates method and the tubular secretion by based on the method of Schlegel. These techniques show a very high correlation coefficient with those standard of gold and they lack the inherent inconveniences to the technique of urine gathering. The used radiopharmaceuticals are diethylen triamine penta acetic-Tc 99m acid and Orto iodine hippurate- I131 the only requirement for the realization of the study is an appropriate hydration (10-15 ml/Kg is calculated.) (Author)

  20. Optical properties of Mg-doped VO{sub 2}: Absorption measurements and hybrid functional calculations

    Hu Shuanglin [Department of Chemistry, Angstroem Laboratory, Uppsala University, P.O. Box 538, SE-75121 Uppsala (Sweden); Li, S.-Y.; Granqvist, C. G.; Niklasson, G. A. [Department of Engineering Sciences, Angstroem Laboratory, Uppsala University, P.O. Box 534, SE-75121 Uppsala (Sweden); Ahuja, R.; Scheicher, R. H. [Department of Physics and Astronomy, Angstroem Laboratory, Uppsala University, P.O. Box 516, SE-75120 Uppsala (Sweden); Hermansson, K. [Department of Chemistry, Angstroem Laboratory, Uppsala University, P.O. Box 538, SE-75121 Uppsala (Sweden); Department of Theoretical Chemistry, Royal Institute of Technology (KTH), Roslagstullsbacken 15, SE-10691 Stockholm (Sweden)

    2012-11-12

    Mg-doped VO{sub 2} thin films with thermochromic properties were made by reactive DC magnetron co-sputtering onto heated substrates, and spectral absorption was recorded at room temperature in the 0.5 < h{omega} < 3.5 eV energy range. Clear evidence was found for a widening of the main band gap from 1.67 to 2.32 eV as the Mg/(V + Mg) atomic ratio went from zero to 0.19, thereby significantly lowering the luminous absorption. This technologically important effect could be reconciled with spin-polarized density functional theory calculations using the Heyd-Scuseria-Ernzerhof [Heyd et al., J. Chem. Phys. 118, 8207 (2003); ibid. 124, 219906 (2006)] hybrid functional. Specifically, the calculated luminous absorptance decreased when the Mg/(V + Mg) ratio was increased from 0.125 to 0.250.

  1. Optical properties of Mg-doped VO2: Absorption measurements and hybrid functional calculations

    Mg-doped VO2 thin films with thermochromic properties were made by reactive DC magnetron co-sputtering onto heated substrates, and spectral absorption was recorded at room temperature in the 0.5 < ħω < 3.5 eV energy range. Clear evidence was found for a widening of the main band gap from 1.67 to 2.32 eV as the Mg/(V + Mg) atomic ratio went from zero to 0.19, thereby significantly lowering the luminous absorption. This technologically important effect could be reconciled with spin-polarized density functional theory calculations using the Heyd-Scuseria-Ernzerhof [Heyd et al., J. Chem. Phys. 118, 8207 (2003); ibid. 124, 219906 (2006)] hybrid functional. Specifically, the calculated luminous absorptance decreased when the Mg/(V + Mg) ratio was increased from 0.125 to 0.250.

  2. Renal function three years after early conversion from a calcineurin inhibitor to everolimus

    Mjörnstedt, Lars; Schwartz Sørensen, Søren; von Zur Mühlen, Bengt; Jespersen, Bente; Hansen, Jesper M; Bistrup, Claus; Andersson, Helene; Gustafsson, Bengt; Solbu, Dag; Holdaas, Hallvard

    2015-01-01

    In a 36-month, open-label, multicenter trial, 202 kidney transplant recipients were randomized at week 7 post-transplant to convert to everolimus or remain on cyclosporine: 182 were analyzed to month 36 (92 everolimus, 90 controls). Mean (SD) change in measured GFR (mGFR) from randomization to.......001). During months 12-36, death-censored graft survival was 100%, patient survival was 98.9% and 96.7% in the everolimus and control groups, respectively, and 13.0% and 11.1% of everolimus and control patients, respectively, experienced mild biopsy-proven acute rejection (BPAR). Protocol biopsies in a limited...... discontinuation was more frequent with everolimus (33.7% vs. 10.0%). Conversion from cyclosporine to everolimus at 7 weeks post-transplant was associated with a significant benefit in renal function at 3 years when everolimus was continued....

  3. Physiological antioxidant system and oxidative stress in stomach cancer patients with normal renal and hepatic function

    E Prabhakar Reddy

    2010-04-01

    Full Text Available Role of free radicals has been proposed in the pathogenesis of many diseases. Gastric cancer is a common disease worldwide, and leading cause of cancer death in India. Severe oxidative stress produces reactive oxygen species (ROS and induces uncontrolled lipid peroxidation. Albumin, uric acid (UA and Bilirubin are important physiological antioxidants. We aimed to evaluate and assess the role of oxidative stress (OS and physiological antioxidant system in stomach cancer patients. Lipid peroxidation measured as plasma Thio Barbituric Acid Reactive substances (TBARS, was found to be elevated significantly (p=0.001 in stomach cancer compared to controls along with a decrease in plasma physiological antioxidant system. The documented results were due to increased lipid peroxidation and involvement of physiological antioxidants in scavenging free radicals but not because of impaired hepatic and renal functions.

  4. Kidney-enquete 1992: State of the art of renal function scintigraphy in Germany

    The aim of the 'Nierenenquete 1992' was to evaluate the present importance, indications and methodological strategies of the renography (RG) in Germany. A questionnaire containing 11 issues was sent to a total of 158 nuclear medicine physicians. 103 of these are practicing at a hospital, 55 at a clinic. The questionnaire demonstrated, that RG today is carried out at a highly differentiated level. An important step toward this status today is the introduction of 99mTc-MAG-3, which has rapidly become the renal radiopharmaceutical agent of first choice for RG in Germany. The increasing use of RG in the pediatric field and for functional monitoring of the transplanted kidney is very likely due to the excellent acceptance of 99mTc-MAG-3. 84% of all nuclear medicine physicians have adopted interventional techniques (e.g. Furosemid, Captopril). These additional indications are responsible for the increase of RG's performed last year. (orig.)

  5. A retrospective characterization of worsening renal function in patients with acute decompensated heart failure receiving nesiritide

    Starr JA

    2009-09-01

    Full Text Available Nesiritide is approved by Food and Drug Administration (FDA for the treatment of patients with acute decompensated heart failure (ADHF due its ability to rapidly reduce cardiac filling pressures and improve dyspnea. Numerous studies have shown that renal dysfunction is associated with unfavorable outcomes in patients with heart failure. In addition, there have been reports suggesting that nesiritide may adversely affect renal function and mortality. Objective: The purpose of this retrospective analysis was to assess the effect of dose and duration of nesiritide use and the dose and duration of diuretic therapy on worsening renal function and increased in-hospital mortality in this patient population.Methods: Seventy-five patients who were hospitalized for ADHF and who were treated with nesiritide for at least 12 hours were reviewed retrospectively. Results: The mean increase in SCr was 0.5 mg/dL (range 0 – 4.4 mg/dL. Thirty-six percent of patients (27/75 met the primary endpoint with an increase in SCr>0.5 mg/dL. Treatment dose and duration of nesiritide did not differ between those patients who had an increase in SCr>0.5 mg/dL and those who did not (p=0.44 and 0.61. Concomitant intravenous diuretics were used in 85% of patients with an increase in SCr >0.5 mg/dL compared to 90% of patients without an increase in SCr>0.5 mg/dL (p=0.57. The in-hospital mortality rate was also higher at 35% in those patients with an increase in creatinine >0.5 mg/dL compared to 11% in those without (p=0.01. Conclusion: Nesiritide was associated with an increase in SCr > 0.5 mg/dL in approximately one-third of patients. The increase occurred independently of dose, duration of nesiritide therapy, blood pressure changes, and concomitant intravenous diuretic use. However, the increase in SCr was associated with an increase in hospital stay and in hospital mortality consistent with previous reports in the literature.

  6. The enhancement of the renal cortex and medulla and the renal function: a correlative study of conventional CT scan with glomerular filtration rate

    CTac/CTam to reflect enhancement of renal cortex, the diseased kidneys can be divided into groups of strong (CTac/CTam ≥2.60); less strong (2.20 ≤ CTac/CTam < 2.60); medium (1.80 ≤ CTac/CTam < 2.20); and weak ( CTac/CTam < 1.80). The consistency with GFR grouping was 80.0%. Conclusions: There is significant correlation between renal cortex-related indicators and GFR, especially CTac/CTam, which can be used as the indicator of renal function in patients with unilateral or bilateral postrenal obstructive hydronephrosis. The conventional contrast enhanced CT scan can be taken as a semi-quantitative method of GFR measuring with relative low X-ray dosage compared with CT perfusion. (authors)

  7. Renal impairment after liver transplantation - a pilot trial of calcineurin inhibitor-free vs. calcineurin inhibitor sparing immunosuppression in patients with mildly impaired renal function after liver transplantation

    Gerhardt T

    2009-05-01

    Full Text Available Abstract Objectives Chronic kidney disease is frequent in patients after orthotopic liver transplantation (OLT and has impact on survival. Patients receiving calcineurin inhibitors (CNI are at increased risk to develop impaired renal function. Early CNI reduction and concomitant use of mycophenolat mofetil (MMF has been shown to improve renal function. Methods The aim of this trial was to compare dose-reduced CNI/MMF versus CNI-free MMF/prednisone-based treatment in stable patients after OLT with respect to glomerular filtration rate (GFR. 21 patients [GFR 44.9 ± 9.9 mL/min/1.73 m2 measured by 99m-Tc-DTPA-clearance, serum creatinine (SCr 1.5 ± 0.42 mg/dL] were randomized either to exchange CNI for 10 mg prednisone (group 1; n = 8 or to receive CNI at 25% of the initial dose (group 2; n = 13 each in combination with 1000 mg MMF b.i.d. Results At month 12 mean SCr (-0.3 ± 0.4 mg/dL, p = 0.031 and GFR improved (8.6 ± 13.1 mL/min/1.73 m2, p = 0.015 in group 2 but remained unchanged in group 1. Main side effects were gastroinstestinal symptoms (14.3% and infections (4.8%. Two biopsy proven, steroid-responsive rejections occurred. In group 1 mean diastolic blood pressure (BP increased by 11 ± 22 mmHg (p = 0.03. Conclusions Reduced dose CNI in combination with MMF but not CNI-free-immunosuppression leads to improvement of GFR in patients with moderately elevated SCr levels after OLT. Addition of steroids resulted in increased diastolic blood pressure presumably counterbalancing the benefits of CNI withdrawal on renal function.

  8. Radionuclide and/or radiological technique as a comprehensive renal function study in clinical pediatric pratice

    84 patients with clinically suspected urinary pathway pathology always underwent CRRA (Computerized Radionuclide Renal Angiography) and IVP (Intra Venous Pyelography); in some selected children RC (Retrograde Cystography) and CRDC (Computerized Retrograde Cysto Scintigraphy) and/or RCS (Retrograde Cysto Scintigraphy) and/or RCS (Retrograde Cysto Scintigraphy) were performed. These children, ranging from 1 day to 14 years of age, were classified, on the basis of clinical features, as: glomerulonephritis (34 cases); pyelonephritis (7 cases); vesico-ureteral reflux (15 cases); kidney and/or urinary tract malformations (29 cases). Clinical suspicion was proven by radioisotope and radiographic studies in 55 patients, namely: glomerulonephritis (23 cases); pyelonephritis (5 cases); vesico-ureteral reflux (11 cases); kidney and/or urinary tract malformation (16 cases). Among complications of the last pathology two cases of pyelo-pyelic reflux in a Y shaped duplication, cause of recurrent lumbar pain and urinary infection, not detected by IVP and RC, were discovered by CRRA; in addition two cases of vesico-ureteral reflux in patients with recurrent urinary infection were detected by CRDC but not confirmed by RC (these refluxes were considered as insignificant and transient). In our opinion, radioisotope studies (CRRA-CRDC-RCS) by i.v. injection (99m-Tc-DTPA; 0.30 MBq/kg) or by vesical catheterisation (99m-Tc-pertecnetate; 18 MBq) are particularly useful to differentiate complete from incomplete, organic from functional urinary tract obstruction, since they allow a quantitative assessment of both kidney function and unilateral renal impairment. Radiographic examination (IVP and RC), on the other hand, provide more detailed anatomical information, but are less suitable for monitoring treatment because of the higher radiation dose delivered to the patients. (Author)

  9. Clinical Usefulness of Serum Cystatin C as a Marker of Renal Function

    Kwang-Sook Woo

    2014-08-01

    Full Text Available BackgroundAccurate renal function measurements are important in the diagnosis and treatment of kidney diseases. In contrast to creatinine, the production of serum cystatin C has been extensively reported to be unaffected by body muscle mass, age, gender, and nutritional status.MethodsOur study included 37 samples from diabetic chronic kidney disease (CKD patients for whom serum creatinine tests had been requested and 40 samples from a healthy populations in Dong-A University Hospital between May 2010 and June 2010. The assay precision (i.e., the coefficient of variation and the reference range of the serum cystatin C test were evaluated. We compared the estimated glomerular filtration rates (GFRs based on cystatin C with those based on creatinine. Moreover, we investigated the influences of age, gender, weight, and muscle mass on serum creatinine and serum cystatin C.ResultsThere was a positive correlation between GFR based on creatinine and that based on cystatin C (r=0.79, P<0.0001 among the diabetic CKD patients. Serum creatinine and cystatin C were significantly correlated with body weight and muscle mass, but the strengths of these correlations were greater for serum creatinine. The precision study revealed excellent results for both the high and low controls. The 95% reference interval of cystatin C in the healthy population was 0.371 to 1.236 mg/L.ConclusionBased on these results, we conclude that, despite the strong correlation between serum creatinine and cystatin C, cystatin C is less affected by weight and muscle mass and might represent a better alternative for the assessment of renal function.

  10. Comparison of Serum Cystatin C and Creatinine Levels to Evaluate Early Renal Function after Kidney Transplantation

    Hamid Eshraghi

    2009-06-01

    Full Text Available Background: Accurate and rapid assessment of allograftfunction is essential in renal transplant recipients in order todetect allograft rejection and to monitor drug nephrotoxicity.We aimed to evaluate the usefulness of cystatin C as a markerof kidney allograft function in the early post-transplant periodand to compare this value with that of conventional serumcreatinine concentration.Methods: Twenty four patients scheduled for kidney transplantationat the Kidney Transplant Center of Ghaem Hospital,Mashhad, Iran from September 2006 to November 2007,were sequentially enrolled into the present study. Serumcreatinine and cystatin C concentrations and urine output weremeasured daily after transplantation for 3 weeks or until dischargefrom the hospital.Results: On the 3rd postoperative day, with a cut-off value of75 mL/min for glomerular filtration rate, areas under the receiveroperating characteristic (ROC curves were 0.926 forcreatinine (P=0.021 and 0.815 for cystatin C (P=0.088. Atthis point creatinine was more sensitive and specific than cystatinC in estimating glomerular filtration rate. On the 7th dayafter transplantation, areas under ROC curves were 0. 893 forcreatinine (P=0.066 and 1.000 for cystatin C (P=0.017.Therefore, cystatin C was more sensitive and specific thancreatinine in estimating glomerular filtration rate. In two patientswith acute rejection and arterial thrombosis, serum cystatinC concentrations increased earlier than serum creatinine.Conclusion: There is a correlation between creatinine and cystatinC early after kidney transplantation. Serum creatinine levelsseem to be more sensitive and specific for detecting transitorychanges in renal function in the 1st week after transplantation.After the 1st week after transplantation, cystatin C wasmore sensitive and specific than serum creatinine concentration.

  11. Accelerated decline and prognostic impact of renal function after myocardial infarction and the benefits of ACE inhibition : the CATS randomized trial

    Hillege, HL; van Gilst, WH; van Veldhuisen, DJ; Navis, G; Grobbee, DE; de Graeff, PA; de Zeeuw, D

    2003-01-01

    Aims Information regarding the cardiorenal axis in patients after a myocardial infarction (MI) is limited. We examined the change in renal function after a first MI, the protective effect of angiotensin converting enzyme (ACE) inhibition and the prognostic value of baseline renal function. Methods a

  12. Pharmacokinetics and safety of olodaterol administered with the Respimat Soft Mist inhaler in subjects with impaired hepatic or renal function

    Kunz C

    2016-03-01

    Full Text Available Christina Kunz,1 Doreen Luedtke,1 Anna Unseld,2 Alan Hamilton,3 Atef Halabi,4 Martina Wein,5 Stephan Formella6 1Translational Medicine and Clinical Pharmacology, 2Global Biometrics and Clinical Applications, Boehringer Ingelheim Pharma GmbH and Co KG, Biberach, Germany; 3Boehringer Ingelheim, Burlington, ON, Canada; 4CRS Clinical Research Services Kiel GmbH, Kiel, 5Drug Metabolism and Pharmacokinetics, Boehringer Ingelheim Pharma GmbH and Co KG, Biberach, 6Medicine Coordination, Boehringer Ingelheim Pharma GmbH and Co KG, Ingelheim, Germany Purpose: In two trials, the influences of hepatic and renal impairment on the pharmacokinetics of olodaterol, a novel long-acting inhaled β2-agonist for treatment of COPD, were investigated.Subjects and methods: The first trial included eight subjects with mild hepatic function impairment (Child–Pugh A, eight subjects with moderate impairment (Child–Pugh B, and 16 matched healthy subjects with normal hepatic function. The second trial included eight subjects with severe renal impairment (creatinine clearance <30 mL·min-1 and 14 matched healthy subjects with normal renal function. Subjects received single doses of 20 or 30 µg olodaterol administered with the Respimat Soft Mist inhaler.Results: Olodaterol was well tolerated in all subjects. The geometric mean ratios and 90% confidence intervals of dose-normalized area under the plasma concentration-time curve from time zero to 4 hours (AUC0–4 for subjects with mild and moderate hepatic impairment compared to healthy subjects were 97% (75%–125% and 105% (79%–140%, respectively. Corresponding values for dose-normalized maximum concentration (Cmax were 112% (84%–151% (mild impairment and 99% (73%–135% (moderate impairment. The geometric mean ratio (90% confidence interval of AUC0–4 for subjects with severe renal impairment compared to healthy subjects was 135% (94%–195%, and for Cmax was 137% (84%–222%. There was no significant relationship

  13. Cadmium causes delayed effects on renal function in the offspring of cadmium-contaminated pregnant female rats.

    Jacquillet, G; Barbier, O; Rubera, I; Tauc, M; Borderie, A; Namorado, M C; Martin, D; Sierra, G; Reyes, J L; Poujeol, P; Cougnon, M

    2007-11-01

    In the adult rat, chronic cadmium intoxication induces nephropathy with Fanconi-like features. This result raises the question of whether intoxication of pregnant rats has any deleterious effects on renal function in their offspring. To test this hypothesis, we measured the renal function of 2- to 60-day-old postnatal offspring from female rats administered cadmium chloride by the oral route (0.5 mg.kg(-1).day(-1)) throughout their entire gestation. Investigations of rat offspring from contaminated pregnant rats showed the presence of cadmium in the kidney at gestational day 20. After birth, the cadmium kidney concentration increased from postnatal day 2 to day 60 (PND2 to PND60), presumably because of 1) milk contamination and 2) neonatal liver cadmium content release. Although the renal parameters (glomerular filtration, U/P inulin, and urinary excretion rate) were not significantly affected until PND45, renal failure appeared at PND60, as demonstrated by a dramatic decrease of the glomerular filtration rate associated with increased excretion of the main ions. In parallel, an immunofluorescence study of tight-junction protein expression of PND60 offspring from contaminated rats showed a disorganization of the tight-junction proteins claudin-2 and claudin-5, specifically expressed in the proximal tubule and glomerulus, respectively. In contrast, expression of a distal claudin protein, claudin-3, was not affected. In conclusion, in utero exposure of cadmium leads to toxic renal effects in adult offspring. These results suggest that contamination of pregnant rats is a serious and critical hazard for renal function of their offspring. PMID:17686954

  14. Trombólise tardia e espontânea de artéria renal sem comprometimento funcional Late and spontaneous thrombolysis of renal artery without functional impairtment

    Claudio Pinho

    2009-09-01

    Full Text Available A aterosclerose em artérias renais é um importante fator desencadeante de tromboses com subsequente comprometimento da função e da viabilidade renal. A oclusão aguda das artérias renais por trombo ou êmbolo é causa incomum e potencialmente reversível de falência renal. Todavia, a duração e o grau de oclusão arterial compatível com a manutenção da viabilidade do parênquima renal ainda não estão bem estabelecidos, razão pela qual o diagnóstico precoce e a intervenção são importantes. O objetivo deste artigo é descrever um caso de trombose de artéria renal de rim funcional único, com lise espontânea e tardia do trombo seguida de recuperação funcional inesperada.Renal artery atherosclerosis is an important triggering factor for thrombosis followed by impairment of renal function and viability. The acute occlusion of the renal artery by a thrombus or an embolus is an unusual and potentially reversible cause of renal failure. However, the duration and degree of arterial occlusion compatible with the viability of the renal parenchyma have not been well established, hence the importance of early diagnosis and intervention. The purpose of this study is to describe a case of renal artery thrombosis of a functionally single kidney, with late and spontaneous thrombolysis followed by unexpected functional recovery.

  15. Exploring genetic and non-genetic risk factors for delayed graft function, acute and subclinical rejection in renal transplant recipients

    Moes, Dirk Jan A R; Press, Rogier R; Ackaert, Oliver; Ploeger, Bart A; Bemelman, Frederike J; Diack, Cheikh; Wessels, Judith A M; van der Straaten, Tahar; Danhof, Meindert; Sanders, Jan-Stephan F; Homan van der Heide, Jaap J; Guchelaar, Henk Jan; de Fijter, Johan W

    2016-01-01

    AIMS: This study aimed at identifying pharmacological factors such as pharmacogenetics and drug exposure as new predictive biomarkers for delayed graft function (DGF), acute rejection (AR) and/or subclinical rejection (SCR). METHODS: Adult renal transplant recipients (n = 361) on cyclosporine-based

  16. Slow Gait Speed and Rapid Renal Function Decline Are Risk Factors for Postoperative Delirium after Urological Surgery

    Sato, Tendo; Okamoto, Teppei; Yamamoto, Hayato; Hosogoe, Shogo; Tobisawa, Yuki; Yoneyama, Tohru; Hashiba, Eiji; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Hirota, Kazuyoshi; Ohyama, Chikara

    2016-01-01

    Objectives The aim of this study was to identify risk factors associated with postoperative delirium in patients undergoing urological surgery. Methods We prospectively evaluated pre- and postoperative risk factors for postoperative delirium in consecutive 215 patients who received urological surgery between August 2013 and November 2014. Preoperative factors included patient demographics, comorbidities, and frailty assessment. Frailty was measured by handgrip strength, fatigue scale of depression, fall risk assessment, and gait speed (the timed Get-up and Go test). Postoperative factors included types of anesthesia, surgical procedure, renal function and serum albumin decline, blood loss, surgery time, highest body temperature, and complications. Uni- and multivariate logistic regression analyses were performed to assess pre- and postoperative predictors for the development of postoperative delirium. Results Median age of this cohort was 67 years. Ten patients (4.7%) experienced postoperative delirium. These patients were significantly older, had weak handgrip strength, a higher fall risk assessment score, slow gait speed, and greater renal function decline compared with patients without delirium. Multivariate analysis revealed slow gait speed (>13.0 s) and rapid renal function decline (>30%) were independent risk factors for postoperative delirium. Conclusions Slow gait speed and rapid renal function decline after urological surgery are significant factors for postoperative delirium. These data will be helpful for perioperative patient management. This study was registered as a clinical trial: UMIN: R000018809. PMID:27145178

  17. Urinary Leukotriene E4 Is Associated with Renal Function but Not with Endothelial Function in Type 2 Diabetes

    Arnar Rafnsson

    2013-01-01

    Full Text Available Leukotrienes are inflammatory and vasoactive mediators implicated in endothelium-dependent relaxations and atherosclerosis. Urinary leukotriene E4 (U-LTE4 is a validated disease marker of asthma and increases also in diabetes and acute coronary syndromes. The aim of the present study was to evaluate the association of U-LTE4 and CRP with endothelial function. Urine samples were obtained from 30 subjects (80% males; median age 65 with type 2 diabetes of at least two years duration and a median glomerular filtration rate (eGFR of 71 (14–129 mL/min. Reactive hyperemia index (RHI was used as a measure of microvascular endothelial function, whereas macrovascular endothelial function was determined be means of flow-mediated dilatation of the brachial artery (FMD. Decreased renal function was associated with lower concentrations of U-LTE4. In addition, U-LTE4 was correlated with serum creatinine (R=−0.572; P=0.001 and eGFR (R=0.517; P=0.0036. A stepwise multiple linear regression analysis identified eGFR as an independent predictor of U-LTE4 concentrations. In conclusion, the present results did not establish an association of U-LTE4 with endothelial dysfunction. However, eGFR was an independent predictor of U-LTE4, but not CRP, in this cohort, suggesting that GFR should be considered in biomarker studies of U-LTE4.

  18. Efficacy of retroperitoneal laparoscopic ureterolithotomy for the treatment of large proximal ureteric stones and its impact on renal function

    Yasui, Takahiro; Okada, Atsushi; Hamamoto, Shuzo; Taguchi, Kazumi; Ando, Ryosuke; Mizuno, Kentaro; Itoh, Yasunori; Tozawa, Keiichi; Hayashi, Yutaro; Kohri, Kenjiro

    2013-01-01

    Purpose The purpose of this study was to evaluate the efficacy of retroperitoneal laparoscopic ureterolithotomy for the management of large proximal ureteric stones and the impact of this treatment on postoperative renal function. Methods The data of 12 patients (7 men and 5 women; mean age, 68.5 ± 8.9 years) with large pyeloureteral junction (2 cases) and upper ureteral (10 cases) stones (25.3 ± 7.4 mm) that had undergone retroperitoneal laparoscopic ureterolithotomy were reviewed. Renal fun...

  19. Evaluation of patient renal function following endovascular aneurysm repair with suprarenal fixation

    YingBin Jia

    2011-09-01

    Full Text Available This study aimed to assess the mid-term renal function of abdominal aortic aneurysm patients following suprarenal endovascular repair. From March 2005 to December 2009, 290 abdominal aortic aneurysm patients were included in the study and grouped according to whether they had received infrarenal or suprarenal endovascular aneurysm repair. Suprarenal endovascular aneurysm repair was performed in 173 patients, with a mean age of 72(±8 years (85.0% male. Infrarenal endovascular aneurysm repair was performed in 117 patients, with a mean age of 71(±9 years (90.6% male. Preoperative and one week, 1-, 3-, 6- and 12-month postoperative serum creatinine and cystatin C values were recorded. Estimated glomerular filtration rate was calculated by cystatin-based formula and Cr-based Cockcroft formula. The t-test was used to determine statistical differences between or within groups. All patients received Talent or Zenith endograft. Patients’ characteristics and operative files in the two groups were well matched. Preoperative serum creatinine and cystatin C were 82 (±8 mmol/L and 0.89 (±0.11 mg/L for suprarenal endovascular aneurysm repair, respectively, and 81 (±11 mmol/L and 0.87 (±0.15 mg/L, respectively, for infrarenal endovascular aneurysm repair; no differences were observed between the two groups. Compared to preoperative renal markers within each group, a deterioration in serum creatinine, cystatin C and estimated glomerular filtration rate values was found at one week and 12 months after surgery(P<0.05. A deterioration in cystatin C [SR:(0.93±0.17 mg/L, IR: (0.92±0.31 mg/L] and estimated glomerular filtration rate by cystatin C was also found at six months after surgery(P<0.05. However, no differences in patient serum creatinine, cystatin C and estimated glomerular filtration rate values were observed between groups at each follow-up time interval. There was no greater significant difference in the association of the use of suprarenal

  20. Pre- and Post-operative cortical function of the kidney with staghorn calculi assessed by sup(99m)Tc-DMSA renal scintigraphy

    sup(99m)Tc-DMSA renal scintigraphy consisting of the cortical image and DMSA renal uptake was used to assess the pre- and post-operative renal function in 39 patients with staghorn calculi or complicated calculi occupying more than 2 major calices. Extended pyelolithotomy was performed on 14 patients, nephrolithotomy on 14 patients, pyelolithotomy combined with nephrotomy on 7 patients, and partial nephrectomy on 4 patients. Nine out of 14 patients who underwent pyelolithotomy and 4 out of 14 patients who underwent nephrolithotomy showed an increase or no change in the postoperative DMSA renal uptake in the diseased kidney. However, there was no increase in the postoperative DMSA renal uptake in the patients who underwent pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight percent of the preoperative DMSA renal uptake in the diseased kidney seems to be the absolute level for predicting a postoperative recovery of the kidney function. The contralateral kidney function can affect the postoperative recovery of the function in the operative side. It seems to be hard to expect an increment in the DMSA renal uptake postoperatively when the ratio of DMSA renal uptake in the operative side to the total DMSA renal uptake is less than 20%. At least 6 months of the follow-up period is necessary for the evaluation of the kidney function in the operative side. DMSA renal scintigraphy is a useful modality to assess pre- and post-operative kidney function in nephrolithiasis from the point of both morphological and functional changes in the renal cortex. (author)

  1. Pre- and post-operative cortical function of the kidney with staghorn calculi assessed by sup(99m)Tc-DMSA renal scintigraphy

    Kawamura, Juichi (Kyoto Univ. (Japan). Faculty of Medicine)

    1982-08-01

    sup(99m)Tc-DMSA renal scintigraphy consisting of the cortical image and DMSA renal uptake was used to assess the pre- and post-operative renal function in 39 patients with staghorn calculi or complicated calculi occupying more than 2 major calices. Extended pyelolithotomy was performed on 14 patients, nephrolithotomy on 14 patients, pyelolithotomy combined with nephrotomy on 7 patients, and partial nephrectomy on 4 patients. Nine out of 14 patients who underwent pyelolithotomy and 4 out of 14 patients who underwent nephrolithotomy showed an increase or no change in the postoperative DMSA renal uptake in the diseased kidney. However, there was no increase in the postoperative DMSA renal uptake in the patients who underwent pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight percent of the preoperative DMSA renal uptake in the diseased kidney seems to be the absolute level for predicting a postoperative recovery of the kidney function. The contralateral kidney function can affect the postoperative recovery of the function in the operative side. It seems to be hard to expect an increment in the DMSA renal uptake postoperatively when the ratio of DMSA renal uptake in the operative side to the total DMSA renal uptake is less than 20%. At least 6 months of the follow-up period is necessary for the evaluation of the kidney function in the operative side. DMSA renal scintigraphy is a useful modality to assess pre- and post-operative kidney function in nephrolithiasis from the point of both morphological and functional changes in the renal cortex.

  2. Evaluation of total renal function from 99mTc-MAG3 scintigraphy in children

    Aim: The aim of the present study was to evaluate the usefulness of dynamic scintigraphy in the assessment of total renal function in children. The Patlak slope of 99mTc-MAG3 renography curves were compared to the plasma clearance values of 51Cr-EDTA. Material and methods: The study sample consisted of 53 boys and 33 girls with various nephrologic disorders, referred for routine clinical reasons. The median age of the subjects was 5.1 years (range 0.3 - 14.1 years). Imaging procedure. In supine position, the patient received a bolus injection of 1 MBq/kg, (minimum 10 MBq) 99mTc-MAG3 and a posterior dynamic gamma camera registration was performed for 21 min using 1 frame per second during the first minute and thereafter 10 seconds frames. Data analysis. Time-activity curves were generated from manually drawn heart and renal regions of interest. The MAG3 uptake was calculated from the Patlak-Rutland plot of each kidney by linear curve fitting until the beginning of the excretory phase. A sum of the slope values was used as a measure of total renal MAG3 uptake. Cr-EDTA clearance. Glomerular filtration rate (GFR) was measured from the plasma clearance of 51Cr-EDTA using single injection, multiple-sample technique. After intravenous injection of 51Cr-EDTA (74 kBq/kg for children up to 7 years, 37 kBq/kg for children older than 7 years), blood samples were drawn at 5, 10, 15, 45, 60, 120 and 180 min for radioactivity measurement. The GFR was calculated according to Broechner-Mortensen and expressed in ml/min. Results: The absolute 51Cr-EDTA clearance varied from 9 to 143 ml/min. There was a close linear relationship between 51Cr-EDTA clearance and MAG3 uptake (Fig). The correlation coefficient was 0.90 and the regression equation (y=43.5 x + 664). Conclusions: In the present study, there was a good correlation between plasma clearance of 51Cr-EDTA and the sum of the Patlak slopes. The regression equation can be utilised to transform the 99mTc-MAG3 uptake to an estimate

  3. Effects of acute hypoxia on renal and endocrine function at rest and during graded exercise in hydrated subjects

    Olsen, Niels Vidiendal; Kanstrup, I L; Richalet, J P;

    1992-01-01

    Renal effects of altitude hypoxia are unclear. Renal and hormonal function was investigated in eight males at rest and during graded exercise at sea level (SL) and 48 h after rapid ascent to 4,350 m (HA). HA did not change resting values of effective renal plasma flow (ERPF), glomerular filtration...... rate (GFR), sodium clearance (CNa), urine flow, or lithium clearance (CLi), which was used as an index of proximal tubular outflow. At rest, HA increased plasma norepinephrine concentration and decreased plasma concentrations of renin and aldosterone. Exercise decreased ERPF similarly in both...... environments. Normoxic exercise progressively reduced GFR, but at HA GFR only decreased during heavy exercise. This resulted in a higher filtration fraction during light and moderate hypoxic exercise. However, calculated absolute proximal reabsorption rate (GFR-CLi) at HA was higher during low...

  4. Erlotinib preserves renal function and prevents salt retention in doxorubicin treated nephrotic rats.

    Raed N Bou Matar

    Full Text Available Nephrotic syndrome is associated with up-regulation of the heparin-binding epidermal growth factor (HB-EGF. Erlotinib blocks the activation of the epidermal growth factor receptor (EGFR in response to HB-EGF. This study investigates the effect of Erlotinib on the progression of proteinuria, renal dysfunction, and salt retention in doxorubicin treated nephrotic rats. Male rats were divided into 3 pair-fed groups (n = 13/group as follows: Control rats (Ctrl; rats receiving intravenous doxorubicin (Dox; and rats receiving intravenous doxorubicin followed by daily oral Erlotinib (Dox + Erl. Upon establishment of high grade proteinuria, urine sodium and creatinine clearance were measured. Kidney tissue was dissected and analyzed for γ-epithelial sodium channel (γENaC, sodium-potassium -chloride co-transporter 2 (NKCC2, sodium chloride co-transporter (NCC, aquaporin 2 (AQP2, and EGFR abundances using western blot. Creatinine clearance was preserved in the Dox + Erl rats as compared to the Dox group (in ml/min: Ctrl: 5.2±.5, Dox: 1.9±0.3, Dox + Erl: 3.6±0.5. Despite a minimal effect on the degree of proteinuria, Erlotinib prevented salt retention (Urinary Na in mEq/d: Ctrl: 2.2±0.2, Dox: 1.8±0.3, Dox + Erl: 2.2±0.2. The cleaved/uncleaved γENaC ratio was increased by 41±16% in the Dox group but unchanged in the Dox + Erl group when compared to Ctrl. The phosphorylated EGFR/total EGFR ratio was reduced by 74±7% in the Dox group and by 77±4% in the Dox + Erl group. In conclusion, Erlotinib preserved renal function and prevented salt retention in nephrotic rats. The observed effects do not appear to be mediated by direct blockade of EGFR.

  5. The Impact of Nonalcoholic Fatty Liver Disease on Renal Function in Children with Overweight/Obesity

    Lucia Pacifico

    2016-07-01

    Full Text Available The association between nonalcoholic fatty liver disease (NAFLD and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m2. Abnormal albuminuria was defined as urinary excretion of ≥30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m2 was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001. The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001. Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16–5.57; p < 0.05 independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease.

  6. A comparative study on renal function parameters and age in females with and without pre-eclampsia in a tertiary health care setup

    2013-01-01

    Background and objective: Pathogenesis of preeclampsia is known to be associated with renal dysfunction. But the best suited renal function parameter to quantify pathogenesis of this clinical condition is unclear. This study is aimed to assess the renal parameters in preeclampsia.Materials and Methods: 185 consecutive mothers in 20th week of gestational period were enrolled into the study. Based on the presence or absence of preeclampsia they were divided into two subgroups: Group A (82 mothe...

  7. Extracellular vesicles: structure, function, and potential clinical uses in renal diseases

    F.T. Borges

    2013-10-01

    Full Text Available Interest in the role of extracellular vesicles in various diseases including cancer has been increasing. Extracellular vesicles include microvesicles, exosomes, apoptotic bodies, and argosomes, and are classified by size, content, synthesis, and function. Currently, the best characterized are exosomes and microvesicles. Exosomes are small vesicles (40-100 nm involved in intercellular communication regardless of the distance between them. They are found in various biological fluids such as plasma, serum, and breast milk, and are formed from multivesicular bodies through the inward budding of the endosome membrane. Microvesicles are 100-1000 nm vesicles released from the cell by the outward budding of the plasma membrane. The therapeutic potential of extracellular vesicles is very broad, with applications including a route of drug delivery and as biomarkers for diagnosis. Extracellular vesicles extracted from stem cells may be used for treatment of many diseases including kidney diseases. This review highlights mechanisms of synthesis and function, and the potential uses of well-characterized extracellular vesicles, mainly exosomes, with a special focus on renal functions and diseases.

  8. Impact of aprotinin and renal function on mortality: a retrospective single center analysis

    Von Visger Jon

    2011-08-01

    Full Text Available Abstract Background An estimated up to 7% of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the U.S. Food and Drug Administration after a large prospective, randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However, only patients with normal kidney function have been studied. Methods In this study, we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question: Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction? Results Based on our model, aprotinin use was associated with a 3.8-fold increase in odds of death one year later compared to no aprotinin use with p-value = 0.0018, regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Conclusions Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding, but for overall safety to the whole organism using long-term clinical outcome studies, including those with varying degree of baseline kidney function.

  9. Cuidando do ser humano hipertenso e protegendo sua função renal Cuidando del ser humano hipertenso y protegiendo su función renal Caring for hipertensive patient and protection his renal function

    Cássia Orsolin

    2005-06-01

    Full Text Available Trata-se de um estudo exploratório-descritivo sobre a compreensão dos efeitos da função renal e sua relação com a hipertensão realizada com doze integrantes de 18 a 60 anos de um grupo de hipertensos vinculados a uma Unidade Básica de Saúde de um município do norte do Rio Grande do Sul. A coleta de dados realizou-se de março a maio de 2004, através de entrevistas grupais, abordando a técnica focal. A análise foi realizada conforme o método de análise temática e posterior categorização. Os resultados demonstraram que os integrantes, apesar de conhecerem, em parte, a fisiopatologia renal, não a vêem como conseqüência da hipertensão arterial.Tratase de una investigación exploratorio-descriptiva sobre la comprención de los efectos de la función renal y su relación con la hipertensión realizada con doce integrantes de 18 a 60 años de un grupo de hipertensos vinculados a una unidad básica de salud de un município del norte del Rio Grande del Sul. La coleta de datos se realizó entre marzo y mayo del 2004, a través de entrevistas de grupos, abordando la técnica focal. El análisis fue realizado de acuerdo al método de análisis temática y posterior categorización. Los resultados demonstraron que los integrantes, apesar de conoceren, en parte, la fisiopatología renal, no la ven como consecuente de la hipertensión arterial.This is an exploratory-descriptive study about the comprehension of the effects of renal function and its relation to hipertension. The study was carried out with 12 members of a hipertension group (range from 18-60 years-old entailed to a Basic Health Unit from a municipality of Rio Grande do Sul State. Data collection was carried out from March to May, 2004, by means of groupal interviews, approaching the focal technique. Analysis was proceeded according to thematic analysis and later categorization. Results demonstrated that the members, despite partially know renal physiopathology, they don

  10. Measurement of renal function by calculation of fractional uptake of technetium-99m dimercaptosuccinic acid

    The purpose of this study was to set up normal values of the fractional uptake (FU) of technetium-99m dimercaptosuccinic acid in adults and in the pediatric population, as well as to evaluate the validity of this parameter at different levels of renal function. A total of 86 subjects was divided into seven groups. In group A there were 23 potential kidney donors and in group B, 18 children in remission after a first urinary tract infection. Another three groups consisted of patients with diabetes i.e. group C, seven patients with normal values of albuminuria, group D, 16 patients with microalbuminuria and group E, five patients with macroalbuminuria. In group F, there were ten patients with a well-functioning transplanted kidney and in group G, seven patients with suspected acute rejection. The procedure began with the quantification of the doses of 99mTc-DMSA to be injected and the measurement of the empty syringe lying on the gamma camera collimator. Thereafter, four planar views of the kidneys were acquired three hours after the injection. The counts from the posterior and anterior views were subtracted for background and corrected for radioactive decay time and patient thickness. The FU was calculated by the geometric mean of counts per second from the posterior and anterior view. It was expressed as a fraction of the injected dose. The mean values of FU in healthy adults were 0.227 ± 0.077 for one kidney and 0.454 ± 0.146 for both kidneys. The mean values of FU for the left and right kidney were 0.225± 0.071 and 0.229 ± 0.079, respectively. In children, the mean values were 0.220 ± 0.092 for one kidney and 0.432 ± 0.094 for both kidneys. The highest values of FU of 0.322 ± 0.078 (0.644 ± 0.138 for both kidneys) were measured in group C. In group D, FU was 0.185 ± 0.065 (0.361 ± 0.125 for both kidneys) and in group E 0.082 ± 0.040 (0.163 ± 0.080 total). In patients with a transplanted kidney, fractional uptake was 0.162 ± 0.039 in group F and 0

  11. The Soluble Epoxide Hydrolase Inhibitor AR9281 Decreases Blood Pressure, Ameliorates Renal Injury and Improves Vascular Function in Hypertension

    Sean Shaw

    2009-12-01

    Full Text Available Soluble epoxide hydrolase inhibitors (sEHIs are demonstrating promise as potential pharmaceutical agents for the treatment of cardiovascular disease, diabetes, inflammation, and kidney disease. The present study determined the ability of a first-inclass sEHI, AR9281, to decrease blood pressure, improve vascular function, and decrease renal inflammation and injury in angiotensin hypertension. Rats were infused with angiotensin and AR9281 was given orally during the 14-day infusion period. Systolic blood pressure averaged 180 ± 5 mmHg in vehicle treated and AR9281 treatment significantly lowered blood pressure to 142 ± 7 mmHg in angiotensin hypertension. Histological analysis demonstrated decreased injury to the juxtamedullary glomeruli. Renal expression of inflammatory genes was increased in angiotensin hypertension and two weeks of AR9281 treatment decreased this index of renal inflammation. Vascular function in angiotensin hypertension was also improved by AR9281 treatment. Decreased afferent arteriolar and mesenteric resistance endothelial dependent dilator responses were ameliorated by AR9281 treatment of angiotensin hypertensive rats. These data demonstrate that the first-in-class sEHI, AR9281, lowers blood pressure, improves vascular function and reduces renal damage in angiotensin hypertension.

  12. Association between microalbuminuria and subclinical atherosclerosis evaluated by carotid artery intima-media in elderly patients with normal renal function

    Kong XiangLei

    2012-06-01

    Full Text Available Abstract Background Moderate to severe renal insufficiency and albuminuria have been shown to be independent risk factors for atherosclerosis. However, little is known about the direct association between subclinical atherosclerosis evaluated by carotid artery intima-media thickness (IMT and microalbuminuria in elderly patients with normal renal function. Methods Subjects were 272 elderly patients (age  ≥ 60 years with normoalbuminuria (n = 238 and microalbuminuria (n = 34. Carotid IMT was measured by means of high-resolution B-mode ultrasonography. Estimated glomerular filtration rate (eGFR ≥ 60 ml/min/1.73 m2 was defined as normal renal function. Those who had macroalbuminuria and atherosclerotic vascular disease were not included. Results Compared to subjects with normoalbuminuria, subjects with microalbuminuria had higher mean carotid IMT (1.02 ± 0.38 vs. 0.85 ± 0.28 mm; P  Conclusions A slight elevation of albuminuria is a significant determinant of carotid IMT independent of traditional cardiovascular risk factors in our patients. Our study further confirms the importance of intensive examinations for the early detection of atherosclerosis when microalbuminuria is found in elderly patients, although with normal renal function.

  13. Aortic Arch Calcification Predicts the Renal Function Progression in Patients with Stage 3 to 5 Chronic Kidney Disease

    Lung-Chih Li

    2015-01-01

    Full Text Available Introduction. The presence of aortic arch calcification (AoAC and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD. However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3–5 CKD. Methods. We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR. Results. Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly. Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3–5.

  14. Tailor the functionalities of metasurfaces: From perfect absorption to phase modulation

    Qu, Che; Hao, Jiaming; Qiu, Meng; Li, Xin; Xiao, Shiyi; Miao, Ziqi; Dai, Ning; He, Qiong; Sun, Shulin; Zhou, Lei

    2015-01-01

    Metasurfaces in metal/insulator/metal configuration have recently been widely used in photonics research, with applications ranging from perfect absorption to phase modulation, but why and when such structures can realize what kind of functionalities are not yet fully understood. Here, based on a coupled-mode theory analysis, we establish a complete phase diagram in which the optical properties of such systems are fully controlled by two simple parameters (i.e., the intrinsic and radiation losses), which are in turn dictated by the geometrical/material parameters of the underlying structures. Such a phase diagram can greatly facilitate the design of appropriate metasurfaces with tailored functionalities (e.g., perfect absorption, phase modulator, electric/magnetic reflector, etc.), demonstrated by our experiments and simulations in the Terahertz regime. In particular, our experiments show that, through appropriate structural/material tuning, the device can be switched across the functionality phase boundaries...

  15. Beta-Blockers and the Kidney: Implications for Renal Function and Renin Release.

    Epstein, Murray; And Others

    1985-01-01

    Reviews and discusses current information on the human renal response as related to beta-blockers (antihypertension agents). Topic areas considered include cardioselectivity, renal hemodynamics, systemic hemodynamics, changes with acute and chronic administration, influence of dose, and others. Implications and an 11-item multiple-choice self-quiz…

  16. ECTOPIC URETER DRAINING A POORLY FUNCTIONING RENAL MOIETY CAN BE MISSED BY IVP BUT NOT BY MRU

    Yusuf Temiz; Ferruh Şimşek; Salih Güran; Rengin Ahıskalı; Tufan Tarcan

    2007-01-01

    Ectopic ureter draining a poorly functioning renal moiety can be missed by classical radiological methods such as ultrasonography, voiding cystourethrogram and intravenous pyelogram. In such conditions, use of computerize tomography and magnetic resonance imaging have been advocated to diagnose poorly functioning, abnormal duplex collecting system and ectopic ureter. A case of a 16-year old girl with continuous dribbling incontinence and normal IVP and cystoscopy findings whose ectopic ureter...

  17. The Function of MicroRNAs in Renal Development and Pathophysiology

    Liming Ma; Lianghu Qu

    2013-01-01

    MicroRNAs (miRNAs) are a class of endogenous small non-coding RNAs that modulate diverse biological processes predominantly by translation inhibition or induction of mRNA degradation.They are important regulatory elements involved in renal physiology and pathology.Dysregulation of miRNAs disrupts early kidney development,renal progenitor cell differentiation and the maintenance of mature nephrons.miRNAs are also reported to participate in various renal diseases,including chronic kidney disease,acute kidney injury,allograft acute rejection and renal cell carcinoma.Differentially regulated miRNAs may represent innovative biomarkers for diagnosis and prognosis.Therefore,determining the roles of miRNAs in different types of renal diseases will help to clarify the pathogenesis and facilitate the development of novel therapies.

  18. N-nitrosodimethylamine (NDMA, Liver Function Enzymes, Renal Function Parameters and Oxidative Stress Parameters: A Review

    Usunobun Usunomena

    2012-08-01

    Full Text Available The aim of this study is to review a procarcinogen, the N-Nitrosodimethylamine (NDMA, liver and kidney functional enzymes (in assessing action of toxicants such as NDMA as well as oxidative stress parameters (in assessing the extent of free radical damage and scavenging. Catalase and hydro peroxidase enzymes convert hydrogen peroxide and hydro peroxides to non-radical forms and functions as natural antioxidant in human body. Enzymes like Superoxide Dismutase (SOD and Catalase (CAT and compounds such as tocopherol and ascorbic acid can protect organisms against free radical damage. Lipid peroxidation is a mechanism generally recognized as being the most important in the pathogenesis of liver injury by a number of toxic compounds including NDMA.

  19. Effects of bulbus Fritillaria water extract on blood pressure and renal functions in the L-NAME-induced hypertensive rats.

    Kang, Dae Gill; Sohn, Eun Jin; Lee, Yun Mi; Lee, An Sook; Han, Jong Hyun; Kim, Tai Yo; Lee, Ho Sub

    2004-03-01

    A pharmacological inhibition of nitric oxide synthase (NOS) in rats produces renal vasoconstriction, renal dysfunction, and hypertension. The present study was aimed at investigating whether Bulbus Fritillaria water extract (BFWE) ameliorates NG-nitro-L-arginine methylester (L-NAME)-induced hypertension. Treatment of rats with L-NAME (60 mg/l drinking water, 4 weeks) caused a sustained increase in systolic blood pressure (SBP). The NO concentration in plasma and NO productions in the vascular tissues of the L-NAME-treated group were significantly reduced as compared with those in the control, whereas the expressions of NOS proteins were not altered. BFWE restored SBP to normal level in the L-NAME-treated hypertensive rats. Moreover, BFWE was able to preserve the vascular NO production and plasma NO metabolites concentration without changes of the expression NOS proteins. The renal functional parameters including urinary volume, sodium excretion, and creatinine clearance (Ccr) were significantly restored in rats co-treated with BFWE and L-NAME compared to the L-NAME-treated group. Taken together, these results suggest that BFWE prevents the increase of SBP in the L-NAME-induced hypertension that may have been caused by enhanced generation of vascular NO and amelioration of renal functions. PMID:15036467

  20. Magnetic resonance imaging evaluation of renal structure and function related to disease: technical review of image acquisition, postprocessing, and mathematical modeling steps.

    Jones, Richard A; Votaw, John R; Salman, Khalil; Sharma, Puneet; Lurie, C; Kalb, Bobby; Martin, Diego R

    2011-06-01

    Kidney disease represents a leading cause of morbidity, with high healthcare costs. The existing methods used to evaluate renal function include measures of glomerular filtration rate (GFR), yet the clinical methods are generally inaccurate and poorly reproducible. A method that improves measures of renal function as part of a comprehensive examination that also evaluates renal structure represents an important unmet clinical need. Use of dynamic contrast-enhanced magnetic resonance imaging (MRI) for the evaluation of renal function has been undergoing development by several groups. The methodology has been referred to as MR Urography (MRU) or MR Nephro-urography (MRNU). MRU/MRNU shows promise for providing new insights into the evaluation of renal structure and function in relation to important disease processes, including urinary obstruction and in relation to renal transplantation. MRU/MRNU generally requires consideration of imaging acquisition technique, image postprocessing strategies, and subsequent kinetic mathematical modeling of the data in reference to specific physiological renal processes, such as renal blood flow and GFR. Here we review the specifics of proposed methods in light of the overall strengths and limitations of each of these strategies. The overall objective is to provide a roadmap for future developments in this evolving field of novel MRI applications. PMID:21590995

  1. Fluctuation of the renal function after discharge from hospital and its effects on drug dosing in elderly patients--study protocol

    Eppenga, W.L.; Wester, W.N.; Derijks, H.J.; Hoedemakers, R.M.; Wensing, M.J.; Smet, P.A.G.M. de; Marum, R.J. van

    2015-01-01

    BACKGROUND: Chronic kidney disease (CKD) is associated with an increased mortality rate, risk of cardiovascular events and morbidity. Impaired renal function is common in elderly patients, and their glomerular filtration rate (GFR) should be taken into account when prescribing renally excreted drugs

  2. Correlation between coagulation function, tumor stage and metastasis in patients with renal cell carcinoma: a retrospective study

    XIAO Bo; MA Lu-lin; ZHANG Shu-dong; XIAO Chun-lei; LU Jian; HONG Kai; LIAO Hong-yi

    2011-01-01

    Background The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.Methods A total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histolopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.Results The preoperative plasma fibrinogen levels of patients with renal cell carcinoma ((383.9±146.7) mg/dl) were significantly higher than those of the control group ((316.7±62.0) mg/dl) (P <0.01). We divided the renal cell carcinoma group into stages la, lb, Ⅱ, Ⅲ, and Ⅳ. The fibrinogen values were (315.6±64.6) mg/dl, (358.3±91.1) mg/dl, (465.6±164.7)mg/dl, (500.0±202.1) mg/dl, and (585.8±179.7) mg/dl, respectively. There were no significant differences in fibrinogen values between stage la and control groups. However, results of other stages showed significant differences when compared to control group values (P <0.01). Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia,plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.Concluslons Preoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is

  3. CT findings in ten patients with failed renal allografts: comparison with findings in functional grafts

    Our aim is to report the computed tomography (CT) features of the long-term failed renal allograft. Ten patients with failed renal transplants in whom the graft was left in situ underwent CT for various unrelated indications. The majority of the failed grafts showed marked shrinkage and coarse punctate diffuse parenchymal calcifications. Small cysts were seen in four grafts. A long-term failed renal transplant appeared on CT as a small rounded soft tissue mass. The graft was almost always heavily calcified. Lack of awareness of the nature of such a mass may mislead the radiologist in interpreting it as a space-occupying lesion

  4. Polarized Synchrotron Emissivities and Absorptivities for Relativistic Thermal, Power-law, and Kappa Distribution Functions

    Pandya, Alex; Zhang, Zhaowei; Chandra, Mani; Gammie, Charles F.

    2016-05-01

    Synchrotron emission and absorption determine the observational appearances of many astronomical systems. In this paper, we describe a numerical scheme for calculating synchrotron emissivities and absorptivities in all four Stokes parameters for arbitrary gyrotropic electron distribution functions, building on earlier work by Leung, Gammie, and Noble. We use this technique to evaluate the emissivities and the absorptivities for a thermal (Maxwell–Jüttner), isotropic power-law, and an isotropic kappa distribution function. The latter contains a power-law tail at high particle energies that smoothly merges with a thermal core at low energies, as is characteristic of observed particle spectra in collisionless plasmas. We provide fitting formulae and error bounds on the fitting formulae for use in codes that solve the radiative transfer equation. The numerical method and the fitting formulae are implemented in a compact C library called symphony. We find that the kappa distribution has a source function that is indistinguishable from a thermal spectrum at low frequency and transitions to the characteristic self-absorbed synchrotron spectrum, \\propto {ν }5/2, at high frequency; the linear polarization fraction for a thermal spectrum is near unity at high frequency; and all distributions produce O(10%) circular polarization at low frequency for lines of sight sufficiently close to the magnetic field vector.

  5. Cardio Renal Syndrome

    KV Sahasranam

    2014-10-01

    Full Text Available For a long time, physicians have recognized that the kidney and the heart are related especially when there is severe dysfunction of either of them. Dysfunction of one of these organs seldom occurs in isolation. Of late the cardio renal syndrome is assuming significance because of its increasing incidence, awareness and complications. There is no definite definition of the cardio renal syndrome. However, an attempted definition states that it is a "decline in renal function in the setting of advanced heart failure". This definition does not cover the whole gamut of the cardio renal syndrome. Cardiac diseases are associated independently with a decrease in renal function and progression of existing renal disease. Chronic Kidney disease (CKD is an independent risk factor for cardiovascular events and outcome. This bidirectional nature of cardiac and renal interaction is called Cardio Renal Syndrome (CRS.

  6. Pretransplant thymic function predicts acute rejection in antithymocyte globulin-treated renal transplant recipients.

    Bamoulid, Jamal; Courivaud, Cécile; Crepin, Thomas; Carron, Clémence; Gaiffe, Emilie; Roubiou, Caroline; Laheurte, Caroline; Moulin, Bruno; Frimat, Luc; Rieu, Philippe; Mousson, Christiane; Durrbach, Antoine; Heng, Anne-Elisabeth; Rebibou, Jean-Michel; Saas, Philippe; Ducloux, Didier

    2016-05-01

    Lack of clear identification of patients at high risk of acute rejection hampers the ability to individualize immunosuppressive therapy. Here we studied whether thymic function may predict acute rejection in antithymocyte globulin (ATG)-treated renal transplant recipients in 482 patients prospectively studied during the first year post-transplant of which 86 patients experienced acute rejection. Only CD45RA(+)CD31(+)CD4(+) T cell (recent thymic emigrant [RTE]) frequency (RTE%) was marginally associated with acute rejection in the whole population. This T-cell subset accounts for 26% of CD4(+) T cells. Pretransplant RTE% was significantly associated with acute rejection in ATG-treated patients (hazard ratio, 1.04; 95% confidence interval, 1.01-1.08) for each increased percent in RTE/CD4(+) T cells), but not in anti-CD25 monoclonal (αCD25 mAb)-treated patients. Acute rejection was significantly more frequent in ATG-treated patients with high pretransplant RTE% (31.2% vs. 16.4%) or absolute number of RTE/mm(3) (31.7 vs. 16.1). This difference was not found in αCD25 monclonal antibody-treated patients. Highest values of both RTE% (>31%, hazard ratio, 2.50; 95% confidence interval, 1.09-5.74) and RTE/mm(3) (>200/mm(3), hazard ratio, 3.71; 95% confidence interval, 1.59-8.70) were predictive of acute rejection in ATG-treated patients but not in patients having received αCD25 monoclonal antibody). Results were confirmed in a retrospective cohort using T-cell receptor excision circle levels as a marker of thymic function. Thus, pretransplant thymic function predicts acute rejection in ATG-treated patients. PMID:27083287

  7. Hemodialysis improves endothelial venous function in end-stage renal disease

    A.M.V. Silva

    2008-06-01

    Full Text Available The objective of the present study was to determine the acute effect of hemodialysis on endothelial venous function and oxidative stress. We studied 9 patients with end-stage renal disease (ESRD, 36.8 ± 3.0 years old, arterial pressure 133.8 ± 6.8/80.0 ± 5.0 mmHg, time on dialysis 55.0 ± 16.6 months, immediately before and after a hemodialysis session, and 10 healthy controls matched for age and gender. Endothelial function was assessed by the dorsal hand vein technique using graded local infusion of acetylcholine (endothelium-dependent venodilation, EDV and sodium nitroprusside (endothelium-independent venodilation. Oxidative stress was evaluated by measuring protein oxidative damage (carbonyls and antioxidant defense (total radical trapping antioxidant potential - TRAP in blood samples. All patients were receiving recombinant human erythropoietin for at least 3 months and were not taking nitrates or a-receptor antagonists. EDV was significantly lower in ESRD patients before hemodialysis (65.6 ± 10.5 vs controls (109.6 ± 10.8; P = 0.010 and after hemodialysis (106.6 ± 15.7; P = 0.045. Endothelium-independent venodilation was similar in all comparisons performed. The hemodialysis session significantly decreased TRAP (402.0 ± 53.5 vs 157.1 ± 28.3 U Trolox/µL plasma; P = 0.001. There was no difference in protein damage comparing ESRD patients before and after hemodialysis. The magnitude of change in the EDV was correlated negatively with the magnitude of change in TRAP (r = -0.70; P = 0.037. These results suggest that a hemodialysis session improves endothelial venous function, in association with an antioxidant effect.

  8. Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload.

    Yılmaz, Süreyya; Yildirim, Yasar; Yilmaz, Zülfükar; Kara, Ali Veysel; Taylan, Mahsuk; Demir, Melike; Coskunsel, Mehmet; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin

    2016-01-01

    BACKGROUND Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. MATERIAL AND METHODS We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Spirometry was performed before and after hemodialysis. RESULTS Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25-75, FEF25-75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. CONCLUSIONS Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload. PMID:27497672

  9. Diuretic 99mTc DTPA renography in assessment of renal function and drainage in infants with antenatally detected hydronephrosis

    Radulović Marija

    2015-01-01

    Full Text Available Background/Aim. The controversy over the postnatal management of infants with antenataly detected hydronephrosis (ANH still exists. We presented the results of diuretic 99mTc diethylenetriamine pentaacetic acid (DTPA renography in 30 infants with the antenatal diagnosis of unilateral renal pelvic dilatation. The aim of this study was to assess the renal function determined by the pattern of drainage and split renal function (SRF on diuretic renography and to correlate these findings with anteroposterior pelvic diameter (APD estimated by ultrasonography. Methods. A total of 30 infants with 60 renal units (RU (25 boys and 5 girls, median age 6.0 months, range 2-24 presented with unilateral hydronephrosis on ultrasound in the newborn period, underwent DTPA diuretic renal scintigraphy (F+15 protocol. The median APD evaluated on perinatal ultrasound was 15 mm (range 5-30. The postnatal associated clinical diagnosis were pelviureteric junction obstruction (PUJ, simple hydronephrosis, megaureter, vesicoureteral reflux (VUR and posterior urethral valves in 11, 10, 6, 2 and 1 infant, respectively. Images and Tmax/2 after diuretic stimulation on the background subtracted renographic curves were used as the criteria for classifying the drainage as good, partial, and poor or no drainage. The SRF was calculated with the integral method. Results. Good drainage was shown in 36/60, partial drainage in 13/60 and poor or no drainage in 11/60 RU. The SRF >40% was observed in 55/60 RU, with no RU showing SRF lower than 23.5%. In infants with severe ANH the obstruction was not excluded in 94.1%. Conclusion. Diuretic renography in antenatally detected hydronephrosis should be a useful tool in postnatal follow up, especially in differentiating nonobstructive hydronephrosis from obstructive. It is also importanat to assess and monitor the SRF. Our results suggest that even in the presence of partial or no drainage, SRF may not be significantly impaired.

  10. The changes in renal function after a single dose of intravenous furosemide in patients with compensated liver cirrhosis

    Mejirisky Yoram

    2006-11-01

    Full Text Available Abstract Background Patients with compensated Child-A cirrhosis have sub clinical hypovolemia and diuretic treatment could result in renal impairment. Aim To evaluate the changes in renal functional mass as reflected by DMSA uptake after single injection of intravenous furosemide in patients with compensated liver cirrhosis. Methods Eighteen cirrhotic patients were divided in two groups; eight patients (group 1, age 56 ± 9.6 yrs, Gender 5M/3F, 3 alcoholic and 5 non alcoholic were given low intravenous 40 mg furosemide and ten other patients (group 2, age 54 ± 9.9, Gender 6M/4F, 4 alcoholic and 6 non alcoholic were given high 120 mg furosemide respectively. Renoscintigraphy with 100MBq Of Tc 99 DMSA was given intravenously before and 90 minutes after furosemide administration and SPECT imaging was determined 3 hours later. All patients were kept under low sodium diet (80mEq/d and all diuretics were withdrawn for 3 days. 8-hours UNa exertion, Calculated and measured Creatinine clearance (CCT were performed for all patients. Results Intravenous furosemide increased the mean renal DMSA uptake in 55% of patients with compensated cirrhosis and these changes persist up to three hours after injection. This increase was at the same extent in either low or high doses of furosemide. (From 12.8% ± 3.8 to 15.2% ± 2.2, p 40%, as compared to normal calculated creatinine clearance (CCT 101 ± 26, and measured CCT of 87 ± 30 cc/min (P Conclusion A single furosemide injection increases renal functional mass as reflected by DMSA in 55% of patients with compensated cirrhosis and identify 45% of patients with reduced uptake and who could develop renal impairment under diuretics. Whether or not albumin infusion exerts beneficial effect in those patients with reduced DMSA uptake remains to be determined.

  11. Effects of tight versus non tight control of metabolic acidosis on early renal function after kidney transplantation

    Etezadi Farhad

    2012-09-01

    Full Text Available Abstract Background Recently, several studies have been conducted to determine the optimal strategy for intra-operative fluid replacement therapy in renal transplantation surgery. Since infusion of sodium bicarbonate as a buffer seems to be safer than other buffer compounds (lactate, gluconate, acetatethat indirectly convert into it within the liver, We hypothesized tight control of metabolic acidosis by infusion of sodium bicarbonate may improve early post-operative renal function in renal transplant recipients. Methods 120 patients were randomly divided into two equal groups. In group A, bicarbonate was infused intra-operatively according to Base Excess (BE measurements to achieve the normal values of BE (−5 to +5 mEq/L. In group B, infusion of bicarbonate was allowed only in case of severe metabolic acidosis (BE ≤ −15 mEq/L or bicarbonate ≤ 10 mEq/L or PH ≤ 7.15. Minute ventilation was adjusted to keep PaCO2 within the normal range. Primary end-point was sampling of serum creatinine level in first, second, third and seventh post-operative days for statistical comparison between groups. Secondary objectives were comparison of cumulative urine volumes in the first 24 h of post-operative period and serum BUN levels which were obtained in first, second, third and seventh post-operative days. Results In group A, all of consecutive serum creatinine levels were significantly lower in comparison with group B. With regard to secondary outcomes, no significant difference between groups was observed. Conclusion Intra-operative tight control of metabolic acidosis by infusion of Sodium Bicarbonate in renal transplant recipients may improve early post-operative renal function.

  12. Effect of vitamin C on endothelial function of children with chronic renal failure: An experimental study

    Sabri, Mohammad Reza; Tavana, Esfandiar Najafi; Ahmadi, Alireza; Gheissari, Alaleh

    2015-01-01

    Background: It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF). Materials and Methods: In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial. Results: In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05). Conclusion: The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed. PMID:26918242

  13. [Evaluation of the renal function in type 2 diabetes: clearance calculation or cystatin C?].

    Dhia, Rym Ben; Hellara, Ilhem; Harzallah, Olfa; Neffati, Fadoua; Khochtali, Ines; Mahjoub, Sylvia; Najjar, Mohamed Fadhel

    2012-01-01

    Screening for diabetic nephropathy is usually done by albuminuria/24h and the use of creatinine clearance. The objective of this study was to evaluate the renal function in Type 2 diabetes by using different formulas of creatinine clearance and to assess the contribution of cystatin C; 83 adults with type 2 diabetes (23 men and 60 women) and 83 adult controls (40 men and 43 women) were studied. Biochemical parameters were determinated on Coba 6000™ (Roche diagnostics). Diabetics showed a significant increase in blood glucose, cholesterol, triglycerides, LDLc, the ApoB, Lp(a), urea, uric acid, creatinine and cystatin C and lower HDLc. Cystatin was increased in patients with degenerative complications and in hypertensive patients. We found strong correlations of cystatin C with creatinine (r = 0.9454), urea (r = 0.8999) and uric acid (r = 0.8325). We found a significant exponentially increase of creatinine and cystatin C from one stage to another. Cystatin C has a strong association with MDRD (r = 0.8086) and CG (r = 0.7915) and a low one with creatinine clearance (r = 0.1044). In conclusion, the use of cystatin C for screening and early treatment of incipient diabetic nephropathy appears to be adequate. CG and MDRD formulas still hold their place, in regards to the classical determination of creatinine clearance, to monitor patients. PMID:22565176

  14. A study of bone uptake according to renal function in the whole body bone scan

    Cho, Yong In; Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Park, Cheol Woo [Dept. of Radiological Technology Dong-Eui Institute of Technology, Busan (Korea, Republic of)

    2013-12-15

    Whole body bone scan has been used to confirm bone metastasis and follow-up study with radio isotope. However, if the factors related to 99mTc uptake and waiting time for study are inappropriate, it would be image of low quality. The purpose of present study was to investigate correlation between the evaluation index of renal function and uptake of radiopharmaceuticals. The population for this retrospective study consisted of 387 patients who underwent whole body bone scan between June 2012 and December 2012. As a result of quantitative and qualitative analysis, we were able to confirm that GFR of less than normal range and creatinine levels in blood of more than average are more likely to be under the mean uptake rate. As a result of analysis on the indicator affecting soft-tissue and bone uptake, the correlation of all elements was somewhat low. Also there are no statistically significances due to the other parameters we did not deal with. Therefore, further research on additional factors is needed for exact study and improvement of the image quality.

  15. Renal function reserve in patients with early type 2 diabetic nephropathy using protein loading-scintirenography

    Objective: To explore a sensitive method and index to evaluate renal functional reserve (RFR) in patients with early diabetic nephropathy (DN) using protein loading-scintirenography. Methods: Fifty subjects were studied and divided into 3 groups.Group one (G1) consisted of 14 healthy volunteers; Group two (G2) consisted of 15 patients with type 2 diabetes mellitus (DM) and normoalbuminuria; Group three (G3) consisted of 21 patients with type 2 DM and microalbuminuria. All subjects underwent baseline and protein loading-99Tcm-DTPA scintirenography within one week. RFR was calculated as the difference between stimulated and baseline glomerular filtration rate (GFR), time of peak (Tb), time of half excretion (C1/2), residual rate at 20 min (C20/b) .Variance analysis and t-test were used to analyze the group differences. Results: (1) The RFR in terms of GFR had statistical difference between any two groups (t=14.884, 32.180, 16.042, all P-1·1.73 m-2 respectively. Therefore, the RFR decreased before microalbuminuria in type 2 DM patients. (2) There was statistical difference between the RFR of G1 and G2 in terms of C1/2 (t = 5.505, P20/b between G1 and G3 (t= 4.376, P99Tcm-DTPA protein loading-scintirenography is an effective method for measuring RFR to evaluate early DN in type 2 DM patients. (authors)

  16. Stability and preclinical tests of 99mTc-EC radiopharmaceuticals for renal function imaging

    Radiopharmaceuticals have shown a real and specific usefulness in medical services, especially for diagnosis of several diseases such as renal function imaging. Preparation of 99mTc-EC and its analysis have been carried out. The preparation consisted of several steps, characterization of EC with FT-IR, formulation of EC kit, labeling of EC with 99mTc followed by radiochemical purity testing using paper chromatography. Stability test of EC kit is to know The expired date has been carried out. Biodistribution test on normal mice was carried out while imaging in wistar rat using gamma camera The FT-IR and melting point analysis results showed that EC can be used for formulation of EC kit. The radiochemical purity of 99mTc-EC is analysed with paper chromatography with the result is higher than 95 %. The stability test showed that EC kit was stable until 5 months and the labeled EC at room temperature was stable after 4 hour incubation post labeling, biodistribution test on mice showed higher uptake in bladder, while imaging with gamma camera showed quite clearly in the kidney area. (author)

  17. Epoetin administrated after cardiac surgery: effects on renal function and inflammation in a randomized controlled study

    de Seigneux Sophie

    2012-10-01

    Full Text Available Abstract Background Experimentally, erythropoietin (EPO has nephroprotective as well as immunomodulatory properties when administered after ischemic renal injury. We tested the hypothesis that different doses of recombinant human EPO administered to patients after cardiac surgery would minimize kidney lesions and the systemic inflammatory response, thereby decreasing acute kidney injury (AKI incidence. Methods In this double-blinded randomized control study, 80 patients admitted to the ICU post-cardiac surgery were randomized by computer to receive intravenously isotonic saline (n = 40 versus α-Epoetin (n = 40: either 40000 IU (n = 20 or 20000 IU (n = 20. The study lasted one year. The primary outcome was the change in urinary NGAL concentration from baseline and 48 h after EPO injection. Creatinine, cystatine C and urinary NGAL levels were measured on the day of randomization and 2–4 days after EPO injection. To assess acute inflammatory response, serum cytokines (IL6 and IL8 were measured at randomization and four days after r-HuEPO injection. Patients and care-takers were blinded for the assignment. Results No patient was excluded after randomization. Patient groups did not differ in terms of age, gender, comorbidities and renal function at randomization. The rate of AKI assessed by AKIN criteria was 22.5% in our population. EPO treatment did not significantly modify the difference in uNGAl between 48 hours and randomization compared to placebo [2.5 ng/ml (−17.3; 22.5 vs 0.7 ng/ml (−31.77; 25.15, p = 0.77] and the incidence of AKI was similar. Inflammatory cytokines levels were not influenced by EPO treatment. Mortality and hospital stays were similar between the groups and no adverse event was recorded. Conclusion In this randomized-controlled trial, α-Epoetin administrated after cardiac surgery, although safe, demonstrated neither nephroprotective nor anti-inflammatory properties. Trial registration number NCT

  18. Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by /sup 99m/technetium-dimercaptosuccinic acid renal scintigraphy

    /sup 99m/Technetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function

  19. Effect of oleic acid-induced acute lung injury and conventional mechanical ventilation on renal function in piglets

    LIU Ai-jun; LING Feng; LI Zhi-qiang; LI Xiao-feng; LIU Ying-long; DU Jie; HAN Ling

    2013-01-01

    Background Animal models that demonstrate changes of renal function in response to acute lung injury (ALl) and mechanical ventilation (MV) are few.The present study was performed to examine the effect of ALl induced by oleic acid (OA) in combination with conventional MV strategy on renal function in piglets.Methods Twelve Chinese mini-piglets were randomly divided into two groups:the OA group (n=6),animals were ventilated with a conventional MV strategy of 12 ml/kg and suffered an ALl induced by administration of OA,and the control group (n=6),animals were ventilated with a protective MV strategy of 6 ml/kg and received the same amount of sterile saline.Results Six hours after OA injection a severe lung injury and a mild-moderate degree of renal histopathological injury were seen,while no apparent histological abnormalities were observed in the control group.Although we observed an increase in the plasma concentrations of creatinine and urea after ALl,there was no significant difference compared with the control group.Plasma concentrations of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C increased (5.6±1.3) and (7.4±1.5) times in the OA group compared to baseline values,and were significantly higher than the values in the control group.OA injection in combination with conventional MV strategy resulted in a dramatic aggravation of hemodynamic and blood gas exchange parameters,while these parameters remained stable during the experiment in the control group.The plasma expression of TNF-α and IL-6 in the OA group were significantly higher than that in the control group.Compared with high expression in the lung and renal tissue in the OA group,TNF-α and IL-6 were too low to be detected in the lung and renal tissue in the control group.Conclusions OA injection in combination with conventional MV strategy not only resulted in a severe lung injury but also an apparent renal injury.The potential mechanisms involved a cytokine response of TNF-α and

  20. To Evaluate the Damage of Renal Function in CIAKI Rats at 3T: Using ASL and BOLD MRI

    Wen-bo Chen

    2015-01-01

    Full Text Available Purpose. To investigate noninvasive arterial spin-labeling (ASL and blood oxygen level-dependent imaging (BOLD sequences for measuring renal hemodynamics and oxygenation in contrast induced acute kidney injury (CIAKI rat. Materials and Methods. Thirteen SD rats were randomly grouped into CIAKI group and control group. Both ASL and BOLD sequences were performed at 24 h preinjection and at intervals of 0.5, 12, 24, 48, 72, and 96 h postinjection to assess renal blood flow (RBF and relative spin-spin relaxation rate (R2*, respectively. Results. For the CIAKI group, the value of RBF in the cortex (CO and outer medulla (OM of the kidney was significantly decreased (P<0.05 at 12–48 h and regressed to baseline level (P=NS at 72–96 h. In OM, the value of R2* was increased at 0.5–48 h (P<0.05 and not statistically significant (P=NS at 72 and 96 h. Conclusions. RBF in OM and CO and oxygen level in OM were decreased postinjection of CM. ASL combining BOLD can further identify the primary cause of the decrease of renal oxygenation in CIAKI. This approach provides means for noninvasive monitoring renal function during the first 4 days of CIAKI in clinical routine work.

  1. Renal ultrasonographic and computed tomographic appearance, volume, and function of cats with autosomal dominant polycystic kidney disease.

    Reichle, Jean K; DiBartola, Stephen P; Léveillé, Renée

    2002-01-01

    The purpose of this study was to describe the ultrasonographic (US) and computed tomographic (CT) appearance of autosomal dominant polycystic kidney disease (ADPKD) in cats; to compare renal volume in cats with ADPKD (n = 5; mean age 59 +/- 10 months)) and normal cats (n = 5; mean age 66 +/- 10 months) using 2 imaging modalities, US and CT; and to calculate cyst volume using CT. Glomerular filtration rate (GFR) was determined by 2 methods: 99mTc-diethylene-triaminepentaacetic acid (99mTc-DPTA) scintigraphic uptake and 99-Tc-DTPA plasma clearance. Sonographically, ADPKD affected kidneys were characterized by multiple anechoic to hypoechoic, round to irregularly shaped structures with variation in size. Affected kidneys had indistinct corticomedullary junctions and foci of mineralization. Intravenous (IV) contrast medium administration allowed more definitive identification of cysts with CT, and identification of distortion of renal pelves by cysts. A significant difference (Welch ANOVA, P = 0.05) was detected between the US-estimated renal volumes of normal and affected cats. No statistically significant differences were detected in CT volume (between the normal and affected cats, or between US and CT volume measurements) or the 2 GFR methods. In this group of clinically normal, middle-aged ADPKD cats, renal function was within normal limits and not significantly different than normal. PMID:12175002

  2. Vitamin K Dependent Protection of Renal Function in Multi-ethnic Population Studies

    Fang-Fei Wei

    2016-02-01

    Interpretation: In the general population, eGFR decreases and CKD risk increases with higher dp-ucMGP, a marker of VK deficiency. These findings highlight the possibility that VK supplementation might promote renal health.

  3. One-year follow-up of renal function in endemic nephropathy families

    Arsenović Aleksandra; Bukvić Danica; Đukanović Ljubica

    2009-01-01

    Introduction. Endemic nephropathy is familial, chronic tubulointerstitial disease with an insidious onset and asymptomatic, slow progressive course. Objective. The present study was undertaken with the aim to find out whether new persons with renal disorders can be detected among members of endemic families in the village of Šopić (Kolubara River region, Serbia). Methods. The study involved 44 members of five endemic families without history of renal disorders. Objective survey and laboratory...

  4. Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

    Sayani R; Ali M.; Shazlee K; Hamid RS; Hamid K

    2011-01-01

    Raza Sayani1, Muhammad Ali1, Kashif Shazlee2, Rana Shoaib Hamid1, Kamran Hamid21Radiology Department, Aga Khan University Hospital, 2Radiology Department, Ziauddin Hospital, Karachi, PakistanPurpose: To determine the role of duplex Doppler ultrasonography (DDU) in patients with acute unilateral renal obstruction.Subjects and methods: A total of 161 patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial res...

  5. Recovery of renal function among ESRD patients in the US medicare program.

    Sumit Mohan

    Full Text Available BACKGROUND: Patients started on long term hemodialysis have typically had low rates of reported renal recovery with recent estimates ranging from 0.9-2.4% while higher rates of recovery have been reported in cohorts with higher percentages of patients with acute renal failure requiring dialysis. STUDY DESIGN: Our analysis followed approximately 194,000 patients who were initiated on hemodialysis during a 2-year period (2008 & 2009 with CMS-2728 forms submitted to CMS by dialysis facilities, cross-referenced with patient record updates through the end of 2010, and tracked through December 2010 in the CMS SIMS registry. RESULTS: We report a sustained renal recovery (i.e no return to ESRD during the available follow up period rate among Medicare ESRD patients of > 5% - much higher than previously reported. Recovery occurred primarily in the first 2 months post incident dialysis, and was more likely in cases with renal failure secondary to etiologies associated with acute kidney injury. Patients experiencing sustained recovery were markedly less likely than true long-term ESRD patients to have permanent vascular accesses in place at incident hemodialysis, while non-White patients, and patients with any prior nephrology care appeared to have significantly lower rates of renal recovery. We also found widespread geographic variation in the rates of renal recovery across the United States. CONCLUSIONS: Renal recovery rates in the US Medicare ESRD program are higher than previously reported and appear to have significant geographic variation. Patients with diagnoses associated with acute kidney injury who are initiated on long-term hemodialysis have significantly higher rates of renal recovery than the general ESRD population and lower rates of permanent access placement.

  6. Copious Podocyturia without Proteinuria and with Normal Renal Function in a Young Adult with Fabry Disease

    H. Trimarchi; R. Canzonieri; Muryan, A.; Schiel, A.; Araoz, A.; Forrester, M.; Karl, A.; F. Lombi; Andrews, J; V. Pomeranz; Rengel, T.; Zotta, E.

    2015-01-01

    The time for starting a patient with Fabry disease on enzyme replacement therapy is still a matter of debate, particularly when no overt classical clinical signs or symptoms are present. With respect to Fabry nephropathy, a dual problem coexists: the reluctance of many nephrologists to start enzyme replacement infusion until signs of renal disease appear as the appearance of proteinuria or an elevation in serum creatinine and the lack of validated biomarkers of early renal damage. In this reg...

  7. Evaluation of absorbed dose in studies of renal function due to 123I/131I (hippuran) e 111In (DPTA)

    The absorbed dose of the kidneys during renal function studies of adult patients is estimated through biokinetics of radiopharmaceuticals containing the 123I/131I (hippuran) e 111In (DPTA). Using the methodology MIRD and representation Cristy-Eckerman for adult kidneys, it is shown that dosimetric contributions of organs of biokinetics 123I/131I (hippuran) e 111In (DPTA) are significant, in estimative of dose for renal function studies. Dosimetric contributions (body and whole bladder, kidneys excluding) are given by 11.90% (for 123I), 4.97% (for 131I) and 28.32% (for 111In). In all cases, the dosimetric contributions are mainly due to photons issued by the whole body

  8. Absorption and scattering 2-D volcano images from numerically calculated space-weighting functions

    Del Pezzo, Edoardo; Ibañez, Jesus; Prudencio, Janire; Bianco, Francesca; De Siena, Luca

    2016-08-01

    Short-period small magnitude seismograms mainly comprise scattered waves in the form of coda waves (the tail part of the seismogram, starting after S waves and ending when the noise prevails), spanning more than 70 per cent of the whole seismogram duration. Corresponding coda envelopes provide important information about the earth inhomogeneity, which can be stochastically modeled in terms of distribution of scatterers in a random medium. In suitable experimental conditions (i.e. high earth heterogeneity), either the two parameters describing heterogeneity (scattering coefficient), intrinsic energy dissipation (coefficient of intrinsic attenuation) or a combination of them (extinction length and seismic albedo) can be used to image Earth structures. Once a set of such parameter couples has been measured in a given area and for a number of sources and receivers, imaging their space distribution with standard methods is straightforward. However, as for finite-frequency and full-waveform tomography, the essential problem for a correct imaging is the determination of the weighting function describing the spatial sensitivity of observable data to scattering and absorption anomalies. Due to the nature of coda waves, the measured parameter couple can be seen as a weighted space average of the real parameters characterizing the rock volumes illuminated by the scattered waves. This paper uses the Monte Carlo numerical solution of the Energy Transport Equation to find approximate but realistic 2-D space-weighting functions for coda waves. Separate images for scattering and absorption based on these sensitivity functions are then compared with those obtained with commonly used sensitivity functions in an application to data from an active seismic experiment carried out at Deception Island (Antarctica). Results show that these novel functions are based on a reliable and physically grounded method to image magnitude and shape of scattering and absorption anomalies. Their

  9. Risk factors for delayed graft function in cardiac death donor renal transplants

    SHAO Ming-jie; YE Qi-fa; MING Ying-zi; SHE Xing-guo; LIU Hong; YE Shao-jun; NIU Ying

    2012-01-01

    Background Delayed graft function (DGF) is common in kidney transplants from organ donation after cardiac death (DCD) donors.It is associated with various factors.Determination of center-specific risk factors may help to reduce the incidence of DGF and improve the transplantation results.The aim of this study is to define risk factors of DGF after renal transplantation.Methods From March 2010 to June 2012,56 cases of recipients who received DCD kidneys were selected.The subjects were divided into two groups:immediate graft function (IGF) and DGF groups.Transplantation factors of donors and recipients as well as early post-transplant results of recipients were compared between the two groups.Results On univariate analysis,preoperative dialysis time of recipients (P<0.001),type of dialysis (P=0.039),human leucocyte antigen (HLA) mismatch sites (P<0.001),the cause of brain death (P=0.027),body mass index (BMI) of donors (P<0.001),preoperative infection (P=0.002),preoperative serum creatinine of donors (P <0.001),norepinephrine used in donors (P <0.001),cardiopulmonary resuscitation (CPR) of donors (P <0.001),warm ischemia time (WIT) (P<0.001) and cold ischemia time (CIT) (P<0.001) showed significant differences.Recipients who experienced DGF had a longer hospital stay,and higher level of postoperative serum creatinine.Conclusion Multiple risk factors are associated with DGF,which had deleterious effects on the early post-transplant period.

  10. Therapeutic effects of curcumin on the functional disturbances and oxidative stress induced by renal ischemia/reperfusion in rats

    Houshang Najafi

    2015-10-01

    Full Text Available Objectives: Curcumin has anti-inflammatory and antioxidative properties. The objective of this study was to investigate the therapeutic effects of curcumin on functional disturbances, oxidative stress, and leukocyte infiltration induced by renal ischemia/reperfusion (I/R. Materials and Methods: Animals were randomly divided into 9 groups. The groups with 24-h reperfusion consisted of sham-24h, I/R-24h, and three I/R groups treated with curcumin at 10, 20, or 30 mg kg-1, i.p. after the ischemic period. The 72-h reperfusion groups also included Sham-72h, I/R-72h, I/R treated with curcumin at single dose of 20 mg kg-1, i.p., and I/R group which received three doses of curcumin at 20 mg kg-1, i.p., consecutively. Renal functional injury was assessed by measuring serum creatinine and urea-nitrogen concentrations. Oxidative stress was evaluated by assessment tissue malondialdehyde (MDA and the ferric reducing/antioxidant power (FRAP levels. Moreover, renal tissue leukocyte infiltration was measured by histopathology examination. Results: Ischemia/reperfusion resulted in a significant increase in serum concentration of creatinine, urea-nitrogen, tissue MDA level, and leukocytes infiltration as well as reduced FRAP level. Treatment with curcumin in 24-h reperfusion groups could only lead to a significant change in the levels of MDA and FRAP. However, in 72-h reperfusion groups, curcumin was able to correct all functional disturbances, oxidative stress, and leukocytes infiltration with more effectiveness in groups that received three doses of curcumin. Conclusion: The administration of curcumin during 72-h reperfusion following 30 minutes of ischemia can decrease renal oxidative stress and leukocytes infiltration as well as improve kidney function. However, during first 24-h reperfusion, curcumin only decreased oxidative stress.

  11. Inflammatory Response as a Mechanism of Perinatal Programming: Long-term Impact on Pulmonary and Renal Function?

    Alejandre Alcázar, Miguel Angel

    2012-01-01

    RATIONALE: Temporal changes in the fetal environment, such as malnutrition and placental insufficiency induce intrauterine growth restriction (IUGR) and lead to a permanent changes of physiological processes later in life. Interestingly, epidemiological studies demonstrated an impairment of lung and renal function in young infants subsequent to IUGR. Complementary, experimental studies showed that IUGR induces a perinatal programming of the developing lung with persisting impairment of pulmon...

  12. Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction

    D. Scrutinio; Agostoni, P; Gesualdo, L.; U. Corra; Mezzani, A; Piepoli, M; Di Lenarda, A.; Iorio, A.; Passino, C; Magri, D.; Masarone, D; Battaia, E; Girola, D; Re, F.; Cattadori, G

    2015-01-01

    Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V˙O2) in heart failure (HF) patients. Methods and Results: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerula...

  13. A comprehensive transcriptomic view of renal function in the malaria vector, Anopheles gambiae

    Overend, Gayle; Cabrero, Pablo; Halberg, Kenneth Agerlin;

    2015-01-01

    Renal function is essential to maintain homeostasis. This is particularly significant for insects that undergo complete metamorphosis; larval mosquitoes must survive a freshwater habitat whereas adults are terrestrial, and mature females must maintain ion and fluid homeostasis after blood feeding....... To investigate the physiological adaptations required for successful development to adulthood, we studied the Malpighian tubule transcriptome of Anopheles gambiae using Affymetrix arrays. We assessed transcription under several conditions; as third instar larvae, as adult males fed on sugar, as adult...

  14. Functional and pharmacological consequences of the distribution of voltage-gated calcium channels in the renal blood vessels

    Hansen, P B L

    2013-01-01

    usually associated with vascular contractility. However, the L-, T- and P-/Q-types of calcium channels are present in the renal vasculature and are differentially involved in controlling vascular contractility, thereby contributing to regulation of kidney function and blood pressure. In the preglomerular...... to preferential efferent vasodilation, reduction of glomerular pressure and proteinuria. Therefore, renovascular T-type channels might provide novel therapeutic targets, and may have superior renoprotective effects compared to conventional calcium blockers....

  15. Long-Term Effects of Maternal Diabetes on Blood Pressure and Renal Function in Rat Male Offspring

    YAN, JIE; LI, XIN; Su, Rina; Zhang, Kai; Yang, Huixia

    2014-01-01

    Aims/Hypothesis Gestational diabetes mellitus (GDM) is increasing rapidly worldwide. Previous animal models were established to study consequences of offspring after exposure to severe intrauterine hyperglycemia. In this study we are aiming to characterize the blood pressure levels and renal function of male offspring obtained from diabetic mothers with moderate hyperglycemia. Methods We established a rat model with moderate hyperglycemia after pregnancy by a single intraperitoneal injection ...

  16. Four hour creatinine clearance is better than plasma creatinine for monitoring renal function in critically ill patients

    Pickering, John W; Frampton, Christopher M; Walker, Robert J.; Shaw, Geoffrey M.; Endre, Zoltán H

    2012-01-01

    Introduction Acute kidney injury (AKI) diagnosis is based on an increase in plasma creatinine, which is a slowly changing surrogate of decreased glomerular filtration rate. We investigated whether serial creatinine clearance, a direct measure of the glomerular filtration rate, provided more timely and accurate information on renal function than serial plasma creatinine in critically ill patients. Methods Serial plasma creatinine and 4-hour creatinine clearance were measured 12-hourly for 24 h...

  17. Therapeutic effects of curcumin on the functional disturbances and oxidative stress induced by renal ischemia/reperfusion in rats

    Najafi, Houshang; Changizi Ashtiyani, Saeed; Sayedzadeh, Sayed Abolhasan; Mohamadi yarijani, Zeynab; Fakhri, Sajad

    2015-01-01

    Objective: Curcumin has anti-inflammatory and antioxidative properties. The objective of this study was to investigate the therapeutic effects of curcumin on functional disturbances, oxidative stress, and leukocyte infiltration induced by renal ischemia/reperfusion (I/R). Materials and Methods: Animals were randomly divided into 9 groups. The groups with 24-h reperfusion consisted of sham-24h, I/R-24h, and three I/R groups treated with curcumin at 10, 20, or 30 mg kg-1, i.p. after the ischemic period. The 72-h reperfusion groups also included Sham-72h, I/R-72h, I/R treated with curcumin at single dose of 20 mg kg-1, i.p., and I/R group which received three doses of curcumin at 20 mg kg-1, i.p., consecutively. Renal functional injury was assessed by measuring serum creatinine and urea-nitrogen concentrations. Oxidative stress was evaluated by assessment tissue malondialdehyde (MDA) and the ferric reducing/antioxidant power (FRAP) levels. Moreover, renal tissue leukocyte infiltration was measured by histopathology examination. Results: Ischemia/reperfusion resulted in a significant increase in serum concentration of creatinine, urea-nitrogen, tissue MDA level, and leukocytes infiltration as well as reduced FRAP level. Treatment with curcumin in 24-h reperfusion groups could only lead to a significant change in the levels of MDA and FRAP. However, in 72-h reperfusion groups, curcumin was able to correct all functional disturbances, oxidative stress, and leukocytes infiltration with more effectiveness in groups that received three doses of curcumin. Conclusion: The administration of curcumin during 72-h reperfusion following 30 minutes of ischemia can decrease renal oxidative stress and leukocytes infiltration as well as improve kidney function. However, during first 24-h reperfusion, curcumin only decreased oxidative stress. PMID:26693415

  18. [Hypertension and renal disease

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  19. The thermotidal exciting function for water vapour absorption of solar radiation

    M. BONAFEDE

    1976-06-01

    Full Text Available The thermotidal exciting function J is considered, for
    the absorption of solar radiation by water vapour, according to the model
    derived by Siebert. The Mugge-Moller formula for water vapour absorption
    is integrated numerically, using experimental data for the water vapour
    concentration in the troposphere and the stratosphere. It appears that
    Siebort's formula is a reasonable approximation at low tropospheric levels
    but it dramatically overestimates the water vapour thermotidal heating
    in the upper troposphere and in the stratosphere. It seems thus possible
    that, if the correct vertical profile is employed for J , the amplitudes and
    phases of the diurnal temperature oscillations and of the tidal wind speeds
    may suffer significant changes from those previously calculated and possibly explain the three hours delay of the observed phases from the computed values.

  20. Expression and Function of CLC and Cystic Fibrosis Transmembrane Conductance Regulator Chloride Channels in Renal Epithelial Tubule Cells: Pathophysiological Implications

    Alain Vandewalle

    2007-02-01

    Full Text Available Cl- channels play important roles in the regulation of a variety of functions, includingelectrical excitability, cell volume regulation, transepithelial transport and acidification ofcellular organelles. They are expressed in plasma membranes or reside in intracellularorganelles. A large number of Cl- channels with different functions have been identified.Some of them are highly expressed in the kidney. They include members of the CLC Clchannelfamily: ClC-K1 (or ClC-Ka, ClC-K2 (or ClC-Kb and ClC-5. The identification ofmutations responsible for human inherited diseases (Bartter syndrome for ClC-Kb andDent’s disease for ClC-5 and studies on knockout mice models have evidenced the physiologicalimportance of these CLC Cl- channels, permitting better understanding on their functionsin renal tubule epithelial cells. The cystic fibrosis transmembrane conductance regulator(CFTR Cl- channel, also expressed in renal tubule epithelial cells, is involved in thetransepithelial transport of Cl- in the distal nephron. This short review focuses on intrarenaldistribution, subcellular localization and function of the ClK-1, ClC-K2 and ClC-5 Cl- channelsin renal tubule epithelial cells, and the role of the CFTR Cl- channel in chloride fluxeselicited by vasopressin in the distal nephron.

  1. Characteristic Functions Describing the Power Absorption Response of Periodic Structures to Partially Coherent Fields

    Craeye, Christophe; Thomas, Christopher N

    2014-01-01

    Many new types of sensing or imaging surfaces are based on periodic thin films. It is explained how the response of those surfaces to partially coherent fields can be fully characterized by a set of functions in the wavenumber spectrum domain. The theory is developed here for the case of 2D absorbers with TE illumination and arbitrary material properties in the plane of the problem, except for the resistivity which is assumed isotropic. Sum and difference coordinates in both spatial and spectral domains are conveniently used to represent the characteristic functions, which are specialized here to the case of periodic structures. Those functions can be either computed or obtained experimentally. Simulations rely on solvers based on periodic-boundary conditions, while experiments correspond to Energy Absorption Interferometry (EAI), already described in the literature. We derive rules for the convergence of the representation versus the number of characteristic functions used, as well as for the sampling to be ...

  2. Comparative scintigraphic study of renal function with 99mTc-Mercaptoacetyl-triglycine and 99mTc-Ethylenedicysteine

    Beiki D.

    2008-03-01

    Full Text Available 99mTc-MAG3 is a standard radiotracer for renal dynamic functional study. Despite its"nproperties for clinical uses, it has numerous technical limitations. 99mTc-EC is also a tubular"nradiotracer for renal imaging, which has not been used worldwide. In this study, the use of 99mTc-EC"nand 99mTc-MAG3 for renal functional study were compared."nMethods: Thirty five patients (20 male, 15 female; mean age of 34.63 ±10.69 years were entered in"nthe study. About 10 mCi of 99mTc-EC and 99mTc-MAG3 were administered in different days within 7"ndays intervals and serial images were obtained for 30 minutes. Serum creatinine and visual"nscintigraphic findings of all patients were within normal limits."nResults: In this study, the renal uptake of 99mTc-EC was significantly higher than 99mTc-MAG3 (6.20%"nvs 4.39% of the injected dose, while the hepatic activity of 99mTc-EC was significantly lower (307 vs"n439 mean pixel count, p<0.0001. Also the absolute values for some other quantitative parameters"nsuch as right and left kidney transit times and ERPF were different for each radiotracer. In spite of"nthese differences most quantitative parameters (except for right kidney transit time, liver uptake and"nTmax of both kidneys showed good correlations for both agents."nConclusion: The calculated ERPF with 99mTc-EC as compared to 99mTc-MAG3 is in closer proximity"nto the true values. Also the use of 99mTc-EC compared to 99mTc-MAG3 in clinic due to simplicity of"npreparation, higher stability, higher renal uptake, and lower hepatobiliary activity is better. Therefore"nthe use of 99mTc-EC as an appropriate substitute or ever preferred radiopharmaceutical for 99mTc-"nMAG3 radiopharmaceutical for renal function studies is recommended.

  3. Comparison of relative split renal function with DMSA using posterior static imaging only with combined anterior-posterior acquisition

    Aim: Protocols for evaluation of renal function with DMSA vary from simple posterior static imaging to more time-consuming methods including anterior and posterior views with depth correction. The aim of this study was to investigate if there is a clinically significant difference between values of relative split renal function using a single posterior image (SP) or combined data from anterior and posterior acquisitions (AP). Material and Methods: We studied 21 consecutive patients, 14 children (ages 2.34±3 years) and 7 adults (ages 54.6±21 years) with a variety of pathologic conditions referred for renal evaluation. All patients had normotopic, bilaterally functioning kidneys. All were injected intravenously with a dose of 1.48 MBq/kg (0.04 mCi/kg) of 99mTc-DMSA and studies acquired 4-6 hours later. Static images were obtained for 5 minutes each, in the posterior and then in the anterior projection with a large field-of-view rectangular gamma camera equipped with a high resolution collimator, using a 64x64 matrix with zoom factor as required. Regions of interest were drawn using a semi-automatic thresholding method for the kidneys with semi-crescent automatic background (BKG) areas. Relative differential function was then calculated using the software provided with the system. One method uses posterior image only with no depth correction and the other uses both anterior and posterior views, requiring the patient's body thickness in cm for geometrical mean calculation plus depth correction. For the first method, the following simple formula is used: Left (or right) % uptake = Left (or right) BKG corrected cts/Left + right BKG corrected cts. For the second method, each kidney counts are first calculated as follows: Kidney counts √(anterior x posterior BKG corrected cts).eμ.T/2. K, where μ is the linear attenuation coefficient (1.22 cm-1), T is the body thickness in cm and K=1. Results: The following values of relative split functions for SP/AP methods were: 48

  4. Evaluation of quantitative split renal function testing methods using 99mTc-DTPA and 99mTc-DMSA renoscintigraphy in children with vesicoureteral reflux

    It is vital to accurately evaluate renal function in children with vesicoureteral reflux. To determine whether quantitative split renal function testing methods using 99mTc-DTPA and 99mTc-DMSA renoscintigraphy reflect renal function as accurately in children as in adults, 99mTc-DTPA and 99mTc-DMSA renoscintigraphies were performed in 21 children with vesicoureteral reflux within 5 days of each other for a total of 40 times. There were 12 boys and 9 girls ranging in age from 2 months to 16 years (mean, 6.8 years). The kidney depth was measured by ultrasonography. The correlation coefficient between 99mTcDTPA and 99mTc-DMSA total renal uptake was 0.275, and the correlation coefficients between 99mTc-DTPA and 99mTc-DMSA total renal uptakes and creatinine clearance were 0.402 and 0.522, respectively. The correlation coefficient between the accumulation count ratio (R/R+L) in 99mTc-DTPA and that in 99mTc-DMSA was 0.974. The total renal uptake obtained from 99mTc-DTPA and 99mTc-DMSA renoscintigraphy is not as reliable in children as in adults, and at present it is most appropriate to use a combination of accumulation count ratio (R/R+L) and 24 hr creatinine clearance value as examinations to evaluate general renal function. (author)

  5. Long-term effects of maternal diabetes on blood pressure and renal function in rat male offspring.

    Jie Yan

    Full Text Available AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM is increasing rapidly worldwide. Previous animal models were established to study consequences of offspring after exposure to severe intrauterine hyperglycemia. In this study we are aiming to characterize the blood pressure levels and renal function of male offspring obtained from diabetic mothers with moderate hyperglycemia. METHODS: We established a rat model with moderate hyperglycemia after pregnancy by a single intraperitoneal injection of streptozotocin (STZ. The male offspring were studied and fed with either normal diet or high salt diet after weaning. Arterial pressure and renal function were measured. RESULTS: Arterial pressure of male offspring increased from 12 weeks by exposure to intrauterine moderate hyperglycemia. At 20 weeks, high salt diet accelerated the blood pressure on diabetic offspring compared to diabetic offspring fed with normal diet. We found offspring exposed to intrauterine moderate hyperglycemia had a trend to have a higher creatinine clearance rate and significant increase of urinary N-acetyl-β-D-glucosaminidase (NAG excretion indicating an early stage of nephropathy progression. CONCLUSIONS/INTERPRETATION: We observed the high blood pressure level and early renal dysfunction of male offspring obtained from diabetic mothers with moderate hyperglycemia. Furthermore, we investigated high salt diet after weaning on offspring exposed to intrauterine hyperglycemia could exacerbate the blood pressure and renal function. Renin angiotensin system (RAS plays an important role in hypertension pathogenesis and altered gene expression of RAS components in offspring with in utero hyperglycemia exposure may account for the programmed hypertension. Therefore, our study provides evidence "fetal programming" of maternal diabetes is critical for metabolic disease development.

  6. Effect of naringin on hemodynamic changes and left ventricular function in renal artery occluded renovascular hypertension in rats

    Asjad Visnagri

    2015-01-01

    Full Text Available Background: Renal artery occlusion (RAO induced hypertension is a major health problem associated with structural and functional variations of the renal and cardiac vasculature. Naringin a flavanone glycoside derived possesses metal-chelating, antioxidant and free radical scavenging properties. Objective: The objective of this study was to investigate the antihypertensive activity of naringin in RAO induced hypertension in rats.Material and Methods: Male Wistar rats (180-200 g were divided into five groups Sham, RAO, naringin (20, 40 and 80 mg/kg. Animals were pretreated with naringin (20, 40 and 80 mg/kg p.o for 4 weeks. On the last day of the experiment, left renal artery was occluded with renal bulldog clamp for 4 h. After assessment of hemodynamic and left ventricular function various biochemical (superoxide dismutase [SOD], glutathione [GSH] and malondialdehyde [MDA] and histological parameters were determined in the kidney. Results: RAO group significantly (P < 0.001 increased hemodynamic parameters at 15, 30 and 45 min of clamp removal. Naringin (40 and 80 mg/kg treated groups showed a significant decrease in hemodynamic parameters at 15 min. after clamp removal that remained sustained for 60 min. Naringin (40 and 80 mg/kg treated groups showed significant improvement in left ventricular function at 15, 30 and 45 min after clamp removal. Alteration in level of SOD, GSH and MDA was significantly restored by naringin (40 and 80 mg/kg treatment. It also reduced histological aberration induced in kidney by RAO. Conclusion: It is concluded that the antihypertensive activity of naringin may result through inhibition of oxidative stress.

  7. Remote ischaemic conditioning on recipients of deceased renal transplants, effect on immediate and extended kidney graft function : a multicentre, randomised controlled trial protocol (CONTEXT)

    Krogstrup, Nicoline V; Oltean, Mihai; Bibby, Bo M; Nieuwenhuijs-Moeke, Gertrude J; Dor, Frank J M F; Birn, Henrik; Jespersen, Bente

    2015-01-01

    Introduction: Delayed graft function due to ischaemia-reperfusion injury is a frequent complication in deceased donor renal transplantation. Experimental evidence indicates that remote ischaemic conditioning (RIC) provides systemic protection against ischaemia-reperfusion injury in various tissues.

  8. Acute renal failure in children

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% ± 1.40 S.D.) and group B (5.95 mg% ± 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  9. RENAL FUNCTION AND ADAPTIVE CHANGES AFTER RADICAL OR PARTIAL NEPHRECTOMY: A SINGLE CENTRE STUDY

    Suraj

    2016-02-01

    Full Text Available OBJECTIVES To study the renal function before partial or total nephrectomy and to study change in renal function and adaptive change in the retained kidney after partial or total nephrectomy. Place and Duration: The prospective study of 40 patients was conducted by the Dept. of Nephrology and Dept. of Urology, Mahatma Gandhi Medical College and Hospital, Jaipur from July 2012 to July 2014 METHODS The data for the study was obtained from all the patients undergoing nephrectomy at Mahatma Gandhi Medical College and Hospital, in the study duration. 20 patients from the donor nephrectomy group and 20 from nephrectomy group were considered. Open Nephrectomy was performed by a lumbar incision in all 40 patients. After tracheal intubation and general anaesthesia, the nephrectomy was performed through an incision under the left or right costal margin. GFR of both kidneys before surgery and of the unilateral retained kidney were determined in each subject using the Tc-99m DTPA Scans. Donors underwent the first follow-up at 1 month after surgery and then at 6 months and 1 year after surgery. The follow-up included measurements of blood pressure, urinary protein, serum creatinine, and GFR of the retained kidney by Tc-99m DTPA scan as well as volume of the retained kidney by ultrasound examination. RESULTS A total number of 80 patients were included in this study. In donor group female to male ratio was 4:1 and in disease group male to female ratio was 3:1. Maximum no. of patients was of age group 50-60 years in both groups, with mean age of 44.8±6.7 years in donor group and 48.7±5.5 years in disease group. In disease group majority patients who underwent nephrectomy were suffering from RCC. Th98ere was no significant effect on blood pressure, haemoglobin, blood sugar level, urine pH., urine specific gravity after nephrectomy in both groups. In both groups 24-hour urine protein increased from preoperative level to 11.3% in donor group and 17.1% in disease

  10. Functional polymorphisms in cell death pathway genes and risk of renal cell carcinoma.

    Zhu, Jian; Qin, Chao; Wang, Meilin; Yan, Fu; Ju, Xiaobing; Meng, Xiaoxin; Ding, Qi; Li, Pu; Yang, Jian; Cao, Qiang; Zhang, Zhengdong; Yin, Changjun

    2010-09-01

    The FAS/FAS ligand (FASL) system plays a key role in regulating apoptotic cell death, and corruption of this signaling pathway has been shown to participate in tumorigenesis. However, the effects of functional promoter polymorphisms of the CASP8, FAS, and FASL genes on risk of renal cell carcinoma (RCC) are unknown. In this study, we genotyped CASP8 -652 6N ins/del, FAS -1377 G > A, FAS -670 A > G, and FASL -844 C > T polymorphisms in a hospital-based case-control study of 353 patients diagnosed with RCC and 365 cancer-free controls in a Chinese population. Compared with CASP8 -652 ins/ins genotype, the del/del genotype had a significantly decreased RCC risk [adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.16-0.84]. For FAS -1377 G > A polymorphism, a significantly increased risk of RCC was found for AA (adjusted OR = 1.65, 95% CI = 1.03-2.64) and GA (adjusted OR = 1.41, 95% CI = 1.02-1.94) genotypes compared with GG genotype. When we combined these two polymorphisms together, we found that individuals carrying CASP8 -652 6N ins/del and FAS -1377 GG genotypes or CASP8 -652 6N del/del and FAS -1377 GG genotypes were associated with a statistically significantly decreased risk of RCC (adjusted OR = 0.46, 95% CI = 0.24-0.88 and OR = 0.12, 95% CI = 0.02-0.58, respectively) compared with individuals carrying CASP8 -652 6N ins/ins and FAS -1377 AA genotypes. These results suggest that the CASP8 -652 6N ins/del and FAS -1377 G > A polymorphisms are involved in the susceptibility to developing RCC in Chinese populations. PMID:20572163

  11. 99mTc-MAG3 scintigraphy for the longitudinal follow-up of kidney function in a mouse model of renal ischemia-reperfusion injury

    Herrler, Tanja; Wang, Hao; Tischer, Anne; Bartenstein, Peter; Jauch, Karl-Walter; Guba, Markus; Diemling, Markus; Nimmon, Cyril; Hacker, Marcus

    2012-01-01

    Background Experimental models are essential tools in the development and evaluation of novel treatment options, but the preclinical model of renal ischemia-reperfusion injury is limited to the retrieval of (very) early functional data, leaving the pivotal long-term outcome unknown. The present study applies technetium-99m-mercapto-acetyl-tri-glycine [99mTc-MAG3] scintigraphy for the longitudinal follow-up examination of long-term kidney function after renal ischemia-reperfusion injury. Metho...

  12. Reduced Graphene Oxide Functionalized with Cobalt Ferrite Nanocomposites for Enhanced Efficient and Lightweight Electromagnetic Wave Absorption

    Ding, Yi; Liao, Qingliang; Liu, Shuo; Guo, Huijing; Sun, Yihui; Zhang, Guangjie; Zhang, Yue

    2016-01-01

    In this paper, reduced graphene oxide functionalized with cobalt ferrite nanocomposites (CoFe@rGO) as a novel type of electromagnetic wave (EW) absorbing materials was successfully prepared by a three-step chemical method including hydrothermal synthesis, annealing process and mixing with paraffin. The effect of the sample thickness and the amount of paraffin on the EW absorption properties of the composites was studied, revealing that the absorption peaks shifted toward the low frequency regions with the increasing thickness while other conditions had little or no effect. It is found that the CoFe@rGO enhanced both dielectric losses and magnetic losses and had the best EW absorption properties and the wide wavelength coverage of the hole Ku-Band when adding only 5wt% composites to paraffin. Therefore, CoFe@rGO could be used as an efficient and lightweight EW absorber. Compared with the research into traditional absorbing materials, this figures of merit are typically of the same order of magnitude, but given the lightweight nature of the material and the high level of compatibility with mass production standards, making use of CoFe@rGO as an electromagnetic absorber material shows great potential for real product applications. PMID:27587001

  13. Graft function based on two hours peak level monitoring of cyclosporine a during the first six months of renal transplantation

    Maryam Hami

    2012-01-01

    Full Text Available Inadequate cyclosporine blood levels may cause acute rejection in transplanted renal graft, and its increase is accompanied with graft toxicity. Cyclosporine has variable bioavailability and pharmacokinetics among patients at different times after transplantation. In this study, we compared the effects of cyclosporine blood levels (trough versus 2-hour peak, C2 on renal graft function during the first six months after transplantation in order to find better methods for drug levels assessment in our patients. We studied 50 patients who received grafts at Mashhad transplant centers from October 2006 to May 2007. Drug levels were monitored seven times during the study; in each assessment, more than 80% of the patients did not reach the therapeutic C2 levels. There was no significant correlation between age, sex, times of transplantation and acute rejection with drug C2 levels. There was no difference between graft function in patients with therapeutic C2 level and those with inadequate C2 levels. However, we found a significant correlation between trough levels and acute rejection (P 0.05. Apparently, peak levels were not a suitable method in drug monitoring in our patients, or peak levels might have occurred at a different time (like 1.5 or 3 or 4 h after ingestion of the drug in our population. Based on this study, trough level may be a better method of evaluation of cyclosporine effects on renal allografts than 2-h peak levels in our patients.

  14. Functional Importance of L- and P/Q-Type Voltage-Gated Calcium Channels in Human Renal Vasculature

    Hansen, Pernille B; Poulsen, Christian B; Walter, Steen;

    2011-01-01

    revealed signals for Ca(v) 2.1 and Ca(v) 3.1 associated with smooth muscle cells of preglomerular and postglomerular vessels. In human intrarenal arteries, depolarization with potassium induced a contraction inhibited by the L-type antagonist nifedipine, EC(50) 1.2×10(-8) mol/L. The T-type antagonist...... L- and P/Q-type channels are of functional importance for the depolarization-induced vasoconstriction. The contribution of P/Q-type channels to contraction in the human vasculature is a novel mechanism for the regulation of renal blood flow and suggests that clinical treatment with calcium blockers......Calcium channel blockers are widely used for treatment of hypertension, because they decrease peripheral vascular resistance through inhibition of voltage-gated calcium channels. Animal studies of renal vasculature have shown expression of several types of calcium channels that are involved in...

  15. Schistosomiasis haematobia in Brazilian patients: clinical and renal functional evaluation with {sup 99m}Tc-DTPA

    DAlmeida, J.; Maliska, C.I.; Pellegrini, P.M.; Collares, R.A.I [Army Central Hospital, Rio de Janeiro, RJ (Brazil). Nuclear Medicine Service]. E-mail: joaquimjdalmeida@yahoo.com.br; Penas, M.E.; Cruz, M.G.A. [Clementino Fraga Filho School Hospital, (UFRJ), Rio de Janeiro, RJ (Brazil). Nuclear Medicine Service

    2007-07-01

    The present study was carried out at the Army Central Hospital, Rio de Janeiro, Brazil, from September 2000 to December 2001, employing diethylenetriamine penta-acetic acid labeled with technetium-99m ({sup 99m}Tc-DTPA) to evaluate the renal function of nineteen symptomatic patients infected with S. haematobium during a peace mission in Mozambique. Results evidenced that the most frequent clinical manifestations were hematuria (68.4%) and low back pain (68.4%) and 73.7% patients had altered dynamic renal scintigraphy expressed by an increase in the excretory phase independently of the symptoms duration; furthermore, none of them had mechanical obstructive pattern. Schistosoma haematobium glomerulopathy could be considered a pathological finding without correlation with the disease clinical manifestations. (author)

  16. A Study on the Effectiveness of Diuretic Renal Scan on Functional and Pathologic Obstructive Uropathy

    Ahn, Cu Rie; Lee, Hun Yong; Kwon, In Sun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1983-09-15

    Diuretic renal scan, a modified method of convectional radionuclide renography by administration of intravenous furosemide was performed in 54 patients with suspected urinary tract obstruction. Two showed normal responses, 41 showed increased washout patterns, and the remainder 15 revealed no changes in response to the furosemide administration. IVP was done in 34 patients. In comparison to the diuretic renal scan, the following results were obtained. 1) Patients with normal results by the scan, showed normal IVP findings also. 2) 10 patients who showed delayed excretory patterns not influenced by the diuretics administration. 9 patients revealed obstructive lesions and hydronephrotic changes, and CPN was diagnosed for the remainder one and the one patient without obstruction was diagnosed as chronic pyelonephritis. 3) 22 patients showed positive results to the diuretics. Among them 10 patients had positive results in IVP. but, were not related to the speed of decrement of the renal activity after the furosemide administration.

  17. A Study on the Effectiveness of Diuretic Renal Scan on Functional and Pathologic Obstructive Uropathy

    Diuretic renal scan, a modified method of convectional radionuclide renography by administration of intravenous furosemide was performed in 54 patients with suspected urinary tract obstruction. Two showed normal responses, 41 showed increased washout patterns, and the remainder 15 revealed no changes in response to the furosemide administration. IVP was done in 34 patients. In comparison to the diuretic renal scan, the following results were obtained. 1) Patients with normal results by the scan, showed normal IVP findings also. 2) 10 patients who showed delayed excretory patterns not influenced by the diuretics administration. 9 patients revealed obstructive lesions and hydronephrotic changes, and CPN was diagnosed for the remainder one and the one patient without obstruction was diagnosed as chronic pyelonephritis. 3) 22 patients showed positive results to the diuretics. Among them 10 patients had positive results in IVP. but, were not related to the speed of decrement of the renal activity after the furosemide administration.

  18. Tow efficiency correction functions of source self-absorption of an HPGe detector

    The efficiency correction function of source absorption of an HPGe γ detector is determined by experiment in energy range from 59.5 keV to 1408 keV and density range from 0.3 g/cm3 to 2.0 g/cm3. Fit Polynomial and fit Sigmoidal are compared. The results show that fit Sigmoidal is better than fit polynomial, and the detection efficiency at any points of energy and density could be conveniently calculated with it in calibrated range. (authors)

  19. Evaluation of renal function in rats: Renal clearance of 99mTc-DTPA underestimates glomerular filtration rate (GFR) as compared with renal clearance of eH-inulin or 51 CR-EDTA

    The rat is the most commonly used experimental animal and frequently being used to examine the pathophysiology in renal disease. Thus, it is important to apply techniques where renal function is assessed accurately. A special challenge exists in chronic unilateral renal disease for accurate measurement of single kidney GFR (SKGFR). We therefore examined the possibility of developing a method where SK GFR is measured in rats from the plasma clearance of 99mTc-DTPA and the reno graphically determined renal split function. A detailed comparison of renal clearance (Clr) and plasma clearance (Clp) of 99mTc-DTPA with that of 51-Cr-EDTA and 3H-inulin was performed in conscious rats with permanent catheters in the carotic artery, jugular vein and the urinary bladder using the following protocols: 1) Comparison of Clr of 99mTc-DTPA with 3H-inulin using a constant infusion clearance technique with four periods (P1-P4)(n=11), 2) comparison of Clr of 99m Tc-DTPA with that of 51Cr-EDTA or 3H-inulin (n=8) 3) comparison of Clr of 51Cr-EDTA and 3H-inulin using a constant infusion clearance technique with Clp of 99mTc-DTPA using a single injection technique with plasma sampling 4 hours after injection (n=11) and 4) comparison of Clp of 51Cr-EDTA with 99mTc-DTPA using the single injection technique (n=5). The results surprisingly showed that Clr of 99mTc-DTPA consistently was significantly lower than Clr of 51Cr-EDTA (548±146 vs. 860±49 □1/min/100g (avg±std);p<0.01) and of 3H-inulin (548±146 vs. 975±135 □1/min/100g; p<0.01: Interestingly, Clr of 99mTc-DTPA was progressively reduced with time in contrast to a constant Clr of inulin (P1:693±108 vs 939±118; P2:591±94 vs 877±17, P3:594±74 vs 947±131; P4:569±78 vs 991±122). Furthermore, Clp of 99mTc-DTPA was significantly lower than Clp of 51Cr-EDTA (874±130 vs. 1092±43 □1/min/100g;p<(0.01). The average clearance ratio DTPA/EDTA using constant infusion was 0.65±0.15 and 0.80±0.15 after single injection. In

  20. Computer analysis of the amount functioning renal parenchyma according scintigraphy with 99mTc - DMSA

    To assess the definition of information values of focal changes in the renal parenchyma as a fuzzy set according kidney scan with 99mTc-DMSA. The results of kidney scan of 99mTc-DMSA 15 patients. It is shown that it is advisable to determine the degree of damage to the renal parenchyma as a fuzzy set, it count lower, upper limits of defeat and 'average' rating. Segmentation algorithms developed scintigraphic imaging of the kidneys are informative, independent and requires their simultaneous use